Objective: To investigate the detection of thyroid nodules and its influencing factors among residents in Dinghai District, Zhoushan City, Zhejiang Province, so as to provide insights into formulation of thyroid nodule control measures. Methods: Residents who were at ages of 18 years and older and had lived for 5 years or more in Dinghai District were sampled using a multi-stage stratified random sampling method from July to September 2022. Basic information was collected using a basic personal information registration form, the height, body weight, waist circumference and blood pressure were measured, and fasting blood glucose, low-density lipoprotein cholesterol (LDL-C) and urinary iodine were detected. Ultrasound examination of the thyroid gland in the neck was performed using a color ultrasound device; and the detection of thyroid nodules was analyzed and standardized by the population of the Sixth National Population Census in 2010. Factors affecting thyroid nodules using a multivariable logistic regression model. Results: A total of 434 residents were included, with a mean age of (49.97±14.74) years. There were 151 males (34.79%) and 283 females (65.21%). Thyroid nodules were detected in 232 cases, with a crude detection rate of 53.46% and a standardized detection rate of 35.69%, and the crude detection rate was 19.82% for solitary nodules and 33.64% for multiple nodules. Multivariable logistic regression analysis identified gender (female, OR=2.355, 95%CI: 1.520-3.647), age (40 to 59 years, OR=2.344, 95%CI: 1.416-3.878; 60 years and older, OR=5.157, 95%CI: 2.869-9.272), high level of LDL-C (OR=1.706, 95%CI: 1.065-2.734) as factors affecting thyroid nodules. Conclusion The risk of thyroid nodules is higher among residents who are female, are 40 years and older and have high levels of LDL-C in Dinghai District.

OBJECTIVETo develop the knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for occupational groups, and to provide a convenient and effective tool for the survey of knowledge, attitude, and behavior on the prevention and control of occupational diseases in occupational groups and the evaluation of intervention effect.

METHODSThe initial questionnaire which was evaluated by the experts was used to carry out a pre-survey in Guangzhou, China. The survey results were statistically analyzed by t test, identification index method, correlation analysis, and Cronbach's a coefficient method. And then the questionnaire was further modified, and the content of the questionnaire was determined finally.

RESULTSAfter modification, there were 18 items on knowledge, 16 items on attitude, and 12 items on behavior in the "Knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for enterprise managers"; there were 19 items on knowledge, 10 items on attitude, and 11 items on behavior in the "Knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for workers".

CONCLUSIONThe knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for occupational groups is developed successfully, and it is a convenient and effective tool for the survey of knowledge, attitude, and behavior on the prevention and control of occupational diseases in occupational groups and the evaluation of intervention effect.

This study was aimed to observe the regulating effect of Shen-Xiong Hua-Y u (SXHY) capsule precondi-tioning on the expression of subtypes of nitric oxide synthase (NOS), including endothelial nitric oxide synthase (eNOS), nervous nitric oxide synthase (nNOS), inducible nitric oxide synthase (iNOS), in cerebral ischemia-reperfu-sion injury (CIRI) among rats, and to further clarify the mechanism of protective effect by SXHY capsule on acute CIRI rats. Rats were randomly divided into the sham operation group, CIRI group, and SXHY capsule of high-, medium-, and low-dose preconditioning group (480, 240, 120 mg·kg-1). Each group was further randomly divided into different subgroups, which were the 3, 6, 12, 24, 48, 72 h group after 2 h CIRI (n=6). Intragastric administration was given once a day for 7 days. The middle cerebral artery occlusion (MCAO) and reperfusion model was repro-duced by an intraluminal filament method on the 7th day. The protein expressions of eNOS, nNOS and iNOS were measured by immunhistochemical method. The results showed that compared with the sham operation group, expres-sions of eNOS, nNOS and iNOS in the CIRI group were increased at different time points (i.e., 3, 6, 12, 24, 48, 72 h, P< 0.05 or P< 0.01). Compared with the CIRI group, eNOS expression increased at different time points in SX-HY capsule group (P< 0.05 or P< 0.01). The nNOS and iNOS expression decreased at different time points (P<0.05 or P < 0.01). Among them, the high-dose group was the group with the most obvious effect. It was concluded that SXHY capsule preconditioning had protective effect on CIRI. Its mechanism may be related to the regulation on protein expression of NOS subtypes.

Objective To do research on Multi-points EGFR gene mutation and heterogeneity in lung adenocarcinoma and its influence on the prognosis,to analyze EGFR gene mutation and its heterogeneity influence on patients'overall prognosis.Methods The clinical features of patients with lung adenocarcinoma at stage Ⅲa from January 2006 to January 2007 at our institution were retrospectively reviewed.The primary lung tumors and corresponding metastatic lymph nodes tissue specimens were obtained by surgery.The adenocarcinoma primary nodes and corresponding metastatic lymph nodes EGFR mutation were detected by amplification refractory mutation system (ARMS).Univariate analysis and multivariate analysis by Cox proportional-hazard model were used to analyze the impact of EGFR mutation and its heterogeneity as influential factor on patients 'prognosis.Results 76 patients with the adenocarcinoma primary nodes and corresponding metastatic lymph nodes were detected by epidermal growth factor receptor (EGFR) mutation.40 patients with EGFR mutation were detected (40/76,52.63％).There were 9 specimens out of 40 who had lung primary nodes and corresponding metastatic lymph nodes EGFR gene heterogeneity (9/40,22.5％).Log-Rank univariate analysis showed that there was no significant difference in overall survival period between EGFR mutation patients and wild-type patients(x2 =0.382,P =0.537),but there was significant difference in illnessfree progression period(x2 =4.147,P =0.042).Gene heterogeneity factor does not affect on the overall survival period and illness-free progression period of the patients with EGFR gene mutation (x2 =1.774,P =0.183 ;x2 =1.249,P =0.264).Multivariate analysis by Cox proportional-hazard model showed that EGFR gene mutation is not the independent risk factor that has 赵 impact on the prognosis of patients with lung adenocarcinoma.Conclusion Assessment of EGFR gene mutations in a single-point specimen can not reflect the whole EGFR gene mutation status,which may probably cause difference between targeted drugs'predicted effect and its actual usage effect.

AIM:To investigate the effect of liraglutide ( LG) on the expression of fibronectin type Ⅲdomain-containing protein 5 (FNDC5) in the C2C12 myotubes.METHODS:The C2C12 mouse myoblast cell line was induced to differentiation.Differentiated cells were stimulated with gradient concentrations (1 ~1000 nmol/L) of LG for different time (0 ~24 h).The effects of LG on the expression of FNDC5 and the activation of adenosine 5'-monophosphate ( AMP)-activated protein kinase ( AMPK) signaling pathway were determined .After pretreated with glucagon-like peptide-1 ( GLP-1 ) receptor antagonist exendin 9-39 , the inhibitor of Ca 2+/calmodulin-dependent protein kinase kinase 2 (CAMKK2), STO609, or the inhibitor of AMPK, Compound C, the LG-induced FNDC5 expression in C2C12 myotubes was examined.The expression of FNDC5 and the activation of AMPK were determined by Western blot .RESULTS: In C2C12 myotubes, LG promoted the expression of FNDC5 in a dose-and time-dependent manner .LG also activated AMPK signaling pathway .These effects of LG were partly abolished by exendin 9-39 , STO609 and Compound C .CONCLUSION:LG promotes the expression of FNDC5 via GLP-1 receptor in the C2C12 myotubes possibly through activation of the CAMKK2/AMPK signaling pathways .

Objective We evaluated the role of a quality improvement initiative in improving clinical outcomes in peritoneal di-alysis ( PD) . Methods In a retrospective analysis of 6 years of data from a hospital registry, the period between 1 July 2005 and 30 June 2008 ( control group) provided baseline data from before implementation of systemic outcomes monitoring, and the period between 1 July 2008 and 30 June 2011 [continuous quality improvement (CQI) group] represented the time when a CQI program was in place.Per-itonitis incidence, patient and technique survival, cardiovascular status, causes of death, and drop-out were compared between the groups. Results In the 370 patients of the CQI group and the 249 patients of the control group, the predominant underlying kidney diseases were chronic glomerulonephritis and diabetic nephropathy.After implementation of the CQI initiative, the peritonitis rate de-clined to 1 episode in 77.3 patient-months from 1 episode in 22.6 patient-months.In the CQI group, the complicance of blood pressure was more significantly improved than the control group ( 67.8% vs 47.4%,P<0.05).During the 3 years of follow-up,cardiothoracic ratio and IVST were significantly increased in the control group [0.55 ± 0.08 vs 0.51 ±0.05,P<0.05,11.07 ±1.66 mm vs 10.25 ±1.38 mm, P<0.05〗.The difference of LVID between the two groups was signifi-cant at the 2nd and 3rd year of follow-up(P<0.05).Patient survival at 1, 2, and 3 years was significantly higher in the CQI group (97.3%, 96.3%, and 96.3%respectively) than in the control group (92.6%, 82.4%, and 67.3%respectively, P<0.001).Imple-mentation of the CQI initiative also appeared to significantly improve technique survival rates:95.6%, 92.6%, and 92.6%in the CQI group compared with 89.6%, 79.2%, and 76.8%in the control group (P<0.001) after 1, 2, and 3 years respectively. Conclusion Integration of a CQI process into a PD program can significantly improve the quality of therapy and its outcomes.

Objective To explore the efficacy and safety of irinotecan as neoadjuvant chemotherapy (INAC) plus radical surgery (RS) for cervical cancer.Methods According to International Federation of Gynecology and Obstetrics (FIGO),81 cases were divided into Ⅱ B,ⅡA,and Ⅰ B2 groups.According to the tests of UGT1A1 gene polymorphisms,we adjusted the injection dose of irinotecan.The parameters were analyzed,including the efficacy,operation time and bleeding volume,postoperative pathology,survival time,and adverse reactions.The articles on irinotecan or paclitaxel combined with cisplatin for neoadjuvant chemotherapy between 2005 and 2015 were collected,and compared.Results The effective rate of chemotherapy was 81.5％ (Ⅰ B2 group:85.7％;Ⅱ A group:83.3％;and ⅡB group:72.2％),operation time was (5.3 ± 1.1) h,and blood loss was (781 ± 361.7) ml.After chemotherapy,37 cases were delayed diarrhea,70 cases were nausea,48 cases were vomiting,and 40 cases were bone marrow suppression.The infiltration rate,operation time,and blood loss on Ⅱ B group was significantly higher than that on Ⅱ A and Ⅰ B2 groups(P ＜ 0.05),and there was no significant difference in the chemotherapy efficiency,invasion depth,lymphatic metastasis,survival time and adverse reactions(P ＞0.05).Compared to three articles,the total effective rate in this study was higher than that in previous studies,also in Ⅱ A and Ⅱ B group.Conclusions Irinotecan chemotherapy regimens combined with cisplatin is effective and well tolerated.It is worthy of popularization and application.Detection of UGT1A1 gene polymorphism has guiding significance for chemotherapy regimen on irinotecan combined with cisplatin.

Objective To validate the possibility of CD133 CD34 CD44 be served as biomarkers in cancer stem cell of human lung adenocarcinoma. Methods Two kinds of culturing methods were performed to generate adhesive tumor cells and floating aggregates, and the differences of expression of CD133 CD34 CD44 between 2 kinds of cultured cells were observed by immunofluorescence. Results Floating aggregates grew more slowly, kept activity for longer period than adhesive cells (72.5% vs 47.5%,P＜0.05). Floating aggregates expressed higher level of CD133, CD34 and CD44 than adhesive cells (68.97%,82.76%,93.10% vs 5.26%,15.79%,5.26%,P＜0.01). Conclusions The combination of CD133, CD34 and CD44 probably can be used as surface markers of cancer stem cells for human lung adenocarcinoma.

Objective: To learn the characteristics of drowning deaths and potential years of life lost（PYLL）among residents in Zhoushan，and to provide basis for formulating drowning prevention and control measures. Methods: The death surveillance data in Zhoushan from 2009 to 2018 were collected from Zhejiang Chronic Disease Surveillance Information Management System. Demographic features，causes of drowning，life and labor lost due to drowning were analyzed through indicators such as mortality，standardized mortality，early death index，PYLL and working potential years of life lost（WPYLL）. Results: The crude and standardized drowning mortality of Zhoushan residents were 7.97/100 000 and 4.68/100 000. The drowning mortality showed a decreasing trend from 2009 to 2018（P<0.05）. The mortality of drowning in males was 8.03/100 000，which was higher than 1.33/100 000 in females（P<0.05）. Totally 322 deaths from drowning were fishery workers，accounting for 41.44%. The main cause of drowning death in residents aged 0-14 years，15-29 years and 65 years or above was accidental fall，accounting for 36.11%（13 cases），23.91%（11 cases）and 14.40%（47 cases），respectively. The main cause of drowning death in residents aged 30-44 years and 45-64 years was ship accident，accounting for 33.33%（58 cases）and 36.01%（130 cases），respectively. PYLL and WPYLL caused by drowning death were 22 511 and 11 911 person-years，of which residents aged 30 to 64 years were accounted for 73.33% and 70.55%. The early death index was 28.97. Conclusion Drowning mortality in Zhoushan showed an downward trend from 2009 to 2018. Men and fishery workers are at higher risk of death from drowning. Drowning can lead to serious life loss，especially for population aged 30-64 years.

Hepatic ischemia-reperfusion injury (HIRI) is a process caused by the combined effect of various factors, and to some extent, it limits the development of liver surgery. In-depth studies on mechanisms of HIRI and the development of reasonable therapeutic strategies have positive effects on the prognosis of patients. This article introduces the pathogenesis of HIRI, including calcium overload, Kupffer cells, microcirculation disturbance, production of reactive oxygen species, complement, non-coding RNA, and various cytokines, and the combined effect of these factors induces the necrosis and apoptosis of hepatocytes. In addition, as a second mode of cell death, autophagy is also involved in HIRI. Due to the complex mechanism of HIRI and many factors involved, intervention should be given from various aspects. This article points out that with the development of intervention such as ischemic pretreatment, mild hypothermia and hydrogen, the new therapeutic methods are expected to bring new thoughts to the clinical intervention of HIRI.