Objective To analyze the effects of three sterilization methods,namely,pressure steam,low-temperature plasma and ethylene oxide,on the magnetic flux of magnetic surgical devices and their sterilization costs.Methods A total of 234 magnetic surgical devices of different specifications and models(magnetic rings)were randomly divided into Group A,Group B and Group C after the paired number was labelled,and each group consisted of 78 pieces(39 pairs).After packaging each pair of devices according to sterilization specifications,Group A was sterilized by pressure steam,Group B was sterilized by low-temperature plasma,and Group C was sterilized by ethylene oxide.We measured the magnetic flux of three sets of magnetic rings before and after sterilization,and comparatively analyzed the sterilization cost and sterilization time of the single package.Results There was no statistically significant difference in the impact of the three sterilization methods on the magnetic flux of the magnetic surgical devices(P＞0.05),but there was a significant difference in the magnetic flux before and after sterilization for each sterilization method(P＜0.001);the sterilization cost was(1.96±0.16)yuan for Group A,(23.17±0.32)yuan for Group B,and(8.16±0.18)yuan for Group C,showing statistically significant differences among the three groups(P＜0.01).The sterilization time was(65.21±3.36)min for Group A,(45.46±1.39)min for Group B,and(1020.38±12.21)min for Group C,with statistically significant differences among the three groups(P＜0.01).Conclusion None of the three sterilization methods affects the magnetic flux of the magnetic surgical devices.Pressure steam method shows the lowest cost of single package,low-temperature plasma method shows the highest cost of single package,while ethylene oxide method shows the highest sterilization time.Pressure steam should be the preferred sterilization method for magnetic surgical devices.

With the development of clinical related disciplines, the update and establishment of relevant standards/guidelines at home and abroad, GBZ 185-2006 Diagnostic Criteria for Occupational Medicamentose-like Dermatitis due to Trichloroethylene (hereinafter referred to as “GBZ 185-2006”) was unable to meet clinical needs. Therefore, the GBZ 185-2006 was revised based on the principles of evidence-based medicine, in accordance with relevant laws/regulations and relevant standards/guidelines in combination with review of research data on occupational medicamentose-like dermatitis due to trichloroethylene (OMDT) home and abroad, and the development of clinical practice and clinical related disciplines. The main modifications include: adding terms and definitions of OMDT, modifying the description of clinical manifestations of the diagnostic principles, adjusting the description of latency, deleting the diagnostic requirement of the incidence probability, adding the specific allergen patch test as the etiological diagnostic index, standardizing the application scope, operating procedure and precautions of the specific allergen patch test. In addition, the relevant content of “Basic Characteristics and Clinical Types of Skin Damage of Medicamentose-like Dermatitis due to Trichloroethylene” in Appendix A is improved, the treatment principles are revised, and the content of new progress in treatment, artificial liver application, are added. The revised GBZ 185-2024 Diagnostic Standard for Occupational Medicamentose-like Dermatitis due to Trichloroethylene is more scientific and practical, and can provide technical basis for the standardized diagnosis and treatment of OMDT in medical and health institutions.

Objective:To analyze the eye lens dose and annual effective dose to interventional radiation workers in some hospitals of Xinxiang city from 2020 to 2022, and to ascertain the dose to interventional radiation workers.Methods:By using TLDs, the eye lens dose Hp(3) and annual effective dose Hp(10) were monitored for three consecutive years in six hospitals in Xinxiang city. The lens doses and annual effective doses to intervention radiation workers in different years in different-level hospitals and departments were analyzed. Results:From 2020 to 2022, a total of 117 people were monitored. The left eye lens dose range was 0.12-164.24 mSv, and the right eye lens dose range was 0.07-51.64 mSv. The average annual dose was 8.56 mSv for left eye lens and 4.49 mSv for right eye lens The average annual dose distribution in the MDL-5 mSv range for the left and right eye lens was 60.68% and 73.50%, respectively. 9.41% (11 people) of the left eye lens doses exceeded 20 mSv. The annual effective doses range was 0.11-31.27 mSv, with average annual dose of 2.56 mSv. The proportion of average annual effective doses mainly distributed in the range of MDL to 1.25 mSv was 52.14%, with 2.56% annual effective dose exceeding 20 mSv. There was no significant difference in left and right eye lens dose and annual effective dose between the tertiary hospitals and the secondary hospitals in three years ( P>0.05). Compared with different departments, the cumulative per capita dose in three years was statistically significant (left eye H=11.42, right eye H=13.72, annual effective dose H=25.94, P<0.05). The lens dose and annual effective dose in neurology department were lower than those in cardiology department and comprehensive intervention department ( Zcardiology department=-3.33, -3.78, -4.83, P<0.05; Zcomprehensive intervention department=-2.71, -2.63, -4.39, P<0.05). Conclusions:Most of the annual equivalent dose and annual effective dose to eye lens of the interventional radiation workers in Xinxiang city meet the national limits, but some of them have higher doses and exceed the national limits. It is suggested that the routine and continuous monitoring of eye lens doses to interventional radiologists should be strengthened while routine monitoring of annual effective dose, and attention should be paid to the eye lens and annual effective dose to interventional radiologists in secondary hospitals to improve the awareness of protection.

Rheumatoid arthritis (RA) is an autoimmune disease with a complex etiology. Monocyte-derived macrophages (MDMs) infiltration are associated with RA severity. We have reported the deletion of G-protein-coupled receptor kinase 2 (GRK2) reprograms macrophages toward an anti-inflammatory phenotype by recovering G-protein-coupled receptor signaling. However, as more GRK2-interacting proteins were discovered, the GRK2 interactome mechanisms in RA have been understudied. Thus, in the collagen-induced arthritis mouse model, we performed genetic GRK2 deletion using GRK2^f/fLyz2-Cre^+/- mice. Synovial inflammation and M1 polarization were improved in GRK2^f/fLyz2-Cre^+/- mice. Supporting experiments with RNA-seq and dual-luciferase reporter assays identified peroxisome proliferator-activated receptor γ (PPARγ) as a new GRK2-interacting protein. We further confirmed that fms-related tyrosine kinase 1 (Flt-1), which promoted macrophage migration to induce angiogenesis, was inhibited by GRK2-PPARγ signaling. Mechanistically, excess GRK2 membrane recruitment in CIA MDMs reduced the activation of PPARγ ligand-binding domain and enhanced Flt-1 transcription. Furthermore, the treatment of mice with GRK2 activity inhibitor resulted in significantly diminished CIA pathology, Flt-1⁺ macrophages induced-synovial inflammation, and angiogenesis. Altogether, we anticipate to facilitate the elucidation of previously unappreciated details of GRK2-specific intracellular signaling. Targeting GRK2 activity is a viable strategy to inhibit MDMs infiltration, affording a distinct way to control joint inflammation and angiogenesis of RA.

Objective To investigate the effects of laparoscopic radiofrequency ablation(LRFA)and percutaneous radiofrequency ablation(PRFA)on anti-tumor immunity,complication rate and recurrence rate in patients with primary liver cancer.Methods A total of 81 patients with primary liver cancer treated in Dazhou Central Hospital from January 2020 to August 2022 were selected and divided into observation group(LRFA,n=42)and control group(PRFA,n=39)according to the treatment plan.Compare the total ablation rate,postoperative complication rate,recurrence rate of the two groups,as well as tumor necrosis factor-α(TNF-α),carbohydrate antigen 199(CA199),interleukin-6(IL-6),Golgi protein 73(GP73),C-reactive protein(CRP),alpha-fetoprotein(AFP)and peripheral blood T lymphocyte subpopulation levels before and after surgery.Results There was no significant difference between the observation group(95.24％)and the control group(92.31％)(P＞0.05).At 1 d postoperatively,IL-6 was(124.63±45.41)pg/ml and(168.28±51.26)pg/ml,CRP was(19.14±5.03)ng/L and(28.26±7.47)ng/L,and TNF-α was(94.32±18.49)pg/ml and(108.41±20.11)pg/ml;at 3 d postoperatively,IL-6 was(92.37±24.11)pg/ml and(105.83±27.45)pg/ml in the observation group and the control group,respectively,CRP was(14.87±4.37)ng/L and(17.25±5.06)ng/L,and TNF-α was(75.41±12.10)pg/ml and(82.64±16.83)pg/ml,which were all higher than that of preoperative period(P＜0.05).At 7 d postoperatively,CD3+in the observation group and control group were(66.27±7.82)％and(65.14±7.63)％,AFP was(156.23±30.27)μg/mland(160.84±32.33)μg/ml,GP73 was(65.21±10.26)μg/L and(67.44±11.03)μg/L,CA199 was(44.89±11.41)U/L and(45.12±13.07)U/L,CD4 was(32.02±6.03)％and(31.53±6.11)％,and CD4+/CD8+was(1.31±0.39)and(1.29±0.37)respectively;at 14 d postoperatively,CD3+was(71.25±6.83)％and(70.89±6.76)％,AFP was(48.52±18.31)μg/ml and(50.11±19.12)μg/ml,GP73 was(48.25±8.46)μg/L and(49.12±10.12)μg/L,CA199 was(19.27±5.16)U/L and(20.07±5.39)U/L,and CD4 was(38.25±7.7)U/L and(20.07±5.39)U/L,respectively,in the observation and control groups.g/L,CA199 was(19.27±5.16)U/L and(20.07±5.39)U/L,CD4 was(38.25±7.45)％and(37.61±7.92)％,and CD4+/CD8+was(1.49±0.42)and(1.47±0.45),respectively,which were higher than that of preoperative period(P＜0.05),but the difference between the two groups was not statistically significant(P＞0.05).The postoperative complication rate of 42.86％and recurrence rate of 2.38％in the observation group were lower than 66.67％and 17.95％in the control group(P＜0.05).The 12-month postoperative survival rate of 97.62％in the observation group was not statistically significant compared with 94.87％in the control group(P＞0.05).Conclusion The efficacy of LRFA and PRFA in the treatment of primary hepatocellular carcinoma is comparable,which can effectively improve the body's anti-tumor immunity and reduce the release of serum tumor markers;however,LRFA has less stressful reaction,reduces the occurrence of postoperative complications,and has a lower recurrence rate,which is especially advantageous in the treatment of hepatocellular carcinoma at special sites.

Objective To explore the clinical values of voxel-based morphometry(VBM)analysis in magnetic resonance imaging(MRI)for detecting secondary damage to the distant thalamus and substantia nigra in patients with cerebral infarction.Methods A total of nineteen patients with first-time unilateral middle cerebral artery(MCA)ischemic stroke were prospectively recruited.Three-dimensional whole-brain MRI scans were performed at 1 week,1 month,and 3 months after onset.VBM analysis was used to analyze changes in the thalamus and substantia nigra volumes.Results VBM analysis revealed that compared to ipsilateral thalamic volume at 1 week after onset,ipsilateral thalamic volume was significantly reduced at 1 month or 3 months after onset(reduced by 637 mm3 and 1488 mm3,respectively;P<0.01),with the atrophy primarily located in the dorsomedial nucleus of the thalamus.Similarly,compared to ipsilateral substantia nigra volume at 1 week after onset,the ipsilateral substantia nigra volume was significantly reduced at 1 month or 3 months after onset(reduced by 64 mm3 and 76 mm3,respectively;P<0.05).Conclusions VBM technology can be used to evaluate the ipsilateral thalamic and substantia nigra volume reduction in patients with cerebral infarction in the MCA supply area at 1-3 months after stroke,and to detect secondary damage.

Objective:This stndy aims to analyze the influence of ChatGPT on medical research and give suggestions on GhatGPT.Methods:This paper expounded the background of ChatGPT, analyze the connection between ChatGPT and medical research management, application and threats of ChatGPT , and gave suggestions to avoid GhatGPT′s damage.Results:Technology will promote the evolution of medical research management. It is recommended to strengthen the supervision of the ChatGPT and research integrity education.Conclusions:It is urgent to establish a scientific management mechanism to take usage the advantages of GhatGPT.

Objective:The effect of serum thyrotropin receptor antibody (TRAb) on permanent hypothyroidism (HT) after 131I treatment in Graves disease patients and its predictive value Methods:479 Graves' disease patients who underwent 131I treatment at the Nuclear Medicine Department of North China University of Technology Affiliated Hospital from October 2013 to October 2021 were selected. Among them, 350 cases (permanent HT group) had permanent HT during follow-up, while 129 cases (non permanent HT group) did not. Collect general clinical data such as gender, age, degree of thyroid enlargement, as well as indicators such as iodine intake rate, thyroid function, and treatment dose 24 hours before treatment, from two groups of patients. Compare the general clinical data and pre treatment levels of various detection indicators between two groups of patients, analyze the risk factors for permanent HT in Graves disease patients after 131I treatment, and evaluate the predictive value of pre treatment serum TRAb levels, and evaluate the consistency between the predicted results and clinical diagnosis. The econometric data with a normal distribution is represented by xˉ± s, and two independent sample t-tests are used for comparison between the two groups; The econometric data that do not conform to the normal distribution are represented by M（ Q1， Q3）, and the Wilcoxon rank sum test is used for comparison between the two groups; The counting data is represented as an example (%), and the comparison between the two groups is conducted using the four grid χ 2 test, while the comparison of grade data is conducted using the Willcoxon rank sum test; The logistic regression model was used for multivariate analysis. Draw a subject work characteristic curve to evaluate the predictive efficacy of TRAb, and screen the predictive threshold based on the Chayoden index; Calculate sensitivity and specificity, and evaluate the consistency between the predicted results and clinical diagnosis by calculating Kappa values. Results:There were no statistically significant differences in gender, age, degree of thyroid enlargement, 24-hour iodine uptake rate, serum thyroid stimulating hormone, free triiodothyronine, free thyroxine levels, and 131I treatment dose between the permanent HT group and the non permanent HT group (all P>0.05); The pre treatment TRAb levels in the permanent HT group were higher than those in the non permanent HT group [14.51(4.95,33.58) U/L vs 3.40(1.67,16.5) U/L], with a statistically significant difference ( Z=5.87, P<0.001). The results of multivariate logistic regression analysis showed that pre treatment TRAb levels were a risk factor for permanent HT in Graves' disease patients after 131I treatment (odds ratio=1.042,95% confidence interval: 1.025-1.059, P<0.001). The area under the working characteristic curve for predicting permanent HT in Graves' disease patients after 131I treatment with pre-treatment TRAb levels is 0.674 (95% confidence interval: 0.616~0.732), and the optimal critical value is 7.025 U/L. Using TRAb>7.025 U/L before treatment as the standard for predicting postoperative permanent HT in patients, the sensitivity and specificity were 73.7% and 75.2%, respectively. The predicted results showed moderate consistency with clinical diagnosis ( Kappa=0.426). Conclusions:The pre treatment TRAb level is a risk factor for permanent HT in Graves disease patients after 131I treatment ( P<0.001), and the diagnostic efficacy of permanent HT is best when TRAb>7.025 U/L.

Perinatal loss is one of the most serious childbirth trauma,which seriously affects maternal physical and mental health.At present,the management strategy of maternal lactation can be divided into two aspects:milk return and milk donation.Breast milk donation may build new values of perinatal loss,which can promote maternal physical and mental recovery.This article reviewed the conception,status,motivations,facilitators,barriers and interventions of lactation management in women following perinatal loss,so as to provide bases for improving the awareness of obstetric nursing staff,quality of obstetric care and future research on lactation management in women following perinatal loss in China.