ObjectiveTo investigate the mechanism by which Gegen Qinliantang（GQT） improves skeletal muscle insulin resistance. MethodsThe db/m mice were used as the normal group， while db/db mice were assigned to a model group， low-dose （3.12 g·kg^-1）， medium-dose （6.24 g·kg^-1）， and high-dose （12.48 g·kg^-1） GQT groups， and a Western medicine group （semaglutide， 0.045 mg·kg^-1），n=6 in each group. All groups received corresponding interventions. Intraperitoneal glucose tolerance test （IPGTT）， intraperitoneal insulin tolerance test （IPITT）， and hematoxylin-eosin （HE） staining were used to evaluate insulin resistance and therapeutic efficacy. Serum lipid levels were measured using an automatic biochemical analyzer， and apoptosis in skeletal muscle was assessed via TUNEL assay. Transcriptome sequencing combined with gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） analyses was performed to identify differentially expressed genes （DEGs）. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to validate gene expression. Molecular docking was applied to evaluate the binding patterns between active components of GQT and key regulatory genes to elucidate pharmacological mechanisms. ResultsCompared with the model group， the medium-dose and high-dose GQT groups showed significantly reduced fasting blood glucose （FBG） levels （P<0.01）. Triglycerides （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） were markedly decreased （P<0.01）， while high-density lipoprotein cholesterol （HDL-C） was significantly increased （P<0.01）. IPGTT， IPITT， and HE staining demonstrated that GQT enhanced insulin sensitivity and restored skeletal muscle morphology. GQT also alleviated apoptosis in skeletal muscle tissue. Transcriptome analysis revealed that GQT primarily affected biological processes such as oxidative phosphorylation， metabolic pathways， cellular processes， and protein binding. Real-time PCR results showed that CBR2， CDK6， F830016B08Rik， IL-1β， Rab27b， and COLEC12 were key regulatory genes. Molecular docking demonstrated that CBR2， IL-1β， Rab27b， and COLEC12 formed stable binding with the main active components of GQT. The therapeutic effects of high- and medium-dose GQT were comparable to those of the semaglutide group. ConclusionGQT improves skeletal muscle insulin resistance， potentially by regulating apoptosis as part of its underlying biological mechanism.

Occupational pneumoconiosis remains the most common occupational disease in China, with occupational mineral dust exposure being its primary causative factor. Although national standards for online monitoring and early warning systems of coal mine dust concentrations have been established, national occupational health standards for rapid and online monitoring of dust concentration and particle size distribution in other industries are still limited. Among dust concentration sensor technologies, the light scattering method is the preferred choice for online dust monitoring owing to its wide measurement range and low cost. The beta-ray absorption method is mature but highly sensitive to humidity. The electrostatic induction method offers high sensitivity, simple structure, and low maintenance costs but exhibits high errors in low-concentration dust monitoring. The tapered element oscillating microbalance method is highly sensitive but costly. Multi-sensor data fusion technology can improve monitoring reliability, however, mature domestic products are not yet available. For monitoring dust particle size distribution, sieving and sedimentation methods are cumbersome. The aerodynamic method shows broad prospects in the online monitoring of respirable dust but has obvious measurement errors for larger dust particles. The use of optical measurement method is limited by dust morphology and is not suitable for monitoring coal dust particle size distribution. The electrical mobility method is primarily applicable to submicron dust. Future research should focus on promoting the application of monitoring technology for respirable dust particle size distribution in online monitoring of industrial dust. By integrating Internet of Things, data mining, and artificial intelligence technologies, along with multi-sensor data fusion and numerical simulation, dust concentration prediction models can be established to achieve accurate dust concentration monitoring and early warning of exceedances. The advancements of technologies will provide scientific support for the assessment of industrial dust hazards and the prevention and control of occupational pneumoconiosis.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective:To understand the status quo of nutrition knowledge, attitude and behavior of nurses in class A tertiary hospital and its influencing factors, and to provide reference for the development of reasonable and standard nutrition training courses.Methods:The knowledge, attitude and behavior of nutrition of 207 nurses in 28 class A tertiary hospitals from 17 provinces cities on October 25-26, 2019 were investigated Questionnaire on Nutritional Knowledge, Attitude and Behavior Cognition of Nurses.Results:The scores of nurses′ nutritional knowledge, attitude and behavior were (69.70 ± 2.92), (82.76 ± 4.97) and (64.90 ± 4.77) respectively. There were significant differences in nurses′ nutritional knowledge, attitude and behavior at different ages, nursing ages, whether they had children, the highest educational background, department rotation, technical titles, administrative positions, employment methods, article publication, whether they had participated in nutrition training courses and in different regions ( F values were 6.80-60.95, t values were 2.94-7.08, all P<0.05). The main factors affecting nutrition knowledge were region, nursing age, the highest educational background, department rotation and whether they had participated in nutrition training courses ( t values were -6.88-6.73, all P<0.05). The main factors affecting nutritional attitude were region, nursing age and the highest educational background ( t=-2.22, 6.84, 3.21, all P<0.05). The main factor affecting nutritional behavior was nursing age ( t=5.45, P<0.05). Conclusions:Nurses′ nutritional attitude level is excellent, but their mastery of nutritional knowledge and nutritional nursing behavior level need to be improved. Reasonable, scientific and feasible nutritional training courses should be formulated according to the influencing factors of their nutritional knowledge, attitude and behavior, so as to improve nurses′ nutritional knowledge, belief and behavior level and improve the nutritional status and prognosis of hospitalized patients.

In order to solve the problem of dust hazard of vibrating screen machine and difficult treatment in catalyst production process, computational fluid dynamics software Fluent was used to carry out numerical simulation calculation of the local exhaust dust removal system for the main dust dispersing points of the vibrating screen machine, including fine/coarse particles outlet and product outlet blowing and cleaning the dust points. The optimal design scheme and key technical parameters of local ventilation and dust removal system of vibrating screen machine were proposed. The results showed that the dust diffusion could be prevented by setting up an upper suction hood without air blowing, but the exhaust air volume needed to be calculated accurately. On the premise of purge, it is necessary to control the air volume to form a wind speed band of 8 m/s with a height of 15 cm at the feed port, so as to effectively remove the dust on the surface of solid particles of catalyst products and ensure that the catalyst products will not be blown away when falling into the feed barrel. The simulated design was applied to the vibrating sieve powder machine of a catalyst company, and the maximum dust concentration in the workplace was reduced from 45.80 mg/m 3 to 5.46mg/m 3, which effectively improved the working environment in the workplace.

Objective:To understand the current situation of the ideological and political cognition of the postgraduate courses for the master degree of nursing and the analysis of the demand for the ideological and political curriculum of the community nursing, and provide preliminary experience for the integration of ideological and political elements into the teaching practice of community nursing.Methods:Using phenomenological research method, the semi-structured interviews were conducted with 15 full-time nursing master degree postgraduates from Tongji University in Shanghai. Colaizzi 7-step analysis was used to analyze the data.Results:Under the mode of curriculum ideological and political education, the cognition and needs of nursing master students can be summarized into four themes: the deficiency of curriculum ideological and political cognition, changes in professional cognition, recognition of the role and importance of curriculum ideological and political education, expectations and needs of community nursing curriculum ideological and political education.Conclusion:Nursing students with master′s degree have a vague understanding of "curriculum ideological and political". In the future, they can add diversified teaching methods starting from professional quality, humanistic care and patriotism education, so as to make the community nursing curriculum ideological and political concept more popular, and strive to cultivate senior nursing talents with both ability and morality.

In order to solve the problem of dust hazard of vibrating screen machine and difficult treatment in catalyst production process, computational fluid dynamics software Fluent was used to carry out numerical simulation calculation of the local exhaust dust removal system for the main dust dispersing points of the vibrating screen machine, including fine/coarse particles outlet and product outlet blowing and cleaning the dust points. The optimal design scheme and key technical parameters of local ventilation and dust removal system of vibrating screen machine were proposed. The results showed that the dust diffusion could be prevented by setting up an upper suction hood without air blowing, but the exhaust air volume needed to be calculated accurately. On the premise of purge, it is necessary to control the air volume to form a wind speed band of 8 m/s with a height of 15 cm at the feed port, so as to effectively remove the dust on the surface of solid particles of catalyst products and ensure that the catalyst products will not be blown away when falling into the feed barrel. The simulated design was applied to the vibrating sieve powder machine of a catalyst company, and the maximum dust concentration in the workplace was reduced from 45.80 mg/m 3 to 5.46mg/m 3, which effectively improved the working environment in the workplace.

Objective:To retrieve the evidence for the prevention and control of lung infection risk factors after hip fracture surgery in geratic patients at home and abroad, so as to summarize the best evidence.Methods:Clinical decision-making, guidelines and evidence summary were systematically retrieved in UpToDate, British Medical Journal (BMJ) Best Practice, Guidelines International Network, National Guideline Clearinghouse, National Institute for Health and Care Excellence, British Orthopaedic Association, Australian and New Zealand Society for Geriatric Medicine, European Society of Trauma and Emergency Surgery, European Respiratory Society and Chinese Medical Association, and the search time limit was from the establishment of the database to September 30, 2020. The thematic evidence summary literature was supplementally searched in PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI) and other databases, and the search time limit was from January 1, 2018 to September 30, 2020.Results:Totals of 2 clinical decisions, 15 evidence-based guidelines, and 1 evidence summary were included. A total of 64 pieces of evidence were summarized from the aspects of perioperative multidisciplinary team construction, personnel training, risk factor screening and evaluation, and risk factor control.Conclusions:Prevention of lung infections after hip fractures in geratic patients requires multidisciplinary collaboration. It is of positive significance to transform the evidence included in this study into a clustered, multidisciplinary clinical implementation plan for the purpose of prevention and control.

Objective:To systematically evaluate and analyze the risk factors for postoperative pulmonary infection in elderly patients with hip fractures.Methods:Two researchers independently searched PubMed, Cochrarne Library, Web of Science, Embase, CINAHL, Chinese Biomedical Literature Database, China National Knowledge Internet (CNKI), VIP, Wanfang database on the cohort or case-control studies on risk factors for postoperative lung infection in elderly patients with hip fracture hip fractures. The search time limit was from the establishment of the databases to June 15, 2020. After literature screening, literature quality evaluation and data extraction, Meta-analysis was performed using RevMan 5.4 software.Results:A total of 17 literatures were included, including 11 Chinese literatures and 6 English literatures. Meta-analysis results showed that male, age of 75 years or older, surgery waiting time greater than 48 hours, surgery time greater than 2 hours, general anesthesia, smoking (history), combination with stroke, anemia, combination with chronic obstructive pulmonary disease (COPD), combination with respiratory disease, hypoproteinemia, American Society of Anesthesiologists gradeⅢ orⅣ, mechanical ventilation, serum vitamin 25 (OH) D deficiency, admission to Intensive Care Unit, combination with diabetes mellitus, the number of preoperative complications greater than 3, cognitive dysfunction and low functional status were risk factors of postoperative lung infection in elderly patients with hip fractures ( P<0.05) . Conclusions:The postoperative pulmonary infection in elderly patients with hip fractures is affected by many factors. It is suggested to establish a multidisciplinary team to timely and accurately identify risk factors of postoperative pulmonary infection and take active measures to prevent the occurrence of postoperative pulmonary infection.