Objective To analyze the status of radiation protection among non-medical radiation institutions in Henan Province. Methods A total of 673 non-medical radiation institutions in Henan Province were selected as the research subjects using the judgmental sampling method. Their basic information and occupational health management practice were investigated. A total of 131 research subjects were selected for monitoring of occupational exposure to ionizing radiation using the stratified random sampling method. Results Among the 132 institutions using baggage inspection devices, none of the associated radiation workers (1 642 individuals) had received radiation protection training, personal dose monitoring, or occupational medical examination. Besides, among the remaining 541 radiation institutions with 8 373 radiation workers, the rates of radiation protection training, personal dose monitoring, and occupational medical examination were 62.2%, 98.1%, and 80.6%, respectively. The equipping rates for radiation monitoring instruments was 76.7%, for personal dose alarm device was 63.4%, and for the personal protective equipment was approximately 63.2% among the 673 non-medical radiation institutions. And the rate of independent monitoring for occupational radioactive hazard factors in workplaces was 65.2%, the rate of commissioned monitoring was 69.8%, the rate of conducting evaluations on the current status of occupational radioactive hazard was 70.4%, and the declaration rate of occupational hazard factor was 66.7%. The ambient dose equivalent rates for X/γ rays, neutron ambient dose equivalent rates, and average surface contamination levels of α/β particles in 131 radiation institutions met the national requirements. However, in three of the five underground metal mines, radon concentration exceeded 1 000.0 Bq/m³ at some operating detection points, with the highest one reaching 4 223.0 Bq/m³. Conclusion There remains a gap between current radiation protection practice in non-medical radiation workplaces in Henan Province and the requirements of national regulations and standards. Radiation protection management and supervision should be strengthened.

Objective To explore the mediating role of sleep quality on the impact of occupational stress on depressive symptom among secondary industry occupational population. Methods A total of 895 secondary industry workers in Wuxi City were selected as the study subjects using the stratified random sampling method. The Core Occupational Stress Scale (COSS), Patient Health Questionnaire-9 items (PHQ-9) and Self-Filled Sleep Questionnaire (SSQ) were used to investigate their occupational stress, depressive symptom and sleep quality. Depressive symptom, occupational stress and sleep quality were respectively regarded as dependent variable, independent variable and mediating variable. Process program was used to construct a mediation model, and Bootstrap method was used to test its mediating effect. Results The median score and 25th, 75th percentile for occupational stress, depressive symptom and sleep quality was 43.0 (43.0, 48.0), 6.0 (3.0, 8.0) and 3.0 (1.0, 3.0) points. The detection rates of occupational stress, depressive symptom, sleep disorder were 28.7%, 63.0% and 38.8%, respectively. Spearman correlation analysis result showed that occupational stress was positively correlated with both depressive symptom and sleep quality (Spearman correlation coefficients of 0.46 and 0.49, all P<0.01). Bootstrap test result showed that occupational stress had positive effect on both depressive symptom and sleep quality (partial regression coefficients of 0.25 and 0.09, all P<0.01). Sleep quality partially mediated the impact of occupational stress on depressive symptom with the mediation effect value of 0.05 (95% confidence interval of 0.03-0.06), accounting for 20.0% of the total effect. Conclusion Both depression symptom and sleep quality are positively correlated with occupational stress in secondary industry occupational population. Sleep quality of this population partially mediate the impact of occupational stress on depressive symptom.

Objective:To compare the antiosteoporosis effect of conventional treatment and conventional treatment combined with Denosumab after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 211 patients with OVCF admitted to the Second Affiliated Hospital of Soochow University from September 2020 to September 2022. All the patients were female, aged 56-90 years [(71.4±8.1)years]. The bone mineral density T-score of the lumbar spine was (-2.6±1.0)SD before operation. Fracture segments included T 1-T 9 in 45 patients, T 10-L 2 in 146, and L 3-L 5 in 69. Of all, 174 patients were treated with single-segment surgery, 25 with two-segment surgery and 12 with surgery involving three or more segments. According to the wishes of the patients, 107 patients were treated with daily oral administration of calcium and active Vitamin D after PKP (conventional treatment group) and 104 patients with Denosumab combined with the conventional treatment after PKP (Denosumab therapy group). The bone mineral density T-scores of the lumbar spine of the two groups were compared before surgery and at the last follow-up. The visual analogue scale (VAS) and Oswestry disability index (ODI) before surgery, at 3 days, 6 months after surgery, and at the last follow-up were evaluated and the refracture rate after surgery was detected. Possible adverse effects after medication during anti-osteoporosis treatment were observed in two the groups. Results:All the patients were followed up for 12-24 months [(13.5±2.0)months]. Before surgery, the bone mineral density T-score of the lumbar spine was (-2.7±1.1)SD in the Denosumab therapy group and (-2.5±0.8)SD in the conventional treatment group ( P>0.05). At the last follow-up, the bone mineral density T-score of the lumbar spine was (-2.1±1.1)SD in the Denosumab therapy group, significantly higher than (-2.5±0.9)SD in the conventional treatment group ( P<0.05). In the Denosumab therapy group, the bone mineral density T-score of the lumbar spine at the last follow-up was significantly increased compared to that before surgery ( P<0.01), while there was no significant difference in the conventional treatment group ( P<0.05). Before surgery and at 3 days after surgery, the VAS scores and ODI values were (8.5±0.9)points, (2.8±0.8)points, 48.7±4.8 and 25.6±4.0 in the Denosumab therapy group, which was not statistically different from those in the conventional treatment group [(8.5±1.3)points and (2.8±0.9)points, 47.9±7.0 and 25.9±3.7] ( P>0.05). At 6 months after surgery and at the last follow-up, the VAS scores and ODI values were (2.2±0.8)points, (1.7±0.8)points, 24.2±3.6 and 23.2±4.1 in the Denosumab therapy group, significantly lower than those of the conventional treatment group [(2.8±0.9)points, (2.8±1.1)points, 26.4±3.2 and 27.3±4.0] ( P<0.01). The VAS scores at each time point after surgery in both groups decreased significantly compared with those before surgery ( P<0.05). The VAS scores continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while no significant difference was found among those at different time points in the conventional treatment group ( P>0.05). The ODI values at each time point after surgery in both groups significantly decreased compared to those before surgery ( P<0.05). The ODI values continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while in the conventional treatment group, no significant difference was found between those at 6 months after surgery and those at 3 days after surgery ( P>0.05) and they were improved at the last follow-up compared with those at 3 days after surgery ( P<0.05). The refracture rate after surgery was 6.7% (7/104) in the Denosumab therapy group, significantly lower than 16.8% (18/107) in the conventional treatment group ( P<0.05). No serious complications were observed during the antiosteoporosis period in either group. Conclusion:Compared with daily oral administration of Calcium and active Vitamin D after PKP, the conventional treatment combined with Denosumab after PKP can effectively increase the bone density, relieve pain continuously, improve functional restoration, and reduce the risk of refracture in OVCF patients.

Objective:To compare the clinical efficacy of robot-assisted percutaneous screw implantation and free-hand open screw implantation by Wiltse approach in the treatment of thoracolumbar fracture.Methods:A retrospective cohort study was performed to analyze the clinical data of 71 patients with thoracolumbar fracture admitted to Second Affiliated Hospital of Soochow University from May 2018 to May 2020. There were 52 males and 19 females, with age range of 22-54 years［(41.0±7.8)years］. Of all, 33 patients were treated with robot-assisted percutaneous screw implantation (Group A) and 38 patients were treated with free-hand open screw implantation by Wiltse approach (Group B). Following parameters were measured, including frequency of radiation exposure, operation time, intraoperative blood loss, length of hospital stay, incidence of complications, rate of fracture healing at 3 months and 6 months postoperatively, visual analogue scale (VAS) and Oswestry dysfunction index (ODI) at 3 days, 3 months, 6 months postoperatively and at the last follow-up, anterior vertebral body height ratio and sagittal Cobb angle preoperatively, at 3 days postoperatively and at the last follow-up, and rate of screw implantation of grade A and B and rate of facet joint violation at 3 days postoperatively.Results:All patients were followed up for 10-24 months［(15.2±4.4)months］. Frequency of radiation exposure and operation time showed no statistical differences between the two groups (both P>0.05). Intraoperative blood loss was 100(100, 135)ml in Group A, less than 160(120, 200)ml in Group B ( P<0.01). Length of hospital stay was 8(7, 11) days in Group A, shorter than 12(10, 16)days in Group B ( P<0.01). There were no complications such as infection, spinal nerve injury or cerebrospinal fluid leakage in both group. There were no significant differences between the two groups in the rate of fracture healing at 3 and 6 months postoperatively (all P>0.05). VAS and ODI in Group A was 3(2, 4)points and 21(18, 23)points at 3 days postoperatively, lower than 4 (3, 5)points and 27(20, 32)points in Group B ( P<0.05 or 0.01), and the two groups showed no significant differences in VAS and ODI at other time points (all P>0.05). There were no significant difference in the anterior vertebral body height ratio or sagittal Cobb angle between the two groups at 3 days postoperatively and at the last follow-up (all P>0.05). Rate of screw implantation of grade A and B was 96.5% (191/198) in Group A, higher than 90.4% (206/228) in Group B ( P<0.05). Rate of facet joint violation was 4.0%(8/198) in Group A, lower than 11.8% (27/228) in Group B ( P<0.01). Conclusion:For thoracolumbar fracture, robot-assisted percutaneous screw implantation is superior to free-hand open screw implantation by Wiltse approach in terms of less bleeding, shorter hospitalization, earlier pain alleviation, higher accuracy of screw implantation and lower risk of facet joint violation.

Nanotechnology has emerged as an ideal approach for achieving the efficient chemo agent delivery. However, the potential toxicity and unclear internal metabolism of most nano-carriers was still a major obstacle for the clinical application. Herein, a novel "core‒shell" co-assembly carrier-free nanosystem was constructed based on natural sources of ursolic acid (UA) and polyphenol (EGCG) with the EpCAM-aptamer modification for hepatocellular carcinoma (HCC) synergistic treatment. As the nature products derived from food-plant, UA and EGCG had good anticancer activities and low toxicity. With the simple and "green" method, the nanodrugs had the advantages of good stability, pH-responsive and strong penetration of tumor tissues, which was expected to increase tumor cellular uptake, long circulation and effectively avoid the potential defects of traditional carriers. The nanocomplex exhibited the low cytotoxicity in the normal cells

Objective: To investigate the relationship between ultrasound derived ratio of femoral vein to femoral artery diameter and hemodynamics in patients with heart failure. Methods: This was a case-control study. A total of 61 patients with heart failure and 49 patients with non-heart failure hospitalized in the Department of Critical Care Medicine from September 2017 to September 2018 were included in this study. Doppler ultrasound was used to measure the femoral artery and vein diameter. After deep inhalation, the femoral vein diameter was measured again, and the ratio of femoral vein and artery diameter was calculated. The central venous pressure (CVP) and mean pulmonary wedge pressure (mPAWP) were also measured. Pearson correlation analysis was used to explore the correlation between the ratio of femoral vein diameter to femoral artery diameter and CVP and mPAWP, and linear regression equation was established. Results: The overall CVP and mPAWP levels were significantly higher, and the femoral vein diameter after deep inhalation was bigger in heart failure patients than in non-heart failure patients(all P<0.001). The femoral vein diameter/femoral artery diameter ratio was positively correlated with CVP (r=0.76, P<0.001), and positively correlated with mPAWP (r=0.40, P<0.001) in heart failure group. The linear regression equation established by the femoral vein/femoral artery diameter ratio and CVP in the heart failure group showed that the inner diameter of the femoral vein/the inner diameter of the femoral artery ratio≥1.3 corresponded CVP≥15.518 cmH₂O(1 cmH₂O=0.098 kPa) in heart failure patients. Conclusions In patients with heart failure, the inner diameter of the femoral vein/femoral artery ratio is positively correlated with CVP and mPAWP. The ratio of inner diameter of the femoral vein/femoral artery can be used to assess the volumetric load of patients with heart failure and to guide the clinical treatment of heart failure patients.

Objective To scale the frequencise of medical X-ray diagnosis based on the survey conducted in 58 hospitals to the all hospitals in Henan province,in order to make them available for providing the basis for reasonable application of diagnostic radiology.Methods Stratified sampling method was used to select medical institutions at different levels in 6 cities in the province as sample hospitals.The information of examined patients on sex,age,diagnostic type and exposure category were gathered and the results were analyzed.Results The sex ratio of male and female examined patients was close to 1∶1.The largest proportion,60.47％,of examined patients was from the age group of above 40 years old among the three age groups.Medical diagnositc medical X-ray examinations mainly include conventional X-ray photography and CT examination,accounting for 52.15％ and 40.31％,respectively.Chest examination contributed the largest propotions,23.84％,of conventional diagnositic X-ray examination and,13.25％,of CT examination respectively.CT examinations were mainly concentrated in the secondary and tertiary hospitals,accounting for 21.54％ and 72.99％ of the total CT examinations,respectively.Contrast examination,mammography and extracorporeal lithotripsy were concentrated in the tertiary hospitals,accounting for 77.82％,95.01％ and 100％ of the same type of examinations,respectively.Conventional photographic examinations were mainly conducted in primary hospitals,accounting for 74.56％ of all types of examinations in the primary hospitals.By using multiple linear regression model,the diagnostic examination frequency in 2016 was estimated to be 826 examinations per 1 000 population,of which the frequency of dianostic X-ray examination and CT examination were 541 per 1 000 and 285 per 1 000,respectively.Conclusions The frequency of diagnostic radiology in Henan has increased rapidly in recent years.All types of diagnostic radiology equipment are unevenly distributed in hospitals at different levels which posed a challenge for health care.Relevant departments should make efforts to reallocation of diagnostic radiology equipment in such hospitals and make utilization of health resources more reasonable.

OBJECTIVETo observe the efficacy of auricular point sticking therapy for abnormal blink in children and the impact on the breakup time of tear film.

METHODSA total of 123 cases (246 eyes) with abnormal blink were randomly assigned into two groups, 62 cases (124 eyes) to an observation group, 61 cases (122 eyes) to a control group. The observation group received auricular point sticking therapy with western medicine; the treatment was given 6 d per week; the next day received no treatment and changed dressing. The auricular points were yan (LO), pingjianqian (TG), pingjianhou (AT), gan (CO), pi (CO), wei (CO). The western medicine pateints took 1 oral multivitamins tablets per day, and received sodium hyaluronate eye drops and tobramycin eye drops in turn, 3 times per day, 7 day as a course; treatment was lasting 3 courses. Patients in the control group only received western medicine. The blink frequency score and breakup time of tear film of children were observed, the curative effect of the two groups was compared.

RESULTSAfter treatment, the blink frequency score was lower significantly (<0.01), and lower significantly in subjects in the observation group compared to those in the control group (<0.01). After treatment, less than 10 s were 51 eyes (41.8%) and greater than 10 s (including 10 s) were 71 eyes (58.2%) in the 122 eyes from the control group; in the observation group, less than 10 s were 13 eyes (10.5%) and greater than 10 s (including 10 s) were 111 eyes (89.5%); there was significant difference between the two groups (<0.01). The effective rate of the observation group was 91.9% (114/124), which was higher than the control group 65.6% (80/122); the difference was statistically significant (<0.01).

CONCLUSIONThe efficacy of auricular point sticking therapy combine western medicine is better in treating children with abnormal blink compared to western medicine by reducing the breakup time of tear film. This suggests that reduction of tear film stability is one of the main reasons which causes frequent eye blink, and breakup time of tear film can be used as the testing standard.

Objective To analyze of the efficacy of minimally invasive surgery combined with medication in the treatment of ureteral calculi.Methods From June 2013 to June 2015,124 patients with ureteral calculi which confirmed by X-ray in our hospital were collected as subjects.According to the treatment method,they were divided into control group and observation group,patients in the control group were treated with simple medication,while the observation group were treated with minimally invasive surgery combined with drug therapy.The effects of treatment and the levels of MCP-1,TFF1 and HMGB1 in urine between two groups were compared.Results The stone expulsion rate and the net rate of the observation group was higher than those of the control group,the differences were significant(P<0.05).The stone expulsion time of observation group was shorter than that of the control group,the formation rate of the observation group was lower than that of the control group,the differences were significant(P<0.05).Adverse reactions occurred in 11 cases of the observation group,in 29 cases of the control group,the incidence of adverse reactions in the observation group was lower than that in the control group,the difference was significant(P<0.05).After the treatment,17 cases of adverse drug reactions occurred in the observation group,which was more than 5 cases of adverse drug reactions in the control group,the difference was significant(P<0.05).After treatment,the levels of MCP-1 and HMGB1 in urine of two groups were decreased compared with those before treatment,the level of TFF1 was increased,the differences were significant(P<0.05);while the levels of MCP-1 and HMGB1 of the observation group after treatment were lower than those of the control group,the level of TFF1 was higher than that of the control group,the difference was significant(P<0.05).The effective rate of the observation group was 88.71％,which higher than 69.35％ of the control group,the difference was significant(P<0.05).Conclusion On the basis of medication,combined with extracorporeal shock wave lithotripsy for ureteral calculi can not only improve the therapeutic effect,but also reduce the risk of adverse reactions.

Objective To compare the effects of two skin sampling methods (negative pressure suction blister and skin shaving) on the physical status of autologous epidermal keratinocytes transplanted to patients with vitiligo. Methods Skin samples were obtained from the normal skin of 32 patients with stable vitiligo by suction blister under negative pressure and skin shaving alone or in combination. Immunohistochemistry was performed to examine the expression of proliferating cell nuclear antigen (PCNA) and caspase-3 in these samples.Skin tissues resected from 15 normal human subjects served as the control. Results There was an expression of PCNA and caspase-3 at different degrees in all the skin tissues obtained by the two sampling methods from the 32 patients. Most PCNA-positive cells were focally distributed at the basal layer in epidermis obtained from suction blisters, and a few PCNA-positive cells were observed in the middle and lower part of the prickle cell layer of epidermis from shaved skin. There was a significant difference in the percentage of PCNA-positive cells between the epidermis from suction blisters and shaved skin as well as between the epidermis from suction blisters and normal control skin (x2 = 10.99, 14.08, both P < 0.05), but not between the epidermis from shaved skin and normal control skin (x2 = 1.31, P > 0.05). The expression of caspase-3 was predominantly located in the cytoplasm of keratinocytes in the basal layer as well as middle and lower part of prick cell layer, and no difference was observed in the percentage of caspase-3-expressing keratinocytes between the epidermis from shaved skin, suction blisters and normal control skin (x2 = 1.41, 2.89, 1.91, all P > 0.05). Conclusions The proliferation activity of epidermal cells seems important to the survival of grafted skin, and compared to the suction blister technique, skin shaving appears to have less influence on the proliferation of keratinocytes.