Objective To study the expression levels of karyopherin β1(KPNB1) and Mer receptor tyrosine kinase (MERTK) in non-small cell lung cancer (NSCLC) tissues and their correlation with clinical pathological features,as well as the prognosis of progression-free survival. Methods A total of 118 NSCLC patients who visited Ordnance Industry 521 Hospital from February 2018 to February 2020 were selected. Immunohistochemical methods were used to detect the expression of KPNB1 and MERTK in NSCLC cancer and paracancer tissue. Kaplan-Meier survival curve analysis was conducted to assess the impact of KPNB1 and MERTK on the progression-free survival prognosis of NSCLC patients. COX regression analysis was performed to identify factors affecting the prognosis of progression-free survival in NSCLC patients. Results The positive rates of KPNB1 (61.02％) and MERTK (62.71％) in cancer tissues were higher than those in adjacent tissues (8.48％,6.78％),and the differences were statistically significant (x2=69.945,81.408,all P<0.001). There was a significant positive correlation between KPNB1 and MERTK expression in the organization (r=0.744,P<0.001). The positive rates of KPNB1(84.21％,82.50％),MERTK (84.21％,85.00％)in NSCLC tissues with lymph node metastasis and TNM stage ⅢA were higher than those without lymph node metastasis(50.00％,52.50％) and TNM stage Ⅰ～Ⅱ(50.00％,51.28％),and the differences were statistically significant (x2=11.078～12.855,all P<0.001). The 3-year progression-free survival rates of KPNB1and MERTK positive and negative groups were 26.39％ (19/72) and 56.52％ (26/46),27.03％ (20/74) and 56.82％ (25/44),respectively,with statistically significant differences (Log Rankx2=0.980,8.463,P=0.001,0.004) . KPNB1 positive,MERTK positive,lymph node metastasis and TNM stage ⅢA were risk factors for progression free survival prognosis in NSCLC patients (waldx2=7.810～10.906,all P<0.001). Conclusion The expression of KPNB1 and MERTK is elevated in NSCLC,both of which are related to TNM staging and lymph node metastasis. They are new biomarkers for evaluating the progression-free survival prognosis of NSCLC.

Objective To investigate the prognostic value of thrombin-antithrombin III complex(TAT),plasmin-α2-plasmin inhibitor complex(PIC),thrombomodulin(TM)and tissue plasminogen activator-inhibitor complex(t-PAIC)in patients with myelodysplastic syndrome(MDS).Methods Selected 88 primary MDS patients diagnosed at the 521 Hospital of Ordnance Industry from January 2018 to January 2021.Plasma levels of TAT,PIC,TM,t-PAIC,fibrin degradation products(FDP)and D-dimer(D-D)were measured.A multivariate approach was used to analyze the association between overall survival(OS)and the levels of each coagulation marker.Coagulation markers significantly associated with OS were used to construct a coagulation prognostic scoring system.Based on the median coagulation marker score,MDS patients were divided into high and low score groups.Kaplan-Meier analysis was used to plot survival curves.Results TAT(OR=1.667),PIC(OR=0.734),TM(OR=1.294)and t-PAIC(OR=1.523)were independent factors influencing OS in MDS patients(Wald χ2=0.671～10.751,all P<0.05).The β-values were integrated as statistical weights to construct a coagulation marker score,calculated as follows:[TAT]×0.502-[PIC]×1.013+[TM]×0.181+[t-PAIC]×0.381.The OS(median 14.6 months)and leukemia free survival(LFS)(median 10.3 months)of patients in the high coagulation marker score group were significantly lower than those in the low score group(33.6 months,35.2 months)(Log rank=20.57,26.84,all P<0.001).Subgroup analysis indicated that in both the low-risk IPSS-R subgroup(very low,low,and intermediate risk)and the high-risk IPSS-R subgroup(high and very high risk),the OS(Log rank=9.12,4.30)and LFS(Log rank=4.54,8.51)of the high coagulation marker score group were lower than those of the low score group(all P<0.05).Bivariate analysis showed a moderate correlation between the coagulation marker score and Revise International Prognostic Scoring System(IPSS-R)(PCC=0.536,P<0.001).Multivariate analysis indicated that IPSS-R and high coagulation marker scores were independent risk factors for OS and LFS in MDS patients(P<0.05).Conclusion The coagulation marker score,based on TAT,PIC,TM and t-PAIC,can serve as an independent prognostic factor for OS and LFS in MDS patients.

The rapid development of the pharmaceutical research and development (R&D) has brought new challenges to occupational health management, including the high uncertainty in the R&D process, emerging hazards, and compliance complexities associated with novel business models. Traditional management approaches exhibit limitations in effectively addressing the occupational health risks associated with these challenges. Based on the perspective of agile governance, this paper proposed an optimized pathway characterized by dynamic response, adaptive flexibility, and multi-stakeholder collaboration. It further offered countermeasures and recommendations from three aspects: concept renewal, mechanism innovation, and tool empowerment, aiming to provide reference for the effective management and control of occupational health risks in the innovation and development of the pharmaceutical R&D industry.

Objective To investigate the prognostic value of thrombin-antithrombin III complex(TAT),plasmin-α2-plasmin inhibitor complex(PIC),thrombomodulin(TM)and tissue plasminogen activator-inhibitor complex(t-PAIC)in patients with myelodysplastic syndrome(MDS).Methods Selected 88 primary MDS patients diagnosed at the 521 Hospital of Ordnance Industry from January 2018 to January 2021.Plasma levels of TAT,PIC,TM,t-PAIC,fibrin degradation products(FDP)and D-dimer(D-D)were measured.A multivariate approach was used to analyze the association between overall survival(OS)and the levels of each coagulation marker.Coagulation markers significantly associated with OS were used to construct a coagulation prognostic scoring system.Based on the median coagulation marker score,MDS patients were divided into high and low score groups.Kaplan-Meier analysis was used to plot survival curves.Results TAT(OR=1.667),PIC(OR=0.734),TM(OR=1.294)and t-PAIC(OR=1.523)were independent factors influencing OS in MDS patients(Wald χ2=0.671～10.751,all P<0.05).The β-values were integrated as statistical weights to construct a coagulation marker score,calculated as follows:[TAT]×0.502-[PIC]×1.013+[TM]×0.181+[t-PAIC]×0.381.The OS(median 14.6 months)and leukemia free survival(LFS)(median 10.3 months)of patients in the high coagulation marker score group were significantly lower than those in the low score group(33.6 months,35.2 months)(Log rank=20.57,26.84,all P<0.001).Subgroup analysis indicated that in both the low-risk IPSS-R subgroup(very low,low,and intermediate risk)and the high-risk IPSS-R subgroup(high and very high risk),the OS(Log rank=9.12,4.30)and LFS(Log rank=4.54,8.51)of the high coagulation marker score group were lower than those of the low score group(all P<0.05).Bivariate analysis showed a moderate correlation between the coagulation marker score and Revise International Prognostic Scoring System(IPSS-R)(PCC=0.536,P<0.001).Multivariate analysis indicated that IPSS-R and high coagulation marker scores were independent risk factors for OS and LFS in MDS patients(P<0.05).Conclusion The coagulation marker score,based on TAT,PIC,TM and t-PAIC,can serve as an independent prognostic factor for OS and LFS in MDS patients.

Objective To study the expression levels of karyopherin β1(KPNB1) and Mer receptor tyrosine kinase (MERTK) in non-small cell lung cancer (NSCLC) tissues and their correlation with clinical pathological features,as well as the prognosis of progression-free survival. Methods A total of 118 NSCLC patients who visited Ordnance Industry 521 Hospital from February 2018 to February 2020 were selected. Immunohistochemical methods were used to detect the expression of KPNB1 and MERTK in NSCLC cancer and paracancer tissue. Kaplan-Meier survival curve analysis was conducted to assess the impact of KPNB1 and MERTK on the progression-free survival prognosis of NSCLC patients. COX regression analysis was performed to identify factors affecting the prognosis of progression-free survival in NSCLC patients. Results The positive rates of KPNB1 (61.02％) and MERTK (62.71％) in cancer tissues were higher than those in adjacent tissues (8.48％,6.78％),and the differences were statistically significant (x2=69.945,81.408,all P<0.001). There was a significant positive correlation between KPNB1 and MERTK expression in the organization (r=0.744,P<0.001). The positive rates of KPNB1(84.21％,82.50％),MERTK (84.21％,85.00％)in NSCLC tissues with lymph node metastasis and TNM stage ⅢA were higher than those without lymph node metastasis(50.00％,52.50％) and TNM stage Ⅰ～Ⅱ(50.00％,51.28％),and the differences were statistically significant (x2=11.078～12.855,all P<0.001). The 3-year progression-free survival rates of KPNB1and MERTK positive and negative groups were 26.39％ (19/72) and 56.52％ (26/46),27.03％ (20/74) and 56.82％ (25/44),respectively,with statistically significant differences (Log Rankx2=0.980,8.463,P=0.001,0.004) . KPNB1 positive,MERTK positive,lymph node metastasis and TNM stage ⅢA were risk factors for progression free survival prognosis in NSCLC patients (waldx2=7.810～10.906,all P<0.001). Conclusion The expression of KPNB1 and MERTK is elevated in NSCLC,both of which are related to TNM staging and lymph node metastasis. They are new biomarkers for evaluating the progression-free survival prognosis of NSCLC.

Objective To investigate the expression of long non-coding RNA(lncRNA)CCAT2 and o-varian cancer domain-containing protease 1(OTUD1)in multiple myeloma(MM)tissue and their correlation with clinicopathological characteristics and prognosis of MM.Methods A total of 132 patients with MM(MM group)diagnosed and treated in this hospital from April 2018 to April 2020 were selected.Seventy patients with non-hematological disease who underwent bone marrow puncture without abnormal bone marrow func-tion during the same period served as the control group.The real-time fluorescence quantitative PCR was used to detect the expression levels of lncRNA CCAT2 and OTUD1 mRNA in bone marrow tissue.The Pearson correlation was performed to analyze the correlation between lncRNA CCAT2 and OTUD1 mRNA expression in bone marrow tissues.The expression differences of lncRNA CCAT2 and OTUD1 mRNA were compared a-mong the MM patients with different clinical and pathological characteristics.The Kaplan-Meier curve was used to analyze the difference of prognosis among the MM patients with different lncRNA CCAT2 and OTUD1 mRNA expressions.The Cox regression was performed to analyze the factors affecting the prognosis in MM patients.Results The expression level of lncRNA CCAT2 in the bone marrow tissue of the MM group was significantly higher than that of the control group(2.31±0.67 vs.0.85±0.24),while the expression level of OTUD1 mRNA in the MM group was lower than that of the control group(1.22±0.37 vs.2.54±0.75),and the differences were statistically significant(t=17.624,16.760,all P＜0.001).The lncRNA CCAT2 expression level in the bone marrow tissue of the MM group had significantly negative correlation with the OTUD1 mRNA expression level(r=-0.731,P＜0.001).The lncRNA CCAT2 and OTUD1 mRNA expression levels had statistical differences among the MM patients with different ISS stages and β2-micro-globulin levels(P＜0.001).The 3-year overall survival rates of the high and low expression groups of ln-cRNA CCAT2 were 42.19％(27/64)and 66.18％(45/68),respectively.The 3-year overall survival rates of the high and low expression groups of OTUD1 mRNA were 72.31％(47/65)and 37.31％(25/67)respective-ly.The 3-year cumulative survival rate of MM patients in the lncRNA CCAT2 low expression group was sig-nificantly higher than that in the lncRNA CCAT2 high expression group,and the difference was statistically significant(Log Rank X2=7.151,P=0.007).The 3-year cumulative survival rate of MM patients in the OTUD1 mRNA low expression group was significantly lower than that in the OTUD1 mRNAhigh expression group(Log Rank x2=13.667,P＜0.001).The ISS stage Ⅲ and lncRNA CCAT2 high expression were the risk factors affecting the prognosis of MM patients(P＜0.01),while the OTUD1 mRNA high expression was the protective factor.Conclusion The lncRNA CCAT2 expression level in bone marrow tissue of the MM pa-tients is increased and OTUD1 expression level is decreased,the both are associated with adverse clinical and pathological characteristics of MM and independent factors affecting the prognosis of MM patients.

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.

Objective To express and purify two domains GcⅠand GcⅡof Xinjiang hemorrhagic fever virus (XHFV) glycoprotein, and to study its immunogenicity and the effects on immune response in mice. Methods The prokaryotic expression plasmids of pET28a-GcⅠand pET32a-GcⅡwere constructed and transformed into E. coli BL21, respectively. The expression and purification conditions of rGcⅠand rGcⅡproteins were optimized. The antigenicity of the fusion protein was detected by Western Blot and enzyme-linked immunosorbent assay (ELISA). BALB/c mice were immunized by protein immunization and DNA priming-protein boosting. The mice were randomly divided into 5 groups, including pVAX1-GcⅠ+rGcⅠgroup, pVAX1-GcⅡ+rGcⅡgroup, rGcⅠgroup, rGcⅡgroup and saline group (control group) with 7 mice in each group. The serum antibody titer of mice was detected by indirect ELISA, and the immune effect was evaluated by spleen T lymphocyte proliferation assay and cytokine content determination. Results The fusion proteins rGcⅠand rGcⅡwere purified and obtained, which could react with positive serum of sheep and had good antigenicity. After three immunizations, the IgG levels in the serum of each experimental group were significantly higher than those in the control group (all P<0.001). The serum antibody titers of the experimental groups were reached above 1:12800. Among them, the concentration of Th2 type cytokine interleukin-4 (IL-4) in the spleen cell culture supernatant of rGcⅡ[(79.97±7.47) ng/L] and pVAX1-GcⅡ+rGcⅡgroup [(61.43±9.27) ng/L] was significantly higher than (24.29±3.81) ng/L of the control group, respectively (all P<0.01). The highest mass concentration [(42.46 ±2.60) ng/L] of Th1 type cytokine interferon-γ(IFN-γ) was observed in the pVAX1-GcⅡ+rGcⅡ group, which was significantly higher than (20.33±1.67) ng/L of the control group, and the difference was statistically significant (P<0.001). That showed a significant antigen-specific splenic T lymphocyte proliferation (P<0.001). Conclusions The purified recombinant proteins rGcⅠand rGcⅡhave good immunogenicity, which can make the immune system T lymphocytes tend to Th2 response, and pVAX1-GcⅡ combined with recombinant protein GcⅡ can induce better antigen-specific immune effect. And pVAX1-GcⅡ combined with recombinant protein GcⅡis expected to be used as vaccine candidates for the prevention and control of XHFV.

Objective: In order to understand and supervise the current situation of school health in Shanghai, the feasibility of internet-technology (IT) based school health management model is exarnined. Methods: Questionnaire survey, The feasibility analysis of IT based school health management model is discussed. Results: Principal directors from educational departments and health supervision centers more optimistic about the school health supervision model than school teachers(80.0%, 95.5%, 52.0%;73.3%, 90.9%, 55.1%). However, the three departments all in the publishing the information of school health(0, 13.9%, 6.3%). Conclusion IT based school health management model will become one of the most important supervision methods in the future. School Health management model based on IT is feasible.

OBJECTIVE: To investigate the effect of down-regulation of miR-205-5p on 3-bromopyruvate-induced apoptosis in human nasopharyngeal carcinoma CNE2Z cells. METHODS: Nasopharyngeal carcinoma CNE2Z cells were transfected with miR- 205-5p-mimic or miR-205-5p-inhibitor, treated with 80 μmol/L 3-bromopyruvate alone, or exposed to both of the treatments. The proliferation of the treated cells was examined with MTT assay, and early apoptosis of the cells was detected using a mitochondrial membrane potential detection kit (JC-1). DAPI fluorescence staining was used to detect morphological changes of the cell nuclei and late cell apoptosis; Annexin V-FITC/PI double staining was employed to detect the cell apoptosis rate. Western blotting was used to detect the expressions of Bcl-2, Bax, Mcl-1 and Bak proteins. RESULTS: Exposure to 3-bromopyruvate significantly inhibited the proliferation of CNE2Z cells, and increasing the drug concentration and extending the treatment time produced stronger inhibitory effects. Treatment with 80 μmol/L 3-bromopyruvate for 24, 48 and 72 h resulted in inhibition rates of (45.7±1.21)%, (64.4±2.02)% and (78.3±1.55)% in non-transfected CNE2Z cells, respectively; the inhibition rates were (27.7±1.04)%, (34.8±2.10)% and (44.3±1.57)% in the cells transfected with miR-205-5p-mimic, and were (80.5 ± 0.94)%, (87.9 ± 0.50)% and (93.8 ± 1.16)% in cells transfected with miR-205-5p-inhibitor, respectively. The results of mitochondrial membrane potential detection showed that the relative proportion of red and green fluorescence decreased significantly in miR-205-5p-inhibitor-transfected cells with 3-bromopyruvate treatment. Combined treatment of the cells with 3-bromopyruvate and miR-205-5p-inhibitor transfection obviously increased nuclear fragmentation and nuclear pyknosis and significantly increased cell apoptotic rate as compared with the two treatments alone ( < 0.01), causing also decreased expressions of Bcl-2 and Mcl-1 proteins and increased expressions of Bax and Bak proteins. CONCLUSIONS Inhibition of miR-205-5p enhances the proapototic effect of 3-bromopyruvate in CNE2Z cells possibly in relation to the down-regulation of Mcl-1 and Bcl-2 and the up-regulation of Bak and Bax proteins.