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.

This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

The rapid emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants that evade immunity elicited by vaccination has posed a global challenge to the control of the coronavirus disease 2019 (COVID-19) pandemic. Therefore, developing countermeasures that broadly protect against SARS-CoV-2 and related sarbecoviruses is essential. Herein, we have developed a lipid nanoparticle (LNP)-encapsulated mRNA (mRNA-LNP) encoding the full-length Spike (S) glycoprotein of SARS-CoV-2 (termed RG001), which confers complete protection in a non-human primate model. Intramuscular immunization of two doses of RG001 in Rhesus monkey elicited robust neutralizing antibodies and cellular response against SARS-CoV-2 variants, resulting in significantly protected SARS-CoV-2-infected animals from acute lung lesions and complete inhibition of viral replication in all animals immunized with low or high doses of RG001. More importantly, the third dose of RG001 vaccination elicited effective neutralizing antibodies against current epidemic XBB and JN.1 strains and similar cellular response against SARS-CoV-2 Omicron variants (BA.1, XBB.1.16, and JN.1) were observed in immunized mice. All these results together strongly support the great potential of RG001 in preventing the infection of SARS-CoV-2 variants of concern (VOCs).

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To construct an enhancer-based prognostic risk prediction model for non-small cell lung cancer (NSCLC) by integrating DNA methylome data and transcriptome data. Methods The weighted gene co-expression network analysis (WGCNA) was used to identify NSCLC related genes from the differentially methylated positions (DMPs) of enhancers. Based on the transcriptome data,the prognostic risk prediction model was constructed using LASSO-Cox regression algorithm. Results Through the analysis on DNA methylome data of NSCLC,19784 DMPs were obtained and their distribution patterns were characterized,including 6089 DMPs of enhancers. WGCNA analysis screened 79 highly correlated DMPs of enhancer with NSCLC from the 6089 DMPs. After analyzing the target genes of 79 DMPs with LASSO-Cox regression based on the transcriptome data,10 genes were used to construct a prognostic risk prediction model. The prognostic risk prediction model was evaluated by calculating the areas under the curve (AUC) of 3-,5-,and 10-year time-dependent receiver operating characteristic (ROC) curves in training set and validation set;and the results showed that the 3-,5-,and 10-year AUC in training set and validation set were all higher than 0.7. Finally,a nomogram was constructed to predict the 3-,5-,and 10-year survival probabilities of NSCLC. Conclusion This study provides new insights into the role of enhancers in NSCLC and has the potential to improve the prognosis by guiding personalized treatment decisions.

Objective To construct an enhancer-based prognostic risk prediction model for non-small cell lung cancer (NSCLC) by integrating DNA methylome data and transcriptome data. Methods The weighted gene co-expression network analysis (WGCNA) was used to identify NSCLC related genes from the differentially methylated positions (DMPs) of enhancers. Based on the transcriptome data,the prognostic risk prediction model was constructed using LASSO-Cox regression algorithm. Results Through the analysis on DNA methylome data of NSCLC,19784 DMPs were obtained and their distribution patterns were characterized,including 6089 DMPs of enhancers. WGCNA analysis screened 79 highly correlated DMPs of enhancer with NSCLC from the 6089 DMPs. After analyzing the target genes of 79 DMPs with LASSO-Cox regression based on the transcriptome data,10 genes were used to construct a prognostic risk prediction model. The prognostic risk prediction model was evaluated by calculating the areas under the curve (AUC) of 3-,5-,and 10-year time-dependent receiver operating characteristic (ROC) curves in training set and validation set;and the results showed that the 3-,5-,and 10-year AUC in training set and validation set were all higher than 0.7. Finally,a nomogram was constructed to predict the 3-,5-,and 10-year survival probabilities of NSCLC. Conclusion This study provides new insights into the role of enhancers in NSCLC and has the potential to improve the prognosis by guiding personalized treatment decisions.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To investigate the application of synchronized immersion course(SIC)in teaching of clinical practice of surgery for eight-year program students.Methods A total of 94 eight-year program students in French class and 4+4 class who received SIC in the study of surgery in Ruijin Clinical School,Shanghai Jiao Tong University from September 2017 to June 2019 were selected as the pilot group.A total of 91 students in English class who were taught in the traditional way in the same period were selected as a horizontal control group.A total of 84 students in French class and 4+4 class who were studying from September 2015 to June 2017 were selected as the longitudinal control group.Teaching satisfaction evaluation,examination results and specialization choice were compared among students in each group to assess teaching effectiveness.Results The total score(3.8±0.3)and satisfaction rate(98.9%)of the questionnaire in the pilot group were better than those in the horizontal control group(3.6±0.4,90.1%)(P=0.001,P=0.008).For the case analysis station in objective structured clinical examination(OSCE),the mean score(86.2±6.9)and pass rate(97.9%)in the pilot group were better than those in the horizontal control group(79.7±11.4,89.0%)(P=0.001,P=0.014),as well as better than those in the longitudinal control group(79.5±13.5,88.1%)(P=0.001,P=0.009).For the history inquiry station,the mean score(86.3±10.7)and pass rate(96.8%)in the pilot group were better than those in the horizontal control group(81.4±11.6,86.8%)(P=0.003,P=0.013).The proportion of students choosing the surgical specialty was higher in the pilot group(55.3%)than in the horizontal control group(46.2%)and the longitudinal control group(44.0%)without statistically significant difference.Conclusions SIC can help eight-year program students strengthen their clinical thinking and practice skills.Meanwhile,SIC can increase students'satisfaction with teaching and their interest in surgery.

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.