Objective To investigate the efficacy of early, short-term, low-dose corticosteroid administration for the prevention and treatment of early acute lung injury (EALI) in patients undergoing thoracoscopic lobectomy. Methods A retrospective analysis was conducted on the clinical data of patients who underwent thoracoscopic lobectomy at the Department of Thoracic and Cardiovascular Surgery, Taihe Hospital, Hubei University of Medicine, from January 2019 to January 2022. Patients were divided into an early steroid therapy group and an observation group based on whether they received corticosteroids in the early postoperative period. In the early steroid therapy group, in addition to standard postoperative care, patients received a low-dose intravenous push of methylprednisolone (80-120 mg/d) for 3 consecutive days. In the observation group, patients received standard postoperative care without intravenous corticosteroids for the first 3 days. Chest plain CT scans were performed on postoperative day (POD) 1 and POD 3 or 4 to evaluate lung injury. CT scores and the incidence of postoperative EALI were recorded. Results A total of 521 patients were included (268 males, 253 females; age range: 11-80 years). There were 318 patients in the observation group and 203 in the early steroid therapy group. On POD 1, the incidence of EALI was 16.0% in the observation group and 13.8% in the early steroid therapy group, with no statistical difference (P=0.486). Correspondingly, there was no statistical difference in chest CT scores among EALI-positive patients between the two groups (P=0.927). On POD 3-4, the incidence of EALI was significantly lower in the early steroid therapy group (22.7%) compared to the observation group (33.6%) (P=0.007). Although chest CT scores among EALI-positive patients were lower in the early steroid therapy group, the difference was not statistically significant (P=0.377). The overall incidence of EALI within the first 4 postoperative days was significantly lower in the early steroid therapy group (26.1%) than in the observation group (37.4%) (P=0.007). Radiological progression (defined as new-onset EALI or progression of existing EALI) occurred in 14.8% of the early steroid therapy group, significantly lower than the 28.9% in the observation group (P<0.001). The early steroid therapy group had a shorter postoperative length of stay (P<0.001), while there was no statistical difference in the incidence of poor wound healing between the groups (P=0.762). Conclusion Early postoperative corticosteroid use effectively reduces the incidence of EALI on POD 3-4, lowers the risk of radiological progression, and decreases the overall incidence of postoperative EALI. This is achieved without prolonging the length of stay or increasing the risk of poor wound healing. Therefore, early administration of low-dose corticosteroids is beneficial in suppressing the occurrence and progression of EALI. Its early use is recommended for patients at high risk for postoperative EALI.

Objective To explore the wearing status and actual noise reduction effect of hearing protectors among noise workers in a typical automobile manufacturing enterprise. Methods In April 2024, an occupational hazard factor testing was carried out in an automobile manufacturing industry, and at the same time, the hearing protection fit test was conducted for noise workers. Intervention and guidance were provided to those who did not pass the minimum standard of baseline PAR. The difference in PAR between baseline and post-intervention was compared, and the effectiveness of hearing protector wearing method training was evaluated. Results The exceeding rate of the company's noise operation post was 50.77% (66/130). The baseline PAR of the subjects with working experience of less than 15 years and wearing hearing protectors throughout noisy work was higher, and the differences were statistically significant (P<0.05). Compared with those with 80dB≤L_{EX, 8h}<85dB, more research subjects with L_{EX, 8h}≥85dB failed baseline PAR (39.13%). After intervention, the PAR of the subjects who did not pass the minimum standard of baseline PRA increased from 2.0 (0.0, 5.3) to 17.0 (14.8, 20.0), and the protection level was significantly improved, and the difference was statistically significant (P<0.01). Conclusion The individual fit test of hearing protector is an important means to evaluate the actual noise reduction level of hearing protector and guide the selection of hearing protection models. Corporate training can help improve the PAR of hearing protectors.

BACKGROUND:Osteoarthritis is pathologically characterized by progressive degeneration of the articular cartilage and abnormal deformation of the subchondral bone.In recent years,with the deepening of medical research,it has been found that the mitogen-activated protein kinases(MAPK)signaling pathway has a regulatory role in inflammatory cell infiltration,inflammatory factor release,and chondrocyte proliferation,which is particularly important for the treatment of osteoarthritis.OBJECTIVE:To briefly review the main research progress in the mechanism of MAPK signaling pathway regulating osteoarthritis in recent years,aiming to provide new ideas for the treatment of osteoarthritis.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature using the search terms of"mitogen-activated protein kinases,osteoarthritis,extracellular signal-regulated MAP kinases,p38 mitogen-activated protein kinases,JNK mitogen-activated protein kinase"in Chinese and English.Relevant literature published from January 2019 to November 2024 was searched,and 108 articles were finally included for summary analysis.RESULTS AND CONCLUSION:(1)Various stimuli inside and outside the cells activate the MAPK signaling pathway,regulate gene transcription and protein synthesis,and promote the release of inflammatory factors,such as tumor necrosis factor-α,interleukin-1β,and interleukin-6.The release of these inflammatory factors aggravates the progression of osteoarthritis.(2)The active ingredients of traditional Chinese medicine,mainly saponins and flavonoids,as well as Chinese herbal formulas and preparations with the main effects of activating blood circulation and removing blood stasis,tonifying the liver and kidney,can play a therapeutic role in osteoarthritis by inhibiting the MAPK signaling pathway,regulating the release of matrix metalloproteinases,balancing the homeostatic state of osteogenesis and osteoblastogenesis,attenuating the synovial inflammation,decreasing the release of inflammatory factors and inflammatory vesicles,decreasing cellular pyroptosis,promoting autophagy,and ameliorating oxidative stress.(3)Although traditional Chinese medicine has become popular in the treatment of osteoarthritis by virtue of its own advantages of multi-components,multi-targets,multi-pathways,and low side effects,the use of MAPK signaling pathway to guide the treatment of individual osteoarthritis is the difficulty of the technology,which needs to be continuously researched and explored.(4)Therefore,further development of relevant herbal inhibitors that can modulate the MAPK signaling pathway may be a potential drug strategy for the treatment of osteoarthritis in the future.

BACKGROUND:Osteoarthritis is pathologically characterized by progressive degeneration of the articular cartilage and abnormal deformation of the subchondral bone.In recent years,with the deepening of medical research,it has been found that the mitogen-activated protein kinases(MAPK)signaling pathway has a regulatory role in inflammatory cell infiltration,inflammatory factor release,and chondrocyte proliferation,which is particularly important for the treatment of osteoarthritis.OBJECTIVE:To briefly review the main research progress in the mechanism of MAPK signaling pathway regulating osteoarthritis in recent years,aiming to provide new ideas for the treatment of osteoarthritis.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature using the search terms of"mitogen-activated protein kinases,osteoarthritis,extracellular signal-regulated MAP kinases,p38 mitogen-activated protein kinases,JNK mitogen-activated protein kinase"in Chinese and English.Relevant literature published from January 2019 to November 2024 was searched,and 108 articles were finally included for summary analysis.RESULTS AND CONCLUSION:(1)Various stimuli inside and outside the cells activate the MAPK signaling pathway,regulate gene transcription and protein synthesis,and promote the release of inflammatory factors,such as tumor necrosis factor-α,interleukin-1β,and interleukin-6.The release of these inflammatory factors aggravates the progression of osteoarthritis.(2)The active ingredients of traditional Chinese medicine,mainly saponins and flavonoids,as well as Chinese herbal formulas and preparations with the main effects of activating blood circulation and removing blood stasis,tonifying the liver and kidney,can play a therapeutic role in osteoarthritis by inhibiting the MAPK signaling pathway,regulating the release of matrix metalloproteinases,balancing the homeostatic state of osteogenesis and osteoblastogenesis,attenuating the synovial inflammation,decreasing the release of inflammatory factors and inflammatory vesicles,decreasing cellular pyroptosis,promoting autophagy,and ameliorating oxidative stress.(3)Although traditional Chinese medicine has become popular in the treatment of osteoarthritis by virtue of its own advantages of multi-components,multi-targets,multi-pathways,and low side effects,the use of MAPK signaling pathway to guide the treatment of individual osteoarthritis is the difficulty of the technology,which needs to be continuously researched and explored.(4)Therefore,further development of relevant herbal inhibitors that can modulate the MAPK signaling pathway may be a potential drug strategy for the treatment of osteoarthritis in the future.

Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.

Objective To analyze the increase in hearing thresholds in different frequency bands of workers exposed to different characteristic noises and the influencing factors of binaural high-frequency hearing loss, and to provide theoretical support for occupational health monitoring in enterprises. Methods In 2021, noise-exposed workers were selected from typical noise-exposing enterprises as research subjects, and their occupational health examination data were tracked for three consecutive years. According to the on-site detection from 2021 to 2023, the cumulative noise exposure (CNE) was calculated. The chi-square test was used to compare the increase of the hearing threshold of workers exposed to different characteristic noises in different frequency bands. A generalized estimation equation was constructed to explore the influencing factors of high-frequency hearing loss in the research subjects. Results The age of the study subjects was 23-54 years old, with 1.6-20.1 years of working experience, mainly distributed in manufacturing workshops, technical workshops and public works workshops. The median LAeq,8h was 85.90 (84.5, 86.1) dB(A), and the average CNE was 94.3±2.6 dB(A). The number of people with increased hearing thresholds in each frequency band was 0.5kHz>6kHz>4kHz>3kHz>1kHz>2kHz. There were statistically significant differences in the increase of hearing thresholds in each frequency band, binaural speech frequency impairment, and high-frequency hearing loss among subjects with different characteristics (P<0.05). The detection rate of binaural speech frequency hearing loss was the highest in subjects aged>45 years, with a length of service of>15 years, and with a CNE>96dB(A). The detection rate of binaural high-frequency hearing loss was the highest in subjects aged 35-40 years, with a length of service of 5-10 years, and with a CNE>96dB(A).In addition, the detection rate of binaural speech frequency and high-frequency hearing loss increased with the increase of CNE(P<0.05). The GEE model showed that age>40 years and CNE>96dB(A) were risk factors for high-frequency hearing loss in both ears. Conclusion With increasing age and CNE, hearing thresholds rise across all frequency bands, elevating the risk of binaural speech-frequency and high-frequency hearing loss, thereby increasing the likelihood of occupational noise-induced deafness.

Background The air quality index (AQI), which is based on the concentration of a dominant pollutant, and the air quality health index (AQHI), which is constructed using excess risk estimates for individual pollutants, may not fully capture the health risks associated with combined exposure to air pollutants. These approaches also provide limited information on the relative contributions of different pollutants. Given the geographical heterogeneity in the composition and health effects of air pollutant mixtures, it is necessary to develop region- and disease-specific AQHIs for different population groups. Objective To develop and evaluate a health risk-based AQHI for respiratory disease mortality associated with air pollutant mixtures using the weighted quantile sum (WQS) regression model and to quantify the relative weight contributions of selected pollutants. Methods Daily data on six air pollutants, the AQI, meteorological factors, and deaths from respiratory diseases in the central urban districts of Tianjin from 2014 to 2019 were collected and integrated into a time-series database. First, generalized additive models (GAMs) were applied to identify indicator pollutants associated with respiratory disease mortality. Second, the WQS regression model was then applied to estimate the relative weight contributions of selected pollutants and to establish the exposure-response relationship between air pollutant mixtures and respiratory disease mortality for AQHI development. Finally, the exposure-response relationships of the AQHI and AQI with respiratory disease mortality were evaluated and compared across population subgroups and seasons. Results Fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), sulfur dioxide (SO₂), and ozone (O₃) were identified as indicator pollutants for combined air pollution exposure. Particulate matter, including PM_2.5 and PM₁₀, and O₃ contributed the most to the mixture index, followed by SO₂. Each interquartile range (IQR) increase in the WQS-based AQHI was significantly associated with respiratory disease mortality in the total population, males, elderly individuals, non-elderly individuals, and during the warm season. The corresponding excess risks (ER) were 3.79% (95%CI: 1.24%, 6.27%), 4.37% (95%CI: 0.96%, 7.67%), 3.16% (95%CI: 0.47%, 5.77%), 9.36% (95%CI: 2.01%, 16.15%), and 7.13% (95%CI: 1.31%, 13.30%), respectively. Compared with the AQI, the AQHI showed stronger associations with respiratory disease mortality across different population subgroups and seasons. Conclusion PM_2.5, PM₁₀, and O₃ contribute substantially to the association between air pollutant mixtures and respiratory disease mortality in Tianjin. Compared with the AQI, the WQS-based AQHI better characterizes the association between air quality and respiratory disease mortality across population subgroups.

Abstract Frailty is a clinical state characterized by increased vulnerability due to the decline of multiple organ functions. It is clinically manifested as slow movement, reduced activity, low energy level and involuntary weight loss. Frailty heightens the risk of disability, long-term hospitalization and mortality in the elderly when they face stressful events. Early assessment of frailty and personalized interventions can prevent and delay its progression, thereby reducing the occurrence of adverse events. This article reviews the literature on frailty published both domestically and internationally from January 2015 to January 2024. It provides an overview of the tools for assessing frailty in the elderly, such as the Clinical Frailty Scale, Frailty Index, Fried Frailty Phenotype, FRAIL Scale, and biological markers, and the management of frailty, including exercise, nutritional interventions, oral health management, and medication management, so as to provide the evidence for early assessment and intervention of frailty.

With the widespread use of antibiotics, drug-resistant bacterial infections have become a significant threat to human health. Finding new antibacterial strategies that can effectively control drug-resistant bacterial infections has become an urgent task. Unlike small molecule drugs that target bacterial proteins, antisense oligonucleotide (ASO) can target genes related to bacterial resistance, pathogenesis, growth, reproduction and biofilm formation. By regulating the expression of these genes, ASO can inhibit or kill bacteria, providing a novel approach for the development of antibacterial drugs. To overcome the challenge of delivering antisense oligonucleotide into bacterial cells, various drug delivery systems have been applied in this field, including cell-penetrating peptides, lipid nanoparticles and inorganic nanoparticles, which have injected new momentum into the development of antisense oligonucleotide in the antibacterial realm. This review summarizes the current development of small nucleic acid drugs, the antibacterial mechanisms, targets, sequences and delivery vectors of antisense oligonucleotide, providing a reference for the research and development of antisense oligonucleotide in the treatment of bacterial infections.

Stroke is the main cause of death and disability among adults in China and is characterized by high incidence， disability， mortality， and recurrence rates. The combination of traditional Chinese and Western medicine has great potential in treating stroke and its sequelae. The classic traditional Chinese medicine prescription Da Chengqitang （DCQT） has a long history and proven efficacy in treating stroke. Clinically， DCQT is often used to treat stroke and its sequelae. However， the number and quality of clinical trials of DCQT in treating stroke need to be improved. Because of the insufficient basic research， the active ingredients and multi-target mechanism of action of DCQT remain unclear. Our research group has previously confirmed that DCQT can effectively reverse neurological damage， reduce iron deposition， and downregulate the levels of pro-inflammatory cytokines in the rat model of hemorrhagic stroke. The treatment mechanism is related to the nuclear factor erythroid 2-related factor 2 （Nrf2）-mediated signaling pathway and p38 mitogen-activated protein kinase （MAPK） signaling-mediated microglia activation. To clarify the pharmacodynamic basis and anti-stroke mechanism of DCQT， this article reviews the research progress in the treatment of stroke with DCQT in terms of clinical trials， pharmacodynamic material basis， safety evaluation， and mechanisms of absorbed components. This article summarizes 45 major phytochemical components of DCQT， 11 of which are currently confirmed absorbed components. Among them， emodin， rhein， chrysophanol， aloe-emodin， synephrine， hesperidin， naringin， magnolol， and honokiol can be used as quality markers （Q-markers） of DCQT. The mechanism of DCQT in treating stroke is complex， involving regulation of inflammatory responses， neuronal damage， oxidative stress， blood-brain barrier， brain-derived neurotrophic factor， and anti-platelet aggregation. This article helps to deeply understand the pharmacodynamic basis and mechanism of DCQT in treating stroke and provides a theoretical basis for the clinical application of DCQT in treating stroke and the development of stroke drugs.