Introduction Job burnout is an occupational psychological syndrome with a high prevalence among nurses in China. Hemodialysis (HD) nursing work has the characteristics of high intensity, high technical content, and high risk. The aims of this study were to investigate the prevalence and level of job burnout among HD nurses in China and explore the potential factors associated with burnout among HD nurses. Methods This was a cross‐sectional study in 2019. Survey data were collected from 2738 HD centers in mainland China. Job burnout was measured by the Chinese version of the Maslach Burnout Inventory. The working atmosphere, interpersonal relationships with colleagues, and intention to leave were each assessed by a single question respectively. Multiple linear regression and structural equation modeling were used for the analysis. Findings A total of 10,570 surveys were collected. A total of 1199 (11.34%) HD nurses reported a high level of emotional exhaustion, 782 (7.40%) reported a high level of depersonalization, and 6767 (64.02%) reported a low level of personal accomplishment. Job burnout in the Northeastern region of mainland China was higher than that in other regions (p < 0.05). The working atmosphere, interpersonal relationships, region, hospital level, educational level, career planning, age, and number of children were significantly associated with burnout among HD nurses (p < 0.001, adjusted R2 = 0.313). The working environment, individual factors, and specialist nurse training were significantly associated with HD nurse burnout and intention to leave (comparative fit index = 0.907; goodness of fit index = 0.930; root mean square error of approximation = 0.055). Discussion There were notable regional differences in the burnout of HD nurses. This study contributes to the knowledge of the possible relationship of job burnout and intention to leave in HD nurses. It is suggested that improving the working atmosphere or interpersonal relationships and providing more training opportunities can alleviate job burnout in HD nurses.

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Background LncRNA LINC00311 participates in osteoporosis, which shows inverse pathological changes to ankylosing spondylitis (AS), indicating that LINC00311 is also involved in AS. Methods All the participants were enrolled in Ganzhou People’s Hospital between January 2016 and January 2018 after this study was approved by Ganzhou People’s Hospital Ethics Committee. Disease activity determination, follow-up and RT-qPCR were carried out during the research. Results In the present study we found that LINC00311 was upregulated in AS patients comparing to healthy controls, and upregulation of LINC00311 distinguished AS patients from healthy controls. LINC00311 expression levels were positively correlated with disease activity. Comparing to pre-treatment levels, LINC00311 expression level decreased significantly after treatment. During 2-year follow-up, patients with high levels of LINC00311 showed a significantly higher rate of rehospitalization. Conclusions Therefore, LINC00311 is overexpressed in AS and predict treatment outcomes and recurrence.

Background: The important effect of regular blood flow surveillance on arteriovenous fistula maintenance is emphasized. The ultrasonic dilution technique for blood flow surveillance can be performed during hemodialysis, but there are some limitations. Blood flow is traditionally measured by duplex Doppler ultrasound during the nondialysis period. However, the surveillance workload for arteriovenous fistula has increased with the rapid increase in the hemodialysis population size. Efficient methods for blood flow surveillance during hemodialysis are needed. Methods: Eighty-four hemodialysis patients with a forearm radiocephalic arteriovenous fistula were enrolled in this cross-sectional study. Each received blood flow measurements using ultrasonic dilution technique and duplex Doppler ultrasound during hemodialysis. Duplex Doppler ultrasound measurements included the blood flow of the brachial artery and radial artery. The correlations between these variables were analyzed. Results: The correlation coefficients ( r) between flow measured by ultrasonic dilution technique and brachial artery flow measured by duplex Doppler ultrasound, between flow measured by ultrasonic dilution technique and radial artery flow measured by duplex Doppler ultrasound, and between brachial artery flow and radial artery flow measured by duplex Doppler ultrasound were 0.724, 0.784, and 0.749, respectively (all p < 0.001). Conclusion: Blood flow measured by ultrasonic dilution technique was positively correlated with blood flow measured by duplex Doppler ultrasound during hemodialysis, suggesting that duplex Doppler ultrasound can be used to monitor the trends in the blood flow of the brachial artery and radial artery for timely intervention to improve patency during hemodialysis.

Purpose: To study the therapeutic influence of meloxicam-glucosamine sulfate combination in patients with osteoarthritis and their effect on serum CTX-I, CTX-II, COMP and MMP-3. Methods: A total of 88 patients with osteoarthritis were assigned to control (n = 44) and treatment groups (n = 44), using the random number table method. Control group was given 7.5 mg of meloxicam, while treatment group received 0.5 g of glucosamine sulfate capsule in addition to meloxicam. Both groups were treated continuously for 8 weeks. Serum levels of C-terminal telopeptide of type I collagen (CTX-I), C-terminal telopeptide of type II collagen (CTX-II), cartilage oligomeric matrix protein (COMP) and matrix metalloproteinase-3 (MMP-3) were compared for the two groups after treatment. Results: Lysholm score significantly increased in the two groups after treatment. Serum CTX-I, CTX-II, COMP and MMP-3 in the two groups were significantly lower than before treatment, but the reductions were more pronounced in the treatment group (p < 0.05). During treatment, mild vomiting and pruritus of the skin appeared in both groups, but these were relieved after symptomatic treatment without any serious adverse reactions. Conclusion: Treatment with a combination of meloxicam and glucosamine sulfate produces significant beneficial effects in patients with osteoarthritis by reduction of clinical symptoms, pain relief and reduction of serum CTX-I, CTX-II, MMP-3 and COMP.

Background: Pulmonary hypertension (PH) is common in patients with end-stage renal disease (ESRD). Arteriovenous fistulas (AVF) creation may involve in the pathogenesis of PH. The aim of this study was to explore the impact of PH after AVF creation on the AVF failure rate in maintenance hemodialysis (MHD) patients. Methods: From January 1, 2009, to January 1, 2019, we retrospectively collected data of 578 MHD patients in Guangdong Provincial People’s Hospital Blood Purification Center, China. Patients were followed-up until AVF failure or death or May 25, 2020. According to the systolic pulmonary artery pressure (SPAP) within 1 year after the establishment of AVF, the MHD patients were divided into three groups: SPAP ⩽ 35 mmHg, 35 < SPAP < 45 mmHg, SPAP ⩾ 45 mmHg. The primary outcome was AVF failure defined as AVF cannot complete hemodialysis. The secondary outcomes were all-cause mortality. Results: A total of 578 patients were analyzed. The average age was 60.66 ± 15.34 years (58.1% men). Of these, 26.1% of patients were reported PH. The SPAP exhibited a left-skewed nonparametric distribution and the overall SPAP after the creation of AVF was 39.00 (29.00–52.00) mmHg. The median follow-up was 5.8 (5.5–6.3) years. Overall, 12.8% (74/578) patients were reported AVF failure events. There was no significant difference in AVF failure rate among three groups ( p = 0.070). A total of 111 (19.2%) died during the follow-up period. Compared with the SPAP ⩽35 mmHg group, only the all-cause death rate significantly increased in MHD patients with PH ( p < 0.001). Conclusions: The secondary pulmonary hypertension after AVF creation did not increase the risk of AVF failure in MHD patients, but significantly increased the risk of mortality for this portion of the patients. Future larger sample sizes, multi-center, and prospective trials are needed to make sure which type of access will benefit on their survival for MHD patients with SPAP ⩾35 mmHg.

BACKGROUND Job burnout is an occupational illness with high prevalence among nurses in China. The job burnout status among hemodialysis nurses should be given more attention because of they handle sophisticated machinery, and there is a high risk of infection in hemodialysis nursing. OBJECTIVE The level and influencing factors of job burnout among hemodialysis nurses in mainland China were investigated. METHODS This was a cross-sectional study conducted in all 31 provinces of mainland China in 2019. Data from nurses responsible for direct care in 2738 hemodialysis units were analyzed. An effective response rate of 99.00% (10570/10677) was achieved. Hemodialysis nurse burnout was measured by the Maslach Burnout Inventory. Working atmosphere and interpersonal relationships with colleagues were each measured by a single question. Multiple linear regression analysis was used to explore the factors related to nurse burnout. Structural equation modeling was used to explore the effect of the working environment, individual factors, and specialist nurse training on the HD nurse burnout and the intention to leave. RESULTS The total burnout score was 38.69 (SD17.47), indicating that the level of job burnout among hemodialysis nurses in mainland China was relatively low. Hemodialysis nurses experienced low-level burnout on the emotional exhaustion and depersonalization subscale and high-level burnout on the personal accomplishment subscale. Statistically significant differences in burnout levels were associated with working atmosphere, interpersonal relationships with colleagues, specialist nurse training, number of children, night shift, and marital status. CONCLUSIONS The burnout level of HD nurses in mainland China was relatively low. Working atmosphere, interpersonal relationships with colleagues, and training of specialist nurses are the most important influencing factors regarding job burnout in hemodialysis nurses. Therefore, it is suggested that improving the working atmosphere and interpersonal relationship processing ability and providing more training opportunities for nurses can alleviate job burnout in nurses.

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