Objective To investigate the radon activity concentrations in subways of Nanning City and assess the average annual effective doses for subway staff and passengers due to radon exposure. Methods Sixty-three stations across the subway lines 2, 3, and 5 were selected as study sites. Radon activity concentrations were measured using the scintillation counting method with scintillation vials. Results The radon activity concentrations in subway lines 2, 3, and 5 were 7.9-24.4, 12.0-26.2, and 12.6-18.2 Bq/m³, respectively. The average radon activity concentrations for these three lines were (17.4 ± 4.6), (19.1 ± 4.1), and (14.6 ± 1.7) Bq/m³, respectively. Statistical analysis using SPSS 26.0 software revealed a significant difference in radon activity concentrations among these stations (P<0.01). Considering the data in previous research, the average radon activity concentration across all stations in the subway lines of Nanning City was determined to be 17.4 Bq/m³. The estimated average annual effective dose due to radon exposure was 0.131 mSv for subway staff and 0.033 mSv for passengers. Conclusion The radon activity concentrations in the subway lines of Nanning City were significantly lower than the national standard limit (400 Bq/m³). The annual effective doses from radon exposure for both subway staff and passengers were below the limits specified in the Basic Standards for Protection Against Ionizing Radiation and for the Safety of Radiation Sources (GB18871—2002). The health impact of radon and its progeny on subway staff and passengers in the subway lines of Nanning City was extremely low and can be considered negligible.

Objective To explore the optimal warning threshold of motor evoked potentials(MEP)in decompression surgery for ossification of the posterior longitudinal ligament(OPLL)at cervical and thoracic segments,and the predictive role of different MEP parameters on postoperative lower extremity motor function.Methods A retrospective analysis was conducted on the clinical data of 227 patients diagnosed with cervical or thoracic OPLL and underwent decompression surgery from January 2022 to January 2024 in the hospital.There were 131 males and 96 females,with an average age of(60±10)years.All patients underwent continuous neuro-physiological monitoring during the operation,and the minimum ratio of MEP amplitude change to the baseline at the beginning of the operation(Dmax)and the ratio of MEP terminal amplitude change to the baseline at the end of the operation(Dend)were recorded.The correlations between these two ratios and the lower extremity motor func-tion immediately after the operation and at 1 year were compared.According to the Medical Research Council muscle strength score(MRC)standard,a postoperative score increase of≥1 point compared to preoperative was defined as postoperative motor dysfunction.Pearson correlation coefficients were used to evaluate the correlations between Dmax and Dend and the lower extremity motor function immediately after the operation and at 1 year.Receiver operating characteristic(ROC)curves were drawn to predict postoperative lower extremity motor dysfunc-tion using Dmax and Dend.Results Among the 227 patients,186 had cervical OPLL and 41 had thoracic OPLL.The incidence of lower extremity motor dysfunction immediately after the operation and at 1 year was 7 cases(3.76%)and 2 cases(1.08%)in the cervical group,and 9 cases(21.95%)and 3 cases(7.32%)in the thoracic group,respectively.The incidence of lower extremity motor dysfunction in the thoracic group was higher than that in the cervical group(P<0.001).The baseline induction rate of bilateral lower extremity MEPs was 98.92%(368/372)in the cervical group and 96.34%(79/82)in the thoracic group.The Pearson correlation coefficients of Dend with the bilateral lower extremity motor function immediately after the operation in the cervical and thoracic groups were both greater than those of Dmax,and the differences were statistically significant(cervical group:r=0.669,0.517,P=0.001 2;thoracic group:r=0.882,0.727,P=0.003 6),while the differences in the Pearson corre-lation coefficients of Dend and Dmax with the bilateral lower extremity motor function at 1 year were not statistically significant(cervical group:r=0.457,0.352,P=0.088;thoracic group:r=0.760,0.625,P=0.098).The cut-off values of Dend for the cervical group were 0.853 immediately after the operation and at 1 year,and the cut-off values of Dmax were 0.881 and 0.978,respectively.For the thoracic group,the cut-off values of Dend were 0.532 immediately after the operation and 0.639 at 1 year,and the cut-off values of Dmax were 0.532 and 0.640,respec-tively.Conclusions In OPLL surgery,the MEP monitoring strategy should be adjusted according to the surgical segment.For the cervical segment,Dmax should be emphasized to balance high sensitivity and specificity,while for the thoracic segment,Dmax or Dend can be flexibly selected.Higher MEP warning thresholds are required for cervical OPLL surgery(Dmax:0.881 immediately after the operation and 0.978 at 1 year;Dend:0.853),while significantly lower thresholds are needed for thoracic OPLL(Dmax/Dend:0.532 immediately after the operation and 0.640 at 1 year).

OBJECTIVE To observe the effect of early warning mechanisms based on nosocomial infection surveil-lance system on precise prevention and control of spread of multidrug-resistant organisms(MDROs)infections in intensive care unit of neurosurgery department.METHODS The dynamic monitoring was performed in the ICU of neurosurgery department of a three-A general hospital by using real-time surveillance system of nosocomial infec-tion from Jan.2023 to Dec.2023.The warning information was sent to the doctor' station immediately once the MDROs infections were detected,the detection of drug-resistant bacteria was carried out for the relevant personnel and their surroundings,and the precise prevention and control measures were implemented.The impact on the iso-lation rate of MDROs,isolation rate of MDROs from the relevant personnel and surroundings,incidence of noso-comial MDROs infections and incidence of surgical site infection was observed after the measures were taken.RESULTS The carrying rate of MDROs was decreased from 21.80％to 5.74％among the relevant personnel after the precise prevention and control measures were taken(P＜0.05),which was improved remarkably among the doctors(decreasing from 21.43％to 6.07％),nurses(decreasing from 23.68％to 3.98％),nursing workers(decreasing from 25.15％to 8.65％),and cleaning staff(decreasing from 25.49％to 5.05％)(P＜0.001).The isolation rate of MDROs was decreased from 20.77％to 7.12％among the surroundings(P＜0.05),which was decreased most remarkably among head cushions(decreasing from 32.28％to 12.13％),bed rails(decreasing from 16.70％to 3.27％),ventilator panels(decreasing from 23.00％to 6.95％)and bedside floors(decreasing from 31.99％to 9.96％)(P＜0.001).The incidence of nosocomial MDROs infections declined from 3.84％to 1.71％(P＜0.05),with incidence of incision infections decreasing from 4.00％to 1.45％(P＜0.05),the inci-dence of intracranial infections decreasing from 2.38％to 0.56％(P＜0.05).CONCLUSION The detection of drug-resistant bacteria is carried out immediately and precisely for the patients with MDROs infection,relevant personnel and their surroundings by using the real-time surveillance system of nosocomial infection,which achieve remarkable effect on prevention of transmission of MDROs and reduction of incidence of hospital-associated infec-tions and surgical site infections.

Objective:To investigate the clinical characteristics and treatment of human immunodeficiency virus (HIV) negative adult disseminated Talaromyces marneffei (TSM) infection, so as to improve the diagnosis and treatment of this disease.Methods:While two HIV-negative adult patients with disseminated T. Marneffei infection were reported, papers published between 1970 and February 2024 were collected from CNKI, Wanfang and Chongqing Weipu databases, and patient data meeting diagnostic criteria were collected. A total of 34 HIV-negative adults with disseminated T. Marneffei infection were collected. The data of 34 patients with this disease were retrospectively analyzed, and the demographic distribution, systematic signs, examination results, complications, diagnosis and treatment plan and effect of this disease were summarized.Results:Among the 34 patients, the ratio of male to female patients was 21∶13. The median age of onset was 51 years, ranging from 24 to 70 years. The incidence area was more common in the south of China. The most common clinical manifestation was fever. 70.6%(24/34) of patients were misdiagnosed, most often with tuberculosis. The methods of diagnosis were as follows: 26 cases were diagnosed by fungal culture, 5 cases by high-throughput sequencing and 3 cases by direct microscopy. 32 patients received antifungal therapy, 9 were cured, 10 improved, 2 died, 4 relapsed, 4 patients were effective (but the outcome was unknown), 2 patients had poor effect, and 1 patient had unknown effect. Two patients died soon after admission due to rapid disease progression.Conclusions:The symptoms of HIV negative adults infected with T. Marneffei are varied and may involve multiple systems. Infection is often misdiagnosed. Early identification and fungal culture can improve the detection rate. High-throughput sequencing is a relatively mature diagnostic technology.

Objective:To investigate the clinical characteristics and treatment of human immunodeficiency virus (HIV) negative adult disseminated Talaromyces marneffei (TSM) infection, so as to improve the diagnosis and treatment of this disease.Methods:While two HIV-negative adult patients with disseminated T. Marneffei infection were reported, papers published between 1970 and February 2024 were collected from CNKI, Wanfang and Chongqing Weipu databases, and patient data meeting diagnostic criteria were collected. A total of 34 HIV-negative adults with disseminated T. Marneffei infection were collected. The data of 34 patients with this disease were retrospectively analyzed, and the demographic distribution, systematic signs, examination results, complications, diagnosis and treatment plan and effect of this disease were summarized.Results:Among the 34 patients, the ratio of male to female patients was 21∶13. The median age of onset was 51 years, ranging from 24 to 70 years. The incidence area was more common in the south of China. The most common clinical manifestation was fever. 70.6%(24/34) of patients were misdiagnosed, most often with tuberculosis. The methods of diagnosis were as follows: 26 cases were diagnosed by fungal culture, 5 cases by high-throughput sequencing and 3 cases by direct microscopy. 32 patients received antifungal therapy, 9 were cured, 10 improved, 2 died, 4 relapsed, 4 patients were effective (but the outcome was unknown), 2 patients had poor effect, and 1 patient had unknown effect. Two patients died soon after admission due to rapid disease progression.Conclusions:The symptoms of HIV negative adults infected with T. Marneffei are varied and may involve multiple systems. Infection is often misdiagnosed. Early identification and fungal culture can improve the detection rate. High-throughput sequencing is a relatively mature diagnostic technology.

Objective To analyze the current research on cardiovascular diseases in pilots using bibliometric methods,so as to provide reference for future researches.Methods Articles indexed by China National Knowledge Infrastructure(CNKI)were selected as the research objects.The time window ranged from January 1990 to February 2024,and the keywords"pilot or flight personnel"and"cardiovascular"were selected to search for all published literatures on cardiovascular diseases in pilots.CiteSpace 6.1.R6 software was used to analyze the authors,institutions,and keywords of the included literatures,and a visual analysis graph was drawn.Results A total of 198 articles were included in this study.The journal with the most published articles was the Chinese Journal of Aerospace Medicine and Aviation Military Medicine.The author with the most published articles was Wang Lujin,followed by Zheng Jun.The institution with the most published articles was Air Force General Hospital(Air Force Medical Center).Risk factors,hypertension,and health assessment were hot keywords.The emerging word was medical appraisal.Conclusion The literatures of cardiovascular diseases among pilots are mainly published in aviation medical journals,forming a research team led by Wang Lujin and Zheng Jun.Research cooperation is mainly within the research team members,with less cooperation between research institutions.The research hotspots are risk factors of cardiovascular disease,hypertension,and health identification,and the forefront of research is the medical identification of cardiovascular diseases among pilots.With the increasing importance of cardiovascular diseases among pilots,it is necessary to strengthen cooperation among research institutions in the future,promote high-quality development in this field,and focus on strengthening scientific research in the prevention of cardiovascular diseases to maintain the physical and mental health of pilots.

The aim of this paper was to investigate the serotypes,virulence factors and drug resist-ance of clinical isolates of Pasteurella rnultocida of porcine origin in recent years.Morphological screening and polymerase chain reaction(PCR)were used to isolate and identify 119 isolates from nasal swabs and lung tissue samples sent from swine farms in Zhejiang Province from 2010 to 2024.The isolates of Pasteurella multocida were subjected to capsular polysaccharide serotyping,lipopolysaccharide serotyping,virulence factor detection and drug resistance analysis by PCR and Kirby-Bauer disc agar diffusion method(K-B).The results showed that there were 64 strains(53.7％)of A-type,54 strains(45.3％)of D-type and 1 strain(0.9％)of F-type among the capsu-lar polysaccharide serotypes,and 10 strains(8.4％)of L1-type,20 strains(16.8％)of L3-type,86 strains(72.2％)of L6-type,and 3 strains(2.6％)of undetermined type among the lipopolysaccha-ride serotypes.The amplification results of 10 virulence genes showed that the detection rate of virulence genes hgbA,higbB and fimA was over 86.0％,the detection rate of toxA was 8.4％,while the virulence gene tbpA was not detected.There were also differences in the distribution vir-ulence genes in different capsular polysaccharide serotypes.Virulence factor pfhA was detected in type A and F but not in type D.The detection rate of adhesin gene tadD in serotype A(92.2％)was significantly higher than that of type D(9.3％),and,on the contrary,the detection rate of ad-hesin gene hsf-l in serotype D(90.7％)was significantly higher than that of type A(20.3％).Drug resistance analysis revealed that Pasteurella multocida showed high susceptibility to antimi-crobial drugs such as amoxicillin,ampicillin,cephalosporins,doxycycline,fosfenicol and ciprofloxa-cin,and showed strong resistance to antimicrobial drugs such as lincomycin,cotrimoxazole,genta-micin and amikacin,and there were 54 multi-drug resistant strains(78.3％).In summary,capsular polysaccharide serotypes were dominated by type A and D,lipopolysaccharide serotypes were dom-inated by L6,the distribution of some virulence genes varied greatly among different serotypes,and the proportion of multi-resistant strains was high,which provide reference for the prevention and control of this disease.

OBJECTIVE To observe the effect of early warning mechanisms based on nosocomial infection surveil-lance system on precise prevention and control of spread of multidrug-resistant organisms(MDROs)infections in intensive care unit of neurosurgery department.METHODS The dynamic monitoring was performed in the ICU of neurosurgery department of a three-A general hospital by using real-time surveillance system of nosocomial infec-tion from Jan.2023 to Dec.2023.The warning information was sent to the doctor' station immediately once the MDROs infections were detected,the detection of drug-resistant bacteria was carried out for the relevant personnel and their surroundings,and the precise prevention and control measures were implemented.The impact on the iso-lation rate of MDROs,isolation rate of MDROs from the relevant personnel and surroundings,incidence of noso-comial MDROs infections and incidence of surgical site infection was observed after the measures were taken.RESULTS The carrying rate of MDROs was decreased from 21.80％to 5.74％among the relevant personnel after the precise prevention and control measures were taken(P＜0.05),which was improved remarkably among the doctors(decreasing from 21.43％to 6.07％),nurses(decreasing from 23.68％to 3.98％),nursing workers(decreasing from 25.15％to 8.65％),and cleaning staff(decreasing from 25.49％to 5.05％)(P＜0.001).The isolation rate of MDROs was decreased from 20.77％to 7.12％among the surroundings(P＜0.05),which was decreased most remarkably among head cushions(decreasing from 32.28％to 12.13％),bed rails(decreasing from 16.70％to 3.27％),ventilator panels(decreasing from 23.00％to 6.95％)and bedside floors(decreasing from 31.99％to 9.96％)(P＜0.001).The incidence of nosocomial MDROs infections declined from 3.84％to 1.71％(P＜0.05),with incidence of incision infections decreasing from 4.00％to 1.45％(P＜0.05),the inci-dence of intracranial infections decreasing from 2.38％to 0.56％(P＜0.05).CONCLUSION The detection of drug-resistant bacteria is carried out immediately and precisely for the patients with MDROs infection,relevant personnel and their surroundings by using the real-time surveillance system of nosocomial infection,which achieve remarkable effect on prevention of transmission of MDROs and reduction of incidence of hospital-associated infec-tions and surgical site infections.

Objective To explore the role and mechanism of peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) in remifentanil (REM) resistance to hepatic ischemia-reperfusion injury (HIRI). Methods Forty SD rats were randomly divided into sham surgery group, HIRI group, HIRI+REM group, HIRI+PGC-1α inhibitor SR-18292 (HIRI+SR-18292) group and HIRI+REM+SR-18292 group, 8 rats in each group. HIRI rat models were constructed using non-invasive arterial clip occlusion method, and REM or SR-18292 were intravenously injected before surgery. The liver function indicators and liver tissue adenosine triphosphate (ATP) levels in the serum of rats were detected by assay kits. The activity levels of mitochondrial respiratory chain complexes Ⅲ and Ⅳ (COX-Ⅲ, COX-Ⅳ) in rat liver tissue were assessed by colorimetric methods. The pathological changes in rat liver tissue were observed by hematoxylin-eosin staining. Reactive oxygen species (ROS) and oxidative stress-related indicators in rat liver tissue were measured using the fluorescent probe (DCFH-DA) method and colorimetric methods. The mitochondrial DNA (mtDNA) copies and the expression levels of PGC-1α, nuclear respiratory factor-1 (NRF-1) and mitochondrial transcription factor A (TFAM) messenger RNA (mRNA) in rat liver tissue were quantified by real-time fluorescent quantitative polymerase chain reaction (RT-qPCR). And the protein expression levels of PGC-1α, NRF-1 and TFAM in rat liver tissue were assessed by Western blotting. Results Compared with the sham group, rats in the HIRI group showed increased pathological scores and hepatic cell necrosis in liver tissue, elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum, and increased levels of ROS and malondialdehyde (MDA) in liver tissue. Additionally, there was a decrease in ATP content and the activity levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), COX-Ⅲ and COX-Ⅳ in liver tissue, as well as a decrease in mtDNA copies and the expression levels of PGC-1α, NRF-1 and TFAM mRNA and protein (all P<0.05). Compared with the HIRI group, rats in the HIRI+REM group exhibited decreased pathological scores and hepatic cell necrosis, reduced levels of serum ALT and AST, and decreased levels of ROS and MDA in liver tissue. There was also an increase in ATP content and the activity levels of SOD, GSH-Px, COX-Ⅲ and COX-Ⅳ in liver tissue, as well as an increase in mtDNA copies and the expression levels of PGC-1α, NRF-1 and TFAM mRNA and protein (all P<0.05). In contrast, rats in the HIRI+SR-18292 group showed increased pathological scores and hepatic cell necrosis, elevated levels of serum ALT and AST, and increased levels of ROS and MDA in liver tissue. There was a decrease in ATP content and the activity levels of SOD, GSH-Px, COX-Ⅲ and COX-Ⅳ in liver tissue, as well as a decrease in mtDNA copies and the expression levels of PGC-1α, NRF-1 and TFAM mRNA and protein (all P<0.05). Compared with the HIRI+REM group, rats in the HIRI+REM+SR-18292 group had increased pathological scores and hepatic cell necrosis, elevated levels of serum ALT and AST, and increased levels of ROS and MDA in liver tissue. There was a decrease in ATP content and the activity levels of SOD, GSH-Px, COX-Ⅲ and COX-Ⅳ in liver tissue, as well as a decrease in mtDNA copies and the expression levels of PGC-1α, NRF-1 and TFAM mRNA and protein (all P<0.05). Conclusions PGC-1α plays a role in regulating the process of REM resistance to HIRI by promoting mitochondrial biogenesis and reducing the levels of oxidative stress.