Objective To analyze the unexamined items and situations in occupational health examinations of radiation workers, and provide a reference for the revision of occupational health examination standards for radiation workers. Methods A total of 29 630 radiation workers who underwent occupational health examinations at The Third People’s Hospital of Henan Province in 2023 were selected, and the non-examination rates were statistically analyzed according to occupation, gender, and age. Results The overall non-examination rate of non-medical radiation workers was significantly lower than that of the medical radiation workers (P<0.05). The non-examination rate of chest X-rays among medical radiation workers was significantly higher than that of non-medical radiation workers (P<0.05), while no significant differences were found in other items (P>0.05). Gender-stratified analysis showed that the non-examination rate of routine urine tests was higher in females than in males in both medical and non-medical radiation workers (P<0.05). Age-stratified analysis revealed no significant differences in non-examination rates among different age groups in non-medical radiation workers (P>0.05), whereas the chest X-ray non-examination rate was relatively high in medical radiation workers under 30 years old (P<0.05). Conclusion Significant differences were observed in the non-examination rates of occupational health examinations among radiation workers based on occupation, gender, and age. The overall non-examination rate was relatively low in non-medical radiation workers.

Objective To analyze the clinical features of chronic obstructive pulmonary disease (COPD) patients with heart failure (HF) in Nanjing and explore the influencing factors. Methods A total of 773 COPD inpatients were selected from January 2021 to January 2024 in Nanjing Combined Hospital of Traditional Chinese and Western Medicine, Nanjing Qixia District Hospital, Nanjing Lishui District People's Hospital, Nanjing Pukou District Hospital of Traditional Chinese Medicine and Nanjing First Hospital., and were divided into 2 groups according to the presence or absence of combined HF. The general data and medical records of the two groups were compared, the clinical characteristics of COPD patients with HF were summarized, and the influencing factors of COPD patients with HF were analyzed by multivariate logistic regression. Results Among the 242 patients (31.31%) with COPD had HF, chronic paroxysmal dyspnea was the most common first symptom, 169 patients (69.83%) had left heart failure, 63 patients (30.17%) were diagnosed as right heart failure or global heart failure , 17 patients (7.02%) had myocardial infarction. Multivariate logistic regression analysis showed that the risk of HF was 1.678 times and 1.691times higher in COPD groups ≥ 50 years old and male COPD groups than in < 50 years old and female groups, respectively; the risk of HF was 1.491 times higher in COPD groups engaged in physical work than in physical work groups; the risk of HF was 1.447 times and 1.580 times higher in COPD groups with hypertension and coronary heart disease than in COPD groups without hypertension and coronary heart disease, respectively; the risk of HF was 1.859 times higher in COPD groups smoking>400 vial/year than in COPD groups≤400 vial/ year; the risk of HF was 1.757 times higher in COPD groups with acute exacerbation frequency≥2 times/year than in COPD groups<2 times/year; the above differences were statistically significant (P<0.05). Conclusion Attention should be paid to elderly, male and heavy physical work group of COPD patients. Active treatment of hypertension and coronary heart disease, effective tobacco control and reduction of the frequency of acute exacerbation are effective ways to reduce the risk of HF in COPD patients in Nanjing.

BackgroundSchizophrenia is a highly heterogeneous disease with different clinical subtypes. Artificial intelligence technology represented by deep learning models has provided considerable benefits for the electroencephalogram （EEG）-based schizophrenia diagnosis， treatment and research， however， to date little research has been conducted regarding any of these benefits among Chinese schizophrenic patients. ObjectiveTo investigate the application of deep learning techniques utilizing EEG parameters for the diagnosis of first-episode schizophrenia and grading of EEG abnormalities in patients， with the aim of contributing to improved clinical diagnosis and treatment strategies for the disorder. MethodsFrom January 2020 to January 2023， a total of 130 patients with first-episode schizophrenia who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10）， and attended at the Third People's Hospital of Fuyang， along with 150 health checkup examinees， were enrolled. All of them underwent EEG examination. An optimized long short-term memory （LSTM） deep learning model was developed utilizing EEG signals. Ten-fold cross-validation method was employed to evaluate the model's performance. The dataset was then split into two components： a training set （90%） for LSTM model development and a test set （10%） for validation. The accuracy， recall rate， precision， F1-score， schizophrenia diagnosis and EEG abnormality grading were used as evaluation indicators， and the results of the proposed model were compared to the assessments made by experienced psychiatrists. ResultsFor schizophrenia diagnosis， the modeling group achieved the following performance metrics： precision （94.40±3.03）%， recall rate （94.30±3.23）%， accuracy （94.60±2.22）%， and F1-score （94.20±2.20）%. In the validation group， the corresponding metrics were precision （90.90±2.85）%， recall rate （92.20±1.14）%， accuracy （92.20±1.69）%， and F1-score （91.50±1.78）%. Statistical analysis revealed no significant differences between the LSTM diagnostic model and the experienced psychiatrists in terms of precision， recall rate， accuracy， and F1-score for schizophrenia diagnosis （χ²=1.500， 0.750， 2.722， 1.056， P>0.05）. The modeling group demonstrated an accuracy rate of （91.71±1.73）% in grading EEG abnormalities. For Grade 1 abnormalities， the modeling group reported a precision of （96.40±2.39）%， a recall rate of （94.77±1.40）%， and an F1-score of （95.55±1.14）%. In the case of Grade 2 abnormalities， the precision was （85.89±2.04）%， the recall rate was （88.10±6.18）%， and the F1-score was （87.06±3.12）%. For the more severe Grade 3 abnormalities， the modeling group's precision was （79.61±7.33）%， the recall rate was （81.79±9.87）%， and the F1-score was （80.41±6.79）%. Additionally， the validation group exhibited an accuracy rate of （85.61±6.16）%. The precision， recall rate， and F1-score for Grade 1 abnormalities were （91.43±6.25）%， （92.64±9.65）% and （91.56±4.83）%， respectively. For Grade 2 abnormalities， these metrics were （71.17±19.02）%， （77.64±17.24）% and （71.88±11.33）%. In the case of Grade 3 abnormalities， the precision was （90.00±21.08）%， the recall rate was （80.00±25.82）%， and the F1-score was （81.67±19.95）%. There was no significant difference in the accuracy， recall， accuracy and F1 value between LSTM model and senior doctors in evaluating the abnormal degree of EEG in schizophrenia （χ²=0.098， 0.036， 0.020， 0.336， P>0.05）. The LSTM model takes less time to diagnose schizophrenia and EEG abnormalities than senior doctors， and the differences were statistically significant （t=57.147， 43.104， P<0.01）. ConclusionThe study utilizes an EEG-based LSTM deep learning model for diagnosing first-episode schizophrenia and grading EEG abnormalities， and the model not only matches the performance of experienced psychiatrists but also significantly reduces the time required for diagnosis.

OBJECTIVE To promote the application of drones in emergency rescue and related fields， expand “low-altitude+ medical” rescue services， and advance the standardization of “low-altitude+medical” distribution services. METHODS The Consensus on Low-altitude Transport and Delivery Services for Emergency Medicines via Drones （2025 Edition） （hereinafter referred to as the Consensus） was jointly initiated by the Division of Therapeutic Drug Monitoring， Chinese Pharmacological Society and the Expert Committee on Precision Medication of the Guangdong Pharmaceutical Association. Guangzhou Red Cross Hospital served as the leading unit， organizing 53 multidisciplinary experts nationwide to participate in drafting and reviewing. A nominal group technique was employed to discuss and finalize the consensus outline， resulting in a preliminary draft. Delphi method was employed， and 11 external review experts were invited to conduct the evaluation. After the experts’ opinions were analyzed and integrated， the Consensus was finalized. RESULTS & CONCLUSIONS The finalized Consensus includes its purpose， principles， and applicable scenarios， basic requirements， and operational procedures for low-altitude transport and delivery of emergency medications； distribution requirements and precautions for controlled substances， fragile medications， and temperature-sensitive medications； and recommendations for emergency medications supplies suitable for the low-altitude transportation and distribution. The release of this Consensus is expected to provide guidance and support for the standardization of “low-altitude+medical” distribution services and the application of low-altitude economy in the healthcare sector.

Objective To evaluate the clinical efficacy and safety of Huoxue Jiedu Prescription in the treatment of polycythemia vera with heat toxicity and blood stasis syndrome.Methods Totally 155 patients of polycythemia vera with heat toxicity and blood stasis syndrome from 5 hospitals including Langfang Traditional Chinese Medicine Hospital from October 2022 to March 2024 were collected.Patients were divided into an observation group(79 cases)and control group(76 cases)using a random number table method.Both groups received conventional Western medicine treatment.The observation group was given Huoxue Jiedu Prescription,one dosage per day,taken orally twice a day;both groups received one treatment course of one month,and three treatment courses were observed.The efficacy of Western medicine and TCM syndromes was observed,and the total symptom assessment scale of myeloproliferative neoplasms(MPN-10)scores,hematological indicators,coagulation function before and after treatment were compared.The safety indicators of the two groups were monitored.Results The control group and observation group lost 2 and 4 cases,respectively.The total effective rate of Western medicine in the observation group was 90.67%(68/75),while the control group was 67.57%(50/74),with statistical significance(P<0.01).The total effective rate of TCM syndromes in the observation group was 94.67%(71/75),while in the control group was 71.62%(53/74),with statistical significance(P<0.01).Compared with before treatment,the total score of MPN-10 in both groups significantly decreased(P<0.05);after treatment,the total score of MPN-10 in the observation group was lower than that in the control group(P<0.05).Compared with before treatment,both groups showed significant reductions in hemoglobin,white blood cell count,hematocrit and platelet count after treatment(P<0.05);after treatment,the above hematological indicators in the observation group were better than those in the control group(P<0.05).Compared with before treatment,the levels of D-dimer and fibrinogen in both groups significantly decreased after treatment,and the activated partial thromboplastin time and prothrombin time were significantly shortened(P<0.05);after treatment,the observation group showed better improvement in the coagulation function indicators compared to the control group(P<0.05).There were no significant adverse reactions in the two groups.Conclusion Huoxue Jiedu Prescription can improve clinical efficacy of polycythemia vera with heat toxicity and blood stasis syndrome,improve hematological indexes,reduce coagulation indexes,and has good safety.

Objective To explore the effect of adjuvant hydrogen inhalation therapy(AHIT)on postoperative neurological recovery in elderly patients with cerebral hemorrhage.Methods A pro-spective study was conducted on 100 patients with cerebral hemorrhage who underwent surgical treatment in our department between January 2021 and February 2023.They were randomly divid-ed into an observation group(AHIT)and a control group(conventional treatment),with 50 pa-tients in each group.Glasgow Coma Scale(GCS)score,NIHSS score,short from 36-item question-naire(SF-36)score,as well as levels of serum brain-derived neurotrophic factor(BDNF),insulin-like growth factor 1(IGF-1)and calcitonin gene-related peptide(CGRP),and incidence of compli-cations were compared between the two groups.Results The observation group obtained signifi-cantly higher GCS score and SF-36 scores at 4 and 8 weeks after treatment,and lower NIHSS score when compared with the control group(P＜0.01).At 8 weeks after treatment,the serum BDNF,IGF-1 and CGRP levels were notably higher in the observation group than the control group(P＜0.01).There was no statistical difference in the incidence of complications between the two groups(6.00％vs 10.00％,P＞0.05).Conclusion AHIT can significantly improve the neuro-logical recovery and quality of life of patients with cerebral hemorrhage,as well as elevate the lev-els of serum neurofunctional markers.

Objective To present an assessment method based on oscillometric upper-arm cuff pressure wave for realizing home-based detection of arteriosclerosis.Methods An upper-arm cuff pressure wave acquisition device based on an electronic blood pressure monitor was designed to implement data collection for cuff inflation and deflation,as well as the 15 s pressure holding phase.Following preprocessing of the data collected during this holding phase,individual pulse waves were extracted for pulse decomposition analysis(PDA).A novel model that superimposed a logarithmic normal function with two Gaussian functions,and an optimization method that combined template matching and particle swarm optimization were proposed to efficiently and accurately extract PDA features.Gaussian process regression was employed for multifeature fusion analysis,leading to the proposal of a new predictive indicator for arteriosclerosis.Results The mean absolute error of PDA was less than 1.2%,and the average processing time for a single pulse wave was less than 0.2 s.The regression determination coefficient R2 between the obtained indicators and baPWV was 0.8178.Conclusion The analysis on upper-arm cuff pressure wave provides a new reference for non-invasive arteriosclerosis detection,and it can be applied to electronic blood pressure monitors for home-based monitoring,offering significant practical value.

Objective To investigate the effects of implant length,diameter,and abutment angle on bone stress distributions around maxillary central incisors,and determine the optimal parameter combination.Methods A three-dimensional(3D)model of the maxilla was reconstructed based on CBCT data.Using an orthogonal table,a total of 16 dental implant 3D models were established,varying in length,diameter,and abutment angle.These models were assembled with the maxillary and rigid-body models.Finite element analysis was performed using the transient dynamics module of ANSYS.Orthogonal experiments and one-way analysis of variance(ANOVA)were conducted on the obtained stress data.Results The implant diameter showed a statistically significant effect on the maximum von Mises stress in cortical bone(P=0.010),while implant length(P=0.229)and abutment angle(P=0.844)did not demonstrate a statistical significance.The optimal parameter combination for cortical bone stress was 5.0 mm implant diameter,12 mm implant length,and 0° abutment angle.In cancellous bone,implant length(P=0.001),diameter(P=0.011),and abutment angle(P=0.013)all had statistically significant effects on the maximum von Mises stress.The optimal parameter combination for cancellous bone stress was 14 mm implant length,5.0 mm implant diameter,and 5° abutment angle.Conclusions Implant diameter significantly affects the stress of both cortical and cancellous bone.Clinically,a larger diameter should be preferred to reduce the stress peak.Implant length is the next most important factor,while abutment angle has the least effect.

Objective:To construct three photosensitive fusion proteins between protein G C3 domain and Avitag for site-spe-cific biotinylation of goat IgG.Methods:DNA sequences of protein G C3 domain with amber codon mutation and C-terminal containing 1,2,3 Avitag were obtained by chemical synthesis,respectively,and sub-cloned into pTXB1 plasmid to construct three fusion pro-tein expression vectors.Three plasmids and pEVOL-pBpF plasmid were co-transformed into competent bacterium E.coli BL21,respec-tively.Target fusion proteins CBpa-Avitag,CBpa-(Avitag)2 and CBpa-(Avitag)3 were prepared using genetic codon extension technology,and were purified by His Trap Chelating HP column,then biotinylated by Avitag/BirA system.Photo-conjugation efficiency,crosslink site and antigen-binding activity of photo-conjugates were investigated by SDS-PAGE,control experiment,and competitive ELISA.Results:Three expression vectors were successfully constructed,and three designed photoactivatable fusion proteins CBpa-Avitag,CBpa-(Avitag)2 and CBpa-(Avitag)3 were successfully expressed with molecular weights consistent with their theoretical values.Heavy-chain conjugation efficiencies of biotinylated fusion protein with goat IgG were 85%with Fc-specific conjugation,and conjugates maintained its antigen-binding activity after photo-conjugation.Conclusion:CBpa-Avitag,CBpa-(Avitag)2 and CBpa-(Avitag)3 fusion proteins are successfully prepared,and mediates by those photosensitive fusion proteins,biotins molecules are conjugated to Fc fragment of goat IgG,results site-specific biotinylation of goat IgG.

Objective To evaluate the efficacy of myopia progression control over a one-year period for defocus in-corporated multiple segments lenses(DIMS),peripheral defocus modifying(PDM)lenes and single vision spectacle lenses(SVL)in a real-world cohort.Methods A total of 188 cases in the DIMS group,116 cases in the PDM group,and 373 ca-ses in the SVL group,all diagnosed with refractive errors and aged 6-16 years,were enrolled in Department of Ophthal-mology,Fujian Provincial Hospital from July 2019 to June 2022.A 1∶1 propensity score matching(PSM)of covariates was used to balance factors between the groups.The changes in spherical equivalent(SE)and axial length(AL)in each patient before and 1 year after wearing glasses were compared without other interventions.The myopia control effects of different groups were compared through the changes in SE and AL.Results After PSM,92 cases were matched between DIMS group and PDM group,163 cases were matched between DIMS group and SVL group,and 99 cases were matched between PDM group and SVL group.The changes in SE and AL in the DIMS group were less than those in the PDM and SVL groups,with statistically significant differences(all P＜0.05).However,there were no statistically significant differences in the changes in SE and AL between the PDM and SVL groups(all P＞0.05).In the age subgroup analysis,in the younger age group(6～＜13)and the older age group(13～16)the changes in SE and AL in the DIMS group were less than those in the PDM group and SVL group,with statistically significant differences(all P＜0.05).In the younger age group,the changes in SE and AL in the PDM group were less than those in the SVL group,with statistically significant differences(all P＜0.05);while in older age group,there were no statistically significant differences in the changes in SE and AL between the PDM and SVL groups(all P＞0.05).Conclusion The myopia control efficacy of DIMS is superior to that of PDM and SVL.In younger children,the myopia control efficacy of PDM is superior to that of SVL.