The core idea of occupational health risk assessment models is to systematically evaluate occupational health risks according to target hazard characteristics and relevant exposure levels of workers. Occupational exposure assessment is based on concentration, frequency, exposure time, and other indicators that indicate actual exposure of workers to occupational hazards, which is a critical component of health risk assessment. However, the accuracy and comparability of assessment results are affected by differences in parameter assignment for exposure assessment across different studies, as well as insufficient emphasis on multiple occupational hazard exposure. This review aimed to explore the assignment and standardization of exposure assessment parameters for occupational health risk assessment modeling, and systematically sorted out the meaning, assignment methods, and sources of exposure assessment related parameters in commonly used occupational health risk assessment models, with the goal of providing researchers with standardized assessment tools to enhance the scientific rigor and practicality of occupational health risk assessments. Considering the individual differences and temporal fluctuations in occupational exposure, it is recommended that researchers should adopt appropriate sampling strategies, reasonably select sample subjects and time based on the division of similar exposure group (SEG), and conduct statistical inference on the obtained data to derive representative exposure parameters. For combined exposure to chemicals with similar toxic effects, the health risk assessment methods are relatively mature. However, the assessment of combined exposure to hazards with different properties and health effects still lacks scientific authority and needs further research and discussion.

[摘 要] 目的：探讨环磷腺苷效应元件结合蛋白（CREB）对前列腺癌细胞恶性生物学行为的影响。方法：常规培养前列腺癌细胞PC3，用转染试剂将过表达对照质粒，CREB过表达质粒（CREB-oe)、敲减对照序列（si-NC）和si-CREB序列转染至PC3细胞，分为vector，CREB-oe、si-NC和si-CREB组。用划痕愈合实验、Transwell小室实验和流式细胞术分别检测各组细胞的迁移、侵袭能力和细胞周期情况。用CRISPR/cas9技术构建CREB敲除的PC3细胞，用PC3细胞移植瘤实验检测CREB敲除对移植瘤生长的影响。结果：在PC3细胞中成功地敲减或过表达了CREB（均P < 0.01），过表达或敲减CREB均可明显促进或抑制PC3细胞的迁移、侵袭能力（均P < 0.01），过表达CREB可促使PC3细胞进入S期，而敲减CREB表达则使PC3细胞阻滞于G1期（均P < 0.01）。成功地构建了CREB敲除PC3细胞，敲除CREB可明显抑制PC3细胞移植瘤的生长（P < 0.01）。结论：敲减或敲除CREB能够抑制PC3细胞的迁移和侵袭，并使其阻滞于G1期，进而抑制移植瘤的生长。

Objective To mine and analyze the routine blood test data of children with allergic rhinitis (AR), identify routine blood parameters related to childhood allergic rhinitis, establish an effective diagnostic model, and evaluate the performance of the model. Methods This study was a retrospective study of clinical cases. The experimental group comprised a total of 1110 children diagnosed with AR at the First Affiliated Hospital of Air Force Medical University during the period from December 12, 2020 to December 12, 2021, while the control group included 1109 children without a history of allergic rhinitis or other allergic diseases who underwent routine physical examinations during the same period. Information such as age, sex and routine blood test results was collected for all subjects. The levels of routine blood test indicators were compared between AR children and healthy children using comprehensive intelligent baseline analysis, with indicators of P≥0.05 excluded; variables were screened by Lasso regression. Binary Logistic regression was used to further evaluate the influence of multiple routine blood indexes on the results. Five kinds of machine model algorithms were used, namely extreme value gradient lift (XGBoost), logistic regression (LR), gradient lift decision tree (LGBMC), Random forest (RF) and adaptive lift algorithm (AdaBoost), to establish the diagnostic models. The receiver operating characteristic (ROC) curve was used to screen the optimal model. The best LightGBM algorithm was used to build an online patient risk assessment tool for clinical application. Results Statistically significant differences were observed between the AR group and the control group in the following routine blood test indicators: mean cellular hemoglobin concentration (MCHC), hemoglobin (HGB), absolute value of basophils (BASO), absolute value of eosinophils (EOS), large platelet ratio (P-LCR), mean platelet volume (MPV), platelet distribution width (PDW), platelet count (PLT), absolute values of leukocyte neutrophil (W-LCC), leukocyte monocyte (W-MCC), leukocyte lymphocyte (W-SCC), and age. Lasso regression identified these variables as important predictors, and binary Logistic regression further analyzed the significant influence of these variables on the results. The optimal machine learning algorithm LightGBM was used to establish a multi-index joint detection model. The model showed robust prediction performance in the training set, with AUC values of 0.8512 and 0.8103 in the internal validation set. Conclusion The identified routine blood parameters can be used as potential biomarkers for early diagnosis and risk assessment of AR, which can improve the accuracy and efficiency of diagnosis. The established model provides scientific basis for more accurate diagnostic tools and personalized prevention strategies. Future studies should prospectively validate these findings and explore their applicability in other related diseases.
Humans ; Male ; Female ; Rhinitis, Allergic/blood* ; Child ; Biomarkers/blood* ; Retrospective Studies ; Early Diagnosis ; Child, Preschool ; ROC Curve ; Logistic Models ; Hematologic Tests ; Algorithms ; Adolescent ; Machine Learning

Objective To analyze the correlations between the thoracic electrical impedance tomography(EIT)-derived parameters global inhomogeneity(GI),center of ventilation(COV),regional ventilation delay(RVD),and atelectasis in hospitalized patients,and to explore their effectiveness in evaluating atelectasis.Methods The clinical data of 140 hospitalized patients monitored by thoracic EIT between Sep.2024 and Jan.2025 were retrospectively analyzed.Patients were assigned to 2 groups based on chest computed tomography confirmation of atelectasis within the preceding short-term period during EIT monitoring:non-atelectasis group or atelectasis group.The algorithm software designed with MATLAB was used to acquire GI and COV.RVD was obtained through analysis with the Dr?ger EIT Data Analysis Tool 6.3 software,and patients'general data were concurrently documented.Comparative analysis of EIT-derived parameters between groups was conducted.Multivariate logistic regression analysis was employed to investigate the correlations of GI,COV,and RVD with atelectasis,while receiver operating characteristic curve analysis was performed to assess the efficacy of EIT-derived parameters in evaluating atelectasis.Results A total of 140 patients were enrolled,with 19(13.6%)cases presenting atelectasis.Compared to the non-atelectasis group,the atelectasis group demonstrated significantly higher proportions of male patients and cardiovascular disease and thoracic surgery(non-pulmonary)histories,lower body mass index(BMI),and alongside elevated GI and RVD values with reduced COV(all P＜0.05).Multivariate logistic regression analysis revealed that GI,COV,and RVD maintained independent associations with atelectasis after adjusting for age,gender,BMI,pleural effusion,and emphysema(odds ratio[OR]=1.39,95%confidence interval[CI]1.20-1.67;OR=0.85,95%CI 0.75-0.96;OR=1.22,95%CI 1.09-1.39;all P＜0.05).The area under curve(AUC)values of GI,COV,and RVD for evaluating atelectasis in hospitalized patients were 0.82,0.80,and 0.82,respectively(while RVD demonstrated a higher AUC,its clinical applicability was influenced by respiratory patterns).Conclusion Thoracic EIT-derived parameters GI and COV demonstrate significant correlations with atelectasis and may serve as valuable indicators for evaluating atelectasis in hospitalized patients.

Objective: To identify core acupoint patterns and elucidate the molecular mechanisms of acupuncture for primary depressive disorder (PDD) through data mining and network analysis. Methods: A comprehensive literature search was conducted across PubMed, Embase, Ovid Technologies (OVID), Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), China National Knowledge Infrastructure Database (VIP), Wanfang Data, and SinoMed Database from database foundation to January 31, 2025, for clinical studies on acupuncture treatment of PDD. Descriptive statistics, high-frequency acupoint analysis, degree and betweenness centrality evaluation, and core acupoint prescription mining identified predominant therapeutic combinations for PDD. Network acupuncture was used to predict therapeutic target for the core acupoint prescription. Subsequent protein-protein interaction (PPI) network and molecular complex detection (MCODE) analyses were conducted to identify the key targets and functional modules. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses explored the underlying biological mechanisms of the core acupoint prescription in treating PDD. Results: A total of 57 acupoint prescriptions underwent systematic analysis. The core therapeutic combinations comprised Baihui (GV20), Yintang (GV29), Neiguan (PC6), Hegu (LI4), and Shenmen (HT7). Network acupuncture analysis identified 88 potential therapeutic targets (79 overlapping with PDD), while PPI network analysis revealed central regulatory nodes, including interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, toll-like receptor 4 (TLR4), IL-10, brain-derived neurotrophic factor (BDNF), transforming growth factor (TGF)-β1, C-X-C motif chemokine ligand 10 (CXCL10), mitogen-activated protein kinase 3 (MAPK3), and nitric oxide synthase 1 (NOS1). MCODE-based modular analysis further elucidated three functionally coherent clusters: inflammation-homeostasis (score = 6.571), plasticity-neurotransmission (score = 3.143), and oxidative stress (score = 3.000). GO and KEGG analyses demonstrated significant enrichment of the MAPK, phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), and hypoxia-inducible factor (HIF)-1 signaling pathways. These mechanistic insights suggested that the antidepressant effects mediated through mechanisms of neuroinflammatory regulation, neuroplasticity restoration, and immune-oxidative stress homeostasis. Conclusion This study reveals that acupuncture alleviates depression through a multi-level mechanism, primarily involving the neuroinflammation suppression, neuroplasticity enhancement, and oxidative stress regulation. These findings systematically clarify the underlying mechanisms of acupuncture’s antidepressant effects and identify novel therapeutic targets for further mechanistic research.

Objective To investigate the systemic immune-inflammation index(SII),albumin to globulin ratio(AGR),and high-sensitivity C-reactive protein(hs-CRP)in patients with ulcerative colitis(UC)compli-cated by Epstein-Barr virus(EBV)infection,and to evaluate their diagnostic value in UC complicated by EBV infection.Methods A total of 237 patients with UC admitted to the hospital from February 2024 to Septem-ber 2024.Patients were divided into a complicated group(150 cases)and a control group(87 cases)based on EBV-DNA test results.The counts of neutrophils,lymphocytes,and platelets,as well as the levels of albumin(ALB),globulin,hs-CRP,and erythrocyte sedimentation rate(ESR)were collected from the patients'routine blood tests,and the parameters of SII and AGR were calculated.Spearman correlation test was used for corre-lation analysis.Multivariate binary Logistic regression was used to analyze the influencing factors of EBV in-fection in UC patients,and receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of individual and combined detection of various indicators.Results There were statistically significant differences in disease activity,lesion range,ALB,AGR,ESR,hs-CRP,and SII between the complicated group and the control group(P<0.05).Correlation analysis showed that the positive copy number of EBV-DNA in the complicated group was positively correlated with disease activity,hs-CRP,and SII(P<0.05),and nega-tively correlated with ALB and AGR(P<0.05).Multivariate binary Logistic regression analysis indicated that SII and AGR were independent influencing factors for UC patients complicated by EBV infection.The combined detection of ALB,AGR,SII,hs CRP,ESR and various indicators has certain predictive value for UC patients with EBV infection.The area under the curve of the combined detection of ALB,AGR,SII,hs-CRP,ESR and the AUC of the combined detection of SII,AGR,hs-CRP were the largest,and the sensitivity and specificity were also high.Conclusion SII and AGR are independent influencing factors for UC patients com-plicated by EBV infection.The combined detection of SII,AGR,and hs-CRP has good diagnostic value for UC complicated by EBV infection and could serve as valuable biomarkers for evaluating UC complicated by EBV infection.

By summarizing the biological formation and component function of Mycobacterium tuberculosis extracellular vesicles, this manuscript discusses the potential usage of Mycobacterium tuberculosis extracellular vesicles in diagnosis, prevention, and treatment of tuberculosis. It is concluded that both Mycobacterium tuberculosis membrane vesicles and exosomes secreted by the host contain the components of Mycobacterium tuberculosis to participate in immune regulation, and play different roles in the diagnosis, prevention, and treatment of tuberculosis. Mycobacterium tuberculosis extracellular vesicles contain abundant biomarkers and have natural immunogenicity, which are expected to become new targets for diagnosis, prevention, and treatment of tuberculosis.

Health technology assessment(HTA)is an important tool to inform health decision-making.Although highly related to ethical issues in the context of HTA,equity has attracted much attention from the academia,a consensus has not yet been reached on how to define and evaluate equity in China and abroad.It introduces the concept of equity,pointes out the necessity to realize health equity and the reflection of equity in healthcare sector,and further elaborates four ways to consider equity,and described the official practice of equity in HTA at home and abroad.It proposes several suggestions for China's HTA:considering equity in HTA and the discussion of equity should depend on specific decision-making scenarios;clarifying what health measurement perspective should be adopted before measuring health equity;paying attention to the value judgment of equity adopted by various stakeholders;conducting basic researches on the general population's preference for health measurement perspectives and value judgments of equity in China in a gesture to improve the evaluation system of equity in HTA.

In recent years， the incidence of pulmonary nodules has kept rising. To give full play to the advantages of traditional Chinese medicine （TCM） in the treatment of pulmonary nodules and identify the breakthrough points of integrating TCM with Western medicine， the China Association of Chinese Medicine organized medical experts in TCM and western medicine to carry out in-depth discussion regarding this disease. The discussion encompassed the modern medical advances， TCM theories of etiology and pathogenesis， the role and advantages of TCM in the whole course management of pulmonary nodules， contents and methods of research on pulmonary nodules， and science popularization work， aiming to provide a reference for clinical practice and scientific research. After discussion， the experts concluded that the occurrence of pulmonary nodules was rooted in the deficiency of the lung and spleen and triggered by phlegm dampness， blood stasis， and Qi stagnation. TCM can treat pulmonary nodules by controlling and reducing nodules， improving physical constitution， ameliorating multi-system nodular diseases， reducing anxiety and avoiding excessive diagnosis and treatment， and serving as an alternative for patients who are unwilling or unfit for surgical treatment. At present， the optimal diagnosis and treatment strategy for pulmonary nodules has not been formed， which needs to be further studied from multiple perspectives such as clinical epidemiology， biology， and evidence-based medicine. The primary task of current research is to find out the advantages， effective prescriptions， and target populations and determine the effective outcomes of TCM in the treatment of pulmonary nodules. At the same time， basic research should be carried out to explore the etiology and biological behaviors of pulmonary nodules. The expert consensus on the diagnosis and treatment of pulmonary nodules with integrated TCM and Western medicine needs to be continuously revised to guide clinicians to conduct standardized， scientific， and accurate effective diagnosis and treatment.

Background and Objective Accurate diagnosis of mucous cystic lesion(PCL)remains a clinical difficult.Both Carcinoembryonic antigen(CEA)and glucose(GLU)are reported to have ability to distinguish mucinous PCL from non-mucinous PCL,but the accuracy was limited.The objective of this study was to evaluate the value of cystic CEA combined with GLU in the diagnosis of mucinous PCL.Methods PCL patients who underwent pancreatic surgery and endoscopic ultrasonography guided fine-needle aspiration(EUS-FNA)were retrospectively collected from the First Affiliated Hospital of Naval Medical University.Clinical data and cystic fluid analysis of included PCLs patients were analyzed using receiver operator(ROC)curves.ROC analysis,sensitivity and specificity analyses were used to evaluate the value of CEA combined with GLU in the diagnosis of mucinous PCL.Results From January 2015 to December 2021,a total of 84 patients underwent cyst fluid CEA and GLU analysis,of whom 44(52.4％)had mucinous PCL and 40(47.6％)had non-mucinous PCL.The AUC for distinguishing mucinous from non-mucinous PCL by CEA was 0.82[(95％confidence interval(CI):0.72-0.92)].When 192 ng/mL was used as the cutoff level,the diagnostic sensitivity and specificity were 50％and 93％,respectively.Using 20 ng/mL as cutoff level,the diagnostic sensitivity increased to 80％and the specificity decreased to 68％.The AUC for the cystic GLU to distinguish mucinous from non-mucinous PCL was 0.73(95％CI:0.99-0.87),and the diagnostic sensitivity and specificity were 100％and 60％,respectively.When the cutoff level of CEA was 192 ng/mL,the AUC of CEA combined with GLU in the diagnosis of mucinous PCLs was 0.94(95％Cl:0.86-0.99),while when the cutoff level of CEA was 20 ng/mL,the AUC of CEA combined with Glu in the diagnosis of mucinous PCLs was 0.94(95％CI:0.85-0.99).The AUCs were significantly higher than the AUC with single diagnostic indicators.Conclusion When using the cutoff level of 192 ng/mL,cyst fluid CEA combined with GLU has high sensitivity and specificity in differentiating mucinous PCL from non-mucinous PCL,so it can be considered for clinical application.Lower CEA cutoff level(20 ng/mL)can improve the sensitivity of diagnosis.