Objective: To evaluate the efficacy and safety of plasma exchange (PE) in thymoma-associated myasthenia gravis (MG), thereby to provide theoretical support for its application in the treatment of thymoma-associated MG. Methods: A total of 133 patients with thymoma-associated MG admitted from January 2018 to September 2024 were retrospectively analyzed. Patients were matched using propensity score to reduce selection bias, yielding 22 matched pairs for both PE group (n=22) and non-PE group (n=22). Patient characteristics including gender, age of disease onset, course of disease, history of thymoma resection, clinical absolute scores [clinical absolute scores (CAS) and clinical relative scores (CRS)], and synchronized immunotherapy regimen of the two groups were analyzed. The CAS scores before and after treatment were compared between the two groups, and the CRS was used to assess the treatment efficiency. Safety of the two treatment regimens were also compared. Continuous variables were compared using the t-test or ANOVA, while categorical data were compared by the chi-square test. Results: A total of 133 patients were included and divided into two groups according to whether they underwent plasma exchange treatment: the PE group (n=22) and the non-PE group (n=111). To exclude bias caused by large difference in the number of cases between the two groups, we performed propensity score matching. After matching, the number of cases in both groups was 22. There was no significant difference in baseline clinical characteristics between the two groups (P>0.05), including gender, age of onset, duration of disease course, history of thymectomy and baseline CAS score before treatment. Compared to the non-PE group, patients in the PE group showed more significant improvement in CAS score (5.09±1.95 vs 3.59±1.50, P<0.05) and a higher CRS score (75.00% vs 50.00%, P<0.001). Compared to the non-PE group, PE group had significantly longer ICU stay, longer hospital stay and higher hospitalization cost (P<0.05). There was no statistically significant difference in adverse events between the two groups during treatment (P>0.05). During long-term follow-up, both the PE and non-PE groups showed relatively low 1-, 3-, and 5-year recurrence rate, with no significant difference between the two groups (P>0.05). Conclusion: This study indicates that plasma exchange has clear value in the treatment of patients with thymoma-associated myasthenia gravis. It can not only significantly improve patients' muscle strength to alleviate motor dysfunction and enhance quality of life, but also does not significantly increase the incidence of adverse reactions. Therefore, it can be regarded as one of the preferred treatment options that achieve a "balance between efficacy and safety" for such patients, and provides an important basis for optimizing treatment strategies, improving prognosis, and promoting the application of subsequent treatment regimens.

Objective To investigate the influence of intravenous esketamine infusion on anesthetic effect and awakening quality in elderly patients undergoing laparoscopic surgery for prostate cancer.Methods One hundred and twenty patients with laparoscopic radical prostatectomy were selected and divided into the esketamine group(group E)and control group(group C)by the random number table method,60 ca-ses in each group.The group E used esketamine for anesthesia induction and maintenance,while the group C received the same amount of physiological saline at the same time during operation process as control.The es-ketamine pumping infusion or normal saline in the two groups was stopped at 30 min before operation end.In addition,the types and doses of other drugs used during the induction and maintenance phase of anesthesia were identical between the two groups.The use total amounts of anesthetic drugs during perioperative period were recorded.The heart rate(HR)and mean arterial pressure(MAP)were recorded before operation(T1),instantly before tracheal intubation(T2),at 1 min after tracheal intubation(T3),1 h during surgery(T4),end of skin suture(T5),and 5 min after extubation(T6)in the two groups respectively;the anesthetic recovery time after extubation was recorded.The Riker sedation and restlessness score was used to conduct the agita-tion evaluation,the incidence rates of agitation and bucking and the resuscitation room stay time were recor-ded.The pain VAS score was used to conduct the pain evaluation in the patients.The incidence rates of ad-verse events such as respiratory depression,shiverring,nausea,vomiting,drowsiness after extubation were re-corded.Results The perioperative doses of resutanil and propofol in the group E were significantly lower than those in the group C,and the difference was statistically significant(P＜0.05).HR and MAP at T2 in the group E were higher than those in the group C,while HR and MAP at T3 in the group E were lower than those in the group C.The recovery time after extubation in the group E was longer than that in the group C,the agitation incidence rate,acute bucking incidence rate and VAS score were lower,the stay time in the recov-ery room was shorter.The incidence rate of drowsiness in the group E was significantly higher than that in the group C(P＜0.05).The incidence rates of other adverse events had no statistical differnece(P＞0.05).Con-clusion Esketamine is safe and effective in the elderly patients with laparoscopic prostate cancer surgery,which is conducive to stabilize the hemodynamic parameters and reduce the incidence rate of agitation and buc-king.

Objective To understand the current situation and influencing factors of work-related musculoskeletal disorders (WMSDs) in medical staff in Beijing City. Methods A total of 2 687 medical staff were selected as the research subjects using the multi-stage sampling method. The current situation of WMSDs and occupational stress, anxiety symptoms, depressive symptoms, and insomnia symptoms were investigated using the Musculoskeletal Disorders Questionnaire, the Core Occupational Stress Scale, the Generalized Anxiety Disorder Scale, the Patient Health Questionnaire Depression Scale, and the Self-Sleep Management Questionnaire. The Max-Min Hill-Climbing algorithm was used to construct a Bayesian network model to analyze the influencing factors and internal relationships of WMSDs and to conduct reasoning and prediction of the model. Results The prevalence of WMSDs among the research subjects was 88.9%. Binary logistic regression analysis was used to identify age, educational level, personal monthly income, anxiety symptoms, depressive symptoms, insomnia symptoms, prolonged forward-head desk work, and prolonged static posture work to construct the Bayesian network model. The model consisted of nine nodes and eleven directed edges. Prolonged static posture work, prolonged forward-head desk work, and anxiety symptoms were directly related to WMSDs. Age and educational level were indirectly related to WMSDs through their influence on prolonged forward-head desk work. Depression symptoms were indirectly associated with WMSDs through their influence on anxiety symptoms. The model's prediction accuracy was 90.5%. Conclusion The prevalence of WMSDs among medical staff in Beijing City is relatively high. Prolonged static posture work, prolonged forward-head desk work, and anxiety symptoms may directly increase the risk of developing WMSDs.

Objective To establish a portable gas chromatography-mass spectrometry (GC-MS) method for determining carbon disulfide in workplace air. Methods Samples were collected using the built-in Tenax GR adsorption tube in the portable GC-MS, followed by thermal desorption. The analytes were separated on a DB-1 chromatographic column and detected by a 3D ion trap mass spectrometer, with 1,3,5-tris(trifluoromethyl)benzene used as the internal standard. Qualitative analysis was based on retention time and characteristic ions, and quantitative analysis was performed using the internal standard method. Results The method showed a linear range of 0.034-0.340 mg/m³ with a correlation coefficient of 0.999 4 using the adsorption tube enrichment mode. The detection limit was 0.007 mg/m³, and the lower limit of quantification was 0.022 mg/m³. The average recovery ranged from 97.5% to 104.0%. The within-run and between-run relative standard deviation was 2.7%-10.4% and 8.8%-14.8%, respectively. Conclusion A rapid, green, highly sensitive, and interference-resistant on-site detection method was established. As a supplement to existing national standard methods, this method is suitable for real-time monitoring of carbon disulfide in workplace air and for occupational exposure risk assessment.

Objective To demonstrate the feasibility of oblique lumbar interbody fusion(OLIF)com-bined with 4-screw fixation for treating two-level lumbar degenerative diseases.Methods An intact finite element model of L3-S1(MO)was constructed and validated.Then,we constructed the M1 model by simulating OLIF surgery at L3/4 and L4/5 segments on the MO model.By attachment of posterior 4-screw or 6-screw fixation to the M1 model,three 4-screw fixation models(M2-M4)and one 6-screw fixation model(M5)were established.The segmental and overall range of motion(ROM)and the peak von Mises stresses of superior endplate,cage,and posterior screw-rod were investigated under each implanted condition.Results Under the motion modes of forward flexion,backward extension,bilateral(left and right)flexion,and left and right rotation,the L3/4 ROM of M2 model and L4/5 ROM of M3 model increased,while the L3/4 and L4/5 ROM of M4 and M5 models significantly decreased compared with those of M1 model.Under all motion modes,the L4 superior endplate in M2 model and the L5 superior endplate in M3 model showed the maximum peak von Mises stress,and the peak von Mises stresses of L4 and L5 superior endplates in M4 and M5 models were close.The L3/4 cage in M2 model and the L4/5 cage in M3 model showcased the largest peak von Mises stress,and the peak von Mises stresses of cages in M4 and M5 models were close.The peak stresses of internal fixation in M2-M5 models were close.Conclusion Four-screw fixa-tion can replace 6-screw fixation in the OLIF surgery for treating two-level degenerative lumbar diseases.

Objective To evaluate the applicability of the comprehensive index method for assessing occupational health risks on chemical hazards in key work sites of a metal product enterprise. Methods A metal product enterprise in Beijing City was chosen as the research subject using the convenience sampling method. Occupational health investigations and chemical hazard monitoring were conducted at four work sites: grinding machine operation, welding, cutting, and painting. The comprehensive index method was used to determine the risk levels of chemical hazards. Results The grinding dust in the grinding machine operation work site was assessed as moderate risk. The nitrogen oxides and ozone in the welding (southeast) work sites were assessed as moderate risk. The nitrogen oxides ozone and welding fumes in the welding (northwest) and cutting work site were assessed as moderate risk. Benzene in the painting work site was assessed as moderate risk. All chemical hazards in other work sites were determined to pose low risks. Co-exposures to nitrogen oxides and ozone in the two welding work sites and cutting work site were classified as moderate risk. Co-exposure to ethylbenzene, xylene, methanol, ethyl acetate, and butyl acetate in the painting work site also posed moderate risk, while the co-exposure to toluene and methanol in the painting work site was assessed as low risk. Conclusion The comprehensive index method could be used for the occupational health risk assessment in the metal product enterprise. The enterprise should strengthen hazard control measures for exposure to grinding dust, welding fumes, nitrogen oxides, ozone, and benzene, and closely monitor the health risks associated with co-exposures of chemical hazards.

Objective:To evaluate the safety and efficacy of the domestic robotic surgical system for general surgery.Methods:A prospective single-center, single-arm exploratory study was conducted at Gansu Provincial People's Hospital from Jun 2022 to Oct 2023, enrolling 54 patients undergoing general surgery using domestically produced Toumai? Endoscopic Surgical Robotic System. The primary study endpoint was surgical success rate, and the secondary study endpoints were intraoperative bleeding, operative time, complications, system performance, hospitalization days.Results:In this study, robotic surgery was successfully completed in 52 patients, and in 2 patients undergoing thyroid operation it was converted to open surgery due to bleeding, with a success rate of 96%, no organ injury or death during surgery, and no system failure. The types of surgery included cholecystectomy, radical gastric cancer resection, radical colorectal cancer resection, inguinal hernia repair, partial hepatectomy, total thyroidectomy and choledocho-jejunal anastomosis.Conclusion:The study provides preliminary evidence of the safety and efficacy of the Toumai? Endoscopic Surgical Robotic System for the treatment of general surgical diseases.

Complex brain diseases seriously endanger human health, and early diagnostic biomarkers and effective treatments are currently lacking. Due to ethical constraints on human research, establishing monkey models is crucial to address these issues. With the rapid development of technology, transgenic monkey models of a range of brain diseases, especially autism spectrum disorder (ASD), have been successfully established. However, to establish practical and effective brain disease models and subsequently apply them to disease mechanism and treatment studies, there is still a lack of a standard tool, i.e., a system for collecting and analyzing the daily behaviors of brain disease model monkeys. Therefore, with the goal of undertaking a comprehensive and quantitative study of behavioral phenotypes, we established a standard daily behavior collection and analysis system, including behavioral data collection protocols and a monkey daily behavior ethogram (MDBE) for rhesus and cynomolgus monkeys, which are the most commonly used non-human primates in model construction. Then, we used ASD as an application example after referring to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), which is widely used in clinical disease diagnosis to obtain ASD core clinical symptoms. We then established a sub-ethogram (ASD monkey core behavior ethogram (MCBE-ASD)) specifically for quantitative assessment of the core clinical symptoms of an ASD monkey model based on MDBE. Subsequently, we demonstrated the high reproducibility of the system.
Animals ; Autism Spectrum Disorder ; Macaca mulatta ; Disease Models, Animal ; Behavior, Animal ; Macaca fascicularis ; Male ; Humans

OBJECTIVE: To analyze the relationship between Chemokine IP10 and its receptor CXCR3 during prion infection. METHODS: We investigated the increases in IP10 signals, primarily localized in neurons within the brains of scrapie-infected mice, using western blotting, ELISA, co-immunoprecipitation, immunohistochemistry, immunofluorescence assays, and RT-PCR. RESULTS: Both CXCR3 levels and activation were significantly higher in the brains of scrapie-infected mice and prion-infected SMB-S15 cells. Enhanced CXCR3 expression was predominantly observed in neurons and activated microglia. Morphological colocalization of PrP ^C/PrP ^Sc with IP10/CXCR3 was observed in scrapie-infected mouse brains using immunohistochemistry and immunofluorescence. immunohistochemistry (IHC) analysis of whole brain sections further revealed increased accumulation of IP10/CXCR3 specifically in brain regions with higher levels of PrP ^Sc deposits. Co-immunoprecipitation and biomolecular interaction assays revealed the molecular interactions between PrP and IP10/CXCR3. Notably, a significantly larger amount of IP10 accumulated within prion-infected SMB-S15 cells than in the normal partner cell line, SMB-PS. Importantly, resveratrol treatment effectively suppressed prion replication in SMB-S15 cells, thereby restoring the accumulation and secretion pattern of cellular IP10 similar to that observed in SMB-PS cells. CONCLUSION Our data demonstrate that the activation of IP10/CXCR3 signaling in prion-infected brain tissues coincides with PrP ^Sc deposition. Modulation of IP10/CXCR3 signaling in the brain represents a potential therapeutic target for mitigating the progression of prion diseases.
Animals ; Receptors, CXCR3/metabolism* ; Mice ; Chemokine CXCL10/metabolism* ; Brain/metabolism* ; Scrapie/metabolism* ; Signal Transduction ; PrPSc Proteins/metabolism*

Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.
Male ; Female ; Humans ; Adult ; Rhinitis, Allergic, Seasonal/drug therapy* ; Nasal Sprays ; Quality of Life ; Administration, Intranasal ; Rhinorrhea ; Double-Blind Method ; Treatment Outcome ; Rhinitis, Allergic/drug therapy*