Pathological interaction between CD4 + T cells and B cells is one of the important mechanisms of systemic autoimmune diseases. Follicular helper T cells (Tfh) and peripheral helper T cells (Tph) are key cells for assisting B cells. Tph cell is a newly discovered helper T cell subset, and their phenotype is PD-1 highCXCR5 -CD4 +. Tph cell and Tfh cell have certain differences in phenotype, function, and site of action. It interacts with B cells, promoting the differentiation of B cells into plasma cells and the production of autoantibodies, as well as promoting the formation of ELS to maintain local inflammation and antibody responses. Tph cells have recently been reported in various autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, Sjogren′s syndrome, and IgG4-related diseases. This review summarizes the progress in peripheral immune response of Tph cells in different systemic autoimmune diseases, aiming to explore the new mechanism of autoantibody production and help to develop new diagnostic and therapeutic targets in the future.

Objective:To investigate the current status of occupational stress among electronic manufacturing workers in Qingdao and analyze its effect on depressive symptoms and anxiety symptoms.Methods:From July to September 2022, a cluster random sampling method was employed to select frontline workers from 14 electronic manufacturing enterprises in Qingdao as the study subjects. A total of 1134 questionnaires were distributed, with 1000 valid questionnaires collected, yielding an effective response rate of 88.18%. The Core Occupational Stress Scale (COSS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were adopted to assess occupational stress, depressive symptoms, and anxiety symptoms, respectively. Binary logistic regression was employed to analyze influencing factors of occupational stress and its effects on depressive and anxiety symptoms.Results:The detection rates of occupational stress, depressive symptoms, and anxiety symptoms were 15.1% (15/1000), 7.9% (79/1000), and 13.8% (138/1000), respectively. The influencing factor analysis of occupational stress revealed that female gender ( OR=0.621, 95% CI: 0.434-0.890) and weekly working hours of 45-48 hours ( OR=0.537, 95% CI: 0.309-0.935) were protective factors ( P<0.05), while weekly working hours ≥55 hours ( OR=2.176, 95% CI: 1.290-3.670) and shift work ( OR=2.038, 95% CI: 1.412-2.940) were risk factors ( P<0.05). Spearman correlation analysis showed that the COSS score was positively related with the PHQ-9 score and the GAD-7 score ( rs=0.438, 0.289, P<0.01). Workers judged with occupational stress had 3.596 times (95% CI: 2.181-5.931, P<0.001) and 3.121 times (95% CI: 2.046-4.761, P<0.001) higher risks of detecting depressive and anxiety symptoms compared to those without occupational stress. Conclusion:Electronic manufacturing workers in Qingdao experience a certain level of occupational stress, which may increase the risk of developing depressive and anxiety symptoms. Enterprises should implement appropriate interventions to promote workers' mental health.

Objective To observe the value of self-made improved cone-beam CT(CBCT)fixation components for maxillofacial scanning.Methods CBCT fixation components(chin rest,temporal clamp)equipped by Planmeca ProMax 3D Mid dental panoramic X-ray system were modified to obtain improved CBCT fixation components,including improved chin rest,temporal clamp and occipital retention band.Totally 571 patients who underwent maxillofacial CBCT examinations for dental-related diseases were retrospectively enrolled,including 288 cases(group A)underwent scanning by a junior technician using original chin rest+original temporal clamp(component 1,n=78,A1 subgroup),modified chin rest+original temporal clamp(component 2,n=74,A2 subgroup),original chin rest+original temporal clamp+occipital retention band(component 3,n=68,A3 subgroup)or modified chin rest+original temporal clamp+occipital retention band(component 4,n=68,A4 subgroup),while the rest 283 cases(group B)underwent scanning by a senior using the above components,respectively,and were taken as B1(n=72),B2(n=69),B3(n=73)and B4(n=69)subgroups.The incidence of motion artifacts were compared among A2/B2,A3/B3,A4/B4 subgroups and A1/B1 subgroups.Results Compared with A1+B1 subgroups,the overall motion artifacts rate in A4+B4 subgroups decreased from 17.33％(26/150)to 8.03％(11/137)(P=0.019),while in A2+B2 subgroups(13.29％[19/143])and A3+B3 subgroups(9.93％[14/141])did not significantly decrease(P=0.337,0.067).In group A,no statistical difference of motion artifacts rate was found between A 2(17.57％[13/74])or A3(13.24％[9/68])subgroups and A1 subgroup(23.08％[18/78])(P=0.399,0.127),while the motion artifacts rate in A4 subgroup(10.29％[7/68])was lower than that in A1 subgroup(23.08％[18/78])(P=0.041).In group B,no significant difference of motion artifacts rates was found between B2,B3 or B4 subgroups(8.70％[6/69],6.85％[5/73],5.80％[4/69])and B1 subgroup(11.11％[8/72])(P=0.632,0.369,0.258).Conclusion Self-made improved CBCT fixation components could effectively secure patients' head and reduce motion artifacts in maxillofacial CBCT.

Objective:Based on the adverse drug event active surveillance and assessment system-Ⅱ (ADE-ASAS-Ⅱ) and the information of inpatients in the hospital information system (HIS), the automatic monitoring module of movement disorders was constructed and its application effect in the real-world study of drug-induced movement disorders (DIMDs) was explored.Methods:Literature reviews, case reports, spontaneous reports and medical records were collected, the keyword set was screened based on ADE-ASAS-Ⅱ system and text classification technology, and an automatic monitoring module was constructed. The information of hospitalized patients in Chinese PLA General Hospital (our hospital) was selected from October 10 to 16, 2022. The results of manual evaluation and the system alarm by the automatic monitoring module were compared, and the performance of the automatic monitoring module was evaluated and optimized through repeated machine learning. The medical record information of hospitalized patients who used sodium valproate throughout the year in our hospital in 2022 were collected, and the occurrence of movement disorders related to sodium valproate was analyzed using the automatic monitoring module.Results:A total of 4 918 hospitalized patients (146 with movement disorders) were collected, and the final setting conditions of the automatic monitoring module were determined, including inclusion criteria (43 text keywords, 3 diagnosis) and exclusion criteria (11 text and 20 document titles were omitted). Among the 1 138 hospitalized patients using sodium valproate in 2022, the incidence of DIMDs with tic and tremor as main clinical manifestations detected by automatic monitoring module was 1.67% (19/1 138).Conclusion:The automatic monitoring module of drug-induced movement disorders based on machine learning and manual evaluation can be applied to explore the occurrence characteristics of DIMDs in the real world, and provide information for pharmacovigilance in clinic.

Objective To understand the current situation as well as the implementation of infection prevention and control measures against bacterial contamination of external and vaginal ultrasound probes in medical institutions(MIs),and explore the risk of ultrasound probe-related infection under current prevention and control measures.Methods Through on-site sampling,external ultrasound probes from 179 MIs and vaginal ultrasound probes from 83 MIs in 15 prefecture-level cities in Henan Province underwent quantitative bacterial detection,and the implemen-tation of relevant infection prevention and control measures was assessed using questionnaire survey.Results A to-tal of 513 ultrasound probe specimens were detected.Bacterial detection rate and exceedance rate of the disinfected vaginal ultrasound probes were 18.02％(20/111)and 2.70％(3/111),respectively,which were both lower than external ultrasound probes(40.05％[161/402]and 5.22％[21/402],respectively).Bacterial detection rate of dis-infected specimens was lower than that of the towel-wiping group([33.86％,149/440]vs[50.00％,27/54],x2=5.46,P=0.019).Bacterial detection rate of the quaternary ammonium salt disinfectant group was lower than that of the alcohol disinfectant group([17.31％,18/104]vs[40.63％,128/315],x2=18.74,P＜0.001).The quali-fied rates of specimens using different disinfection methods and with different probe types showed no statistically significant differences(all P＞0.05).The implementation rates of"single disinfection for every use"for external ul-trasound probes and vaginal ultrasound probes were 60.34％(108/179)and 70.54％(79/112),respectively.The disinfectants used were mainly quaternary ammonium salts(57.27％)and alcohols(36.36％).The coupling agents used for external and vaginal ultrasound examinations were mainly large packaged products for multiple time use,accounting for 93.85％and 57.89％,respectively.33.33％(56/168)of external ultrasound coupling agents and 20.00％(11/55)of vaginal ultrasound coupling agents were used for more than 7 days.In vaginal ultrasound exa-minations,the usage rates of disinfectant coupling agents and sterile coupling agents were 28.42％(27/95)and 14.74％(14/95),respectively.In vaginal ultrasound examinations,50.00％(56/112)of MIs used condoms as probe co-vers,and 45.54％(51/112)used sound-transmission ultrasound isolation membranes.60.55％(66/109)of MIs didn't change gloves after cleaning and disinfecting the vaginal ultrasound probe and before examination.Conclusion Ultrasound probes have cross infection risks in key processes such as reprocessing(disinfection/sterilization),phy-sical barrier use,coupling agent selection,and glove replacement.It is urgent to develop and implement standar-dized ultrasound probe infection prevention and control technical specifications based on evidence-based research.

Objective:Based on the adverse drug event active surveillance and assessment system-Ⅱ (ADE-ASAS-Ⅱ) and the information of inpatients in the hospital information system (HIS), the automatic monitoring module of movement disorders was constructed and its application effect in the real-world study of drug-induced movement disorders (DIMDs) was explored.Methods:Literature reviews, case reports, spontaneous reports and medical records were collected, the keyword set was screened based on ADE-ASAS-Ⅱ system and text classification technology, and an automatic monitoring module was constructed. The information of hospitalized patients in Chinese PLA General Hospital (our hospital) was selected from October 10 to 16, 2022. The results of manual evaluation and the system alarm by the automatic monitoring module were compared, and the performance of the automatic monitoring module was evaluated and optimized through repeated machine learning. The medical record information of hospitalized patients who used sodium valproate throughout the year in our hospital in 2022 were collected, and the occurrence of movement disorders related to sodium valproate was analyzed using the automatic monitoring module.Results:A total of 4 918 hospitalized patients (146 with movement disorders) were collected, and the final setting conditions of the automatic monitoring module were determined, including inclusion criteria (43 text keywords, 3 diagnosis) and exclusion criteria (11 text and 20 document titles were omitted). Among the 1 138 hospitalized patients using sodium valproate in 2022, the incidence of DIMDs with tic and tremor as main clinical manifestations detected by automatic monitoring module was 1.67% (19/1 138).Conclusion:The automatic monitoring module of drug-induced movement disorders based on machine learning and manual evaluation can be applied to explore the occurrence characteristics of DIMDs in the real world, and provide information for pharmacovigilance in clinic.

Objective:To investigate the current status of occupational stress among electronic manufacturing workers in Qingdao and analyze its effect on depressive symptoms and anxiety symptoms.Methods:From July to September 2022, a cluster random sampling method was employed to select frontline workers from 14 electronic manufacturing enterprises in Qingdao as the study subjects. A total of 1134 questionnaires were distributed, with 1000 valid questionnaires collected, yielding an effective response rate of 88.18%. The Core Occupational Stress Scale (COSS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were adopted to assess occupational stress, depressive symptoms, and anxiety symptoms, respectively. Binary logistic regression was employed to analyze influencing factors of occupational stress and its effects on depressive and anxiety symptoms.Results:The detection rates of occupational stress, depressive symptoms, and anxiety symptoms were 15.1% (15/1000), 7.9% (79/1000), and 13.8% (138/1000), respectively. The influencing factor analysis of occupational stress revealed that female gender ( OR=0.621, 95% CI: 0.434-0.890) and weekly working hours of 45-48 hours ( OR=0.537, 95% CI: 0.309-0.935) were protective factors ( P<0.05), while weekly working hours ≥55 hours ( OR=2.176, 95% CI: 1.290-3.670) and shift work ( OR=2.038, 95% CI: 1.412-2.940) were risk factors ( P<0.05). Spearman correlation analysis showed that the COSS score was positively related with the PHQ-9 score and the GAD-7 score ( rs=0.438, 0.289, P<0.01). Workers judged with occupational stress had 3.596 times (95% CI: 2.181-5.931, P<0.001) and 3.121 times (95% CI: 2.046-4.761, P<0.001) higher risks of detecting depressive and anxiety symptoms compared to those without occupational stress. Conclusion:Electronic manufacturing workers in Qingdao experience a certain level of occupational stress, which may increase the risk of developing depressive and anxiety symptoms. Enterprises should implement appropriate interventions to promote workers' mental health.

Pathological interaction between CD4 + T cells and B cells is one of the important mechanisms of systemic autoimmune diseases. Follicular helper T cells (Tfh) and peripheral helper T cells (Tph) are key cells for assisting B cells. Tph cell is a newly discovered helper T cell subset, and their phenotype is PD-1 highCXCR5 -CD4 +. Tph cell and Tfh cell have certain differences in phenotype, function, and site of action. It interacts with B cells, promoting the differentiation of B cells into plasma cells and the production of autoantibodies, as well as promoting the formation of ELS to maintain local inflammation and antibody responses. Tph cells have recently been reported in various autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, Sjogren′s syndrome, and IgG4-related diseases. This review summarizes the progress in peripheral immune response of Tph cells in different systemic autoimmune diseases, aiming to explore the new mechanism of autoantibody production and help to develop new diagnostic and therapeutic targets in the future.

Objective To understand the current situation as well as the implementation of infection prevention and control measures against bacterial contamination of external and vaginal ultrasound probes in medical institutions(MIs),and explore the risk of ultrasound probe-related infection under current prevention and control measures.Methods Through on-site sampling,external ultrasound probes from 179 MIs and vaginal ultrasound probes from 83 MIs in 15 prefecture-level cities in Henan Province underwent quantitative bacterial detection,and the implemen-tation of relevant infection prevention and control measures was assessed using questionnaire survey.Results A to-tal of 513 ultrasound probe specimens were detected.Bacterial detection rate and exceedance rate of the disinfected vaginal ultrasound probes were 18.02％(20/111)and 2.70％(3/111),respectively,which were both lower than external ultrasound probes(40.05％[161/402]and 5.22％[21/402],respectively).Bacterial detection rate of dis-infected specimens was lower than that of the towel-wiping group([33.86％,149/440]vs[50.00％,27/54],x2=5.46,P=0.019).Bacterial detection rate of the quaternary ammonium salt disinfectant group was lower than that of the alcohol disinfectant group([17.31％,18/104]vs[40.63％,128/315],x2=18.74,P＜0.001).The quali-fied rates of specimens using different disinfection methods and with different probe types showed no statistically significant differences(all P＞0.05).The implementation rates of"single disinfection for every use"for external ul-trasound probes and vaginal ultrasound probes were 60.34％(108/179)and 70.54％(79/112),respectively.The disinfectants used were mainly quaternary ammonium salts(57.27％)and alcohols(36.36％).The coupling agents used for external and vaginal ultrasound examinations were mainly large packaged products for multiple time use,accounting for 93.85％and 57.89％,respectively.33.33％(56/168)of external ultrasound coupling agents and 20.00％(11/55)of vaginal ultrasound coupling agents were used for more than 7 days.In vaginal ultrasound exa-minations,the usage rates of disinfectant coupling agents and sterile coupling agents were 28.42％(27/95)and 14.74％(14/95),respectively.In vaginal ultrasound examinations,50.00％(56/112)of MIs used condoms as probe co-vers,and 45.54％(51/112)used sound-transmission ultrasound isolation membranes.60.55％(66/109)of MIs didn't change gloves after cleaning and disinfecting the vaginal ultrasound probe and before examination.Conclusion Ultrasound probes have cross infection risks in key processes such as reprocessing(disinfection/sterilization),phy-sical barrier use,coupling agent selection,and glove replacement.It is urgent to develop and implement standar-dized ultrasound probe infection prevention and control technical specifications based on evidence-based research.

Objective To observe the value of self-made improved cone-beam CT(CBCT)fixation components for maxillofacial scanning.Methods CBCT fixation components(chin rest,temporal clamp)equipped by Planmeca ProMax 3D Mid dental panoramic X-ray system were modified to obtain improved CBCT fixation components,including improved chin rest,temporal clamp and occipital retention band.Totally 571 patients who underwent maxillofacial CBCT examinations for dental-related diseases were retrospectively enrolled,including 288 cases(group A)underwent scanning by a junior technician using original chin rest+original temporal clamp(component 1,n=78,A1 subgroup),modified chin rest+original temporal clamp(component 2,n=74,A2 subgroup),original chin rest+original temporal clamp+occipital retention band(component 3,n=68,A3 subgroup)or modified chin rest+original temporal clamp+occipital retention band(component 4,n=68,A4 subgroup),while the rest 283 cases(group B)underwent scanning by a senior using the above components,respectively,and were taken as B1(n=72),B2(n=69),B3(n=73)and B4(n=69)subgroups.The incidence of motion artifacts were compared among A2/B2,A3/B3,A4/B4 subgroups and A1/B1 subgroups.Results Compared with A1+B1 subgroups,the overall motion artifacts rate in A4+B4 subgroups decreased from 17.33％(26/150)to 8.03％(11/137)(P=0.019),while in A2+B2 subgroups(13.29％[19/143])and A3+B3 subgroups(9.93％[14/141])did not significantly decrease(P=0.337,0.067).In group A,no statistical difference of motion artifacts rate was found between A 2(17.57％[13/74])or A3(13.24％[9/68])subgroups and A1 subgroup(23.08％[18/78])(P=0.399,0.127),while the motion artifacts rate in A4 subgroup(10.29％[7/68])was lower than that in A1 subgroup(23.08％[18/78])(P=0.041).In group B,no significant difference of motion artifacts rates was found between B2,B3 or B4 subgroups(8.70％[6/69],6.85％[5/73],5.80％[4/69])and B1 subgroup(11.11％[8/72])(P=0.632,0.369,0.258).Conclusion Self-made improved CBCT fixation components could effectively secure patients' head and reduce motion artifacts in maxillofacial CBCT.