Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective:To analyze the eye lens dose and annual effective dose to interventional radiation workers in some hospitals of Xinxiang city from 2020 to 2022, and to ascertain the dose to interventional radiation workers.Methods:By using TLDs, the eye lens dose Hp(3) and annual effective dose Hp(10) were monitored for three consecutive years in six hospitals in Xinxiang city. The lens doses and annual effective doses to intervention radiation workers in different years in different-level hospitals and departments were analyzed. Results:From 2020 to 2022, a total of 117 people were monitored. The left eye lens dose range was 0.12-164.24 mSv, and the right eye lens dose range was 0.07-51.64 mSv. The average annual dose was 8.56 mSv for left eye lens and 4.49 mSv for right eye lens The average annual dose distribution in the MDL-5 mSv range for the left and right eye lens was 60.68% and 73.50%, respectively. 9.41% (11 people) of the left eye lens doses exceeded 20 mSv. The annual effective doses range was 0.11-31.27 mSv, with average annual dose of 2.56 mSv. The proportion of average annual effective doses mainly distributed in the range of MDL to 1.25 mSv was 52.14%, with 2.56% annual effective dose exceeding 20 mSv. There was no significant difference in left and right eye lens dose and annual effective dose between the tertiary hospitals and the secondary hospitals in three years ( P>0.05). Compared with different departments, the cumulative per capita dose in three years was statistically significant (left eye H=11.42, right eye H=13.72, annual effective dose H=25.94, P<0.05). The lens dose and annual effective dose in neurology department were lower than those in cardiology department and comprehensive intervention department ( Zcardiology department=-3.33, -3.78, -4.83, P<0.05; Zcomprehensive intervention department=-2.71, -2.63, -4.39, P<0.05). Conclusions:Most of the annual equivalent dose and annual effective dose to eye lens of the interventional radiation workers in Xinxiang city meet the national limits, but some of them have higher doses and exceed the national limits. It is suggested that the routine and continuous monitoring of eye lens doses to interventional radiologists should be strengthened while routine monitoring of annual effective dose, and attention should be paid to the eye lens and annual effective dose to interventional radiologists in secondary hospitals to improve the awareness of protection.

To report 2 cases of Iso-Kikuchi syndrome, both of which were congenital. Case 1, a 7-month-old female infant, visited the hospital due to abnormalities in the nail plate of the left index finger for 7 months; case 2, a 3-year-old male child, also visited the hospital due to abnormalities in the nail plate of the left index finger for 3 years. The 2 patients both presented with 2 tiny, independent nail plates on both sides of the nail bed of the left index finger, instead of normal nail plates. Based on their clinical features, the 2 patients were diagnosed with Iso-Kikuchi syndrome (congenital onychodysplasia of the index finger). The mother of case 1 had a history of progesterone use to prevent miscarriage during pregnancy, the mothers of the two patients both suffered from hypothyroidism and continued to receive thyroid hormone replacement therapy during pregnancy, and the mother of case 2 had a history of gestational diabetes. It is still unclear whether these comorbidities and drugs are directly related to the occurrence of Iso-Kikuchi syndrome.

Objective:To investigate the expression of nicotinamide-N-methyltransferase (NNMT) in various tumor tissues and its prognostic value in papillary thyroid carcinoma.Methods:The paraffin samples of surgically resected tissues from 168 cases of colorectal cancer, 75 cases of gastric cancer, 178 cases of lung cancer, 15 cases of liver cancer, 60 cases of thyroid cancer, 7 cases of prostate cancer, 74 cases of breast cancer, and 14 cases of renal cancer were collected from Sir Run Run Show Hospital, Zhejiang University School of Medicine and the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine between January 2016 and December 2021; tissue samples of 58 cases of papillary thyroid cancer and another 19 cases of thyroiditis were collected between January 2016 and December 2016. Immunohistochemistry kits were prepared and performance tests were performed. Normal specimens (>5 cm from the margin of paracancerous tissues) and the samples of gastric cancer, colorectal cancer, lung cancer, thyroid cancer, prostate cancer, breast cancer, and kidney cancer tissues as well as their paracancerous tissues (3 cm from the tumor edge) were selected. Immunohistochemistry kits were used to detect the expression of NNMT protein in normal tissue samples, different tumor tissues and their paracancerous tissues. X-tile software combined with the receiver operating characteristics curve of NNMT in the diagnosis of tumor tissues and paracancerous tissues in papillary throid carcinoma were used to determine the optimal cut-off value (41.5); < 41.5 was treated as the NNMT protein low expression group and ≥ 41.5 was treated as the NNMT protein high expression group. The expression of NNMT protein in patients with papillary thyroid carcinoma with different clinicopathological characteristics was compared; Kaplan-Meier method was used to analyze the overall survival of the patients with papillary thyroid carcinoma; Cox proportional risk model was used to conduct multivariate analysis on the influencing factors of overall survival.Results:The prepared immunohistochemistry kits were valid for at least 12 months, with good intra-batch and batch-to-batch repeatability, good stability and specificity. NNMT protein was not or occasionally lowly expressed in colorectal, lung, thyroid, prostate, breast, kidney, and gastric tissues. NNMT protein was highly expressed in colorectal cancer, gastric cancer, breast cancer, kidney cancer, thyroid cancer, lung cancer, prostate cancer tissues, while lowly expressed in colorectal cancer, gastric cancer, breast cancer, kidney cancer, thyroid cancer, lung cancer, prostate cancer adjacent tissues. The high expression rates of NNMT protein in thyroiditis tissue, papillary thyroid cancer tumor tissue and paracancerous tissues were 15.79% (3/19), 68.97% (40/58) and 31.03% (18/58), respectively, and the high expression rate of NNMT protein in papillary thyroid carcinoma tissue was higher than that in thyroiditis tissue and paracancerous tissue. All patients with papillary thyroid cancer were divided into the NNMT protein high expression group (40 cases) and the low expression group (18 cases). There were no statistically significant differences in NNMT protein expression among patients with different age, gender, degree of differentiation, lump diameter, TNM stage, lymph node metastasis, and serum anti-thyroglobulin antibody (TgAb) level (all P > 0.05). The median overall survival time of 58 patients was 18.5 months, and the 5-year overall survival rate was 90.0%. The overall survival of patients with a lump diameter of ≥2 cm was worse than that of those with a lump diameter of < 2 cm ( P < 0.001), and the overall survival of patients with lymph node metastasis was worse than that of those without lymph node metastasis ( P = 0.041). The overall survival of patients in the NNMT protein high expression group was worse than that of those in the NNMT protein low expression group, and the overall survival of patients with high serum TgAb level was worse than that of those with low serum TgAb level, while the differences were not statistically significant (all P >0.05). Lump diameter ( HR = 35.56, 95% CI 2.64-478.25, P = 0.007), NNMT protein expression ( HR = 308.12, 95% CI 2.21-42 958.20, P = 0.023), serum TgAb level ( HR = 142.85, 95% CI 1.88-10 854.25, P = 0.025) were independent influencing factors for the OS of patients with papillary thyroid carcinoma. Conclusions:NNMT is highly expressed in various tumor tissues. NNMT expression is related to the prognosis of patients with papillary thyroid carcinoma;the patients with high expression of NNMT have worse prognosis compared with those with low expression of NNMT.

Objective:To provide ideas and references for improving the lumbar stability of flying personnel by reviewing the research progress and tendency on Schmorl′s nodes of lumbar spine in flying personnel. Literature resource and selection Relevant papers and monographs about Schmorl′s nodes published at home and abroad. Literature quotation Thirty-six published references were cited. Literature synthesis It is generally considered that Schmorl′s nodes of lumbar spine are cartilaginous nodes formed by the herniation of the intervertebral discs tissue into the vertebral body through the broken cartilaginous endplates. There are different opinions on the epidemiology and pathogenesis of Schmorl′s nodes of lumbar spine. Because most of them have no obvious clinical symptoms, they were once considered to be of no research value. However, the investigation showed that the further study on Schmorl′s nodes of lumbar spine in flying personnel is realistic. Schmorl′s nodes of lumbar spine may not only cause lumbago, but also are closely related to lumbar intervertebral discs degeneration. The formation of Schmorl′s nodes of lumbar spine in flying personnel will affect the viscoelasticity of lumbar intervertebral discs, and this will affect their anti-G and anti-vibration abilities, accelerate the degeneration of lumbar spine and intervertebral discs, and induce clinical symptoms or reduce flight endurance. Conclusions:Schmorl′s nodes of lumbar spine are closely related to lumbar disc degeneration and lumbar instability. Schmorl′s nodes are commonly seen in the lumbar spine and have an important effect on the overall stability of lumbar spine of flying personnel.

Objective:To provide references for aeromedical support by investigating the effect of training at high altitude on acute hypoxia tolerance of pilots.Methods:Eighteen high performance fighter pilots who had returned to plain for 1 week as they finished 3-month residence in plateau were chosen as training group and 36 pilots who flied same aircraft type but without plateau stay and training were assigned as control group. Both groups received anti-G and anti-hypoxia training. The acceptance line of hypoxia experience training was defined to 2 min and the arterial oxygen saturation (SaO 2) and the heart rate of pilots were tested every 20 s. The anti-G and anti-hypoxia ability detector of pilots and BeneView T6 ECG monitor were used for training, assessment and monitoring. Results:SaO 2 level in the training group was significantly higher than that in the control group at the corresponding time point from the 60 s of the training, and the differences was statistically significant ( t=2.63, 3.32, 4.79, 4.32, P=0.011, 0.002,<0.001,<0.001). The average of SaO 2 in the control group decreased rapidly with the extension of hypoxia time, while the average of SaO 2 in the training group decreased slowly with the extension of hypoxia time. The average of effective consciousness time of the training group [(441.11±67.03) s] was significantly longer than that of the control group [(195.00±31.49) s], and was 2.26 times of the control group, the difference was statistically significant ( t=17.74, P<0.001). Conclusions:After stationed and trained in plateau, the SaO 2 and the effective consciousness time of high performance fighter pilots under acute hypoxia have been significantly improved. Short term chronic hypoxia process can significantly improve the acute hypoxia tolerance of pilots, which is conducive to the effective response to high aerial hypoxia.

Objective:To provide ideas and references for improving the lumbar stability of flying personnel by reviewing the research progress and tendency on Schmorl′s nodes of lumbar spine in flying personnel. Literature resource and selection Relevant papers and monographs about Schmorl′s nodes published at home and abroad. Literature quotation Thirty-six published references were cited. Literature synthesis It is generally considered that Schmorl′s nodes of lumbar spine are cartilaginous nodes formed by the herniation of the intervertebral discs tissue into the vertebral body through the broken cartilaginous endplates. There are different opinions on the epidemiology and pathogenesis of Schmorl′s nodes of lumbar spine. Because most of them have no obvious clinical symptoms, they were once considered to be of no research value. However, the investigation showed that the further study on Schmorl′s nodes of lumbar spine in flying personnel is realistic. Schmorl′s nodes of lumbar spine may not only cause lumbago, but also are closely related to lumbar intervertebral discs degeneration. The formation of Schmorl′s nodes of lumbar spine in flying personnel will affect the viscoelasticity of lumbar intervertebral discs, and this will affect their anti-G and anti-vibration abilities, accelerate the degeneration of lumbar spine and intervertebral discs, and induce clinical symptoms or reduce flight endurance. Conclusions:Schmorl′s nodes of lumbar spine are closely related to lumbar disc degeneration and lumbar instability. Schmorl′s nodes are commonly seen in the lumbar spine and have an important effect on the overall stability of lumbar spine of flying personnel.

Objective:To provide references for aeromedical support by investigating the effect of training at high altitude on acute hypoxia tolerance of pilots.Methods:Eighteen high performance fighter pilots who had returned to plain for 1 week as they finished 3-month residence in plateau were chosen as training group and 36 pilots who flied same aircraft type but without plateau stay and training were assigned as control group. Both groups received anti-G and anti-hypoxia training. The acceptance line of hypoxia experience training was defined to 2 min and the arterial oxygen saturation (SaO 2) and the heart rate of pilots were tested every 20 s. The anti-G and anti-hypoxia ability detector of pilots and BeneView T6 ECG monitor were used for training, assessment and monitoring. Results:SaO 2 level in the training group was significantly higher than that in the control group at the corresponding time point from the 60 s of the training, and the differences was statistically significant ( t=2.63, 3.32, 4.79, 4.32, P=0.011, 0.002,<0.001,<0.001). The average of SaO 2 in the control group decreased rapidly with the extension of hypoxia time, while the average of SaO 2 in the training group decreased slowly with the extension of hypoxia time. The average of effective consciousness time of the training group [(441.11±67.03) s] was significantly longer than that of the control group [(195.00±31.49) s], and was 2.26 times of the control group, the difference was statistically significant ( t=17.74, P<0.001). Conclusions:After stationed and trained in plateau, the SaO 2 and the effective consciousness time of high performance fighter pilots under acute hypoxia have been significantly improved. Short term chronic hypoxia process can significantly improve the acute hypoxia tolerance of pilots, which is conducive to the effective response to high aerial hypoxia.

Objective:To carry out investigation and analysis of an extensive skin radiation injury to the back accidentally caused by interventional procedure and to explore the problems faced in the event with emphasis on avoiding the reoccurance of similar events in the future.Methods:The data were collected by consulting the patient′s detailed medical history, collecting and analyzing clinical diagnosis and treatment data, tracking and observing their clinical manifestations and signs. The patient′s peripheral blood samples were also collected, together with the biological dose estimated and the equipment data collected on the site of the interventional treatment hospital.Results:The whole body dose to the patient was estimated to be 0.95 Gy. The typical values of kerma rate of radiation incident on the body surface due to fluoroscopic procedures were 373.5 mGy/min in subtraction modality and 47.8 mGy/min in fluoroscopy modality, respectively. The annual effective dose to the interventional radiologist was 20.51 mSv due to his operation in long-time radiation exposure conditions, higher than 3.09 mSv for other interventional radiologists with similar workload in the same department. The whole body and local clinical manifestations of the patients were in line with radiation injury. No clear diagnosis has been obtained in several hospitals, nor can obvious treatment outcomes be obsevered.Conclusion:Combined with the biological dose estimation result and clinical manifestations, the case was diagnosed as degree Ⅳ skin radiation injury. Radiation injury is closely related to whether the operation is conducted according to the standard and the output dose of X-ray machine. Non-specialized hospitals should strengthen clinical diagnosis and treatment of radiation injury.