Objective To study the health effect of harmful substances produced in house decoration through the investigation of occupational heath impacts in the workers engaged in house decoration.Methods From July to October in 2007, in Luzhou,200 workers engaged in house decoration and 200 building workers were selected.The questionnaires investigation was conducted on general condition,working circumstances,living conditions,personal protect and health status.Results All the workers had little knowledge about the health impacts caused by house decoration materials.The working circumstance of the workers engaged in house decoration was bad and almost no personal protection in working.In house decoration workers,the prevalence rate of dermal redness(13%),dryness(10%),headache(8.0%),vertigo(9.5%),cough(15.5%),asthma(8.5%),chest tightness(7.5%) nausea(8%),vomit(5%),discomfort sense in eyes(30.0%),eyes ache(15.0%),photophobia lacrimation(15.0%), abnormal smell(15.0%),nasopharyngeal discomfort(12.5%) and sore throat(10.5%) was higher compared with the building workers (P

Objective To investigate the seasonal variability of the onset of acute deep vein thrombosis(DVT).Methods The clinical manifestations in 774 DVT patients during January 2008 to December 2012 were collected and circular distribution statistics was used to identify seasonal variability.Results The total sample had the significant seasonal variability (P ＜ 0.01):DVT was most frequent in winter while less frequent in summer and the peak day was January 1.Female subgroup has significant seasonal variability (P ＜0.01):on peak in winter and at trough in summer while male subgroup has no significant seasonal variability (P ＜ 0.01).Different age subgroups (＜ 40 years,40-69 years,＜70 years)have significant seasonal variability(P ＜ 0.05,P ＜ 0.01,P ＜ 0.01).DVT was most common in December and less frequent in August.Left lower limb subgroup and both lower limb subgroup has significant seasonal variability (P ＜ 0.01,P ＜ 0.01),on peak in December-January.Immobilization subgroup also has significant seasonal variability (P ＜ 0.001):frequent in winter,January 1 is on the peak.Conclusions DVT has significant seasonal variability in onset:it is most frequently seen in winter while less frequent in summer.Some subgroups (female,＜70 years and immobilization) have the most significant seasonal variability in onset.

Objective To compare the clinical efficacy of catheter directed thrombolysis(CDT ) ,thrombectomy(ST ) and system‐atic anticoagulant(SA) in treating acute iliofemoral deep vein thrombosis(AIFDVT ) of lower limb using Meta analysis method . Methods The systematic review was initialted by electronic literature searches (PUBMED ,MEDLINE ,ELSEVIER ,etc .) for stud‐ies comparing catheter directed thrombolysis ,thrombectomy and systematic anticoagulant clinical effects published from January 1984 to January 2014 based on the keyword such as iliofemoral deep vein thrombosis;thrombolysis;anticoagulant therapy ;throm‐bectomy ;RCTs;Meta analysis.A Meta analysis was conducted to estimate early vein patency ,post thrombotic syndrome(PTS) , venous reflux(VR) rate ,venous obstruction(VO) rate ,etc .Results Ten RCTs were included in this analysis ,including 626 pa‐tients .The early vein patency rate was higher in the CDT group and the difference was statistically significant(OR=4 .61 ,95% CI 1 .93-10 .98 ,P<0 .05);there was no statistically difference between ST and SA group(OR= 2 .54 ,95% CI 0 .49 -13 .24 ,P>0 .05) .The post thrombotic syndrome rate was less both in the CDT group(OR=0 .18 ,95% CI 0 .07 -0 .43 ,P< 0 .05) and ST group(OR=0 .50 ,95% CI 0 .28 -0 .87 ,P< 0 .05);the difference was statistically significant .The difference of the venous reflux rate was not statistically significant in both two groups .The venous obstruction rate was less in the CDT group(OR=0 .19 ,95% CI 0 .11-0 .34 ,P<0 .05) and the difference was statistically significant ;while the difference was not statistically significant between ST and SA group (OR=1 .53 ,95% CI 0 .72-3 .26 ,P>0 .05) .Conclusion For acute iliofemoral deep vein thrombosis(AIFDVT) , short term (< 7 d) outcomes of catheter directed thrombolysis was better than anticoagulant therapy ,but thrombolysis brought more bleeding .In long term(>6 m) outcomes ,the post thrombotic syndrome rate was less both in the thrombolysis group and the thrombectomy ,and catheter directed thrombolysis could diminish the vein obstruction rate .

Malignant tumors， a group of serious diseases in China， endangers the health of the people. They are mainly treated by surgery， radiotherapy， chemotherapy， targeted therapy， and immunotherapy. With the development of precision medicine， targeted anti-tumor drugs have garnered increasing attention from researchers and gradually applied in clinical treatment. The mitogen-activated protein kinase （MAPK）/nuclear factor-κB （NF-κB） signaling pathway plays a key role in the occurrence and development of tumors， participating in the regulation of tumor microenvironment and the invasion， migration， proliferation， apoptosis， and drug resistance of tumor cells. Therefore， the key effectors targeting the regulation of the MAPK/NF-κB signaling pathway have become potential targets for the treatment of tumors. In China， traditional Chinese medicine （TCM） has become a key approach of tumor treatment since it can exert anti-tumor effects in a multi-component， multi-effect， multi-target， and multi-pathway manner， demonstrating definite clinical efficacy in tumor treatment. The available studies published in recent years have shown that the active components， herb pairs， and compound prescriptions of TCM can play an anti-tumor role by interfering with the MAPK/NF-κB signaling pathway， promoting apoptosis， inhibiting cell proliferation， blocking the cell cycle， inhibiting tumor invasion and metastasis and tumor stem cell characteristics， improving the immune function， and reversing tumor multi-drug resistance. However， a systematic review of the relevant studies remains to be conducted. This paper introduces the mechanism of tumor management via the MAPK/NF-κB pathway and reviews the research progress in TCM treatment of tumors via this pathway in recent years， aiming to provide a theoretical basis for the clinical application of anti-tumor TCM， drug development， and in-depth mechanism research.

Objective:To investigate the serum levels of myonectin, corticostatin and Delta like ligand 4 (DLL4) in patients with type 2 diabetes mellitus (T2DM) diabetes retinopathy (DR) and their clinical significance.Methods:A prospective selection of 341 T2DM patients admitted to Beijing Hospital of Traditional Chinese Medicine, Huairou Hospital from May 2020 to March 2022 was conducted. The patients underwent fundus examination and were divided into a non DR group ( n=85 cases) and a DR group ( n=256 cases) based on DR diagnostic criteria. The DR group was divided into non proliferative and proliferative types according to the staging criteria in China′s DR clinical diagnosis and treatment guidelines, with 142 cases and 114 cases, respectively; 190 healthy individuals who underwent physical examinations in our hospital during the same period were selected as the control group. Enzyme linked immunosorbent assay was used to detect the levels of serum sarconectin, corticostatin, and DLL4 in three groups, collect patient data, and detect biochemical indicators. Logistic regression analysis was used to analyze the influencing factors of DR, and Pearson correlation analysis was used to investigate the relationship between serum sarconectin, corticostatin, DLL4, glucose and lipid metabolism, and insulin resistance; Logistic regression analysis was used to analyze the influencing factors of DR, and Pearson correlation analysis was used to investigate the relationship between serum sarconectin, corticostatin, DLL4, glucose and lipid metabolism, and insulin resistance; The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum sarconectin, corticostatin, and DLL4 in DR. Results:The levels of serum sarconectin and DLL4 in the DR group and non DR group were higher than those in the control group, while the levels of corticostatin were lower than those in the control group (all P<0.05); The levels of sarconectin and DLL4 in the DR group were higher than those in the non DR group, while the levels of corticostatin were lower than those in the non DR group (all P<0.05). The serum levels of sarconectin and DLL4 in proliferative DR patients were higher than those in non proliferative DR patients, while the levels of corticostatin were lower than those in non proliferative DR patients (all P<0.05). The duration of T2DM in the DR group was longer than that in the non DR group, with smoking and alcohol consumption, systolic blood pressure, fasting blood glucose, glycated hemoglobin, triglyceride and insulin resistance index (HOMA-IR) were higher than those in non DR group (all P<0.05). Logistic regression analysis showed that the course of T2DM, systolic blood pressure, smoking and alcohol consumption, glycated hemoglobin, triglycerides, myonectin, corticostatin and DLL4 were the influencing factors of DR (all P<0.05). Pearson correlation analysis results showed that serum sarconectin, DLL4, and fasting blood glucose, glycated hemoglobin, fasting insulin and HOMA-IR were positively correlated (all P<0.05), while cortisol was negatively correlated with fasting blood glucose, glycated hemoglobin and HOMA-IR (all P<0.05). The ROC analysis results showed that the area under the curve (AUC) for the diagnosis of DR was 0.691, 0.745, 0.749, and 0.861 for sarconectin, corticostatin, and DLL4 alone and in combination, respectively. The combined application had higher diagnostic value. Conclusions:Patients with T2DM complicated with DR have elevated levels of serum sarconectin and DLL4, while decreased levels of corticostatin, which are closely related to glucose and lipid metabolism and insulin resistance, and are influencing factors for the occurrence of DR. Combined detection of the three can improve the value of predicting DR.

Objective To assess the prognostic value of HER2 (human epidermal growth factor receptor-2) somatic mutations S310F and V777L in breast cancer patients.Methods HER2 somatic mutations S310F and V777L was screened in 338 consecutive patients with operable primary breast cancer using direct Sanger sequencing analysis.Results A total of 12 carriers of HER2 gene S310F and V777L mutations were found,10 were HER2-negative and 2 were HER2-positive.The median follow-up was 43 months (range from 1 to 61 months).4 were found with local or distant metastasis,and all were HER2-negative patients.Survival analysis found significantly lower survival rates in patients with S3 10F and V777L mutations than in non-carriers (RFS,unadjusted hazard ratio [HR]:5.89,95％ confidence interval [CI]:1.96-17.71,P ＜ 0.001;DRFS,unadjusted HR:5.53,95％ CI:1.56-19.55,P =0.003) and this difference was more manifest in the HER2-negative patients (RFS,unadjusted HR:8.93,95％ CI:2.79-28.62,P ＜ 0.001;DRFS,unadjusted HR:9.89,95％ CI:2.54-38.49,P ＜ 0.001).HER2 somatic mutations S310F and V777L are independent predictors of poor prognosis in breast cancer.Conclusion The prognosis of breast cancer patients carrying HER2 somatic mutations S310F and V777L is significantly worse than that of non-carriers,especially in HER2-negative patients.

Tetanus consists of neonatal tetanus and non-neonatal tetanus. Non-neonatal tetanus remains a serious public health problem, although neonatal tetanus has been eliminated in China since 2012. Non-neonatal tetanus is a potential fatal disease. In the absence of medical intervention, the mortality rate of severe cases is almost 100%. Even with vigorous treatment, the mortality rate remains 30%-50% globally. These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China, in order to improve medical quality and safety. These specifications introduce the etiology, epidemiology, pathogenesis, clinical manifestations and laboratory tests, diagnosis, differential diagnosis, grading and treatment of non-neonatal tetanus.

Tetanus consists of neonatal tetanus and non-neonatal tetanus. Although neonatal tetanus in China has been eliminated since 2012, non-neonatal tetanus remains a serious public health problem. Non-neonatal tetanus is a potential fatal disease, and the mortality rate of severe cases is almost 100% in the absence of medical intervention. Even with vigorous treatment, the mortality rate is still 30~50% globally. In order to standardize the diagnosis and treatment of non-neonatal tetanus in China, this specification is hereby formulated. This standard includes etiology, epidemiology, pathogenesis, clinical manifestations, laboratory tests, diagnosis, differential diagnosis, classification, grading and treatment of non-neonatal tetanus.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.