Objective To investigate and analyze the occupational stress levels and influencing factors among radiation workers in China, and provide a reference for alleviating occupational stress and promoting mental health. Methods Using the general situation questionnaire, Effort-Reward Imbalance questionnaire, and radiation protection knowledge questionnaire, a convenience sampling method was adopted to investigate the occupational stress of 243 radiation workers in Liaoning, Fujian, Guangdong, and Xinjiang provinces. The independent samples t-test, one-way analysis of variance, chi-square test, and binary logistic regression were used to analyze the influencing factors. Results The average score of Effort-Reward Imbalance was 0.97 ± 0.22, and 100 (41.15%) radiation workers had occupational stress. There were significant differences in the detection rate of occupational stress among radiation workers of different ages, working years in radiation positions, monthly incomes, daily sleep durations, and daily working hours (P < 0.05). Logistic regression analysis identified daily working hours as a factor contributing to occupational stress. Conclusion The occupational stress among radiation workers in China is relatively severe. It is recommended to pay attention to the associated risks and implement targeted intervention measures to reduce the impact of occupational stress.

OBJECTIVE: To investigate the safety and prognostic factors influencing the treatment of upper urinary tract urothelial carcinoma (UTUC) combined with bladder cancer (BCa) by laparoscopic simultaneous radical cystectomy and nephroureterectomy (RCNU). METHODS: The clinical data of patients admitted to Peking University Third Hospital for laparoscopic RCNU surgery from January 2009 to September 2023 were analyzed retrospectively. Based on the same gender, age (±5 years), history of uroepithelial tumors, underlying diseases, T-stage, N-stage, M-stage, American Society of Anesthesiologists (ASA) score, Charlson comorbidity index, and body mass index (BMI) (±5), 34 patients with RCNU were matched 1 ∶1 with patients with bladder cancer who underwent laparoscopic radical cystectomy (RC) alone. Kaplan-Meier survival analysis was used to calculate patient survival, and Cox proportional regression risk model was used to analyze clinical factors affecting prognosis. RESULTS: Of the 68 patients enrolled, the follow-up rate was 100% with a median follow-up time of 27.0 (11.7, 60.2) months. Comparison of intraoperative conditions (including operation time, estimated intraoperative bleeding, intra-operative blood transfusion, etc.) between the two groups of patients showed no significant difference (P>0.05). Comparison of preoperative creatinine and postoperative creatinine between the two groups of patients showed significant differences (P < 0.05). The perioperative Clavien grade Ⅲ-Ⅳ complication rates were 2.9% (1/34) in the RC group and 5.9% (2/34) in the RCNU group. There was no significant difference in terms of perioperative complications between the two groups. Overall survival was significantly lower in the patients receiving RCNU compared with the matched group receiving RC alone (P < 0.05). Cox regression analysis suggested that two factors, high N stage and high postoperative creatinine, were independent risk factors affecting the prognosis of patients in the 2 groups (P < 0.05). CONCLUSION The overall survival prognosis of patients undergoing RCNU surgery was worse compared with laparoscopic RC surgery alone during the same period. There was no clinically significant difference between the two groups in terms of operation time, intraoperative bleeding, and perioperative complications, and there were clinically significant differences in preoperative renal function and post-operative renal function.
Humans ; Laparoscopy/methods* ; Nephroureterectomy/methods* ; Cystectomy/methods* ; Prognosis ; Male ; Retrospective Studies ; Female ; Urinary Bladder Neoplasms/mortality* ; Middle Aged ; Aged

Objective To analyze the impact of different maze structures of medical electron linear accelerator on the radiation level at the entrance of the treatment room. Methods The Monte Carlo simulation method was used to compare the radiation field distribution in two accelerator rooms with different maze widths and to conduct a detailed analysis of the radiation levels. Results The radiation level at the entrance of the accelerator room with a wide maze was significantly higher than that at the entrance of a compact maze. The neutron radiation level at the entrance of the narrow maze model decreased by 38.6% compared to the wide maze model, and the level of X-ray radiation also showed a declining trend. Conclusion When designing medical electron linear accelerators, a compact maze structure should be adopted to reduce the setting of unnecessary space, thereby lowering the radiation level at the entrance of the treatment room and enhancing the effectiveness of radiation protection.

Objective To investigate the current situation of occupational stress among radiation workers in nuclear power plants in China, to explore the factors influencing occupational stress, and to provide a reference for improving occupational stress. Methods A convenient sampling method was adopted to investigate the occupational stress of 100 radiation workers in two nuclear power plants in Fujian and Liaoning, using the general situation questionnaire, effort-reward imbalance questionnaire, and the radiation protection knowledge questionnaire. Independent samples t-test, one-way analysis of variance, chi-square test, and binary logistic regression analysis were used to examine the current situation of occupational stress and the influencing factors. Results The average value of effort-reward imbalance was 0.99 ± 0.15 and 47 (47%) radiation workers had occupational stress. There were significant differences in the detection rate of occupational stress among radiation workers with different ages, years of radiation work, monthly incomes, sleep durations (day), and exercise habits (P < 0.05). Logistic regression analysis showed that monthly income, sleep duration (day), and exercise habits were the influencing factors for occupational stress. Conclusion The occupational stress of radiation workers in nuclear power plants is a serious issue influenced by many factors. Attention should be given to this issue, and targeted interventions should be implemented to improve the social and working environment of this occupational group and reduce the level of occupational stress.

The new generation of artificial intelligence technology,represented by deep learning,has emerged as a crucial driving force in the advancement of new drug research and development.This article creatively proposes a workflow named"Molecular Factory"for the design and optimization of drug molecules based on artificial intelligence technology.This workflow integrates intelligent molecular generation models,high-performance molecular docking algorithms,and accurate protein-ligand binding affinity prediction methods.It has been integrated as a core module into DrugFlow,a one-stop drug design software platform,providing a comprehensive set of mature solutions for the discovery and optimization of lead compounds.Utilizing the"Molecular Factory"module,we conducted the research of second-generation inhibitors against Menin that can combat drug resistance.Through the integration of computational and experimental approaches,we rapidly identified multiple promising compounds.Among them,compound RG-10 exhibited the IC50 values of 9.681 nmol/L,233.2 nmol/L,and 40.09 nmol/L against the wild-type Menin,M327I mutant,and T349M mutant,respectively.Compared to the positive reference molecule SNDX-5613,which has entered Phase Ⅱ clinical trials,RG-10 demonstrated significantly enhanced inhibitory activity against the M327I and T349M mutants.These findings fully demonstrate the unique advantages of the"Molecular Factory"technology in practical drug design and development scenarios.It can rapidly and efficiently generate high-quality active molecules targeting specific protein structures,holding significant value and profound implications for advancing new drug discovery.

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Objective:To explore the clinical efficacy of adult donor dual kidney transplantation.Methods:Retrospective analysis of case data of 13 adult donor kidney dual kidney transplantation (DKT) performed in the The Second Xiangya Hospital of Central South University from September 2016 to December 2020. For 13 donors, the average age and BMI were (53.5±12.4)years and (24.3±2.8) kg/m 2, respectively. Their mean Serum creatinine (SCr) at admission and before procurement was (132.9±54.1)and (228.7±112.4)μmol/L, respectively. 3 of them had diabetes mellitus history, and 8 had hypertension history. 11 met the United Network for Organ Sharing (UNOS) DKT criteria and 6 met Remuzzi score DKT criteria. For 13 recipients, the average age and BMI were (39.3±8.9)years and (20.2±2.4)kg/m 2, respectively. All of them received ABO blood type-matched kidney transplants. 2 of them had their grafts transplanted in the bilateral iliac. In 12 cases, the grafts filled rapidly and urinated immediately when opening blood flow. In 1 case, the grafts were dark in color and vascular showed weak pulsation after opening blood flow. The time to recovery of perioperative graft function (from the day of surgery to the natural reduction of SCr to the normal range 44-133μmol/L), the occurrence of delayed graft function (DGF), acute rejection (AR), ureteral and surgical incision complications, as well as the recipients’ final follow-up SCr, eGFR, urinary protein, and grafts outcome were observed. Risk factors affecting outcomes were assessed by univariate logistic regression analysis. Results:The SCr dropped to the normal range at discharge in 10 recipients, and the average recovery time was (13.8±13.0) days. In other 3 cases SCr at discharge were 300.0, 149.0, 152.5μmol/L. 4 cases had DGF, 4 had AR, 1 experienced urinary fistula, and 1 experienced incisional dehiscence, which were treated with anti-rejection, J-tube implantation, continuous catheterization to maintain bladder void, secondary suturing, respectively. The follow-up time ranged from 4 to 54 months, with a median of 28(15.5, 31.0) months. At the final follow-up time, 10 cases had good graft function, 2 suffered impaired kidney function, and 1 experienced graft failure. The average SCr and eGFR except for graft failure patient were (144.2±101.3)μmol/L and (52.9±21.2)ml/min, respectively. 4 had positive urine protein. Univariate logistic regression analysis showed that donor age, BMI, history of diabetes mellitus and hypertension, and SCr were not significantly correlated with recipients’ DGF and graft impairment ( P>0.05), and due to the small sample size, multifactorial logistic regression analysis was not performed. Conclusion:The short to medium-term effects of adult donor DKT coule be safe and feasible.

In recent years, occupational stress has become a focus of public attention in public health in China and abroad. Radiation workers are exposed to ionizing radiation in their daily work, which further exacerbates their levels of occupational stress. This not only affects their physical and mental health, but also increases the potential for radiation incidents or accidents. Based on the literature on occupational stress among radiation workers in China throughout the years, this article provides a summary, conclusion, and systematical analysis of the research status of occupational stress among radiation workers, with a detailed sorting of the data. It explores key research issues and directions and provides reference for future work.

Objective:To conduct radiation detection and dose assessment in selective internal radiotherapy with 90Y resin microspheres for the purpose of providing a reference for radiological protection. Methods:The dose rates from radiotherapy with 90Y resin microspheres were detected in the process of each operation at different distances from the body surface of patients the levels of dose to the persons concerned were compared with the relevant national regulations and standards. Results:The estimated dose rates were 1.12-454 μSv/h during 90Y resin microspheres dispensing and 2.06-58.2 μSv/h during surgical procedure. The dose rates at 0.5 h after surgery were 22.7-64.1 μSv/h at 5 cm and 0.82-2.55 μSv/h at 1 m from three patient′s body surface. Assuming treating 200 patients a year, the annual individual effective dose to the radiation workers was 0.12-1.03 mSv/year. The annual individual effective dose to the public, comforters and carers of patients was 0.02-0.24 mSv/year after release of a patient. Conclusions:During the treatment, nursing and release of patients, the radiation doses to workers, carers and the public are lower than the individual dose limit given in the GB18871-2002 basic standards for protection against ionizing radiation and for the safety of radiation sources and the management target value set by of the relevant medical institutions.

Objective:To evaluate 90Y activity concentration in renal excretions during the first 48 hours after being treated with 90Y resin microspheres seleceive internal radiation therapy(SIRI) and to provide advice on the management of patient excreta after surgery. Methods:After surgery, urine excreted from 3 patients during 0-24 h and 24-48 h was collected respectively, and the 90Y activity concentration in urine was tested and analyzed. Results:90Y radioctivity in the urine excreted from 3 patients after surgery was (1 266±258)kBq/GBq during 0-24 h and (140±106) kBq/GBq during 24-48 h, respectively, and 90Y activity concentration were (640±113) kBq/L during 0-24 h and (53±12) kBq/L during 24-48 h. Conclusions:90Y radioactivity in patient′s urine excreted at 1 d was about 10 times higher than that at 2 d. After surgery, patients can accelerate the reduction of free 90Y activity by increasing excretion. Urine excreted by the patients during hospitalization should be handled in accordance with the requirements of the national standard HJ 1188-2021 Radiation protection and safety requirements for nuclear medicine.