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.

Objective To obtain the protective performance parameters of barium sulfate mortar against positron nuclide γ-rays, provide reference data for precise shielding calculations, and guide the design, evaluation, and construction of radiation shielding. Methods The FLUKA program was used to build a model for simulating the dose equivalent rate variation around points of interest under the irradiation of the most commonly used positron nuclide ¹⁸F with changes in the thicknesses of lead and barium sulfate mortar. The transmission curves of lead and barium sulfate mortar were fitted, and the half-value layer (HVL) and lead equivalence of barium sulfate mortar were calculated based on the fitted curves. Results The ambient dose equivalent rate coefficient of positron nuclide ¹⁸F was 1.339 4×10⁻¹ μSv·m²/MBq·h and the HVL for lead was 4.037 mm, with deviations of 0.043% and 1.53% compared to the values provided in the AAPM Report No. 108, respectively. The HVLs for γ-rays produced by ¹⁸F, using barium sulfate mortar with apparent densities of 4.20, 4.00, and 3.90 g/cm³ mixed with 35.2-grade cement in a 4∶1 mass ratio, were 2.914, 2.969, and 3.079 cm, respectively. The lead equivalences were 0.1385, 0.1360, and 0.1311 mmPb/mm, respectively. Conclusion The three types of barium sulfate mortar can provide good protection against γ-rays in positron imaging locations. As the apparent density of barium sulfate increases, its protective effect improves slightly but remains significantly better than common construction materials like concrete and solid bricks.

ObjectiveTo introduce the three main techniques for tuberculosis screening currently used in China, to systematically evaluate their accuracy in diagnosing latent tuberculosis infection (LTBI), so as to provide scientific basis and recommendations for the formulation of China’s tuberculosis screening strategy. MethodsLiterature on the diagnosis of tuberculosis by tuberculin skin test (TST), interferon-γ release assay (IGRA), and recombinant Mycobacterium tuberculosis fusion protein (EC) skin test from January 1, 2010 to August 22, 2024 was comprehensively retrieved from PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Database through computerized search. Besides, all the literature was screened in accordance to the inclusion criteria for diagnostic tests, and characteristic information of the literature selected was extracted simultaneously. Meta-analysis was performed using Stata 17.0 software, with a random-effects model used for weighted quantitative synthesis of included literature, calculating pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and their 95% confidence intervals (CI). ResultsA total of 543 relevant articles were retrieved, with 105 ultimately included. Among them, 33 articles reported diagnostic data for TST, with a pooled sensitivity of 0.68 (95%CI: 0.62‒0.73), specificity of 0.67 (95%CI: 0.60‒0.73), positive likelihood ratio of 2.0 (95%CI: 1.7‒2.5), and negative likelihood ratio of 0.48 (95%CI: 0.40‒0.58). Ninety-four articles reported the diagnostic value of IGRAs test, with a pooled sensitivity of 0.88 (95%CI: 0.87‒0.89), specificity of 0.82 (95%CI: 0.79‒0.84), positive likelihood ratio of 4.8 (95%CI: 4.2‒5.6), and negative likelihood ratio of 0.15 (95%CI: 0.13‒0.17). Data on EC skin test was limited, but preliminary analysis showed that it had high sensitivity and specificity. ConclusionIGRA has a significant advantage in diagnosing LTBI, and EC skin test also shows good diagnostic performance, although relevant data is limited. TST remains suitable for large-scale screening due to its cost-effectiveness.

Objective:To systematically evaluate the perioperative risk factors for deep vein thrombosis (DVT) in aged patients with hip fractures.Methods:A comprehensive search was conducted in CNKI, VIP, Wanfang, PubMed, Web of Science, Cochrane Library, and Embase for studies on DVT risk factors in aged patients with hip fractures. The search timeframe was from January 1, 2000, to January 31, 2023.Results:A total of 55 studies were included, comprising 41 case-control studies and 14 cohort studies. Meta-analysis results showed that age, female, body mass index, hypertension, hyperlipidemia, diabetes, pulmonary disease, cerebrovascular disease, smoking history, thrombosis history, combined anesthesia, intraoperative bleeding, intraoperative blood transfusion, hemoglobin, albumin, activated partial thromboplastin time, D-dimer, fibrinogen, intertrochanteric fractures, high-energy injury, prolonged bed rest, time from injury to admission, and time from injury to surgery were risk factors for DVT in aged hip fracture patients ( P<0.05) ; the use of anticoagulants was found to be a protective factor ( P<0.05) . Conclusions:The occurrence of DVT in aged hip fracture patients is influenced by multiple factors. Nursing staff should enhance the assessment and screening for DVT and take measures to minimize its incidence in this patient population.

Objective:To systematically evaluate influencing factors of multi-drug resistant organisms (MDROs) infection in patients undergoing liver transplantation and to provide reference for infection prevention and control.Methods:The relevant literatures on the influencing factors of MDROs infection after liver transplantation included in PubMed, Medline, Embase, Wed of Science, China Biology Medicine disc, Wanfang Database, China National Knowledge Infrastructure and VIP were searched by computer, and the search time was from the establishment of databases to September 1, 2023. The languages were limited to Chinese and English. Two evaluators screened literature and extracted data, and used The Newcastle Ottawa Scale to evaluate the quality of the final included literature. Meta-analysis was performed using RevMan5.4 software.Results:Finally, a total of 17 literatures were included, including five case-control studies and 12 cohort studies. The results of Meta-analysis showed that ClassⅡ toⅣ hepatic encephalopathy, renal insufficiency, colonization of drug-resistant organisms before transplantation, performing tracheal intubation, tracheal intubation time greater than or equal to 48 h, tracheal intubation time greater than or equal to 72 h, length of ICU stay, use of antibiotics before transplantation, postoperative bile leakage, postoperative fungal culture of positivity, reoperation after transplantation and hemodialysis were risk factors for MDROs infection after liver transplantation ( P<0.05) . Conclusions:There are many influencing factors for multi-drug resistant organisms infection in liver transplant patients after surgery. Medical staff should be vigilant and identify relevant risk factors, conduct infection risk assessment and take preventive and control measures based on risk factors to improve the prognosis of liver transplant patients.

Objective:To retrieve, evaluate, and integrate evidence related to balance function management in stroke patients with hemiplegia.Methods:A systematic search was conducted on BMJ Best Practice, UpToDate, National Institute for Health and Care Excellence, Guidelines International Network, Scottish Intercollegiate Guidelines Network, Australia Joanna Briggs Institute Evidence-Based Practice Center, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, PubMed, Web of Science, Medlive, and other websites or data platforms for relevant guidelines, best practices, evidence summaries, systematic reviews, and Meta-analyses on balance function management in stroke patients with hemiplegia, with a retrieval period from March 2014 to March 2024. Two researchers trained in evidence-based practices evaluated the methodological quality of the literature and extracted and summarized the relevant evidence.Results:Based on the inclusion and exclusion criteria, a total of eight guidelines and seven systematic reviews were included, yielding 29 pieces of best evidence across nine aspects: the importance of balance function training, organizational management, assessment tools, assessment timing, assessment content, assessment frequency, balance exercise programs, exercise duration, and health education.Conclusions:This study summarizes the best evidence for balance function management in stroke patients with hemiplegia, providing accurate evidence-based support for clinical practice among medical professionals. It is recommended that healthcare providers appropriately apply this evidence based on clinical scenarios to improve measures related to balance function management in stroke patients with hemiplegia.

Objective To investigate the effect of miR-17 on autophagy and fibrosis in transforming growth factor-β1(TGF-β1)induced pulmonary fibrosis cell models in vitro.Methods Human embryonic lung fibroblast HFL1 cells were induced with recombinant human TGF-β1 protein,and the pulmonary fibrosis cell model was established.CCK-8 was used to detect the cell activity,and the hydroxyproline(Hyp)content in the cell supernatant was detected by ELISA kit.The cells were divided into control group,model group,3-methyladenine(3-MA)group,miR-17 inhibitor group and miR-17 inhibitor+3-MA group.Cell proliferation was detected by CCK-8,cell apoptosis was detected by flow cytometry,and the expressions of mitochondrial auto-phagy associated proteins LC3-Ⅱ and p62,fibrosis markers α-SMA and collagen Ⅰ protein were detected by Western blot-ting.Results HFL1 cell activity increased after TGF-β1 induction(P＜0.01),the content of Hyp in cell supernatant was in-creased(P＜0.01),in vitro pulmonary fibrosis cell model was constructed successfully.Compared with the control group,the cell viability of model group was significantly increased(P＜0.01),the apoptosis rate was significantly decreased(P＜0.01),LC3-Ⅱ protein expression level was significantly decreased(P＜0.01),the protein expression levels of p62,α-SMA and collagenⅠ were significantly increased(all P＜0.01).Compared with the model group,cell viability of miR-17 inhibitor group was sig-nificantly decreased(P＜0.01),the apoptosis rate was significantly increased(P＜0.01),LC3-Ⅱ protein expression level was significantly increased(P＜0.01),the protein expression levels of p62,α-SMA and collagen Ⅰ were significantly decreased(all P＜0.01).Cell viability of miR-17 inhibitor+3-MA group was significantly decreased compared with 3-MA inhibitor group(P＜0.01),the apoptosis rate was significantly increased(P＜0.01),LC3-Ⅱ protein expression level was significantly increased(P＜0.01),the protein expression levels of p62,α-SMA and collagen Ⅰ were significantly decreased(all P＜0.01).Conclusion Inhi-bition of miR-17 can inhibit TGF-β1-induced pulmonary fibrosis through activation of autophagy.

Objective:To establish a risk management system of bedside monitor based on risk assessment management model,and to analyze its application value in the clinical management of critically ill patients in neurosurgery department.Methods:Based on the risk assessment management model,the failure risk index was screened,and the risk management system of bedside monitor was established.A total of 150 critically ill neurosurgical patients admitted to The First Affiliated Hospital of Air Force Medical University from December 2021 to December 2022 were selected and divided into control group and observation group by random number table method,with 75 cases in each group.During the hospitalization of the two groups of patients,30 responsible nurses participated in clinical care,and 16 multifunctional bedside monitors were used to monitor patients'vital signs.The control group received routine nursing management intervention.On the basis of routine nursing intervention,the observation group carried out risk assessment management based on the risk assessment management model of bedside monitor risk management system.The differences in patient monitoring quality score,equipment management quality score and responsible nurse ability score were compared between the two groups.Results:The average scores of respiration,blood pressure,blood oxygen saturation and ECG monitoring quality of the patients in observation group were(37.52±0.26)points,(36.61±1.29)points,(36.56±2.57)points and(38.25±0.56)points,respectively,which were higher than those in control group,the difference was statistically significant(t=43.925,33.150,13.655,32.035,P<0.05).The average scores of performance control quality and operation quality of bedside monitor in the observation group were(95.43±0.46)points and(96.51±0.77)points,respectively,which were higher than those in control group,the difference was statistically significant(t=70.976,35.439,P<0.05).The average scores of nurses in terms of ability of equipment collaboration,equipment use mastery and equipment alarm management in the observation group were(9.43±0.25)points,(8.56±0.64)points and(9.25±0.24)points,respectively,which were higher than those in the control group,the differences were statistically significant(t=92.952,24.455,58.024,P<0.05).Conclusion:The bedside monitor risk management system based on the risk assessment management model can realize the efficient management of bedside monitors for critically ill neurosurgical patients,and improve the operating efficiency and quality of the equipment on the basis of ensuring the life safety of patients.

Objective To observe the effects of Renshen Yimai Prescription on oxidative stress and vascular aging in ApoE-/-mice;To explore its mechanism of intervention in vascular aging.Methods Forty ApoE-/-mice were divided into model group,Western medicine group(rosuvastatin,2.6 mg/kg),TCM low-and high-dosage group(Renshen Yimai Prescription,4.29,8.58 g/kg),with 10 mice in each group.Another 10 C57BL/6J mice were set as normal group.A vascular aging model was established by ApoE-/-mice fed with a Western diet.Each medication group was given corresponding drugs by gavage for 12 consecutive weeks,the normal group and model group were given equivalent volume of pure water.HE staining and Masson staining were used to observe the morphological changes of aortic tissue,and ox-LDL content in serum was detected by ELISA,the contents of ROS,GSH,GPX and NAD+in serum were detected by colorimetric method,the expressions of SIRT1,p53,p21 and NOX4 protein in aortic tissue were detected by Western blot.Results Compared with the normal group,the model group mice showed significant fat deposition in the aorta,thickening of the intima and media,a significant decrease in elastic fibers,and an increase in collagen fibers;the serum contents of ox-LDL and ROS significantly increased(P<0.01),while the contents of GSH,GPX and NAD+significantly decreased(P<0.01);the expression of SIRT1 protein in the aortic tissue significantly decreased(P<0.05),the expressions of p21 and p53 protein significantly increased(P<0.01,P<0.05).Compared with the model group,a small amount of lipid deposition was observed in the intima of aorta in each medication group,with clearer membrane structures in each layer and reduced collagen fiber;the serum contents of ox-LDL and ROS in each medication group were significantly decreased(P<0.01),while the GSH content significantly increased(P<0.05,P<0.01),the NAD+content in TCM low-dosage group significantly increased(P<0.05);the expressions of p21 and NOX4 protein in aortic tissue of the TCM high-dosage group significantly increased(P<0.05,P<0.01).Compared with the Western medicine group,the TCM high-dosage group showed a significant decrease in ROS content(P<0.01)and a significant decrease in p53 protein expression(P<0.05).Compared with the TCM low-dosage group,the TCM high-dosage group showed a significant decrease in p21 protein expression(P<0.01)and a significant increase in NOX4 protein expression(P<0.01).Conclusion Renshen Yimai Prescription may reduce vascular endothelial damage by regulating oxidative stress levels and related protein expression,thereby playing a role in improving vascular aging.

As an important non-drug treatment for chronic obstructive pulmonary disease(COPD),pulmonary rehabilitation helps to improve dyspnea and negative emotions.This article mainly elaborates on pulmonary rehabilitation contents such as smoking cessation,breathing training,exercise training,traditional Chinese medicine rehabilitation,and psychological rehabilitation,and discusses the application of telemedicine and virtual reality technology in COPD pulmonary rehabilitation.The COVID-19 has a certain impact on the traditional pulmonary rehabilitation model.This article explores the relationship between COVID-19 and COPD and the implementation methods of pulmonary rehabilitation for COPD patients with COVID-19,so as to provide evidence-based basis for the implementation of pulmonary rehabilitation in the context of COVID-19,and provide new ideas and methods for improving the clinical treatment effect of COPD.