Background The novel coronavirus infection is widespread in the world, resulting in more pneumoconiosis patients complicated with coronavirus disease 2019 (COVID-19). Objective To understand the clinical characteristics and prognosis of hospitalized COVID-19 patients complicated with or without pneumoconiosis. Methods A total of 36 COVID-19 patients admitted to the Shandong Provincial Occupational Disease Hospital from 10 December to 31 December 2022 were selected, including 21 cases in the complication group (pneumoconiosis complicated with COVID-19) and 15 cases in the COVID-19 group without pneumoconiosis. Symptoms, signs, laboratory test results(e.g. routine blood test), imaging findings, treatment plans and prognosis of the two groups were observed and compared. Results Regarding symptoms and signs in the complication group and the COVID-19 group, the proportions of dyspnea (57.14% vs 0.00%), lung wheezing (28.57% vs 0.00%), wet rales (76.19% vs 33.30%), and fever (61.90% vs 93.33%) were significantly different (P<0.05). Compared with the COVID-19 group, the level of D-dimer in the complication group was significantly increased [2.340 (1.0, 6.5) mg·L⁻¹ vs 0.250 (0.2, 0.4) mg·L⁻¹] (P<0.01), the serum sodium level was decreased [(138.10±2.68) mmol·L⁻¹ vs (140.47±2.27) mmol·L⁻¹] (P<0.05). In terms of drug treatment and prognosis, there were statistically significant differences in the proportion of antiviral drugs (19.00% vs 80.00%), glucocorticoids (38.10% vs 80.00%), and anticoagulants (28.60% vs 0.00%) between the complication group and the COVID-19 group (P<0.05). Compared with the COVID-19 group, the cure rate of the complication group (90.50% vs 100.00%) showed no statistical difference. However, there were 2 deaths in the complication group. Conclusion Patients with pneumoconiosis complicated with COVID-19 have less fever and more dyspnea, wheezing, and wet rales. The increase of plasma D-dimer is a potential predictor in patients with pneumoconiosis complicated with COVID-19.

Objective To study the effect of active respiratory circulation combined with incremental resistance exercise on exercise endurance in elderly patients with rheumatic heart disease.Methods A total of 120 elderly patients with rheumatic heart disease hospitalized in the cardiac rehabilitation department of this hospital from October 2021 to October 2022 were selected as the study subjects and divided into the observa-tion group and control group by the random number table method,60 cases in each group.The patients in the control group were treated with the conventional treatment and rehabilitation nursing,and the observation group adopted the active respiratory circulation technique combined with incremental resistance exercise on the basis of the former.The 30 s arm flexion,2 min step test,6 min walking distance,cardiac function and nursing satisfaction on 1 d before training and 30 d after training were compared between the two groups.Re-sults The number of 30 s arm flexions and 2 min steps on 30 d after training in the observation group was higher than that in the control group[32.23(12.88,52.33)times vs.23.46(1.77,44.48)times,(9.62±0.48)times vs.(9.03±0.35)times],the 6-min walking distance was longer than that in the control group[(427.59±20.36)m vs.(394.89±17.95)m],the levels of LVEF and BNP were higher than those in the con-trol group[(56.32±3.60)％vs.(52.23±3.13)％,(645.00±9.12)pg/mL vs.(637.00±9.16)pg/mL],and the proportion of very satisfaction was higher than that in the control group(78.33％vs.21.66％),the differ-ences were statistically significant(P＜0.05).Conclusion Active respiration and circulation technology com-bined with incremental resistance exercise could effectively improve the flexion mobility ability of both upper limbs,the flexibility and exercise ability of both lower limbs,and improve the muscle strength of the limbs and cardiac function in elderly patients with rheumatic heart disease.

Objective To analyze the influencing factors of poor anal function after laparoscopic intersphincteric resection(Lap-ISR)for extremely low rectal cancer,and to construct and verify a prediction model based on this model,in order to provide guidance for improving the anal function of patients with extremely low rectal cancer after Lap-ISR.Method A total of 127 patients with extremely low rectal cancer who underwent Lap-ISR in Taizhou People's Hospital from June 2020 to June 2022 were retrospectively selected.Patients were followed up for 12 months after surgery,and postoperative anal function was evaluated by the anal incontinence score(Wexner).According to Wexner score,the patients were divided into good anal function group(106 cases)and poor anal function group(21 cases).The clinical data of patients were collected and the risk factors affecting postoperative poor anal dysfunction were analyzed,and a Nomogram model was constructed to predict the risk of postoperative anal dysfunction in patients after Lap-ISR,and the receiver operating characteristic curve(ROC)was drawn.The area under the curve(AUC)was used to analyze the predictive efficacy of the prediction model for poor anal dysfunction after Lap-ISR.Result The incidence of anal dysfunction after Lap-ISR in patients with extremely low rectal cancer was 16.54％(21/127).Univariate analysis showed that there was no significant difference in gender,age,body mass index,clinical stage,combined underlying diseases,operation time,intraoperative blood loss,anastomosis method,and the distance from the lower edge of the tumor to the dentate line between the two groups(P＞0.05).The proportion of tumor diameter≥5 cm,the proportion of neoadjuvant chemotherapy,the distance between anastomosis and anal verge＜2 cm,and the proportion of anastomotic leakage in the anal dysfunction group were higher than those in the good anal function group(P＜0.05).Cox multivariate regression analysis showed that tumor diameter≥5 cm(OR=5.124),neoadjuvant chemotherapy(OR=5.761)and anastomotic leakage(OR=6.881)were risk factors for postoperative anal function(P＜0.05).Wexner score of patients with tumor diameter ≥5 cm was higher than that of patients with tumor diameter＜5 cm,Wexner score of patients with neoadjuvant chemotherapy was higher than that of patients without neoadjuvant chemotherapy,and Wexner score of patients with anastomotic leakage was higher than that of patients without anastomotic leakage(P＜0.05).Internal validation of Bootstrap method showed that the C-index was 0.785(95％CI:0.692-0.851).The results of ROC curve showed that the sensitivity and specificity of the nomogram model in predicting postoperative poor anal function of patients were 85.70％and 88.70％,respectively,and the AUC was 0.895(95％CI:0.795-0.984).Conclusion Tumor diameter,neoadjuvant chemotherapy and anastomotic leakage are risk factors for poor anal function after Lap-ISR in patients with extremely low rectal cancer.The nomogram risk prediction model based on the above risk factors has a good risk efficiency in evaluating the risk of postoperative anal dysfunction in patients.

Objective To investigate the expression levels of FOXO1 and SMAD4 in esophageal cancer (EC) tissues and their associations with clinicopathological features and prognosis. Methods Tissue samples of cancerous and adjacent non-cancerous tissues were collected from 131 EC patients. Hematoxylin-eosin (HE) staining was performed to observe the pathological morphology of EC and adjacent tissues. The mRNA expression of FOXO1 and SMAD4 was measured using quantitative real-time polymerase chain reaction (qRT-PCR), while the protein expression of FOXO1 and SMAD4 was determined by immunohistochemistry; Spearman's correlation analysis was employed to assess the correlation between FOXO1 and SMAD4 protein expression in EC tissues; Cox regression analysis was conducted to analyze factors influencing the prognosis of EC patients; Kaplan-Meier analysis was used to perform survival analysis for EC patients. Results The expression of FOXO1 mRNA and its protein positive expression rate were significantly higher in the EC tissues than those in the adjacent tissues, whereas the expression of SMAD4 mRNA and its protein positive expression rate were significantly lower (P < 0.05). FOXO1 and SMAD4 were associated with tumor diameter, tumor differentiation, lymph node metastasis and TNM stage (P < 0.05). A negative correlation was observed between FOXO1 and SMAD4 protein expression in EC tissues (r=-0.419, P < 0.05). FOXO1, SMAD4, tumor diameter, differentiation, lymph node metastasis and TNM stage were identified as factors influencing mortality in EC patients (P < 0.05). The 3-year overall survival rate of EC patients was 84.73% (111/131). The 3-year cumulative survival rate was significantly lower in the EC patients with positive FOXO1 expression than in thosewith negative FOXO1 expression (P < 0.05), while it was significantly higher in patients with positive SMAD4 expression than in those with negative SMAD4 expression (P < 0.05). Conclusion The positive expression rate of FOXO1 is higher, while that of SMAD4 is lower in EC tissues. Their protein expressions were associated with clinicopathological features and prognosis in EC patients. FOXO1 and SMAD4 may serve as important biomarkers for predicting the prognosis of EC.

OBJECTIVE To provide reference for the clinical application and further research and development of Shenling baizhu powder. METHODS Using the methods of textual research and bibliometrics， the key information such as the composition， dose， processing and usage of Shenling baizhu powder in ancient and modern literature were systematically summarized and sorted out， and the number of publications， keywords， and other contents of modern literature were visually analyzed. RESULTS & CONCLUSIONS Shenling baizhu powder was first collected in Taiping Huimin Hejiju Fang （abbreviated “Jufang”）， the composition of core drugs and most widely used dose ratio in previous generations were the same as those in Jufang， basically focusing on powder making and being taken after mixed with liquid； the dosage was concentrated on 2-3 qian； the function and application of it had been expanded to a certain extent compared with Jufang； its clinical application had gradually extended from internal medicine to surgery， gynecology， pediatrics， ophthalmology， dermatology， etc.， covering all aspects of the disease caused by spleen deficiency in general； the composition mechanism revolved around “strengthening the spleen， replenishing qi and removing dampness”； the recommended prescription drugs were all selected from the corresponding varieties in the pharmacopoeia. Modern research mainly focuses on clinical practice， with traditional Chinese medicine or traditional Chinese and Western medicine combined with this formula as the main modified treatment for various intestinal diseases， diarrhea diseases， and lung diseases. The efficacy and application are the frontier hot spots today， and the mechanism of action has begun to be explored. The usage in the literature and the inclusion in the pharmacopoeia are inconsistent， and further research is needed.

Objective To analyze the NBS-LRR disease resistance gene family of Codonopsis pilosula(Franch.)Nannf.and explore the disease resistance mechanism,so as to solve the problem of root rot disease of C.pilosula and promote the breeding and industrial development of C.pilosula.Methods Based on the transcriptome data of C.pilosula in response to root rot pathogen,gene structure,phylogeny,gene interaction and expression pattern of C.pilosula NBS-LRR family genes were analyzed by using bioinformatics methods.Results 88 NBS-LRR family genes were successfully identified.Including N,NL,CN,CNL,TN,TNL and PN,there are 50,14,1,14,4,3 and 2 genes respectively.Their physical and chemical properties,gene structure,phylogeny,gene interaction and expression pattern were analyzed.The results showed that CNL subfamily genes of C.pilosula were amplified during evolution;CNL and TNL gene structures ar-relatively conservative;Expression pattern analysis showed that there were differences in temporal expression patterns of C.pilosula NBS-LRR family genes under F.oxysporum infection.The highly expressed genes DN64786c1g6,DN64786c1g5,DN48234c0g2,DN54844c1g2,DN59747c0g3,DN56071c1g8,DN64591c1g1,DN48464c1g1,DN59886c0g1 play an important role in regulating the disease resistance of C.pilosula.The DN54844c1g2 may interact with GLR family,and then participate in immune regulation by regulating Ca2+ influx;DN64786c1g5 may interact with cytc-1 and cytc-2,and then participate in the response of C.pilosula to root rot by participating in redox reaction;DN59747c0g3 may interact with MPK3 and play an important role in the response of C.pilosula to root rot by participating in map signal cascade,phosphorylating WRKY transcription factor and participating in hypersensitivity reaction(HR).Conclusion The identification and expression analysis of NBS-LRR family genes of C.pilosula is of great significance to explore the mechanism of root rot resistance and gene function of C.pilosula..

Hypertensive disorder of pregnancy (HDP) involves two major public health issues: mother-infant safety and prevention and controlling major chronic disease. HDP poses a serious threat to maternal and neonatal safety, and it is one of the leading causes of maternal and perinatal morbidity and mortality worldwide, as well as an important risk factor for long-term cardiovascular disease (CVD). In order to explore effective strategies to prevent and control the source of CVD and reduce its risk, we have established a cohort of HDPs in Shenzhen for the primordial prevention of CVD. The construction of the HDP cohort has already achieved preliminary progress till now. A total of 2 239 HDP women have been recruited in the HDP cohort. We have established a cohort data management platform and Biobank. The follow-up and assessment of postpartum cardiovascular metabolic risk in this cohort has also been launched. Our efforts will help explore the pathophysiological mechanism of HDP, especially the pathogenesis and precision phenotyping, prediction, and prevention of pre-eclampsia, which, therefore, may reduce the risk of adverse pregnancy outcomes, and provide a bridge to linking HDP and maternal-neonatal cardiovascular, metabolic risk to promote the cardiovascular health of mothers and their infants.

【Objective】 To investigate the dynamic changes of local and systemic inflammatory responses after high-fat diet feeding of ApoE^-/- mice so as to establish the method to assess the recruitment of PKH26-labeled monocytes into atherosclerotic plaque. 【Methods】 ApoE^-/- mice that had received a high-fat diet (HFD) for 8 and 16 weeks were assessed for: ① atherosclerotic plaque burden (oil red O staining), ② aortic tissue inflammation (by RT-qPCR to detect aortic inflammatory factors and cells), ③ systemic inflammatory responses (by ELISA to measure plasma proinflammatory cytokine levels and flow cytometry to assess inflammatory cellular profile in the peripheral blood), and ④ recruitment of PKH26 labeled monocytes into atherosclerotic lesions (by confocal microscope). 【Results】 Compared to those in high-fat diet 8 weeks group, ApoE^-/- mice in high-fat diet 16 weeks group had more serious atherosclerosis in the whole aorta and aortic root (P<0.01); significantly up-regulated aortic mRNA levels of inflammatory factors CCL2, TNF-α and IL-1β (P<0.01); an increased number of aortic local macrophages (P<0.001); significantly increased protein expression of plasma CCL2 and TNF-α (P<0.01); and the increased percentage of peripheral blood monocytes (P<0.05). Moreover, the number of PKH26 labeled monocytes that migrated to aortic lesions were significantly higher in high-fat diet 16 weeks group (P<0.01). 【Conclusion】 High-fat diet promotes the severity of systemic and local inflammatory responses in ApoE knockout mice, which contributes to the migration of peripheral blood monocytes to atherosclerotic plaque.

Objective:To investigate the expression of integrin-linked kinase (ILK)/zinc finger transcription factor (Snail) signaling pathway in renal tubular epithelial-mesenchymal transition (EMT) in diabetic nephropathy (DN) and the effect of rhein.Methods:Healthy male Wistar rats of 8 weeks old were randomly divided into normal group, diabetic nephropathy group, rhein intervention group and valsartan intervention group, with 12 rats in each group. Streptozotocin (STZ) was used to induce the diabetic nephropathy model, then rhein intervention group and valsartan intervention group were given rhein 100 mg/(kg·d) and valsartan 30 mg/(kg·d), respectively. At the end of the 8th and 16th week, six rats of each group were killed, in situ lavage kidney, take out the kidney tissue of rats after fixed in wax block and slices. Renal tubular interstitial damage index and the relative area of interstitial collagen evaluated by hematoxylin-eosin (HE) and Masson staining respectively. The protein expression of E-cadherin, α-smooth muscle actin (α-SMA), ILK, Snail and matrix metalloproteinase-9 (MMP-2) in renal tubular epithelial cells were detected by immunohistochemistry.Results:Comparing to normal group, the renal tubular interstitial damage index and relative area of renal interstitial collagen of diabetic nephropathy rats were both increased. The expression of E-cadherin in renal tubular epithelial cells decreased and the expression of α-SMA significantly increased ( P<0.05). Comparing with diabetic nephropathy group, in rhein and valsartan intervention groups, the expression of E-cadherin in renal tubular epithelial cells increased, while the expression of α-SMA significantly decreased ( P<0.05). There was no significant difference in the above indexes between rhein intervention group and valsartan intervention group ( P>0.05). Compared to normal group, the expressions of ILK, Snail, MMP-2 increased progressively with the disease ( P<0.05). Compared with diabetic nephropathy group, rhein and valsartan intervention groups showed significant decrease in expression of ILK, Snail, MMP-2 ( P<0.05). There was no significant difference in the above indexes between rhein intervention group and valsartan intervention group ( P>0.05). Conclusions:Rhein could inhibit EMT progression by down-regulating the expression of ILK/Snail signaling pathway in renal tubular epithelial cells of DN rats.

Objective:To analyze the risk factors related to lung cancer in participants with low-dose computed tomography (LDCT) screening, to provide data support for identifying high-risk groups of lung cancer and to improve the effectiveness of LDCT lung cancer screening.Methods:A total of 5 366 asymptomatic subjects (2 762 males and 2 604 females) who underwent LDCT lung cancer screening were recruited at Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2017. The result of LDCT and the risk factors of participants were analyzed. The LDCT positive results were defined as solid or part-solid nodules≥5 mm and non-solid nodule≥8 mm. A total of 12 factors were included and multivariate logistic regression was used to analyze the risk factors associated with lung cancer in the study.Results:Of the 5 366 asymptomatic subjects, 389 were positive and 4 977 were negative for LDCT screening. Among them, 26 of 389 positive cases were confirmed as lung cancers pathologically, and the detection rate of stage I lung cancer was 92.3% (24/26). Multivariate logistic regression showed that age, smoking, low level of education were the relevant risk factors for lung cancer and positive nodules. A stratified analysis of age showed that no risk factors were detected in the 40-49 years old group, while age, smoking, low level of education (primary school and below) were recognized as risk factors in the ≥50 years old group. No statistically significant risk factor was detected between the lung cancer group and the positive nodules group.Conclusions:Age, smoking, and low level of education (primary school and below) are related risk factors for lung cancer and positive nodules. People aged 50 years or older, smoking, and low level of education may be a high risk group for lung cancer. LDCT can effectively detect early lung cancer.