With the vigorous development of computers and internet, the construction of the information management system for Occupational Health Technical Service (OHTS) institutions in China has achieved impressive progress. But for the management of OHTS institutions, there are relatively few systems that can fully explore and utilize OHTS information. Base on this background, in light of the actual situation of the OHTS institution in Henan Province, an OHTS Information Management System was developed under the Java Spring Boot framework, with a MySQL database and a B/S multi-tier architecture. The platform integrates a vertical three-level network of ″provincial-municipal-county/district″ and a horizontal network involving health commissions, disease prevention and control bureaus, Centers for Disease Control and Prevention (occupational disease prevention and treatment institutes), and OHTS institutions. The system includes five core modules: dynamic management of institutional and personnel qualifications, full-process project supervision (including five categories of technical services such as pre-evaluation and control-effectiveness evaluation), multidimensional decision analysis (including eight statistical indicators of institutional distribution, equipment allocation, and occupational hazard factors), rapid generation and automated submission of various reports, and early warning and intelligent supervision. The system has been implemented in 61 OHTS institutions in Henan Province, improving the ″off-site supervision rate″ of supervision department and promoting the standardization and digital transformation of occupational health services.

Objective:To investigate the influencing factors of enlarged perivascular space (PVS) in relapsing-remitting multiple sclerosis (RRMS) patients and their relationship with cognitive function.Methods:Twenty-seven individuals with RRMS (RRMS group) and 27 healthy controls (healthy control group) who presented to the Department of Neurology, the Sixth Medical Center of People′s Liberation Army General Hospital from July 2022 to November 2024 underwent cognitive function assessments. PVS volume fractions, lesion volumes, and brain volumes were calculated using FreeSurfer, FSL, and other relevant softwares. Group differences in PVS volume fractions, lesion volumes, brain volumes, and cognitive function assessments were compared. Furthermore, correlations between PVS volume fractions and lesion volumes, brain volumes, and cognitive function assessments were analyzed within the RRMS group.Results:Compared with the healthy control group, the RRMS group exhibited significantly higher PVS volume fractions in white matter (PVS_w) (3.14‰±0.29‰ vs 2.91‰±0.30‰, t=2.877, P=0.006) and PVS volume fractions in deep gray matter (PVS_d) (2.25‰±0.10‰ vs 2.17‰±0.09‰, t=2.681, P=0.010), indicating an enlargement of the PVS. Compared with the healthy control group, the RRMS group showed a significant decrease in both white matter volumes [297.3 (274.3, 340.2) ml vs (324.2 (311.0, 350.0) ml, U=-2.085, P=0.037] and deep grey matter volumes [40.2 (34.9, 43.6) ml vs 42.7 (40.2, 44.8) ml, U=-2.292, P=0.022]. Compared with the healthy control group, the RRMS group showed significantly lower scores in cognitive function assessments ( P<0.05). Univariate analysis showed that PVS_w in the RRMS group was significantly positively correlated with age ( r=0.486), white matter lesion volumes ( r=0.437) and deep gray matter lesion volumes ( r=0.394;all P<0.05); PVS_d was also significantly positively correlated with white matter lesion volumes ( r=0.418) and deep gray matter lesion volumes ( r=0.480; both P<0.05). Multiple linear regression analysis showed that age ( B=0.011,95% CI 0.004-0.017), white matter lesion volumes ( B=0.026,95% CI 0.011-0.040) and deep gray matter lesion volumes ( B=0.401,95% CI 0.032-0.771) in the RRMS group were significantly positively correlated with PVS_w, while white matter lesion volumes ( B=0.007,95% CI 0.001-0.014) and deep gray matter lesion volumes ( B=0.204,95% CI 0.029-0.380) were significantly positively correlated with PVS_d (both P<0.05). Univariate analysis showed that immediate memory score in the RRMS group was significantly negatively correlated with PVS_d ( r=-0.428), and was significantly positively correlated with education level ( r=0.471), deep gray matter volumes ( r=0.530) and total brain volumes ( r=0.389; all P<0.05); short-term delayed memory score in the RRMS group was significantly negatively correlated with age ( r=-0.390), PVS_w ( r=-0.417) and white matter lesion volumes ( r=-0.438), and was significantly positively correlated with gender ( r=0.393), white matter volumes ( r=0.478), deep gray matter volumes ( r=0.579) and total brain volumes ( r=0.602;all P<0.05); verbal fluency test score in the RRMS group was significantly negatively correlated with PVS_d ( r=-0.409) and was significantly positively correlated with education level ( r=0.419) and total brain volumes ( r=0.400;all P<0.05). Multiple linear regression analysis revealed that PVS_d ( B=-5.572, 95% CI -11.513--0.368) and brain volumes ( B=0.012, 95% CI 0.001-0.023) in the RRMS group were both significant predictors of immediate recall score, while PVS_d ( B=-14.203,95% CI -27.514--0.891) was an independent predictor of verbal fluency test score (all P<0.05). Conclusions:The PVS is enlarged in individuals with RRMS compared with the healthy controls, and increased lesion volumes may be a significant predictor. Furthermore, enlarged PVS in the deep gray matter may be a significant predictor of impairment of verbal memory and verbal function in individuals with RRMS.

Objective To investigate the clinical effect of cranial electrotherapy stimulation （CES） combined with music intervention on insomnia and its effect in improving cognitive function. Methods A total of 75 patients with insomnia were randomly divided into control group with treatment-as-usual （TAU） alone，CES+double beat+TAU group， and CES+pink noise+TAU group， with a sample size of 1∶1∶1 for the three groups. Sleep onset latency （SL）， total sleep time （TST）， and sleep quality were analyzed before and after treatment， and the Go/NoGo paradigm for the assessment of cognitive function was used to assess the effect of CES combined with music intervention in improving cognitive function. Results As for the treatment of insomnia， the experimental groups had significant changes in sleep quality （PSQI and SRSS） （P<0.05） and a significant reduction in sleep latency （P<0.05）after treatment， with a significantly higher reduction rate than the control group. As for cognitive function， there was a reduction in the latency of Go-N2 and Go-P3 and an increase in amplitude in the patients with insomnia after CES combined with music intervention， as well as reductions in the latency and amplitude of NoGo-N2 and NoGo-P3. Conclusion CES combined with music intervention can safely and effectively shorten sleep latency and improve sleep quality and cognitive function.

BACKGROUND:Understanding the characteristics and influencing factors of the gut microbiota in athletes can help determine the optimal gut microbial composition for relevant sport events.Further investigation in this area could provide important insights for improving athletic performance and recovery as well as developing personalized nutrition prescriptions.OBJECTIVE:To summarize the characteristics of gut microbiota in athletes,and to elucidate the important factors influencing the gut microbiota characteristics of athletes from the perspectives of exercise training and dietary intake.METHODS:A literature search was conducted using the PubMed,ScienceDirect,CNKI,WanFang and VIP databases for publications from 2004 to 2024.The search terms included"microbiota,microbiome,athlete,exercise,training,diet,nutrition,dietary fiber,protein,ketogenic,fat"in English and Chinese.After excluding studies of poor quality and irrelevant content,a total of 65 articles were included for review and analysis.RESULTS AND CONCLUSION:(1)The gut microbiota of elite athletes differs from that of the general population,characterized by increased α-diversity,elevated Firmicutes/Bacteroidetes ratio,increased abundance of beneficial bacteria,and enrichment of functional pathways contributing to athletic performance.(2)The type of sport and training load are closely related to the species structure and functional expression of the gut microbiota in athletes.(3)The bidirectional communication between the host and gut microbiota mediated by metabolites is an important mechanism by which exercise influences the gut microbiota.(4)Phase training typically induces adaptive changes in the gut microbiota,and alterations in the structure or function of the microbiota have lasting effects.(5)The type,quantity,and combination of macronutrients intake can significantly influence the structure and function of the gut microbiota,and interact synergistically or antagonistically with exercise training.(6)In the future,it is important to continue the exploration of the gut microbiota in athletes,clarify causal relationships,and establish new targets for exercise training interventions.

BACKGROUND:Understanding the characteristics and influencing factors of the gut microbiota in athletes can help determine the optimal gut microbial composition for relevant sport events.Further investigation in this area could provide important insights for improving athletic performance and recovery as well as developing personalized nutrition prescriptions.OBJECTIVE:To summarize the characteristics of gut microbiota in athletes,and to elucidate the important factors influencing the gut microbiota characteristics of athletes from the perspectives of exercise training and dietary intake.METHODS:A literature search was conducted using the PubMed,ScienceDirect,CNKI,WanFang and VIP databases for publications from 2004 to 2024.The search terms included"microbiota,microbiome,athlete,exercise,training,diet,nutrition,dietary fiber,protein,ketogenic,fat"in English and Chinese.After excluding studies of poor quality and irrelevant content,a total of 65 articles were included for review and analysis.RESULTS AND CONCLUSION:(1)The gut microbiota of elite athletes differs from that of the general population,characterized by increased α-diversity,elevated Firmicutes/Bacteroidetes ratio,increased abundance of beneficial bacteria,and enrichment of functional pathways contributing to athletic performance.(2)The type of sport and training load are closely related to the species structure and functional expression of the gut microbiota in athletes.(3)The bidirectional communication between the host and gut microbiota mediated by metabolites is an important mechanism by which exercise influences the gut microbiota.(4)Phase training typically induces adaptive changes in the gut microbiota,and alterations in the structure or function of the microbiota have lasting effects.(5)The type,quantity,and combination of macronutrients intake can significantly influence the structure and function of the gut microbiota,and interact synergistically or antagonistically with exercise training.(6)In the future,it is important to continue the exploration of the gut microbiota in athletes,clarify causal relationships,and establish new targets for exercise training interventions.

Objective:To investigate the influencing factors of enlarged perivascular space (PVS) in relapsing-remitting multiple sclerosis (RRMS) patients and their relationship with cognitive function.Methods:Twenty-seven individuals with RRMS (RRMS group) and 27 healthy controls (healthy control group) who presented to the Department of Neurology, the Sixth Medical Center of People′s Liberation Army General Hospital from July 2022 to November 2024 underwent cognitive function assessments. PVS volume fractions, lesion volumes, and brain volumes were calculated using FreeSurfer, FSL, and other relevant softwares. Group differences in PVS volume fractions, lesion volumes, brain volumes, and cognitive function assessments were compared. Furthermore, correlations between PVS volume fractions and lesion volumes, brain volumes, and cognitive function assessments were analyzed within the RRMS group.Results:Compared with the healthy control group, the RRMS group exhibited significantly higher PVS volume fractions in white matter (PVS_w) (3.14‰±0.29‰ vs 2.91‰±0.30‰, t=2.877, P=0.006) and PVS volume fractions in deep gray matter (PVS_d) (2.25‰±0.10‰ vs 2.17‰±0.09‰, t=2.681, P=0.010), indicating an enlargement of the PVS. Compared with the healthy control group, the RRMS group showed a significant decrease in both white matter volumes [297.3 (274.3, 340.2) ml vs (324.2 (311.0, 350.0) ml, U=-2.085, P=0.037] and deep grey matter volumes [40.2 (34.9, 43.6) ml vs 42.7 (40.2, 44.8) ml, U=-2.292, P=0.022]. Compared with the healthy control group, the RRMS group showed significantly lower scores in cognitive function assessments ( P<0.05). Univariate analysis showed that PVS_w in the RRMS group was significantly positively correlated with age ( r=0.486), white matter lesion volumes ( r=0.437) and deep gray matter lesion volumes ( r=0.394;all P<0.05); PVS_d was also significantly positively correlated with white matter lesion volumes ( r=0.418) and deep gray matter lesion volumes ( r=0.480; both P<0.05). Multiple linear regression analysis showed that age ( B=0.011,95% CI 0.004-0.017), white matter lesion volumes ( B=0.026,95% CI 0.011-0.040) and deep gray matter lesion volumes ( B=0.401,95% CI 0.032-0.771) in the RRMS group were significantly positively correlated with PVS_w, while white matter lesion volumes ( B=0.007,95% CI 0.001-0.014) and deep gray matter lesion volumes ( B=0.204,95% CI 0.029-0.380) were significantly positively correlated with PVS_d (both P<0.05). Univariate analysis showed that immediate memory score in the RRMS group was significantly negatively correlated with PVS_d ( r=-0.428), and was significantly positively correlated with education level ( r=0.471), deep gray matter volumes ( r=0.530) and total brain volumes ( r=0.389; all P<0.05); short-term delayed memory score in the RRMS group was significantly negatively correlated with age ( r=-0.390), PVS_w ( r=-0.417) and white matter lesion volumes ( r=-0.438), and was significantly positively correlated with gender ( r=0.393), white matter volumes ( r=0.478), deep gray matter volumes ( r=0.579) and total brain volumes ( r=0.602;all P<0.05); verbal fluency test score in the RRMS group was significantly negatively correlated with PVS_d ( r=-0.409) and was significantly positively correlated with education level ( r=0.419) and total brain volumes ( r=0.400;all P<0.05). Multiple linear regression analysis revealed that PVS_d ( B=-5.572, 95% CI -11.513--0.368) and brain volumes ( B=0.012, 95% CI 0.001-0.023) in the RRMS group were both significant predictors of immediate recall score, while PVS_d ( B=-14.203,95% CI -27.514--0.891) was an independent predictor of verbal fluency test score (all P<0.05). Conclusions:The PVS is enlarged in individuals with RRMS compared with the healthy controls, and increased lesion volumes may be a significant predictor. Furthermore, enlarged PVS in the deep gray matter may be a significant predictor of impairment of verbal memory and verbal function in individuals with RRMS.

Objective:To evaluate the predictive value of preoperative frailty combined with nutritional status for prolonged postoperative ileus (PPOI) in the patients with gynecological malignancies.Methods:Patients undergoing elective surgery for gynecological malignancies in the Affiliated Hospital of Jiangnan University from April 2022 to February 2023 were selected. The Frail scale was used to evaluate the frailty within 24 h of admission, and the nutritional status was evaluated by the Controlling Nutritional Status score. The general characteristics of patients and occurrence of PPOI were recorded, and the risk factors for PPOI were analyzed by multivariate logistic regression. The ability of frailty, nutritional status and their combination to predict PPOI was assessed by the receiver operating characteristic curve.Results:Two hundred and fourteen patients were finally included, 52 cases developed of PPOI, and 98 cases were frail patients. Preoperative frailty combined with moderate to severe malnutrition was an independent risk factor for PPOI in the patients with gynecological malignancies ( P<0.05), and the area under the curve in predicting the occurrence of PPOI was 0.796 (95% confidence interval 0.736-0.857) in the patients with gynecological malignancies. Conclusions:Preoperative frailty combined with moderate to severe malnutrition has a higher accuracy in predicting PPOI in the patients with gynecological malignancies.

Background and purpose:Leptomeningeal metastasis is a form of central nervous system metastasis of melanoma.High mobility group A2(HMGA2)has been proven to play an important role in the occurrence and development of various tumors,but its biological functions in leptomeningeal metastatic melanoma cells remain unclear.On the basis of building mouse models of central nervous system metastasis of melanoma,this study investigated the differences in cell migration and cell proliferation among leptomeningeal metastatic melanoma cells,primary site melanoma cells and brain parenchymal metastatic melanoma cells,and further clarified the effects of differentially expressed gene HMGA2 on cell migration and proliferation of leptomeningeal metastatic melanoma cells.Methods:B16 mouse melanoma cells(B16-parental cells,B16-Par)stably expressing tdTomato and luciferase were generated by lentiviral infection.Subsequently,B16 specific brain parenchymal metastatic cells(B16-brain metastatic cells,B16-BrM)and B16 specific leptomeningeal metastatic cells(B16-leptomeningeal metastatic cells,B16-LM)were collected after adaptive screening of metastatic sites in vivo.The differences in migration and proliferation among B16-Par,B16-BrM and B16-LM were assessed by wound healing assay and cell counting kit-8(CCK-8).RNA sequencing(RNA-seq)was used to analyze differential gene expression in B16-Par,B16-BrM and B16-LM,and HMGA2 gene specifically upregulated in B16-LM was screened out.The results were verified by real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR)and Western blot.Gene ontology(GO)analysis was performed for genes which were upregulated in B16-LM specifically.siRNA was used to interfere with the expression of HMGA2 gene in B16-LM,and the knock-down effect was verified by RTFQ-PCR and Western blot.The effects of knocking down HMGA2 on cell migration and proliferation were detected by wound healing assay and CCK-8 assay.Using GSE174401 data in Gene Expression Omnibus(GEO),the specificity of HMGA2 gene expression in leptomeningeal metastatic melanoma cells from patients was verified.Results:Compared with Par cells,tumor cells screened by the brain environment were more likely to colonize the central nervous system.B16-LM had stronger migration and proliferation abilities,and upregulated the expression of HMGA2 gene.GO analysis revealed that HMGA2 was associated with many biological processes such as angiogenesis and cell proliferation.When the expression of HMGA2 gene was knocked down,the migration and proliferation of B16-LM could be inhibited.HMGA2 was upregulated in leptomeningeal metastatic melanoma cells from patients.Conclusion:Leptomeningeal metastatic melanoma cells had relatively unique cellular characteristics,which promoted cell migration and proliferation by upregulating HMGA2 gene expression.

Objective:To summarize the best evidence of medication adherence interventions for patients with multiple chronic conditions.Methods:According to the "6S" evidence model, literature on medication adherence in patients with multiple chronic conditions was retrieved from BMJ Best Clinical Practice, UpToDate, Medlive, National Institute for Health and Clinical Excellence, Cochrane Library, Embase, PubMed, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang data and so on. The search period was from establishing the database to August 30, 2023.Results:A total of 16 articles were included, including three guidelines, four expert consensus, seven systematic reviews, and two meta-analyses. Twenty-seven pieces of evidence were summarized from six aspects of compliance assessment, educational intervention, behavioral intervention, optimized treatment program, technical reminder intervention, and social-psychological-emotional intervention.Conclusions:The best evidence of medication adherence interventions for patients with multiple chronic conditions summarized provides a reference for medical and nursing staff to develop medication adherence interventions.

Objective:To investigate the differences and applicability of free silica detection methods of different crystal forms in dust, and to provide a basis for the selection of various methods.Methods:From December 2021 to June 2022, dust samples from 20 enterprises in different industries in 18 cities in Henan Province were randomly selected as the investigation objects. X-ray diffraction (XRD) method was used to analyze the samples and classify the samples. Based on GBZ/T 192.4-2007 "Determination of Dust in the Air of Workplace-Part 4: Content of Free Silica in Dust", pyrophosphate method and infrared spectrophotometry were used for quantitative determination. The measured results were analyzed by paired sample t test to evaluate the advantages and disadvantages of the two methods and their applicable scope. Results:The XRD results of 20 dust samples could be divided into α, β, γ crystal types and the mixed type of α and γ. There was no significant difference between pyrophosphate method and infrared spectrophotometry ( P=0.180). The pyrophosphate method results of β, γ and α, γ mixed crystalline free silica were significantly higher than those of infrared spectrophotometry, and the difference was statistically significant ( P<0.001) . Conclusion:Pyrophosphate method and infrared spectrophotometry are suitable for α-type free silica, while pyrophosphate method is suitable for β, γ and α, γ mixed crystalline free silica.