BACKGROUND: This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability. METHODS: This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability. RESULTS: STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min. CONCLUSION The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
Reproducibility of Results ; Surveys and Questionnaires ; Practice Guidelines as Topic ; Humans

Humans ; Kidney/pathology*

Objective: To examine a predictive model that incorporating high risk pathological factors for the prognosis of stage Ⅰ to Ⅲ colon cancer. Methods: This study retrospectively collected clinicopathological information and survival outcomes of stage Ⅰ~Ⅲ colon cancer patients who underwent curative surgery in 7 tertiary hospitals in China from January 1, 2016 to December 31, 2017. A total of 1 650 patients were enrolled, aged (M(IQR)) 62 (18) years (range: 14 to 100). There were 963 males and 687 females. The median follow-up period was 51 months. The Cox proportional hazardous regression model was utilized to select high-risk pathological factors, establish the nomogram and scoring system. The Bootstrap resampling method was utilized for internal validation of the model, the concordance index (C-index) was used to assess discrimination and calibration curves were presented to assess model calibration. The Kaplan-Meier method was used to plot survival curves after risk grouping, and Cox regression was used to compare disease-free survival between subgroups. Results: Age (HR=1.020, 95%CI: 1.008 to 1.033, P=0.001), T stage (T3:HR=1.995,95%CI:1.062 to 3.750,P=0.032;T4:HR=4.196, 95%CI: 2.188 to 8.045, P<0.01), N stage (N1: HR=1.834, 95%CI: 1.307 to 2.574, P<0.01; N2: HR=3.970, 95%CI: 2.724 to 5.787, P<0.01) and number of lymph nodes examined (≥36: HR=0.438, 95%CI: 0.242 to 0.790, P=0.006) were independently associated with disease-free survival. The C-index of the scoring model (model 1) based on age, T stage, N stage, and dichotomous variables of the lymph nodes examined (<12 and ≥12) was 0.723, and the C-index of the scoring model (model 2) based on age, T stage, N stage, and multi-categorical variables of the lymph nodes examined (<12, 12 to <24, 24 to <36, and ≥36) was 0.726. A scoring system was established based on age, T stage, N stage, and multi-categorical variables of lymph nodes examined, the 3-year DFS of the low-risk (≤1), middle-risk (2 to 4) and high-risk (≥5) group were 96.3% (n=711), 89.0% (n=626) and 71.4% (n=313), respectively. Statistically significant difference was observed among groups (P<0.01). Conclusions: The number of lymph nodes examined was an independent prognostic factor for disease-free survival after curative surgery in patients with stage Ⅰ to Ⅲ colon cancer. Incorporating the number of lymph nodes examined as a multi-categorical variable into the T and N staging system could improve prognostic predictive validity.
Male ; Female ; Humans ; Prognosis ; Neoplasm Staging ; Retrospective Studies ; Nomograms ; Lymph Nodes/pathology* ; Risk Factors ; Colonic Neoplasms/surgery*

Objective （ ） To explore the feasibility of using generalized estimating equation GEE to analyze the influencing - （ ） factors of high frequency hearing loss HFHL among noise exposed workers in an air conditioner manufacturing enterprise. Methods - The noise exposed workers in an air conditioner manufacturing industry who had been tested for pure tone hearing threshold twice or more from 2015 to 2019 were selected as the research subjects using the judgment sampling method. Data ， ， ， ， ， （ ） such as age length of service gender smoking alcohol consumption body mass index BMI and HFHL were collected. The Results influencing factors of HFHL were analyzed using the GEE. The detection rates of HFHL from 2015 to 2019 were ， ， ， ， ， 22.2% 23.8% 24.2% 24.1% and 20.9% respectively. Among them the detection rate of HFHL in 2019 was lower than that （ P ） ， ， in 2017 and 2018 all <0.001 . The GEE analysis results showed that the risks of HFHL in 2015 2016 2017 and 2018 were （ P ）， higher than that in 2019 all <0.01 regardless of interaction effects and after adjusting for confounding factors such as ， ［OR（ CI）］ （ - duration of noise exposure smoking and BMI. The odds ratios and 95% confidence intervals 95% were 1.19 1.07 ）， （ - ）， （ - ） （ - ）， 1.33 1.26 1.13 1.39 1.30 1.18 1.43 and 1.27 1.15 1.39 respectively. The risk of HFHL was higher in males than in （P ）， OR（ CI） （ - ） ， （P ）， OR females <0.01 and 95% was 3.78 3.00 4.77 . The older the age the higher the risk of HFHL <0.01 and （ CI） （ - ） Conclusion - 95% was 1.07 1.05 1.09 . The influencing factors of HFHL among noise exposed workers in the air conditioner industry are age and gender. GEE can be used to analyze the factors influencing the longitudinal data of HFHL in workers with noise exposure.

OBJECTIVE: To analyze the epidemiological characteristics of pneumoconiosis among migrant workers without liability subject(hereinafter referred to as Pneumoconiosis without Liability Subject) in Hunan Province. METHODS: The cases of pneumoconiosis without liability subject from 2017 to 2019 in Hunan Province were selected as the research subjects using typical sampling method. They were clinical diagnosis by occupational disease diagnostic institutions. The distributions of age, gender, length of service, area, type of work, type of pneumoconiosis, pneumoconiosis stage and the situation of poor households with filing and registration card were analyzed. RESULTS: A total of 18 870 cases of pneumoconiosis without liability subject were clinically diagnosed in Hunan Province from 2017 to 2019. The patients were mainly males(accounting for 99.8%), with the age ranged 50-65 years old(64.7%). Most of them had dust exposure service length of 5-29 years(78.4%). The cases of stage Ⅰ, Ⅱ and Ⅲ pneumoconiosis accounted for 32.2%, 26.0% and 41.8% respectively. The main types of disease were coal workers′ pneumoconiosis and silicosis(accounted for 99.3%). The first five geographical distributions were Chenzhou City, Zhuzhou City, Hengyang City, Yiyang City and Shaoyang City, accounting for 17.9%, 14.6%, 14.1%, 11.8% and 9.2% respectively. The distribution of work types were mainly mine-related jobs(91.3%). There were 1 774 cases who had complications(9.4%), of which the top three complications were emphysema, pulmonary and bronchial infection and tuberculosis. There were 3 662 cases with poor households archives and cards(19.4%). CONCLUSION: The hazards of pneumoconiosis among migrant workers in Hunan Province should not be ignored. In 2017, Hunan Province took the lead in launching a large-scale basic medical treatment and rescue operation for migrant workers with pneumoconiosis, which helped solve the problem of pneumoconiosis in migrant workers who had no professional history certification and responsible employer.

Automobiles ; Hearing Loss, High-Frequency ; Hearing Loss, Noise-Induced/etiology* ; Humans ; Male ; Noise, Occupational/adverse effects* ; Occupational Diseases/epidemiology* ; Occupational Exposure

This paper analyzed the clinical data of 17 patients with inhalation dimethyl sulfate poisoning in Changzhou Third People's Hospital, in order to understand the clinical characteristics, treatment and prognosis of patients with inhalation dimethyl sulfate poisoning, and guide clinicians to make effective measures in time. Dimethyl sulfate poisoning progresses rapidly and dangerously. The prognosis is usually better if the patients are separated from the toxic environment as soon as possible, given glucocorticoids in early and short-term, closely observed respiratory tract injury, and treated with endotracheal intubation and invasive mechanical ventilation when necessary.
Humans ; Respiration, Artificial ; Sulfuric Acid Esters

Humans ; Lung ; Pneumoconiosis/diagnostic imaging* ; Retrospective Studies ; Silicosis/diagnostic imaging* ; Tomography, X-Ray Computed

The advancement and popularization of molecular diagnostic techniques has challenged and redefined the traditional concept of genetic metabolic disease. Regardless of disease origin, all genetic defects that lead to hepatobiliary dysfunction or structural abnormalities are termed as genetic liver disorders. Online Mendelian Inheritance in Man (OMIM) is a database consisting 693 genetic diseases with clear molecular mechanism of liver related phenotypes. Moreover, the effective measures to control infectious liver disease have strengthened the importance of research in the field of (adult and children) genetic liver disorders at home and abroad by well-recognized hepatologists. Notably, all patients with unexplained hepatopathy and multiple system diseases involving liver and gallbladder needs screening for genetic liver disorders, except for factors such as infection, immunity, drug-related, and anatomical abnormalities. We hope more patients with complicated liver disorders will benefit from definitive diagnosis and effective treatment in the near future with clear explanation of clinical phenotype, genotype, and metabolomics.
Child ; Databases, Genetic ; Genetic Diseases, Inborn ; Genotype ; Humans ; Liver Diseases/therapy* ; Phenotype

Objective To determine the antioxidant activity of different polar fractions of Jasmine leaves.Methods The extract of jasmine flo wer leaves was extracted with petroleum ether,ethyl acetate and n-butanol to obtain the petroleum ether,ethyl acetate,n-butanol and water fractions.The scavenging abilities of different polar fractions of jasmine leaf on 1,1-two-2-three nitro phenyl hydrazine (DPPH) free radicals,ABTS + radicals,O2-radicals,OH-radicals and the reduction of Fe3 +,Fe2+ were investigated and were compared with that on 2,6-tert butyl -4-methyl phenol (BHT).Results All the fractions had the ability to scavenge DPPH free radicals and ABTS + radicals.The petroleum ether fracton had the strongest ability to scavenge oxygen anion radicals and the ability of different fractions to scavenge hydroxyl radicals was n-butanol ＞ ethyl acetate ＞ petroleum ether ＞ water.For the ability to restore Fe3 +,the most powerful was water reducing part,the weakest was the ethyl acetate part,for the ability of chelating Fe2+ ethyl acetate part was higher than BHT,and the n-butanol part was the weakest.Conclusion The different polar fractions of Guangxi Jasmine leaves had certain antioxidant activity.