Background::Early detection of esophageal squamous cell carcinoma (ESCC) can considerably improve the prognosis of patients. Aberrant cell-free DNA (cfDNA) methylation signatures are a promising tool for detecting ESCC. However, available markers based on cell-free DNA methylation are still inadequate. This study aimed to identify ESCC-specific cfDNA methylation markers and evaluate the diagnostic performance in the early detection of ESCC.Methods::We performed whole-genome bisulfite sequencing (WGBS) for 24 ESCC tissues and their normal adjacent tissues. Based on the WGBS data, we identified 21,469,837 eligible CpG sites (CpGs). By integrating several methylation datasets, we identified several promising ESCC-specific cell-free DNA methylation markers. Finally, we developed a dual-marker panel based on methylated KCNA3 and OTOP2, and then, we evaluated its performance in our training and validation cohorts. Results::The ESCC diagnostic model constructed based on KCNA3 and OTOP2 had an AUC of 0.91 [95% CI: 0.85–0.95], and an optimal sensitivity and specificity of 84.91% and 94.32%, respectively, in the training cohort. In the independent validation cohort, the AUC was 0.88 [95% CI: 0.83–0.92], along with an optimal sensitivity of 81.5% and specificity of 92.9%. The model sensitivity for stage I–II ESCC was 78.4%, which was slightly lower than the sensitivity of the model (85.7%) for stage III–IV ESCC. Conclusion::The dual-target panel based on cfDNA showed excellent performance for detecting ESCC and might be an alternative strategy for screening ESCC.

Objective:To evaluate the effect of oropharyngeal aspiration on reducing ventilator-associated pneumonia,in order to provide a basis for clinical operation and practice.Methods:CNKI, Wanfang, China Biology Medicine Disc, VIP, PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases were searched for relevant studies on the effects of oropharyngeal attraction on ventilators associated pneumonia. At the same time, the included references were screened, and the search time limit was from the establishment of the database to January 1, 2023. The quality of the included literature was strictly evaluated and data extracted by two researchers with evidence-based training, and Meta-analysis was performed by RevMan 5.4 software.Results:The results of meta-analysis showed that oropharyngeal aspiration could reduce the incidence of ventilator-associated pneumonia ( OR=0.30, 95% CI 0.22-0.40, P<0.01) and shorten the duration of mechanical ventilation ( MD=-2.39, 95% CI -3.59--1.20, P<0.01) and reduced length of stay in ICU ( MD=-2.62, 95% CI -2.99--2.26, P<0.01). Conclusions:Strengthening oropharyngeal aspiration can reduce the incidence of ventilator-associated pneumonia in patients with mechanical ventilation. In clinical practice, oropharyngeal aspiration should be performed when the position changes, and continuous aspiration can be performed if conditions are met.

Objective To study the stress distributions of the surrounding bone during the dynamic implantation of micro-implants,a finite element model of self-attacking orthodontic micro-implant dynamic implantation was proposed and established.Methods A three-dimensional(3D)oral model was constructed using CBCT data.The local model around the implant and the 3D finite element model of the micro-implant were established using ABAQUS software.The micro-implant was implanted into the jaw with an axial propulsion force of 40 N at a constant speed of 0.5 r/s.Results The 3D finite element model was successfully established to simulate dynamic self-attacking orthodontic micro-implant implantation in the jaw bone.The results showed that implantation stage and thread position had significant effects on bone stress distribution and the stress states of different bones had obvious differences:the maximum stress on the cortical bone was 167 MPa,and the maximum stress at the stable stage was approximately 50 MPa.The maximum stress on cancellous bone was 30 MPa.Conclusions The implantation stage and thread position have apparent influences on stress distribution.The stress difference between the cortical and cancellous bones was evident.The stress characteristics can judge the bone type,and whether the jaw is in a suitable implantation state can be judged by the bone stress distributions around the implant.

Objective To investigate the influence of individual factors and labor organization factors on work-related musculoskeletal disorders (WMSDs) in automobile manufacturing workers, and to provide a scientific basis for the prevention and treatment of WMSDs in automobile manufacturing workers. Methods In April 2020, 5564 workers in an automobile factory were selected by cluster sampling method. The prevalence of WMSDs was investigated by using the Musculoskeletal Disorders Questionnaire, and the influence of individual factors and labor organization factors on WMSDs was investigated by using generalized estimation equation. Results The prevalence rate of WMSDs was 79.00% (4396/5564), and the prevalence rate of multisite WMSDs was 67.95% (3781/5564). The analysis of generalized estimation equation showed that doing the same job every day (OR= 1.478, P < 0.05), age ≥40 years (OR=1.416, P< 0.05), personnel shortage (OR= 1.356, P < 0.05), and work length of 6～10 years and 11～15 years (OR= 1.349, P< 0.05) were the main risk factors for WMSDs in automobile manufacturing workers. Shift work and working time > 40 hours per week increased the risk of WMSDs (P< 0.05). Male and adequate rest time were protective factors for WMSDs. The job correlation matrix showed that WMSDs in most parts had a positive correlation. Conclusions The prevalence of multisite WMSDs of workers in automobile manufacturing industry is high, and unreasonable labor organization is the main risk factor of WMSDs. Appropriate work breaks can effectively reduce the risk of WMSDs, and effective intervention measures should be carried out to prevent the occurrence of WMSDs in workers in automobile manufacturing industry. The generalized estimation equation can better analyze the influencing factors of WMSDs.

Objective To clone the HnGUA gene from Hirudo nipponia and conduct bioinformatics analysis,protein prokaryotic expression analysis and gene differential expression analysis.Methods Based on the transcriptome data of H.nipponia in the previous study,the full-length cDNA of HnGUA was cloned by rapid amplification of cDNA ends(RACE),and bioinformatics analysis was performed.The prokaryotic expression vector was constructed,transformed into Escherichia coli BL21(DE3)competent cells and the expression of recombinant protein was induced by IPTG.The qPCR was used to further analyze the tissue-specific expression of HnGUA.Results The size of HnGUA gene was 504 bp,containing an open reading frame(ORF)of 231 bp and encoding 76 amino acids.Its protein molecular weight and isoelectric point are 8.17 kDa and 4.44,respectively.Multiple sequence alignment analysis showed that HnGUA was highly homologous to genes in other leech species that encode inhibitory proteins.The results of the prokaryotic expression analysis showed that the constructed pET32a-HnGUA vector could be successfully expressed in E.coli BL21(DE3),and the SDS-PAGE results showed that the induced recombinantly expressed HnGUA protein was around 6 kDa,which was basically consistent with the predicted protein size.The results of the Real-time PCR revealed spatial and temporal differences in the expression profiles of HnGUA,with high levels of expression detected in the skin and crop tissues.Conclusion This study represents the first successful cloning of the HnGUA gene from H.nipponia and the expression of the corresponding recombinant protein in E.coli.It provides a foundation for future exploration of the biosynthetic pathways and molecular regulatory mechanisms of active small anticoagulant molecules in leeches.

Objective: To investigate the influencing factors and population attributable risk percent (PAR%) of low back pain in automobile assemblers. Methods: A total of 634 assemblers from 11 automobile manufacturers in Shiyan City, Hubei Province were chosen as research subjects using judgment sampling method. The prevalence of low back pain in the past one year was investigated using Musculoskeletal Disorders Questionnaire. PAR% was used to analyze the contribution of influencing factors to low back pain. Results: The annual prevalence of low back pain was 68.8%. The results of multivariate logistics regression showed that length of service>15 years, high school or secondary college education or above, standing most of the time, sitting most of the time, the proportion of cumulative time of poor posture in work shift time ≥1/8, and bending for insufficient height of working space were the risk factors for low back pain (all P<0.05). The PAR% of the proportion of cumulative time of poor posture in work shift time ≥1/8 was 43.0%, 37.8% for standing most of the time, and 12.8% for bending for insufficient height of working space. Conclusion: The annual prevalence of low back pain was higher in automobile assemblers. The influencing factors included individual factors and occupational factors. The proportion of cumulative time of poor posture in work shift time ≥1/8, standing most of the time and bending for insufficient height of working space should be taken as the priority intervention factors to reduce the prevalence of low back pain among assemblers in this enterprise.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Background The urban heat island effect has a significant negative impact on human health. Urban green space can effectively improve the urban thermal environment while enhancing human thermal comfort. Objective To investigate the effects of vegetation configuration structure on temperature and humidity and on human thermal comfort, with a view to providing reference for the landscape planning of urban reserve, preventing and reducing the impact of urban heat island effect on the health of urban residents. Methods The study was carried out on a typical clear and cloudless summer day without extreme weather in a university reserve area in Hefei. The numerical simulation accuracy of ENVI-met software was verified by measured data. Based on the quantitative definition of vegetation configuration structure scheme from vertical and horizontal perspectives, nine simulation scenarios were established based on three aspects including vegetation configuration type (grass, shrub + grass, tree + grass, tree + shrub + grass), planting layout (column planting, uniform spot planting), and planting density [the aspect ratio of trees (ART) between plants was 0.75, 1.13, 1.50, and 2.25, respectively] to quantitatively evaluate the cooling and humidifying effects and human thermal comfort [physiological equivalent temperature (PET)] of the vegetation configurations. Results The change trends of the cooling and humidifying effects of all the simulated scenarios were consistent, basically first increasing and then decreasing. Among all the simulated scenarios, the cooling and humidifying effects of scenario 8 (tree + grass, ART=2.25, uniform spot planting) were the best, with the greatest cooling of 1.36 ℃ and humidification of 6.29% in comparison to the worst scenario 1 in the reserve area. The human thermal comfort of scenario 9 (tree + shrub + grass, ART=2.25, uniform spot planting) was the best, with the PET of 35.37 ℃. The order of improvement effect of different vegetation configurations on thermal comfort from strong to weak was tree + shrub + grass structure (scenario 9) > tree + grass structure (scenario 8) > shrub + grass structure (scenario 2) > grass structure (scenario 1). At 15:00, the PET value of tree + shrub + grass structure (scenario 9) decreased by 7.44 ℃ in comparison to that of grass structure (scenario 1). The higher the planting density among trees, the higher the difference in temperature and relative humidity between the simulated and the original scenarios. In case of holding the same amount of greenery, uniform spot planting showed better human comfort when the vegetation was planted sparsely, but the difference between the PET value of scenario 3 (tree + grass, ART=0.75, uniform spot planting) and scenario 5 (tree + grass, ART=1.5, column planting) was only 0.15 ℃; when the vegetation was planted densely, column planting was more favorable to wind circulation and more effective in reducing the temperature of the site, with a lower PET value of 0.87 ℃ for scenario 7 (tree + grass, ART=2.25, column planting) than for scenario 4 (tree + grass, ART=1.13, uniform spot planting). Conclusion Urban green space has obvious cooling and humidifying effects in summer. The human comfort of tree + shrub + grass structure with uniform spot planting is optimal, and the cooling and humidifying effects of tree + grass structure with uniform spot planting are the most obvious. The optimization of vegetation configuration structure is crucial for reducing urban heat island, improving human thermal comfort, and promoting residents’ health.

Humans ; Acetabulum ; Consensus ; Developmental Dysplasia of the Hip/therapy* ; Hip Joint ; Treatment Outcome ; China

OBJECTIVE: To introduce a scout view scanning technique of back-forward bending CT (BFB-CT) in simulated surgical position for evaluating the remaining real angle and flexibility of thoracolumbar kyphosis secondary to old osteoporotic vertebral compression fracture. METHODS: A total of 28 patients with thoracolumbar kyphosis secondary to old osteoporotic vertebral compression fracture who met the selection criteria between June 2018 and December 2021 were included in the study. There were 6 males and 22 females with an average age of 69.5 years (range, 56-92 years). The injured vertebra were located at T ₁₀-L ₂, including 11 cases of single thoracic fracture, 11 cases of single lumbar fracture, and 6 cases of multiple thoracolumbar fractures. The disease duration ranged from 3 weeks to 36 months, with a median of 5 months. All patients received examinations of BFB-CT and standing lateral full-spine X-ray (SLFSX). The thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), local kyphosis of injured vertebra (LKIV), lumbar lordosis (LL), and the sagittal vertical axis (SVA) were measured. Referring to the calculation method of scoliosis flexibility, the kyphosis flexibility of thoracic, thoracolumbar, and injured vertebra were calculated respectively. The sagittal parameters measured by the two methods were compared, and the correlation of the parameters measured by the two methods was analyzed by Pearson correlation. RESULTS: Except LL ( P>0.05), TK, TLK, LKIV, and SVA measured by BFB-CT were significantly lower than those measured by SLFSX ( P<0.05). The flexibilities of thoracic, thoracolumbar, and injured vertebra were 34.1%±18.8%, 36.2%±13.8%, and 39.3%±18.6%, respectively. Correlation analysis showed that the sagittal parameters measured by the two methods were positively correlated ( P<0.001), and the correlation coefficients of TK, TLK, LKIV, and SVA were 0.900, 0.730, 0.700, and 0.680, respectively. CONCLUSION Thoracolumbar kyphosis secondary to old osteoporotic vertebral compression fracture shows an excellent flexibility and BFB-CT in simulated surgical position can obtain the remaining real angle which need to be corrected surgically.
Male ; Female ; Humans ; Aged ; Fractures, Compression/surgery* ; Spinal Fractures/diagnostic imaging* ; Lumbar Vertebrae/surgery* ; Thoracic Vertebrae/surgery* ; Kyphosis/surgery* ; Osteoporotic Fractures/surgery* ; Lordosis ; Tomography, X-Ray Computed ; Retrospective Studies