Objective To analyze the lung function condition and the prevalence of pulmonary ventilation disorders in the occupational population of Wuhan, and to explore their influencing factors. Methods Physical examination data from the Wuhan Prevention and Treatment Center for Occupational Diseases were used in this study, and finally 9499 people were selected as the study subjects. The linear regression model and logistic regression model were used to analyze the influencing factors of pulmonary ventilation function and pulmonary dysfunction. The restricted cubic spline was used to explore the nonlinear relationship. Results The prevalence of pulmonary ventilation disorders was 1.7%, and the lung function indexes FVC, FEV1, and FEV1/FVC were significantly lower in the population aged >27 years than in the population aged <27 years (P<0.001). The lung function indexes FVC and FEV1 were significantly lower in females than in males (P<0.001). The lung function indexes FVC and FEV1 were significantly lower in underweight occupational groups than in normal-weight groups (P<0.001), and FVC and FEV1 were significantly lower in dust-exposed occupational groups than in groups without dust exposure(P<0.05). Restricted cubic spline plots showed a nonlinear relationship between age and lung function indexes FVC and FEV1 (P_nonlinear< 0.05). Age and BMI were the risk factors for pulmonary ventilation disorders. Conclusion Age, gender, BMI, and dust exposure are risk factors for decreased FVC and FEV1. Age is the risk factor for decreased FEV1/FVC. Age and BMI are the risk factors for pulmonary ventilation disorders.

OBJECTIVE: To investigate the midterm clinical efficacy of medial patellofemoral complex (MPFC) reconstruction for recurrent patellar dislocation with high-grade trochlear dysplasia. METHODS: A retrospective analysis was carried out among adult patients who underwent arthroscopically assisted MPFC reconstruction between January 2014 and December 2020. Dejour classification was evaluated to grade trochlear dysplasia; tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index were measured. Preoperative and postoperative patient-reported outcome measures (PROMs) were compared, including International Knee Documentation Committee (IKDC) score, Kujala score, Lysholm score and Tegner score. Information regarding returning-to-sport rate, re-instability events and complications was collected. Patellar tilt (PT), lateral patellar displacement (LPD) and bisect offset (BSO) ratio were measured based on axial computed tomography before and after surgery to assess the patellofemoral congruence. RESULTS: A total of 46 MPFC reconstructions in 43 patients were enrolled, including 16 male and 27 female. Mean age at surgery was (22.2±7.6) years (range: 14-44 years). Mean follow-up was (49.9±22.6) months (range: 18-102 months). The percentages of Dejour B, C and D dysplasia were 37.0% (17/46), 43.5% (20/46), and 19.6% (9/46), respectively. Mean Insall-Salvati index was 1.2±0.2 (range: 0.85-1.44), and mean TT-TG distance was (19.6±3.5) mm (range: 10.6-28.7 mm). At latest follow-up, there were significant improvements in all PROMs (P < 0.001): IKDC score, from 56.3±15.1 to 86.2±8.1; Kujala score, from 58.9±15.6 to 92.6±5.4; Lysholm score, from 63.7±15.0 to 94.0±5.7; Tegner score, from 3.1±1.4 to 4.7±1.4, and there were no significant differences in the improvements of the scores between the patients with Dejour B, C and D dysplasia. Overall, ninety percent of the patients returned to their preoperative sports level. One patient reported a postoperative subluxation, while no cases of infection, limited range of motion or patella fracture were observed. PT, LPD and BSO ratio were all significant altered (P < 0.001) after MPFC reconstruction. CONCLUSION Arthroscopically assisted MPFC reconstruction yielded satisfactory midterm clinical results for recurrent patellar dislocation with high-grade trochlear dysplasia. No significant differences of improvements in knee function were observed among the three types of high-grade trochlear dysplasia.
Humans ; Patellar Dislocation/surgery* ; Male ; Female ; Adult ; Arthroscopy/methods* ; Retrospective Studies ; Adolescent ; Young Adult ; Patellofemoral Joint/surgery* ; Recurrence ; Plastic Surgery Procedures/methods* ; Patella/surgery* ; Treatment Outcome

Metastasis serves as an indicator of malignancy and is a biological characteristic of carcinomas. Epithelial-mesenchymal transition (EMT) plays a key role in the promotion of tumor invasion and metastasis and in the enhancement of tumor cell aggressiveness. Prostaglandin E synthase 3 (p23) is a cochaperone for heat shock protein 90 (HSP90). Our previous study showed that p23 is an HSP90-independent transcription factor in cancer-associated inflammation. The effect and mechanism of action of p23 on lung cancer metastasis are tested in this study. By utilizing cell models in vitro and mouse tail vein metastasis models in vivo, the results provide solid evidence that p23 is critical for promoting lung cancer metastases by regulating downstream CXCL1 expression. Rather than acting independently, p23 forms a complex with RNA-binding motif protein 14 (RBM14) to facilitate EMT progression in lung cancer. Therefore, our study provides evidence for the potential role of the RBM14-p23-CXCL1-EMT axis in the metastasis of lung cancer.

Elemene is widely recognized as an effective anti-cancer compound and is routinely administered in Chinese clinical settings for the management of several solid tumors, including non-small cell lung cancer (NSCLC). However, its detailed molecular mechanism has not been adequately demonstrated. In this research, it was demonstrated that elemene effectively curtailed NSCLC growth in the patient-derived xenograft (PDX) model. Mechanistically, employing high-throughput screening techniques and subsequent biochemical validations such as microscale thermophoresis (MST), microRNA-145-5p (miR-145-5p) was pinpointed as a critical target through which elemene exerts its anti-tumor effects. Interestingly, elemene serves as a binding stabilizer for miR-145-5p, demonstrating a strong binding affinity (dissociation constant (K _D) = 0.39 ± 0.17 μg/mL) and preventing its degradation both in vitro and in vivo, while not interfering with the synthesis of the primary microRNA transcripts (pri-miRNAs) and precursor miRNAs (pre-miRNAs). The stabilization of miR-145-5p by elemene resulted in an increased level of this miRNA, subsequently suppressing NSCLC progression through the miR-145-5p/mitogen-activated protein kinase kinase kinase 3 (MAP3K3)/nuclear factor kappaB (NF-κB) pathway. Our findings provide a new perspective on revealing the interaction patterns between clinical anti-tumor drugs and miRNAs.

Objective:To translate the Triage Risk Screening Tool (TRST) into Chinese and to test its reliability and validity among older patients in the emergency department.Methods:The Brislin translation model was used to translate and back-translate the English version of the TRST. After cultural adaptation and pre-testing, and subsequently, the final Chinese version of the TRST (TRST-C) was formed. Using the convenience sampling method, a questionnaire survey was conducted on 174 elderly patients who visited the emergency department of Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University to verify the reliability and validity of the scale.Results:The item-level content validity index and the scale-level average content validity index were 0.89-1.00 and 0.978, respectively. Exploratory factor analysis extracted 2 common factors, and the cumulative variance explanation rate was 63.095%. Using 2 points as the threshold for high risk of adverse outcomes. The sensitivity of TRST-C for 30-day death, emergency department readmission, rehospitalization and composite adverse outcomes were 94.4%, 81.8%, 84.6% and 84.9% respectively, and the negative predictive values were 98.3%, 86.4%, 86.4% and 76.3%, respectively. The Cronbach α coefficient and the Guttman split-half reliability of the TRST-C were 0.639 and 0.669, respectively. The Kappa coefficient was 0.911. Conclusions:The TRST-C has good reliability and validity, which can screen elderly patients of emergency department at risk of adverse outcomes.

Objective:To investigate the predictive value of preoperative coagulation function and inflammation response biomarkers for postoperative recurrence of non-muscle-invasive bladder cancer (NMIBC) patients.Methods:The clinical data of 390 NMIBC patients underwent surgical treatment from May 2014 to May 2021 in the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. The baseline characteristics coagulation function, inflammation response indexes and tumor characteristics were recorded. The baseline characteristics included gender, age and smoking history; the coagulation function included prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-dimer; the inflammation response indexes included neutrophil count, lymphocyte count, platelet count and monocyte count, and the systemic inflammatory response index (SIRI) and systemic immune-inflammation index (SII) were calculated; tumor characteristics included TNM stage, pathological grade, tumor length, tumor amount and postoperative instillation drugs. The patients were followed up until May 2022, with recurrence records and grouping. The "pROC" package was used to draw the receiver operating characteristic (ROC) curve, and calculate the optimal cutoff values of biomarkers. Multivariate Cox regression analysis was used to analyze the independent risk factors of recurrence in patients with NMIBC (variables were selected with P<0.1). The nomogram and its calibration curve were drawn by the "survival" and "rms" packages, and the area under the curve (AUC) was calculated with the "pROC" package for assessing the predictive ability of the model. The "caret" package was used for ten-fold cross-validation to evaluate the external applicability of the nomogram. Results:The ROC curve analysis result showed that the optimal cutoff values of PT, APTT, FIB, D-dimer, SIRI and SII were 11.95 s, 17.65 s, 0.233 mg/L, 565 ng/L, 0.62 and 291.5, respectively. The 390 patients with NMIBC were followed up 29 to 71 months, with a median follow-up time of 49 months. Among them, 113 patients experienced postoperative recurrence (recurrence group), and the recurrence rate was 29.0%; while 277 patients did not experience recurrence (non-recurrence group). The rate of FIB≥0.233 mg/L, D-dimmer ≥565 ng/L, SIRI≥0.62 and SII≥291.5, T 1 stage, high-grade tumor, tumor length ≥2.3 cm and multiple tumor in recurrence group were significantly higher than those in non-recurrence group: 90.3% (102/113) vs. 71.5% (198/277), 33.6% (38/113) vs. 23.5% (65/277), 74.3% (84/113) vs. 56.7% (157/277), 84.1% (95/113) vs. 60.6% (168/277), 77.9% (88/113) vs. 38.6% (107/277), 25.7% (29/113) vs. 8.3% (23/277), 49.6% (56/113) vs. 32.1% (89/277) and 41.6% (47/113) vs. 19.9% (55/277), and there were statistical differences ( P<0.01 or <0.05); there were no statistical differences in gender ratio, age, smoking history, PT, APTT and postoperative instillation drugs between the two groups ( P>0.05). Multivariate Cox regression analysis result showed that FIB≥0.233 mg/L, SII≥291.5, T 1 stage, high pathological grade, tumor length≥2.3 cm and multiple tumor were independent risk factors of postoperative recurrence in patients with NMIBC ( HR = 2.186, 1.627, 3.182, 1.675, 1.775 and 2.052; 95% CI 1.149 to 4.159, 0.913 to 2.902, 1.988 to 5.095, 1.067 to 2.630, 1.208 to 2.608 and 1.388 to 3.033; P<0.1). A nomogram model was constructed to predict postoperative 1-, 3- and 5-year non-recurrence based on FIB, SII, T stage, tumor length, pathological grade and tumor amount. The calibration curve analysis result showed that the nomogram model predicted good consistency between the postoperative 1-, 3-, 5-year non-recurrence rates and the actual incidence rate in patients with NMIBC. ROC curve analysis result showed that the AUC of the nomogram model for predicting postoperative 1-, 3- and 5-year non-recurrence in patients with NMIBC were 0.746, 0.789 and 0.835 (95% CI 0.695 to 0.832, 0.703 to 0.875 and 0.756 to 0.915). The ten-fold cross-validation result showed that the nomogram model had good external applicability for predicting postoperative 1-, 3- and 5-year non-recurrence in patients with NMIBC, with AUC of 0.754, 0.781 and 0.832 (95% CI 0.689 to 0.817, 0.724 to 0.832 and 0.778 to 0.879). Conclusions:The nomogram model based on FIB, SII, T stage, tumor length, pathological grade and tumor amount can accurately predict the postoperative 1-, 3- and 5-year recurrence risks in patients with NMIBC. The model helps clinical doctors early identify high-risk recurrent NMIBC patients, and provides reference for the development of individualized treatment plans.

Elemene is widely recognized as an effective anti-cancer compound and is routinely administered in Chinese clinical settings for the management of several solid tumors,including non-small cell lung cancer(NSCLC).However,its detailed molecular mechanism has not been adequately demonstrated.In this research,it was demonstrated that elemene effectively curtailed NSCLC growth in the patient-derived xenograft(PDX)model.Mechanistically,employing high-throughput screening techniques and subsequent biochemical validations such as microscale thermophoresis(MST),microRNA-145-5p(miR-145-5p)was pinpointed as a critical target through which elemene exerts its anti-tumor effects.Inter-estingly,elemene serves as a binding stabilizer for miR-145-5p,demonstrating a strong binding affinity(dissociation constant(KD)=0.39±0.17 μg/mL)and preventing its degradation both in vitro and in vivo,while not interfering with the synthesis of the primary microRNA transcripts(pri-miRNAs)and precursor miRNAs(pre-miRNAs).The stabilization of miR-145-5p by elemene resulted in an increased level of this miRNA,subsequently suppressing NSCLC progression through the miR-145-5p/mitogen-activated pro-tein kinase kinase kinase 3(MAP3K3)/nuclear factor kappaB(NF-κB)pathway.Our findings provide a new perspective on revealing the interaction patterns between clinical anti-tumor drugs and miRNAs.

Objective To explore the impact factors of volume reduction rate(VRR)of benign thyroid nodules after thermal ablation based on conventional ultrasound and contrast-enhanced ultrasound(CEUS)manifestations.Methods Totally 238 patients with benign thyroid nodules who underwent thermal ablation were retrospectively enrolled and divided into VRR＜75%group(n=93)and VRR≥75%group(n=145)according to VRR of lesions 12 months after treatment.Multivariate logistic regression analysis was used to screen the independent impact factors of VRR of lesions 12 months after thermal ablation based on conventional ultrasound and CEUS manifestations.Receiver operating characteristic curve was plotted,the area under the curve(AUC)was calculated to evaluate the efficacy of the combination of the above factors for predicting VRR of lesions.Results High echo,calcification,cystic and solid components,high enhancement,enhancement loss and high ablation energy were all independent risk factors,while circular enhancement was the independent protective factor of VRR of benign thyroid nodules 12 months after thermal ablation(all P＜0.05).The AUC of combination of the above factors for predicting VRR of benign thyroid nodules 12 months after thermal ablation was 0.926.Conclusion High echo,calcification,cystic and solid components,high enhancement,enhancement loss and high ablation energy were all independent risk factors,while circular enhancement was the independent protective factor of VRR of benign thyroid nodules 12 months after thermal ablation.

Objective:To investigate the interaction of workplace noise, body mass index (BMI) and systemic inflammatory response on hypertension.Methods:In January 2019, 1124 male workers from an automobile factory in Wuhan were selected by cluster random sampling method. The study population was divided into normal body weight group (BMI<24 kg/m 2) and overweight group (BMI≥24 kg/m 2) according to BMI, and were followed up for 3 years. The occupational health examination of the workers was carried out every year, blood routine and blood biochemical indexes were collected, and the information of the workers' age, BMI, type of work and age of exposure to injury were collected through field questionnaires. The noise intensity of the workplace of the enterprise was measured for 3 consecutive years, and the equivalent sound level was calculated according to the working time. Normal and skewness measurements were described by Mean±SD and [ M ( Q1, Q3) ], respectively. t-test or Wilcoxon rank sum test was used for inter-group comparisons. Categorical variables were expressed by frequency and percentage (%), and Chi-square test was used for inter-group comparisons. Mixed effects models and generalized estimation equations were fitted to analyze the relationship between occupational noise, systemic inflammation, and their interaction terms with blood pressure and hypertension risk. Results:Univariate analysis revealed that the white blood cell counts, neutrophil counts, lymphocyte counts and eosinophil counts were positively associated with systolic blood pressure and diastolic blood pressure in overweight group ( n=467), respectively ( P<0.05). The participants with white blood cell counts≥5.94×10 9/L, neutrophil counts≥3.31×10 9/L, lymphocyte counts ≥2.03×10 9/L, and eosinophil counts ≥0.12×10 9/L had increased risk of hypertension by 52% ( RR=1.52, 95% CI: 1.11-2.05), 37% ( RR=1.37, 95% CI: 1.01-1.83), 58% ( RR=1.58, 95% CI: 1.18-2.09), and 52% ( RR=1.52, 95% CI: 1.12-2.06), respectively (all P<0.05). Multivariate analysis found a positive association between BMI and the risk of hypertension in the overweight group ( P<0.05), the participants with lymphocyte counts≥2.03×10 9/L and eosinophil counts≥0.12×10 9/L had increased risk of hypertension by 39% ( RR=1.39, 95% CI: 1.01-1.89) and 46% ( RR=1.46, 95% CI: 1.06-1.98), respectively (all P<0.05). There was no correlation between BMI and the risk of hypertension in normal weight group ( P>0.05). The multiplicative interaction of occupational noise (≥80 dB) with white blood cell counts (≥5.94×10 9/L) and lymphocyte counts (≥2.03×10 9/L) increased the risk of hypertension by 100% ( RR=2.00, 95% CI: 1.06-3.55) and 89% ( RR=1.89, 95% CI: 1.01-3.32) (all P<0.05) in overweight group, respectively. Additionally, a significant additive interaction was observed between noise exposure (≥80 dB) and basophil counts (≥0.03×10 9/L) on hypertension risk in the overweight group (RERI=0.49, 95% CI: 0.02-0.96, P<0.05) . Conclusion:The combined exposure of occupational noise and systemic inflammation may increase the risk of hypertension in overweight workers in automobile manufacturing plants, and the two have additive and multiplicative interactions.

Objective To explore the impact factors of volume reduction rate(VRR)of benign thyroid nodules after thermal ablation based on conventional ultrasound and contrast-enhanced ultrasound(CEUS)manifestations.Methods Totally 238 patients with benign thyroid nodules who underwent thermal ablation were retrospectively enrolled and divided into VRR＜75%group(n=93)and VRR≥75%group(n=145)according to VRR of lesions 12 months after treatment.Multivariate logistic regression analysis was used to screen the independent impact factors of VRR of lesions 12 months after thermal ablation based on conventional ultrasound and CEUS manifestations.Receiver operating characteristic curve was plotted,the area under the curve(AUC)was calculated to evaluate the efficacy of the combination of the above factors for predicting VRR of lesions.Results High echo,calcification,cystic and solid components,high enhancement,enhancement loss and high ablation energy were all independent risk factors,while circular enhancement was the independent protective factor of VRR of benign thyroid nodules 12 months after thermal ablation(all P＜0.05).The AUC of combination of the above factors for predicting VRR of benign thyroid nodules 12 months after thermal ablation was 0.926.Conclusion High echo,calcification,cystic and solid components,high enhancement,enhancement loss and high ablation energy were all independent risk factors,while circular enhancement was the independent protective factor of VRR of benign thyroid nodules 12 months after thermal ablation.