Objective:To investigate the changing trends and influencing factors of two kinds of absorbable hemostatic gauze in clinical use based on real-world data,so as to provide a reference for the refined management of absorbable hemostatic gauze.Methods:Data of surgical samples of a total of 34658 pieces of absorbable hemostatic gauzes,whose brand include brand A and brand B,in 27,468 surgeries of the Affiliated Wuxi People's Hospital of Nanjing Medical University between January 1,2015 and December 31,2023 were selected.In them,12729 surgeries used hemostatic gauzes(18,457 pieces)of brand A,and 14,739 surgeries used hemostatic gauzes(16,201 pieces)of brand B.The changing trends of the usage and cost of two kinds of absorbable hemostatic gauzes were compared and analyzed,which correlations of that with the different indicators of workload also were compared and analyzed.Results:The usage amount of absorbable hemostatic gauze of brand B increased annually,which had higher average costs per surgery but lower average usage amount per surgery.Brand B was mainly used in surgery of level-4.Both the usage amounts of brand A(18,457 pieces)and brand B(16,201 pieces)showed a positive correlation with the proportion of patients with difficult and critically ill(r=0.232,0.593,P<0.05),as well as with the proportion of medical consumables expenditure(r=0.334,0.491,P<0.05).Compared to brand A,brand B demonstrated a stronger positive correlation with the proportion of patients with difficult and critically ill,and the proportion of consumables expenditure.However,there was no significant correlation between the usage amount of each brand and the number of inpatients who received surgeries(P>0.05).The usage amount of absorbable hemostatic gauze of each brand was negative correlation with the proportion of pharmaceutical expenditure(r=-0.538,-0.696,P<0.05).Conclusion:The evaluation based on real-world data for clinical use of absorbable hemostatic gauze can reveal that brand B is gradually replacing brand A in clinical application.In clinical practice,the surgery with higher-level more prefers to use brand B.This result can guide management departments to monitor the use of absorbable hemostatic gauze.However,the balance between clinical demand and cost-effectiveness also should be considered,so as to promote the rational use of hemostatic materials,and ensure effective allocation for resource.

Objective To estimate the biological dose in a patient who developed radiation dermatitis after a local X-ray exposure incident. Methods Peripheral blood samples, which were used to performed lymphocyte chromosome aberration analysis, were collected from the patient at 54 and 102 days after the last exposure. Biological dose in the patient was estimated using four published X-ray dose-effect calibration curves for chromosomal aberrations. The absorbed dose in the patient was reconstructed using Dolphin′s model and time correction factors. Results The abnormal rates of chromosome aberration at 54 and 102 days after exposure were 1.00% and 0.40%, respectively. Based on the four calibration curves, the estimated local exposure dose at 54 day ranged from 3.59 to 10.51 Gy, and the time-corrected whole-body equivalent dose ranged from 0.27 to 0.87 Gy. The local dose estimated at 102 days ranged from 2.24 to 6.64 Gy, with a time-corrected whole-body equivalent dose of 0.12 to 0.60 Gy, which differed from the day-54 estimates. The biological doses estimated by both methods were lower than the physical dose (29.43 Gy). Conclusion The estimation of local biological dose of patient various in four dose-effect curves selected in this study. Delayed blood sampling will lead to underestimate biological dose. Early blood collection after radiation incidents is critical to ensure accuracy and reliability. Moreover, biological dose reconstruction methods for complex exposure scenarios require further research to improve the accracy of emergency response in radiation accidents.

Objective To explore the feasibility of applying artificial intelligence (AI) technology in chromosomal aberration (CA) analysis for occupational health surveillance of radiation workers and in biological dose estimation during nuclear emergency responses. Methods Peripheral blood samples from healthy volunteers were irradiated in vitro with X-rays and cobalt-60 (⁶⁰Co) γ rays. Chromosome slides were prepared using an automated harvesting and dropping device. The data training and outcome evaluation of CA analysis was performed on the AI software using chromosome images from occupational medical examination of radiation workers from the current lab or chromosome slides from blood samples irradiated with X-rays. The trained AI software was then used to assist in CA analysis and biological dose estimation among occupational medical examination of radiation workers, with results compared with manual reading and actual exposure doses. Results The trained AI software achieved a CA recognition accuracy of 95.11%. In the occupational health examination of radiation workers, the positive CA detection rate using AI + manual review was 2.25% higher than that in manual reviewing alone. The errors in biological dose estimation for ⁶⁰Co γ rays and X-rays using AI + manual review analysis were 11.86% and 7.33%, respectively, both within the acceptable 20.00% error margin. Conclusion AI + manual review can be effectively applied in CA analysis for occupational health examination and biological dose estimation during nuclear emergencies, significantly improving analysis efficiency.

Objective To evaluate the efficacy and safety of dupilumab combined with 2％cleboride ointment in the treatment of moderate to severe atopic dermatitis,as well as its impact on serological indica-tors.Methods A retrospective analysis was conducted on the clinical data of 67 patients with moderate to se-vere atopic dermatitis(AD)admitted to the Department of Dermatology of Shaoxing University Affiliated Hospital from March 2021 to December 2024.The study subjects were divided into an experimental group(n=35)and a control group(n=32)according to the treatment method.The experimental group was treated with Dupilumab injection and 2％Cleboride ointment,while the control group was treated with ebastine tab-lets and 2％cleboride ointment.Clinical and related serological indicators of patients after 16 weeks of treat-ment were collected,and the itch digital scale score,eczema area and severity(EASI)score,IL-4,IL-13 levels,and incidence of local skin adverse reactions were analyzed before and after treatment in both groups.Results The total effective rate of the experimental group after treatment was 94.29％(33/35),which was higher than the control group[53.13％(17/32)],and the difference was statistically significant(x2=12.862,P＜0.001).There was no statistically significant difference in symptom scores,IL-4,and IL-13 levels between the two groups before treatment(P＞0.05).After treatment,the symptom scores of the experimental group were lower than those of the control group,and the difference was statistically significant(P＜0.05).The lev-els of IL-4 and IL-13 in the experimental group were lower than those in the control group,and the difference was statistically significant(P＜0.05).The incidence of adverse reactions in the experimental group was 2.86％(1/35),significantly lower than the 34.38％(11/32)in the control group,and the difference was sta-tistically significant(x2=9.252,P=0.002).Conclusion The combination of dupilumab injection and 2％cleboride ointment is effective in relieving skin symptoms,regulating cellular immune function,reducing in-flammatory reactions,and minimizing local skin adverse reactions in patients with moderate to severe AD.It is worthy of clinical promotion and use.

Objective:To investigate the changing trends and influencing factors of two kinds of absorbable hemostatic gauze in clinical use based on real-world data,so as to provide a reference for the refined management of absorbable hemostatic gauze.Methods:Data of surgical samples of a total of 34658 pieces of absorbable hemostatic gauzes,whose brand include brand A and brand B,in 27,468 surgeries of the Affiliated Wuxi People's Hospital of Nanjing Medical University between January 1,2015 and December 31,2023 were selected.In them,12729 surgeries used hemostatic gauzes(18,457 pieces)of brand A,and 14,739 surgeries used hemostatic gauzes(16,201 pieces)of brand B.The changing trends of the usage and cost of two kinds of absorbable hemostatic gauzes were compared and analyzed,which correlations of that with the different indicators of workload also were compared and analyzed.Results:The usage amount of absorbable hemostatic gauze of brand B increased annually,which had higher average costs per surgery but lower average usage amount per surgery.Brand B was mainly used in surgery of level-4.Both the usage amounts of brand A(18,457 pieces)and brand B(16,201 pieces)showed a positive correlation with the proportion of patients with difficult and critically ill(r=0.232,0.593,P<0.05),as well as with the proportion of medical consumables expenditure(r=0.334,0.491,P<0.05).Compared to brand A,brand B demonstrated a stronger positive correlation with the proportion of patients with difficult and critically ill,and the proportion of consumables expenditure.However,there was no significant correlation between the usage amount of each brand and the number of inpatients who received surgeries(P>0.05).The usage amount of absorbable hemostatic gauze of each brand was negative correlation with the proportion of pharmaceutical expenditure(r=-0.538,-0.696,P<0.05).Conclusion:The evaluation based on real-world data for clinical use of absorbable hemostatic gauze can reveal that brand B is gradually replacing brand A in clinical application.In clinical practice,the surgery with higher-level more prefers to use brand B.This result can guide management departments to monitor the use of absorbable hemostatic gauze.However,the balance between clinical demand and cost-effectiveness also should be considered,so as to promote the rational use of hemostatic materials,and ensure effective allocation for resource.

ObjectiveTo investigate the relationship between plasma surfactant protein⁃A （SP⁃A） expression level and silicosis progression， and to provide early evidence for exploring whether SP⁃A can be used as a biomarker for clinical monitoring of silicosis disease progression. MethodsWe recruited 187 silicosis patients in Guangdong Province hospital for occupational disease prevention and treatment between November， 2019 and November，2020. Their peripheral venous blood samples were collected for the plasma isolation. The level of pulmonary SP⁃A was detected by enzyme-linked immunosorbent assay. ResultsThere was a statistically significant difference in the level of SP⁃A among the silicosis groups （P<0.05）， and the plasma SP-A level of the silicosis patients in stage Ⅲ was higher than that in stage Ⅰ and stage Ⅱ （P<0.05）. Smoking had effect on plasma SP⁃A levels， Age， working years and drinking had no effect on plasma SP⁃A levels. ConclusionThe expression level of SP⁃A in the plasma of silicosis patients is increased， which has a certain correlation with the disease stage， and plays a certain early warning role in the occurrence and development of silicosis， and may be a potential biomarker for the diagnosis and prognosis of silicosis.

Objective To analyze the occupational health status of radiation workers in Guangdong Province. Methods A total of 8 913 radiation workers who underwent occupational medical examination (OME) in Guangdong Province Hospital for Occupational Disease Prevention and Treatment in 2020 were selected as the exposure group, and 2 024 non-radiological workers who underwent health examination in the same hospital in the same period of time were selected as the control group using convenient sampling method. The study analyzed the prevalence of abnormalities in thyroid, eye lens, blood pressure, complete blood count and micronucleus in individuals of the two groups. Results The abnormal rates of eye lens, blood pressure and complete blood count in the radiation workers in the exposure group were higher than those in the control group (23.3% vs 8.0%, 18.6% vs 9.0%, 18.1% vs 8.5%, all P<0.01). However, there was no significant difference in the abnormal rates of thyroid and micronucleus in workers between these two groups (12.8% vs 11.5%, 0.1% vs 0.0%, all P>0.05). The abnormal rates of thyroid, eye lens and blood pressure in radiation workers increased with the exposure period of radiation (all P<0.05). Conclusion Long-term exposure to low-dose ionizing radiation have certain effects on the thyroid, eye lens, and blood pressure of radiation workers, with a time-effect relationship of years of radiation work.

Objective:To investigate the correlation between EOS level and hormone therapy effect and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:From January 2016 to June 2018, 120 patients with AECOPD were selected in the Fifth People's Hospital of Datong.According to EOS levels, all patients were divided into two groups, including EOS ≥2% group(56 cases) and EOS<2% group(64 cases). The general clinical data and treatment related indicators of patients with different EOS levels were compared, and the clinical value of EOS level in predicting the risk of severe AECOPD recurrence and death of patients were evaluated.Results:The levels of WBC, N%, NLR and CRP of the EOS≥2% group were significantly lower than those of the EOS<2% group[(6.89±1.16)×10 9/L, (69.08±12.79)%, (3.54±1.16), (5.30±1.18)mg/L vs.(8.45±1.85)×10 9/L, (76.42±16.58)%, (6.08±1.42), (7.43±1.77)mg/L]( t=5.27, 4.81, 4.65, 2.58, all P<0.05). The used time of antibiotics of the EOS≥2% group was significantly shorter than that of the EOS<2% group[8.0(6.0, 10.0)d vs.9.0(7.0, 11.0)d]( U=2.46, P<0.05). The time of hormone therapy and hospitalization time of the EOS≥2% group were significantly shorter than those of the EOS<2% group[9.0(7.0, 11.0)d, 10.0(9.0, 12.0)d vs.11.0(7.0, 13.0)d, 12.0(10.0, 13.0)d]( U=2.79, 2.56, all P<0.05). The proportion of CAT score decreased ≥2 points at 7d after treatment of the EOS≥2% group was significantly higher than that of the EOS<2% group[86.84% vs.68.18%](χ 2=2.84, P<0.05). Logistic regression analysis showed that EOS≥2% was the independent risk factor for severe AECOPD recurrence and death( OR=2.84, 95% CI: 1.49~5.03, P<0.05). There was no relationship between EOS level and death risk ( P>0.05). Conclusion:Serum EOS level can independently predict the clinical effect of hormone therapy and prognosis in patients with AECOPD, and clinicians can make more reasonable clinical treatment plan accordingly.

Objective To analyze the prevalence and risk factors of anemia in a general population in Kailuan.Methods Working and retired employees m Kailuan Company who had participated in biennial physical examination from 2006-2014 were investigated by questionnaire and blood test.Hemoglobin levels＜ 120 g/L in male and＜ 110 g/L in female are defined as anemia.The trend of prevalence of anemia was analyzed by chi square test.Multivariable logistic regression was used to analyze the factors associated with anemia.Results (1) The biennial prevalence of anemia in Kailuan during 2006-2014 were 3.7％,3.1％,2.4％,1.3％,1.5％.The corresponding proportion were 3.3％,2.3％,1.9％,0.8％,1.0％ in males and 5.3％,5.9％,4.2％,3.1％ and 3.3％ in females,respectively.The differences between males and females were statistically significant (all P＜0.05).The prevalence of anemia declined over time (P for trend＜0.05).(2) The results of multivariable logistic regression showed that aging and elevated hs-CRP were positively associated with anemia,with OR=1.01 (95％CI 1.01-1.02)and 1.03 (95％CI 1.02-1.03),respectively.While male,BMI,physical exercise,smoking,hyperlipidemia were negatively associated with anemia with OR=0.60(95％CI 0.55-0.65),0.99 (95％CI 0.98-0.99),0.91 (95％CI 0.82-0.98),0.87 (95％CI 0.81-0.95)and 0.87(95％CI0.81-0.94),respectively.Conclusions The prevalence of anemia in a large general population in Kailuan has been analyzed.Prevalence of anemia is higher in males than females and declines over time.Several demographic and clinical characteristics are associated with anemia.

Objective To study the immunoregulatory effects of emodin on macrophages during Brucella infection and to provide theoretical and experimental basis for developing new drugs to treat brucello-sis. Methods Bone marrow cells were isolated from BALB/c mice and cultured with MG-CSF to induce differentiation. Flow cytometry was used to detect the differentiation of bone marrow cells into macrophages (MΦ) by using FITC-labeled mouse anti-F4/80 antibody and PE-labeled anti-CD11b antibody. MTT meth-od was used to detect the influences of various concentrations of emodin on the survival rate of MΦ. Doxy-cycline was used as the control to compare half maximal inhibitory concentrations (IC50) of the two drugs. MΦ were cultured with Brucella at a ratio of 100 : 1 for 4 h. MΦ and Brucella were further cultured for 1, 6,12,24 and 48 h after adding emodin. Effects of emodin on the survival of MΦ were analyzed by colony counting method. ELISA was performed to detect the levels of TNF-α, IL-6 and IFN-γ in culture superna-tants. Results On day 8 of culturing,91.28% of bone marrow cells differentiated into macrophages. The IC50of emodin(608.4 μg/ml) was significantly higher than that of doxycycline(225.5 μg/ml). The logC-FU values of emodin stimulation groups (6,12,24 and 48 h) were significantly lower than those of blank control groups. Among all emodin stimulation groups, the 24 h group had the lowest logCFU value, which was also lower than that of the doxycycline treatment group. The levels of TNF-α,IL-6 and IFN-γ in 6,12 and 24 h emodin stimulations group increased significantly as compared with those of the corresponding con-trol groups. The levels of TNF-α, IL-6 and IFN-γ peaked at 24 h of culturing Brucella-infected MΦ with emodin. No significant difference in IFN-γ level was found between the 12 and 24 h emodin stimulation groups [(74.233 ±4.416) pg/ml vs (78.328 ±8.932) pg/ml]. Conclusion Emodin may enhance the ability of macrophages to kill Brucella through promoting the expression of TNF-α,IL-6 and IFN-γ.