Objective:To analyze the incidence and risk factors of ocular surface disease among power grid construction workers in plateau.Methods:A total of 11 132 construction personnel from the Ngari prefecture-central Tibet power grid interconnection project were included from 2019 to 2020.Baseline characteristics including age, gender, body mass index, developmental and nutritional status, relevant clinical indicators, etc.and follow-up data regarding incidence of ocular surface diseases were obtained from the medical records of Ali interconnection project staff medical station.The altitude of workplace and residence of the study population were obtained from the website (https: //zh-cn.topographic-map.com/legal/).The mean age of the subjects was (36.17±10.48) years, of which 95.33%(10, 612 subjects) were male.The median follow-up time was 1.53 years.The altitude of the residence and workplace were (1 954.77±940.64) and (4 535.09±232.71) meters, respectively.The incidence of ocular surface diseases in groups with different characteristics was calculated.Differential variables for the incidence of ocular surface diseases were screened by univariate Cox proportional hazards regression model.Influencing factors of ocular surface diseases multivariate were explored by Cox proportional hazards model.This study was approved by the Ethics Committee of Peking University Health Science Center (No.IRB00001052-21066).Results:During the follow-up period, the incidence of ocular surface disease was 9.27% (1 032 cases), and the incidence of conjunctivitis and keratitis was 6.58% (733 cases) and 1.80% (200 cases), respectively.Multivariate Cox proportional hazards regression analysis showed that for every 1 000 meters increase in altitude of residence, the risk of ocular surface disease decreased by 15% ( HR[95% CI]: 0.85[0.80~0.91], P<0.001).For every 100 meters increase in altitude of workplace, the risk of ocular surface disease increased by 5% ( HR[95% CI]: 1.04[1.01~1.07], P=0.006).Decreased blood oxygen saturation ( HR[95% CI]: 1.09[1.02~1.16], P=0.007), hearing pulmonary dry rales (hazard ratio ( HR)[95% CI]: 1.53[1.12~2.09], P=0.007) and heart murmurs ( HR[95% CI]: 4.44[1.43~13.83], P=0.010) were associated with ocular surface disease. Conclusions:The incidence of ocular surface disease in personnel engaged in electric grid construction at high altitudes should not be ignored.High working altitude, low residence altitude, pulmonary dry rales, heart murmurs and low blood oxygen saturation are factors associated with the incidence of ocular surface disease.

Objective To investigate the value of multi-slice spiral computed tomography (MSCT) features, along with the expression levels of epidermal growth factor receptor (EGFR) and insulin-like growth factor 1 receptor (IGF1R), in differential diagnosis of benign and malignant adrenal cortical tumors. Methods A total of 98 patients with adrenal cortical tumors admitted to Zibo Municipal Central Hospital from January 2020 to July 2024 were included in this study. All subjects underwent MSCT scans of the adrenal gland. The CT values of tumor parenchyma on plain scans and at arterial and venous phases were estimated. The surgical tumor specimens were collected for immunohistochemical staining and measurement of EGFR and IGF1R expression. The MSCT features and EGFR and IGF1R expression levels were compared among patients with different pathological types of adrenal cortical tumors. Results Of the 98 patients with adrenal cortical tumors, there were 18 cases with cortical carcinoma, 10 cases with metastatic tumors, 31 cases with pheochromocytoma, 25 cases with aldosterone-producing adenomas, and 14 cases with cortisol adenomas. The CT values of adrenal aldosterone-producing adenomas were significantly lower than other pathological types of adrenal cortical tumors on plain scans and at arterial and venous phases (P < 0.05). The CT values of metastatic tumors and cortical carcinoma were significantly lower than those of pheochromocytoma and cortisol adenomas at arterial and venous phases (P < 0.05). Specifically, at arterial and venous phases, the CT values of metastatic tumors were lower than those of cortical carcinoma, and the CT values of cortisol adenomas were lower than those of pheochromocytoma (P < 0.05). The positive expression levels of EGFR and IGF1R were higher in tumor specimens from patients with metastatic tumors and cortical carcinomas than from pheochromocytoma, aldosterone-producing adenomas, and cortisol adenomas (P < 0.05). There were no significant differences between patients with metastatic tumors and cortical carcinomas in terms of positive EGFR and IGF1R expression (P > 0.05). In addition, there were no significant differences in the proportions of positive EGFR and IGF1R expression among patients with malignant adrenal cortical tumors in terms of ages, genders, tumor sizes, and TNM stages (P > 0.05). Conclusion The CT values of MSCT scans at arterial and venous phases as well as EGFR and IGF1R expression levels correlate with the pathological types of adrenal cortical tumors.

Objective:To establish an HPLC characteristic chromatogram method to simultaneously determine the content of 6 components in Bombyx Batryticatus and its processed products; To provide a scientific means for quality evaluation.Methods:The HPLC analysis was performed on a Waters Xselect HSS T3 column (250 mm×4.6 mm, 5 μm), with a mobile phase consisting of acetonitrile and 5 mmol/L ammonium acetate solution (adjust pH to 4.5 with acetic acid) in gradient mode at a flow rate of 1.0 ml/min. The column temperature was 30 ℃. The detection wavelength was 260 nm. The injection volume was 10 μl. The SIMCA-P 14.0 software was used for cluster analysis and partial least squares discriminant analysis to evaluate the quality of Bombyx Batryticatus and its processed products.Results:Nine common peaks were identified in the HPLC characteristic spectra of Bombyx Batryticatus and its processed products, and seven common peaks were identified. Cluster analysis and partial least squares discriminant analysis can classify Bombyx Batryticatus and its processed products into two groups, with peak 4, peak 2, peak 1, peak 6, and peak 3 as their mass difference markers. Uric Acid, Hypoxanthine, Uridine, Adenine, Guanosine, and Adenosine showed good linearity ( R2≥0.999 9) within 43.95-879.04, 2.05-41.07, 2.35-47.09, 2.02-40.36, 2.32-46.43, 2.32-46.43 μg/ml, respectively. The precision, stability (24 h), repeatability relative standard deviation (RSD) were all <3.00%. The average spiked recoveries were all in the range of 94.57%-102.01%, and the RSDs were all in the range of 0.96%-3.32%. In 15 batches of Bombyx Batryticatus, the content of the above 6 components, was determined to be 11.51, 0.33, 0.38, 0.42, 0.35, 0.36 mg/g in the following order. And in 15 batches of fried Bombyx Batryticatus, the content of components was determined to be 12.06, 0.35, 0.36, 0.18, 0.21, 0.24 mg/g in the following order. Conclusions:The method established in this study is simple, rapid, and repeatable. PLS-DA can distinguish Bombyx Batryticatus and its processed products, which can provide a reference for the quality evaluation of Bombyx Batryticatus and its processed products.

Objective To explore the effect of high-sensitivity cardiac troponin T(hs-cTnT)and frailty on all-cause mortality risk in elderly inpatients without acute coronary syndrome(ACS).Methods A prospective cohort study was conducted on 613 non-ACS inpatients admitted to our department from June 2015 to December 2019.According to the tertile fo hs-cTnT level,the patients were divided into the low hs-cTnT group(＜13 ng/L,n=184),median hs-cTnT group(13-19 ng/L,n=226),high hs-cTnT group(＞19 ng/L,n=203).Based on the results of Fried frailty scale,they were also assigned into a non-frail group(n=410)and a frail group(n=203).So,there were six groups,that is,low hs-cTnT and non-frail group(n=139),low hs-cTnT with frailty group(n=45),median hs-cTnT and non-frail group(n=172),median hs-cTnT with frail-ty group(n=54),high hs-cTnT and non-frail group(n=99),and high hs-cTnT with frailty group(n=104).Baseline clinical data were collected in all the patients.All of them were followed for 2 years to observe all-cause mortality.The effects of hs-cTnT and frailty on mortality risk were analyzed.The predictive value of hs-cTnT combined with Fried frailty classification for mortality was evaluated.Results During the 2-year follow-up,83(13.5％)all-cause deaths occurred.Cox regression analysis revealed that after adjustment for confounders,the high hs-cTnT and non-frail group had increased mortality risk than the low hs-cTnT and non-frail group(HR=3.005,95％CI:1.171-7.711,P=0.022),while the high hs-cTnT with frailty group had the high-est risk(HR=4.470,95％CI:1.775-11.255,P=0.001).ROC curve analysis demonstrated that an AUC value of hs-cTnT,Fried frailty score and their combination in predicting mortality was 0.694(95％CI:0.656-0.730,P＜0.01),0.669(95％CI:0.631-0.707,P＜0.01),and 0.723(95％CI:0.686-0.758,P＜0.01),respectively.Conclusion For the elderly non-ACS inpatients,those with hs-cTnT elevation and frailty are at the highest risk for all-cause mortality.The combination of hs-cTnT and Fried frailty score demonstrates higher predictive value than either indicator alone.

Objective:To analyze the incidence and risk factors of ocular surface disease among power grid construction workers in plateau.Methods:A total of 11 132 construction personnel from the Ngari prefecture-central Tibet power grid interconnection project were included from 2019 to 2020.Baseline characteristics including age, gender, body mass index, developmental and nutritional status, relevant clinical indicators, etc.and follow-up data regarding incidence of ocular surface diseases were obtained from the medical records of Ali interconnection project staff medical station.The altitude of workplace and residence of the study population were obtained from the website (https: //zh-cn.topographic-map.com/legal/).The mean age of the subjects was (36.17±10.48) years, of which 95.33%(10, 612 subjects) were male.The median follow-up time was 1.53 years.The altitude of the residence and workplace were (1 954.77±940.64) and (4 535.09±232.71) meters, respectively.The incidence of ocular surface diseases in groups with different characteristics was calculated.Differential variables for the incidence of ocular surface diseases were screened by univariate Cox proportional hazards regression model.Influencing factors of ocular surface diseases multivariate were explored by Cox proportional hazards model.This study was approved by the Ethics Committee of Peking University Health Science Center (No.IRB00001052-21066).Results:During the follow-up period, the incidence of ocular surface disease was 9.27% (1 032 cases), and the incidence of conjunctivitis and keratitis was 6.58% (733 cases) and 1.80% (200 cases), respectively.Multivariate Cox proportional hazards regression analysis showed that for every 1 000 meters increase in altitude of residence, the risk of ocular surface disease decreased by 15% ( HR[95% CI]: 0.85[0.80~0.91], P<0.001).For every 100 meters increase in altitude of workplace, the risk of ocular surface disease increased by 5% ( HR[95% CI]: 1.04[1.01~1.07], P=0.006).Decreased blood oxygen saturation ( HR[95% CI]: 1.09[1.02~1.16], P=0.007), hearing pulmonary dry rales (hazard ratio ( HR)[95% CI]: 1.53[1.12~2.09], P=0.007) and heart murmurs ( HR[95% CI]: 4.44[1.43~13.83], P=0.010) were associated with ocular surface disease. Conclusions:The incidence of ocular surface disease in personnel engaged in electric grid construction at high altitudes should not be ignored.High working altitude, low residence altitude, pulmonary dry rales, heart murmurs and low blood oxygen saturation are factors associated with the incidence of ocular surface disease.

Objective To explore the effect of high-sensitivity cardiac troponin T(hs-cTnT)and frailty on all-cause mortality risk in elderly inpatients without acute coronary syndrome(ACS).Methods A prospective cohort study was conducted on 613 non-ACS inpatients admitted to our department from June 2015 to December 2019.According to the tertile fo hs-cTnT level,the patients were divided into the low hs-cTnT group(＜13 ng/L,n=184),median hs-cTnT group(13-19 ng/L,n=226),high hs-cTnT group(＞19 ng/L,n=203).Based on the results of Fried frailty scale,they were also assigned into a non-frail group(n=410)and a frail group(n=203).So,there were six groups,that is,low hs-cTnT and non-frail group(n=139),low hs-cTnT with frailty group(n=45),median hs-cTnT and non-frail group(n=172),median hs-cTnT with frail-ty group(n=54),high hs-cTnT and non-frail group(n=99),and high hs-cTnT with frailty group(n=104).Baseline clinical data were collected in all the patients.All of them were followed for 2 years to observe all-cause mortality.The effects of hs-cTnT and frailty on mortality risk were analyzed.The predictive value of hs-cTnT combined with Fried frailty classification for mortality was evaluated.Results During the 2-year follow-up,83(13.5％)all-cause deaths occurred.Cox regression analysis revealed that after adjustment for confounders,the high hs-cTnT and non-frail group had increased mortality risk than the low hs-cTnT and non-frail group(HR=3.005,95％CI:1.171-7.711,P=0.022),while the high hs-cTnT with frailty group had the high-est risk(HR=4.470,95％CI:1.775-11.255,P=0.001).ROC curve analysis demonstrated that an AUC value of hs-cTnT,Fried frailty score and their combination in predicting mortality was 0.694(95％CI:0.656-0.730,P＜0.01),0.669(95％CI:0.631-0.707,P＜0.01),and 0.723(95％CI:0.686-0.758,P＜0.01),respectively.Conclusion For the elderly non-ACS inpatients,those with hs-cTnT elevation and frailty are at the highest risk for all-cause mortality.The combination of hs-cTnT and Fried frailty score demonstrates higher predictive value than either indicator alone.

Objective To explore the effect of ligustrazine on the learning and memory function of rats with aluminum-induced cognitive impairment and its mechanism.Methods Sixty male Wistar rats were divided into a blank control group,a model group,a low-dose ligustrazine group,a high-dose ligustrazine group,and a piracetam group using a random number table method,with 12 rats in each group.The rats in the blank control group were not subjected to any treatment;the rats in the model group,low-dose ligustrazine group,high-dose ligustrazine group,and piracetam group were first prepared with aluminum toxicity models by daily gavage of 100 mg·kg-1 AlCl3 solution.After successful modeling,the rats in the piracetam group were intragastrically administered with piracetam at a dose of 400 mg·kg-1,while rats in the low-dose and high-dose ligustrazine groups were intragastrically administered with 100 and 200 mg·kg-1 ligustrazine,respectively;the rats in the blank control group and the model group were intragastrically administered with the same volume of physiological saline.All rats in the five groups received intragas tric administration once a day for 30 consecutive days.After 30 days of intervention,the Morris water maze test was used to evaluate the learning and memory function of rats in the five groups.After completing the water maze experiment,rats in the five groups were anesthetized with 200 g·L-1 chloral hydrate,and their brain tissues were quickly removed after decapitation.Immunohistochemical staining was used to observe the expression of calcium voltage-gated channel subunit alpha 1E(CACNA1E),calmodulin(CALM),and brain-derived neurotrophic factor(BDNF)in the hippocampal CA1 region of rats in the five groups;Western blot was used to detect the relative expression levels of CACNA1E,CALM,and BDNF proteins in the hippocampal CA1 region of rats in the five groups;and real-time fluorescence quantitative polymerase chain reaction was used to detect the relative expression levels of CACNA1E,CALM,and BDNF mRNA in the hippocampal CA1 region of rats in the five groups.Results On the 1st day of the Morris water maze test,the latent periods of rats in the model group,piracetam group,low-dose ligustrazine group,and high-dose ligustrazine group were significantly higher than those in the blank control group(P＜0.05);there was no statistically significant difference in the latent periods of rats among the piracetam group,low-dose ligustrazine group,high-dose ligustrazine group,and model group(P＞0.05).On the 3rd day of the Morris water maze test,the latent periods of rats in the model group,piracetam group,low-dose ligustrazine group,and high-dose ligustrazine group were significantly higher than those in the blank control group(P＜0.05);the latent periods of rats in the piracetam group and high-dose ligustrazine group were significantly lower than those in the model group and low-dose ligustrazine group(P＜0.05);there was no statistically significant difference in the latent periods of rats between the low-dose ligustrazine group and the model group(P＞0.05).On the 5th day of the Morris water maze test,the latent periods of rats in the model group,piracetam group,low-dose ligustrazine group,and high-dose ligustrazine group were significantly higher than those in the blank control group(P＜0.05);the latent periods of rats in the piracetam group and high-dose ligustrazine group were significantly lower than those in the model group and low-dose ligustrazine group(P＜0.05);there was no statistically significant difference in the latent periods of rats between the low-dose ligustrazine group and the model group(P＞0.05).On the 3rd and 5th days of the Morris water maze test,there was no statistically significant difference in the latent periods of rats between the piracetam group and the high-dose ligustrazine group(P＞0.05).The times of rats crossing platform in the model group,piracetam group,low-dose ligustrazine group,and high-dose ligustrazine group were significantly lower than those in the blank control group,and the times of rats crossing platform in the piracetam group and high-dose ligustrazine group were significantly higher than those in the model group and low-dose ligustrazine group(P＜0.05);there was no statistically significant difference in the times of rats crossing platform between the low-dose ligustrazine group and the model group(P＞0.05);there was no statistically significant difference in the times of rats crossing platform between the piracetam group and the high-dose ligustrazine group(P＞0.05).Under the microscope,brown CACNA1E,CALM,and BDNF positive cells could be observed in the hippocampal CA1 region.The expressions of CACNA1E,CALM,and BDNF proteins in the hippocampal CA1 region of rats in the model group,piracetam group,low-dose ligustrazine group,and high-dose ligustrazine group were significantly lower than those in the blank control group,and the expressions of CACNA1E,CALM,and BDNF proteins in the hippocampal CAl region of rats in the piracetam group and high-dose ligustrazine group were significantly higher than those in the model group and low-dose ligustrazine group(P＜0.05);there was no statistically significant difference in the expressions of CACNA1E,CALM,and BDNF proteins in the hippocampal CAI region of rats between the low-dose ligustrazine group and the model group(P＞0.05);there was no statistically significant difference in the expressions of CACNA1E,CALM,and BDNF proteins in the hippocampal CA1 region of rats between the piracetam group and the high-dose ligustrazine group(P＞0.05).The relative expression levels of CACNA1E,CALM,and BDNF proteins and mRNAs in the hippocampal CA1 region of rats in the model group,piracetam group,low-dose ligustrazine group,and high-dose ligustrazine group were significantly lower than those in the blank control group(P＜0.05);the relative expression levels of CACNA1E,CALM,and BDNF proteins and mRNAs in the hippocampal CA1 region of rats in the piracetam group and high-dose ligustrazine group were significantly higher than those in the model group and low-dose ligustrazine group(P＜0.05);there was no statistically significant difference in the relative expression levels of CACNA1E,CALM,and BDNF proteins and mRNAs in the hippocampal CA1 region of rats between the low-dose ligustrazine group and the model group(P＞0.05);there was no statistically significant difference in the relative expression levels of CACNA1E,CALM,and BDNF proteins and mRNAs in the hippocampal CA1 region of rats between the piracetam group and the high-dose ligustrazine group(P＞0.05).Conclusion Ligustrazine has significant protective effects on aluminum-induced cognitive impairment in rats and can greatly enhance the learning and memory function of rats.The mechanism may be related to the up-regulation of CANA1E,CALM and BDNF expression in the brain induced by ligustrazine.

Objective:To explore the factors leading to communication disorders in ICU patients during mechanical ventilation from the perspective of both patients and medical staff, and to use the theoretical framework of acceptability to identify the barriers that can be improved by intervention.Methods:Using the method of descriptive phenomenology from July to August 2022, 11 patients with mechanical ventilation and 8 medical staff in the comprehensive ICU of a Yuhuangding Hospital in Yantai were selected for interviews by the purpose sampling method, combined with participatory observation. The interviews of patients were conducted off ventilator. With Nvivo12.0 Plus software, the seven-step analysis method of Colaizzi phenomenology was adopted to summarize the theme and the theoretical framework of acceptability was used to identify the obstacle factors that could be improved by intervention.Results:The age of 11 patients was 18-46 years old, the duration of mechanical ventilation was 9.5-312.3 h. The age of 8 medical staff was 26-54 years old, the length of service in ICU was 2-30 years. A total of 14 themes were extracted. For patients: defensive mood, difficulty in presenting information, introverted personality, communication tools are hard to use, emergency treatment conflict, deny the ability to communicate, thought slowness. For medical staff: defensive mood, cognitive load, high time cost, lack of humane communication strategies, poor training, other priorities, loss of confidence in effective communication, awareness of the importance of communication was not enough.Conclusions:There are many factors that can be improved for patients with mechanical ventilation in ICU. It is suggested to speed up the research and development of high-tech and personalized alternative communication tools in China, reduce negative communication between doctors and patients and nurses and patients, and implement evidence-based multi-mode and progressive communication intervention strategies.

OBJECTIVES: Firefighters are prone to suffer from psychological trauma and post-traumatic stress disorder (PTSD) in the workplace, and have a poor prognosis after PTSD. Reliable models for predicting PTSD allow for effective identification and intervention for patients with early PTSD. By collecting the psychological traits, psychological states and work situations of firefighters, this study aims to develop a machine learning algorithm with the aim of effectively and accurately identifying the onset of PTSD in firefighters, as well as detecting some important predictors of PTSD onset. METHODS: This study conducted a cross-sectional survey through convenient sampling of firefighters from 20 fire brigades in Changsha, which were evenly distributed across 6 districts and Changsha County, with a total of 628 firefighters. We used the synthetic minority oversampling technique (SMOTE) to process data sets and used grid search to finish the parameter tuning. The predictive capability of several commonly used machine learning models was compared by 5-fold cross-validation and using the area under the receiver operating characteristic curve (ROC-AUC), accuracy, precision, recall, and F1 score. RESULTS: The random forest model achieved good performance in predicting PTSD with an average AUC score at 0.790. The mean accuracy of the model was 90.1%, with an F1 score of 0.945. The three most important predictors were perseverance, forced thinking, and reflective deep thinking, with weights of 0.165, 0.158, and 0.152, respectively. The next most important predictors were employment time, psychological power, and optimism. CONCLUSIONS PTSD onset prediction model for Changsha firefighters constructed by random forest has strong predictive ability, and both psychological characteristics and work situation can be used as predictors of PTSD onset risk for firefighters. In the next step of the study, validation using other large datasets is needed to ensure that the predictive models can be used in clinical setting.
Humans ; Stress Disorders, Post-Traumatic/diagnosis* ; Firefighters/psychology* ; Cross-Sectional Studies ; Algorithms ; Machine Learning

Objective:To study the efficacy of endoscopic papillary balloon dilatation (EPBD) in the treatment of non-dilated small choledocholithiasis.Methods:Clinical data of 142 patients with non-dilated small choledocholithiasis admitted to Zhanjiang Central People's Hospital from April 2021 to March 2023 were retrospectively analyzed, including 63 males and 79 females, aged (55.1±15.4) years old. Patients were divided into the EPBD group ( n=63) and endoscopic sphincterotomy (EST) group ( n=79). Blood amylase, liver enzymology, liver metabolism, and blood routine were monitored before and 48 hours after treatment. The occurrences of intraoperative bleeding, perforation, post-ERCP pancreatitis (PEP), and cholangitis were compared between the groups. Patients were followed up and screened for stone recurrence by outpatient review 3 to 12 months from discharge. Results:Compared to preoperative data, the white blood cell count, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bili-rubin, and direct bilirubin decreased 48 hours after treatment (all P<0.05). The operation time in EPBD group was slightly longer than that in EST group [(43.1±5.9) min vs. (38.5±4.5) min, P=0.064] without statistical significance. There were no case of perforation in both groups. The incidences of intraopera-tive bleeding [3.17%(2/63) vs. 6.33%(5/79)], PEP [17.46%(11/63) vs. 10.53%(8/79)], and postoperative cholangitis [4.76%(3/63) vs. 1.27%(1/79)] were comparable between the groups (all P>0.05). Conclusion:EPBD could be feasible for non-dilated small choledocholithiasis, which does not increase the operation time and incidence of adverse events compared to EST.