Objective To evaluate the levels and changes in occupational individual external radiation dose in non-medical nuclear utilization units in Nanning City, and to provide a basis for radiation protection in such units. Methods Thermoluminescent dosimeters were used to monitor individual radiation doses among radiation workers in 38 non-medical nuclear utilization units in Nanning City. The results were subjected to statistical analysis. Results From 2021 to 2023, a total of 3724 person-times were monitored in 38 non-medical nuclear utilization units in Nanning City. The mean annual effective dose was 0.101 mSv in 2021, 0.060 mSv in 2022, and 0.094 mSv in 2023, with a three-year average of 0.085 mSv, all well below the occupational exposure limit of 1.0 mSv. Significant differences in mean annual effective doses were observed across occupations and sexes (P<0.05). Female workers received significantly lower mean annual effective dose than male workers. Workers in the cement manufacturing industry had a significantly higher mean annual effective dose compared to those in government institutions and industrial flaw detection practitioners (F = 2.913, P<0.05). No significant differences were found among workers exposed to unsealed radioactive sources, sealed radioactive sources, and radiation-generating equipment (F = 0.585, P>0.05). Conclusion The occupational individual external radiation doses in non-medical nuclear utilization units in Nanning City are at low levels. There are no significant differences in mean annual effective dose across different nuclear utilization units. However, differences in occupational roles between males and females significantly affect the mean annual effective dose.

OBJECTIVE: To investigate the effects of Huayu Tongluo (transforming stasis and unblocking collaterals) moxibustion on cognitive function and insulin resistance in patients with type 2 diabetes mellitus (T2DM) and cognitive decline. METHODS: Ninety patients with T2DM and cognitive decline were randomly divided into a moxibustion group (n=45, 3 cases dropped out, 2 cases were eliminated) and a waiting moxibustion group (n=45, 2 cases dropped out). Both groups received routine hypoglycemic treatment for 12 weeks. The moxibustion group additionally received Huayu Tongluo moxibustion at Baihui (GV20), Shenting (GV24), and Dazhui (GV14). Pressing moxibustion was applied to Baihui (GV20) for 20 min, while suspended moxibustion was applied to Shenting (GV24) and Dazhui (GV14) for 20 min each. Treatments of moxibustion were administered every other day (three times per week) for 12 weeks. All patients were followed up for 12 weeks, during which their original hypoglycemic medication regimen was maintained. Before treatment, after 12 weeks of treatment, and at the 12-week follow-up, the scores of Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), Addenbrooke's cognitive examination Ⅲ (ACE-Ⅲ), symbol digit modalities test (SDMT), and Athens insomnia scale (AIS) and the insulin resistance index (HOMA-IR) were observed in the two groups. RESULTS: Compared with before treatment, the MoCA scores, MMSE scores, ACE-Ⅲ subscale scores (attention, memory, language fluency, language, visuospatial ability) and total scores, and SDMT scores were increased (P<0.01), while the AIS scores were decreased (P<0.05) in the moxibustion group after treatment and at follow-up. Compared with before treatment, the MMSE score, ACE-Ⅲ subscale scores (memory, attention) and total score after treatment, as well as the ACE-Ⅲ subscale scores (language, memory, attention) and total score, and SDMT score at follow-up were increased (P<0.05, P<0.01) in the waiting moxibustion group. Compared with before treatment, HOMA-IR was decreased in both groups after treatment and at follow-up (P<0.01). At follow-up, ACE-Ⅲ subscale scores (attention, memory), and the total score in the moxibustion group were lower than those after treatment (P<0.05, P<0.01), and the ACE-Ⅲ language subscale score, total ACE-Ⅲ score, and SDMT score in the waiting moxibustion group were higher than those after treatment (P<0.01, P<0.05). After treatment and at follow-up, compared with the waiting moxibustion group, the moxibustion group had higher MoCA scores, MMSE scores, SDMT scores, ACE-Ⅲ subscale scores (attention, memory, language fluency) and total scores (P<0.05, P<0.01), and lower HOMA-IR (P<0.05). CONCLUSION Huayu Tongluo moxibustion can effectively improve cognitive function in patients with T2DM and cognitive decline. This improvement may be associated with the reduction in insulin resistance.
Humans ; Insulin Resistance ; Diabetes Mellitus, Type 2/complications* ; Male ; Female ; Moxibustion ; Middle Aged ; Aged ; Cognition ; Acupuncture Points ; Adult ; Cognitive Dysfunction/therapy*

Objective To explore the potential characteristics of self-management behavior in maintenance hemodialysis patients with hypertension and determine the influencing factors of different characteristics,so as to provide reference for improving self-management behavior.Methods A total of 192 maintenance hemodialysis patients with hypertension who received dialysis in The First Hospital Affiliated to Naval Medical University from May to September 2022 were enrolled by convenience sampling.A general information questionnaire,hypertension self-management behavior scale,Morisky medication adherence scale-8 items,and medication adherence self-efficacy scale-revision(MASES-R)were used to investigate the potential categories of self-management behavior in maintenance hemodialysis patients with hypertension,and the predictive indicators of each category were analyzed by latent profile analysis.Results Three latent categories of self-management behavior in maintenance hemodialysis patients with hypertension were identified:low self-management behavior,moderate self-management behavior,and high self-management behavior.Medication adherence and medication adherence self-efficacy were predictors of high self-management behavior.Monitoring blood pressure once daily was a predictor of moderate self-management behavior.Conclusion There is significant self-management characteristics among maintenance hemodialysis patients with hypertension.These characteristics and risk factors should be identified early to help patients improving their self-management.

Objective To investigate the prognostic value of atherogenic index of plasma(AIP)for the occurrence of major adverse cardiovascular events(MACE)in elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 355 elderly patients with acute STEMI who received coronary interventional therapy in Department of Cardiology,Affilia-ted Hospital of Hebei University from January to May 2023 were recruited retrospectively,and fi-nally 343 of them with complete telephone follow-up data were included in this study.According to their AIP quartile level,they were divided into A1 group(＜0.212,84 cases),A2 group(0.212-0.339,87 cases),A3 group(0.339-0.434,86 cases)and A4 group(≥0.434,86 cases).The incidences of cardiac death,nonfatal myocardial infarction,ischemia-driven target vessel re-modeling and heart failure re-hospitalization were observed during 1-year follow-up.Kaplan-Meier survival curve was plotted to compare the incidence of MACE in the 4 groups.ROC curve analysis was employed to determine the predictive value of AIP.Results During 1-year follow-up,signifi-cant differences were observed in the proportions of ischemia-driven target vessel revasculariza-tion,heart failure re-hospitalization and non-fatal acute myocardial infarction among the 4 groups(P＜0.05,P＜0.01),and such difference was also seen in the cumulative survival rate among them(log rankx2=8.528,P=0.036).Multivariate Cox proportional hazards regression analysis showed that gender,hypertension,atrial fibrillation,multi-vessel disease,left main artery disease,number of stents,SYNTAX score,Killip grade,BNP,HbA1c,TC,LDL-C and HDL-C levels,and AIP were independent predictors of MACE.The AUC value of AIP in predicting MACE in elderly patients with acute STEMI was 0.855(95％CI:0.776-0.933),with a sensitivity of 66.7％and a specificity of 93.0％.When the above indicators combined together,the AUC value was 0.907(95％CI:0.954-0.987),and the sensitivity and specificity was 100.0％and 90.7％,respectively.The AUC value of combined prediction was significantly better than that of single indicator(P＜0.05).Conclusion AIP is a powerful biomarker,and can be used to predict the prognosis of elderly acute STEMI after coronary interventional therapy,and it combined with Killip grade,SYNTAX score,HbA1c,and number of stents shows better predictive efficacy.

Insertion/deletion polymorphism(InDel)markers are a class of length polymorphic genetic markers widely distributed in genomes,which have the characteristics of both STR and SNP.InDel markers can be applied to the work like individual identification of degraded materials and the identification of complex relationship.It can narrow the scope of investigation by ancestral inference,which have important practical value in forensic genetics inspection and analysis.With the development of research on Multi-InDel and Multi-allelic InDel markers,the identification efficiency of InDel markers continues to improve,and their forensic application scenarios are also expanded.This review summarized the application and development of InDel markers in forensic genetics,and explored the development in the future.

Objective:To evaluate the effect of Kuntai capsules combined with progestin-primed ovarian stimulation (PPOS) protocol on the ovarian response, laboratory parameters and embryo transfer outcomes of expected poor ovarian response (POR) patients undergoing invitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. Methods:A retrospective cohort study was performed at Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital from June 2020 to July 2023. A total of 1 733 expected POR patients were enrolled and divided into the PPOS only group (control group) and the Kuntai capsules combined with PPOS regimen group (trial group). After a 1∶1 propensity score matching, 423 cases were included in each group. Further analyses and comparisons were made between the two groups, concerning the ovarian stimulation outcomes, embryo laboratory parameters and pregnancy rates after the first frozen-thawed embryo transfer cycles. The primary outcome measure was the number of oocytes retrieved.Results:No statistically significant difference was found in baseline characteristics after matching between the two groups (all P>0.05). Compared with control group, the number of oocytes retrieved did not differ significantly in the trial group ( P=0.295). The level of luteinizing hormone (LH) on the trigger day [3.3 (2.2, 5.0) U/L], the number of available blastocysts formed [1 (0, 1)] and the available blastocyst formation rate [46.2% (85/184)] in the trial group were significantly higher than those in control group [2.9 (1.9, 4.5) U/L, P=0.004; 0 (0, 1), P=0.034; 30.0% (48/160), P=0.002]. However, there were no significant differences in the duration and dosage of gonadotropin used, progesterone and estradiol levels on the trigger day, incidence of premature LH surge, number/rate of fertilized oocytes, number/rate of cleaved embryos, number/rate of high-quality embryos, as well as rate of unavailable embryos (all P>0.05). Compared with control group, the trial group demonstrated comparable implantation rate, clinical pregnancy rate, early miscarriage rate, ongoing pregnancy rate and live birth rate after the first frozen-thawed embryo transfer cycles (all P>0.05). Conclusion:Compared with the PPOS only regimen, the combination of Kuntai capsules and PPOS did not increase the number of oocytes retrieved but could increase the number and rate of available blastocysts formed in expected POR patients.

Objective:To evaluate the effect of Kuntai capsules combined with progestin-primed ovarian stimulation (PPOS) protocol on the ovarian response, laboratory parameters and embryo transfer outcomes of expected poor ovarian response (POR) patients undergoing invitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. Methods:A retrospective cohort study was performed at Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital from June 2020 to July 2023. A total of 1 733 expected POR patients were enrolled and divided into the PPOS only group (control group) and the Kuntai capsules combined with PPOS regimen group (trial group). After a 1∶1 propensity score matching, 423 cases were included in each group. Further analyses and comparisons were made between the two groups, concerning the ovarian stimulation outcomes, embryo laboratory parameters and pregnancy rates after the first frozen-thawed embryo transfer cycles. The primary outcome measure was the number of oocytes retrieved.Results:No statistically significant difference was found in baseline characteristics after matching between the two groups (all P>0.05). Compared with control group, the number of oocytes retrieved did not differ significantly in the trial group ( P=0.295). The level of luteinizing hormone (LH) on the trigger day [3.3 (2.2, 5.0) U/L], the number of available blastocysts formed [1 (0, 1)] and the available blastocyst formation rate [46.2% (85/184)] in the trial group were significantly higher than those in control group [2.9 (1.9, 4.5) U/L, P=0.004; 0 (0, 1), P=0.034; 30.0% (48/160), P=0.002]. However, there were no significant differences in the duration and dosage of gonadotropin used, progesterone and estradiol levels on the trigger day, incidence of premature LH surge, number/rate of fertilized oocytes, number/rate of cleaved embryos, number/rate of high-quality embryos, as well as rate of unavailable embryos (all P>0.05). Compared with control group, the trial group demonstrated comparable implantation rate, clinical pregnancy rate, early miscarriage rate, ongoing pregnancy rate and live birth rate after the first frozen-thawed embryo transfer cycles (all P>0.05). Conclusion:Compared with the PPOS only regimen, the combination of Kuntai capsules and PPOS did not increase the number of oocytes retrieved but could increase the number and rate of available blastocysts formed in expected POR patients.

Insertion/deletion polymorphism(InDel)markers are a class of length polymorphic genetic markers widely distributed in genomes,which have the characteristics of both STR and SNP.InDel markers can be applied to the work like individual identification of degraded materials and the identification of complex relationship.It can narrow the scope of investigation by ancestral inference,which have important practical value in forensic genetics inspection and analysis.With the development of research on Multi-InDel and Multi-allelic InDel markers,the identification efficiency of InDel markers continues to improve,and their forensic application scenarios are also expanded.This review summarized the application and development of InDel markers in forensic genetics,and explored the development in the future.

Objective:To analyze the phenotypes and genetic etiology of microcephaly- seizures-development delay (MCSZ) syndrome.Methods:The patient was diagnosed with MCSZ syndrome in June 2018 at Shenzhen Maternity and Child Healthcare Hospital. She was the couple's first child, and the mother conceived a second child in 2020. The clinical data of the proband were retrospectively analyzed, and the bioinformatics analysis and whole-exome sequencing (WES) were performed on the proband and her parents to identify the pathogenic variants, which were further validated using Sanger sequencing. The prenatal genetic diagnosis of the second fetus was performed following the molecular diagnosis of the proband was confirmed. The clinical manifestations and pathogenesis of MCSZ syndrome were summarized by reviewing related literature.Results:(1) Case report: The patient, an eight-month-old girl, was admitted to our hospital due to microcephaly and repeated seizures. Another clinical characteristic was mental retardation. Auditory evoked potential detected moderate impairment of the left auditory nerve pathway. WES showed a compound heterozygous variation in the PNKP gene of the proband. Moreover, the pathogenic variation, c.199-10_203delinsTCTGAGGGGT, was inherited from the father, and the likely pathogenic variation, c.1505C>T(p.P502>L), was inherited from the mother, which was both de novo mutations. The compound heterozygous variation in the PNKP gene was considered genetic etiology based on the genetic testing and clinical features. Prenatal diagnosis showed that the second fetus did not inherit the PNKP gene variants from the parents and the couples chose to continue the pregnancy. A girl was born, and her psychomotor development and occipitofrontal size circumference were normal at 13 months old. (2) Literature review: 39 MCSZ syndrome cases were retrieved, including the present case and 38 cases from 12 relevant literature. The clinical characteristics were microcephaly (91.7%, 33/36), seizures (88.2%, 30/34), development delay (96.4%, 27/28), hyperactivity (25.6%, 9/39), gastroesophageal reflux (10.3%, 4/39), and hearing loss (7.7%, 3/39). Most patients' first onset of epilepsy was in infancy (96.3%, 26/27). Cranial MRI examination showed brain dysplasia in 31 cases (91.2%, 31/34). Conclusions:When the fetal head circumference is smaller than normal and is progressively reduced combined with postnatal microcephaly, epilepsy, developmental retardation, hyperactivity disorder, gastroesophageal reflux, and hearing loss, MCSZ syndrome should be considered. The prognosis varies widely, and genetic testing facilitates the early diagnosis and genetic counseling of MCSZ syndrome.

Objective:To summarize clinical characteristics of and treatment experience with patients with critical illnesses in a dermatological ward.Methods:All patients with serious or life-threatening conditions, who were hospitalized at the dermatological ward of the Second Xiangya Hospital of Central South University from July 9, 2011 to December 31, 2020, were collected, and their clinical data were retrospectively analyzed. Demographic characteristics, disease types and proportions, main complications, causes of serious or life-threatening conditions, important treatment measures and outcomes were summarized, and causes of death were also analyzed and discussed.Results:A total of 1 057 patients with critical illnesses were collected, with a male-to-female ratio of 1∶1.11, and 64.81% of them aged 18 to 65 years. The types of diseases mainly included drug eruptions (332 cases) , connective tissue diseases (226 cases) , bullous skin diseases (104 cases) , psoriasis (57 cases) , erythroderma (45 cases) , infectious skin diseases (67 cases) , etc. Among them, psoriasis (39 cases) and erythroderma (32 cases) mostly occurred in males, and connective tissue diseases (168 cases) mostly occurred in females. Common complications mainly involved infections, important organ damage or dysfunction, hypoalbuminemia, and fluid, electrolyte and acid-base imbalances. A total of 94 patients were diagnosed with life-threatening conditions, which were found to be mainly caused by primary skin diseases, hematologic abnormalities, respiratory failure, nervous system abnormalities, renal failure, sepsis, fluid, electrolyte and acid-base imbalances, etc. During the management of critical illnesses, 43 patients were treated with high-dose glucocorticoid pulse therapy, 264 were treated with gamma-globulin pulse therapy, 355 were transfused with other blood products, and 34 received special therapies such as hemoperfusion/immunoadsorption therapy, plasma exchange, dialysis, artificial liver support therapy; 42 patients were transferred to the intensive care unit (ICU) , 12 were transferred to the department of surgery for operations, and 12 were transferred to the department of obstetrics and gynecology for delivery or induction of labor. After treatment, 989 patients (93.57%) achieved improvement and were discharged. A total of 14 patients (1.32%) died, of whom 7 died of secondary sepsis, 2 died of severe pulmonary infections, 2 died of asphyxia caused by respiratory mucosa shedding-induced airway obstruction, the other 3 died of gastrointestinal hemorrhage, cerebral hemorrhage and neuropsychiatric systemic lupus erythematosus, respectively.Conclusions:Critical cases in the dermatological ward mainly suffered from serious skin diseases such as severe drug eruptions, connective tissue diseases and bullous skin diseases, as well as complications such as severe underlying diseases, severe organ dysfunction, sepsis or severe fluid, electrolyte and acid-base imbalances. In terms of treatment, it is of critical significance to make a clear diagnosis and assess the severity of disease as early as possible, monitor and prevent possible complications, and to consult with specialists in relevant disciplines in time.