Objective To investigate the effects of intraoperative application of esketamine on post-operative anxiety and depression in burn patients undergoing escharectomy and skin grafting.Methods Seventy-three patients undergoing escharectomy and skin grafting were selected,46 males and 27 females,aged 18-64 years,BMI 18.5-27.9 kg/m2,ASA physical status Ⅱ or Ⅲ.According to the random number table method,the patients were divided into two groups:esketamine group(group E,n=37)and control group(group C,n=36).Group E received a 0.2 mg/kg intravenous bolus of esketamine during anesthesia induction followed by a 0.1 mg·kg-1·h-1 continuous infusion until the end of surgery.Group C received an equal volume of normal saline.Patients in both groups received patient-controlled intravenous analgesia(PCIA)after surgery.The postoperative eye opening time,extubation time,PACU residence time,hospitalization and the number of effective compressions and total compressions of postoperative anal-gesia pumpand remediate analgesia after surgery were recorded.The self-rating anxiety scale(SAS),self-rating depression scale(SDS)and incidence of anxiety and depression were recorded 1 day before surgery,3 and 7 days after surgery.The occurrence of adverse reactions within 48 hours after surgery were also recor-ded.Results Compared with group C,the postoperative PACU residence time and hospitalization in group E were shortened(P＜0.05),the times of effective and total compressions and remediate analgesia after surgery in group E were decreased(P＜0.05),the scores of SAS and SDS and incidence of anxiety and depression at 3 and 7 days after surgery in group E were decreased(P＜0.05).There were no statistical differences in adverse reactions within 48 hours after surgery between the two groups.Conclusion Intraop-erative application of esketamine in burn patients undergoing escharectomy and skin grafting can improve postoperative anxiety and depression,reduce the usage of postoperative opioids and promote early recovery.

Objective To observe the effect of different concentrations of glutamine(Gln)on the radiosensitivity of colorectal cancer HT-29 cells and explore the possible mechanism.Methods According to different Gln concentrations,HT-29 cells at logarithmical growth were divided into control group(2 mmol/L,as the basal medium concentration group)and experimental groups Ⅰ,Ⅱ and Ⅲ(4,6 and 8 mmol/L).After a 2-hour pre-treatment,all groups were exposed to 8 Gy irradiation of a Co-60 radiation source.CCK-8 assay and clonal formation assay were used respectively to explore the effects of different Gln concentrations on cell viability and cell radiosensitivity after irradiation.The level of reactive oxygen species(ROS)in each group was measured in 24 h after irradiation,and the apoptotic rate was detected with flow cytometry in 48 h after irradiation.The protein expression levels of Nrf2,HO-1,and cleaved-Caspase3 were determined by Western blotting.Results In 24 h after Gln intervention,the cell viability of experimental groups Ⅱ and Ⅲof non-irradiated HT-29 cells was significantly higher than that of the control group and of experimental group Ⅰ(P＜0.05).In 24 h after radiation,the cell viability of each experimental group was significantly higher than that of the control group(P＜0.05).In 14 d after radiation,there were more clone formation in each experimental group than the control group(P＜0.05).The ROS level was significantly lower in each experimental group than the control group in 24 h after radiation(P＜0.05).After 48 h of radiation,the apoptotic rate was notably lower in each experimental group than the control group(P＜0.05).The expression level of Nrf2 in the experimental group Ⅰ was higher than that of the control group(P＜0.05),those of Nrf2 and HO-1 in the experimental groups Ⅱ and Ⅲ were higher than those of the control group and experimental group Ⅰ(P＜0.05).While the expression of cleaved-Caspase3 in the experimental groups Ⅱ and Ⅲ was lower than the control group and experimental group Ⅰ(P＜0.05),and it in the experimental group Ⅲ was lower than that of experimental group Ⅱ(P＜0.05).Conclusion Gln can significantly reduce the radiosensitivity of HT-29 cells,which is associated with its reducing oxidative stress damage and reducing cell apoptosis.Our results suggest that Gln might be detrimental to radiation therapy in patients with colorectal cancer.

Background Excessive radon exposure is considered the second risk factor for lung cancer. Since the opening of the subway in a city of Zhejiang Province, the exposure level of radioactive gas radon in subway stations and its impact on occupational health have become one of the important issues of public concern. Objective To monitor the radon concentration of subways in a city in Zhejiang Province and explore the effect of radon exposure on chromosome aberration and micronuclei in the working population. Methods A total of 55 vehicle control rooms of 55 stations affiliated to two different subway lines in a city were measured for one year; the 110 ticket offices and 55 security checkpoints from the same 55 stations were measured from 16 March to 14 June. The radon concentrations were compared by job types, subway lines, and seasons referring to Measurement methods for determination of radon in environmental air (HJ 1212-2021). Peripheral blood lymphocyte chromosome aberration and micronucleus analyses were conducted in 165 subway workers from monitoring sites for three different job types, then the influencing factors were analyzed. The detection methods were adopted from the standards of Test and assessment of chromosomal aberrations on occupational health examinations for radiation workers (GBZ/T 248-2014) and Standard for the method of micronucleus detection in lymphocytes on occupational health examination for radiation workers and exposure dose estimation (GBZ/T 328-2023). Results The radon concentration range of the target subways in Zhejiang Province was 10-320 Bq·m⁻³, all lower than the national limit (≤400 Bq·m⁻³). The differences in radon radioactivity levels among different lines, job types, and time segments were statistically significant (P<0.05). The rates of chromosomal aberration and micronucleus formation among the 165 subjects were 0.224% and 0.024%, respectively. There were significant differences in the rates of chromosome aberration and micronuclei among different jobs (vehicle control room, ticket office, security checkpoint) (P<0.05), but the abnormal rates were lower than the limits of the corresponding national standard. No significant correlation was found between jobs and chromosomal aberrations or micronuclei (P>0.05). Chromosome aberration and micronuclei varied by age, subway station seniority, and smoking (P<0.05). No effect of the above factors on chromosome aberration and micronuclei was observed by logistic regression (P>0.05). Conclusion The radon concentration in the target subway system is at a normal level. The rates of chromosomal aberration and micronucleus formation vary by jobs, but both are lower than the corresponding national limits. Therefore, radon exposure has not yet caused outstanding health impact on the subway workers.

Objective To investigate the current situation of occupational health of radiation workers in Zhejiang Province, China, and to provide a theoretical basis for the improvement of standards and management systems for occupational health examinations of radiation workers. Methods Data of occupational health examination cases were collected from occupational health examination institutions, including basic information, type of physical examination (pre-job, on-job, off-job), and health examination results. The differences in occupational health examination results among different groups were analyzed, and the factors influencing occupational health of radiation workers were analyzed using a logistic regression model. Results A total of 5668 cases were collected, with 86% of the participants being male and 14% being female. Compared with the pre-job group, the on-job group showed an increased abnormal rate of triiodothyronine and the off-job group demonstrated an increased abnormal rate of leukocyte count (P < 0.05). Compared with the industrial group, the nuclear fuel group showed decreased abnormal rates of thyroid structure and thyroxine and an increased abnormal rate of triiodothyronine, and the medical group demonstrated an increased abnormal rate of thyroid structure (P < 0.05). The abnormal rates of thyroid structure and white blood cell count increased with the increase of working age (P < 0.05). The abnormal rates of white blood cell count, thyroid structure, triiodothyronine, and thyroid stimulating hormone were higher in female radiation workers than in male radiation workers (P < 0.05). Sex (female), radiation work history, and age were the risk factors affecting the occupational health of radiation workers (P < 0.05). Conclusion The occupational health status of radiological workers in Zhejiang Province needs to be further improved, and the occupational health management of radiological workers should be strengthened.

Objective To investigate the current situation of occupational health of radiation workers in Zhejiang Province, China, and to provide a theoretical basis for the improvement of standards and management systems for occupational health examinations of radiation workers. Methods Data of occupational health examination cases were collected from occupational health examination institutions, including basic information, type of physical examination (pre-job, on-job, off-job), and health examination results. The differences in occupational health examination results among different groups were analyzed, and the factors influencing occupational health of radiation workers were analyzed using a logistic regression model. Results A total of 5668 cases were collected, with 86% of the participants being male and 14% being female. Compared with the pre-job group, the on-job group showed an increased abnormal rate of triiodothyronine and the off-job group demonstrated an increased abnormal rate of leukocyte count (P < 0.05). Compared with the industrial group, the nuclear fuel group showed decreased abnormal rates of thyroid structure and thyroxine and an increased abnormal rate of triiodothyronine, and the medical group demonstrated an increased abnormal rate of thyroid structure (P < 0.05). The abnormal rates of thyroid structure and white blood cell count increased with the increase of working age (P < 0.05). The abnormal rates of white blood cell count, thyroid structure, triiodothyronine, and thyroid stimulating hormone were higher in female radiation workers than in male radiation workers (P < 0.05). Sex (female), radiation work history, and age were the risk factors affecting the occupational health of radiation workers (P < 0.05). Conclusion The occupational health status of radiological workers in Zhejiang Province needs to be further improved, and the occupational health management of radiological workers should be strengthened.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.