Objective To analyze the unexamined items and situations in occupational health examinations of radiation workers, and provide a reference for the revision of occupational health examination standards for radiation workers. Methods A total of 29 630 radiation workers who underwent occupational health examinations at The Third People’s Hospital of Henan Province in 2023 were selected, and the non-examination rates were statistically analyzed according to occupation, gender, and age. Results The overall non-examination rate of non-medical radiation workers was significantly lower than that of the medical radiation workers (P<0.05). The non-examination rate of chest X-rays among medical radiation workers was significantly higher than that of non-medical radiation workers (P<0.05), while no significant differences were found in other items (P>0.05). Gender-stratified analysis showed that the non-examination rate of routine urine tests was higher in females than in males in both medical and non-medical radiation workers (P<0.05). Age-stratified analysis revealed no significant differences in non-examination rates among different age groups in non-medical radiation workers (P>0.05), whereas the chest X-ray non-examination rate was relatively high in medical radiation workers under 30 years old (P<0.05). Conclusion Significant differences were observed in the non-examination rates of occupational health examinations among radiation workers based on occupation, gender, and age. The overall non-examination rate was relatively low in non-medical radiation workers.

OBJECTIVE:To assess the efficacy and safety of transcranial magnetic stimulation in the treatment of refractory depression and to compare the differences in efficacy between various transcranial magnetic stimulation treatment protocols in refractory depression,thereby providing a theoretical basis for the clinical selection of transcranial magnetic stimulation treatment protocols.METHODS:A comprehensive search was conducted across multiple databases,including PubMed,Embase,Cochrane Library,Web of Science,CNKI,WanFang Data,CBM and VIP.The search terms were"transcranial magnetic stimulation,treatment-resistant depression,randomized controlled trial"in Chinese,and"depressive disorder,treatment-resistant,transcranial magnetic stimulation,randomized controlled trial"in English.The objective was to identify randomized controlled trials on the treatment of patients with refractory depression published from the establishment of the databases to September 2024.The quality of the included studies was evaluated using the Cochrane risk of bias assessment tool,version 5.1.0,and the Physiotherapy Evidence Database scale.Meta-analysis of the outcome indicators was conducted using the Review Manager 5.4 and Stata 18.0 software.RESULTS:(1)Following a comprehensive review,20 randomized controlled trials were included in the analysis.All of the trials were assessed to be of high or very high quality according to the Physiotherapy Evidence Database scale.(2)Meta-analysis results showed that,compared with the sham stimulation group,high-frequency repetitive transcranial magnetic stimulation could significantly reduce the scores of Hamilton Depression Rating Scale[mean difference(MD)=-3.89,95％confidence interval(CI):-6.14 to-1.65,P＜0.05)or the Montgomery Depression Rating Scale(MD=-3.97,95％CI:-6.57 to-1.36,P＜0.05).(3)The probability ranking results of the network Meta-analysis showed that,in terms of the Hamilton Depression Rating Scale score,the probability ranking results were as follows:high-frequency repetitive transcranial magnetic stimulation(69.9％)＞intermittent theta burst stimulation(62.8％)＞bilateral theta pulse stimulation(57.5％)＞low-frequency repetitive transcranial magnetic stimulation(54.9％)＞bilateral sequential transcranial magnetic stimulation(49.0％)＞transcranial pulsed electromagnetic field(37.0％)＞sham stimulation(18.9％).And in terms of the Montgomery Depression Rating Scale score,the probability ranking results were as follows:high-frequency repetitive transcranial magnetic stimulation(93.3％)＞bilateral theta pulse stimulation(50.3％)＞sham stimulation(45.9％)＞low-frequency repetitive transcranial magnetic stimulation(32.1％)＞bilateral sequential transcranial magnetic stimulation(28.4％).CONCLUSION:Transcranial magnetic stimulations can improve the depressive symptoms of patients with treatment-resistant depression.Among them,the high-frequency repetitive transcranial magnetic stimulation mode has the best effect on improving the depressive symptoms of patients with treatment-resistant depression,followed by the intermittent θ burst stimulation mode.

Objective To investigate the effect of benserazide combined with respiratory training on post-stroke dysphagia.Methods A total of 120 patients with dysphagia after stroke were prospectively selected and randomly divided into the combination group and the breathing exercise group,with 60 cases in each group.The breathing exercise group was treated with rehabilitation breathing training,and the combination group was treated with dopa serazide on the basis of rehabilitation breathing training,3 times a day,1 tablet once.The traditional Chinese medicine(TCM)syndrome scores,clinical efficacy and swallowing function indexes including dysphagia angiography score(VDS),osmotic-aspiration scale(PAS)score,Lowada drinking water test score and VFSS score were compared between the two groups.Nutritional indices[total cholesterol(TC),triglyceride(TG),albumin(ALB),hemoglobin(Hb)],related indexes of nerve function[nerve function and serum growth differentiation factor 15(GDF-15),central nerve specific protein soluble protein-100β(S100β)],quality of life and anxiety disorder score[Quality of Life Rating Scale(SF-36)score,Generalized Anxiety Disorder Scale(GAD-7)score]and adverse reactions were compared between the two groups.Results The total effective rate of the combination group(91.67%)was obviously increased(P＜0.05)compared to the breathing exercise group(58.33%).Compared with before treatment,after treatment,tongue flaccidity,slow swallowing,choke after drinking water,tongue coating ecchymosis,score of fine pulse,VDS,PAS,score of Lowada drinking water test,GDF-15 level and GAD-7 score were decreased in the two groups,and those of the combination group were significantly lower than the breathing exercise group(P＜0.05).The levels of TC,TG,ALB,Hb,S100β,VFSS and SF-36 were increased in the two groups,and those of the combination group were higher than the breathing exercise group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Benserazide combined with respiratory training has high clinical efficacy in patients with post-stroke dysphagia,which can effectively improve the TCM evidence score and nutritional indicators,improve swallowing function,reduce anxiety,improve quality of life,and have more ideal clinical application.

Objective To investigate the effect of benserazide combined with respiratory training on post-stroke dysphagia.Methods A total of 120 patients with dysphagia after stroke were prospectively selected and randomly divided into the combination group and the breathing exercise group,with 60 cases in each group.The breathing exercise group was treated with rehabilitation breathing training,and the combination group was treated with dopa serazide on the basis of rehabilitation breathing training,3 times a day,1 tablet once.The traditional Chinese medicine(TCM)syndrome scores,clinical efficacy and swallowing function indexes including dysphagia angiography score(VDS),osmotic-aspiration scale(PAS)score,Lowada drinking water test score and VFSS score were compared between the two groups.Nutritional indices[total cholesterol(TC),triglyceride(TG),albumin(ALB),hemoglobin(Hb)],related indexes of nerve function[nerve function and serum growth differentiation factor 15(GDF-15),central nerve specific protein soluble protein-100β(S100β)],quality of life and anxiety disorder score[Quality of Life Rating Scale(SF-36)score,Generalized Anxiety Disorder Scale(GAD-7)score]and adverse reactions were compared between the two groups.Results The total effective rate of the combination group(91.67%)was obviously increased(P＜0.05)compared to the breathing exercise group(58.33%).Compared with before treatment,after treatment,tongue flaccidity,slow swallowing,choke after drinking water,tongue coating ecchymosis,score of fine pulse,VDS,PAS,score of Lowada drinking water test,GDF-15 level and GAD-7 score were decreased in the two groups,and those of the combination group were significantly lower than the breathing exercise group(P＜0.05).The levels of TC,TG,ALB,Hb,S100β,VFSS and SF-36 were increased in the two groups,and those of the combination group were higher than the breathing exercise group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Benserazide combined with respiratory training has high clinical efficacy in patients with post-stroke dysphagia,which can effectively improve the TCM evidence score and nutritional indicators,improve swallowing function,reduce anxiety,improve quality of life,and have more ideal clinical application.

Objective To develop a toolkit suitable for assisting community health institutions in the early identification and inter-vention of mild cognitive impairment(MCI)among older adults.Methods A literature review was conducted to construct a draft of the identification and intervention toolkit.Tools with an expert approval rate above 70%were included after expert consultation.The final version of the toolkit was developed by integrating these tools with officially recommended tools in China.Results The expert consultation yielded an authority coefficient of 0.84.The finalized toolkit included the assessment tools of Mini-Mental State Examination,Montreal Cognitive Assessment,General Practitioner Assessment of Cognition,Cognitive Abilities Screening Instrument and Clock Drawing Test,and 18 intervention measures in-cluding pharmacological treatment,cognitive training and psychological interventions,etc.Conclusion The MCI Identification-Intervention Toolkit may serve as a reference for guiding the identification and inter-vention of MCI among older adults for community health institutions.

Objective To systematically compare the efficacy of different virtual reality(VR)technologies on motor dysfunction in patients with Parkinson's disease(PD)through a network meta-analysis(NMA).Methods Following the PRISMA-NMA guidelines,randomized controlled trials(RCT)that compared the effect of at least two interventions on motor function in patients with PD were searched in PubMed,Embase,Cochrane Li-brary,Web of Science,CNKI,Wanfang data and VIP.The interventions included immersive virtual reality(IVR),non-immersive virtual reality(VRT),augmented reality(AR),treatment as usual(TAU)and active control(AC).The primary outcomes included Unified Parkinson's Disease Rating Scale Part Ⅲ(UPDRS-Ⅲ),Berg Balance Scale(BBS)and Timed Up and Go Test(TUGT).A frequentist-based random-effects model was used to conduct NMA,and the surface under the cumulative ranking curve(SUCRA)was used to rank the interventions.Results A total of 20 RCT involving 890 patients were included.IVR performed best in improving the score of UPDRS-Ⅲ(SUCRA=97.7%)and was significantly superior to TAU(SMD=-0.82,95%CI-1.28 to-0.37).IVR showed the highest probability of being the best option for the score of BBS(SUCRA=85.2%)and was signifi-cantly superior to TAU(SMD=3.94,95%CI 1.08 to 6.80).IVR performed best in the outcome of TUGT(SU-CRA=95.1%)and was significantly superior to VRT(SMD=1.06,95%CI 0.40 to 1.72),AR(SMD=-1.09,95%CI-1.98 to-0.19)and TAU(SMD=-1.38,95%CI-1.95 to-0.82).However,subgroup analysis revealed that the efficacy advantage of IVR was mainly confirmed in short-term(four to six weeks)interventions,while the evidence for long-term efficacy was currently very limited.Conclusion The efficacy of interventions on motor rehabilitation in patients with PD appears to be positively correlated with the technology's level of immersion.As the most immersive technology,IVR is the optimal choice for im-proving overall motor function,balance and mobility in patients with PD.VRT and AR serve as effective adju-vants and are superior to TAU.

Objective To systematically compare the efficacy of different virtual reality(VR)technologies on motor dysfunction in patients with Parkinson's disease(PD)through a network meta-analysis(NMA).Methods Following the PRISMA-NMA guidelines,randomized controlled trials(RCT)that compared the effect of at least two interventions on motor function in patients with PD were searched in PubMed,Embase,Cochrane Li-brary,Web of Science,CNKI,Wanfang data and VIP.The interventions included immersive virtual reality(IVR),non-immersive virtual reality(VRT),augmented reality(AR),treatment as usual(TAU)and active control(AC).The primary outcomes included Unified Parkinson's Disease Rating Scale Part Ⅲ(UPDRS-Ⅲ),Berg Balance Scale(BBS)and Timed Up and Go Test(TUGT).A frequentist-based random-effects model was used to conduct NMA,and the surface under the cumulative ranking curve(SUCRA)was used to rank the interventions.Results A total of 20 RCT involving 890 patients were included.IVR performed best in improving the score of UPDRS-Ⅲ(SUCRA=97.7%)and was significantly superior to TAU(SMD=-0.82,95%CI-1.28 to-0.37).IVR showed the highest probability of being the best option for the score of BBS(SUCRA=85.2%)and was signifi-cantly superior to TAU(SMD=3.94,95%CI 1.08 to 6.80).IVR performed best in the outcome of TUGT(SU-CRA=95.1%)and was significantly superior to VRT(SMD=1.06,95%CI 0.40 to 1.72),AR(SMD=-1.09,95%CI-1.98 to-0.19)and TAU(SMD=-1.38,95%CI-1.95 to-0.82).However,subgroup analysis revealed that the efficacy advantage of IVR was mainly confirmed in short-term(four to six weeks)interventions,while the evidence for long-term efficacy was currently very limited.Conclusion The efficacy of interventions on motor rehabilitation in patients with PD appears to be positively correlated with the technology's level of immersion.As the most immersive technology,IVR is the optimal choice for im-proving overall motor function,balance and mobility in patients with PD.VRT and AR serve as effective adju-vants and are superior to TAU.

OBJECTIVE To construct a prevention and control index system suitable for stomatology outpatient de-partment of general hospital,so as to provide a theoretical basis for risk assessment of stomatology outpatient de-partment,and to provide an evidence-based basis for precise prevention and control.METHODS Based on the methods of literature research,literature quality evaluation and brainstorming,a draft index of the prevention and control of the general hospital's oral outpatient department was constructed,and the index system for the preven-tion and control in the stomatology outpatient department of a general hospital was finally established through re-search group discussion,content analysis and expert consultation.The three-level indicators in the index system were incorporated into the risk points of risk assessment,the failure mode and effects analysis were applied to con-duct the risk assessment,and the intervention measures and rectification cycles were formulated and implemented in clinical practice for the risk points with risk priority number(RPN)greater than 125.Based on the established index system and risk points with RPN＞125,the hospital infection prevention and control checklist for stoma-tology outpatient was developed and regularly checked in the clinic.After the rectification was completed,the risk points were evaluated again,and the RPN values were compared before and after the risk control.RESULTS The recovery rate of expert consultation questionnaire was 100.00％,and the average expert authority coefficient was 0.84.The consistency ratio(CR)for the first-level indicators was 0.0499,and the consistency ratio(CR)of the second-level indicators was 0.0000-0.0790,which was less than 0.1,and the consistency was acceptable.Final-ly,a hospital infection prevention and control index system was established,comprising 5 first-level indicators,7 second-level indicators and 23 third-level indicators.The improved key control risk points were evaluated again,and the RPN values before and after comparing the risk control were reduced and＜125,indicating that the im-provement measures were effective.CONCLUSION The evaluation system of prevention and control for the stoma-tology outpatient department of a general hospital established in this study is reliable,scientific and practical,and the improvement measures of risk assessment before and after the control of risk points are effective,which pro-vides evidence-based basis for risk assessment and precise prevention and control in the stomatology outpatient de-partment of general hospitals.

Objective To develop a toolkit suitable for assisting community health institutions in the early identification and inter-vention of mild cognitive impairment(MCI)among older adults.Methods A literature review was conducted to construct a draft of the identification and intervention toolkit.Tools with an expert approval rate above 70%were included after expert consultation.The final version of the toolkit was developed by integrating these tools with officially recommended tools in China.Results The expert consultation yielded an authority coefficient of 0.84.The finalized toolkit included the assessment tools of Mini-Mental State Examination,Montreal Cognitive Assessment,General Practitioner Assessment of Cognition,Cognitive Abilities Screening Instrument and Clock Drawing Test,and 18 intervention measures in-cluding pharmacological treatment,cognitive training and psychological interventions,etc.Conclusion The MCI Identification-Intervention Toolkit may serve as a reference for guiding the identification and inter-vention of MCI among older adults for community health institutions.

This study aims to understand the biological characteristics of Streptococcus dysgalacti-ae of yak origin.Bacterial isolation and identification,drug susceptibility test,virulence gene test and pathogenicity test were carried out on milk samples of yaks from Naqu City to evaluate the bi-ological characteristics of the isolated strains.Meanwhile,molecular biological information such as virulence factors and drug resistance genes were analyzed by whole genome sequencing,and viru-lence genes were verified by PCR.The results showed that a strain of Streptococcus dysgalactiae was isolated from the milk of yak,and its colony morphology was pinpoint size,smooth edge and milky white.This strain is sensitive to many antibiotics(penicillin G,cephalosporin,ciprofloxacin,tetracycline,erythromycin,etc.).Virulence gene test results showed that the strain carries six key virulence genes(cyl,eno,scpB,bca,bac and napr),which may be closely related to its pathoge-nicity.In the pathogenicity test,the mice were listless and less active after infection,but no death occurred during the observation period.The pathological changes of spleen,kidney,liver and lung tissue were found,suggesting that the strain had certain pathogenic potential but not high lethali-ty.Whole genome sequencing data showed that the gene length of this strain was 4 079 280 bp,the GC content was 39.41％,3 964 coding genes were predicted,604 of which were annotated as viru-lence factors,and another 28 gene mutations may enhance its pathogenic ability.Through annota-tion of CARD database,two Pat A resistance genes and two lmrp resistance genes were found,re-vealing their potential resistance mechanism.Through whole genome sequencing technology and bioinformatics analysis method,this study revealed the genomic characteristics,drug resistance and pathogenicity mechanism of Streptococcus dysgalactiae of yak origin.The findings provide impor-tant scientific evidence for further exploration of the pathogenicity,drug resistance mechanisms,and molecular evolution of yak-derived Streptococcus agalactiae.