The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

OBJECTIVE To explore the protective effect and mechanism of Longshengzhi capsules on cerebral ischemia- reperfusion injury in rats. METHODS The model of middle cerebral artery occlusion （MCAO） was established by using the improved thread occlusion method. The experiment was divided into six groups： sham surgery group （only separating blood vessels without inserting thread plugs， given the same volume of normal saline）， model group （modeling， given the same volume of normal saline）， nimodipine group （positive control， modeling， dose of 20 mg/kg）， and low-dose， medium-dose， and high-dose groups of Longshengzhi capsules （modeling， doses of 0.72， 1.44 and 2.88 g/kg， respectively）， with 10 mice in each group. Each group was given corresponding medication solution/normal saline by gavage， once a day， for 7 consecutive days. One hour after the last administration， the Zea Longa scoring method was used to score the neurological deficits in each group of rats， and the ABC enzyme-linked immunosorbent assay was used to detect the serum levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in rats； TTC staining was used to observe the volume of cerebral infarction in rats and calculate the cerebral infarction volume ratio. Hematoxylin eosin staining was used to observe the pathological changes in the brain tissue of rats. Immunohistochemical staining was used to detect the positive expression of NLRP3 protein in the brain tissue of rats. Real-time fluorescence quantitative PCR was used to detect mRNA relative expressions of Toll-like receptor 4 （TLR4） and nuclear factor-κB （NF-κB） in the brain tissue of rats. Western blot assay was adopted to detect the relative expressions of TLR4， NLRP3 and phosphorylated NF-κB （p-NF-κB） protein in the brain tissue of rats and its intracellular NF-κB protein. RESULTS Compared with the sham surgery group， the neural dysfunction score， serum levels of TNF-α and IL-6， cerebral infarction volume ratio， relative expression levels of NF-κB and TLR4 mRNA， as well as protein relative expressions of TLR4， NLRP3 and p-NF-κB in the brain tissue， and relative protein expression of intracellular NF-κB were increased significantly in the model group （P＜0.01）； the enlarged gap and significant edema were observed in cortical nerve cells of brain tissue in rats， with a large amount of inflammatory cell infiltration； the positive expression of NLRP3 protein in brain tissue of rats obviously increased. Compared with the model group， the levels of the above indicators in the medium-dose and high-dose groups of Longshengzhi capsules， as well as the Nimodipine group， were reversed to varying degrees， and most differences were statistically significant （P＜0.05 or P＜0.01）； the pathological morphology observation showed a significant improvement， and the positive expression of NLRP3 protein in the brain tissue of rats was obviously reduced. CONCLUSIONS Longshengzhi capsules may inhibit TLR4/NF-κB/NLRP3 signaling pathway and neuroinflammatory response， thereby achieving a protective effect against cerebral ischemia-reperfusion injury in rats.

Rheumatoid arthritis is a chronic, systemic autoimmune disease predominantly based on joint lesions with an extremely high disability and deformity rate. Several drugs have been used for the treatment of rheumatoid arthritis, but their use is limited by suboptimal bioavailability, serious adverse effects, and nonnegligible first-pass effects. In contrast, transdermal drug delivery systems (TDDSs) can avoid these drawbacks and improve patient compliance, making them a promising option for the treatment of rheumatoid arthritis (RA). Of course, TDDSs also face unique challenges, as the physiological barrier of the skin makes drug delivery somewhat limited. To overcome this barrier and maximize drug delivery efficiency, TDDSs have evolved in terms of the principle of transdermal facilitation and transdermal facilitation technology, and different generations of TDDSs have been derived, which have significantly improved transdermal efficiency and even achieved individualized controlled drug delivery. In this review, we summarize the different generations of transdermal drug delivery systems, the corresponding transdermal strategies, and their applications in the treatment of RA.

Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

OBJECTIVE: To assess the influence of social support and self-efficacy on job burnout in sanitation workers. METHODS: A convenient sampling method was used to select 405 sanitation workers as study objects. The Maslach Burnout Inventory General Survey, Perceived Social Support Scale and General Self-Efficacy Scale were used to investigate the three dimensions of emotional exhaustion,cynicism and reduced personal accomplishment in job burnout, as well as the social support and self-efficacy. RESULTS: The cynicism was positively correlated with self-efficacy [partial correlation coefficient(r)=0.17, P<0.01]. Reduced personal accomplishment was negatively correlated with self-efficacy and social support respectively(r were-0.32 and-0.20, P<0.01). Hierarchical regression analysis indicated that the demographic variables can explain 30.4%, 29.9%, 22.0% of the three dimensions of sanitation workers′ emotional exhaustion, cynicism and reduced personal accomplishment respectively(P<0.01). After controlling for the demographic variables, self-efficacy could positively predict cynicism(P<0.01), the social support and self-efficacy could negatively predict reduced personal accomplishment(P<0.01). CONCLUSION: The institutional factor is the main reason affecting job burnout of sanitation workers. Cynicism is positively correlated with self-efficacy. Improving social support and self-efficacy can help alleviate the reduced personal accomplishment.

OBJECTIVE: To understand the current situation of psychological resilience of sanitation workers and its impact on their happiness. METHODS: A total of 277 sanitation workers from Dongguan City of Guangdong Province were enrolled as study participants by stratified random sampling method. The psychological resilience and happiness were measured by Connor-Davidson Resilience Scale and Campbell Index of Well-being Scale respectively. RESULTS: The median scores of psycological resilience and happiness of the study subjects were 49. 0 and 7. 8,respectively. Psycological resilience was positively correlated with happiness( P < 0. 01). The multivariate linear regression analysis showed that the types of work,education level,personal monthly income and daily working time were the influencing factors of sanitation workers 'psychological resilience( P < 0. 05). The types of work and psychological resilience can significantly predict happiness(P < 0. 05). After controlling the demographic variables such as age,type of work,education level,personal monthly income,and daily working time,the psychological resilience prediction happiness contribution rate increased by 34. 1%(P < 0. 01). Age has a regulating effect on psychological resilience and happiness. Psychological resilience is easier to predict in the second generation( born after 1978) of sanitation workers in the sense of happiness. CONCLUSION: Psycological resilience of sanitation workers affects their happiness. Enhancing psychological resilience can help improve the happiness of sanitation workers.

Objective To analyze the genetic characteristics of chromosomes and related fusion genes in acute myeloid leukemia (AML) (non-M3), and to evaluate the prognosis of patients with chemotherapy of DA regimen with different doses of daunorubicin. Methods Fifty-six patients with newly diagnosed non-M3 AML from January 2013 to January 2015 were collected. Adopted short-term culture method was used to treat bone marrow, R-binding chromosome karyotyping was used to detect cytogenetic. Thirty-one types of fusion gene were identified by PCR and 10 % agarose gel electrophoresis. All patients treated by DA regimen were divided into group A, group B and group C according to different dosage of daunorubicin. Then, complete remission (CR) rate and survival time in the 3 groups were observed. The effect of cytogenetic and molecular biology abnormality on the chemotherapy, CR rate and overall survival (OS) of the 3 groups were analyzed by the chi-square test. Results Among the 56 patients, 18 cases (32.1%) had abnormal chromosome karyotype, 6 cases (10.7 %) had abnormal number of chromosome, 16 cases (28.6 %) had abnormal structure of chromosome, and 4 cases (7.1 %) had both abnormal number and structure of chromosome. Meanwhile, the most common abnormal structure was t(8;21), and the most common abnormal quantity were+8, -Y. Detective rate of genetic abnormality was raised to 62.00 % through fusion gene and chromosome karyotype analysis. The total CR rate of DA-induced chemotherapeutic regimen was 73.2 %, and the two-year OS rate was 42.9%. The remission rate of chemotherapy in the middle-risk group was significantly lower than that in the low-risk group (χ 2 = 8.976, P = 0.002), but there was no significant difference between the low-dose chemotherapy group and the standard dose chemotherapy group (P>0.05). The standard dose group showed a significant advantage in the OS rate (χ2= 8.045, P= 0.005). Conclusions Adult acute leukemia has its unique cytogenetic characteristics, which can assist in guiding clinical diagnosis, classification and prognosis. The prognosis of middle-risk patients is significantly lower than the low-risk group. Low-risk patients could benefit from a reduced dose of DA regimen, but the standard dose DA regimen has a significant advantage in long-term survival.

The guidelines for standard nursing in the PET/MR imaging examination included preparation of examination,injecting drug,observing during scanning,post scanning care,management of adverse reaction of contrast agent and radiation protection.The purpose of these guidelines could were to provide the practical and effective management for nursing care in PET/MR imaging,and offer a framework for nurses that could provide useful and helpful in clinical practice and research.

The hybrid PET/MR has been gradually applied in clinical practice.However,the hybrid PET/MR is a com plex advanced technique,and it brings to the new challenges,especially regarding the workflow and scan protocols.The guidelines for hybrid PET/MR in brain imaging include information related to the indications and contraindications,preparation before examination,procedures of examination (PET imaging,conventional MRI brain imaging and special MRI imaging for brain disease),application of radiopharmaceutical and MRI contrast-enhanced agent.The purpose of the guidelines is to offer a framework that would be practical and helpful for clinical PET/MR brain imaging.In PET tracers,the guidelines only limit to the 18 F-FDG.

Objective To understand the current status of disinfection and sterilization of medical institutions at all levels in 30 counties in Chongqing ,and to guide the work that medical institutions regulate and improve the quality of disinfection and steriliza‐tion ,and urge the relevant departments to strengthen the monitoring of disinfection quality of medical institutions .Methods Using field investigation and sampling inspection method ,the disinfection quality of medical institutions at all levels in 30 counties of Chongqing city was monitored and analyzed .Results From 30 districts and counties ,the medical institutions were sampled from 28 510 parts ,the overall average pass rate of 93 .3% .The qualified rate of medical institutions at all levels from high to low were as follows ,the village health room (96 .7% ) ,urban community medical institutions (96 .6% ) ,district level medical institutions (96 .1% ) ,individual clinic (90 .9% ) ,private hospitals (93 .7% ) and township (street) medical institutions (86 .5% ) .Different types of medical institutions got different qualified rate ,and the difference was statistically significant(χ2 =666 .84 ,P<0 .01) .Pro‐ject with the lowest qualified rate was radiation intensity of ultraviolet lamp(52 .8% ) ,secondly was indoor air (80 .4% ) and differ‐ent projects′qualified rate was significantly different(χ2 =1 706 .81 ,P<0 .01) .Conclusion Medical and health institutions at all levels′s disinfection quality were generally good ,but the village health room monitoring coverage ,ultraviolet light intensity and oth‐er individual monitoring projects need to be improved .