Background In recent years, the increasingly widespread application of nuclear and medical radiation technologies has resulted in a large number of occupational populations exposed to low-dose ionizing radiation (LDIR). At present, there is no consistent conclusion on the effects of long-term exposure to LDIR on the metabolic health of the occupational population. Objective To explore the association between long-term exposure to LDIR and metabolic syndrome (MetS) among medical radiologists. Methods A cross-sectional study was conducted to enroll 6431 medical radiologists who ordered occupational health checkups from January 2022 to December 2023, and basic information such as demographic characteristics, occupational characteristics, lifestyles, and dietary habits was collected through questionnaires. Physical examinations were conducted using a standardized protocol. Individual dose equivalents of occupational external exposure were monitored by dosimeters worn by medical radiologists. Logistic regression model was used for identifying influencing factors of MetS and sensitivity analysis, and restricted cubic spline model was used to explore the dose-response relationship between cumulative effective dose and MetS. Two-stage linear regression was used to evaluate threshold effect of association between cumulative effective dose and MetS. Results The positive rate of MetS was 13.6% (877/6431) among the enrolled 6431 study participants. The logistic regression showed that gender, age, monthly income, body mass index (BMI), cumulative effective dose, and smoking were influencing factors for MetS. The risk of MetS was higher in males (OR=1.511, 95%CI: 1.209, 1.888); using the < 30 years old group as reference, the risk of MetS was higher in the 30-39 years old (OR=1.509, 95%CI: 1.095, 2.079), 40-49 years old (OR=2.214, 95%CI: 1.551, 3.161), and ≥50 years old (OR=3.480, 95%CI: 2.338, 5.181) groups; using the <10000 yuan group as reference, the risk of MetS was lower in the group with a monthly income of 10000-14999 yuan (OR=0.715, 95%CI: 0.582, 0.878); the risk of MetS was higher in the BMI ≥ 24 kg·m⁻² group (OR=7.548, 95%CI: 6.223, 9.156); using the < 0.76 mSv group as reference, the risk of MetS was higher in the cumulative effective dose of 0.76-2.73 mSv group (OR=1.270, 95%CI: 1.017, 1.586); the risk of MetS was higher in the smoking group (OR=1.734, 95%CI: 1.428, 2.107). The results of restricted cubic spline showed that the cumulative effective dose was nonlinearly correlated with MetS (P _{non-linearity}=0.028), with an inflection point of 1.25 mSv. The risk of developing MetS increased by 34.1% for each unit increase in cumulative effective dose up to 1.25 mSv, whereas above 1.25 mSv, the statistical association was not significant. The sensitivity analysis results showed that after excluding the self-reported hypertensive and diabetic patients, the cumulative effective dose 0.76-2.73 mSv group still had an increased risk of developing MetS compared with the < 0.76 mSv group (P < 0.05), and the results were robust. Conclusion Among medical radiologists, male, age, BMI, and smoking are positively correlated with MetS, and monthly income is negatively correlated with MetS; cumulative effective dose is non-linearly correlated with MetS among medical radiologists.

L-phosphinothricin (L-PPT) is an efficient broad-spectrum herbicide. To realize the multi-enzyme catalytic preparation of L-PPT, we constructed an engineered strain Escherichia coli YM-1 for efficient expression of D-amino acid transaminase, which could catalyze the generation of the intermediate 2-oxo-4-[(hydroxymethylphosphonyl)] butyric acid (PPO) from D-phosphinothricin (D-PPT). In addition, E. coli pLS was constructed to co-express glutamate dehydrogenase and glucose dehydrogenase, which not only catalyzed the generation of L-PPT from PPO but also regenerated the coenzyme nicotinamide adenine dinucleotide phosphate (NADPH). A fed-batch fermentation process was then established for E. coli YM-1 and pLS, and the apparent activities of D-amino acid transaminase and glutamate dehydrogenase were increased by 22.68% and 100.82%, respectively, compared with those in shake flasks. The process parameters were optimized for the catalytic preparation of L-PPT by whole-cell cascade of E. coli YM-1 and pLS with D, L-PPT as the substrate. After reaction for 8 h, 91.36% conversion of D-PPT was achieved, and the enantiomeric excess of L-PPT reached 90.22%. The findings underpin the industrial production of L-PPT.
Escherichia coli/enzymology* ; Aminobutyrates/metabolism* ; Glutamate Dehydrogenase/biosynthesis* ; Glucose 1-Dehydrogenase/biosynthesis* ; Herbicides/metabolism* ; Multienzyme Complexes/metabolism* ; Transaminases/metabolism* ; Phosphinic Acids/metabolism*

OBJECTIVE To systematically evaluate the repair strategies for temporal bone-parotid composite defects,compare the clinical applicability of local muscle flaps and free flaps,and provide references for optimizing the reconstruction of complex head and neck defects.METHODS We retrospectively analyzed the medical records of 17 patients with postoperative defects in the temporal bone-parotid region treated at Beijing Tongren Hospital,Capital Medical University,between January 2018 and June 2023.There were 11 males and 6 females,with a median age of 58 years(range:42-72 years).All patients had undergone radical resection.Defects were reconstructed with local flaps in 13 cases(temporalis muscle flap,n=6;sternocleidomastoid flap,n=3;submental platysma flap,n=2;submental island flap,n=2)and with free flaps in 4 cases(anterolateral thigh fascial flap,n=1;anterolateral thigh flap,n=1;free abdominal adipofascial flap,n=2).RESULTS The primary diseases of the 17 patients were malignant tumors of the external auditory canal and parotid gland(6 cases of squamous cell carcinoma,6 cases of adenoid cystic carcinoma,and 3 cases of ductal carcinoma).All flaps survived completely.One patient with temporalis muscle flap repair developed postoperative wound infection,which healed after debridement and dressing change.The median follow-up period was 16 months(4-29 months).Two cases(11.8%)of external auditory canal squamous cell carcinoma had local recurrence,one case(5.9%)of parotid ductal carcinoma developed pulmonary metastasis 9 months after surgery and died at 15 months.The remaining 14 cases(82.4%)were tumor-free survivors.Functional evaluation showed that the local tissue flap group had a shorter repair time,but was limited by muscle flap rotation arc;the free flap group could accurately match the defect shape,but the surgical time was prolonged to 3.5-4.5 hours.Fourteen cases(82.4%)received postoperative adjuvant radiotherapy.None of the tissue flaps developed radiation necrosis after radiotherapy.CONCLUSION Temporal bone-parotid composite defects need to balance the dual requirements of surgical cavity coverage and cosmetic repair.Local muscle flaps are easy to operate and have reliable blood supply,suitable for small and medium-sized defects;free tissue flaps have better shape adaptability in complex three-dimensional defect reconstruction,but require microsurgical technical support.The repair plan should be comprehensively decided based on the defect range,vascular conditions,and radiotherapy plan.The data of this group confirmed that both techniques can achieve stable therapeutic effects.

Objective To elucidate how the overexpression of cystathionine-β-synthase(CBS)plays an antihypertensive role by affecting peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α)expression.Methods The adeno-associated viruses(AAVs),ones that overexpressed CBS,and another knocked down PGC-1α,were injected into the hypothalamic paraventricular nucleus(PVN)of spontaneously hypertensive rats(SHRs).The rats'blood pressure was monitored,and the level of norepinephrine(NE)was examined by ELISA;PVN inflammatory response,oxidative stress and tyrosine hydroxylase(TH)expression were detected with RT-qPCR and immunofluorescence.Results PVN overexpression of CBS could increase the transcription level of CBS(by 3.8 times,P＜0.05)and PGC-1α(by 1.6 times,P＜0.05)in PVN of SHR.PVN overexpression of CBS could reduce blood pressure in SHR(from 177.81 mmHg to 128.77 mmHg,P＜0.001),but PVN knockdown of PGC-1αweakened such effect(from 128.77 mmHg to 152.79 mmHg,P＜0.05).PVN overexpression of CBS could alleviate PVN inflammatory response and oxidative stress,but this effect was weakened or even eliminated when knocking down PGC-1α was performed at the same time.Conclusion PVN overexpression of CBS can reduce blood pressure in SHR,and this effect may be achieved by increasing the transcriptional level of PGC-1α,alleviating PVN inflammatory response,oxidative stress,and improving sympathetic nerve excitation.

Objective To analyze the changes of serum inhibin B(INHB),anti-Müllerian hormone(AMH)and sex hormone levels in patients with infertility caused by polycystic ovary syndrome(PCOS).Methods A total of 302 patients with infertility caused by PCOS admitted to the hospital from June 2021 to June 2023 were selected as the experimental group,and 300 healthy women of childbearing age with normal menstrual cycle were selected as the control group.The levels of serum INHB,AMH and sex hormone indexes[serum luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL),progesterone(P),testoster-one(T),estradiol(E2)]and homeostasis model assessment of insulin resistance(HOMA-IR)were observed and compared between the two groups.Results The serum levels of AMH,INHB and HOMA-IR in test group were significantly higher than those in control group,with statistical significance(P＜0.05).Serum levels of LH/FSH,PRL,T and P in experimental groups were significantly higher than those in control group,and serum E2 levels were significantly lower than those in control group,with statistical significance(P＜0.05).With the passage of treatment time,serum AMH,INHB,LH/FSH,PRL,T and P levels gradually decreased,and E2 levels gradually increased(P＜0.05).The area under the curve(AUC)of AMH and INHB combined detection in the diagnosis of infertility caused by PCOS was 0.905,which was higher than the AUC of AMH or INHB detection alone(P＜0.05).Serum AMH and INHB levels were positively correlated with FSH,LH,T and HOMA-IR,PRL,P(P＜0.05),and negatively correlated with serum E2 levels(P＜0.05).Conclusion The levels of AMH and INHB in serum of infertility patients caused by PCOS are significantly increased,and AMH and INHB are correlated with sex hormone levels.Detection of serum AMH,INHB and sex hormone levels is helpful for the diagnosis of infertility caused by PCOS.

Objective To construct and verify a risk prediction model of emergence agitation in patients undergoing thoracoscopic radical resection of lung cancer,and to screen the optimal model by using machine learning algorithm,so as to provide references for clinical formulation of a nursing risk management plan.Methods The convenience sampling method was used to retrospectively select 476 patients who underwent thoracoscopic radical resection of lung cancer in a tertiary hospital in Hangzhou,Zhejiang Province from January to December 2023 as a construction group.Logistic regression,decision tree,random forest and naive Bayesian model were constructed by SPSS 29.0 and R 4.3.0 software.The prediction performance of each model was compared by accuracy,precision,recall,F1 score and area under the receiver operating characteristic curve,and the optimal model was screened.From January to June 2024,204 patients in the unit were prospectively selected as the research subjects of an external validation group.The discrimination and calibration of the optimal model were evaluated by AUC value and calibration curve.Results A total of 680 patients completed the survey.All 4 models showed that multimodal analgesia,thoracic drainage tube type,pain score,tracheal intubation type,state anxiety and catheter indwelling time were the influencing factors of emergence agitation in patients undergoing thoracoscopic radical resection of lung cancer(P＜0.05).The 4 risk prediction models showed that the random forest prediction model had the best comprehensive performance.The external verification results showed that the AUC value was 0.913,and the calibration curve fitted well with the 45° ideal line.Conclusion Among the 4 risk prediction models,the random forest prediction model has the best performance,which is more suitable for the assessment of the risk of emergence agitation in patients undergoing thoracoscopic radical resection of lung cancer,and has good generalization and clinical application value.

Objective:To study and analyze radiation doses to the eye of the lens dose in interventional radiology staff of Guandong medical institutions from 2019 to 2023.Methods:Employing a convenience sampling method, the lens dose and chest dose was monitored with TLD dosimeters in 34 level A tertiary medical institutions. The monitoring data were analyzed on the basis of a summary, and the relationship between the two was explored.Results:A total of 1 033 interventional radiology staff were monitored. The ocular lens doses were in the range of (

Objective To analyze the association between eye-related behaviors and myopia among preschool chil-dren in Ningxia Hui Autonomous Region,and to develop a predictive nomogram model.Methods Using stratified cluster random sampling,36 062 preschool children from 400 randomly selected kindergartens in Ningxia Hui Autonomous Region were enrolled between October and December 2023.Primary caregivers of participants completed structured question-naires.Data were randomly split into a training set(n=25 243,70％)and a validation set(n=10 819,30％)in a ratio of 7∶3.The training set was used for model construction,and the validation set for external validation.Calibration plots and the Hosmer-Lemeshow(H-L)goodness-of-fit test assessed agreement between predicted and observed risks.Decision curve analysis(DCA)and clinical impact curve analysis(CICA)evaluated clinical utility.Results The myopia preva-lence among preschool children in Ningxia Hui Autonomous Region was 3.8％.A nomogram model based on binary Logistic regression showed area under the curve(AUC)values of 0.88(95％CI:0.87-0.89)for the training set and 0.89(95％CI:0.87-0.90)for the validation set,indicating strong discriminative ability.Calibration curves and H-L tests revealed good model fit(training set:x2=4.92,P=0.766;validation set:x2=5.52,P=0.961),with all P＞0.05.DCA and CICA confirmed clinical utility.The nomogram identified parental myopia,academic pressure,frequency of eye fatigue,daily screen time,and regular vision checks as the top five predictors of myopia.Conclusion The nomogram demonstrates promising potential for predicting myopia risk in preschool children in Ningxia Hui Autonomous Region,serving as a robust tool for clinical and educational myopia risk assessment.

Objective To analyze the association between eye-related behaviors and myopia among preschool chil-dren in Ningxia Hui Autonomous Region,and to develop a predictive nomogram model.Methods Using stratified cluster random sampling,36 062 preschool children from 400 randomly selected kindergartens in Ningxia Hui Autonomous Region were enrolled between October and December 2023.Primary caregivers of participants completed structured question-naires.Data were randomly split into a training set(n=25 243,70％)and a validation set(n=10 819,30％)in a ratio of 7∶3.The training set was used for model construction,and the validation set for external validation.Calibration plots and the Hosmer-Lemeshow(H-L)goodness-of-fit test assessed agreement between predicted and observed risks.Decision curve analysis(DCA)and clinical impact curve analysis(CICA)evaluated clinical utility.Results The myopia preva-lence among preschool children in Ningxia Hui Autonomous Region was 3.8％.A nomogram model based on binary Logistic regression showed area under the curve(AUC)values of 0.88(95％CI:0.87-0.89)for the training set and 0.89(95％CI:0.87-0.90)for the validation set,indicating strong discriminative ability.Calibration curves and H-L tests revealed good model fit(training set:x2=4.92,P=0.766;validation set:x2=5.52,P=0.961),with all P＞0.05.DCA and CICA confirmed clinical utility.The nomogram identified parental myopia,academic pressure,frequency of eye fatigue,daily screen time,and regular vision checks as the top five predictors of myopia.Conclusion The nomogram demonstrates promising potential for predicting myopia risk in preschool children in Ningxia Hui Autonomous Region,serving as a robust tool for clinical and educational myopia risk assessment.

Objective:To study and analyze radiation doses to the eye of the lens dose in interventional radiology staff of Guandong medical institutions from 2019 to 2023.Methods:Employing a convenience sampling method, the lens dose and chest dose was monitored with TLD dosimeters in 34 level A tertiary medical institutions. The monitoring data were analyzed on the basis of a summary, and the relationship between the two was explored.Results:A total of 1 033 interventional radiology staff were monitored. The ocular lens doses were in the range of (