Objective To estimate the biological dose in a patient who developed radiation dermatitis after a local X-ray exposure incident. Methods Peripheral blood samples, which were used to performed lymphocyte chromosome aberration analysis, were collected from the patient at 54 and 102 days after the last exposure. Biological dose in the patient was estimated using four published X-ray dose-effect calibration curves for chromosomal aberrations. The absorbed dose in the patient was reconstructed using Dolphin′s model and time correction factors. Results The abnormal rates of chromosome aberration at 54 and 102 days after exposure were 1.00% and 0.40%, respectively. Based on the four calibration curves, the estimated local exposure dose at 54 day ranged from 3.59 to 10.51 Gy, and the time-corrected whole-body equivalent dose ranged from 0.27 to 0.87 Gy. The local dose estimated at 102 days ranged from 2.24 to 6.64 Gy, with a time-corrected whole-body equivalent dose of 0.12 to 0.60 Gy, which differed from the day-54 estimates. The biological doses estimated by both methods were lower than the physical dose (29.43 Gy). Conclusion The estimation of local biological dose of patient various in four dose-effect curves selected in this study. Delayed blood sampling will lead to underestimate biological dose. Early blood collection after radiation incidents is critical to ensure accuracy and reliability. Moreover, biological dose reconstruction methods for complex exposure scenarios require further research to improve the accracy of emergency response in radiation accidents.

Objective:To analyze the correlation between mental health status and metabolic syndrome (MetS) in health checkup people.Methods:It was a cross-sectional study, 2 920 participants who received health checkup in the Health Examination Center of Peking University Third Hospital from January 2019 to December 2023 were selected using cluster sampling method. Their general information, physical examination, biochemical indicators, body composition, and self-evaluation scores on the Symptom Checklist-90 (SCL-90) were collected. According to the inclusion and exclusion criteria, a total of 2 813 study subjects were included, and divided into the MetS group and the non-MetS group based on whether they had MetS. The differences in general demographic information, body composition, blood biochemistry, and SCL-90 scores between the two groups were compared. Binary Logistic regression analysis was used to explore the correlation between mental health status and MetS.Results:Of the 2 813 subjects included, 1 576 were males (56.0%) and 1 237 were females (44.0%), with an average age of (41.7±11.0) years, the MetS group had 586 cases (20.8%) and the non-MetS group had 2 227 cases (79.2%). The MetS group had higher levels of age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), fasting blood glucose, glycosylated hemoglobin (HbA 1c), free thyroxine(FT4), total triiodothyronine (TT3), free triiodothyronine (FT3), waist-to-hip ratio, visceral fat area, body fat percentage, uric acid/creatinine, homocysteine (Hcy), aspartate aminotransferases (AST), and alanine transaminase (ALT) levels, as well as higher scores for somatization, hostility, paranoia, and other factor compared to the non-MetS group (all P<0.05), while high density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) levels were lower than those in the non-MetS group (all P<0.05). The proportion of male, and the positive rates of SCL-90, somatization, interpersonal sensitivity, hostility, paranoia and other factor in the MetS group were higher than those in the non-MetS group (all P<0.05). Multifactorial analysis showed that individuals with a positive SCL-90 assessment had a 1.34 times higher risk of MetS than those with a negative assessment ( OR=1.34, 95% CI: 1.06-1.68; P=0.014). Among them, individuals with positive somatization ( OR=2.02, 95% CI: 1.25-3.28; P=0.004) and hostility ( OR=1.61, 95% CI: 1.02-2.56; P=0.042) had increased risk of MetS. Conclusion:Poor mental health status increases the risk of MetS.

Objective:To explore the correlation between normalized grip strength (NGS) and normal weight obesity (NWO) in the population undergoing health check-ups.Methods:It was a cross-sectional study. A cluster sampling method was adopted to consecutively select 4 104 subjects who completed general health check-ups, body composition tests, and grip strength tests at the Medical Examination Center of Peking University Third Hospital from January 2019 to December 2023. The general information, physical examination results, biochemical indicators, body composition, and grip strength test results were collected. The subjects were grouped by gender and whether they had NWO (male: NWO group 314 cases, normal control group 690 cases; female: NWO group 834 cases, normal control group 2 266 cases). The differences in various indicators between the NWO group and the normal control group were compared by using t-tests, χ 2 tests, or Mann-Whitney U tests. The subjects were divided into four groups with the quartiles of NGS (Q 1-Q 4 groups), and binary logistic regression analysis was used to explore the correlation between the NGS and NWO. The receiver operating characteristic (ROC) curve was used to evaluate the optimal cut-off point of the NGS for diagnosing NWO. Results:Among the 4 104 subjects included in the analysis, 1 148 (28.0%) had NWO. The risk of NWO in both males and females increased with the decrease of NGS. Compared with the Q 4 group, the risk of NWO in the Q 2 and Q 1 groups of males increased by 2.600 times ( OR=2.600, 95% CI:1.556-4.343) and 4.350 times ( OR=4.350, 95% CI: 2.618-7.229), respectively; the risk of NWO in the Q 3, Q 2, and Q 1 groups of females increased by 2.024 times ( OR=2.024, 95% CI: 1.322-3.099), 4.265 times ( OR=4.265, 95% CI: 2.856-6.371), and 7.395 times ( OR=7.395, 95% CI: 4.991-10.956), respectively (all P<0.05). The optimal cut-off point of the NGS for diagnosing NWO in males and females was 0.636 2 and 0.472 2, respectively. Conclusions:The NGS is negatively correlated with the risk of NWO. Evaluation of the NGS can provide a reference for the early diagnosis and prevention of NWO.

Objective:To explore changes in immune status in patients with cervical intraepithelial neoplasia(CIN)after cer-vical conization and its relationship with prognosis of high-risk human papilloma virus(HR-HPV).Methods:A total of 227 patients with CINⅡ～Ⅲ admitted to Jinjiang Municipal Hospital(Shanghai Sixth People's Hospital Fujian Campus)from January 2019 to November 2022 were included to analyze HPV typing situation of different patients.Patients were divided into conversion group and persistent infection group according to postoperative conversion status.Different patients'postoperative immune indexes and regression were observed,and relationship between HPV types and immune indexes and postoperative regression was analyzed.Results:HPV types 16,33,52 and 58 were predominant in CINⅡ patients;HPV types 16 and 58 were predominant in CINⅢ patients.Differences between conversion and persistent infection groups were statistically significant regarding time to surgery,IL-10,TGF-β,TNF-α,CD4+T and CD4+T/CD8+T(P<0.05).After surgery,patients'CD8+T level decreased with time,CD4+T and CD4+T/CD8+T levels showed an increasing trend with time,and HPV types 16,33,52 and 58 were significantly correlated with immune indicators.Generalized linear mixed-effects models showed that CD8+T was a risk factor for patient regression,CD4+T and CD4+T/CD8+T were protective factors for patient regression.Generalized multifactor downscaling model interaction analysis showed that CD4+T,CD8+T,CD4+T/CD8+T and HPV typing were interactive on postoperative regression.Conclusion:Postoperative patients of cervical conization have decreased level of CD8+T and increased levels of CD4+T and CD4+T/CD8+T,CD8+T is risk factor for patient regression,while CD4+T and CD4+T/CD8+T are protective factors for patient regression.

Objective:To explore changes in immune status in patients with cervical intraepithelial neoplasia(CIN)after cer-vical conization and its relationship with prognosis of high-risk human papilloma virus(HR-HPV).Methods:A total of 227 patients with CINⅡ～Ⅲ admitted to Jinjiang Municipal Hospital(Shanghai Sixth People's Hospital Fujian Campus)from January 2019 to November 2022 were included to analyze HPV typing situation of different patients.Patients were divided into conversion group and persistent infection group according to postoperative conversion status.Different patients'postoperative immune indexes and regression were observed,and relationship between HPV types and immune indexes and postoperative regression was analyzed.Results:HPV types 16,33,52 and 58 were predominant in CINⅡ patients;HPV types 16 and 58 were predominant in CINⅢ patients.Differences between conversion and persistent infection groups were statistically significant regarding time to surgery,IL-10,TGF-β,TNF-α,CD4+T and CD4+T/CD8+T(P<0.05).After surgery,patients'CD8+T level decreased with time,CD4+T and CD4+T/CD8+T levels showed an increasing trend with time,and HPV types 16,33,52 and 58 were significantly correlated with immune indicators.Generalized linear mixed-effects models showed that CD8+T was a risk factor for patient regression,CD4+T and CD4+T/CD8+T were protective factors for patient regression.Generalized multifactor downscaling model interaction analysis showed that CD4+T,CD8+T,CD4+T/CD8+T and HPV typing were interactive on postoperative regression.Conclusion:Postoperative patients of cervical conization have decreased level of CD8+T and increased levels of CD4+T and CD4+T/CD8+T,CD8+T is risk factor for patient regression,while CD4+T and CD4+T/CD8+T are protective factors for patient regression.

Objective:To analyze the correlation between mental health status and metabolic syndrome (MetS) in health checkup people.Methods:It was a cross-sectional study, 2 920 participants who received health checkup in the Health Examination Center of Peking University Third Hospital from January 2019 to December 2023 were selected using cluster sampling method. Their general information, physical examination, biochemical indicators, body composition, and self-evaluation scores on the Symptom Checklist-90 (SCL-90) were collected. According to the inclusion and exclusion criteria, a total of 2 813 study subjects were included, and divided into the MetS group and the non-MetS group based on whether they had MetS. The differences in general demographic information, body composition, blood biochemistry, and SCL-90 scores between the two groups were compared. Binary Logistic regression analysis was used to explore the correlation between mental health status and MetS.Results:Of the 2 813 subjects included, 1 576 were males (56.0%) and 1 237 were females (44.0%), with an average age of (41.7±11.0) years, the MetS group had 586 cases (20.8%) and the non-MetS group had 2 227 cases (79.2%). The MetS group had higher levels of age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), fasting blood glucose, glycosylated hemoglobin (HbA 1c), free thyroxine(FT4), total triiodothyronine (TT3), free triiodothyronine (FT3), waist-to-hip ratio, visceral fat area, body fat percentage, uric acid/creatinine, homocysteine (Hcy), aspartate aminotransferases (AST), and alanine transaminase (ALT) levels, as well as higher scores for somatization, hostility, paranoia, and other factor compared to the non-MetS group (all P<0.05), while high density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) levels were lower than those in the non-MetS group (all P<0.05). The proportion of male, and the positive rates of SCL-90, somatization, interpersonal sensitivity, hostility, paranoia and other factor in the MetS group were higher than those in the non-MetS group (all P<0.05). Multifactorial analysis showed that individuals with a positive SCL-90 assessment had a 1.34 times higher risk of MetS than those with a negative assessment ( OR=1.34, 95% CI: 1.06-1.68; P=0.014). Among them, individuals with positive somatization ( OR=2.02, 95% CI: 1.25-3.28; P=0.004) and hostility ( OR=1.61, 95% CI: 1.02-2.56; P=0.042) had increased risk of MetS. Conclusion:Poor mental health status increases the risk of MetS.

Objective:To explore the correlation between normalized grip strength (NGS) and normal weight obesity (NWO) in the population undergoing health check-ups.Methods:It was a cross-sectional study. A cluster sampling method was adopted to consecutively select 4 104 subjects who completed general health check-ups, body composition tests, and grip strength tests at the Medical Examination Center of Peking University Third Hospital from January 2019 to December 2023. The general information, physical examination results, biochemical indicators, body composition, and grip strength test results were collected. The subjects were grouped by gender and whether they had NWO (male: NWO group 314 cases, normal control group 690 cases; female: NWO group 834 cases, normal control group 2 266 cases). The differences in various indicators between the NWO group and the normal control group were compared by using t-tests, χ 2 tests, or Mann-Whitney U tests. The subjects were divided into four groups with the quartiles of NGS (Q 1-Q 4 groups), and binary logistic regression analysis was used to explore the correlation between the NGS and NWO. The receiver operating characteristic (ROC) curve was used to evaluate the optimal cut-off point of the NGS for diagnosing NWO. Results:Among the 4 104 subjects included in the analysis, 1 148 (28.0%) had NWO. The risk of NWO in both males and females increased with the decrease of NGS. Compared with the Q 4 group, the risk of NWO in the Q 2 and Q 1 groups of males increased by 2.600 times ( OR=2.600, 95% CI:1.556-4.343) and 4.350 times ( OR=4.350, 95% CI: 2.618-7.229), respectively; the risk of NWO in the Q 3, Q 2, and Q 1 groups of females increased by 2.024 times ( OR=2.024, 95% CI: 1.322-3.099), 4.265 times ( OR=4.265, 95% CI: 2.856-6.371), and 7.395 times ( OR=7.395, 95% CI: 4.991-10.956), respectively (all P<0.05). The optimal cut-off point of the NGS for diagnosing NWO in males and females was 0.636 2 and 0.472 2, respectively. Conclusions:The NGS is negatively correlated with the risk of NWO. Evaluation of the NGS can provide a reference for the early diagnosis and prevention of NWO.

Abstract: Objective　To analyze and understand the mutations of drug resistance genes in imported Plasmodium falciparum in Shenzhen, aiming to assess the efficacy of antimalarial drugs and guide effective drug use. Methods A total of 85 samples from individuals with imported Plasmodium falciparum confirmed by fluorescence quantitative polymerase chain reaction (PCR) in Shenzhen from 2022 to 2023 were collected and genomic DNA was extracted. Nested PCR was used to amplify resistance genes, including Plasmodium falciparum Kelch 13 (PfK13), multidrug resistance gene 1 (Pfmdr1), chloroquine resistance transporter (Pfcrt), dihydrofolate reductase (Pfdhfr), and dihydropteroate synthase (Pfdhps) genes. Bidirectional sequencing was conducted, and mutations in these resistance genes were analyzed using MEGA11.06 software. Results　The study found one missense mutation (S549P) and four synonymous mutations in PfK13. For Pfmdr1, 62.69% of the samples showed Y184F mutation, and no N86Y mutation was detected. No mutations at positions 72 and 73 were detected in the Pfcrt gene, while mutations at M74I, N75E, and K76T accounted for 17.46%, 15.87%, and 15.87%, respectively. The wild-type of Pfcrt gene is dominant (82.54%, 52), followed by the triple mutant I74E75T76 (15.87%, 10). The most common mutation type for Pfdhfr is I51R59N108 (91.78%, 67), followed by the wild type (2.74%, 2). More than half (60.32%, 38) of the Pfdhps samples were wild-type, with single mutation K540E being the most common mutation type. S436A, G437A, K540E, A581G, A613S, I431V, G556K, and G579E site mutations were detected. Among the Pfdhfr-Pfdhps combination mutations, I51R59N108-E540 was the most frequent combination mutation (11.48%), with 59.02% of samples showing solitary Pfdhfr mutations. Conclusions In this study, PfK13 mutation rates were low, with no reported resistance mutations. The Y184F mutation emerged as the dominant Pfmdr1 mutation, with no detection of N86Y. For Pfcrt, the wild-type was dominant, followed by the I74E75T76 triple mutation variant. Triple mutant I51R59N108 of Pfdhfr was very common, and our study did not find Pfdhfr Pfdhps completely resistant and super resistant mutants, but there were other quintuple and septuple mutant types. In the future, it is crucial to continue to strengthen the monitoring of malaria parasite resistance genes and to further integrate in vivo efficacy monitoring to effectively guide clinical drug use.

Objective To perform laboratory detection and molecular traceability analysis on a case of imported kala-azar in Shenzhen to determine the infection strain. Methods Bone marrow puncture fluid and blood samples from a case of kala-azar in Shenzhen were collected for laboratory tests. The patient's bone marrow puncture fluid smears were stained with Giemsa and examined under a microscope. Blood samples were examined for antibodies using the rk39 visceral leishmania rapid diagnostic reagent. Whole blood DNA was extracted, and the ITS-1 sequence was amplified by PCR, sequenced and aligned, and a phylogenetic tree was constructed based on the ITS-1 sequence. Results Microscopic examination of the patient's bone marrow smears revealed a large number of Leishmania amastigotes without flagella, confirming the diagnosis of kala-azar. The patient's blood was tested positive with the rk39 rapid diagnostic reagent, and PCR amplification yielded an ITS-1 gene product sequence that matched the expected size. Sequence alignment with the NCBI database showed 100% sequence similarity with the ITS-1 gene sequence of Leishmania infantum, confirming the infecting strain as Leishmania infantum. Phylogenetic tree construction of the amplified ITS-1 sequence revealed clustering into a clade with Leishmania infantum , and close to KC347299, one of the reference sequence selected. Conclusions The case of kala-azar in Shenzhen was caused by Leishmania infantum. Kala-azar still occurs in China, so the diagnostic technology of medical personnel in non-epidemic areas should be strengthened so that they can actively use new diagnostic technologies to assist in diagnosis, thus improving their prevention and control ability of Leishmania parasites.

ABSTRACT:Objective To explore perioperative nursing experience of severe epistaxis with angiography and embolization.Methods A total of 20 cases with angiography and embolization in the treatment of severe epistaxis were in the observation group,another 20 cases with angiography and embolization treatment of severe epistaxis patients were selected as control group,the two groups were given conventional nursing service,the observation group was given perioperative nursing on the basis of conventional nursing.Short and long-term curative effect of two groups was observed.Results After 3 months of follow-up,hemostatic time,intraoperative volume, short-term and long-term therapeutic effects in the observation group were better than the con-trol group(P <0.05).Conclusion The curative effect of perioperative nursing on the severe nasal blooding with angiography and embolization was obvious,so it is worthy of clinical application.