Objective:To investigate the alteration and regulatory of macrophage subtypes and the underlying mechanisms of cellular interactions in mouse photoaged skin.Methods:Immune cell type identification was performed by estimating relative subpopulations of RNA transcripts (CIBERSORT) on 18 samples from the public dataset GSE58915. A total of 15 healthy male C57BL/6J mice aged 6-8 weeks were exposed to an animal UV-radiation chamber for 4 weeks (4W-UV group) and 8 weeks (8W-UV group). Skin samples were collected for hematoxylin-eosin staining, Masson staining, immunohistochemistry and immunofluorescence to evaluate skin architecture, inflammatory status and macrophage infiltration. Dermal fibroblasts of passages 3-5 were irradiated daily at 36 mW/cm2 for 7 days to establish a photoaged model; senescence-associated indicators were detected by β-galactosidase staining and Western blot. A co-culture system of photoaged fibroblasts and mouse monocyte-macrophages was then constructed; phagocytosis assays and flow cytometry were employed to determine the phagocytic capacity and polarization of monocyte-macrophages.Results:The number of M1 macrophages in mouse skin increased with UV-radiation duration; M1 counts in the 8W-UV and 4W-UV groups were (17.2±4.7) and (10.3±2.1) cells/HPF, respectively, both higher than the (3.8±0.7) cells/HPF observed in the control group (both P<0.01). Monocyte-macrophages treated with supernatant from photoaged fibroblasts exhibited enhanced phagocytic activity and a higher proportion of CD86-positive cells. Conclusions:Prolonged UV radiation aggravates photoaging and increases M1-macrophage infiltration in skin tissue. Cytokines secreted by photoaged fibroblasts induce M1 polarization of macrophages.

Objective:To investigate the alteration and regulatory of macrophage subtypes and the underlying mechanisms of cellular interactions in mouse photoaged skin.Methods:Immune cell type identification was performed by estimating relative subpopulations of RNA transcripts (CIBERSORT) on 18 samples from the public dataset GSE58915. A total of 15 healthy male C57BL/6J mice aged 6-8 weeks were exposed to an animal UV-radiation chamber for 4 weeks (4W-UV group) and 8 weeks (8W-UV group). Skin samples were collected for hematoxylin-eosin staining, Masson staining, immunohistochemistry and immunofluorescence to evaluate skin architecture, inflammatory status and macrophage infiltration. Dermal fibroblasts of passages 3-5 were irradiated daily at 36 mW/cm2 for 7 days to establish a photoaged model; senescence-associated indicators were detected by β-galactosidase staining and Western blot. A co-culture system of photoaged fibroblasts and mouse monocyte-macrophages was then constructed; phagocytosis assays and flow cytometry were employed to determine the phagocytic capacity and polarization of monocyte-macrophages.Results:The number of M1 macrophages in mouse skin increased with UV-radiation duration; M1 counts in the 8W-UV and 4W-UV groups were (17.2±4.7) and (10.3±2.1) cells/HPF, respectively, both higher than the (3.8±0.7) cells/HPF observed in the control group (both P<0.01). Monocyte-macrophages treated with supernatant from photoaged fibroblasts exhibited enhanced phagocytic activity and a higher proportion of CD86-positive cells. Conclusions:Prolonged UV radiation aggravates photoaging and increases M1-macrophage infiltration in skin tissue. Cytokines secreted by photoaged fibroblasts induce M1 polarization of macrophages.

Objective:To explore the relevant risk factors for deep venous thrombosis (DVT) of lower limb occurring 3 months after joint replacement surgery.Methods:A retrospective analysis was conducted on the clinical data of 1,782 patients who underwent joint replacement surgery at Drum Tower Hospital, School of Medicine of Nanjing University, from February 2015 to December 2018. Of these, 1,298 were male and 484 were female, with an average age of 65.4±12.3 years (range, 18-95 years). Fourteen factors associated with DVT occurrence at 3 months were investigated, including age, gender, body mass index (BMI), season of surgery, preoperative coagulation function, type of surgery, selection of minimally invasive approach, occurrence of lower limb venous thrombosis 1 day after surgery, history of previous thrombotic diseases, smoking, tumors, diabetes, hypertension, and heart disease. Independent sample t-tests and chi-square tests were used to analyze the risk factors for DVT occurrence. Indicators with statistically significant differences were included in a binary logistic regression analysis to determine the risk factors for DVT 3 months after surgery. The risk prediction model was established according to the results of logistic regression analysis, and the receiver operating characteristic curve was drawn. The area under the curve of the prediction model was calculated. Results:A total of 1,782 patients were included. The overall incidence of DVT occurring 3 months after joint replacement surgery was 10.5% (187/1,782). The thrombosis group included 5 symptomatic cases and 182 asymptomatic cases, with 13 proximal and 174 distal cases. DVT was found in the iliac vein (1 case), femoral vein (10 cases), popliteal vein (8 cases), peroneal vein (14 cases), and intramuscular vein (168 cases). Single-factor analysis showed that female gender, increasing age, previous thrombotic disease, hypertension, surgery in autumn, and the occurrence of DVT on the first day after surgery were correlated with DVT occurring 3 months after joint replacement surgery ( P<0.05). After excluding the missing data, a total of 1,744 patients were included in the final analysis. DVT occurrence on the first day after surgery [ OR=7.498, 95% CI (5.312, 10.584), P<0.001], surgery in autumn [ OR=1.834, 95% CI (1.215, 2.769), P=0.004], age [ OR=1.024, 95% CI (1.007, 1.042), P=0.009], female gender [ OR=1.863, 95% CI(1.184, 2.931), P=0.007], and history of previous thrombotic diseases [ OR=0.012, 95% CI (1.136, 2.830), P=0.012] were found to be associated with DVT occurrence at 3 months after surgery. The area under the curve (AUC) for predicting DVT three months after hip or knee arthroplasty was 0.803 [95% CI (0.761, 0.844)]. Conclusion:Advanced age, female gender, history of previous thrombotic diseases, occurrence of DVT on the first day after surgery, and surgery in autumn are risk factors for DVT occurring 3 months after joint replacement surgery.

Objective:To explore the relevant risk factors for deep venous thrombosis (DVT) of lower limb occurring 3 months after joint replacement surgery.Methods:A retrospective analysis was conducted on the clinical data of 1,782 patients who underwent joint replacement surgery at Drum Tower Hospital, School of Medicine of Nanjing University, from February 2015 to December 2018. Of these, 1,298 were male and 484 were female, with an average age of 65.4±12.3 years (range, 18-95 years). Fourteen factors associated with DVT occurrence at 3 months were investigated, including age, gender, body mass index (BMI), season of surgery, preoperative coagulation function, type of surgery, selection of minimally invasive approach, occurrence of lower limb venous thrombosis 1 day after surgery, history of previous thrombotic diseases, smoking, tumors, diabetes, hypertension, and heart disease. Independent sample t-tests and chi-square tests were used to analyze the risk factors for DVT occurrence. Indicators with statistically significant differences were included in a binary logistic regression analysis to determine the risk factors for DVT 3 months after surgery. The risk prediction model was established according to the results of logistic regression analysis, and the receiver operating characteristic curve was drawn. The area under the curve of the prediction model was calculated. Results:A total of 1,782 patients were included. The overall incidence of DVT occurring 3 months after joint replacement surgery was 10.5% (187/1,782). The thrombosis group included 5 symptomatic cases and 182 asymptomatic cases, with 13 proximal and 174 distal cases. DVT was found in the iliac vein (1 case), femoral vein (10 cases), popliteal vein (8 cases), peroneal vein (14 cases), and intramuscular vein (168 cases). Single-factor analysis showed that female gender, increasing age, previous thrombotic disease, hypertension, surgery in autumn, and the occurrence of DVT on the first day after surgery were correlated with DVT occurring 3 months after joint replacement surgery ( P<0.05). After excluding the missing data, a total of 1,744 patients were included in the final analysis. DVT occurrence on the first day after surgery [ OR=7.498, 95% CI (5.312, 10.584), P<0.001], surgery in autumn [ OR=1.834, 95% CI (1.215, 2.769), P=0.004], age [ OR=1.024, 95% CI (1.007, 1.042), P=0.009], female gender [ OR=1.863, 95% CI(1.184, 2.931), P=0.007], and history of previous thrombotic diseases [ OR=0.012, 95% CI (1.136, 2.830), P=0.012] were found to be associated with DVT occurrence at 3 months after surgery. The area under the curve (AUC) for predicting DVT three months after hip or knee arthroplasty was 0.803 [95% CI (0.761, 0.844)]. Conclusion:Advanced age, female gender, history of previous thrombotic diseases, occurrence of DVT on the first day after surgery, and surgery in autumn are risk factors for DVT occurring 3 months after joint replacement surgery.

OBJECTIVE: To investigate the feasibility and effectiveness of "tail compression fixation+suture bridge" technology under shoulder arthroscopy for treating primary tear in medial enthesis of rotator cuff. METHODS: The clinical data of 11 patients with primary tear in medial enthesis of rotator cuff who met the selection criteria between October 2020 and October 2022 were retrospectively analyzed, including 3 males and 8 females, aged 39-79 years, with an average of 61.0 years. Rotator cuff injury was caused by traumatic fall in 8 cases, and the time from injury to admission was 1-4 months, with an average of 2.0 months; the remaining 3 cases had no obvious inducement. The active range of motion of the affected shoulder was limited, with an active forward flexion range of motion of (64.1±10.9)°, abduction of (78.1±6.4)°, internal rotation of (48.2±6.6)°, and external rotation of (41.8±10.5)°; 5 cases had shoulder stiffness. The preoperative visual analogue scale (VAS) score was 7.8±0.8 and the American Society of Shoulder and Elbow Surgeons (ASES) score was 23.9±6.4. The patients were treated with "tail compression fixation+suture bridge" technology under shoulder arthroscopy, and the pain and functional recovery were evaluated by VAS score, ASES score, and active range of motion of shoulder joint at last follow-up; MRI was performed after operation, and the integrity of rotator cuff was evaluated by Sugaya classification system. RESULTS: All the 11 patients were followed up 2-22 months, with an average of 13.5 months. All incisions healed by first intention, and there was no complication such as infection, rotator cuff re-tear, and anchor falling off. At last follow-up, the VAS score was 0.8±0.7 and the ASES score was 93.5±4.2, which significantly improved when compared with those before operation ( P<0.05). All 11 patients had no significant swelling in the shoulders, and the active range of motion was (165.1±8.8)° in flexion, (75.3±8.4)° in abduction, (56.6±5.5)° in internal rotation, and (51.8±4.0)° in external rotation, which significantly improved when compared with those before operation ( P<0.05). Shoulder MRI showed adequate tendon thickness and good continuity in 9 cases, including 4 cases with partial high signal area; and 2 cases with inadequate tendon thickness but high continuity and partial high signal area. According to Sugaya classification system, there were 4 cases of type 1 (36.4%), 5 cases of type 2 (45.5%), and 2 cases of type 3 (18.1%). CONCLUSION For the patients with primary tear in medial enthesis of rotator cuff, the "tail compression fixation+suture bridge" technology under shoulder arthroscopy is simple and effective.
Male ; Female ; Humans ; Rotator Cuff/surgery* ; Shoulder ; Arthroscopy ; Retrospective Studies ; Treatment Outcome ; Rotator Cuff Injuries/surgery* ; Rupture ; Shoulder Joint/surgery* ; Sutures ; Range of Motion, Articular

Background The complex and diverse occupational disease hazards in automobile manufacturing industry pose high occupational health risks to workers. Objective To explore the methods that can accurately reflect the workplace health risk grade of automobile manufacturing enterprises, and to guide enterprises to practice risk classification management. Methods Comprehensive index method, International Commission on Mining and Metals occupational health risk assessment method (ICMM method), and risk index method were used toassess health risks of occupational disease hazards in major workstations such as welding, polishing, and painting in three automobile manufacturing enterprises in Hunan Province. Kappa consistency test was used to test the grading results of the three assessment methods. The re-examine results and detection rate of contraindications of occupational health examinations in the past three years were used to verify the assessment results. Results The results of comprehensive index method showed that the hazards of each selected workstation in enterprises A and B were evaluated as grade 2-3, among which NO₂ in enterprise A was grade 3, and welding fume, NO₂, and formaldehyde in enterprise B were all grade 3. The hazards of each selected workstation in enterprise C were grade 3-4, among which NO₂ and benzene in were grade 4, and welding fume, manganese and its compounds, grinding wheel dust, and xylene were grade 3. The hazards evaluated by ICMM quantitative method were grade 2 and grade 5, among which manganese and its compounds in enterprise A and welding fume, grinding wheel dust, and benzene series in enterprise C were graded as grade 5. The hazards evaluated by risk index method were grade 1-4, among which manganese and its compounds in enterprises A and B were grade 3, and manganese and its compounds and benzene in enterprise C were grade 4. The Kappa value between comprehensive index method and ICMM method was 0.084 (P>0.05), that between comprehensive index method and risk index method was −0.046 (P>0.05), and that between ICMM method and risk index method was 0.014 (P>0.05), indicating poor consistency. By comparing the results of occupational health surveillance with the results of occupational health risk assessment, one worker was found to have occupational contraindication of manganese exposure and 1 worker was found to have excessive manganese in hair in enterprise A. However, the comprehensive index method graded low risk for manganese and its compounds in enterprise A and the result is conservative. The key workstations identified by ICMM method were consistent with the occupational health examination results, but the assessment grades were all extremely high risk, and the results were too strict. One worker was found to be contraindicated to welding fumes, and 2 polishers were found to have severe mixed pulmonary ventilation dysfunction in enterprise C. Mild and moderate pulmonary ventilation dysfunction was found to be common in welding and polishing workstations in each enterprise. The assessment results of welding fumes and grinding wheel dust by the risk index method were negligible risks, which were inconsistent with the occupational health examination results. Conclusion The comprehensive index method, ICMM method, and risk index method can basically identify workstations with serious occupational hazards, but they have certain limitations and applicability. In general, the evaluation results of the comprehensive index method were generates more consistent with the results with occupational health surveillance than the other two methods, is more comprehensive and objective in consideration, and is more suitable for health risk assessment of automobile manufacturing enterprises.

Background The mining of non-coal underground mines may come into contact with various types of dust, such as lead, zinc, copper, and non-metallic minerals. Dust of various kinds commonly exists in all aspects of mining and selection, and is one of the main occupational hazard groups in non-coal underground mines. Objective To compare the application of two risk assessment methods in the occupational health risk assessment of productive dust in non-coal underground mines, and to provide a reference for the selection of dust hazard health risk assessment methods and the management of dust hazards in non-coal mines. Methods A field investigation of the dust hazards of three typical non-coal underground mining enterprises (lead-zinc mines, copper mines, and fluorite mines) was carried out, and the comprehensive index method and the occupational health risk assessment method from the International Council on Mining and Metals (ICMM) were used to perform risk assessments. The comprehensiveindex method considers the following factors: dust monitoring data, the aerodynamic diameter of dust, hazard control measures, occupational health management, daily usage, and daily exposure time to determine exposure levels. The ICMM method determines the risk level based on the consequences caused by dust, exposure probability, exposure time, and uncertainty coefficient. Kendall consistency test was used to compare agreement between the results generated by the two methods. Results The results generated by the comprehensive index method were as follows: level 3 (medium risk) or level 4 (high risk) for silica dust or lead dust; level 1 (negligible risk) or level 2 (low risk) for other dust (dust with free SiO₂ content<10% and containing lead, zinc, and copper, using other dust limit values for comparison), fluorspar mixed dust, fluorine and its compounds, zinc oxide, and copper dust. The risk levels graded by the ICMM method were as follows: level 4 (very high risk) and level 3 (high risk) for exposure to silica dust and lead dust, respectively, and level 1 (tolerable risk) or level 2 (potential risk) for exposure to other dust (dust with free SiO₂ content <10% and containing lead, zinc, and copper, using other dust limit values for comparison), fluorspar mixed dust, fluorine and its compounds, zinc oxide, and copper dust. The consistency level between the results graded by the two methods was very high (Kendall W coefficient=0.974, P < 0.05). Conclusion For the occupational health risk assessment of productive dust in non-coal underground mines, the consistency level of risk assessment results between the ICMM method and the comprehensive index method is very high. The ICMM method is more convenient to operate and should be preferred in assessing health risks of dust hazard in non-coal underground mines.

Objective:To compared theclinic effectiveness ofBikini incision with that of traditional incisionbased on a short-term following and provide a suggesting reference for surgeons.Methods:The data of patients who accepted total hip arthroplasty (THA) through direct anterior approach (DAA) from January to November in 2019 were collected, male 13 and female 73, age 67.5±11.8 years (42-90 years). Forty-three patients were recruited to analyzeas one retrospective study in each group. Bikini incision: male 5 and female 38; age 69.7±10.8 years (51-90 years), following up 5.7 months (3.0-8.5 months). Traditional incision: male 8 and female 35; age 66.1±10.6 years (42-90 years), following up 6.5 months (3.0-10.0 months). The length area of incision, duration of operation, intraoperative blood loss, the rate of infection, lateral femoral cutaneous nerve (LFCN) deficits, and the Harris score were analyzed between those two groups. The scars were evaluated according toPatients Scar Assessment Scale and Vancouver Scar Scale.Results:There were no significant difference in age, sex, BMI and diseases distribution between Bikini and traditional incision group. The length of incision, duration of operation, analgesic drugs dosage and hip Harris score wereanalysed no significant difference between those two groups. No patients in those twogroupssuffered from infection of incision. As to LFCN deficits, Bikini group had lower than traditional group (11.6% vs 32.6%, P=0.019). The scar area of Bikini group 1.0±0.4 cm 2 wasmeasured smaller rate than that of traditional group 16.5±28.7 cm 2. As to the Patients Scar Assessment Scale and Vancouver Scar Scale, Bikini group was 8.2±3.2 and 2.4±1.8, which was better than traditional group which was 17.0±5.8 and 4.2±3.0. Conclusion:Compared to traditional incision, Bikini incision was evaluated having significant lower rate of LFCN deficits and smaller scar,good cosmetic appearance and clinical application value.

Many studies have shown that the incidence of type 1 diabetes mellitus (T1DM) is increasing with an annual of 2％ to 5％.As the same with type 2 diabetes mellitus,T1DM is also a risk factor for stroke.Although some T1DM studies have taken stroke as a component of the composite endpoint of cardiovascular events,a few studies have focused on the risk of stroke in patients with T1DM.Recent studies have shown that the risk of stroke in patients with T1DM is significantly higher than those without diabetes mellitus,especially in the population under the age of 50.In addition,the T1DM patients died of the risk of stroke are 3 to 4 times higher than the general population.This article reviews the relationship between T1DM and stroke.

Effective prevention is the best approach for reducing the burden of stroke.The reduction of low-density lipoprotein cholesterol with statins may decrease the risks of patients with the first ever stroke and ischemic stroke or recurrent stroke in patients with transient ischemic attack.In stroke prevention,the treatment of statins has become the most important advance following aspirin and antihypertensive treatment.This article reviews the roles of statins in the prevention of stroke.