Objective: To establish a risk assessment system for infectious disease prevention and control in schools in Shangcheng District, Hangzhou and determine risk levels for each school, and propose corresponding risk management measures, so as to provide a scientific reference for infectious disease prevention and control in primary and secondary schools. Methods: Based on the Failure Mode and Effects Analysis (FMEA) method, potential failure analysis and current situation investigation of infectious disease prevention and control risks were conducted in 110 primary and secondary schools from 2022 to 2024 in Shangcheng District, Hangzhou. Risk levels were classified using K-Means cluster analysis. Results: Through expert panel discussions using FMEA, 6 first level indicators and 28 second level indicators were identified. The top three risk priority numbers were implementation of required prevention and control measures for clustered infectious disease outbreaks in schools in the past three years ( 189.00 ), student morning/afternoon health checks (168.00), and reporting status of clustered infectious disease outbreaks in schools in the past three years (144.00). The comprehensive prevention scores of schools ranged from 61.00 to 98.00 (mean: 87.40 ). There were no statistically significant differences in the average scores(primary school: 88.17±7.39, nine year consistent education: 86.26±7.68, junior high school: 85.55±8.20, and high school: 88.72±4.91) and risk level distribution of schools with different educational stages( F/H=0.95,1.47, P >0.05).K-Means cluster analysis divided the schools into 5 risk levels with cluster centers at 93.25, 85.78, 79.69, 70.29, 61.00 ( F=309.21, P <0.05), with 80% of schools classified as low risk or below. Conclusion The infectious disease prevention and control risk assessment system for primary and secondary schools can be established, and hierarchical management can be conducted according to school risk levels, thereby improving the efficiency and effectiveness of school infectious disease prevention and control, and enhancing the precision and sustainability of prevention efforts.

Objective:To investigate the effect of Notch on periprosthetic fracture (PPF) of the femoral prosthesis after primary total knee arthroplasty.Methods:A total of 34 patients diagnosed with femoral PPF at Xi'an Honghui Hospital were retrospectively collected from January 2013 to December 2020. There were 4 males and 30 females with a mean age of 69.2±7.2 years (range, 55-84 years). A total of 102 patients without PPF were matched by gender and age as the control group in a ratio of 1∶3. There were 12 males and 90 females with a mean age of 69.2±7.2 years (range, 55-84 years). The main observation indexes included patients' general information and factors such as coronal alignment, prosthesis design and Notch conditions. Then, subgroup analysis was performed with the depth and Tayside classification of Notch to analyze their effects on PPF.Results:The PPF and control groups were comparable in terms of baseline information such as gender, age, body mass index (BMI), and surgical side. There was no significant difference between the two groups in coronal alignment (χ 2=1.019, P=0.601) and prosthesis design (χ 2=1.545, P=0.214). There was no statistical difference in Notch between the PPF and control groups (χ 2=3.548, P=0.060). The mean length of Notch in the PPF group was 4.5±2.7 mm, compared with 4.9±2.8 mm in the control group, with no significant difference between the two groups ( t=0.732, P=0.465). Further subgroup analysis using a Notch depth of 3 mm as a cut-off and Tayside classification revealed a statistical difference between the two groups (χ 2=11.262, P=0.004; χ 2=14.601, P=0.003). Compared with patients without Notch, the risk of PPF was higher when the depth of Notch exceeded 3 mm, with an odds ratio ( OR) of 4.88 (95% CI: 1.76, 13.51). The incidence of PPF was higher when Notch depth reached Tayside grade 3 or 4. Compared with patients without Notch, the risk of PPF would be 6.99-fold (95% CI: 1.85, 26.32) higher when Notch depth reached grade 3. In female patients, there was a significant difference in Notch status between the PPF and control groups (χ 2=3.956, P=0.047), with a higher risk of PPF in female patients with Notch, OR 2.33 (95% CI: 1.01, 5.43). In patients who underwent right-sided TKA, the risk of PPF was higher in patients with Notch compared to those without Notch (χ 2=5.502, P=0.019), with an OR of 3.58 (95% CI: 1.19, 10.75). Conclusion:The Notch has no significant effect on the femoral PPF after primary total knee arthroplasty. However, the risk of PPF will increase significantly when the Notch depth exceeds 3 mm or is above Tayside grade 3.

Objective:To investigate the effects of hyperbaric oxygen（HBO）combined with Temozolomide（TMZ）on the cell cycle and apoptosis of lung cancer A549 cells，and to study its mechanisms.Methods:After the cell culture，the human lung cancer A549 cells were divided into control group，HBO group，TMZ group，and HBO+TMZ group according to the experimental design，and were given，respectively，no treatment，50 μmol/L TMZ for 24 h，0.2 MPa HBO for 3 h，and 0.2 MPa HBO pretreatment for 3 h followed by 50 μmol/L TMZ for 24 h. The cell proliferation was detected by Cell Counting Kit-8（CCK-8）experiment；the cell apoptosis and cell cycle were detected by flow cytometry；the expression of AKT/mTOR signaling pathway proteins in A549 cells was detected by Western blotting.Results:The survival rate of A549 cells in the HBO+TMZ group was significantly lower than those of the other three groups（ P < 0.05 or P < 0.01）. The apoptosis rates in the control group，HBO group，TMZ group，and HBO+TMZ group were（6.73 ± 1.47）%，（8.52 ± 0.87）%，（32.78 ± 3.49）%，and（49.61 ± 5.74）%，respectively；the apoptosis rate in the HBO+TMZ group was significantly higher than those in the other three groups，and the differences were statistically significant（ P < 0.05）. The results of cell cycle experiment showed that the number of A549 cells in G2/M phase was increased in the HBO+TMZ group with a cell percentage of 35.81%，which was significantly higher than those of the other three groups（ P < 0.05）. The expression levels of p-AKT and mTOR proteins in A549 cells in the HBO+TMZ group were significantly lower than those in the other three groups（ P < 0.01）. Conclusion:The combination of HBO and TMZ can greatly improve the inhibition on the proliferation and induce apoptosis of lung cancer A549 cells，which is achieved by regulating the AKT/mTOR signaling pathway to block the A549 cells in the G2/M phase.

Objective:To investigate the effects of hyperbaric oxygen（HBO）combined with Temozolomide（TMZ）on the cell cycle and apoptosis of lung cancer A549 cells，and to study its mechanisms.Methods:After the cell culture，the human lung cancer A549 cells were divided into control group，HBO group，TMZ group，and HBO+TMZ group according to the experimental design，and were given，respectively，no treatment，50 μmol/L TMZ for 24 h，0.2 MPa HBO for 3 h，and 0.2 MPa HBO pretreatment for 3 h followed by 50 μmol/L TMZ for 24 h. The cell proliferation was detected by Cell Counting Kit-8（CCK-8）experiment；the cell apoptosis and cell cycle were detected by flow cytometry；the expression of AKT/mTOR signaling pathway proteins in A549 cells was detected by Western blotting.Results:The survival rate of A549 cells in the HBO+TMZ group was significantly lower than those of the other three groups（ P < 0.05 or P < 0.01）. The apoptosis rates in the control group，HBO group，TMZ group，and HBO+TMZ group were（6.73 ± 1.47）%，（8.52 ± 0.87）%，（32.78 ± 3.49）%，and（49.61 ± 5.74）%，respectively；the apoptosis rate in the HBO+TMZ group was significantly higher than those in the other three groups，and the differences were statistically significant（ P < 0.05）. The results of cell cycle experiment showed that the number of A549 cells in G2/M phase was increased in the HBO+TMZ group with a cell percentage of 35.81%，which was significantly higher than those of the other three groups（ P < 0.05）. The expression levels of p-AKT and mTOR proteins in A549 cells in the HBO+TMZ group were significantly lower than those in the other three groups（ P < 0.01）. Conclusion:The combination of HBO and TMZ can greatly improve the inhibition on the proliferation and induce apoptosis of lung cancer A549 cells，which is achieved by regulating the AKT/mTOR signaling pathway to block the A549 cells in the G2/M phase.

OBJECTIVES: Clarifying the expression of breast cancer receptor is the key to clinical treatment for breast cancer. This study aims to explore the correlation between X-ray and clinical characteristics of 4 molecular subtypes and their receptor types of breast cancer. METHODS: A total of 439 breast cancer patients who confirmed by pathology and performed X-ray examination were enrolled. The X-ray and clinical characteristics of 4 molecular subtypes and the expression of their receptors were analyzed. RESULTS: Luminal A type showed the highest proportion of spiculate masses, and the lowest calcification score, showing significant difference with other 3 subtypes (all CONCLUSIONS Four molecular subtypes of breast cancer and their receptor expressions are correlated with X-ray and clinical characteristics, which can provide a basis for clinical diagnosis and treatment.
Biomarkers, Tumor ; Breast Neoplasms/genetics* ; Female ; Humans ; Receptor, ErbB-2/genetics* ; Receptors, Estrogen ; Receptors, Progesterone ; X-Rays

OBJECTIVE: To explore the influencing factors and correlation of job burnout and organizational support in medical staffs. METHODS: The cluster random sampling method was used to select 1 231 medical staffs as the study subjects from 7 municipal hospitals in Zhengzhou City,Henan Province. Maslach Burnout Inventory-General Survey and Organizational Support Scale were used for questionnaire survey. The correlation between job burnout and organizational support was analyzed by canonical correlation analysis. RESULTS: The score of job burnout was( 36. 0 ± 14. 1),and the median score of organizational support was 72. 0, showing a negative correlation( Spearman correlation coefficient was-0. 333,P < 0. 01). There is canonical correlation between job burnout and organizational support( F = 1. 94,P <0. 01). CONCLUSION: The present situation of job burnout among medical staffs is serious. Job burnout of medical staffs can be reduced by improving their sense of organizational support.

BACKGROUND:The prevalence of osteoporosis is high in the patients undergoing total hip arthroplasty. Osteoporosis is associated with the survival of prostheses. Both canal flare index and bone mineral density are aged-related.
OBJECTIVE:To study the cxorrelation between canal flare index of the proximal femur and bone mineral density of femoral neck, and to pay more attention to osteoporosis.
METHODS:A retrospective study of the correlation between canal flare index of the proximal femur on pelvic radiograph and bone mineral density of femoral neck was made in 57 patients undergoing total hip arthroplasty.
RESULTS AND CONCLUSION:The canal flare index were ranged 1.8-4.8 (3.1±0.7) in 57 patients. There were 23 patients in canal flare index<3 (chimney-type medul ary cavity), 33 in canal flare index between 3 and 4.7 (normal-type medul ary cavity), and one in canal flare index>4.7 (funnel-type medul ary cavity). The age had an impact on the type of medul ary cavity. The prevalence of chimney-type medul ary cavity were significantly higher in>60 years old group than≤60 years old group, and bone mineral density of femoral neck in the group of canal flare index≥3 was significantly higher than the group of canal flare index<3. The bone mineral density of femoral neck was gradual y reduced with age, and were significantly higher in≤60 years old group than in>60 years old group [(0.751±0.235) g/cm2, (0.590±0.092) g/cm2, P=0.000]. As bone mineral density reduced, canal flare index was also decreased. Experimental findings indicate that, the bone mineral density of femoral neck is significantly correlated with canal flare index.