Background The high work intensity and possible subsequently increased susceptibility to occupational hazards of calcium carbide plants may lead to hypertension in workers, but there are few studies on the relationship between occupational hazard exposure and hypertension in workers involving the production process of calcium carbide. Objective To explore the influence of occupational hazards on the incidence of hypertension in calcium carbide plants. Methods Using historical cohort design, the employees of a calcium carbide factory in the western part of Inner Mongolia Autonomous Region were selected as research subjects. According to the pre-determined inclusion and exclusion criteria, the study population comprised an exposure group of 377 employees (including furnace workers, inspection workers, and maintenance workers) exposed to dust, noise & carbon monoxide, and a control group of 388 employees (including central control workers, electricians, and administrative personnel) without above-mentioned exposure. The total sample size was 765 participants. The follow-up period was from April 2011 to October 2022, and the study endpoint was defined as the conclusion of the follow-up period or diagnosed hypertension in annual occupational health examination. Information on general demographic characteristics, living habits, and work status was collected from all study subjects. Cox proportional hazards regression model was used to analyze the association between occupational hazard exposure and the risk of hypertension among the calcium carbide plant employees. Results The average age, mean systolic and diastolic blood pressure, proportion of males, smoking rate, and alcohol consumption rate in the exposure group were higher than those in the control group (P<0.05). Compared to baseline, both systolic and diastolic blood pressure levels increased in the exposure group and the control group at the end of the follow-up (P<0.05). At the end of the follow-up, the average differences between systolic/ diastolic blood pressure and baseline values in the exposure group were higher than those in the control group (P<0.05). During the follow-up period, a total of 223 cases of hypertension occurred, with a total follow-up of 2785 person-years, resulting in an incidence density of 8007.18 per 100000 person-years, an average age of onset of (35.90±8.22) years, and an average working age of onset of (2.69±1.97) years. The incidence density in the exposure group was 128.71% higher than that in the control group, and the risk of hypertension in the exposure group was 2.115 times that of the control group. The risk of hypertension was 2.199 times higher for men than for women, 1.344 times higher for those aged 30 and above than for those under 30, 1.546 times higher for smokers than for non-smokers, and 1.750 times higher for drinking workers than for non-drinking ones. The results of Cox proportional hazards regression modeling indicated that the hazard ratio (95%CI) of hypertension among the employees exposed to dust, noise, and carbon monoxide was 2.254 (1.703, 2.982), 1.594 (1.107, 2.295), and 1.567 (1.079, 2.274), respectively, when different covariates (gender, age, smoking, and alcohol consumption) were included. The results of Log-rank test showed that there were statistically significant differences in the distribution of disease-free survival between the exposure group and the control group (P<0.05). Conclusion Occupational exposures to dust, noise, and carbon monoxide may increase the risk of hypertension among calcium carbide plant workers.

Objective:To evaluate the effects of different exercises on patients with chronic kidney disease based on network Meta-analysis so to provide a basis for medical and nursing staff to develop exercise programs.Methods:Randomized controlled trials on the effects of different exercises on patients with chronic kidney disease were electronically searched in databases such as Web of Science, PubMed, Embase, Cochrane Library, China Biology Medicine disc, WanFang Data, and China National Knowledge Infrastructure. The search period was from January 1, 2000, to March 1, 2023. Two researchers conducted literature screening, data extraction, and literature quality evaluation independently. The data was analyzed by using R software in conjunction with the gemtc package and plotted by using Stata software.Results:A total of 52 articles were included, with a cumulative sample size of 3 127 cases, involving three types of exercise (aerobic, resistance, and combined). The network Meta-analysis showed statistically significant differences between the three exercise methods and routine nursing in delaying renal function progression and improving cardiovascular endurance ( P<0.05). In controlling blood pressure and improving walking ability, the effects of three exercise methods were all superior to routine nursing, and the differences were statistically significant ( P<0.05). The area under the cumulative ranking probability curve showed that aerobic exercise>resistance exercise>combined exercise in terms of delaying renal function progression. In controlling blood pressure, resistance exercise>aerobic exercise>combined exercise. In terms of improving cardiovascular endurance, aerobic exercise>resistance exercise>combined exercise; In terms of improving walking ability, resistance exercise>combined exercise>aerobic exercise. Subgroup analysis showed that ≥ 24 weeks was the optimal intervention period for aerobic exercise. Resistance exercise intervention for ≥ 12 weeks could lower blood pressure, and intervention for ≤12 weeks could improve walking ability. However, when the intervention time was longer than 24 weeks, combined exercise had an excellent effect. Conclusions:Aerobic exercise is an excellent way to delay renal function progression and improve cardiovascular endurance. Resistance exercise is the optimal exercise method for controlling blood pressure and improving walking ability. Medical and nursing staff should choose appropriate types of exercise based on the patient's medical needs.

Objective:To systematically review and synthesize qualitative studies on the experiences of information communication in the treatment decision-making process for patients with end-stage renal disease (ESRD) .Methods:Electronic databases, including PubMed, CINAHL, Embase, Cochrane Library, Medline, China National Knowledge Infrastructure, WanFang data, and VIP, were searched for studies on information communication experiences among ESRD patients during their treatment decision-making process up to March 1, 2023. The quality of the included studies was evaluated using the 2016 version of the Joanna Briggs Institute's qualitative research quality assessment criteria. A Meta-synthesis approach and NVivo 12.0 software were utilized for data synthesis.Results:Eleven studies were included, from which 28 themes related to information communication were extracted, integrated into six new categories, and synthesized into three consolidated findings: attitudes towards information communication during the treatment decision-making process for ESRD patients, needs for information communication during the treatment decision-making process, and the impact of information communication on treatment decision-making for ESRD.Conclusions:Information communication is crucial in the decision-making process for ESRD patients regarding treatment. Healthcare professionals should encourage patient involvement in information communication, meet their information needs, and establish diversified mechanisms of information communication to guide patients in choosing the best treatment options.

Objective:To explore the molecular mechanism of NF-κB signaling pathway mediated by MCP-1/CCR2 axis in the migra-tion of dental pulp stem cells(DPSCs)stemulated by inflamation factor.Methods:DPSCs of SD rats were in vitro cultured,and identified by flow cytometry.The inflammation model of DPSCs was established by LPS treatment,Western blot and Q-PCR were used to detect the expression of MCP-1 and CCR2 in DPSCs of the groups.The inflamatory DPSCs were treated by NF-κB pathway activator TNF-α and NF-κB pathway inhibitor BMS-345541 respectively,the activation of P65 in inflammatory DPSCs was detected by immuno-fluorescence.Scratch experiment was used to detect the migration ability of DPSCs.Results:Higher expression of MCP-1 and CCR2 genes was observed in LPS-induced DPSCs than in the controls,TNF-α treated DPSCs showed higher expression of MCP-1 and CCR2 genes than the LPS tread and the NF-κB pathway inhibitor BMS-345541 treated cells.TNF-α treated DPSCs showed higher scratch healing effect than LPS treated and BMS-345541 treated cells.Conclusion:The expression of MCP-1 and CCR2 genes in DPSCs is higher in inflammatory state,and the activation of NF-κB signaling pathway can enhance this expression,which can ultimately promote the migration ability of DPSCs in inflammatory state.

Objective To evaluate the efficacy and safety of neoadjuvant arterial interventional chemotherapy(NAIC)and neoadjuvant intravenous chemotherapy(NIVC)for the treatment of locally advanced cervical cancer(LACC).Methods Randomized controlled trials(RCTs)which fit the theme were included by searching PubMed,Web of Science,Embase,CNKI,and Wanfang databases.After study quality assessment and data extraction,statistical analysis was performed using Stata 17.0,and outcome quality was assessed using the GRADE system.Results A total of 14 RCTs were included,with 1 063 LACC patients.The results of the Meta-analysis showed that NAIC and NIVC had a positive effect on the effectiveness indicators:complete response(CR)[RR=1.23,95％CI(0.91,1.67),P=0.174],partial response(PR)[RR=1.10,95％CI(0.86,1.20),P=0.874],total response(TR)[RR=1.10,95％CI(0.95,1.25),P=0.212],no change(NC)[RR=0.62,95％CI(0.33,1.16),P=0.137]and progressive disease(PD)[RR=1.43,95％CI(0.41,4.99),P=0.574]were not statistically significant.Differences in safety indicators:gastrointestinal reactions[RR=0.96,95％CI(0.76,1.23),P=0.755],hepatic and renal impairment[RR=0.71,95％CI(0.41,1.23),P=0.226]were not statistically significant.While in the incidence of myelosuppression[RR=0.62,95％CI(0.45,0.86),P=0.04],NAIC was superior to NIVC.In addition,the GRADE score results showed CR,PR,TR,and NC were high-quality evidence.Conclusion For LACC patients,the incidence of myelosuppression after treatment with NAIV is lower and safer than that with NIVC,and no significant difference was found between the two in terms of other efficacy and safety indicators.Clinicians should choose the appropriate neoadjuvant chemotherapy regimen based on a comprehensive assessment of the patient's actual condition.

Objective To investigate the hemodynamic characteristics of carotid artery models with different degrees of artificial arterial stenosis based on hemodynamic numerical simulation,and to analyze causes of internal carotid artery stenosis and the diseases due to the stenosis from the perspective of hemodynamics.Methods Two-dimensional CT data of healthy individuals were collected from Affiliated Hospital of Inner Mongolia Minzu University,and the three-dimensional model of carotid artery was reconstructed from the two-dimensional CT data using medical modeling software MIMICS20.0.Subsequently,the obtained carotid artery model was imported to 3-Matic Medical software and interfered with various degrees of artificial internal carotid artery stenosis at the same location to obtain the models with 25%,50%and 75%internal carotid artery stenosis.After format conversion,boundary condition setting and mesh generation,the models were imported to computational fluid dynamics software FLUENT14.5 for the hemodynamic numerical simulation and analysis of the carotid artery and two-phase blood flow.Results The comparison of the blood streamlines and velocity vector maps of 3 different degrees of internal carotid artery stenosis at the same location revealed that with the increase of stenosis severity,the phenomenon of blood vortex flow at the carotid sinus decreases rapidly,but obvious vortex flow appeared above and below the internal carotid artery stenosis,and the blood flow was selectively deflected.During the internal carotid artery stenosis from 25%to 50%and then to 75%,the pressure on the wall of internal carotid artery was always low,and the pressure on the wall of internal carotid artery was gradually increased,forming a high pressure area.There was high shear stress area at the stenosis,and the low shear stress ranges above and below the stenosis were obviously larger.Conclusion The technology of using computer software to obtain models with artificial stenosis is convenient and efficient.When the internal carotid artery stenosis increases from 25%to 50%and then to 75%,the blood flow of the carotid artery changes obviously,obvious vortex flow appears in the internal carotid artery,and the mechanical properties of the wall of the carotid artery also change.

Objective To observe clinical and imaging findings of Kaposiform hemangioendothelioma(KHE)involved bone.Methods Data of 10 children with KHE involved bone diagnosed by surgery or biopsy pathology who underwent X-ray and non-contrast CT examination of the lesion site were retrospectively analyzed,among them 3 received enhanced CT and 9 received non-contrast MR examination.Clinical and imaging findings were observed,and the lesions were classified into type Ⅰ(confined to only bone)and type Ⅱ(involved both bone and surrounding soft tissue)according to CT findings.Results Single bone involvement was detected in 7 cases(7/10,70.00％),while multiple bone involvements were noticed in 3 cases(3/10,30.00％).CT type Ⅰ and Ⅱ were identified each in 5 cases.The median age of onset was 88.0 months,and the median course of disease was 4.0 months in type Ⅰ,all involved single bone,and the main clinical manifestations were pain but without Kasabach-Merritt phenomenon(KMP).The median age of onset was 5.0 months and the median course of disease was 1.0 months in type Ⅱ,including 3(3/5,60.00％)cases of multiple bone involvements,with swelling and limited movement of the lesion site,and KMP was observed in 2 cases(2/5,40.00％).X-ray shown most of the lesions with uneven bone density(8/10,80.00％)or lamellar low density(1/10,10.00％),while no obvious abnormality was found in 1 case(1/10,10.00％).On non-contrast CT,all affected bones in 10 cases present as worm erosion or osteolytic bone destruction,which could be accompanied by peripheral bone hyperplasia and sclerosis(8/10,80.00％),while significantly enhancement occurred in 2 cases with type Ⅱ lesion(2/3)on enhanced CT,while no obvious enhancement was found in 1 case with type Ⅰ lesion(1/3).Soft tissue involvement presented in 5 cases(5/10,50.00％),with borderless diffuse slightly low-density,including 2 cases of lesions significantly enhanced after enhancement.Non-contrast MRI showed that the affected bone presented equal T1 or slightly lower T1,mixed T2 or slightly higher T2 signal,while the affected soft tissue were found with equal T1 and slightly higher T2 signal.Conclusion Clinical and imaging findings of KHE involved bone had certain characteristics.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Objective To investigate the impact of healthy eating patterns on the mortality rate and in-cidence rates of end-stage kidney disease(ESKD)and cardiovascular disease(CVD)in the patients with chronic kidney disease(CKD)by meta analysis.Methods The studies on the relationship between the dietary patterns on the mortality,and the incidence rates of ESKD and CVD in the patients with CKD were retrieved from PubMed,Embase,Cochrane Library,CNKI,Wanfang Database and VIP Database.The retrieval time was from the database establishment to January 2023.The two researchers independently screened the literatures,ex-tracted the data and conducted the literature quality evaluation.The RevMan5.3 software was used for the meta-analysis of the included literatures.Results A total of 10 studies were included in this study,involving 27 291 patients.The results showed that the mortality(HR=0.70,95％CI:0.57-0.87,Z=3.18,P=0.001)and the ESKD incidence rate(HR=0.80,95％CI:0.71-0.91,Z=3.44,P＜0.001)and CVD inci-dence rate(HR=0.77;95％CI:0.61-0.97,Z=2.21,P=0.003)had statistical differences between the pa-tients with high dietary score and the patients with low dietary score.Conclusion Persisting in the healthy dieta-ry patterns could decrease the mortality rate,and incidence rates of ESKD and CVD in the patients with CKD.