Objective To analyze the lung function condition and the prevalence of pulmonary ventilation disorders in the occupational population of Wuhan, and to explore their influencing factors. Methods Physical examination data from the Wuhan Prevention and Treatment Center for Occupational Diseases were used in this study, and finally 9499 people were selected as the study subjects. The linear regression model and logistic regression model were used to analyze the influencing factors of pulmonary ventilation function and pulmonary dysfunction. The restricted cubic spline was used to explore the nonlinear relationship. Results The prevalence of pulmonary ventilation disorders was 1.7%, and the lung function indexes FVC, FEV1, and FEV1/FVC were significantly lower in the population aged >27 years than in the population aged <27 years (P<0.001). The lung function indexes FVC and FEV1 were significantly lower in females than in males (P<0.001). The lung function indexes FVC and FEV1 were significantly lower in underweight occupational groups than in normal-weight groups (P<0.001), and FVC and FEV1 were significantly lower in dust-exposed occupational groups than in groups without dust exposure(P<0.05). Restricted cubic spline plots showed a nonlinear relationship between age and lung function indexes FVC and FEV1 (P_nonlinear< 0.05). Age and BMI were the risk factors for pulmonary ventilation disorders. Conclusion Age, gender, BMI, and dust exposure are risk factors for decreased FVC and FEV1. Age is the risk factor for decreased FEV1/FVC. Age and BMI are the risk factors for pulmonary ventilation disorders.

BACKGROUND: This study aimed to investigate programmed death-ligand 1 tumor proportion score in predicting the safety and efficacy of PD-1/PD-L1 antibody-based therapy in treating patients with advanced non-small cell lung cancer (NSCLC) in a real-world setting. METHODS: This retrospective, multicenter, observational study enrolled adult patients who received PD-1/PD-L1 antibody-based therapy in China and met the following criteria: (1) had pathologically confirmed, unresectable stage III-IV NSCLC; (2) had a baseline PD-L1 tumor proportion score (TPS); and (3) had confirmed efficacy evaluation results after PD-1/PD-L1 treatment. Logistic regression, Kaplan-Meier analysis, and Cox regression were used to assess the progression-free survival (PFS), overall survival (OS), and immune-related adverse events (irAEs) as appropriate. RESULTS: A total of 409 patients, 65.0% ( n = 266) with a positive PD-L1 TPS (≥1%) and 32.8% ( n = 134) with PD-L1 TPS ≥50%, were included in this study. Cox regression confirmed that patients with a PD-L1 TPS ≥1% had significantly improved PFS (hazard ratio [HR] 0.747, 95% confidence interval [CI] 0.573-0.975, P = 0.032). A total of 160 (39.1%) patients experienced 206 irAEs, and 27 (6.6%) patients experienced 31 grade 3-5 irAEs. The organs most frequently associated with irAEs were the skin (52/409, 12.7%), thyroid (40/409, 9.8%), and lung (34/409, 8.3%). Multivariate logistic regression revealed that a PD-L1 TPS ≥1% (odds ratio [OR] 1.713, 95% CI 1.054-2.784, P = 0.030) was an independent risk factor for irAEs. Other risk factors for irAEs included pretreatment absolute lymphocyte count >2.5 × 10 9 /L (OR 3.772, 95% CI 1.377-10.329, P = 0.010) and pretreatment absolute eosinophil count >0.2 × 10 9 /L (OR 2.006, 95% CI 1.219-3.302, P = 0.006). Moreover, patients who developed irAEs demonstrated improved PFS (13.7 months vs. 8.4 months, P <0.001) and OS (28.0 months vs. 18.0 months, P = 0.007) compared with patients without irAEs. CONCLUSIONS A positive PD-L1 TPS (≥1%) was associated with improved PFS and an increased risk of irAEs in a real-world setting. The onset of irAEs was associated with improved PFS and OS in patients with advanced NSCLC receiving PD-1/PD-L1-based therapy.
Humans ; Carcinoma, Non-Small-Cell Lung/metabolism* ; Male ; Female ; Retrospective Studies ; Middle Aged ; Lung Neoplasms/metabolism* ; Aged ; B7-H1 Antigen/metabolism* ; Programmed Cell Death 1 Receptor/metabolism* ; Adult ; Aged, 80 and over ; Immune Checkpoint Inhibitors/therapeutic use*

Based on the data from the 5^th National Physical Fitness Surveillance in China, this study aimed to explore the relationship between abnormal body weight and physical fitness levels in older adults.

To investigate the effect of isthmin-1 (ISM1) on the invasion and metastasis of pancreatic cancer and its underlying mechanism, this study analyzed the expression of ISM1 in pancreatic cancer patients and normal pancreatic tissues using The Cancer Genome Atlas (TCGA) database. Western blot was employed to detect differences in ISM1 protein expression between pancreatic cancer cell lines (Aspc1, Bxpc3, PANC1, SW1990) and the pancreatic epithelial cell line (hPNE). Cell models with stable ISM1 overexpression and knockdown were constructed, and changes in cell migration and invasion capabilities were assessed via Transwell invasion assays and wound healing assays. Meanwhile, Western blot was used to detect the expression levels of key markers of epithelial-mesenchymal transition (EMT). Furthermore, TCGA and the Gene Expression Omnibus (GEO) database were utilized to analyze pathways regulated downstream of ISM1 and the mechanisms promoting pancreatic cancer invasion and metastasis. Immunoprecipitation combined with mass spectrometry (IP-MS) was used to screen for vimentin as an ISM1-binding protein, and the interaction between ISM1 and vimentin was verified by immunofluorescence and co-immunoprecipitation (Co-IP). Bxpc3 cells overexpressing ISM1 were treated with the protein synthesis inhibitor cycloheximide (CHX) to detect vimentin protein stability. The results indicate that ISM1 promotes the EMT process by inhibiting vimentin degradation, thereby enhancing the invasion and metastasis of pancreatic cancer. This study provides new experimental evidence for elucidating the mechanism of pancreatic cancer metastasis.

Objective:To construct the optimal prediction model for in-hospital mortality risk in emergency multiple trauma patients based on different supervised machine learning algorithms.Methods:A retrospective analysis was conducted on the clinical data of 817 patients with emergency multiple trauma who were admitted to the Daxing Teaching Hospital, Capital Medical University from January 2019 to December 2023. Among them, 602 were males and 215 were females, the age ranged from 18 to 89 years, with an average of (54.82±17.25) years. The general information and laboratory test indicators of patients were collected as relevant predictor variables, with in-hospital mortality defined as the study endpoint. The patients were simply and randomly divided into the training set ( n=571) and the testing set ( n=246) in a 7∶3 ratio. Univariate analysis was performed on the training set to compare the relevant variables between the survival and death groups. Variables with statistical significance were then subjected to LASSO regression analysis to identify predictors with non-zero coefficients, which were selected as final features. Three supervised machine learning models, namely Logistic regression (LR), random forest (RF), and support vector machine (SVM) were selected to construct the model. The predictive performance of each model in testing set was evaluated, and the predictive efficacy of the models was verified using receiver operating characteristic (ROC) curve. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and comparisons between groups were conducted using the t-test. The measurement data with non-normal distribution were expressed as median and interquartile range [ M( Q1, Q3)], and comparisons between groups were conducted using rank-sum tests. The count data were expressed as the number of cases and percentages, and comparisons between groups were conducted using the Chi-test or Fisher exact probability method. Results:A total of 817 patients were included, with 65 deaths, resulting in a mortality of 8.0%. Univariate analysis was conducted based on the training set data, and then LASSO regression analysis was performed on the variables with statistically significant differences. The results showed 17 variables were risk factors for in-hospital mortality in patients with emergency multiple trauma, including age, albumin, red blood cell (RBC), creatine kinase (CK), glucose (GLU), brain natriuretic peptide (BNP), C-reactive protein (CRP), lactic acid, PCO 2, low-density lipoprotein cholesterol (LDL-C), prothrombin time (PT), fibrinogen (FIB), fibrin degradation products (FDP), troponin I (TNI), procalcitonin (PCT), injury severity score (ISS), and Glasgow coma scale (GCS). Based on the above 17 variables, three supervised machine learning models were established. Among the LR model, the top 5 in terms of importance were PCO 2, PCT, FDP, PT, and RBC. Among the RF model, the top 5 in terms of importance were PCO 2, ISS, GLU, ALB, and GCS. Among the SVM model, the top 5 in terms of importance were PCT, FDP, PCO 2, PT, and GLU. Model performance evaluation in the testing set showed that the area under the curve (AUC) of the LR model was 0.952, the specificity was 0.996, the accuracy was 0.963, and both the sensitivity and recall rate were 0.600. The AUC of the RF model was 0.970, better than the LR and SVM models, the specificity was 0.987, the accuracy was 0.959, and both the sensitivity and recall rate were 0.650. The AUC of the SVM model was 0.944, the specificity was 0.996, the accuracy was 0.947, and both the sensitivity and recall rate were 0.400. Each model had its strengths, but the RF model demonstrated the best overall performance. Conclusion:The RF model constructed using 17 optimal variables such as PCO 2, ISS, GLU, ALB, and GCS shows strong predictive capability for in-hospital mortality in emergency multiple trauma patients and warrants further clinical investigation.

Objective To investigate the clinical efficacy of Jianpi Qushi Method(a spleen-invigorating and dampness-removing approach)combined with Chinese herbal fumigation therapy in treating seborrheic alopecia of spleen deficiency with dampness-accumulation type and to observe its influence on hormone levels.Methods The observation was carried out in 104 patients with spleen deficiency with dampness-accumulation type of seborrheic alopecia,who admitted to the Department of Dermatology at Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2023 to February 2024.The patients were equally randomized into a trial group and a control group,with 52 cases in each group.The control group received oral administration of Finasteride Tablets,while the trial group was additionally treated with Jianpi Qushi Method combined with Chinese herbal fumigation therapy for 3 months.Serum hormone levels,hair loss scores,clinical symptom scores(including greasy hair,pruritus,scaling,and growth of new hair),and trichoscopic parameters of the hair in the two groups were assessed before and after treatment.After treatment,the clinical efficacy and adverse reactions in the two groups were also evaluated.Results(1)After 3 months of treatment,the total effective rate in the trial group was 94.23％(49/52)and that in the control group was 73.08％(38/52).The trial group demonstrated significantly superior efficacy compared to the control group(tested by chi-square test,P<0.01).(2)After treatment,both groups exhibited a significant decrease in serum testosterone level(P<0.05)and a significant increase in serum estradiol level(P<0.05)compared to those before treatment.Notably,the trial group showed a more pronounced reduction in testosterone and a greater elevation in estradiol than the control group(P<0.01).(3)Both groups displayed a significant reduction in hair loss scores after treatment(P<0.05),and the trial group achieved a markedly greater decrease than the control group(P<0.01).(4)After treatment,the clinical symptom scores for greasy hair,pruritus,scaling,and growth of new hair significantly decreased in both groups compared to those before treatment(P<0.05).And the trial group exhibited significantly greater improvements in the scores of all symptoms than the control group(P<0.01).(5)After treatment,both groups showed a significant increase in hair density(hairs/cm2)and count of upright regrowing hair(P<0.05),along with a significant decrease in vellus hair count,hair count in the single hair follicle,and count of perifollicular keratosis(P<0.05).The trial group demonstrated significantly superior improvements in all trichoscopic parameters compared to the control group(P<0.01).(6)No significant adverse reactions were observed in either group during the treatment period,indicating a favorable safety profile for both therapeutic approaches.Conclusion Jianpi Qushi Method combined with Chinese herbal fumigation therapy exerts significant efficacy in treating seborrheic alopecia of spleen deficiency with dampness-accumulation type.The combined therapy is effective on regulating hormone levels,promoting hair regeneration,and alleviating symptoms such as greasy hair and pruritus,and demonstrates favorable safety.

Objective To investigate the effects of Aurora kinase A(AURKA)on the tumor microenvironment of colorectal cancer(CRC)and to predict the active compounds in Chinese herbs that can target AURKA.Methods Based on the transcriptomic data and clinical information from 380 CRC tissues and 51 paracancerous tissues in The Cancer Genome Atlas(TCGA)database,the infiltration of different cells in the tumor tissues was analyzed using xCell and the binding of active compounds of Chinese herbs with AURKA was predicted through molecular docking.Results The expression of AURKA was significantly upregulated in CRC tissues compared with that in paracancerous tissues(P＜0.05),and CRC patients with high AURKA expression had shorter overall survival.Compared with the AURKA low-expression group,the abundance of macrophages,monocytes,and effector memory CD4+and CD8+T cells was significantly downregulated in the AURKA high-expression group(P＜0.05).In addition,the cytotoxicity of T cells was significantly reduced(P＜0.05).Further analysis revealed that AURKA expression was positively correlated with the abundance of myeloid-derived suppressor cells(MDSCs)and the expression levels of their chemokines CXCL2 and CXCL5(P＜0.05).Genes that were differentially expressed between the AURKA high-and low-expression groups were mainly enriched in monocyte migration,chemokine-induced cellular responses,and other related processes.Chinese herbal compounds,including hesperidin,aristololactam A Ⅱ a,anacardic acid,coumestrol,and 17β-estradiol,all showed binding energies to AURKA lower than-1.2 kcal/mol,indicating a certain level of binding stability.Among these Chinese herbal compounds,17β-estradiol exhibited the best binding stability to AURKA-3UOL.Conclusion The high expression of AURKA in CRC tissues suggests a poor clinical prognosis.AURKA can promote the development of a suppressive immune microenvironment in CRC,and 17β-estradiol,an active compound from Chinese herbs,is a potential therapeutic agent targeting AURKA.

Objective:To investigate the role of the Smad3 signaling pathway in the process of silica-induced epithelial-mesenchymal transition (EMT) .Methods:In September 2022, lung epithelial cells (BEAS-2B) were exposed to different concentrations of silica suspension (0, 50, 100, and 150 μg/ml) for 6 and 12 hours. Additionally, SIS3, a specific inhibitor of phosphorylated Smad3 (p-Smad3) , was utilized to establish the p-Smad3 inhibition model. The cells were divided into four groups: blank control gruop, silica group, SIS3 intervention group, and SIS3 +silica group. Cell morphology was observed using an inverted fluorescence microscope, while cell viability was assessed using a Cell Counting Kit-8 (CCK-8) . The mRNA and protein expression levels of E-cadherin (E-Cad) , N-cadherin (N-Cad) , Vimentin, Smad3, and p-Smad3 were analyzed by Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting, respectively. Differences between two groups were compared using Student's t-test, and multiple group comparisons were analyzed using a one-way analysis of variance with the Student-Newman-Keuls test.Results:Compared with the blank control group, the morphology of BEAS-2B cells shifted from epithelial to mesenchymal cell-like following silica exposure, and the cell viability of BEAS-2B cells declined after exposure to 150 μg/ml silica for 6 and 12 hours. Furthermore, silica exposure led to significant reductions in mRNA and protein expression levels of the epithelial cellular marker (E-Cad) in BEAS-2B cells, accompanied by increased expressions of interstitial cellular markers (N-Cad and Vimentin) . Importantly, the level of p-Smad3/Smad3 expression levels was also elevated in silica-treated cells ( P<0.05) . Compared to the blank control group, the level of p-Smad3/Smad3 expression levels was significantty reduced. Moreover, compared to the silica group, the protein expression levels of N-Cad and Vimentin in the cell of the SIS3+silica group were significantly reduced, while the E-Cad expression was increased ( P<0.05) . Conclusion:Silica exposure can prmote the epithelial mesenchymaol transformotion process by activating smod3 signa ling pathuay, and in hibiting smad3 signa ling pathuay can effctively alleviate the occurrence of epithelial mesenchymal transformation process.

Objective In response to the clinical needs for personalized wrist orthoses,a topological optimization design method was proposed to achieve an integrated macro-and micro-structural optimization of a personalized,lightweight,and comfortable wrist orthosis.Methods A composite biomechanical finite element model of the wrist orthosis and upper limb was established to quantify the effects of the orthosis geometry on its fixation performance and comfort.A multi-condition topological optimization and microstructure design approach was employed to optimize the non-load-bearing areas of the orthosis.The orthosis was manufactured using three-dimensional(3D)-printed polyether ether ketone(PEEK),and the feasibility of the design was validated.Results While maintaining mechanical strength,the weight of the 3D-printed PEEK orthosis was reduced by 28％compared to the traditional orthoses.Both the pressure at the skin contact interface and the results of a subjective questionnaire indicated that test subjects experienced a high level of comfort wearing the orthosis.Conclusions The orthosis design achieved personalization,lightweight structure,and high comfort while ensuring mechanical strength and fixation performance.