Procedure optimization and realistic option——To evaluate the improvement of efficiency in the new Administration Measures for the Diagnosis and Verification of Occupational Disease / 中国职业医学

@#Improving the efficiency of occupational disease diagnosis and verification is conducive to protecting the rights and interests of workers, better realizing the legislative value pursuit of the Law of the People's Republic of China on the Prevention and Control of Occupational Diseases, and truly demonstrating the spirit of legal fairness and justice. In 2021, the Administration Measures for the Diagnosis and Verification of Occupational Disease was revised and implemented. The working procedures of occupational disease diagnosis are adjusted and optimized, and the efficiency of diagnosis of occupational disease is greatly improved. They include items such as new provisions specifying working time limits; optimize the working mode; the diagnosis of occupational disease attribution applies to presumptive causality is emphasized and the logical thinking of inversion of burden of proof is carried out. However, the work efficiency of occupational disease diagnosis does not make a great breakthrough in quality, mainly manifests in three aspects: difficult to confirm labor relationships, raising the threshold of occupational disease diagnosis, the administrative field investigation is empty and the diagnosis of occupational disease is complicated. There are many pre-procedures in occupational disease diagnosis, which restrict the efficiency of diagnosis. In the future, attention needs to be paid to promote the independent work of occupational disease diagnosis institutions, and through the revision of the Law of the People's Republic of China on the Prevention and Control of Occupational Diseases. Occupational disease diagnosis institutions should be empowered to confirm labor relationship, so as to lower the threshold of diagnosis of occupational disease and maximize the protection of the rights and interests of workers.

Analysis on occupational noise deafness in a provincial occupational disease diagnosis institution from 2016 to 2020 / 中国职业医学

@#Objective - （ ） To analyze the epidemiological characteristics of occupational noise induced deafness ONID （ ） diagnosed by Guangdong Province Hospital of Occupational Disease Prevention and Control GDHOD from 2016 to 2020 and - Methods the reasons non ONID diagnosis. The data of ONID patients diagnosed in GDHOD from 2016 to 2020 were collected “ from the Occupational Disease Report Card in the Occupational Disease and Occupational Health Information Monitoring ” “ ” - System subsystem of the China Disease Prevention and Control Information System . The data of non ONID subjects were ， collected from the occupational disease diagnosis archives in the same hospital and the relevant data were analyzed Results ， ， （ ） retrospectively. Of the 1 432 subjects 824 subjects were diagnosed as ONID patients mainly of mild ONID 86.0% . （M） ， M Male patients accounted for 88.0%. The median of diagnosis age was 45.0 years old and of length of employment of ， ， ， diagnosis was 8.3 years. ONID patients were mainly found in Zhongshan Dongguan Zhuhai Jiangmen and Guangzhou City in ， ， （ ） the Pearl River Delta accounting for 67.6%. The cases distributed in 519 enterprises mainly on manufacturing 90.2% . ， - ， ； Among the 139 enterprises each enterprise had 2 11 patients worked within five years accounting for 53.9% 91.1% of the -， - - - ONID patients were distributed in large medium and small enterprises. ONID patients mainly worked in non public enterprises that accounted for 91.3%. There were 606 subjects could not be diagnosed as ONID. The main reasons for not being （ ）， diagnosed were that the weighted value of better ear hearing threshold was less than 26 dB 34.8% the working history of （ ）， occupational noise exposure was less than three years 31.5% the weighted value of better ear hearing threshold was less thanConclusion 26 dB and the average hearing threshold of binaural high frequency was less than 40 dB 16.2% . The ONID ， ， -， - patients have the characteristics of group aggregation. The Pearl River Delta manufacturing industry large medium and - - ： small non public enterprises are the key points of ONID prevention. The main reasons for not being diagnosed as ONID were ， the working history of occupational noise exposure was less than three years the weighted value of better ear hearing threshold ， - was less than 26 dB and the average high frequency hearing threshold of both ears was less than 40 dB.

MYC and BCL-2 protein co-expression and prognosis of patients with diffuse large B-cell lymphoma: a propensity score matching analysis / 中华血液学杂志

Objective: We investigated the impact of MYC/BCL-2 protein co-expression on the prognosis of diffuse large B-cell lymphoma (DLBCL) patients and observed whether double expression (DE) remains an independent poor prognostic factor in DLBCL after the addition of therapeutic factors such as DA-EPOCH-R, central prophylaxis, and transplantation. Methods: Available pathological findings were retrospectively collected from 223 DLBCL patients at the Peking Union Medical College Hospital from 2015 to 2018. Seventy-five patients with high MYC/BCL-2 expression were categorized as the DE group. From the 148 non-DE patients, 75 DLBCL patients were selected as the control group, using a 1∶1 matching on propensity scores for age, international prognostic index score, treatment choice, and etc. The differences in overall survival (OS) and progression-free survival (PFS) between the two groups were compared. Results: The 3-year OS was (69.8±5.5) % for the DE group and (77.0±4.9) % for the non-DE group (P=0.225) , while the 3-year PFS was (60.7±5.8) % and (65.3±5.5) % , respectively (P=0.390) . Subgroup analysis in patients treated with the R-CHOP regimen revealed that for the DE and non-DE patients, the 3-year OS was (61.3±7.5) % and (77.2±5.6) % (P=0.027) , and the 3-year PFS was (52.1±7.5) % and (70.6±6.0) % (P=0.040) , respectively. Multivariate analysis showed that age, stage of Ann Arbor, COO staging, whether central prophylaxis was performed, and whether transplantation was performed were significant independent risk factors of the prognosis of DLBCL patients (P<0.05) . On the other hand, MYC/BCL-2 protein double expression was not significantly associated with prognostic outcomes. Conclusion: MYC/BCL-2 protein double expression was significantly associated with poor prognosis under R-CHOP regimen treatment, but the poor prognostic impact of DE on DLBCL was eliminated under intensive regimens such as DA-EPOCH-R and transplantation.

Cell heterogeneity of laryngeal carcinoma and evolution trajectory of epithelial cells / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the classification and functions of cell subsets in laryngeal carcinoma and metastatic lymph nodes, and to explore the evolution trajectory of epithelial cells to tumor cells. Methods: Single-cell RNA sequencing was performed on 5 cases of laryngeal cancer, matched metastatic lymph nodes and 3 normal tissues. Patients were admitted to Ningbo Medical Center Lihuili Hospital from October 22, 2019 to December 16, all patients were male, aged 53-70 years old. Cell subsets of the above-mentioned tissues were analyzed by the Seurat, and the biological functions of cell subpopulation were investigated by functional enrichment analysis. Malignant epithelial cells were identified using copy number variation (CNV). The evolutionary trajectory of epithelial cells to cancer cells was analyzed by cell trajectory analysis, and cancerous transitional cells were identified. The highly expressed genes in transitional cells were analyzed by the FindAllMarker of the Seurat and verified by immunohistochemistry. Results: A total of 66 969 high-quality cells were obtained in 9 major clusters: epithelial cells, T cells, B cells, fibroblasts, endothelial cells, myeloid cells, mast cells, plasmacytoid dendritic cells and nerve cells. The first 5 cell clusters were divided into 8, 6, 4, 3 and 2 subgroups, respectively. Four epithelial cell subsets (C0, C1, C2 and C5) were derived from tumor tissues and metastatic lymph nodes, and had high levels of CNV and tumor cell content. Cell trajectory analysis showed that the evolution trajectory of epithelial cells was from normal epithelial subpopulation C4 to early cancerous cell population C0, which differentiated into three major malignant cell subsets C1, C3, and C5. Epithelial cell C0 may represent the transitional cell population of carcinogenesis, and were enriched in biological processes such as epithelial-mesenchymal transformation and angiogenesis. C0 highly expressed sulforaphane (SFN) which may be related to the occurrence and development of cancer. Immunohistochemistry confirmed that SFN was highly expressed in tumor tissues and metastatic lymph nodes compared with paracancerous tissues. Conclusion: Single-cell sequencing may be used to elucidate the diversity of cells and functions in laryngeal carcinoma tissues and metastatic lymph nodes, and cell population C0 plays a key role in the evolution of cells.

Influencing factors of the early vault after phakic posterior chamber implantable collamer lens implantation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the early variation trend of the vault after phakic posterior chamber implantable collamer lens/toric implantable collamer lens(ICL/TICL V4c)implantation and analyze the related influencing factors.METHODS:In this retrospective study, a total of 49 patients(98 eyes)who underwent ICL/TICL V4c implantation in the Lanzhou Huaxia Eye Hospital from October 2020 to March 2021 were enrolled. Preoperative ocular biometric parameters were collected, including spherical equivalent(SE), intraocular pressure, axial length, anterior chamber depth(ACD), lens thickness(LT), central corneal thickness, anterior chamber angle(ACA), anterior chamber volume(ACV), white to white corneal diameter(WTW), mean keratometry K1 and K2, and intraoperative implantation size of ICL. The vault was measured by anterior segment optical coherence tomography(AS-OCT)at 1, 3d, 1wk and 1mo after surgery. The patients were divided into insufficient vault group(&#x003C;250μm, 12 eyes), normal vault group(250-750μm, 62 eyes)and excessive vault group(&#x003E;750μm, 24 eyes)according to the vault at 1mo after surgery. The factors affecting the postoperative vault were analyzed.RESULTS:The mean vault values at 1 and 3d, 1wk and 1mo after surgery were 591.05±293.44, 599.62±309.78, 592.22±301.49 and 586.69±285.63μm, respectively. There were significant differences in WTW, ACA, ACV, ACD, ICL size and LT at 1mo after surgery(all P&#x003C;0.05). The regression equation of vault at 1mo after surgery was as follows: vault(μm)=-3142.19+388.25×WTW+10.40×ACA-301.63×LT(R=0.674, R2=0.454, adjusted R2=0.436). WTW had the greatest influence on vault at 1mo after surgery(β=0.47, P&#x003C;0.001), followed by LT(β=-0.34, P&#x003C;0.001)and ACA(β=0.17, P=0.047).CONCLUSION:WTW, ACA and LT were the main factors that affected and predicted the vault at 1mo after ICL/TICL V4c implantation.

Electroacupuncture Attenuates Immune-Inflammatory Response in Hippocampus of Rats with Vascular Dementia by Inhibiting TLR4/MyD88 Signaling Pathway / 中国结合医学杂志

OBJECTIVE@#To investigate whether electroacupuncture (EA) alleviates cognitive impairment by suppressing the toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88) signaling pathway, which triggers immune-inflammatory responses in the hippocampus of rats with vascular dementia (VaD).@*METHODS@#The experiments were conducted in 3 parts and in total the Sprague-Dawley rats were randomly divided into 8 groups by a random number table, including sham, four-vessel occlusion (4-VO), 4-VO+EA, 4-VO+non-EA, sham+EA, 4-VO+lipopolysaccharide (LPS), 4-VO+LPS+EA, and 4-VO+TAK-242 groups. The VaD model was established by the 4-VO method. Seven days later, rats were treated with EA at 5 acupoints of Baihui (DV 20), Danzhong (RN 17), Geshu (BL 17), Qihai (RN 6) and Sanyinjiao (SP 6), once per day for 3 consecutive weeks. Lymphocyte subsets, lymphocyte transformation rates, and inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor α(TNF-α) were measured to assess immune function and inflammation in VaD rats. Transmission electron microscopy was used to observe the ultrastructure of nerve cells in the hippocampus. The levels of TLR4, MyD88, IL-6, and TNF-α were detected after EA treatment. TLR4/MyD88 signaling and cognitive function were also assessed after intracerebroventricular injection of TLR4 antagonist TAK-242 or TLR4 agonist LPS with or without EA.@*RESULTS@#Compared with the 4-VO group, EA notably improved immune function of rats in the 4-VO+EA group, inhibited the protein and mRNA expressions of TLR4 and MyD88 in the hippocampus of rats, reduced the expressions of serum IL-6 and TNF-α (all P0.05).@*CONCLUSIONS@#EA attenuated cognitive impairment associated with immune inflammation by inhibition of the TLR4/MyD88 signaling pathway. Thus, EA may be a promising alternative therapy for the treatment of VaD.

Accelerate implementation of occupational health protection actions / 中国职业医学

The tasks and directions of occupational health works in the new era mainly include three aspects: actions for pneumoconiosis prevention and treatment, risk assessment of occupational health and construction of healthy enterprises. These three aspects exist independently, but they are interrelated, constituting the work support, reflecting the work characteristics, features and direction of different stages of occupational health works. It is necessary to establish a new of ″trinity″ with these three aspects of occupational health works, emphasize the prevention and treatment of pneumoconiosis, promote the occupational health risk assessment and the construction of healthy enterprises. However, as poverty alleviation becomes a past, occupational health risk assessment might be underestimated, and the construction of healthy enterprises might be neglected, the task of occupational health remains laborious. Accelerating the implementation of occupational health protection action is a requirement of the era. It is also the direction of occupational disease prevention and treatment, and the duty of occupational prevention personnel, that must be fully promoted in the right direction.

Genetic Testing for Alpha and Beta Thalassemia in Children in Quanzhou Region of Fujian Province in China / 中国实验血液学杂志

OBJECTIVE@#To analyze the genotypes and distribution of thalassemia in children in Quanzhou Region so as to provide reference for the prevention and control of thalassemia.@*METHODS@#A total of 1 302 children with suspected thalassemia were collected from January 2014 to April 2020 in Quanzhou Region. The deletional α-thalassemia was detected by Gap-PCR, and DNA reverse dot blot (RDB) hybridization was used to detect α- and β-thalassemia mutations.@*RESULTS@#In the 1 302 cases, 667 cases were identified as thalassemia carriers, and the positive detection rate was about 51.23%. Among them, 380 cases of α-thalassemia gene were detected, and --@*CONCLUSION@#There are various genotypes of thalassemia in children in Quanzhou Region, and many children with thalassemia major or intermedia. Therefore, further prevention and control of thalassemia need to be strengthened for reducing the birth of thalassemia major or intermedia.

Effect of electrothermal acupuncture on moderate to severe cancer pain with / 中国针灸

OBJECTIVE@#To observe the effectiveness and safety of electrothermal acupuncture therapy for patients of moderate to severe cancer pain with @*METHODS@#A total of 60 patients of moderate to severe cancer pain with @*RESULTS@#The variation of NRS scores in the observation group were larger than the control group 3, 5 days into treatment (@*CONCLUSION@#On the basis of the conventional western medication for analgesia, electrothermal acupuncture could relieve pain, reduce the dose of opioid painkillers and improve the quality of life in patients of moderate to severe cancer pain with

Buyang Huanwutang Promoted Proliferation and Differentiation of Neural Stem Cells via Regulating Autophagy Following Oxygen-glucose Deprivation/Reoxygenation Injury / 中国实验方剂学杂志

Objective:To investigate the effect of Buyang Huanwutang （BHT） on proliferation and differentiation in neural stem cells （NSCs） after oxygen-glucose deprivation/reoxygenation （OGD/R） injury. Method:NSCs isolated from the hippocampus of SD rats were cultured and randomly divided into a normoxia group， a model group， a BHT group， a rapamycin （Rapa） group， and a combination group ［autophagy inhibitor 3-methyladenine （3-MA） combined with BHT］. The 20% blank serum was used in the normoxia group， and 20% BHT-medicated serum in the BHT group. The doses of Rapa and 3-MA were 1 μmol·L^-1 and 5 mmol·L^-1， respectively. The cells were subjected to OGD/R except those in the normoxia group. The cell morphology was observed under a light microscope. NSCs were confirmed by immunofluorescence detection of nestin expression. The viability and proliferation of NSCs were assessed by cell counting kit-8 （CCK-8） assay and 5-ethynyl-2-deoxyuridine （EdU） labeling， respectively. Furthermore， Ad-mCherry-GFP-LC3B fluorescence assay was performed to investigate autophagy. The effect of BHT on autophagy-related protein expression was detected by western blot assay. Brain derived neurotrophic factor （BDNF）， <italic>β</italic>-tubulin Ⅲ， and glial fibrillary acidic protein （GFAP） were evaluated by immunofluorescence assay. Result:OGD/R significantly reduced the cell viability of rat NSCs as compared with the normoxia group. Compared with the model group， the BHT group exhibited significantly improved viability of rat NSCs （<italic>P</italic><0.01）. BHT induced the production of autophagosomes in NSCs after OGD. The BHT group showed increased expression of microtuble-associated protein 1 light chain 3Ⅱ (LC3Ⅱ） and Beclin-1 （<italic>P</italic><0.05，<italic>P</italic><0.01） and slightly changed p62 compared with the normoxia group， and significantly up-regulated LC3Ⅱ and Beclin-1 （<italic>P</italic><0.05，<italic>P</italic><0.01） and down-regulated expression of p62 （<italic>P</italic><0.01） compared with the model group. The Rapa group had similar effect as the BHT group （<italic>P</italic><0.05，<italic>P</italic><0.01）， while the combination group inhibited the activity of autophagy （<italic>P</italic><0.01）. As indicated by the results of ad-mCherry-GFP-LC3B， compared with the normoxia group， the model group showed increased fluorescence intensity （<italic>P</italic><0.01）， and the BHT and Rapa groups could further increased the fluorescence intensity of autophagy （<italic>P</italic><0.01）， while the combination group inhibited autophagy activity （<italic>P</italic><0.01）. Immunofluorescence results revealed that compared with the normoxia group， the model group displayed significantly reduced positive cells of EdU， <italic>β</italic>-tubulin Ⅲ， GFAP， and BDNF （<italic>P</italic><0.01）， and the BHT and Rapa groups exerted similar protective and promoting effects （<italic>P</italic><0.05，<italic>P</italic><0.01）， while the combination group partially blocked the neuroprotection and differentiation ability of BHT （<italic>P</italic><0.05）. Conclusion:BHT pretreatment can effectively protect rat NSCs against OGD-induced injury and promoted proliferation and differentiation by up-regulating autophagy.

Treatment of Thin Endometrium in Infertility Based on Thought of "Blood Being Basis of Women" / 中国实验方剂学杂志

Infertility is commonly seen but difficult to treat in the department of obstetrics and gynecology. The incidence of infertility in women of childbearing age has reached as high as 25% in China， which seriously affects social harmony and people's happiness. As the lifestyle of modern women changes， thin endometrium has gradually become an important reason for infertility and embryo transfer failure. Such factors as repeated operations in uterine cavity and oral intake of hormones have resulted in destructed blood vessels and reduced blood flow in endometrium， impaired growth of glandular epithelial cells， insufficient local blood supply， retarded development of endometrium， reduced receptivity， and therefore poor acceptance of endometrium to the implanted gestational sac， which is not conducive to the implantation of fertilized eggs. As a result， the infertility will occur. Traditional Chinese medicine （TCM） has a long history of treating infertility. During the long-term clinical practice， physicians of ancient and modern times have gained rich experience in the diagnosis and treatment of infertility. The idea of "blood being the basis of women" sprouted in the Spring and Autumn and Warring States Periods and determined in the Song Dynasty as an important guiding principle that can be applied in various physiological periods of women. It emphasizes "blood regulation" for gynecological diseases to ensure sufficient blood in blood vessels and its normal circulation， thus allowing the thoroughfare and conception vessels and endometrium to be nourished and the pregnancy to be facilitated. With blood as the basis， the paper explored the physiopathological correlations of five zang organs and thoroughfare and conception vessels with blood， pointed out the preference for "blood harmonization" in ancient literature based on the differentiation of infertility into blood stasis， blood cold， blood heat， and blood deficiency syndromes， reviewed the key methods of modern physicians in assisting pregnancy including tonifying kidney and nourishing blood， tonifying kidney and activating blood， tonifying kidney and invigorating spleen， as well as invigorating kidney and soothing liver， and summarized the efficacy of integrated TCM and western medicine in promoting ovulation， regulating hormones， improving blood supply， and nourishing endometrium to assist pregnancy. All these would contribute to the clinical treatment and scientific research of thin endometrium in infertility from multiple angles.

Treatment of Perimenopausal Anovulatory Dysfunctional Uterine Bleeding Based on Thought of Liver Being Innate Basis of Women / 中国实验方剂学杂志

Perimenopausal anovulatory dysfunctional uterine bleeding （ADUB） is a severe acute disease that is difficult to be dealt with in gynecology， accounting for about 70% of abnormal uterine bleeding. The significant differences in bleeding patterns make it particularly challenging to treat. The main manifestations of perimenopausal ADUB are prolonged menstrual period， inexhaustible menstrual bleeding， or heavy inter-menstrual vaginal bleeding， which allow it to be classified into the category of metrorrhagia and metrostaxis in traditional Chinese medicine （TCM）. After conducting in-depth research on this disease， physicians of the past dynasties have figured out its etiology and pathogenesis and accumulated rich experience in its differentiation and treatment， thus forming a relatively systematic theoretical system. The existing literature mainly focuses on four types of its pathogenesis， namely blood heat， blood stasis， spleen deficiency， and kidney deficiency， and there are few discussions on liver. However， patients with metrorrhagia and metrostaxis due to liver dysfunction are commonly seen in clinical practice. The theory of liver being innate basis of women explores the special physiological and pathological characteristics of women and emphasizes the important role of liver in the treatment of this disease based on its characteristic functions and meridian circulation. Considering the close relationship of liver Qi and blood with spleen， kidney， and thoroughfare and conception vessels， this paper discussed the TCM treatment of perimenopausal ADUB from the following four aspects： soothing liver Qi and nourishing liver blood， liver and kidney sharing the same source， simultaneous regulation of liver and spleen， and liver meridian circulation， so as to broaden the clinical treatment options. Perimenopause is a unique physiological period when women tend to suffer from Qi stagnation and blood deficiency. Liver， characterized by Yin in property and Yang in function， governs the free flow of Qi， induces ovulation， stores blood， and regulates blood volume. Therefore， the liver should be emphasized in the treatment of perimenopausal ADUB， which contributes to correcting the hormone disorder caused by abnormal ovulation， stopping bleeding， and alleviating perimenopausal symptoms. This paper has provided a new direction for the clinical treatment of perimenopausal ADUB .

Downregulation of LINC01508 contributes to cisplatin resistance in ovarian cancer via the regulation of the Hippo-YAP pathway / 부인종양

Background@#Some long non-coding RNAs (lncRNAs) have been found to contribute to cisplatin resistance. Here, we identified a novel lncRNA that was downregulated in cisplatin-resistant to ovarian cancer (OC) cells and aimed to examine the contribution of LINC01508 to cisplatin resistance in OC cells. @*Methods@#Differences in the lncRNA expression profile between OV2008 and C13K cells were assessed by lncRNA expression microarray. The expression of LINC01508 in ovarian epithelial cells, four OC cells, and OC, benign ovary tumor and normal ovary, cisplatin-resistant and non-resistant OC specimens were evaluated by quantitative real-time polymerase chain reaction (qPCR). The role of LINC01508 in OC cisplatin-resistant was evaluated by cell counting kit-8 (CCK-8), flow cytometry, colony formation, wound healing, Transwell, and tumor growth inhibition study in vivo. The clinical associations of LINC01508 in OC were evaluated using correlation analysis. The effects of verteporfin (VP) on cisplatin were explored to reveal the function of the hippo-YAP pathway on the cisplatin tolerance of C13K. @*Results@#LINC01508 was downregulated in cisplatin-resistant OC cells and platinum-resistant OC tissue (p<0.01). LINC01508 downregulation was correlated with tumor size, residual tumor, and platinum resistance. The overexpression of LINC01508 improves in vitro and in vivo sensitivity to cisplatin while predicts the poor overall survival which need further follow-up research. The increased level of LINC01508 could suppress the cisplatin resistance of OC cells through the inhibition of the hippo-YAP pathway. @*Conclusions@#The study proposes that dysregulation of LINC01508 expression results in resistance of OC to cisplatin through the inhibition of the hippo-YAP pathway.

One-stage surgery in patients with both cardiac and non-cardiac diseases / 北京大学学报(医学版)

OBJECTIVE@#To investigate the possibility and feasibility of one-stage cardiac and non-cardiac surgery.@*METHODS@#From July 1999 to August 2018, one hundred and eleven patients suffering from cardiac and non-cardiac diseases were treated by one-stage cardiac and non-cardiac operation in Department of Cardiac Surgery and Thoracic Surgery, General Surgery, Urinary Surgery, and Gynecology, Peking University First Hospital. There were 83 males (74.8%) and 28 females (25.2%), aged 41 to 84 years [mean age: (64.64±8.97) years]. The components of the cardiac disease included coronary heart disease, valvular heart disease, cardiac tumors, chronic constrictive pericarditis and congenital heart disease. The components of the non-cardiac diseases included lung benign and malignant diseases, thymoma and thymic cyst, breast cancer, chest wall giant hemangioma, digestive tract benign and malignant diseases, urinary system carcinoma and gynecological diseases.@*RESULTS@#Two patients died after operations in hospital; thus, the hospital mortality rate was 1.8%. One patient died of multiple organ failure on the 153th days after emergency coronary artery bypass grafting (CABG) combined with radical resection of bladder cancer. The other of pericardium stripping with lung cancer operation died of the multiple organ failure on the tenth day after surgery. The remaining 109 patients recovered and were discharged. There were 13 cases of complications during the days in hospital. The total operative morbidity was 11.7%: postoperative hemorrhage in 2 cases (1.8%), pulmonary infection and hypoxemia in 3 cases (2.7%), hemorrhage of upper digestive tract in 1 case (0.9%), incisional infection in 3 cases (2.7%), subphrenic abscess in 1 case (0.9%), and postoperative acute renal failure and hemofiltration in 3 case (2.7%). Of the 109 patients discharged, 108 patients were followed up. All the patients survived for 6 months, and 21 patients died due to tumor recurrence or metastasis within 1 to 5 years of follow-up, but no cardiogenic death. During the follow-up period, 1 patient developed cardiac dysfunction, 1 patient underwent percutaneous coronary intervention (PCI), 1 patient had cerebral hemorrhage due to excessive postoperative anticoagulation, and 1 patient suffered from incisional hernia.@*CONCLUSION@#One-stage surgeries in patients suffering from both cardiac and non-cardiac benign or malignant diseases are safe and possible with satisfactory short-term and long-term survival.

Analysis on the old and new Administrative Measures for the Diagnosis and Verification of Occupational Diseases / 中国职业医学

As occupational health work enters a new era, the diagnosis and identification of occupational diseases, that are closely related to the protection of workers′ health rights, require higher and newer standards. In 2021, the National Health Commission of the People′s Republic of China revised and issued the Administrative Measures for the Diagnosis and Verification of Occupational Diseases to improve and perfect the original diagnosis and verification system of occupational diseases. These measures clarify the time limit for diagnosis of occupational diseases and shorten the time limit for identification of occupational diseases; and strengthen the main responsibility of the employer. This new system design is more operable. It embodies the management idea of Streamline administration, delegate power, combine decentralization, and optimize services. The language expression is more accurate and standardized. The revision of the Administrative Measures for Diagnosis and Verification of Occupational Disease is conducive to improving the efficiency of occupational disease diagnosis and protecting the rights and interests of workers. It is conducive to strengthening the supervision and management of occupational disease diagnosis institutions and occupational disease verification offices by administrative supervision and management departments. It is conducive to strengthening the responsibilities of employers. However, there are some problems: Article No. 28 sets up obstacles to the realization of legal value, which does not clearly stipulate the concept of new evidence. The effective time of this regulation has caused difficulties for occupational disease diagnosis institutions and occupational disease verification offices. It is recommended that this regulation can be further improved in the future revisions.

Study on the dilemma and optimization of applying the rule of inversion of proof in the diagnosis of occupational diseases——Comment on article 28 of Administrative Measures for Diagnosis and Verification of Occupational Diseases / 中国职业医学

In the process of occupational disease diagnosis and verification, the rule of inversion of proof is implemented. The purpose of proof is to solve the causal relationship between occupational hazardous factors and occupational diseases in the workplace, and its essence is the responsibility for consequences. However, in the practice of diagnosis and verification of occupational diseases, there are many difficulties in the application of the rule of inversion of burden of proof, which is dare not apply, difficult to apply, and wrong application might occur. Satisfying probability is the premise for the application of the rule of inversion of burden of proof. The relevant judgment of evidence is the basic way to apply the rule. Optimize the article 28 of Administrative Measures for Diagnosis and Verification of Occupational Diseases, delete the precondition “urged by health authorities”, that is an important guarantee for the accurate application of the rule. To clarify the nature of the burden of proof, correctly apply and optimize the rules of proof in the practice of diagnosis and verification occupational diseases, further improve the legislation, and promote the accurate application of the relevant legal system are conducive to protecting the rights and interests of workers in occupational health and implementing the principal responsibility of employers for occupational disease prevention and control.

Research advances on silica dust induced-autoimmune diseases and its mechanism / 中国职业医学

Silica dust is one of the main occupational hazards in various industries. In addition to causing occupational silicosis, silica dust can also stimulate innate and acquired immunity and induce autoimmune diseases(AID) such as systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, and antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis. Silica dust exposure can induce changes in the levels of autoantibodies in vivo, such as rheumatoid factor, antinuclear antibody, ANCA, anti-centromere antibody, anti-topoisomerase Ⅰ antibody, anti-desmoglein antibody, anti-centromere antigens-B antibody, anti-carbamylated protein antibody, anti-smooth muscle antibody and anti-glomerular basement membrane antibody. At present, the mechanism of autoimmune disorders induced by silica dust has not yet been fully elucidated. The current research suggests that it is related to cell apoptosis of alveolar macrophages, the disorder of the Fas/Fas ligand system, the imbalance of T cell proportion, and the dysregulation of T helper cell(Th) 1 and Th2 type cytokines homeostasis. Understanding the pathogenesis of autoimmune disorders induced by silica dust and exploring possible therapeutic targets will provide new ideas for the treatment of silicosis.

Effects of double-tract reconstruction versus total gastrectomy on nutritional status in patients with gastric cancer / 第二军医大学学报

Objective: To explore the influence of different reconstruction methods of digestive tract on postoperative short-term nutritional status of patients with early malignant tumor in upper gastric body. Methods: Retrospective analysis was conducted on 109 patients with early upper gastric cancer who underwent surgical treatment in our hospital from Jun. 2016 to Jan. 2018. Double-tract reconstruction was performed in 59 patients (double-tract reconstruction group), and total gastrectomy was performed in 50 patients (total gastrectomy group). Nutritional indexes (hemoglobin, total protein, albumin and prealbumin) were compared between the two groups during hospitalization (at admission, 1, 3, 5 days after operation, and at discharge) and one year after operation. The changes in body weight were observed in the first year after operation. Results: There were no significant differences in age, gender, body weight or nutritional indexes (hemoglobin, albumin, total protein, prealbumin) at admission, operation time, operation method, tumor location, tumor maximum diameter, or tumor differentiation between the two groups (P>0.05). On the 3rd day after the operation, albumin in the total gastrectomy group was significantly lower than that in the double-tract reconstruction group (t=2.30, P=0.023). There were no significant differences in the hemoglobin, total protein or prealbumin between the two groups on day 1, 3 and 5 after operation, and at discharge (P>0.05). The levels of hemoglobin, total protein, albumin and prealbumin were significantly decreased in both groups at discharge as compared with that at admission (P0.05). But the body weight loss in the double-tract reconstruction group was significantly lower than that in the total gastrectomy group (- 10.45%[- 17.11%, - 5.19%) vs - 17.83%[- 22.06%, - 13.10%], Z=4.31, P<0.01). Conclusion: In comparison to total gastrectomy, double-tract reconstruction surgery can effectively improve the nutritional status of patients with early upper gastric cancer.

Research Progress on Automatic Assessment of Bone Age / 法医学杂志

Bone age is an important indicator of human growth and development, which can objectively reflect the growth level and maturity of individuals. Traditional manual bone age assessment usually compares the X-ray of the left wrist with the reference standard to obtain the corresponding bone age. This method is time-consuming and its results vary with different observers. In recent years, with the continuous development of computer science, bone age assessment has began to change from traditional manual assessment to automatic assessment. Although there has already been numerous researches on automatic bone age assessment, most of them are still in the experimental stage. This paper reviews related research and progress on automatic bone age assessment at home and abroad in recent years, in order to provide reference and research ideas for relevant researchers.

Action Mechanism of Main Components from Glycyrrhizae Radix et Rhizoma in Improving Insulin Resistance in L6 Rat Myoblasts / 中国实验方剂学杂志

Objective::To determine whether the main components of Glycyrrhizae Radix et Rhizoma can improve insulin resistance by regulating glycogen synthesis, glycolysis pathway and fatty acid synthesis in myoblasts of L6 rat myoblasts. Method::Insulin resistance (IR) model of L6 rat myoblasts was established through incubation with 0.05 mmol·L-1 palmitic acid (PA) for 9 hours. Normal group, model group, glycyrrhizic acid (GA, 25 μmol·L-1) group, 18β-glycyrrhetinic acid (18β-GA, 25 μmol·L-1) group, isoliquiritigenin (ILG, 25 μmol·L-1) group and isoliquiritin (ILQ, 25 μmol·L-1) group were set up, glucose content in supernatant of cell culture medium was detected by glucose kit, myoblasts glycogen content was determined by glycogen detection kit, protein expression levels of Sterol regulatory element binding protein-1c(SREBP-1c), fatty acid synthetase (FAS) and glycogen synthase kinase3β(GSK3β) were detected by Western blot, and the mRNA expressions of key enzymes in glycolysis were detected by quantitative real-time fluorescence polymerase chain reaction(Real-time PCR). Result::Compared with those in the normal group, the glucose consumption rate was significantly down-regulated in model group (P<0.01), the glycogen content was decreased (P<0.05), the protein expressions of Sterol regulatory element binding protein-1c (SREBP-1c) and fatty acid synthase (FAS) were decreased (P<0.05, P<0.01), the mRNA expressions of fructose phosphate kinase 1 (PFK1), pyruvate kinase (PK) and hexokinase (HK) were down-regulated (P<0.05), and the protein expression of glycogen synthase kinase 3 (GSK3β) protein was increased (P<0.05). Compared with model group, GA, 18β-GA and ILG could significantly increase glycogen content in myoblasts of IR-L6 rats (P<0.05, P<0.01). GA, 18β-GA and ILQ could significantly increase the expression of SREBP-1c (P<0.05, P<0.01), and GA, 18β-GA, ILG and ILQ could significantly increase the expression of FAS (P<0.05, P<0.01), the mRNA expressions of PFK1, PK and HK (P<0.05, P<0.01), and down-regulate the protein expression of GSK3β (P<0.05). Conclusion::The main components of licorice improve the insulin resistance by promoting glycolysis and glycogen synthesis and regulating fatty acid synthesis.