The impact of goggle-associated harms to health and working status of nurses during management of COVID-19

BackgroundTo investigate the impact of goggles on their health and clinical practice during management of patients with COVID-19. Methods231 nurse practitioners were enrolled who worked in isolation region in designated hospitals to admit patients with COVID-19 in China. Demographic data, goggle-associated symptoms and underlying reasons, incidence of medical errors or exposures, the effects of fog in goggles on practice were all collected. Data were stratified and analyzed by age or working experience. Risk factors of goggle-associated medical errors were analyzed by multivariable logistical regression analysis. FindingsGoggle-associated symptoms and foggy goggles widely presented in nurses. The most common symptoms were headache, skin pressure injury and dizziness. Headache, vomit and nausea were significantly fewer reported in nurses with longer working experience while rash occurred higher in this group. The underlying reasons included tightness of goggles, unsuitable design and uncomfortable materials. The working status of nurses with more working experience was less impacted by goggles. 11.3% nurses occurred medical exposures in clinical practice while 19.5% nurses made medical errors on patients. The risk factors for medical errors were time interval before adapting to goggle-associated discomforts, adjusting goggles and headache. InterpretationGoggle-associated symptoms and fog can highly impact the working status and contribute to medical errors during management of COVID-19. Increased the experience with working in PPE through adequate training and psychological education may benefit for relieving some symptoms and improving working status. Improvement of goggle design during productive process was strongly suggested to reduce incidence of discomforts and medical errors.

Oxidative Stress Status and Its Effect on Regulation of Hepcidin in Patients with HbHCS / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the oxidative stress status and its effects on hepcidin in patients with hemoglobin H Constant Spring disease (HbH-CS).</p><p><b>METHODS</b>A total of 35 patients were enrolled in the study, including 15 splenectomized cases and 20 non-splenectomized cases. 20 healthy volunteers were selected as controls. Serum superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH), oxidized glutathione (GSSG) levels, erythropoietin (EPO), serum free transferrin receptor (sFTR), growth differentiation factor 15 (GDF15) as well as the level of hepcidin were detected. Correlation analysis and multiple factor regression analysis were performed to investigate the factors affecting the iron metabolism and erythropoiesis.</p><p><b>RESULTS</b>Compared with healthy control, the SOD and GSH levels in patients with HbHCS decreased, while MDA and GSSG levels increased. The levels of SOD, MDA, GSG and GSSG were not significantly different between the patients with splenectomy and those without splenectomy. Correlation analysis showed that inpatients with HbHCS, EPO, sFTR and GDF15 correlated negatively with SOD level and positively with MDA level. EPO and sFTR levels negatively correlated with Hepcidin.</p><p><b>CONCLUSION</b>Excessive oxidative stress is present in patients with HbHCS, and hepcidin is inhibited by the upregulation of EPO and sFTR, and hence involved in iron overload in patients.</p>

Expression of radioresistant genes survivin and HO-1 in mesenchymal stem cells / 中国实验血液学杂志

This study was aimed to investigate the expression of radioresistant genes survivin and HO-1 in mesenchymal stem cells (MSC). Human bone marrow MSC were isolated and enriched by Fircoll density gradient centrifugation, then identified by flow cytometry. MSC were induced with dexamethasone, insulin, 3-isobutyl-1-methyl-xanthine (IBMX) and indomethacin to differentiate into adipocytes. Then the expression of survivin and HO-1 in MSC was detected by RT-PCR. The results indicated that the expressions of surface antigen CD34 and HLA-DR in MSC in vitro were negative while the expressions of CD44 and CD71 were positive. MSC could be differentiated into adipocytes by inductor. RT-PCR showed the expression of radioresistant genes survivin and HO-1 in MSC. It is concluded that MSC have lower sensitivity to radiation, which may associate with the expression of radioresistant genes survivin and HO-1 in MSC.

Influences of hypertension and diabetes on arterial compliances and endothelial microparticle level / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the influences of hypertension and diabetes on arterial compliances and endothelial microparticle level.</p><p><b>METHODS</b>Fifty patients with hypertension and diabetes, 46 with hypertension, and 48 with diabetes were enrolled in this study, with 50 healthy volunteers group serving as the normal control. Large arterial compliance (C1) and small arterial compliance (C2) were measured using CVProfilor DO2020 cardiovascular profiling system, and the levels of CD31+/CD42- endothelial microparticles (EMPs) were determined by flow cytometry in these subjects.</p><p><b>RESULTS</b>Compared with the hypertensive patients, diabetic patients and healthy volunteers, the patients with both hypertension and diabetes showed significantly decreased C1 and C2. C1 and C2 were significantly decreased in the hypertensive patients in comparison with those in the diabetic patients and the healthy volunteers. Compared with the healthy volunteers group, the diabetic patients showed markedly decreased C2 but normal C1. The levels of CD31+/CD42- EMPs were significantly increased in patients with both hypertension and diabetes compared with the other groups, and the diabetic patients had higher EMPs levels than the hypertensive patients. Pearson regression analysis indicated that C1 and C2 were inversely, while the levels of EMPs positively, correlated to the pulse pressure and 2 h plasma glucose; the levels of EMPs were not related with fasting glycemia.</p><p><b>CONCLUSION</b>Hypertension appears to have greater impact on arterial compliance, especially C1, while diabetes is the major factor responsible for increased release of EMPs.</p>