Objective To systematically evaluate the radiation impact of radioactive sources used in online elemental analyzers in cement enterprises on the surrounding environment, and to provide a scientific basis for radiation monitoring and safety management at the application sites of this type of radioactive sources. Methods A statistical analysis was conducted on 15 cement enterprises in Guangxi Province using online elemental analyzers with ²⁵²Cf as the radioactive source. On-site investigation of radiation safety management and on-site monitoring of radiation environment were performed, followed by an evaluation based on the collected data. Results Although the gamma radiation ambient dose equivalent rate and neutron ambient dose equivalent rate increased around the sites using online elemental analyzers with ²⁵²Cf as the radioactive source, they all met the requirements of the Radiological Health Protection Requirements for Instruments with Sealed Sources (GBZ 125—2009). Conclusion Under the current usage and management conditions, the application of this type of radioactive sources has controllable radiation impact on the surrounding environment, and will not pose a threat to public health and environmental safety. However, continuous strengthening of radiation safety management measures and regular radiation monitoring work are still needed to ensure the safe use of radioactive sources, further reducing potential radiation risks and providing strong guarantees for the safe application of radioactive sources in online elemental analyzers in cement enterprises.

Objective To explore the effect of high-sensitivity cardiac troponin T(hs-cTnT)and frailty on all-cause mortality risk in elderly inpatients without acute coronary syndrome(ACS).Methods A prospective cohort study was conducted on 613 non-ACS inpatients admitted to our department from June 2015 to December 2019.According to the tertile fo hs-cTnT level,the patients were divided into the low hs-cTnT group(＜13 ng/L,n=184),median hs-cTnT group(13-19 ng/L,n=226),high hs-cTnT group(＞19 ng/L,n=203).Based on the results of Fried frailty scale,they were also assigned into a non-frail group(n=410)and a frail group(n=203).So,there were six groups,that is,low hs-cTnT and non-frail group(n=139),low hs-cTnT with frailty group(n=45),median hs-cTnT and non-frail group(n=172),median hs-cTnT with frail-ty group(n=54),high hs-cTnT and non-frail group(n=99),and high hs-cTnT with frailty group(n=104).Baseline clinical data were collected in all the patients.All of them were followed for 2 years to observe all-cause mortality.The effects of hs-cTnT and frailty on mortality risk were analyzed.The predictive value of hs-cTnT combined with Fried frailty classification for mortality was evaluated.Results During the 2-year follow-up,83(13.5％)all-cause deaths occurred.Cox regression analysis revealed that after adjustment for confounders,the high hs-cTnT and non-frail group had increased mortality risk than the low hs-cTnT and non-frail group(HR=3.005,95％CI:1.171-7.711,P=0.022),while the high hs-cTnT with frailty group had the high-est risk(HR=4.470,95％CI:1.775-11.255,P=0.001).ROC curve analysis demonstrated that an AUC value of hs-cTnT,Fried frailty score and their combination in predicting mortality was 0.694(95％CI:0.656-0.730,P＜0.01),0.669(95％CI:0.631-0.707,P＜0.01),and 0.723(95％CI:0.686-0.758,P＜0.01),respectively.Conclusion For the elderly non-ACS inpatients,those with hs-cTnT elevation and frailty are at the highest risk for all-cause mortality.The combination of hs-cTnT and Fried frailty score demonstrates higher predictive value than either indicator alone.

PURPOSE: Septic shock is associated with high mortality and poor outcomes among sepsis patients with coagulopathy. Although traditional statistical methods or machine learning (ML) algorithms have been proposed to predict septic shock, these potential approaches have never been systematically compared. The present work aimed to develop and compare models to predict septic shock among patients with sepsis. METHODS: It is a retrospective cohort study based on 484 patients with sepsis who were admitted to our intensive care units between May 2018 and November 2022. Patients from the 908th Hospital of Chinese PLA Logistical Support Force and Nanchang Hongdu Hospital of Traditional Chinese Medicine were respectively allocated to training (n=311) and validation (n=173) sets. All clinical and laboratory data of sepsis patients characterized by comprehensive coagulation indexes were collected. We developed 5 models based on ML algorithms and 1 model based on a traditional statistical method to predict septic shock in the training cohort. The performance of all models was assessed using the area under the receiver operating characteristic curve and calibration plots. Decision curve analysis was used to evaluate the net benefit of the models. The validation set was applied to verify the predictive accuracy of the models. This study also used Shapley additive explanations method to assess variable importance and explain the prediction made by a ML algorithm. RESULTS: Among all patients, 37.2% experienced septic shock. The characteristic curves of the 6 models ranged from 0.833 to 0.962 and 0.630 to 0.744 in the training and validation sets, respectively. The model with the best prediction performance was based on the support vector machine (SVM) algorithm, which was constructed by age, tissue plasminogen activator-inhibitor complex, prothrombin time, international normalized ratio, white blood cells, and platelet counts. The SVM model showed good calibration and discrimination and a greater net benefit in decision curve analysis. CONCLUSION The SVM algorithm may be superior to other ML and traditional statistical algorithms for predicting septic shock. Physicians can better understand the reliability of the predictive model by Shapley additive explanations value analysis.
Humans ; Shock, Septic/blood* ; Machine Learning ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Sepsis/complications* ; ROC Curve ; Cohort Studies ; Adult ; Intensive Care Units ; Algorithms ; Blood Coagulation ; Critical Illness

The structure of intestinal tissue is complex. In vitro simulation of intestinal structure and function is important for studying intestinal development and diseases. Recently, organoids have been successfully constructed and they have come to play an important role in biomedical research. Organoids are miniaturized three-dimensional (3D) organs, derived from stem cells, which mimic the structure, cell types, and physiological functions of an organ, making them robust models for biomedical research. Intestinal organoids are 3D micro-organs derived from intestinal stem cells or pluripotent stem cells that can successfully simulate the complex structure and function of the intestine, thereby providing a valuable platform for intestinal development and disease research. In this article, we review the latest progress in the construction and application of intestinal organoids.
Organoids/cytology* ; Intestines/physiology* ; Humans ; Animals ; Pluripotent Stem Cells

mRNA therapy involves delivering target molecules in the form of mRNA into cells to treat dis-eases.The highly variable nature of mRNA sequences offers potential solutions for high-throughput drug discovery and personalized treatment.This review begins with an overview of the development history of mRNA,tracing its journey from discovery to becoming a potential treatment.The review also discusses the applications of mRNA in protein replacement therapy,cancer treatment,in vivo gene editing,and in-fectious disease prevention based on the different categories of proteins delivered by mRNA.Additionally,optimizing mRNA formulations and their delivery vehicles is crucial for clinical application.This review further explains how to enhance the translation efficiency and stability of mRNA through nucleoside modi-fications and sequence optimization,and we systematically compare the pros and cons of novel circular mRNA versus traditional linear mRNA in vaccine development.Moreover,we summarize common deliv-ery methods,such as lipid nanoparticles,and discuss the latest advancements in targeted delivery sys-tems.For currently approved and in-development mRNA drugs,we systematically review the diseases treated,effector molecules delivered,and their clinical stages.Finally,we explore the challenges facing mRNA therapies and the potential diseases they could address,aiming to provide a theoretical foundation and reference for the development of mRNA therapies.

mRNA therapy involves delivering target molecules in the form of mRNA into cells to treat dis-eases.The highly variable nature of mRNA sequences offers potential solutions for high-throughput drug discovery and personalized treatment.This review begins with an overview of the development history of mRNA,tracing its journey from discovery to becoming a potential treatment.The review also discusses the applications of mRNA in protein replacement therapy,cancer treatment,in vivo gene editing,and in-fectious disease prevention based on the different categories of proteins delivered by mRNA.Additionally,optimizing mRNA formulations and their delivery vehicles is crucial for clinical application.This review further explains how to enhance the translation efficiency and stability of mRNA through nucleoside modi-fications and sequence optimization,and we systematically compare the pros and cons of novel circular mRNA versus traditional linear mRNA in vaccine development.Moreover,we summarize common deliv-ery methods,such as lipid nanoparticles,and discuss the latest advancements in targeted delivery sys-tems.For currently approved and in-development mRNA drugs,we systematically review the diseases treated,effector molecules delivered,and their clinical stages.Finally,we explore the challenges facing mRNA therapies and the potential diseases they could address,aiming to provide a theoretical foundation and reference for the development of mRNA therapies.

Objective To explore the effect of high-sensitivity cardiac troponin T(hs-cTnT)and frailty on all-cause mortality risk in elderly inpatients without acute coronary syndrome(ACS).Methods A prospective cohort study was conducted on 613 non-ACS inpatients admitted to our department from June 2015 to December 2019.According to the tertile fo hs-cTnT level,the patients were divided into the low hs-cTnT group(＜13 ng/L,n=184),median hs-cTnT group(13-19 ng/L,n=226),high hs-cTnT group(＞19 ng/L,n=203).Based on the results of Fried frailty scale,they were also assigned into a non-frail group(n=410)and a frail group(n=203).So,there were six groups,that is,low hs-cTnT and non-frail group(n=139),low hs-cTnT with frailty group(n=45),median hs-cTnT and non-frail group(n=172),median hs-cTnT with frail-ty group(n=54),high hs-cTnT and non-frail group(n=99),and high hs-cTnT with frailty group(n=104).Baseline clinical data were collected in all the patients.All of them were followed for 2 years to observe all-cause mortality.The effects of hs-cTnT and frailty on mortality risk were analyzed.The predictive value of hs-cTnT combined with Fried frailty classification for mortality was evaluated.Results During the 2-year follow-up,83(13.5％)all-cause deaths occurred.Cox regression analysis revealed that after adjustment for confounders,the high hs-cTnT and non-frail group had increased mortality risk than the low hs-cTnT and non-frail group(HR=3.005,95％CI:1.171-7.711,P=0.022),while the high hs-cTnT with frailty group had the high-est risk(HR=4.470,95％CI:1.775-11.255,P=0.001).ROC curve analysis demonstrated that an AUC value of hs-cTnT,Fried frailty score and their combination in predicting mortality was 0.694(95％CI:0.656-0.730,P＜0.01),0.669(95％CI:0.631-0.707,P＜0.01),and 0.723(95％CI:0.686-0.758,P＜0.01),respectively.Conclusion For the elderly non-ACS inpatients,those with hs-cTnT elevation and frailty are at the highest risk for all-cause mortality.The combination of hs-cTnT and Fried frailty score demonstrates higher predictive value than either indicator alone.

Objective To investigate the effect of varying ureteral wall thickness(UWT)at the site of ureteral stones on the clinical efficacy of ureteroscopic lithotripsy(URL).Methods The clinical data of 164 patients with ureteral stones in our hospital were retrospectively analyzed.According to different UWT,the patients were divided into the mild thickening group(84 cases,UWT<3.16 mm),the moderate thickening group(31 cases,UWT 3.16 to 3.49 mm),and the severe thickening group(49 cases,UWT>3.49 mm),and the differences of clinical related indicators among the three groups were compared.Results The incidence of postoperative renal colic and leukocyte disorder in the mild thickening group and the moderate thickening group were lower than those in the severe thickening group,and the differences were statistically significant(P<0.05).The postoperative catheterization time in the mild thickening group and the moderate thickening group were shorter than that in the severe thickening group,and the incidences of secondary lithotripsy,residual stones and stone return to kidney in the mild thickening group and the moderate thickening group were lower than those in the severe thickening group,with statistically significant differences(P<0.05).The length of hospital stay and hospitalization cost in the mild thickening group and the moderate thickening group were shorter/less than those in the severe thickening group,with statistically significant differences(P<0.05).Conclusion With the increase of UWT(especially when UWT>3.49 mm),the incidence of postoperative complications and hospitalization cost of URL increase to varying degrees,and the surgical efficacy decreases.In clinical work,UWT measurement holds potential value in predicting the surgical efficacy and complications of URL.

Nuclear receptor corepressor (NCoR1) interacts with various nuclear receptors and regulates the anabolism and catabolism of lipids. An imbalance in lipid/energy homeostasis is also an important factor in obesity and metabolic syndrome development. In this study, we found that the deletion of NCoR1 in intestinal epithelial cells (IECs) mainly activated the nuclear receptor PPARα and attenuated metabolic syndrome by stimulating thermogenesis. The increase in brown adipose tissue thermogenesis was mediated by gut-derived tricarboxylic acid cycle intermediate succinate, whose production was significantly enhanced by PPARα activation in the fed state. Additionally, NCoR1 deletion derepressed intestinal LXR, increased cholesterol excretion, and impaired duodenal lipid absorption by decreasing bile acid hydrophobicity, thereby reversing the possible negative effects of intestinal PPARα activation. Therefore, the simultaneous regulatory effect of intestinal NCoR1 on both lipid intake and energy expenditure strongly suggests that it is a promising target for developing metabolic syndrome treatment.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.