Background In recent years, the increasingly widespread application of nuclear and medical radiation technologies has resulted in a large number of occupational populations exposed to low-dose ionizing radiation (LDIR). At present, there is no consistent conclusion on the effects of long-term exposure to LDIR on the metabolic health of the occupational population. Objective To explore the association between long-term exposure to LDIR and metabolic syndrome (MetS) among medical radiologists. Methods A cross-sectional study was conducted to enroll 6431 medical radiologists who ordered occupational health checkups from January 2022 to December 2023, and basic information such as demographic characteristics, occupational characteristics, lifestyles, and dietary habits was collected through questionnaires. Physical examinations were conducted using a standardized protocol. Individual dose equivalents of occupational external exposure were monitored by dosimeters worn by medical radiologists. Logistic regression model was used for identifying influencing factors of MetS and sensitivity analysis, and restricted cubic spline model was used to explore the dose-response relationship between cumulative effective dose and MetS. Two-stage linear regression was used to evaluate threshold effect of association between cumulative effective dose and MetS. Results The positive rate of MetS was 13.6% (877/6431) among the enrolled 6431 study participants. The logistic regression showed that gender, age, monthly income, body mass index (BMI), cumulative effective dose, and smoking were influencing factors for MetS. The risk of MetS was higher in males (OR=1.511, 95%CI: 1.209, 1.888); using the < 30 years old group as reference, the risk of MetS was higher in the 30-39 years old (OR=1.509, 95%CI: 1.095, 2.079), 40-49 years old (OR=2.214, 95%CI: 1.551, 3.161), and ≥50 years old (OR=3.480, 95%CI: 2.338, 5.181) groups; using the <10000 yuan group as reference, the risk of MetS was lower in the group with a monthly income of 10000-14999 yuan (OR=0.715, 95%CI: 0.582, 0.878); the risk of MetS was higher in the BMI ≥ 24 kg·m⁻² group (OR=7.548, 95%CI: 6.223, 9.156); using the < 0.76 mSv group as reference, the risk of MetS was higher in the cumulative effective dose of 0.76-2.73 mSv group (OR=1.270, 95%CI: 1.017, 1.586); the risk of MetS was higher in the smoking group (OR=1.734, 95%CI: 1.428, 2.107). The results of restricted cubic spline showed that the cumulative effective dose was nonlinearly correlated with MetS (P _{non-linearity}=0.028), with an inflection point of 1.25 mSv. The risk of developing MetS increased by 34.1% for each unit increase in cumulative effective dose up to 1.25 mSv, whereas above 1.25 mSv, the statistical association was not significant. The sensitivity analysis results showed that after excluding the self-reported hypertensive and diabetic patients, the cumulative effective dose 0.76-2.73 mSv group still had an increased risk of developing MetS compared with the < 0.76 mSv group (P < 0.05), and the results were robust. Conclusion Among medical radiologists, male, age, BMI, and smoking are positively correlated with MetS, and monthly income is negatively correlated with MetS; cumulative effective dose is non-linearly correlated with MetS among medical radiologists.

Objective:To explore the factors influencing adherence to voice therapy among patients with voice disorders in China. Methods:Patients with voice disorders who visited the Voice Therapy Center at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from February to May 2022 were enrolled in the study. Adherence was assessed using the URICA-Voice scale, while influencing factors were assessed through the Voice Handicap Index（VHI） scale and a general information questionnaire. Correlation analysis was conducted using univariate and multivariate logistic regression analysis. Results:A total of 247 patients were included in the study, comprising 57 males（23.08%） and 190 females（76.92%）. The results revealed that: ①Female patients demonstrated higher likelihood of being in the contemplation stage（OR=0.22） compared to males. ②Patients with a monthly family income per capita>6 000 yuan were more likely to be in the contemplation stage than those with<3 000 yuan with an OR = 13.94. ③High vocal-demand occupations increased contemplation stage probability（OR=7.70） compared to moderate-demand occupations. ④Residence within 30-minute commute predicted action/maintenance stages（OR=7.14） versus≥60-minute commute. ⑤Patients whose occupations had high voice demands were more likely to be in the action and maintenance stages than those with average voice demands, with an OR of 16.20. Conclusion:Gender, monthly family income per capita, occupational voice demands, and distance to the hospital significantly impact the URICA-Voice compliance stages of patients. Patients who are female, have higher family income, have occupations with high voice demands, and live closer to the hospital exhibit higher compliance with voice training.
Humans ; Male ; Female ; Voice Disorders/therapy* ; Patient Compliance ; Voice Training ; Surveys and Questionnaires ; China ; Middle Aged ; Adult ; Voice Quality ; Logistic Models ; Aged

Protein arginine methyltransferase 5 (PRMT5) exhibits elevated expression levels in a variety of cancers and has emerged as a critical target for cancer therapy in recent years. However, first-generation PRMT5 inhibitors have exhibited inadequate selectivity, leading to significant hematological toxicity, thus limiting their clinical utility. The second-generation PRMT5 inhibitors have shown marked improvement in safety and efficacy by selectively targeting MTAP-null tumor cells without impacting normal cells. This review systematically summarizes the biological and functional roles of PRMT5 in MTAP-deficient tumor cells, and comprehensively analyzes the research and development process, molecular binding mechanisms, and the latest advancements in clinical trials of the five second-generation PRMT5 inhibitors currently under investigation, aiming to provide valuable insights for further in-depth studies in this field.

Objective:To explore the value of machine learning models based on multiple structural MRI features for diagnosis of Parkinson disease (PD).Methods:The clinical and imaging data of 60 PD patients (PD group) diagnosed in the Neurology Department of the Second Affiliated Hospital of Soochow University from November 2017 to August 2019 and 56 normal elderly people (NC group) recruited from the community were retrospectively analyzed. All subjects underwent brain MR imaging. Multiple structural MRI features were extracted from cerebellum, deep nuclei and of brain cortex based on different partition templates. The Mann-Whitney U test, as well as least absolute shrinkage and selection operator regression were used to select the most discriminating features. Finally, logistic regression (LR) and linear discriminant analysis (LDA) classifier combined with the 5-fold cross-validation scheme were used to construct the models based on structural features of cerebellum, deep nuclei and cortex, and a combined model based on all features. The receiver operating characteristic curves were drawn, and the diagnostic performance and clinical net benefit of each model were evaluated by the area under curve (AUC) and the decision curve analysis (DCA). Results:In total, four cerebellum (asymmetry index of Lobule Ⅵ volume, asymmetry index of Lobule ⅦB cortical thickness, asymmetry index of total gray matter volume and absolute value of right Lobule Ⅵ gray matter volume), 3 deep nuclei (absolute value of right nucleus accumbens volume, absolute and relative value of total nucleus accumbens volume) and 3 cortex features (local gyration index of left PFm, local fractal dimension of right superior frontal gyrus and sulcal depth of left superior occipital gyrus) were selected as the most discriminating features, and the related models were constructed. In validation set, the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LR classifier were 0.692, 0.641, 0.747 and 0.816; the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LDA classifier were 0.726, 0.610, 0.752 and 0.818. The diagnostic efficiency of the combined models based on LR and LDA classifiers were significantly better than those of other models ( P<0.05). The DCA curve demonstrated that the combined models based on LR and LDA classifiers showed the highest clinical net benefit. Conclusion:The combined models with all structural features of cerebellum, deep nuclei and cortex included based on LR and LDA classifiers showed favorable performance and clinical net benefit for diagnosis of PD, which have the potential application value in clinical diagnosis.

Helicobacter pylori (H. pylori), creating a global infection rate over 50%, presents great challenges in clinical therapies due to its complex pathological microenvironment in vivo. To improve the eradication efficacy, herein we fabricated a pharmaceutical vesicle RHL/Cl-Ch-cal where cholesterol-PEG, calcitriol and first-line antibiotic clarithromycin were co-loaded in the rhamnolipid-composed outer lipid layer. RHL/Cl-Ch-cal could quickly penetrate through gastric mucus layer to reach H. pylori infection sites, and then effectively destroyed the architecture of H. pylori biofilms, killed dispersed H. pylori and inhibited the re-adhesion of residual bacteria (called biofilms eradication tetralogy). Moreover, RHL/Cl-Ch-cal activated the host immune response to H. pylori by replenishing cholesterol to repair lipid raft on the cell membrane of host epithelial cells. Finally, RHL/Cl-Ch-cal killed the intracellular H. pylori through recovering the lysosomal acidification and assisting degradation. In experiments, RHL/Cl-Ch-cal demonstrated prominent anti-H. pylori efficacy in the classical H. pylori-infected mice model. Therefore, the study provides a "comprehensive attack" strategy for anti-H. pylori therapies including biofilms eradication tetralogy, immune activation and intracellular bacteria killing.

Objective:To evaluate the optimization efficacy of anterior quadratus lumborum block at supra-arcuate ligament (SA-AQLB) combined with general anesthesia for laparoscopic gynecological surgery.Methods:Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 28-64 yr, weighing 52-78 kg, with height of 154-166 cm, scheduled for elective laparoscopic gynecological surgery, were divided into general anesthesia group (group G, n=40) and SA-AQLB combined with general anesthesia group (group SG, n=40) using a random number table method.In group SG, bilateral SA-AQLB was performed under ultrasound guidance before anesthesia induction, and 0.4% ropivacaine 25 ml plus dexamethasone 5 mg was injected into both sides.Combined intravenous-inhalational anesthesia was applied in both groups.Patient-controlled intravenous analgesia (PCIA) with sufentanil 2 μg/kg (in 150 ml of normal saline) was performed after surgery.The PCIA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.Visual analogue scale (VAS) scores for abdomen, pelvis and shoulder pain were recorded at 1, 6, 12, 24 and 48 h after operation.Flurbiprofen was used for rescue analgesia when VAS score >4.The occurrence of intraoperative cardiovascular events and amount of sufentanil used during operation were recorded.The time to first pressing the analgesia pump, effective pressing times of PCA, requirement for rescue analgesia and consumption of sufentanil after operation were recorded.The extubation time, time to first flatus after operation, first ambulation time, length of hospital stay and development of postoperative adverse reactions such as nausea and vomiting, urinary retention and respiratory depression within 48 h after operation were recorded. Results:Compared with group G, the incidence of intraoperative hypertension and tachycardia was significantly decreased, the incidence of intraoperative hypotension and bradycardia was increased, the intraoperative consumption of sufentanil was reduced, the extubation time was shortened, the time to first pressing the analgesia pump was prolonged, the effective pressing times of PCA, requirement for rescue analgesia and postoperative consumption of sufentanil were reduced, the time to first flatus, first ambulation time and length of hospital stay were shortened, VAS scores for abdomen, pelvis and shoulder pain were decreased at each time point after operation, and the incidence of nausea and vomiting, urinary retention and respiratory depression after operation was decreased in group SG ( P<0.01). Conclusions:Compared with general anesthesia, the combination of SA-AQLB and general anesthesia can reduce the opioid consumption, inhibit intraoperative stress responses and postoperative hyperalgesia and promote early postoperative recovery when used for the patients undergoing laparoscopic gynecological surgery.

Nursing education emphasizes the cultivation of high-quality talents, and high-fidelity simulation has been applied to the training and evaluation of nursing staff. This article summarizes the status quo of nursing education evaluation at home and abroad and the application of high-fidelity simulation in education evaluation, in order to apply high-fidelity simulation to the evaluation of nursing professionals and provide ideas for the reform of nursing education.

Objective To analyze the Oncomelania hupensis snail distribution and the changes of snail situation in Chang-zhou City from 2013 to 2016,so as to provide the evidence for formulating the schistosomiasis prevention and control interven-tions. Methods The data of snail monitoring in Changzhou City from 2013 to 2016 were collected and statistically analyzed. Re-sults The total area with snails was 40.17 hm2 and the newly discovered area was 30.63 hm2 in Changzhou City from 2013 to 2016. In the four years,3454 snails were dissected,and no schistosome infected snails were found. There were totally 51 spots with snails,and the areas with snails of different types of marshland,inland and mountain were 12.13(30.19％),25.54 hm2 (63.57％)and 2.51 hm2(6.24％),respectively. In the newly discovered snail environment,the areas of types of marshland and inland were 8.00 hm2(26.12％)and 22.63 hm2(73.88％),respectively. The main causes for snail existence were external input and adjacent diffusion. In the past four years,the total snail control area with molluscicides was 71.74 hm2,the consolidated snail control area with molluscicides was 155.15 hm2,and the total environmental modification areas in the current snail spots and historic snail spots were 15.90 hm2 and 11.30 hm2 respectively. Conclusion The diffusion of snails in inland rivers is the key of the newly discovered snail areas in Changzhou City in recent years,and the snail monitoring and control measures should be strengthened in the future.

Objective To investigate the prevalence of Toxoplasma gondii infection and related knowledge and behavior among special population in Changzhou City,so as to provide the evidence for formulating effective measures of toxoplasmosis prevention. Methods The pregnant women and patients with neoplasia in Changzhou hospitals,and livestock and poultry breeding or processing workers were selected as the subjects of the study. Venous blood samples were collected from each partici-pant for detecting IgG and IgM antibodies against T. gondii by ELISA. A questionnaire investigation on knowledge and behavior about T. gondii infection was conducted. Results Among the total 300 respondents investigated from March to May,2015,the prevalence of T. gondii infection was 16.3％(49/300). Totally 52 respondents knew the knowledge about the prevention and con-trol of T. gondii infection with an awareness rate of 17.3％(52/300). The proportion of participants who frequently contacted with cats/dogs(25.0％,13/52)in the group who knew the knowledge about the prevention and control of T. gondii infection was lower than that of participants(50.8％,126/248)in the group who did not know the knowledge about the prevention and control of T. gondii infection,and the difference was statistically significant(X2=11.51,P<0.05). The proportion of participants sepa-rating chopping boards for raw and cooked food(61.5％,32/52)in the group who knew the knowledge about the prevention and control of T. gondii infection was statistically higher than that of the participants(9.3％,23/248)in the group who did not know the knowledge about the prevention and control of T. gondii infection,and the difference was statistically significant (X2=78.43,P<0.001). There was a negative correlation between the awareness rate of the knowledge about the prevention and con-trol of T. gondii infection and the infection rate of T. gondii. The infection rate of T. gondii(5.8％,3/52)in the group who knew the knowledge about the prevention and control of T. gondii infection was lower than that(18.5％,46/248)of the group who did not know the knowledge about the prevention and control of T. gondii infection,and the difference was statistically significant (X2=5.14,P<0.05). Conclusions The awareness rate of the knowledge about the prevention and control of T. gondii infec-tion among special population in Changzhou City is low. The health education on the knowledge of the prevention and control of toxoplasmosis should be strengthened,in order to improve the awareness of personal hygiene and change the unhealthy lifestyles and dietary habits.

Objective To understand the status of knowledge,attitude,and practice of schistosomiasis prevention and con-trol and infection status in Armed Police Forces stationed along the Yangtze River,so as to provide the reference for formulating the schistosomiasis prevention and control measures in Armed Police Forces. Methods A questionnaire survey was conducted in the Armed Police Forces along the Yangtze River in Jiangsu Province,and the investigation content included social demo-graphic data,schistosomiasis prevention knowledge,attitude and behavior. All the subjects were examined for Schistosoma ja-ponicum infection. Results Totally 376 soldiers were investigated in 2 sites. The total passing rate of schistosomiasis knowl-edge was 72.87%. The passing rate among different age groups had no significant difference( χ2 =0.26,P > 0.05). The passing rate of soldiers from endemic areas was significantly higher than that of the soldiers from non-endemic areas( χ2 =4.71,P <0.05). The passing rate of officers was significantly higher than that of the soldiers(χ2 = 4.21,P <0.05). The passing rate of sol-diers with the education levels of junior school,high school,college,undergraduate and above increased gradually,with a sig-nificant difference( χ2 =8.16,P < 0.05). The soldiers with positive attitude accounted for 93.88%. Among the water contact be-haviors,training accounted for 17.55% and participating in the task(such as flood fighting and water work)accounted for 86.44%. When launching,the rate of taking protective measures was 52.93%. The rate of taking protective measures in the knowledge passing group was much higher than that in the knowledge failed group( χ2 =10.55,P < 0.05). The stool was harm-lessly treated in the two camps. Among 376 soldiers,the positive rate of blood examinations was 0.53%,but the stool examina-tions were all negative. Conclusions The overall level of knowledge and correct behavior of schistosomiasis prevention in the Armed Police Forces along the Yangtze River still should be improved. The better health education and behavior intervention are crucial to schistosomiasis prevention in the army.