Background Photovoltaic (PV) cells can convert solar energy into electricity and alleviate the dilemma of energy supply shortage. Shanghai's PV module industry is booming, but there are few reports on the health status of the workers and there is an urgent need for health risk assessment. Objective To evaluate the health status of PV module production workers and the association between work and health status, in order to provide a direction for the health management of the workers. Methods Among the PV module production workers who completed prescriptive occupational health examination by a designated medical institution in 2021, 2453 workers with more than one year of working age were selected as the exposure group and 538 newly hired workers as the control group. On the basis of the Technical specifications for occupational health surveillance (GBZ 188−2014), the health examination included physical examination and laboratory examination and information such as sociodemographics, living habits, and disease history. We compared the indicators of pure-tone hearing test, blood routine examination, electrocardiogram (ECG), liver function, and kidney function between the two groups. The blood routine results included erythrocyte-related indicators, leukocyte-related indicators, and platelet-related indicators, and the results of liver function included hepatocyte injury indicators, hepatic secretory function indicators, and hepatic synthesis function indicators. The workers were divided into four groups by quartiles of working age. Trend chi-square test was used to analyze differences in health status between the four working age groups. Multiple logistic regression models were used to evaluate the association between working age and health indicators. Results Among the exposure group workers, 2035 (83.0%) were male and 418 (17.0%) were female. The median (P₂₅, P₇₅) age was 34.0 (30.0, 39.0) years and the median (P₂₅, P₇₅) working age was 6.0 (3.0, 10.0) years. The abnormality rate of blood routine was 61.7%. Among them, the abnormality rates of platelet-related indicators and liver secretory function indicators were 39.8% and 48.1% respectively. The risks of abnormal hepatocyte injury-related indicators, fatty liver, and platelet-related indicator abnormalities among the exposure group were 1.471 (95%CI: 1.060, 2.054), 1.691 (95%CI: 1.208, 2.385), and 7.576 (95%CI: 4.967, 11.994) times higher than those in the control group respectively. The single-factor analysis demonstrated a positively linear trend between working age and hypertension prevalence, electrical audiometry abnormality rate, or liver secretory function indicator abnormality rate. Corrected for gender, age, smoking status, hypertension, etc., the results of logistic analysis showed that quartile working age was positively related to abnormal liver secretion function and abnormal platelet-related indicators respectively (OR=1.047, P=0.005; OR=1.037, P=0.014), and inversely associated with the abnormal rate of renal function (OR=0.953, P=0.044). Conclusion Negative associations between health status and working age are identified in PV module production workers. The target PV module production employees are in younger age, and with the increase of working age, the abnormalities of liver function and platelets may increase. Therefore, the enterprises should extend occupational health work from workplace to workers.

Objective:To observe the efficacy and safety of vitrectomy combined with subretinal injection of alteplase (tPA) and intravitreal injection of Conbercept in the treatment of large area submacular hemorrhage (SMH) secondary to polypoidal choroidal vasculopathy (PCV).Methods:A retrospective clinical study. From January to September 2021, 32 eyes of 32 patients with massive SMH secondary to PCV diagnosed in the Affiliated Eye Hospital of Nanchang University were included in the study. Large SMH was defined as hemorrhage diameter ≥4 optic disc diameter (DD). There were 32 patients (32 eyes), 20 males and 12 females. The mean age was (72.36±8.62) years. All patients had unilateral disease.The duration from onset of symptoms to treatment was (7.21±3.36) days. All patients underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examination. BCVA examination was performed using the international standard visual acuity chart, which was converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. The central macular thickness (CMT) was measured by spectral domain-OCT. The average size of SMH was (6.82±1.53) DD. The logMAR BCVA 1.73±0.44; CMT was (727.96±236.40) μm. All patients were treated with 23G pars plana vitrectomy combined with subretinal injection of tPA and intravitreal injection of Conbercept. At 1, 3, 6 and 12 months after treatment, the same equipment and methods were used for relevant examinations before treatment. The changes of BCVA and CMT, the clearance rate of macular hemorrhage, and the complications during and after surgery were observed. BCVA and CMT before and after treatment were compared by repeated measures analysis of variance.Results:Compared with before treatment, BCVA gradually increased at 1, 3, 6 and 12 months after treatment, and the differences were statistically significant ( F=77.402, P<0.001). There was no significant difference in BCVA between any two groups at different time points after treatment ( P>0.05). Correlation analysis showed that BCVA at 12 months after treatment was negatively correlated with the course of disease ( r=-0.053, P=0.774). One week after treatment, macular hemorrhage was completely cleared in 30 eyes (93.75%, 30/32). The CMT was (458.56±246.21), (356.18±261.46), (345.82±212.38) and (334.64±165.54) μm at 1, 3, 6 and 12 months after treatment, respectively. Compared with before treatment, CMT decreased gradually after treatment, and the difference was statistically significant ( F=112.480, P<0.001). There were statistically significant differences in different follow-up time before and after treatment ( P<0.001). The number of treatments combined with Conbercept during and after surgery was (4.2±1.8) times. At the last follow-up, there was no recurrence of SMH, retinal interlamellar effusion and other complications. Conclusion:Subretinal injection of tPA combined with intravitreal injection of Conbercept is safe and effective in the treatment of large SMH secondary to PCV, and it can significantly improve the visual acuity of patients.

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Objective:To explore the high-risk factors of endometrial cancer (EC) and provide clinical basis for early screening, diagnosis and treatment of EC.Methods:From January 2017 to December 2022, patients admitted to Shanxi Provincial Maternal and Child Health Hospital for hysteroscopic surgery or diagnostic curettage due to abnormal uterine bleeding, postmenopausal vaginal bleeding and other related symptoms were selected as the research objects. After histopathological examination, they were diagnosed with no atypical endometrial hyperplasia (EH), atypical endometrial hyperplasia (AEH), and EC as the research subjects. The general data of patients′ records, vaginal ultrasound, cervical liquid-based cytology test (LCT), carbohydrate antigen 125 (CA125) and pelvic magnetic resonance imaging were collected, and a case-control study was conducted and the risk factors of AEH and EC were explored using univariate and multivariate logistic regression analysis.Results:This study included a total of 420 cases, including 215 in the EH group, 69 in the AEH group, and 136 in the EC group. Through the comparison of various indicators among the three groups and the results of univariate factor logistic regression analysis, age, menopause, previous delivery history, hypertension, diabetes, color ultrasound showed endometrial thickening (>10 mm), uneven endometrial echo, abnormal echo mass in the uterine cavity, endometrial blood flow signals, cervical LCT examination showed that atypical glandular cells were related to the occurrence of EC, with a statistically significant difference (all P<0.05). The results of multivariate logistic regression analysis showed that age>48 years ( OR=3.65, 95% CI: 2.06-6.45), menopause ( OR=3.19, 95% CI: 1.46-6.98), uneven endometrial echo ( OR=4.08, 95% CI: 2.26-7.36), and intrauterine blood flow signal ( OR=2.91, 95% CI: 1.52-5.58), cervical LCT suggests that atypical glandular cells ( OR=4.25, 95% CI: 1.38-13.11) were independent risk factors for EC and precancerous lesions (all P<0.05). Conclusions:For patients with clinical symptoms such as abnormal uterine bleeding or postmenopausal bleeding, timely and focused screening based on whether they have EC risk factors is an economic, safe, and effective method for early detection and treatment of EC.

Objective:To investigate the effect of a short hairpin RNA (shRNA) targeting epidermal growth factor receptor (EGFR) combined with sirolimus on proliferation and apoptosis of the human cutaneous squamous cell carcinoma cell line Colo-16, and to explore underlying mechanisms.Methods:Cultured Colo-16 cells were divided into 5 groups: normal cell group receiving conventional culture and treatment with phosphate-buffered saline (PBS) , negative control group transfected with a shRNA-NC-expressing plasmid and treated with PBS, sirolimus group receiving conventional culture and sirolimus treatment, EGFR shRNA group transfected with an EGFR shRNA-expressing plasmid and treated with PBS, and combined group transfected with an EGFR shRNA-expressing plasmid and treated with sirolimus. Methyl thiazol tetrazolium (MTT) assay was performed to evaluate cellular proliferative activity in the above groups from 24 to 96 hours, and flow cytometry to detect cell apoptosis after 48-hour treatment. Semiquantitative RT-PCR was conducted to determine the mRNA expression of Bcl-2 and Bax, and Western blot analysis to determine the expression of apoptosis-related proteins cleaved caspase-3, cleaved caspase-9, Bcl-2, Bax, cell proliferation-related proteins phosphorylated mammalian target of rapamycin (p-mTOR) , phosphorylated protein kinase B (p-AKT) , phosphorylated 70-kDa ribosomal protein S6 kinase (p-P70S6k) , and cyclin D1. Comparisons among groups were carried out by using one-way analysis of variance, and multiple comparisons between 2 groups by using Student-Newman-Keuls q test. Results:MTT assay showed that the proliferative activity of Colo-16 cells was significantly lower in the sirolimus group, EGFR shRNA group and combined group during 24 - 96 hours than in the normal cell group (all P < 0.05) , and higher in the combined group than in the sirolimus group and EGFR shRNA group at 24-96 hours (all P < 0.001) , and there was no significant difference in the cellular proliferative activity at any time points between the normal cell group and negative control group (all P > 0.05) . Flow cytometry showed that the apoptosis rate was significantly higher in the sirolimus group, EGFR shRNA group and combined group (9.52% ± 0.25%, 12.65% ± 0.23%, 19.81% ± 0.31%, respectively) than in the normal cell group (3.33% ± 0.18%, q = 60.07, 78.08, 122.81, respectively, all P < 0.001) and negative control group (3.42% ± 0.19%, q = 59.90, 77.91, 122.64, respectively, all P < 0.001) , and was highest in the combined group. As RT-PCR and Western blot analysis revealed, the sirolimus group, EGFR shRNA group and combined group showed significantly decreased mRNA expression of Bcl-2 and protein expression of cyclin D1, p-AKT, p-mTOR, p-P70S6K and Bcl-2, but significantly increased mRNA expression of Bax and protein expression of cleaved caspase-3, cleaved caspase-9 and Bax compared with the normal cell group (all P < 0.05) . Compared with the sirolimus group and EGFR shRNA group, the combined group showed significantly decreased mRNA expression of Bcl-2 and protein expression of cyclin D1, p-AKT, p-mTOR, p-P70S6K and Bcl-2 (all P < 0.05) , but significantly increased mRNA expression of Bax and protein expression of cleaved caspase-3, cleaved caspase-9 and Bax (all P < 0.01) . Conclusion:EGFR shRNA and sirolimus exerted a synergistic effect in inhibiting the proliferation and promoting the apoptosis of Colo-16 cells, which may be related to the inhibition of the phosphoinositide 3-kinase (PI3K) /AKT/mTOR pathway.

Background and Objectives: Apoptosis is an outstanding determinant of glucocorticoid (GC)-induced osteonecrosis of the femoral head (ONFH). Human umbilical cord mesenchymal stem cells (hUC-MSCs) have been demonstrated to be associated with apoptosis in diseases models. However, the role of hUC-MSCs in GC-induced ONFH via regulating apoptosis still needs further study. Methods: and Results: In the present study, a GC-induced ONFH model was built in vivo through a consecutive injection with lipopolysaccharide (LPS) and methylprednisolone. The necrosis and apoptosis of the femoral head was evaluated by histological and Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL) assay. The level of collagen and TRAP positive cells were determined by Masson and TRAP staining, respectively. M1 macrophage polarization was assessed using immunofluorescence assay. The level of proinflammatory cytokines including tumor necrosis factor (TNF)‐α, Interleukin (IL)‐1β and IL-6 of femoral head was determined by enzyme-linked immunosorbent assay (ELISA) kits. The protein expression of AKT, mTOR, p-AKT and p-mTOR was detected using western blot assay. The results showed that hUC-MSCs treatment prominently promoted the GC-induced the decrease of the collagen level and the increase of TRAP positive cells. Besides, hUC-MSCs treatment decreased necrosis and apoptosis, macrophage polarization, the level of TNF‐α, IL‐1β and IL-6, the protein expression of p-AKT and p-mTOR, and the radio of p-AKT to AKT and p-mTOR to mTOR of femoral head in vivo. Conclusions Therefore, the present study revealed that hUC-MSCs improved the necrosis and osteocyte apoptosis in GC-induced ONFH model through reducing the macrophage polarization, which was associated with the inhibition of AKT/mTOR signaling pathway.

Pseudomonas aeruginosa is a common pathogen of respiratory infections. The conventional diagnostic methods for Pseudomonas aeruginosa have certain weakness, for example, sputum culture is time-consuming and of low sensitivity; and polymerase chain reaction cannot be popularized clinically due to its high cost. Meanwhile, detection of volatile organic compounds is a sensitive, rapid, portable and inexpensive diagnostic method. This review focuses on the detection of volatile organic compounds in the diagnosis of Pseudomonas aeruginosa respiratory infection, discusses the existing problems, and puts forward relevant suggestions to provide reference for clinical application and future researches.

Objective:To investigate the effect of Fuzheng-Peiyuan recipe assisted modified VAD program on M protein, myeloma cells and immune function in patients with multiple myeloma (MM). Methods:A total of 96 patients with MM from January 2017 to May 2019 in our hospital were selected as the research objects, and they were divided into two groups according to the random number table method, with 48 patients in each group. The control group was given a modified VAD regimen (vincristine + adriamycin + dexamethasone), and the observation group was given Fuzheng-Peiyuan recipe as an auxiliary VAD regimen. Both groups were treated for 3 cycles. The clinical efficacy, TCM syndrome score, bone pain score, blood creatinine, hemoglobin, blood calcium, M protein, myeloma cells, immune function [Interleukin-2 (IL-2), Interferon-gamma (INF-γ), Interleukin-4 (IL-4), Interleukin-10 (IL-10)] levels and adverse reactions of the two groups were recorded and compared before and after treatment. Results:The total effective rate of the observation group was 81.3% (39/48), and the control group was 62.5% (30/48). The difference between the two groups was statistically significant ( χ2=4.174, P=0.041). The scores of TCM syndromes ( t=4.674, 13.328) and bone pain scores ( t=4.505, 11.398) in the observation group were significantly lower than those in the control group ( P<0.01) at 1 and 3 cycles after treatment; SCr ( t=4.452, 10.039), blood calcium ( t=4.578, 4.155) in the observation group were significantly lower than those in the control group ( P<0.01); HbAlc levels ( t=5.290, 8.871) in the observation group was significantly higher than that of the control group ( P<0.01); M protein ( t=11.145, 33.812), myeloma cells ( t=6.415, 19.731) in the observation group were significantly lower than those in the control group ( P<0.01); serum IL-2 ( t=4.922, 8.789), INF-γ ( t=5.610, 8.886) in the observation group were significantly higher than those in the control group ( P<0.01); IL-4 ( t=4.709, 6.784), IL-10 ( t=5.287, 12.823) in the observation group were significantly lower than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions in the observation group was 41.7% (20/48) and that in the control group was 62.5% (30/48). The difference between the two groups was statistically significant ( χ2=4.174, P=0.041). Conclusion:Fuzheng-Peiyuan recipe assisted in improving the VAD regimen in the treatment of MM has a significant clinical effect, which can relieve the clinical symptoms of patients and reduce the degree of bone pain, and promote the reduction of myeloma cells in patients, improve their immune function, and improve the tolerance of chemotherapy.

【Objective】 To analyze the data of non-small cell lung cancer (NSCLC) gene chip using the bioinformatics method, screen differential expression genes (DEGs), and explore the biomarkers related to the prognosis of NSCLC so as to provide a new target for the treatment of NSCLC. 【Methods】 The NSCLC gene chip data were downloaded from the GEO database and the common DEGs in the two datasets were screened by GEO2R tool and FunRich3.1.3 software. The DAVID database was used in GO analysis and KEGG analysis of the DEGs. The protein-protein interaction (PPI) network was constructed using the STRING database; Cytoscape 3.8.0 software was used to select the top 20 hub genes. Then Kaplan-Meier plotter was used to analyze the prognosis of the identified hub genes, and multiple external databases were used to verify the expressions of the hub genes and their relationship with prognosis. 【Results】 A total of 159 intersect DEGs were screened from the two datasets. A total of 20 hub genes were identified via PPI network. Survival analysis and validation results from multiple external databases showed that SPP1 was highly expressed in NSCLC tumor tissues and was significantly correlated with the patients’ poor prognosis (P<0.05). The subgroup analysis showed that SPP1 might cause the poor prognosis by affecting lymph node metastasis. 【Conclusion】 SPP1 may be a biomarker for evaluating the prognosis of NSCLC patients, providing a new idea for the targeted therapy of NSCLC.

Objective:To investigate the effects of driving pressure(DP)-guided individualized positive end-expiratory pressure(PEEP)on intraoperative pulmonary function in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy.Methods:This was a retrospective case-control study.A total of 40 elderly patients undergone robot-assisted radical resection of prostate cancer were enrolled and divided into the control group and the DP-guided group(n=20, each group)based on the random number table method.Data on the peak inspiratory pressure(PIP)at time points including 4 min after the first PEEP set(T1), 4 min, 1 hour, 2 hours(T2-4)after the second PEEP set, and 1 min after closing abdomen(T5), lung compliance(Crs), PEEP and the partial pressure of carbon dioxide in end expiratory gas(PetCO 2)were recorded and compared between the two groups.Blood gas analysis was conducted, and the oxygenation index(OI), alveolar-arterial oxygen tension difference(A-aDO 2)and the dead space volume/tidal volume(Vd/Vt)were calculated. Results:Compared with the control group, Crs, OI and PaO 2 were increased and DP, Vd/Vt, A-aDO 2 and PaCO 2 were decreased in the DP-guided group at each time point( P<0.05). PIP showed no significant difference between the two groups at each time point( P>0.05). Compared with T1, PIP and DP were increased and Crs was decreased( P<0.05)in both groups at T2-T4( P<0.05). At T5, PIP was increased in both groups( P<0.05), Crs was decreased and DP was increased in the control group( P<0.05), while Crs and DP had no significant difference in the DP group at T1( P>0.05). OI and PaO 2 showed no significant difference between the two groups at T2-T5( P>0.05). Vd/Vt and PaCO 2 were increased in both groups at T3-T5( P<0.05). Compared with T1 levels, A-aDO 2 was increased in the control group at T3-T5( P<0.05)and in the DP group at T4( P<0.05). Conclusions:DP-guided individualized PEEP can reduce the occurrence of intraoperative atelectasis, improve intraoperative respiratory mechanical state and gas exchange, reduce the risk of potential ventilator-related lung injury and has good lung-protective effects of PEEP in elderly patients undergoing robot-assisted laparoscopic prostatectomy.