Lumbar disc (LD) herniation and aging are prevalent conditions that can result in substantial morbidity. This study aimed to clarify the mechanisms connecting the LD aging and herniation, particularly focusing on cellular senescence and molecular alterations in the nucleus pulposus (NP). We performed a detailed analysis of NP samples from a diverse cohort, including individuals of varying ages and those with diagnosed LD herniation. Our methodology combined histological assessments with single-nucleus RNA sequencing to identify phenotypic and molecular changes related to NP aging and herniation. We discovered that cellular senescence and a decrease in nucleus pulposus progenitor cells (NPPCs) are central to both processes. Additionally, we found an age-related increase in NFAT1 expression that promotes NPPC senescence and contributes to both aging and herniation of LD. This research offers fresh insights into LD aging and its associated pathologies, potentially guiding the development of new therapeutic strategies to target the root causes of LD herniation and aging.
Intervertebral Disc Displacement/metabolism* ; Humans ; Aging/pathology* ; Nucleus Pulposus/pathology* ; Male ; Female ; Transcriptome ; Middle Aged ; Lumbar Vertebrae/pathology* ; Adult ; Cellular Senescence ; Stem Cells/pathology* ; Aged ; Intervertebral Disc Degeneration/metabolism*

Objective To understand the time change trend and epidemiological characteristics of occupational exposure of medical personnel in a general class A tertiary hospital in Shenzhen,and to provide practical guidance for occupational protec-tion management practice and optimization of occupational exposure prevention and control strategies.Methods The data of 813 cases of occupational exposure reported from 2017 to 2022 in our hospital were retrospectively investigated and analyzed,inclu-ding the basic information of exposure sources,exposed persons and exposure events.Results During 2017 to 2022,the number of occupational exposure cases showed a trend of first increase and then fluctuation,with the largest number of occupational expo-sure cases occurring in the third quarter and 8-11 o'clock of the day.Among the 813 cases of occupational exposure,569 were female(69.99％),nurses accounted for the highest proportion(391,48.09％),the number of people with 1-5 years of working life experienced occupational exposure was the highest(343,42.19％),and staff with junior professional titles accounted for the highest proportion(324,39.85％).Most were exposed for the first time(621,76.38％).Most of the occupational exposure occurred in the ward(301 cases,37.02％),82.41％was acute injuries,the upper limbs such as fingers,arms,etc.,the high-est exposure ratio(87.21％),most of the secondary exposure(49.45％).In 410 cases(50.43％),the primary sources of oc-cupational exposure were hepatitis B(255 cases,62.20％)and syphilis(119 cases,29.02％).Conclusion The key to effec-tively reduce the occurrence of occupational exposure and its adverse consequences is to implement key management for key groups,key places and key times,emphasize the importance of occupational safety education,and actively carry out relevant training and emergency drills.

Objectives:Distolingual root of the permanent mandibular first molar(PMFM-DLR)has been frequently reported,which may complicate the treatment of periodontitis.This study aimed to assess the morphological features of PMFM-DLR and investigate the correlation between the morphological features of PMFM-DLR and periodontal status in patients with Eastern Chinese ethnic background.Materials and methods:A total of 836 cone beam computed tomography(CBCT)images with 1497 mandibular first molars were analyzed to observe the prevalence of PMFM-DLR at the patients and tooth levels in Eastern China.Among them,complete periodontal charts were available for 69 Chinese patients with 103 teeth.Correlation and regression analyses were used to evaluate the correlation between the morphological features of DLR,bone loss,and periodontal clinical parameters,including clinical attachment loss(CAL),probing pocket depth(PPD),gingival recession(GR),and furcation involvement(FI).Results:The patient-level prevalence and tooth-level prevalence of DLR in mandibular first molars were 29.4%and 26.3%,respectively.Multiple linear regression analysis suggested that bone loss at the lingual site and CAL were negatively affected by the angle of separation between distolingual and mesial roots in the transverse section,while they were significantly influenced by age and the angle of separation between distobuccal and mesial roots in the coronal section.Conclusions:The prevalence of PMFM-DLR in Eastern China was relatively high in our cohort.The morphological features of DLR were correlated with the periodontal status of mandibular first molars.This study provides critical information on the morphological features of DLR for improved diagnosis and treatment options of mandibular molars with DLR.

Objective To understand the time change trend and epidemiological characteristics of occupational exposure of medical personnel in a general class A tertiary hospital in Shenzhen,and to provide practical guidance for occupational protec-tion management practice and optimization of occupational exposure prevention and control strategies.Methods The data of 813 cases of occupational exposure reported from 2017 to 2022 in our hospital were retrospectively investigated and analyzed,inclu-ding the basic information of exposure sources,exposed persons and exposure events.Results During 2017 to 2022,the number of occupational exposure cases showed a trend of first increase and then fluctuation,with the largest number of occupational expo-sure cases occurring in the third quarter and 8-11 o'clock of the day.Among the 813 cases of occupational exposure,569 were female(69.99％),nurses accounted for the highest proportion(391,48.09％),the number of people with 1-5 years of working life experienced occupational exposure was the highest(343,42.19％),and staff with junior professional titles accounted for the highest proportion(324,39.85％).Most were exposed for the first time(621,76.38％).Most of the occupational exposure occurred in the ward(301 cases,37.02％),82.41％was acute injuries,the upper limbs such as fingers,arms,etc.,the high-est exposure ratio(87.21％),most of the secondary exposure(49.45％).In 410 cases(50.43％),the primary sources of oc-cupational exposure were hepatitis B(255 cases,62.20％)and syphilis(119 cases,29.02％).Conclusion The key to effec-tively reduce the occurrence of occupational exposure and its adverse consequences is to implement key management for key groups,key places and key times,emphasize the importance of occupational safety education,and actively carry out relevant training and emergency drills.

Humans ; Mechanistic Target of Rapamycin Complex 2/metabolism* ; Multiprotein Complexes/metabolism* ; Neural Stem Cells/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; Rapamycin-Insensitive Companion of mTOR Protein/metabolism* ; TOR Serine-Threonine Kinases/metabolism*

Objective: The mitotic count of gastrointestinal stromal tumors (GIST) is closely associated with the risk of planting and metastasis. The purpose of this study was to develop a predictive model for the mitotic index of local primary GIST, based on deep learning algorithm. Materials and Methods: Abdominal contrast-enhanced CT images of 148 pathologically confirmed GIST cases were retrospectively collected for the development of a deep learning classification algorithm. The areas of GIST masses on the CT images were retrospectively labelled by an experienced radiologist. The postoperative pathological mitotic count was considered as the gold standard (high mitotic count, > 5/50 high-power fields [HPFs]; low mitotic count, ≤ 5/50 HPFs). A binary classification model was trained on the basis of the VGG16 convolutional neural network, using the CT images with the training set (n = 108), validation set (n = 20), and the test set (n = 20). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated at both, the image level and the patient level. The receiver operating characteristic curves were generated on the basis of the model prediction results and the area under curves (AUCs) were calculated. The risk categories of the tumors were predicted according to the Armed Forces Institute of Pathology criteria. Results: At the image level, the classification prediction results of the mitotic counts in the test cohort were as follows:sensitivity 85.7% (95% confidence interval [CI]: 0.834–0.877), specificity 67.5% (95% CI: 0.636–0.712), PPV 82.1% (95% CI: 0.797–0.843), NPV 73.0% (95% CI: 0.691–0.766), and AUC 0.771 (95% CI: 0.750–0.791). At the patient level, the classification prediction results in the test cohort were as follows: sensitivity 90.0% (95% CI: 0.541–0.995), specificity 70.0% (95% CI: 0.354–0.919), PPV 75.0% (95% CI: 0.428–0.933), NPV 87.5% (95% CI: 0.467–0.993), and AUC 0.800 (95% CI: 0.563–0.943). Conclusion We developed and preliminarily verified the GIST mitotic count binary prediction model, based on the VGG convolutional neural network. The model displayed a good predictive performance.

Objective: To investigate the correlation between serum asymmetric dimethylarginine (ADMA) and cystatin C (CysC) in degenerative calcific aortic valvular disease and its clinical application value. Methods: One hundred and eighty patients with degenerative calcific aortic valvular disease who were treated in Beijing Luhe Hospital Affiliated to Capital Medical University from June 2016 to June 2018 were selected as the study subjects, and another 82 healthy subjects from the same hospital in the same period were selected as the control group. Serum ADMA and CysC levels were detected by enzyme-linked immunosorbent assay and latex-enhanced immunoturbidimetric assay. Risk factors of degenerative calcific aortic valvular disease were analyzed by Logistic regression analysis. Evaluation of the diagnostic efficacy of serum ADMA and CysC for degenerative calcific aortic valvular disease was used by receiver operating characteristic curve. Results: There were no significant differences in the general data between the two groups in terms of age, gender, body mass index, drinking history, smoking history, and history of hypertension (P>0.05). The systolic blood pressure(SBP), diastolic blood pressure (DBP), heart rate (HR), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterin(LDL-C), CysC and ADMA levels of the study group were significantly higher than those of the control group [(131.51 ± 19.09) mmHg (1 mmHg=0.133 kPa) vs. (126.48 ± 16.68) mmHg, (91.11 ± 16.35) mmHg vs. (86.89 ± 10.71) mmHg, (74.39 ± 15.22) beats/min vs. (70.09 ± 13.01) beats/min, (4.51 ± 1.12) mmol/L vs. (4.15 ± 0.92) mmol/L, (1.91 ± 0.63) mmol/L vs. (1.60 ± 0.65) mmol/L, (2.59 ± 1.13) mmol/L vs. (2.27 ± 0.85) mmol/L, (1.01 ± 0.22) mg/L vs. (0.79 ± 0.16) mg/L, (20.17 ± 6.38) ng/L vs. (11.88 ± 4.22) ng/L], and left ventricular ejection fraction (LVEF), high density lipoprotein cholesterin (HDL-C) levels were significantly lower than those of the control group [(56.45 ± 9.21)%vs. (60.87 ± 10.02)%, (1.56 ± 0.63) mmol/L vs. (1.76 ± 0.62) mmol/L], there were significant differences (P<0.05). Logistic multivariate regression analysis showed that serum CysC and ADMA were independent risk factors for degenerative calcific aortic valvular disease (P<0.05). Receiver operator characteristic (ROC) curve analysis showed that area under curve (AUC) of serum CysC for degenerative valvular heart disease was 0.785, with a sensitivity of 71.67%, and a specificity of 73.17%. The AUC of serum ADMA for degenerative valvular heart disease was 0.862, with a sensitivity of 71.67%, and a specificity of 87.80%. The AUC of serum CysC combined with ADMA in the diagnosis of degenerative valvular heart disease was 0.910, with a sensitivity of 85.56%, and a specificity of 84.15%, which was significantly higher than the two alone (Z=4.897 and 3.335, P<0.05). Conclusions Serum ADMA is positively correlated with CysC in patients with degenerative valvular heart disease, and can be used as diagnostic serum markers for degenerative calcific aortic valvular disease. It has clinical reference value for improving the diagnosis of degenerative calcific aortic valvular disease.

Objective: To study the correlation between left atrial sphericity (LASP) and thromboembolic events (TE) in patients with atrial fibrillation (AF). Methods: This study was conducted in patients with AF underwent radiofrequency ablation in the Department of Cardiology of First Affiliated Hospital of Zhengzhou University from January 2011 to October 2018. The AF patients with TE (study group, n=157) and the AF patients without TE (control group, n=157) were matched for age and gender. The differences of LASP and other related indexes between the two groups were compared, and the correlation between LASP and TE was analyzed by conditional logistic regression. The receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of LASP for TE. Results: (1) The LASP in the study group was significantly higher than that in the control group [ (87.5±7.1) % vs. (82.8±6.1) %, P=0.001]. (2) Conditional logistic regression analyses showed that LASP (OR=1.10, 95%CI 1.05-1.16, P=0.001), left atrial volume index (OR=1.01, 95%CI 1.00-1.02, P=0.016) and CHA₂D-VASc score (OR=1.77, 95%CI 1.30-2.41, P=0.001) were independently and positively correlated with TE. (3) The ROC curve analysis showed that the area under the curve (AUC) of left atrial sphericity (AUC=0.712, 95%CI 0.656-0.768, P=0.001) was larger than the AUC of either left atrial volume index (AUC=0.650, 95%CI 0.589-0.710, P=0.001) or CHA₂D-VASc score (AUC=0.612, 95%CI 0.550-0.674, P=0.001). (4) CHA₂D-VASc-LASP₂ score was positively correlated with TE (OR=1.95, 95%CI 1.55-2.42, P=0.001). Conclusion LASP is independently and positively correlated with TE in patients with AF.

Objectives: To explore the expression regulation of type 1 and type 2 (Th1 and Th2) cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis, 630 coal miners were studied. Methods: A total of 90 male patients diagnosed as coal workers' pneumoconiosis (CWP) in a institute for occupational health and 19 male workers newly diagnosed as CWP patients was chosen as CWP group with simple random sampling method from a coal mine group from January 2013 to December in 2015. 180 male coal miners with abnormal but not diagnosed as CWP were selected as CWP suspected group with simple random sampling methods, meanwhile 180 male coal miners with normal chest X-ray photograph was as dust-exposed group by 1∶1 matched as age. And 161 healthy males accepted pre-employed examination were selected as control group, CWP suspected group, dust-exposed group and control group called as non-CWP group. According to screening test and diagnosis test, the basic information and occupational history of all subjects were collected, and cytokines including IL-1β, IL-8, IFN-γ, IL-6 and IL-10 of serum were detected. Receiver operator characteristic (ROC) curve was used to determine the optimal cutoff value of each cytokine. Area under curve (AUC), the validity and reliability were calculated and judged. Results: The average age of control group, dust-exposed group, CWP suspected group and CWP group were (27.4±5.0) , (43.4±10.7) , (48.2±6.2) , (64.7±7.0) years old, respectively. The median level of IL-1β, IL-8, IFN-γ and IL-6 in cases group (1 638.30, 2 099.49, 815.18,140.32 pg/ml) were higher than that of non-cases group (1 445.57, 1 402.26, 736.38, 95.73 pg/ml) (P<0.05) . The level of IL-8 (1 503.99 pg/ml) in CWP suspected group was higher than that of control group (1 295.67 pg/ml) and dust-exposed group (1 376.94 pg/ml) , but the level of IL-10 (654.08 pg/ml) was lower than that of control group (596.64 pg/ml) . The ratio of IFN-γ/IL-6 ranged from 5 to 8, and the ratio in CWP group (5.87) was lower than that of non-CWP group (7.61) . The IL-6 and IL-8 among the subjects of dust-exposed group in terms of the age distribution of among had reached statistical significance. According to ROC, the cutoff value of IL-1β, IL-6, IL-8, IL-10 and INF-γ reached 1 582.65, 116.53, 1 791.54, 581.08 and 792.69 pg/ml, respectively. The AUC was 0.668, 0.895, 0.859, 0.716 and 0.637, respectively. It was found that IL-6 and IL-8 could be used as biomarkers in detecting CWP, the sensitivity and specificity was 82.6% and 84.6%, 78.0% and 84.8%, respectively; Youden's index was 0.674 and 0.628 and the consistency rate was 84.3% and 83.7%, while Kappa value was 0.55 and 0.52. Conclusion There was Type 1 and type 2 cytokine dysregulation in CWP patients. IL-6 and IL-8 can be used as effective biomarkers to forecast lung injury before X-ray changes.