Objective To study the clinical value of tamsulosin in prevention of urinary retention after radical hysterectomy.Methods Sixty-six patients after radical hysterectomy were enrolled in this study, and divided into two groups in random.Thirty-three cases in the treatment group were treated with tamsulosin 0.2 mg once every night,3 days before the catheter was drawn.While 33 cases in the control group only with placebo.Catheter keeping days, residual urine volume at first extraction,the rate of urinary retention and urinary tract infection,hospitalization time and drug adverse reaction were compared in two groups.Results Catheter keeping days and hospitalization time were shorter in the treatment group than those in the control group(P< 0.05).The residual urine volume at first extraction was(38.2 ± 5.6) ml in the treatment group and (168.5 ± 11.8) ml in the control group,there was significant difference between two groups (P< 0.05).The rate of urinary retention was 18.2%(6/33) in the treatment group and 36.4%(12/33) in the control group,there was significant difference between two groups (P <0.05).There was no adverse reaction resulted from tamsulosin in the treatment group.Conclusion Tamsulosin is an effective drug which could prevent and treat the urinary retention after radical hysterectomy.

Objective To understand the disinfectant resistance of clinically isolated Escherichia coli (E.coli)and carriage of disinfectant resistance genes.Methods Disinfectant resistance gene sugE (c ),sugE (p ),qacEΔ1 ,and qacE of 82 isolates of E.coli were detected with polymerase chain reaction (PCR),minimal inhibitory concentra-tions (MICs)were measured with agar dilution methods.Results Among 82 E.coli isolates,positive rates of dis-infectant resistance gene sugE (c ),sugE (p ),qacEΔ1 ,qacE,sugE (c )+qacEΔ1 ,and qacE+qacEΔ1 +sugE (c ) were 84.15% (n=69),1 .22% (n=1),76.83% (n=63),73.17 % (n=60),68.29% (n=56),and 59.76% (n=49)respectively.There was no significant differences in carriage status of four disinfectant resistance genes be-tween extended-spectrumβ-lactamases (ESBLs)-producing and non-ESBLs-producing strains,as well as cefepime sensitive and resistant strains (all P >0.05);MIC values of benzalkonium chloride,cetylpyridinium chloride,am-monium bromide,and triclosan for 82 isolates of E.coli were all > standard stain;MIC values of chlorhexidine for 32 isolates of E.coli were all > standard stain,for 50 other E.coli strains were all ≤ standard strain.There were no significant difference in MIC values of benzalkonium chloride,cetylpyridinium chloride,ammonium bromide,and triclosan between ESBLs-and non-ESBLs-producing strains,as well as cefepime sensitive and resistant strains(all P >0.05);while MIC values of chlorhexidine showed a significant difference (both P <0.05).Conclusion Detection rates of disinfectant resistance gene qacE,qacEΔ1 ,and sugE(c)in E.coli from clinical specimens are high,MICs of disinfectants such as benzalkonium chloride for E.coli are generally higher than standard strain.

Objective To evaluate the efficacy and safety of CT-guided percutaneous argon-helium cryoablation in treating hepatic metastases from nasopharyngeal carcinoma. Methods The clinical data of 16 patients with hepatic metastases from nasopharyngeal carcinoma, who had received percutaneous argonhelium cryoablation therapy, were retrospectively analyzed. The quality of life before and after therapy, and the postoperative complications were recorded. After argon-helium cryoablation therapy, the progression-free survival (PFS), the overall survival (OS), and the one-month, 3-month, 6-month, 12-month postoperative tumor local control rates were calculated. Results In all 16 patients, no severe complications occurred and the quality of life was significantly improved after argon-helium cryoablation therapy. The one-month, 3-month, 6-month, 12-month postoperative tumor local control rates were 100％, 87.5％, 80.0％ and 58.3％respectively. The median PFS was 11 months (95％CI: 8.4-13.6 months), and the median survival time was19 months (95％CI: 9.2-28.8 months) . After argon-helium cryoablation therapy, the half-year, one-year and2-year survival rates were 93.8％, 75％ and 43.8％ respectively. Conclusion For the treatment of hepatic metastases from nasopharyngeal carcinoma, CT-guided percutaneous argon-helium cryoablation is minimally-invasive, safe and effective with reliable curative effect.

Objective To investigate the effect of prostaglandin E2 receptor 1 (EP1) on Adriamycin (ADR)-induced glomerular podocytes injury and its possible mechanism.Methods (1) In vivo experiments:6-8 weeks old male Balb/c mice were randomly divided into four groups:Control group;ADR group;EP1 agonist 17-phenyl PGE2+ADR group;EP1 antagonist SC-19220+ADR group.The mouse model of nephrotic syndrome was induced by injection of ADR (10 mg/kg) into tail vein,and then EP1 agonist (1 μg/g) and antagonist (25 μg/g) were administered respectively.Six weeks later,all mice were sacrificed and urine,blood and kidney tissues were collected.Detecting urine protein,blood chemistry,changes of renal pathology and podocyte-related proteins,electron microscopy changes of podocytes.(2) In vitro experiments:Podocytes were cultured in vitro and divided into different groups:Control group;ADR group (0.2 μmol/L);EP1 agonist (0.1,1,10 μmol/L)+ADR (0.2 μmol/L) group;antagonist (0.1,0.5,1 μmol/L)+ ADR (0.2 μmol/L) group.The proliferation of podocytes was measured by CCK-8.Expression of PGE2 in podocytes was detected by ELISA.Indirect immunofluorescence was used to determine the localization of podocyte-related proteins nephrin,podocin and CD2AP.Expression of nephrin,podocin,CD2AP,COX2 in podocytes was detected by Western blotting and Real-time quantitative PCR.p38 MAPK or phospho-p38 MAPK was measured by Western blotting as well.Flow cytometry was used to detect cell apoptosis.Results (1) In vivo experiments:Compared with control group,obvious proteinuria,blood biochemical changes and renal pathological changes were observed in ADR group,proteinuria,blood biochemical and renal pathological changes were more serious in mice dealt with agonist,while antagonist could reduce ADR-induced injury (all P ＜ 0.05).Results of immunohistochemistry showed that the expression of podocyterelated proteins nephrin,podocin and CD2AP in ADR group were significantly lower than those in control group,and EP1 agonist could further inhibit expression of these proteins,while antagonist could reverse this inhibitory effects (P ＜ 0.05).Electron microscopic results showed that mice in ADR group appeared foot enlargement and fusion,and the agonist group further aggravated the injury,while antagonist intervention could inhibit the injury of podocytes.(2) In vitro experiments:Compared with control group,expression of PGE2 and COX2 were increased;mRNA and protein expression of nephrin,podocin,CD2AP were decreased,p38 MAPK activity and podocytes apoptosis were increased in ADR group (P ＜ 0.05);Agonist could aggravate podocytes damage (P ＜ 0.05),while Antagonist could downregulate the expression of PGE2 and COX2,promote the expression of nephrin,podocin and CD2AP,and inhibit the activity of p38 MAPK and podocytes apoptosis (P ＜ 0.05).The addition of p38 MAPK inhibitor(10 μmol/L) could reduce the inhibitory effect of EP1 agonist on the expression of podocyterelated proteins nephrin,podocin and CD2AP (P ＜ 0.05).Conclusions EP1 receptor may activate the p38 MAPK signaling pathway to inhibit podocytes-related proteins nephrin,podocin and CD2AP,as well as mediate the ADR induced podocyte injury.Inhibition of EP1 receptor however have a protective effect.

[Abstact] Objective To analyze the related parameters of the treatment plans for the pancreatic cancer with the Cyber-knife system.Methods The clinical data of 129 patients with single-target pancreatic cancer for the first time who underwent CyberkKnife radiosurgery between January 2017 and December 2017 in Shanghai Changhai Hospital were retrospectively analyzed.The parameters were all selected from the MultiPlan @4.0.2 treatment planning system and the data were analyzed.Results The volume of the targets in 129 patients with pancreatic cancer was 3.355-238.936 cm3,with the average volume of 51.43 ± 55.64 cm3.Patients were averagely treated for 5 to 8 sessions,and the average prescription dose was 6 Gy × 6 fraction,which equaled to 58 Gy in the biological equivalent dose (BED).The collimators with 20 mm and 15 mm accounted for up to 31％ and 27％,respectively,which were the top 2 options.The finally designed the conformal index(CI),new conformal index(nCI),and the homogeneity index were 1.14 ± 0.09,1.29 ± 0.09 and 1.42 ± 0.04,respectively.The coverages of tumor target was 80.3％-95.6％,with the average of 90.0 ± 4.6％.The treatment nodes,beams and Mus are 79,180 and 7 060 in average.The estimated treatment time was 42 ± 8 minutes.The organs at risk can be protected very well.Conclusions Reasonable Cyber-knife treatment plan can guarantee that stereotactic body radiation therapy can effectively treat Pancreatic Cancer.

Background The development of railways has a long history, but there is limited research on the health of railway workers at home and abroad. China's high-speed railway development has attracted worldwide attention in recent years, and it is of great significance to study how to promote the health of this occupational population to ensure the safety of railway transportation. Objective To identify development trends and hotspots in the field of railway workers' health at home and abroad. Methods The research literature related to the health of railroad workers dated from January 1, 1973 to December 31, 2022 was searched using the China Knowledge Network Infrastructure (CNKI) and Web of Science Core Collection (WoS) databases. After screening and cleaning, the included literature was subjected to bibliometric analysis by applying CiteSpace 6.1R6 software to visualize and analyze literature co-citation, keyword emergence, and keyword timeline graphs, and by VOSviewer 1.6.19 to visualize and analyze country/region collaboration, keyword co-occurrence, and keyword clustering. Results During the period from 1973 until 2022, a total of 273 Chinese literature and 165 English literature were found to report studies related to the health of railway workers. The Chinese literature began to grow rapidly in 2009 and peaked in 2015, and the number of English literature published in a relatively flat state over the studied period. The country with the most papers indexed by Science Citation Index (SCI) was the United States (58 papers), which also presented the richest international collaborations. The document with the highest domestic citation frequency was published in the Chinese Journal of Mental Health in 1994, and the document with the highest SCI citation frequency was published in the American Journal of Epidemiology in 1994. The keyword co-occurrence analysis showed that the included Chinese literature mainly focused on health checkups, health management, hypertension, mental health, and chronic diseases and their prevalence; the included English literature focused on mortality, lung cancer, epidemiology, and diesel engine exhaust and its exposure. The analysis of emergent words showed that health management, frontline workers, and occupational stress were the topics of interest in Chinese literature in the last five years, while occupational stress, diesel exhaust emissions, and noise exposure were the topics of interest in English literature in the last ten years. The results of the timeline graph analysis suggested that the recent research directions in Chinese literature were health intervention, humanistic care, staff canteens, etc. There were few English-language articles related to this area after 2010. Conclusion The research hotspots of railroad practitioners' health will keep changing with the development of high-speed railways in countries around the world. The outstanding rise of Chinese literature issued in the last decade has been in striking contrast to the slow progress and decreasing of English literature. The Chinese literature has gradually expanded the hotspots from chronic diseases to health management, occupational stress, and sleep disorders.

Background Occupational stress is an important factor affecting the health of working population, wellness is a topic that has received much attention in recent years, and sleep quality and wellness have a certain impact on occupational stress. Objective To understand the current situation of occupational stress among locomotive engineers in in the Yangtze River Delta, explore the influence of well-being and sleep quality on occupational stress, and provide a theoretical basis for occupational stress intervention among locomotive engineers. Methods Sampling was conducted from October to December 2022 using stratified random sampling. The Chinese version of the Brief Occupational Tension Questionnaire based on the Job Demand-Control Model (JDC model), the World Health Organization 5-item Well-Being Index (WHO-5), and the Pittsburgh Sleep Quality Index (PSQI) scale were used to investigate the occupational stress, well-being, and sleep quality of locomotive engineers. Logistic regression was used to analyze the effects of sleep quality and well-being on occupational stress, and additive and multiplicative interaction models were applied to evaluate the interactive effects of well-being and sleep quality on occupational stress. Results A total of 8243 questionnaires were collected from five locomotive companies, and after excluding unqualified questionnaires, a total of 7976 questionnaires were included in the analysis. The number of locomotive engineers in the Yangtze River Delta reporting positive occupational stress was 4633 (58.09%), the number of low-level well-being was 4949 (62.05%), and the number of poor sleep quality was 4129 (51.77%). The distribution of occupational stress varied by age, length of service, region, technical level, nature of vehicle, education, per capita monthly family income, marital status, smoking, drinking, number of exercise sessions per week, quality of sleep, work shifts, and length of commute (P<0.01). The results of logistic regression showed that a lower level of occupational stress was associated with >11000 yuan per capita monthly household income (OR=0.795, 95%CI: 0.656, 0.964), high level of well-being (OR=0.477, 95%CI: 0.430, 0.528), and good sleep quality (OR=0.588, 95%CI: 0.531, 0.651); a higher level of occupational stress was associated with night shifts: 1 or fewer night shifts (OR=1.707, 95%CI: 1.312, 2.221), 2 to 3 night shifts (OR=2.649, 95%CI: 2.111, 3.325), and 4 or more night shifts (OR=2.804, 95%CI: 2.202, 3.571); a higher level of occupational stress was associated with 60 min or more commuting time (OR=1.353, 95%CI: 1.111, 1.646). Regarding interaction between poor sleep quality and low well-being on occupational stress, the relative excess risk ratio (RERI), attributable risk index (API), and synergy index (SI) were 1.451 (1.059, 1.844), 0.417 (0.327, 0.507), and 2.407 (1.787, 3.241), respectively, and the result of the multiplicative interaction was an OR of 1.546 (95%CI: 1.262, 1.893). Conclusion The prevalence of occupational stress among locomotive engineers in the Yangtze River Delta region is generally at a medium level compared with other industries. Good sleep quality reduces the risk of occupational stress to a greater extent than high well-being, and poor sleep quality and low well-being can interact and further increase the risk of occupational stress.

Objective : To construct a cell-free DNA ( cfDNA) methylation model for early screening in male pa- tients with gastric cancer by using novel cfDNA methylation detection technology． Methods : Methylation informa- tion of the whole genome of gastric cancer patients were detected by cell-free methylated DNA immunoprecipitation and highthroughput sequencing ( cfMeDIP-seq ) technology and locate gastrogenic cfDNA． Then bioinformation methods were used to extract specific methylation labels which could distinguish GC patients and establish diagnosis model by random forest algorithm. Related validation clinical researches were also conducted. Results : 63 most sig- nificant DMR were selected to construct the cfDNA methylation model based on GC samples and normal control samples，the goal sensitivity was above 85 percent while the goal specificity was above 95% ．The sensitivity and specificity of the validation set were 98. 7% and 99. 0% while the area under curve(AUC) was 0. 999． Conclusion The cfDNA methylation model constructed in this study has good performance in predicting GC.