Objective:To investigate the clinicopathological features, molecular pathology characteristics, and prognosis of non-small cell lung carcinoma (NSCLC) exhibiting co-expression of p40 and thyroid transcription factor1 (TTF1).Methods:Clinical and pathological data of six NSCLC cases with co-expression of p40 and TTF1 diagnosed at the First People′s Hospital of Xiaoshan District, Hangzhou, China from January 2016 to December 2023 were collected. Relevant literature was also reviewed.Results:NSCLC with co-expression of p40 and TTF1 commonly occurred in male smokers and had been in stage Ⅲ-Ⅳ when diagnosis. Microscopic examination revealed that the tumor cells were arranged in solid nests and sheets with marked atypia and visible mitotic figures. There was no prominent evidence of keratinization or glandular formation. The tumor cells diffusely co-expressed p40 and TTF1, exhibiting a dual immunophenotype characteristic of both squamous cell carcinoma and adenocarcinoma. Molecular testing of four NSCLC co-expressing p40 and TTF1 revealed the presence of common EGFR mutations, as well as mutations of NRAS (mutation rate of 2.09%), EML4-ALK (mutation rate of 24.77%), and PIK3CA (exon 10 c.1658 G>C p.S553T, mutation rate of 4.32%). All six tumors were poorly differentiated, highly invasive, and associated with poor prognosis. Four of the six patients experienced widespread metastasis and died within 7 to 30 months after the diagnosis or initial treatment.Conclusions:NSCLC with co-expression of p40 and TTF1 exhibits distinct clinicopathological features, immunophenotypes, molecular alterations, and clinical outcomes, characterized by rapid progression and poor prognosis. Pathologists should be vigilant in recognizing this entity to avoid misdiagnosis and missed diagnosis.

Objective:To study the value of myocardial perfusion imaging (MPI) and coronary flow reserve (CFR) combined with coronary artery calcium score (CACS) in the diagnosis of obstructive coronary artery disease (CAD).Methods:From January 2019 to December 2020, 96 confirmed or suspective CAD patients (65 males, 31 females; age: 30-81 years) who completed rest/stress MPI, CFR and CACS defection in Fuwai Central China Cardiovascular Hospital were retrospectively analyzed. Coronary angiography (CAG) was used as the diagnostic standard to calculate the sensitivity and accuracy of MPI, CFR and MPI/CFR combined with CACS in the diagnosis of CAD. The χ2 test was used to compare the diagnostic efficiency of different methods. Results:The diagnostic sensitivity of MPI was 76.06%(54/71), and the accuracy was 75.00%(72/96), while the sensitivity increased to 97.18%(69/71; χ2=13.67, P<0.001) and the accuracy increased to 87.50%(84/96; χ2=4.92, P=0.020) with significant differences after combined with CACS. The sensitivity and accuracy of CFR were 91.55%(65/71)and 87.50%(84/96), which increased to 97.18%(69/71; χ2=2.12, P=0.137) and 89.58%(86/96; χ2=0.21, P=0.411) with no significant differences after combined with CACS. The sensitivity of MPI in the diagnosis of three-vessel CAD was 70.00%(21/30), which increased to 100%(30/30; χ2=7.75, P=0.004) after combined with CACS; while the sensitivity of MPI combined with CACS in the diagnosis of single-vessel and double-vessel CAD were not significantly improved ( χ2 values: 3.29, 1.51, P values: 0.114, 0.416). Conclusion:The combination of MPI and CACS can significantly improve the diagnostic efficiency of CAD, contributed by the improvement of the diagnostic sensitivity in three-vessel disease; whereas the diagnostic efficiency of CFR for CAD is not significantly improved after combined with CACS.

Sleep deprivation (SD) has a profound impact on the central nervous system, resulting in an array of mood disorders, including depression and anxiety. Despite this, the dynamic alterations in neuronal activity during sleep deprivation have not been extensively investigated. While some researchers propose that sleep deprivation diminishes neuronal activity, thereby leading to depression. Others argue that short-term sleep deprivation enhances neuronal activity and dendritic spine density, potentially yielding antidepressant effects. In this study, a two-photon microscope was utilized to examine the calcium transients of anterior cingulate cortex (ACC) neurons in awake SD mice in vivo at 24-hour intervals. It was observed that SD reduced the frequency and amplitude of Ca2+ transients while increasing the proportions of inactive neurons. Following the cessation of sleep deprivation, neuronal calcium transients demonstrated a gradual recovery. Moreover, whole-cell patch-clamp recordings revealed a significant decrease in the frequency of spontaneous excitatory post-synaptic current (sEPSC) after SD. The investigation also assessed several oxidative stress parameters, finding that sleep deprivation substantially elevated the level of malondialdehyde (MDA), while simultaneously decreasing the expression of Nuclear Factor erythroid 2-Related Factor 2 (Nrf2) and activities of Superoxide dismutase (SOD) in the ACC. Importantly, the administration of gallic acid (GA) notably mitigated the decline of calcium transients in ACC neurons. GA was also shown to alleviate oxidative stress in the brain and improve cognitive impairment caused by sleep deprivation. These findings indicate that the calcium transients of ACC neurons experience a continuous decline during sleep deprivation, a process that is reversible. GA may serve as a potential candidate agent for the prevention and treatment of cognitive impairment induced by sleep deprivation.

Objective:To study the photoneutron radiation field caused by photonuclear reaction during the operation of high energy medical linac.Methods:Monte Carlo was used to simulate the photoneutron pollution of Clinic 2300CD medical electron accelerator in 15 MV X-ray mode. The photoneutron spectrum at different positions of the head and the variation in neutron ambient dose equivalent in different irradiation fields were investigated, and the dose distribution of photoneutron on the isocenter plane and the dose attenuation in the water model were analyzed.Results:When the collimator was closed, the average photoneutron energy at the lower surface of target, primary collimator, flattening filter and multi-leaf collimator was 1.08, 1.20, 0.35 and 0.30 MeV, respectively. The neutron ambient dose equivalent at the isocenter first increased and then decreased with the irradiation field expanding, reaching the maximum in about 30 cm × 30 cm irradiation field. With the increase in the depth of the measuring point in water phantom, the neutron fluent first increased and then decreased, while the neutron dose gradually decreased. In different irradiation fields, the photoneutron dose rate was almost close to the background when the depth of the water was 20 cm.Conclusions:By exploring the photoneutron spectrum and dose distribution characteristics of the high energy medical linac head, as well as the dose deposition mechanism of photoneutron in water phantom, this study provides data support for further research on the additional dose and secondary cancer effects on patients caused by photoneutron pollution from the high energy medical linac.

Objective:To investigate the status of exposure to xylene and Formaldehyde of medical and technical personnel in Pathology Department of a hospital, and to provide references for prevention of occupational hazards.Methods:From July to October in 2019, 52 medical workers and working places in Pathology Department of a third-class hospital in Jiangxi Province were selected as survey objects, the distribution of occupational hazards, protective measures and personal protective equipment were investigated, and the control wind speed of Formaldehyde, xylene and ventilation facilities were detected and analyzed statistically.Results:It showed that the detection rate of xylene and formaldehyde was 82.1% (23/28) , and the detection rate of xylene CSTEL in the two sampling posts was 14.3% (2/14) , the local suction device on each side and the control wind speed of the fume hood do not meet the national standards. Conclusion:It is necessary to strengthen the prevention and control of the occupational hazards in the Department of Pathology to prevent the occurrence of occupational diseases.

Objective:To investigate the status of exposure to xylene and Formaldehyde of medical and technical personnel in Pathology Department of a hospital, and to provide references for prevention of occupational hazards.Methods:From July to October in 2019, 52 medical workers and working places in Pathology Department of a third-class hospital in Jiangxi Province were selected as survey objects, the distribution of occupational hazards, protective measures and personal protective equipment were investigated, and the control wind speed of Formaldehyde, xylene and ventilation facilities were detected and analyzed statistically.Results:It showed that the detection rate of xylene and formaldehyde was 82.1% (23/28) , and the detection rate of xylene CSTEL in the two sampling posts was 14.3% (2/14) , the local suction device on each side and the control wind speed of the fume hood do not meet the national standards. Conclusion:It is necessary to strengthen the prevention and control of the occupational hazards in the Department of Pathology to prevent the occurrence of occupational diseases.

Objective:To identify the process nodes and types of dust existing during subway construction, evaluate the occupational health risk assessment, analyze the key control points, and provide technical basis for occupational health management.Methods:From August 2017 to December 2018, the field occupational health survey method was used to investigate the whole construction period of subway, and the occupational health risk assessment method was used to assess the degree of dust hazard, and the consistency of the assessment results of ICMM, UQ and MLSP methods were compared.Results:The dust in the operation site exists in multiple nodes of the construction cycle, and the operators were exposed to a variety of dust at the same time. Concrete workers and other jobs were key control posts. The risk level assessed by ICMM method was relatively higher than that by UQ method and MLSP method, the latter two results were relatively close.Conclusion:The three occupational health risk assessment methods are all suitable for the site risk assessment without occupational monitoring data, and UQ method has better applicability to the construction industry.

Objective:To identify the process nodes and types of dust existing during subway construction, evaluate the occupational health risk assessment, analyze the key control points, and provide technical basis for occupational health management.Methods:From August 2017 to December 2018, the field occupational health survey method was used to investigate the whole construction period of subway, and the occupational health risk assessment method was used to assess the degree of dust hazard, and the consistency of the assessment results of ICMM, UQ and MLSP methods were compared.Results:The dust in the operation site exists in multiple nodes of the construction cycle, and the operators were exposed to a variety of dust at the same time. Concrete workers and other jobs were key control posts. The risk level assessed by ICMM method was relatively higher than that by UQ method and MLSP method, the latter two results were relatively close.Conclusion:The three occupational health risk assessment methods are all suitable for the site risk assessment without occupational monitoring data, and UQ method has better applicability to the construction industry.

OBJECTIVE: To understand the exposure of occupational hazards, occupational and mental health status of high-speed railway locomotive drivers. METHODS: A total of 150 male high-speed railway locomotive drivers from Nanchang Railway administration were selected as experimental group, and 80 male ordinary train drivers were selected as control group by using a judgment sampling method. The occupational disease hazard testing and occupational health examinations were conducted in drivers of these two groups. The mental health status survey was conducted using the Symptom Checklist 90(SCL-90). RESULTS: The noise, power frequency electric field, formaldehyde, benzene, toluene, xylene and carbon dioxide in all the work place of these two groups were in line with the national occupational health standards. The exposure noise intensity of the experimental group was lower than that of the control group [(70.5±3.7) vs(77.4±4.1) dB(A), P<0.05]. The detection rates of hypertension and chronic gastritis were higher in the experimental group(18.7% vs 34.7%, 26.2% vs 42.0%, P<0.05). The detection rate of high frequency hearing loss decreased in the experimental group compared with the control group(22.5% vs 10.7%, P<0.05). The total score of SCL-90 in the experimental group was higher than that in the control group [(169.5±6.1) vs(148.0±6.0) score, P<0.01]. The positive rate of psychological symptoms was higher in the experimental group than that of the control group(41.3% vs 23.8%, P<0.01). CONCLUSION: The concentration/intensity of occupational disease hazards in the workplace of high-speed railway locomotives drivers is within normal limit. The occupational health status of high-speed railway locomotive drivers is generally good, but attention should be paid to their occupational mental health hazards.

Since the reform and opening up, a large number of migrant workers to enter into the mining enterprises of the town, due to poor working conditions and lack of awareness of labor protection, a large number of workers at that time were diagnosed with occupational diseases such as pneumoconiosis, the lack of effective treatment and compensation mechanisms, it faces many difficulties of life, health care, employment and marriage, becoming more vulnerable, need access to national and social support and assistance. Currently, the patient's occupation of social assistance there are some flaws, and for the growing demand for professional rescue patients, China is still not established specifically for the social assistance system of the patient career, but also lack of systematic research. The paper combing through social assistance in the form and content of the existing occupation for patients and found deficiencies and problems of the current social assistance vocational patient exists, and proposed a framework for the establishment of vocational social assistance system of the patient, specific measures and means.