Objective To investigate and analyze the occupational stress levels and influencing factors among radiation workers in China, and provide a reference for alleviating occupational stress and promoting mental health. Methods Using the general situation questionnaire, Effort-Reward Imbalance questionnaire, and radiation protection knowledge questionnaire, a convenience sampling method was adopted to investigate the occupational stress of 243 radiation workers in Liaoning, Fujian, Guangdong, and Xinjiang provinces. The independent samples t-test, one-way analysis of variance, chi-square test, and binary logistic regression were used to analyze the influencing factors. Results The average score of Effort-Reward Imbalance was 0.97 ± 0.22, and 100 (41.15%) radiation workers had occupational stress. There were significant differences in the detection rate of occupational stress among radiation workers of different ages, working years in radiation positions, monthly incomes, daily sleep durations, and daily working hours (P < 0.05). Logistic regression analysis identified daily working hours as a factor contributing to occupational stress. Conclusion The occupational stress among radiation workers in China is relatively severe. It is recommended to pay attention to the associated risks and implement targeted intervention measures to reduce the impact of occupational stress.

Objective To analyze the differential expression of non-coding RNAs (ncRNAs) from liver tissues adjacent to hepatic cystic echinococcosis (CE) lesions and distant normal liver tissues using whole transcriptome sequencing, and perform functional annotations of differentially expressed ncRNAs, so as to explore the potential role of ncRNAs in the pathogenesis of CE. Methods Intraoperative liver tissue specimens adjacent to hepatic CE lesions and distant normal liver tissue specimen were sampled from patients with hepatic CE, and the expression profiles of microRNAs (miRNAs), circular RNAs (circRNAs), and long non-coding RNAs (lncRNAs) were detected using whole transcriptome sequencing. Differentially expressed genes were identified, and functional annotations were performed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. In addition, a circRNA/lncRNA-miRNA-messenger RNA (mRNA) competing endogenous RNA (ceRNA) network was constructed using the Cytoscape software, and the expression of hub miRNAs in the network was validated using real-time quantitative reverse transcription PCR (RT-qPCR) assay. Results A total of 41 differentially expressed miRNAs were identified between the adjacent and distal tissues of hepatic CE lesions, including 8 up-regulated and 33 down-regulated miR-NAs, which were significantly enriched in biological processes of Ras signaling and neutrophil activation. Five differentially expressed circRNAs were detected, including 3 up-regulated and 2 down-regulated circRNAs, which were significantly enriched in molecular functions of hormone signaling pathways and RNA transcription regulation. A total of 447 differentially expressed lncRNAs were identified, including 200 up-regulated and 247 down-regulated lncRNAs, which were involved in cell proliferation, immune regulation, and extracellular matrix remodeling pathways. MiRNA target analysis predicted hsa-miR-27a-5p, hsa-miR-21-3p, and hsa-miR-181b-2-3p as hub nodes in the ceRNA network. RT-qPCR assay detected that the relative expression levels of ENSG00000253736, HAS2-AS1, PCSK6, hsa-miR-21-3p, hsa-miR-27a-5p, MIR23AHG, VIPR1-AS1, LINC02910, and hsa-miR-181b-2-3p were 3.00 ± 0.25, 2.75 ± 0.33, 1.01 ± 0.51, 2.65 ± 0.41, 1.01 ± 0.29, 1.10 ± 0.31, 1.05 ± 0.27, 0.25 ± 0.49, and 2.56 ± 0.35 in adjacent tissues of hepatic CE lesions, normalized to that in distant tissues from hepatic CE lesions, respectively (t = 6.21, 5.83, 7.51, 7.46, 6.12, 6.65, 7.13, 1.87 and 7.81, all P values < 0.01), which was consistent with whole transcriptome sequencing results. Conclusions Differentially expressed ncRNAs from adjacent and distal liver tissues of hepatic CE lesions may contribute to the pathological mechanisms of CE through mediating cell proliferation, immune evasion, and inflammatory responses, in which hsa-miR-27a-5p and hsa-miR-21-3p may serve as hub miRNAs.

Gastroesophageal reflux disease (GERD) is a chronic digestive system disorder triggered by multiple factors, which is clinically prevalent and affects patients' quality of life. Laparoscopic fundoplication serves as the mainstay of surgical treatment for GERD, requiring standardized preoperative examinations to assess patients' reflux status and esophageal motility for individualized selection of fundoplication techniques. Intraoperative regulation of the fundoplication tension with a bougie aims to balance the anti-reflux efficacy and the risk of postoperative dysphagia. Additionally, membranous anatomy research guided by embryonic development facilitates optimization of surgical approaches and provides a theoretical basis for surgical innovation. This article deeply discusses the status of GERD diagnosis and treatment, as well as the surgical anti-reflux mechanisms, from multiple aspects including pathogenesis, diagnosis, and surgical management. We also contemplate the existing challenges in the embryonic development and anatomy of the anti-reflux barrier.

Neurofilament proteins(NFs),defined as a type Ⅳ intermediate filaments,are important components of the neuronal cytoskeleton.They play a key physiological role in maintaining the structural integrity and plasticity of axons and in ensuring the axonal transport function.Under pathological conditions,NFs detach from axons and undergo abnormal aggregation,causing axonal transport dysfunction.In addition,some components of the detached NFs leak into the peripheral circulation system.In patients with amyotrophic lateral sclerosis(ALS),the concentration of NFs is significantly elevated in the cerebrospinal fluid and blood,and the changes in NFs concentration is significantly positively correlated with the disease progression of ALS,suggesting the potential of NFs being used as early diagnostic biomarkers for ALS.In this review,we explored the relationship between NFs structure,assembly,and physiological function,focusing on the molecular mechanisms and clinical manifestations of ALS caused by abnormal assembly of NFs.We comprehensively summarized recent advances in the application of NFs as a new humoral biomarkers for early diagnosis and therapeutic monitoring of ALS.Key challenges in biomarker development—including undefined pathological neurofilament light chain(NFL)fragments,limited antibody availability,and poor assay reproducibility—are discussed.Strategies,including ultrasensitive detection technologies such as single molecule array(Simoa),antibody optimization based on pathological fragment identification,and multi-omics biomarker panels,should be integrated.These approaches may lead to breakthroughs,pave the way for precision-based ALS diagnosis,provide theoretical support for promoting its clinical translation and application,and offer ideas for future research.

Gastroesophageal reflux disease (GERD) is a chronic digestive system disorder triggered by multiple factors, which is clinically prevalent and affects patients' quality of life. Laparoscopic fundoplication serves as the mainstay of surgical treatment for GERD, requiring standardized preoperative examinations to assess patients' reflux status and esophageal motility for individualized selection of fundoplication techniques. Intraoperative regulation of the fundoplication tension with a bougie aims to balance the anti-reflux efficacy and the risk of postoperative dysphagia. Additionally, membranous anatomy research guided by embryonic development facilitates optimization of surgical approaches and provides a theoretical basis for surgical innovation. This article deeply discusses the status of GERD diagnosis and treatment, as well as the surgical anti-reflux mechanisms, from multiple aspects including pathogenesis, diagnosis, and surgical management. We also contemplate the existing challenges in the embryonic development and anatomy of the anti-reflux barrier.

Objective:To investigate the changes in plasma ghrelin and influencing factors of weight loss effects after laparoscopic sleeve gastrectomy combined with fundoplication surgery (LSGFD).Methods:The retrospective cohort study was conducted. The clinical data of 115 obesity patients who were admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from April to June 2023 were collected. There were 37 males and 78 females, aged (37±9)years. Of 115 pati-ents, 93 cases undergoing laparoscopic sleeve gastrectomy (LSG) were divided into the LSG group, and 22 cases undergoing LSGFD were divided into the LSGFD group. Measurement data with normal distribution were represented as Mean± SD, and the independent sample t test was used for com-parison between groups. Count data were described as absolute numbers, and the chi-square test was used for comparison between groups. Repeated measurement data were analyzed using the repeated ANOVA, and their variances were tested using a spherical test. The Logistic regression model was used for univariate and multivariate analyses. Results:(1) Changes in preoperative and postoperative plasma ghrelin in two groups of patients. The plasma ghrelin of patients at preopera-tive and postoperative 6 months changed from (16±14)×10 2 ng/L to (10±4)×10 2 ng/L in the LSG group and changed from (12±11)×10 2 ng/L to (11±3)×10 2 ng/L in the LSGFD group. There was no significant difference in the time effect, inter group effect, and interaction effect of changes in plasma ghrelin between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=2.199, Fgroup=0.001, Finteraction=0.793, P>0.05). There was a significant difference in plasma ghrelin in the LSG group before and after surgery at 6 months ( t=4.148, P<0.05), and there was no significant difference in plasma ghrelin in the LSGFD group before and after surgery at 6 months ( t=0.622, P>0.05). (2) Changes in preoperative and postoperative weight loss and metabolic related indicators in two groups of patients. ① There was a significant difference in the time effect of changes in body mass between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=242.285, P<0.05), and there was no significant difference in the inter group effect and interaction effect of changes in body mass between the LSG group and the LSGFD group before and after surgery at 6 months ( Fgroup=1.163, Finteraction=0.606, P>0.05). There were significant differences in body mass in the LSG group or the LSGFD group before and after surgery at 6 months ( t=23.597, 14.680, P<0.05). ② There was a significant difference in the time effect of changes in body mass index (BMI) between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=382.431, P<0.05), and there was no significant difference in the inter group effect and interaction effect of changes in BMI between the LSG group and the LSGFD group before and after surgery at 6 months ( Fgroup=1.619, Finteraction=1.085, P>0.05). There were significant differences in BMI in the LSG group or the LSGFD group before and after surgery at 6 months ( t=25.645, 16.628, P<0.05). ③ There was a significant difference in the time effect of changes in excess weight loss (%EWL) between the LSG group and the LSGFD group after surgery at 1 to 6 months ( Ftime=666.136, P<0.05), and there was no significant difference in the inter group effect and interaction effect of changes in %EWL between the LSG group and the LSGFD group after surgery at 1 to 6 months ( Fgroup=0.127, Finteraction=0.498, P>0.05). ④ There was no significant difference in the time effect, inter group effect, and interaction effect of changes in fasting blood glucose between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=1.573, Fgroup=1.872, Finteraction=0.948, P>0.05). There was a significant difference in fasting blood glucose in the LSG group before and after surgery at 6 months ( t=2.675, P<0.05), and there was no significant difference in fasting blood glucose in the LSGFD group before and after surgery at 6 months ( t=1.074, P>0.05). ⑤ There were significant differences in the inter group effect and interaction effect of changes in triglyceride between the LSG group and the LSGFD group before and after surgery at 6 months ( Fgroup=8.419, Finteraction=3.180, P<0.05), and there was no significant diffe-rence in the time effect of changes in triglyceride between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=1.398, P>0.05). Results of individual effect shown that there was no significant difference in triglyceride in the LSG group or the LSGFD group before and after surgery at 3 months ( F=2.956, 3.248, P>0.05), and there were significant differences in trigly-ceride in the LSG group or the LSGFD group after surgery at 1 month and 6 months ( F=14.152, 3.477, P<0.05). There was a significant difference in triglyceride in the LSG group before and after surgery at 6 months ( t=3.164, P<0.05), and there was no significant difference in triglyceride in the LSGFG group before and after surgery at 6 months ( t=0.023, P>0.05). ⑥ There were significant differences in the time effect and inter group effect of changes in total cholesterol between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=3.662, Fgroup=7.591, P<0.05), and there was no significant difference in the interaction effect of changes in total cholesterol between the LSG group and the LSGFD group before and after surgery at 6 months ( Finteraction=0.626, P>0.05). There was a significant difference in cholesterol in the LSG group before and after surgery at 6 months ( t=3.253, P<0.05), and there was no significant difference in total cholesterol in the LSGFG group before and after surgery at 6 months ( t=1.567, P>0.05). ⑦ There were significant differences in the time effect and inter group effect of changes in uric acid between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=15.306, Fgroup=4.244, P<0.05), and there was no significant difference in the interaction effect of changes in uric acid between the LSG group and the LSGFD group before and after surgery at 6 months ( Finteraction=0.968, P>0.05). There were significant differ-ences in uric acid in the LSG group or the LSGFG group before and after surgery at 6 months ( t=6.152, 3.660, P<0.05). (3) Analysis of influencing factors on postoperative weight loss effects. Results of multivariate analysis showed that preoperative BMI, postoperative 6 months plasma ghrelin were independent protective factors for postoperative weight loss effects ( odds ratio=0.881, 0.673, 95% confidence interval as 0.817-0.950, 0.577-0.787, P<0.05). Conclusions:The decrease in plasma ghrelin in patients after LSGFD is not as obvious as that in patients after LSG, but it can achieve the same weight loss and metabolic improvement effects as after LSG. The lower preoperative BMI and postoperative 6 months plasma ghrelin are independent protective factors for postoperative weight loss effects.

Objective To explore the relationship between serum nerve growth factor(NGF)and neurofil-amentlight-chain(NF-L)levels with the severity and prognosis of traumatic brain injury(TBI)patients,as well as their predictive value through a prospective research.Methods A total of 132 TBI patients and 132 ordinary trauma patients were collected as the observation group and the control group,respectively.TBI pa-tients in the observation group were divided into three subgroups of mild,moderate,and severe according to Glasgow Coma Scale(GCS)scores,and they were also divided into good and poor subgroups according to Glasgow Outcome Scale(GOS)scores at 6-month follow-up.Enzyme-linked immuno sorbent assay(ELISA)was used to detect serum NGF and NF-L levels in all patients after admission.Through comparison between the observation group and the control group,the relationship between TBI and serum NGF and NF-L levels was clarified.By comparing the differences between different subgroups of the observation group,the relation-ship between serum NGF and NF-L levels and the severity and prognosis of TBI was determined.Through correlation analysis,receiver operating characteristic(ROC)curve and multivariate Logistic regression analy-sis,and the predictive value of serum NGF and NF-L levels for TBI was clarified.Results Compared with the control group,serum NGF and NF-L levels were significantly increased while GCS scores were significantly decreased in the observation group(P＜0.01).In addition,serum NGF and NF-L levels gradually increased a-mong subgroups of mild,moderate,and severe groups in the observation group(P＜0.01).The area under the curve(AUC)of serum NGF and NF-L levels for predicting mild TBI were 0.924(95％CI:0.889-0.986)and 0.991(95％CI:0.982-1.000),and the cut off values were 12.5 ng/mL and 66.5 μg/mL,respectively.AUC of serum NGF and NF-L levels for predicting moderate TBI were 0.776(95％CI:0.686-0.862)and 0.837(95％CI:0.763-0.911),respectively,and AUC for predicting severe TBI was 0.950(95％CI:0.900-0.987)and 0.988(95％CI:0.971-1.000),respectively,with cut off values of 14.5 ng/mL and 157.0 μg/mL,respec-tively.Spearman correlation analysis showed that serum NGF and NF-L levels were negatively correlated with GOS scores of TBI patients(P＜0.01).AUC for predicting the prognosis of TBI patients with serum NGF and NF-L levels were 0.858(95％CI:0.776-0.932)and 0.909(95％CI:0.824-0.978),respectively,with cut off values of 13.5 ng/mL and 71.5 μg/mL,respectively.Logistic regression analysis showed that serum NGF and NF-L levels were risk factors affecting the prognosis of TBI patients.Conclusion Serum NGF and NF-L levels are significantly elevated in TBI patients and could provide reference for early assessment of inju-ry severity in clinical practice.Furthermore,elevated serum NGF and NF-L levels are associated with poor prognosis of TBI patients and are good biological indicators for predicting prognosis.

Objective To evaluate the value of perfusion imaging mismatch and low perfusion ratio(HIR)based on CT perfusion imaging in predicting acute intracranial large vessel occlusion(LVO)associated with intracranial atherosclerotic stenosis(ICAS).Methods A total of 82 pa-tients with acute intracranial LVO who underwent emergency thrombectomy in our hospital from February 2019 to December 2020 were enrolled in this study.According to the etiology,they were divided into ICAS-related LVO group(ICAS-LVO,65 cases)and cardiogenic embolism group(17 cases).ROC curve was plotted to analyze the predictive value of CT perfusion imaging parame-ters.Results Compared with the cardiogenic embolism group,the ICAS-LVO group had signifi-cantly larger male ratio,higher BMI and TG level,more severe progression of disease,longer time from onset to surgery,larger proportion of ischemic penumbra and higher mismatch ratio,and ob-viously less ratio of atrial fibrillation,lower BNP and HDL levels,smaller infarct volume,and lower HIR(P＜0.05,P＜0.01).ROC curve analysis showed that HIR and mismatch ratio had good predictive value for the etiology of ICAS-LVO.The optimal cut-off value of HIR was 0.26,with an AUC value of 0.74,a specificity of 0.88,and a sensitivity of 0.54.The optimal cutoff for the mismatch ratio was 3.84,with an AUC value of 0.84,a specificity of 0.75,and a sensitivity of 0.90.Generalized linear model revealed that HIR and cerebral blood volume index had no signifi-cant difference in prognostic performance(P=0.175).Conclusion HIR and mismatch ratio are helpful to identify the pathogenesis earlier and formulate surgical strategies more accurately,thereby reducing iatrogenic injury to a greater extent,increasing the effective reperfusion rate,re-ducing the disability and mortality,and improving the prognosis of clinical outcomes.

Objective To investigate the effects of abdominal massage combined with electroacupuncture point-through-point method on the expressions of circadian clock genes of Clock,BMAL1,PER1 and neurotransmitters contents of ACh and Glu in insomnia rats and its possible mechanism.Methods Totally 50 SD male rats were randomly divided into normal group,model group,abdominal massage group,electroacupuncture point-through-point group and combination group,with 10 rats in each group.Except for the normal group,an insomnia rat model was established by intraperitoneal injection of p-chlorophenylalanine.Abdominal massage group received abdominal massage;electroacupuncture point-through-point group was treated with flat acupuncture,"Baihui"through"Shenting","Sanyinjiao"through"Yinlingquan"(bilateral),"Shenmen"through"Neiguan"(bilateral),the electroacupuncture instrument dilatational wave,frequency of 1 Hz/20 Hz was connected;the combination group was treated with electroacupuncture through acupoints after abdominal massage;1 time/d for each treatment group,a total of 7 days.The normal group and model group were not intervened.HE staining was used to observe the pathological changes of neurons in hypothalamic tissue,the expression of Clock,BMAL1 and PER1 mRNA were detected by RT-qPCR,the expressions of Clock,BMAL1 and PER1 in hypothalamic tissue were detected by immunohistochemical staining,the expression of Clock,BMAL1 and PER1 protein in hypothalamic tissue were detected by Western blot,the contents of ACh and Glu in serum were detected by ELISA.Results Compared with the normal group,the model group rats had a longer sleep latency,shorter sleep duration,severe damage to the cellular structure of the hypothalamic tissue,and a vacuolar like change,with a decrease in the number of neuronal cells,the expressions of Clock and BMAL1 mRNA and protein in hypothalamic tissue increased,while the expressions of PER1 mRNA and protein decreased;the contents of serum ACh and Glu increased,with statistical significance(P<0.05).Compared with the model group,the abdominal massage group,electroacupuncture point-through-point group,and combination group could all shorten the sleep latency,prolong sleep duration,and improve the morphology of hypothalamic neurons,reduce the expressions of Clock and BMAL1 mRNA and protein in hypothalamic tissue,up-regulate the expressions of PER1 mRNA and protein,and reduce the contents of serum ACh and Glu,with statistical significance(P<0.05),the combination group showed the most obvious effects(P<0.05).Conclusion Abdominal massage combined with electroacupuncture point-through-point method can improve insomnia.Its mechanism may be related to the regulation of circadian clock genes Clock,BMAL1,PER1 mRNA and protein expression,as well as neurotransmitter content.

Objective To explore the funding situation and hot research directions of NSFC(National Natural Science Foundation of China)projects in the discipline of acupoints and meridians from 1991 to 2022;To provide reference for this discipline to apply for the NSFC.Methods National Natural Science Foundation of China was login in to query website.The acupoints and meridians discipline project from 1991 to 2022 were retrieved.The project leader,project name,supporting unit,province,funding category,funding amount,keywords and other information were extracted.The data were input to Excel 2023 to establish a database,and descriptive analysis of project funding situation was performed.Target keywords were extracted,and the word table was classified and uploaded to the micro-word cloud online to draw the word cloud map to analyze the research hotspots.Results From 1991 to 2022,the number of projects funded by the NSFC for acupoints and meridians was 173.The funding category was mainly general projects,and the supporting units were mainly TCM colleges and universities and scientific research institutions.The main research directions were meridian essence,acupoint-viscera/body related effects and mechanism of action,and the signal molecules and related pathways were the entry points.Conclusion From 1991 to 2022,the NSFC-funded acupoints and meridians disciplines are mainly based on general projects,mainly concentrated in scientific research institutions and TCM colleges and universities,with uneven regional distribution.The essence of meridians and collaterals,acupoints-viscera/body-related effects and mechanisms(mechanisms)are the key research directions.