Objective To investigate the effect of β-lactam antibiotics on the false positive rate of the serum Aspergillus galactomannan (GM) assay in patients with lung diseases.Methods We selectively recruited 77 lung disease patients who did not meet the diagnostic criteria of invasive pulmonary Aspergillosis (IPA) and received different β-lactam antibiotics,while 41 patients without IPA who did not receive any antibiotic treatment were recruited as the control group.Serum samples for GM detection were collected from all participants.The rate of false-positive Aspergillus galactomannan was compared between the two groups.Results False-positive serum results were found in patients who received piperacillin-tazobactam (30.8％ or 8/26) and cefoperazone sulbactamand (27.8％ or 5/18).The rate of false-positive Aspergillus galactomannan in patients who receive β-lactam antibiotics were significantly higher than that in the control group (24.7％ or 19/77vs.7.3％ or 3/41,x2 =5.315,P=0.025).Taking false-positive serum Aspergillus galactomannan as the dependent variable and β-lactam antibiotic treatment as the independent variable,univariate logistic regression analysis showed that the rate of false-positive Aspergillus galactomannan in patients who received β-lactam antibiotics were 4.149 times more than that in the control group (OR=4.149,P=0.030).Conclusions The administration of β-lactam antibiotics may increase the occurrence of false-positive serum Aspergillus galactomannan,and physicians should be aware of this possible interference.

Objective To investigate the effect of neuropeptide Y (NPY) on the osteoblastic differentiation of murine MC3T3-E1 cells and its mechanism related to the Wnt signaling pathway.Methods The murine MC3T3-E1 cells were divided into 4 groups according to the stimulators added:phosphate buffered saline (PBS) (control) and different concentrations of NPY (10-8 mol/L,10-10 mol/L and 10-12 mol/L).The cellular proliferation was detected with MTT assay after 1,3,5,7 and 9 days.The cells were identified with cell immunochemistry and Western Blot to find out the most effective concentration of NPY at different time points under osteoblastic condition.The cells were then divided into 4 groups:PBS,NPY,NPY + NPY receptor antagonist,and NPY + DKK1.Western blot was used to determine the expression of β3-catenin and p-GSK-3β in each group.Nuclear signaling activity of β3-catenin was observed using immunofluorescence staining.Results NPY significantly improved the proliferation of MC3T3-E1 cells at 7 and 9 days (P ＜0.05).NPY (10s mol/L and 10-10 mol/L) groups and NPY (10-10 mol/L and 10-12 mol/L) groups significantly improved the ALP activity at 4 and 14 days respectively (P ＜ 0.05).At 4 days,the expression of ALP protein was significantly decreased in the NPY + DKK1 group and the NPY + NPY receptor antagonist group compared with that in the NPY group (P ＜ 0.05).Although the expression levels of [β-catenin and p-GSK-3β protein were uninfluenced in either case,NPY significantly stimulated the nuclear signaling activity of β3-catenin.Conclusions NPY may significantly increase the expression of ALP protein in MC3T3-E1 ceils during osteoblastic differentiation.This effect might be mediated through the canonical Wnt signaling pathway.

Objective:To investigate the effect of modified Miccoli surgery in the treatment of patients with benign thyroid disease and its intervention on the postoperative aesthetic degree of scar score and the expression of pain factors.Methods:The clinical data of 114 patients with benign thyroid diseases in Hankou Hospital from February 2018 to February 2020 were collected, 57 cases with traditional open thyroid surgery were enrolled in the open group, and 57 cases with modified Miccoli surgery were enrolled in the modified group. The surgery related indicators, postoperative recovery indicators, complications and preoperative, postoperative 1, 3 d serum pain factors substance P (SP), β-endorphin (β-EP), dynorphin ( DYN), immune function indexes CD 3+, CD 4+, CD 8+, parathyroid function related indexes parathyrotropic hormone(PTH), blood calcium, 3 months and 6 months after surgery of observer scar evaluation scale (OSAS), Vancouver scar scale (VSS) scores were compared between the two groups. Results:The length of incision, recovery time of neck movement, and hospital stay and the intraoperative blood loss were lower than those in the open group: (2.2 ± 0.4) cm vs. (6.5 ± 0.7) cm, (19.6 ± 4.8) h vs. (28.2 ± 7.8) h, (4.8 ± 1.4) d vs. (7.1 ± 1.8) d, (21.9 ± 5.1) ml vs. (39.5 ± 7.0) ml, the differences were statistically significant ( P<0.05). The levels of serum SP, β-EP and DYN in the modified group were lower than those in the open group at 1 and 3 d after operation: 1 d after surgery:(87.40 ± 12.25) ng/L vs. (114.96 ± 15.79) ng/L, (149.34 ± 21.49) ng/L vs.(192.15 ± 26.43) ng/L, (1.14 ± 0.21) mg/L vs. (1.59 ± 0.30) mg/L; 3 d after surgery: (80.18 ± 10.79) ng/L vs.(96.24 ± 12.36) ng/L, (137.46 ± 18.57) ng/L vs. (168.24 ± 21.50) ng/L, (0.94 ± 0.16) mg/L vs. (1.27 ± 0.25) mg/L, the differences were statistically significant ( P<0.05). The levels of CD 3+ and CD 4+ in the modified group were higher than those in the open group at 1 and 3 d after the operation, and the CD8+ level was lower than that of the open group: 1 d after surgery: 0.597 ± 0.053 vs. 0.542 ± 0.049, 0.382 ± 0.041 vs. 0.362 ± 0.036, 0.308 ± 0.048 vs. 0.332 ± 0.060; 3 d after surgery: 0.615 ± 0.060 vs. 0.580 ± 0.055, 0.408 ± 0.051 vs. 0.385 ± 0.046, 0.290 ± 0.038 vs. 0.317 ± 0.045, and the differences were statistically significant ( P<0.05). The levels of serum PTH and blood calcium in the modified group were higher than those in the open group at 1 and 3 d after operation: 1 d after surgery: (29.12 ± 6.58) ng/L vs. (20.67 ± 5.14) ng/L, (1.86 ± 0.22) mmol/L vs. (1.59 ± 0.10) mmol/L; 3 d after surgery: (36.39 ± 7.65) ng/L vs. (24.08 ± 5.97) ng/L, (2.03 ± 0.18) mmol/L vs. (1.72 ± 0.14) mmol/L, the differences were statistically significant ( P<0.05). The OSAS and VSS scores of the modified group were lower than those of the open group at 3 and 6 months after surgery: 3 months after surgery: (15.9 ± 3.3) scores vs. (24.7 ± 6.9) scores, (4.4 ± 1.5) scores vs. (8.1 ± 3.2) scores; 6 months after surgery: (10.3 ± 2.7) scores vs. (17.1 ± 5.4) scores, (3.3 ± 1.2) scores vs. (6.9 ± 2.4) scores, the differences were statistically significant ( P<0.05). The incidence of postoperative complications in the modified group was lower than that in the open group: 3.51%(2/57) vs. 15.79%(9/57), the difference was statistically significant ( P<0.05). Conclusions:The application of modified Miccoli surgery in patients with benign thyroid diseases can reduce the length of the incision, reduce the impact on postoperative pain stress, immune function, and parathyroid function, speed up the process of postoperative recovery, improve the appearance of postoperative aesthetic degree of scar, and reduce the risk of complications.

Objective To evaluate the method and clinical efficacy of utilizing ilioinguinal chimeric perforator bone flap to repair bone and soft tissue defects of limb.Methods From May,2004 to February,2018,there were 11 patients who were diagnosed as bone and soft tissue defect in the upper or lower extremities,7 of which were repaired by chimeric perforator bone flap with the superficial circumflex iliac artery and 4 of which were repaired by chimeric perforator bone flap with the deep circumflex iliac artery.The size of bone flap ranged from 2.5 cm×2.0 cm× 2.0 cm to 6.0 cm×3.0 cm×2.0 cm,and the flap sizes ranged from 5.0 cm×3.0 cm to 17.0 cm×13.0 cm.The donor sites of the flap were directly sutured.Nine patients were implemented by postoperative followed-up visit in hospital.And the appearance,texture,color,shallow sensation of flaps,fracture healing,limb's function and donor site were observed.Results Postoperative followed-up ranged from 3 to 18 months.All flaps survived.The flaps had satisfactory appearance,texture and color.Osseous tissue of defects healed.The function of injury limb was restored well,which metacarpo-phalangeal joint and carpometacarpal joint's movement with metacarpal defect recovered,and gait were normal without pain.As for the donor sites,1 case had hyperplastic scar while the other only had linear scars.Abdominal hernia and numbness with lower extremities were disappeared.Conclusion Ilioinguinal chimeric perforator bone flap can be designed with different pedicles based iliac bone flap according to the size of bone defects.The donor site is concealed with less trauma and less healing time.The operation position is easy to operate,and clinic efficacy is satisfactory.

Objective:To summarise the effect of free perforator flap of radial collateral artery on reconstruction of first web contracture after hand injury.Methods:Retrospective analysis was conducted based on the clinical data of patients with first web contracture after hand injury in the Department of Hand and Foot Surgery and Rehabilitation, Guangdong Work Injury Rehabilitation Hospital from November 2019 to June 2022. Ten patients, 8 males and 2 females aged between 27 and 51 years old with an average of 40.5 years old were included. There were 6 left hands and 4 right hands. Width and the included angle of first web were measured before surgery. Four hands were classified as severe first web contracture, and the rest of 6 hands had moderate first web contracture. After release scars of the first web, the areas of wound were 5.5 cm × 2.0 cm - 10.5 cm × 3.0 cm. The flaps sized were 6.0 cm×2.5 cm - 11.0 cm × 3.5 cm. All of flaps carried the posterior cutaneous nerve of forearm. Donor sites were closed directly. All patients were included in postoperative follow-up regularly through outpatient clinic or via WeChat reviews. The colour, texture, process in change of the transferred flaps, donor and recipient sites healing and complications were observed.Results:All 10 flaps survived and the wound healed by first intention. The patients received 7 to 15 months (10.5 months in average) of postoperative follow-up. The flaps were not bulky, texture and colour were satisfactory and without pigmentation. Protective sensations restored in 6 patients. At the last follow-up, average included angle of the first webs was 47.14°±1.68°, in comparison with 35.43°±3.60° before surgery. The average width of first webs was 5.34 cm±0.52 cm, in comparison with 3.17 cm±0.75 cm before surgery, the differences were statistically significant ( P<0.01). Eight hands were rated excellent, and 2 were good. There were only linear scars left at the donor sites, without sign of radial nerve injury. Conclusion:The free perforator flap of radial collateral artery is a safe and effective method for repair of first web contracture after hand injury.

The biological role of N 6-methyladenine (m 6A) methylation modification has been gradually identified, and it has shown increasing value in tumor. In recent years, with the accumulated explore of epigenetics in RNA modification, many studies have reported that m 6A methylation modification contributes to development and progression of lung cancer. m 6A-related modified regulator has potential application value as a clinical target for diagnosis and treatment of lung cancer.

Objective     To identify the potential factors for psychological burdens and to better understand how the patients’ psychological status affect their treatment preferences. Methods     A questionnaire survey was conducted among 996 patients with pulmonary nodules who visited the Thoracic Surgery Clinic of Guangdong Provincial People's Hospital from January to November 2021, including 381 males and 615 females, aged 47.26±11.53 years. A self-administrated questionnaire was used to investigate the sociodemographic and clinical characteristics of the patients, and the Hospital Anxiety and Depression Scale (HADS) was used to evaluate the psychological status of the patients, with a score>7 points of each subscale indicating potential anxiety or depression. Results     Among the 996 patients with pulmonary nodules, the incidence of anxiety was 42.4% and the incidence of depression was 26.4%, while the incidence of both anxiety and depression was 24.7%. There was a significant correlation between anxiety and depression (ρ=0.834, P<0.05). Age, purpose of CT examination, number of pulmonary nodules and symptoms were independent factors for anxiety, while symptoms and number of pulmonary nodules were independent factors for depression (P<0.05). For treatment preferences, there was a statistical difference in educational level, symptoms, nodule size and anxiety level (P<0.05). Conclusion     Anxiety and depression are common in patients with pulmonary nodules. Symptoms are associated with anxiety and depression, which also make an impact on treatment preferences.

Objective    To explore the distribution pattern of respiratory symptoms and relevant factors in patients with pulmonary nodules. Methods    Demographic and clinical information were collected from patients who visited the Thoracic Surgery Outpatient Clinic of Guangdong Provincial People’s Hospital from January 2021 to January 2022. Hospital Anxiety and Depression Scale (HADS) was used to assess their anxiety and depression level. Results    A total of 1 173 patients were enrolled, including 449 males and 724 females, with an average age of 46.94±11.43 years. Among the patients with pulmonary nodules, 37.7% of them had at least one respiratory symptom; 24.4% had cough, 14.0% had expectoration, 1.3% had hemoptysis and 14.9% had chest pain. Old age, male, exposure to second-hand smoking or environmental smoke, hair coloring and history of tuberculosis were major risk factors for respiratory symptoms (P<0.05). Middle age, old age, male, exposure to environmental smoke were major risk factors for cough (P<0.05); old age, smoking, larger maximum nodules diameters, exposure to environmental smoke and history of pneumonia were major risk factors for expectoration (P<0.05); male, multiple nodules, hair coloring, exposure to second-hand smoking and history of tuberculosis were major risk factors for chest pain (P<0.05). Symptomatic patients showed generally higher HADS scores than asymptomatic patients (P<0.001). Conclusion    Cough, expectoration and chest pain are the predominant respiratory symptoms for patients with pulmonary nodules. The presentation of respiratory symptoms increases patients' anxiety and depression.

OBJECTIVE: To evaluate the exposure status of hand-transmitted vibration(HTV)in golf ball head grinding workers.METHODS: The golf ball head grinding positions in a sports equipment factory were selected as the research subjects by the judgement sampling method.The HTV exposure level of the workers in 66 grinding positions was measured,the key control points for HTV hazards were identified,and the damage of HTV was classified.RESULTS: The median(M)of 4 hours energy equivalent frequency-weighted acceleration to vibration[a_(hw(4))]of grinding positions in this sports equipment factory was 4.21 m/s~2,and the a_(hw(4)) over standard rate was 50.0%(33/66).The a_(hw(4)) of rough grinding positions was higher than that of fine grinding positions(M:5.50 v.s 3.94 m/s~2,P<0.05).In both rough grinding positions and fine grinding positions,the a_(hw(4)) of different ball head grinding types from high to low were hollow titanium alloy ball heads, hollow stainless steel ball heads,and solid stainless steel ball heads(rough grinding positions M:7.41 vs4.43 vs 3.11 m/s~2,P<0.01; fine grinding p ositions M:5.24 vs 4.21 vs 2.93 m/s~2,P<0.01).For the hollow titanium alloy ball head grinding positions,the a_(hw(4)) of rough grinding was higher than that of fine grinding(M:7.47 vs 5.24 m/s~2,P<0.01).Rough grinding positions,especially hollow stainless steel ball heads and hollow titanium alloy ball head grinding positions were key control points for HTV hazards.In the 66 grinding positions,the HTV hazards were classified as grade 0,Ⅰ,Ⅱ,and Ⅲ in the grinding positions accounted for 3.0%,47.0%,40.9%,and 9.1%,respectively,and those with grade Ⅱ and above were 50.0%(33/66). CONCLUSION: The exposure level of HTV in golf ball head grinding workers is high,with a trend of exceeding the standard.The golf ball head grinding workers have a high occupational health risk.

OBJECTIVE: To analyze the characteristic change of fingertip vibrotactile perception threshold(VPT) at two different frequencies among mine drilling workers. METHODS: A total of 48 mine drilling workers exposed to hand-transmitted vibration for at least 1.0 year were selected from mines in Hubei Province as the vibration exposure group by using the random number table method, and workers without hand-transmitted vibration exposure were selected as the control group. An HVLab vibrotactile perception meter was used to measure the fingertip VPT at 31.5 and 125.0 Hz in workers of these two groups. RESULTS: None of the workers in these two groups showed any clinical symptoms associated with occupational hand-arm vibration diseases. At 31.5 and 125.0 Hz, the fingertip VPT in the vibration exposure group was higher than that in the control group(P<0.01), the fingertip VPT of the little fingers was higher than that of the index fingers(P<0.01). At 125.0 Hz, the fingertip VPT of the fingers in dominant hands was higher than that in non-dominant hands in workers of the vibration exposure group(P<0.01). CONCLUSION: The mine drilling workers with hand-transmitted vibration exposure had higher fingertip VPT. There were differences of VPT in fingers and dominant hands.