Objective:To retrospectively summarize the clinical characteristics and treatment of 49 patients with hyperthyroid cardiopath and to explore the diagnosis and treatment methods of hyperthyroid cardiopathy.Methods:A total of 49 patients with hyperthyroid cardiopath(HC group) who were successfully treated and followed up in the Department of Endocrinology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, from January 2016 to December 2021 were collected, and 85 cases of Graves′ disease without heart disease were collected as the control group(GD group). The medical history, laboratory tests, and echocardiographic parameters of the two groups were compared. Differences in thyroid and cardiac indicators before and after treatment in the HC group were summarized, along with the dosage of β-receptor blockers used in treating different types of conditions(atrial fibrillation and heart failure.Results:Patients in the HC group were older and had a longer duration of hyperthyroidism than those in the GD group( P<0.001, P=0.002). There were no significant differences in thyroid hormone levels between the two groups except for reverse triiodothyronine(rT 3). Age and rT 3 were independent risk factors of hyperthyroid cardiopathy. rT 3 level was linearly positively correlated with brain natriuretic peptide, systolic pulmonary artery pressure, left artrium diamete (LAD) and left ventricular end-systolic diameter(LVDs; r=0.352, P<0.001; r=0.392, P=0.019; r=0.202, P=0.029; r=0.242, P=0.028). In patients of HC group, free triiodothyronine(FT 3) level returned to normal range after 2.87(1.63, 5.53) months of treatment with radioiodine(41/49) or antithyroid drugs(8/49), while brain natriuretic peptide, LAD, LVDs, and systolic pulmonary artery pressure declined after 5.00(1.25, 8.00) months of treatment. Non-selective β-receptor blockers were used for both hyperthyroid heart failure and atrial fibrillation, and there was no statistically significant difference in dosage[(86.52±47.83)mg vs(88.67±47.19)mg, P>0.05]. Conclusions:rT 3 may be a biomarker of hyperthyroid cardiopath and indicate the severity of hyperthyroidism. β-receptor blockers are crucial in treating patients with hyperthyroidism who develop atrial fibrillation and heart failure.

Objective To understand the occurrence characteristics of occupational chemical incidents in China by media surveillance, to provide scientific evidences for formulating effective prevention and control strategies, and to provide new ideas for public surveillance and early warning of chemical incidents. Methods Occupational chemical incidents were collected and sorted through the Internet every day. The statistical analysis was conducted from time, region, industry, and causes of the collected incidents. Results A total of 99 occupational chemical incidents were collected in 2021, involving 356 peoples and 186 deaths. April to July was the high incidence period of events, mainly limited space poisoning and asphyxiation events. Majority of the incidents were general grade events, mainly occurring in small and medium enterprises. Guangdong Province had the most incident reporting areas. Incidents mainly occurred in chemical raw material and chemical product manufacturing industry as well as in water production and supply industry, mainly in manufacturing, cleaning and maintenance positions. The main types of poisons were asphyxiating gases and organic solvents, mainly involving hydrogen sulfide and benzene. The incidents could have been caused by lack of safety awareness, leakage of equipment, and lack of protective measures. Conclusion Occupational chemical incidents still occur frequently and cause serious harm. It is suggested that the relevant departments and employers should strengthen supervision and management, effectively manage and control operational risks, and increase supervision of key industries and positions, to ensure the health and safety of workers.

Objective:To investigate the correlation between three-dimensional histogram analysis of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and Gleason score(GS)in prostate cancer(Pca)from two hospital, and its diagnostic efficacy for discriminating low-grade from high-grade Pca.Methods:A total of 102 pathologically confirmed Pca patients in the First Affiliated Hospital of Zhejiang Chinese Medical University and Hangzhou Traditional Chinese Medical Hospital(TCM Hospital)Affiliated to Zhejiang Chinese Medical University from January 2017 to October 2020 were retrospectively analyzed.The quantitative parameters of Pca, including transport constant(K trans), rate constant(K ep), percent volume of the extravascular extracellular space(V e)and fraction of the Intraplasmic contrast volume(V p), were obtained by manually layer by layer delineating of interested regions of all lesions on the original DCE-MRI imaging.Then the three-dimensional histogram analysis of the above parameters were performed to obtain the minimum, maximum, median, mean, area, 10 thpercentile, 25 thpercentile, 75 thpercentile and 90 thpercentile.The correlations between quantitative parameters and GS, and diagnostic efficiencies were analyzed. Results:102 Pca patients were divided into low-grade prostate cancer group(GS≤3+ 4)(n=44)and high-grade Pca group(GS≥4+ 3)(n=58). There were no statistically significant differences in age and location of lesions between the two groups( P>0.05), but there were statistically significant differences in Gleason score, PSA level and lesion diameter between the two groups( U=0.000, 730.000, 711.000, all P<0.05). The median, mean, 10 thpercentile, 25 thpercentile, 75 thpercentile, 90 thpercentile derived from K trans, and K ep(median, mean, 10%, 25%, 75%, 90%)together with maximum of K transand mean for V e were positively correlated with GS( r=0.405 to 0.583, P<0.05), in which mean of K transhad the highest positive correlation( r=0.583, P=0.000). The histogram parameters derived from V pwere negatively correlated with GS( r=-0.301 to 0.341, P<0.05). The area under ROC of 75th percentile derived from K transwas the highest(0.832). When the cut-off value of 75 thpercentile derived from K transwas ≥0.680/min, its Youden index, sensitivity, and specificity were 0.594, 0.776, 0.818, respectively. Conclusions:The three-dimensional histogram of DCE-MRI quantitative parameters has correlation with GS in Pca patients, can be used to discriminate low-grade from high-grade Pca.

Objective:To establish the reference for serum metabolomics profiles among healthy Han adults in China, and explore the variation on metabolomics profiles by geographic regions, sex, and age.Methods:Cross-sectional data and serum samples were obtained from the China National Health Survey. A total of 1 039 male and 1 032 female healthy adults(≥30 years) were included in this study. Serum metabolomics analyses were conducted with ultra-performance liquid chromatography-mass spectrometry(UPLC-MS). Orthogonal partial least squares discriminant analysis(OPLS-DA) was performed to compare the differences of metabolomics among different region, sex, and age.Results:Significant differences on metabolomics profiles were identified among region, sex, and age. A total of 114 region-related metabolites were spotted, including 53 metabolites that involved in human metabolic pathways, mainly peptides(20 metabolites) and glycerophospholipid metabolism-related(14 metabolites). Fifty-nine metabolites were pinned down to be sex-related, among which cotinine was significant in all 7 provinces. Age-related metabolites were only found in Shaanxi and Hainan, with 22 metabolites were recognized.Conclusion:Serum metabolomics varies by geographic regions, sex, and age. When metabolomics is applied for diagnosis or biomarker screening in various studies, it shall take into consideration of setting tailored references.

Objective:To investigate the effects of cabazitaxel on lung cancer cell metastasis and proliferation and the related mechanisms.Methods:Lung cancer cells A549 were divided into two groups. The experimental group were cultured with a low concentration of 50 μg/ml cabazitaxel, and the control group were cultured with an equal volume of a solution of cabazitaxel. The proliferation ability of the two groups of cells was examined using CCK8 and plate cloning experiments. The migration ability of A459 cells was verified by transwell and cell scratch experiments. The expression levels of MMP2/9, CDK4/6, and P16 protein were detected by Western blotting.Results:Compared with the control group, the cell proliferation ability of the A549 cell was weakened in the experimental group. The plate clone formation rate of the experimental group was 17.5%±2.3%, and A549 cell clone formation rate of the control group was 74.8%±4.5%. The cloning ability was reduced in the experimental group. Western blot results showed that the expression of CDK4/6 in the experimental group was down-regulated and the expression of P16 was up-regulated. The scratch healing percentage of the cells in the experimental group was 56.2%±3.8%, and the scratch healing percentage of the cells in the control group was 86.8%±5.2%. The scratch healing ability of the cells in the experimental group decreased. The transwell results showed that the experimental group had 35±4 cells per field of view, while it was 78±9 in the control group. The cell migration ability of the experimental group was decreased. Western blot results showed that the expression of MMP2/9 in the experimental group was down-regulated.Conclusion:Cabazitaxel leads to a decrease in the metastasis ability of lung cancer cells A549 through the extracellular matrix pathway, and inhibits cell proliferation by up-regulating P16.

Objective:To investigate the induction of specific T lymphocyte by bispecific monoclonal antibody in pancreatic cancer and its killing effects on KIF20A positive pancreatic cancer PANC1 cell line.Methods:CD 3/KIF20A bispecific monoclonal antibody was prepared and concentrated by chemical cross-linking method and purified by Sephrose-25 gel chromatography. Peripheral blood samples of healthy volunteers were collected, and monocytes were isolated using lymphocyte separation solution, and then cultured as dendritic cells (DC) and T cells respectively, and then co-cultured as DC-T cells. Meanwhile vitamin C was used to treat DC-T cells (vcDC-T cells). The levels of IFN-γ, IL-2, IL-4 and IL-12 in the supernatants and T cell subsets were detected by flow cytometry. About 1×10 5 T cells, DC-T cells, and vcDC-T cells with 10, 50, 100 and 300 ng CD 3/KIF20A antibody loaded were cocultured with PANC1 cells (20∶1) for 2, 6 and 10 hours to determine the highest killing rate dosage of CD 3/KIF20A antibody loaded cells. DC-T cells and DC-T cells, vcDC-T cells loaded with the highest killing rate dosage of CD 3/KIF20A antibody were cocultured with PANC1 cells (20∶1) for 2, 6, 8, 10 and 12 hours. The aggregation effect of effector cells on target cells was observed under inverted microscope, the killing rate of tumor cells was detected by LDH method. Results:The molecular weight of CD 3/KIF20A antibody was 130 000 measured and validated by SDS gel electrophoresis. The ratio of CD 8+ CD 28+ and CD40L subsets of vcDC-T cells was increased [(47.6±15.8)% vs (38.2±7.6)%, (52.1±4.9)% vs (44.7±3.2)% ] compared with that of DC-T cells, the ratio of negative regulatory cells (Treg) was decreased [(4.3±0.8)% vs (8.3±1.1)%]; the release of IL-2, IFN-γ and IL-12 was increased [(201.2±17.3) ng/L, (163.4±13.1)ng/L, (303.3±22.6)ng/L vs 221.8±17.6)ng/L, (190.4±11.7)ng/L vs (80.3±8.6)ng/L]. All the differences were statistically significant ( P<0.01). 100 ng CD 3/KIF20A loaded T cells were observed under microscope, which obviously targeted KIF20A + pancreatic cancer PANC1 cells and had a strongest killing power. At the killing cells to targeting cells ratio of 20∶1 with 4-hour coculture, the killing rate of CD 3/KIF20A-vcDC-T cells on PANC1 cells was (88.6±2.6)%, which was significantly higher than (68.4±3.4)% and (39.2±2.1)% in the CD3/KIF20A-DC-T group and (39.2±2.1)% in the DC-T group, increasing by 20% and at lease 45%, respectively. Conclusions:DC-T cells loaded with CD 3/KIF20A antibody can significantly increase the killing rate of KIF20A positive pancreatic cancer PANC1 cells, and vitamin C intervention can further enhance the killing ability of antibody loaded T cells.

Objective:To investigate the safety and efficacy of anlotinib in treatment of advanced malignant tumors.Methods:The clinical data of 65 patients with advanced malignant tumors after the failure of the second-line treatment in Shanxi Bethune Hospital from July 2018 to July 2019 were retrospectively analyzed, including 32 cases of non-small cell lung cancer, 12 cases of small cell lung cancer, 15 cases of ovarian cancer, and 6 cases of peritoneal cancer. The objective total remission rate (ORR), disease control rate (DCR), progression-free survival (PFS) time, and the related adverse events were also analyzed.Results:ORR in non-small cell lung cancer group was 43.7% (14/32), DCR was 68.8% (22/32); ORR in small cell lung cancer group was 8.3% (1/12), and DCR was 25.0% (3/12). ORR in ovarian cancer group was 33.3% (5/15), DCR was 73.3% (11/15). In peritoneal carcinoma group, ORR was 0 (0/6) and DCR was 33.3% (2/6). The median PFS time was 8.0 months (95% CI 6.2-9.8 months) in the non-small cell lung cancer group, 3.0 months (95% CI 1.9-4.1 months) in the small cell lung cancer group, 5.0 months (95% CI 3.1-6.9 months) in the ovarian cancer group, and 2.0 months (95% CI 0.0-5.6 months) in the peritoneal cancer group. Hypertension was the most common non-hematology-related adverse event, and there were 6 cases (9.2%) of grade Ⅰ-Ⅱ adverse event and 1 case (1.5%) of grade Ⅲ-Ⅳ adverse event. Among the hematology-related adverse events, thrombocytopenia was the most common, and there were 8 cases (12.3%) of grade Ⅰ-Ⅱ adverse event and 1 case (1.5%) of grade Ⅲ-Ⅳ adverse event. All patients could tolerate the adverse reactions. Conclusion:Anlotinib is one of the options for the treatment of advanced malignant tumors, with mild drug-related adverse reactions and definite efficacy.

Objective: To provide scientific evidence for the prevention and control measures of silicosis by analyzing the epidemiological characteristics of silicosis cases reported in Tianjin city during 2001-2015. Methods: The database of silicosis cases reported in Tianjin from 2001 to 2015 was established and analyzed by SPSS 24.0 software. Results: 2 213 cases of silicosis were reported during 2001~2015 in Tianjin, 2015 of them were new cases, and fewer reports of promoting stage cases and death cases, which were129 and 69 cases. The new cases were increasing by years, mainly stage I silicosis accounting for 99.2%, the years of dust exposure were concentrated from 1970 to 1989, accounting for 69.58%. From 2001 to 2015, the median length of service at the onset of silicosis was 19.30 years, the age of the onset of silicosis is decreasing. The median of onset age in new cases of silicosis was 53.28 years, and increased year by year. There were significant differences in indirect dust working age and diagnostic age in different reporting years. Most cases were distributed in non-mental mineral product industry, and ferrous metal smelting and rolling processing industry. The work types of these cases are various. Conclusion The increasing incidence of silicosis and the shortening of dust-exposed working years suggest that the form of silicosis hazards is still severe in Tianjin. According to the epidemic characteristics of silicosis, we should strengthen the supervision and management of key industries and special investigation, carry out silicosis census and silicosis screening of dust-removal workers, and take pertinent measures to prevent and control the occurrence of silicosis.

Objective To investigate the safety and efficacy of low-dose apatinib in treatment of advanced malignant tumors. Methods The clinical data of 54 patients with advanced malignant tumors who were admitted to Shanxi Dayi Hospital from March 2015 to March 2018 were analyzed retrospectively. These patients were treated with apatinib at doses of 250 mg (29 cases) and 500 mg (25 cases) after initial treatment or failure of multi-line treatment. There were 15 cases of gastric cancer, 11 cases of lung cancer, 9 cases of ovarian cancer, 7 cases of liver cancer, 6 cases of soft tissue sarcoma, 3 cases of esophageal cancer, 2 cases of melanoma, and 1 case of peritoneal cancer. The objective response rate (ORR), disease control rate (DCR), progress free survival (PFS) and overall survival (OS) were analyzed, and the efficacy and related adverse reactions were evaluated. Results The adverse reactions of 54 patients could be evaluated. Non-hematological drug-related adverse reactions were most common with hypertension, hand-foot skin reaction and proteinuria, while hematologic drug-related adverse reactions were most common with leukopenia and thrombocytopenia. All patients were well tolerated. The incidence of drug-related adverse reactions in the 250 mg dose group was lower than that in the 500 mg dose group, and the incidence of grade Ⅰ-Ⅱhypertension between the two groups was statistically different (χ2 = 6.268, P= 0.012). Short-term efficacy:ORR of the patients in the 250 mg and 500 mg dose groups was 6.9％ (2/29) and 12.0％ (3/25), respectively;DCR was 41.4％ (12/29) and 52.0％ (13/25), respectively; and the 500 mg dose group was superior to the250 mg dose group, but the differences were not statistically significant (ORR: χ2= 0.416, P= 0.519; DCR:χ2= 0.609, P= 0.435). Long-term efficacy: the 500 mg dose group had a slight advantage over the 250 mg dose group in both median PFS time (3.9 months vs. 3.6 months) and median OS time (7.8 months vs. 7.6 months), but the differences were not statistically significant (PFS:χ2=0.472, P=0.492; OS:χ2=0.261, P=0.609). Conclusions Low-dose apatinib can be used to treat advanced malignant tumors. The drug-related adverse reactions are small, the curative effects are exact, the adverse reactions are easy to tolerate, and it is convenient for long-term use. Low-dose apatinib is one of the treatment options for advanced malignant tumors.

Objective To understand the cross-time diagnosis stability of autism spectrum disorder (ASD),and analyze the situation of misdiagnosis and missed diagnosis.Methods A retrospective analysis was carried out to analyze 3 163 children who were first time diagnosed as ASD in Shenzhen Maternal and Child Health Care Hospital from January 2014 to September 2018.463 cases of ASD were evaluated again after one year apart.Statistical methods such as rank sum test or chi-square test were used to compare the coincidence rate,misdiagnosis rate and missed diagnosis rate among different age groups.Misdiagnosis was analyzed among different age groups.Results The mean age of the first diagnosis was 39.00 (29.04,56.04) months,and the mean age of second diagnosis was 54.07 (43.83,69.03) months.The interval time between the two diagnoses was 17.78 (14.33,24.94) months.The diagnosis coincidence rate of ASD was 86.96％,the misdiagnosis rate was 5.80％,and the missed diagnosis rate was 7.25％.The misdiagnosis rates of＜24-month-old group and ＞72-month-old group were higher than that of 24-month-old group and 36-month-old group (x2=8.316,P=0.040).There was no difference in missed diagnosis rate between each group (x2=1.358,P=0.715).28 children were misdiagnosed,＜24-month-old group and 24-month-old group were liable to misdiagnosis as the other developmental disorders than ＞72-month-old group.While＞72-month-old group was liable to misdiagnosis as Attention Deficit Hyperactivity Disorder (ADHD) or emotional disorder than these two group (P=0.009).35 children were missed diagnosis,＜24-month-old group and 24-month-old group were liable to missed diagnosis than ＞72-month-old group because of developmental problem,while ＞72-month-old group was liable to missed diagnosis because of ADHD or emotional disorder (P=0.008).Conclusion The diagnostic consistency of ASD with the interval period of 17.78 months,including the initial diagnosis in children younger than 1 year old,is pretty high.ASD is liable to be confused with other developmental disorders at the younger age.When order than 72 months-old,ASD is liable to be confused with ADHD or emotional disorders.