Objective: To investigate the occupational health status of medical radiation workers in Hangzhou City, so as to provide the basis for their occupational health risk assessment. Methods: Data on medical radiological workers who underwent occupational health examinations from 2021 to 2022 were collected through the Physical Examination Information Management System of the Hangzhou Occupational Disease Prevention and Control Hospital. The physical examination data including blood routine, eye lens, thyroid ultrasound, thyroid function, liver function, renal function and blood lipid were collected, and the abnormal rates of occupational health examinations among workers with different genders, working years and occupational exposure types were analyzed. Results: A total of 3 968 medical radiation workers were investigated, including 2 310 males (58.22%) and 1 658 females (41.78%). There were 2 039 (51.39%), 821 (20.69%) and 1 108 (27.92%) workers with 1-<6, 6-<10 years and 10 years and above of work, respectively. Diagnostic radiology was the predomenant type of exposure, with 2 240 workers accounting for 56.45%. The abnormal rates of thyroid ultrasound and blood lipid were 47.73% and 45.21%, respectively, which were relatively higher than other items. The abnormal rates of micronucleus rate, thyroid ultrasound, thyroid function and renal function were higher in females than in males, while the abnormal rates of lymphocyte count, liver function and blood lipid in males were higher in males than in females (all P<0.05). With the increase of working years, the abnormal rates of micronucleus rate and blood lipid showed upward trends (both P<0.05). There were statistically significant differences in the abnormal rates of thyroid ultrasound, liver function and blood lipid among different occupational exposure types (all P<0.05). Conclusion Long-term low-dose ionizing radiation environment affects the thyroid, micronucleus rate and blood lipid of medical radiation workers in Hangzhou City, with differences observed among workers with different genders and occupational exposure types.

Objective : To explore the mechanism of isorhamnetin (Iso) in the treatment of oral squamous cell carcinoma (OSCC) using network pharmacology and molecular docking methods and to verify it in vitro. Methods : The key targets were obtained by constructing the PPI protein interaction network based on the common intersection targets of Iso-OSCC. At the same time, gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) were used to analyze the related signaling pathways of the intersection targets. Iso and core targets were also analyzed through molecular docking and visualization. Colony formation assay and Transwell assay were used to identify the effect of Iso on the proliferation and invasion of Cal-27 cells. Western blot was used to analyze the regulatory effects of different concentrations of Iso on estrogen receptor-1 (ESR1), phosphoinositide-3-kinase regulatory subunit-1 (PIK3R1), Src tyrosine kinase (SRC), and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway proteins. Results: A total of 269 potential intersection targets of Iso-regulated OSCC were obtained. According to the degree obtained by topological analysis, PIK3R1, AKT1, SRC, ESR1, and other core targets were screened out. KEGG analysis showed that 165 signaling pathways were enriched in the intersection targets of Iso-OSCC, among which the PI3K/AKT signaling pathway played an important role in the treatment of OSCC with Iso. Molecular docking results showed that the absolute value of binding energy between target proteins PIK3R1, AKT1, SRC, ESR1, and Iso was high. After Cal-27 cells were treated with Iso, the number of cell colony formations, the number of transmembrane cells, and the expression of PIK3R1, ESR1, SRC, p-PI3K, and p-AKT were negatively correlated with the increase in Iso concentration (P < 0.05). Conclusion Iso can inhibit PI3K/AKT signal transduction and influence the expression of PIK3R1, AKT1, SRC, and ESR1 proteins, thereby inhibiting the occurrence and development of OSCC.

Objective:To construct and validate a nomogram model for predicting the risk of 28-day mortality in sepsis patients.Methods:A retrospective cohort study was conducted. 281 sepsis patients admitted to the department of intensive care unit (ICU) of the 940th Hospital of the Joint Logistics Support Force of PLA from January 2017 to December 2022 were selected as the research subjects. The patients were divided into a training set (197 cases) and a validation set (84 cases) according to a 7∶3 ratio. The general information, clinical treatment measures and laboratory examination results within 24 hours after admission to ICU were collected. Patients were divided into survival group and death group based on 28-day outcomes. The differences in various data were compared between the two groups. The optimal predictive variables were selected using Lasso regression, and univariate and multivariate Logistic regression analyses were performed to identify factors influencing the mortality of sepsis patients and to establish a nomogram model. Receiver operator characteristic curve (ROC curve), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) were used to evaluate the nomogram model.Results:Out of 281 cases of sepsis, 82 cases died with a mortality of 29.18%. The number of patients who died in the training and validation sets was 54 and 28, with a mortality of 27.41% and 33.33% respectively. Lasso regression, univariate and multivariate Logistic regression analysis screened for 5 independent predictors associated with 28-day mortality. There were use of vasoactive drugs [odds ratio ( OR) = 5.924, 95% confidence interval (95% CI) was 1.244-44.571, P = 0.043], acute physiology and chronic health evaluation Ⅱ (APACHEⅡ: OR = 1.051, 95% CI was 1.000-1.107, P = 0.050), combined with multiple organ dysfunction syndrome (MODS: OR = 17.298, 95% CI was 5.517-76.985, P < 0.001), neutrophil count (NEU: OR = 0.934, 95% CI was 0.879-0.988, P = 0.022) and oxygenation index (PaO 2/FiO 2: OR = 0.994, 95% CI was 0.988-0.998, P = 0.017). A nomogram model was constructed using the independent predictive factors mentioned above, ROC curve analysis showed that the AUC of the nomogram model was 0.899 (95% CI was 0.856-0.943) and 0.909 (95% CI was 0.845-0.972) for the training and validation sets respectively. The C-index was 0.900 and 0.920 for the training and validation sets respectively, with good discrimination. The Hosmer-Lemeshoe tests both showed P > 0.05, indicating good calibration. Both DCA and CIC plots demonstrate the model's good clinical utility. Conclusions:The use of vasoactive, APACHEⅡ score, comorbid MODS, NEU and PaO 2/FiO 2 are independent risk factors for 28-day mortality in patients with sepsis. The nomogram model based on these 5 indicators has a good predictive ability for the occurrence of mortality in sepsis patients.

Objective To analyze the expression of miR-4524a-3p in peripheral blood mononuclear cells(PBMCs)and major immune cell subsets of patients with systemic lupus erythematosus(SLE),and evaluate its clinical application.Methods Peripheral blood samples were collected from SLE patients and healthy controls,followed by isolation of PBMCs,CD3+T lymphocytes,CD19+B lymphocytes,and CD14+monocytes using human peripheral blood lymphocyte isolation solution(Ficoll)and immunomagnetic bead cell sorting.The expression level of miR-4524a-3p was quantified using fluorescence quantitative PCR.Pearson's linear correlation analysis was per-formed to assess the relationship between miR-4524a-3p expression and the disease activity score in SLE patients(SLEDAI).Additionally,the diagnostic efficacy of miR-4524a-3p for SLE was evaluated by constructing a receiver operating characteristic curve(ROC).Results The expression of miR-4524a-3p was significantly decreased in PBMCs(P<0.05),CD3+T cells(P<0.001),and CD14+monocytes(P<0.001)from patients with SLE compared to healthy controls.Furthermore,it exhibited a negative correlation with SLEDAI score(r=-0.406,P<0.01).Notably,the expression level of miR-4524a-3p was significantly lower in patients with moderate or severe active stage than those in mild and inactive stages(P<0.01).In addition,the SLE subgroup with lupus nephritis and joint involvement displayed lower levels of miR-4524a-3p compared to the subgroup without such manifestations(P<0.01).Importantly,ROC analysis demonstrated that miR-4524a-3p holds promising diagnostic value for SLE.Conclusion The expression of miR-4524a-3p was significantly diminished in CD3+T cells and CD14+monocytes derived from patients with SLE,exhibiting a close association with disease activity and demonstrating potential clinical diagnostic value for SLE.

Objective To summarize the clinical characteristics and outcomes of corona virus disease 2019(COVID-19)in patients with adrenal insufficiency(AI),and analyze the risk factors of outcomes.Methods The clinical data of COVID-19 patients with AI in Peking Union Medical College Hospital in December 2022 were ana-lyzed retrospectively and the patients were followed up to collect outcomes of their diseases.Results Among 28 COVID-19 patients with AI,20 cases(71.4%)received basal corticosteroid replacement.Among the 18 patients with community-acquired COVID-19,11 cases(61.1%)increased the corticosteroid dosage proactively at home.The most common symptoms of COVID-19 were fever(96.4%),gastrointestinal symptoms(82.1%)and con-sciousness disturbance(78.6%).Occurrence of severe consciousness disturbance was associated with older age and lower basal corticosteroid replacement dose(P＜0.05). Adrenal crisis(AC)occurred in 20 patients(71.4%),which was associated with lower basal corticosteroid replacement dose,hypochloremia,lower eosinophil,lower platelet,and longer activated partial thromboplastin time(APTT)(P＜0.05). 2 patients died during hospitalization.26.3%(5/19)of surviving patient's recovered consciousness longer than 48 hours.Delayed recovery of conscious-ness was associated with lower systolic pressure,higher blood creatinine,and higher fibrinogen(P＜0.05).Long COVID-19 symptoms such as fatigue and poor appetite occurred in 48.0%(12/25)of patients.Among patients with increased corticosteroid dosage,50.0%(12/24)had their dose reduced to baseline within 3 weeks.Conclusions COVID-19 patients with AI have a high frequency of consciousness disturbance and AC.AI patients are lack of awareness of adjusting corticosteroid dosage proactively in case of infection stress,thus education of"sick day rules"for AI patients should be strengthened in clinical practice.

Objective To investigate the characteristics and clinicopathology of v-raf murine sarcoma viral oncogene homolog Bl(BRAF)V600E mutations in papillary thyroid carcinoma(PTC)in Air Force flight personnel.Methods Data of cases and test results of BRAF V600E mutation were collected from Air Force aviators pathologically diagnosed with PTC.A univariate analysis of the relationship between BRAF V600E mutations and clinicopathologic features was performed.Results The overall rate of BRAF V600E mutations among 55 PTC flight crew members was 70.91％.The univariate analysis showed that the number of lymph node metastases in the BRAF V600E mutated group was larger than in the BRAF V600E unmutated group,and the proportion of BRAF V600E mutations in flight crews at intermediate risk of recurrence was higher than that in those at low risk of recurrence(P＜0.05).The presence or absence of BRAF V600E mutations did not affect the results of medical evaluation of PTC in flight personnel.Conclusion The rate of PTC BRAF V600E mutations in Air Force flight crews is similar to that of the general Chinese population.BRAF V600E mutations are associated with an increased number of lymph node metastases and risk of recurrence,and follow-up is recommended for flight personnel with PTC,especially those with BRAF V600E mutations.

Objective:To observe any effect of family rehabilitation interventions based on digital health management on elderly type 2 diabetes mellitus (T2DM) patients with sarcopenia.Methods:One hundred elderly T2DM patients with sarcopenia who had been discharged from hospital after treatment were divided into an observation group and a control group, each of 50. Both groups continued the diet control and training begun during their hospitalization, but the observation group was additionally provided with family rehabilitation based on digital health management. Before and after 3 months, the glucose and lipid metabolism and sarcopenia of both groups were evaluated with related symptom indexes, and their levels of diabetes self-management were compared.Results:Significant improvement was observed in both groups, but the average glucose and lipid metabolism indexes and sarcopenia-related symptom indexes of the observation group were significantly better than the control group′s averages. Their diabetes self-management was also significantly superior.Conclusion:Family rehabilitation based on digital health management can significantly improve glucose and lipid metabolism and muscle mass in elderly T2DM patients with sarcopenia. Such intervention is worthy of promotion and application in clinical practice.

Objective:To explore the applications value of hospital elderly life program in cardiac surgery patients in intensive care unit, and provide reference for improving the prognosis of patients.Methods:This was a prospective study. A total of 84 cardiac surgery patients in intensive care unit from April 2020 to February 2022 in the People′s Hospital of Leshan by convenient sampling method, they were enrolled and divided into the observation group and the control group according to the admission time, each group was 42 cases. Routine nursing care was carried out in both groups, the control group implemented delirium and debility prevention nursing, the observation group adopted hospital elderly life program. The incidence of ICU-acquired delirium and weakness, mechanical ventilation time, duration of ICU stay, the total length of stay and intensive care experience were assessed between the two groups.Results:The 42 cases were included in the final control group and 39 cases in the observation group. The incidence of ICU-acquired delirium and weakness were 17.95% (7/39) and 7.69% (3/39) in the observation group, lower than in the control group 38.10%(16/42) and 23.81%(10/42), the differences were statistically significant ( χ2 = 4.04, 3.90, both P<0.05); the duration of ICU delirium were (1.71 ± 0.95) d in the observation group, shorter than in the control group (2.81 ± 1.05) d, the difference was statistically significant ( t = 2.38, P<0.05); the mechanical ventilation time, duration of ICU stay, the total length of stay, the total score of intensive care experience in hospital in the observation group were (193.54 ± 21.67) h, (9.49 ± 2.11) d, (18.10 ± 3.12) d, (2.72 ± 0.26) points, lower than those in the control group (214.50 ± 27.25) h, (10.90 ± 1.97) d, (20.59 ± 4.07) d, (3.15 ± 0.35) points, the differences were statistically significant ( t values were 3.11-6.35, all P<0.05). Conclusions:Hospital elderly life program can decrease the incidence of ICU-acquired delirium and weakness of cardiac surgery patients in intensive care unit, shorten mechanical ventilation time and hospitalization time, alleviate discomfort in the intensive care experience.

Objective: To investigate the current situation of hearing health among college students and associated factors, and to provide a basis for universities and relevant departments to carry out hearing health work. Methods: By using stratified random sampling method, 1306 students from 4 universities in Taiyuan were screened for hearing loss and were investigated with a questionnaire from March to November 2021. Data were analyzed by using the SPSS 19.0 statistical. Results: The detection rate of hearing loss was 31.70%. The majority (51.91%) failed to pass the 4 000 Hz hearing screening. The total awareness rate of hearing problems was 58.96%. Logistic regression analysis showed that the total daily usage time of earphones >4 h/d, the duration of using earphones >1 h/time were positively correlated with positive screening for hearing loss among college students( OR=1.23, 1.14, P < 0.01), and good awareness of hearing health care and highest education of parents were negatively correlated with positive screening for hearing loss among coollege students( OR =0.54, 0.76, 0.37, P <0.05). Conclusion The awareness of hearing health care among college students is low. Universities and relevant departments should take targeted measures to provide the best hearing health care services.

【Objective】 To study the changes of platelet components(PC), apheresis platelets (AP) and pooled platelet concentrates (PPC) production of 19 provincial blood centers before and during the COVID-19 epidemic. 【Methods】 The data related to the collection of AP and the preparation of PPC from 2016 to 2021 of 19 provincial blood centers was collected. The production of PC, AP and PPC during the four years before the epidemic (i.e. 2016-2019) and during the COVID-19 epidemic (i.e. 2020 and 2021) were calculated respectively, and the change of production was analyzed. 【Results】 The total production of PC in 19 blood centers steadily increased from 2016 to 2019, with a decrease of 4.16% in 2020 and an increase of 15.60% in 2021, exceeding the output before the COVID-19 epidemic. In 2020, the production of PC of 42.11% (8/19) blood centers decreased compared with 2019, while 94.74% (18/19) in 2021 increased compared with 2020. The changes of AP output was basically consistent with the trend of PC. The total production of PPC in 2017 and 2018 both doubled compared to the previous year, while decreased by 67.98% in 2019, increased by 30.38% in 2020 and decreased by 27.08% in 2021. 【Conclusion】 The total production of PC kept increasing steadily between 2016 and 2019, but decreased in 2020 under the COVID-19 epidemic, with some blood centers being significantly affected. In 2021, with the strong support from government and various measures by blood centers, the total production of PC increased.