Background Lead (Pb) is a highly toxic heavy metal that accumulates in the body, potentially leading to multi-systemic impairment. Compared with traditional statistical methods, machine learning techniques offer unique advantages, opening new avenues for occupational health risk assessment and the exploratory analysis of complex associations. Objective To examine the association between occupational lead exposure and multiple health indicators and to identify key risk factors for lead toxicity. Methods A cross-sectional study was conducted, integrating occupational hygiene investigation results from 16 lead-acid battery enterprises in Jiangsu Province with occupational health examination data from 1914 lead-exposed workers. Inter-group differences were analyzed using the χ² test or Fisher's exact test. Binary logistic regression and machine learning algorithms [CatBoost, Naive Bayes model (NBM), and random forest (RF)] were employed to evaluate the association between blood lead (PbB), urine lead (PbU), and health indicators including blood pressure (BP), red blood cell count (RBC), and alanine aminotransferase (ALT). Results The prevalence of abnormal PbB and PbU were 14.52% and 9.35%, respectively. The risks of abnormal BP, RBC, and ALT were significantly increased in the population with high lead levels (P<0.05). PbB abnormalities were closely associated with gender, environmental lead concentration, wearing masks, smoking, and alcohol consumption (P<0.05). Regarding occupational hazards, workers exposed to lead dust had a 1.98-fold risk of PbU abnormality compared to those exposed to lead fumes. The plate coating and acid leaching process posed the highest risk for both PbB (OR=8.81) and PbU (OR=5.46) abnormalities compared with assembly process. Furthermore, the risks of PbB and PbU abnormalities were significantly elevated among workers with abnormal BP, RBC or ALT (P<0.05). Among the models, CatBoost performed best in predicting RBC abnormality (accuracy: 95.8%; precision: 44.9%; F1 score: 0.952; AUC: 0.981). Feature importance analysis identified PbB and PbU as the core factors affecting abnormal RBC and ALT, while RBC and ALT abnormalities as key features for predicting the risk of PbB and PbU abnormalities. Conclusion By integrating traditional statistical methods with machine learning, this study reveals a complex bidirectional association between occupational lead exposure and multiple health indicators, and identifies gender, job category, and environmental Pb concentration as the key factors influencing PbB abnormalities. These findings provide a scientific foundation for the implementation of precision occupational health management models.

Background Lead (Pb) is a highly toxic heavy metal that accumulates in the body, potentially leading to multi-systemic impairment. Compared with traditional statistical methods, machine learning techniques offer unique advantages, opening new avenues for occupational health risk assessment and the exploratory analysis of complex associations. Objective To examine the association between occupational lead exposure and multiple health indicators and to identify key risk factors for lead toxicity. Methods A cross-sectional study was conducted, integrating occupational hygiene investigation results from 16 lead-acid battery enterprises in Jiangsu Province with occupational health examination data from 1914 lead-exposed workers. Inter-group differences were analyzed using the χ² test or Fisher's exact test. Binary logistic regression and machine learning algorithms [CatBoost, Naive Bayes model (NBM), and random forest (RF)] were employed to evaluate the association between blood lead (PbB), urine lead (PbU), and health indicators including blood pressure (BP), red blood cell count (RBC), and alanine aminotransferase (ALT). Results The prevalence of abnormal PbB and PbU were 14.52% and 9.35%, respectively. The risks of abnormal BP, RBC, and ALT were significantly increased in the population with high lead levels (P<0.05). PbB abnormalities were closely associated with gender, environmental lead concentration, wearing masks, smoking, and alcohol consumption (P<0.05). Regarding occupational hazards, workers exposed to lead dust had a 1.98-fold risk of PbU abnormality compared to those exposed to lead fumes. The plate coating and acid leaching process posed the highest risk for both PbB (OR=8.81) and PbU (OR=5.46) abnormalities compared with assembly process. Furthermore, the risks of PbB and PbU abnormalities were significantly elevated among workers with abnormal BP, RBC or ALT (P<0.05). Among the models, CatBoost performed best in predicting RBC abnormality (accuracy: 95.8%; precision: 44.9%; F1 score: 0.952; AUC: 0.981). Feature importance analysis identified PbB and PbU as the core factors affecting abnormal RBC and ALT, while RBC and ALT abnormalities as key features for predicting the risk of PbB and PbU abnormalities. Conclusion By integrating traditional statistical methods with machine learning, this study reveals a complex bidirectional association between occupational lead exposure and multiple health indicators, and identifies gender, job category, and environmental Pb concentration as the key factors influencing PbB abnormalities. These findings provide a scientific foundation for the implementation of precision occupational health management models.

Glyphosate is an organophosphorus herbicide with a large global production volume and wide application. It is commonly present in the environment and has a relatively long residual period. Its long-term toxicity, carcinogenic potential and other health effects deserve attention and further research. Glyphosate exposure has toxic effects on a variety of organs, including but not limited to hepatotoxicity, reproductive toxicity, neurotoxicity, etc., and is associated with the occurrence and development of different types of cancer. This article summarizes the physicochemical properties of glyphosate, its usage and pollution status in China, sorts out and summarizes its population load situation, and focuses on discussing the hepatotoxic effects of glyphosate under various exposure scenarios, including the acute poisoning situation and the progress of long-term low-dose exposure in the general population, and long-term high dose exposure condition in the occupational population. The hepatotoxic effects of glyphosate on mammals, fish, and organs and cells in vitro experiments were deeply analyzed. The possible toxicological mechanism of glyphosate hepatotoxicity was analyzed from oxidative stress, mitochondrial dysfunction, inflammation and other aspects, aiming to explore the effects of glyphosate exposure on liver health and provide a reference for scientific guidance on the rational use of glyphosate.

Objective:To explore the formulation patterns and potential targets of traditional Chinese medicine (TCM) in the treatment of pneumoconiosis using data mining, network pharmacology, and Mendelian randomization (MR) .Methods:In November 2023, prescription data for TCM compound treatments of pneumoconiosis from the past five years were retrieved from the China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases. The formulation patterns of TCM for pneumoconiosis were analyzed based on drug frequency, association rules, and cluster analysis, followed by the identification of core drugs. Network pharmacology and MR analysis were then applied to determine the potential targets for pneumoconiosis treatment.Results:A total of 100 TCM prescriptions were included, involving 182 herbs, with 15 high-frequency herbs. A total of 24 strong association rules were identified, including 16 herbs. Cluster analysis identified three groups of drug combinations. The core drug combination, "Astragalus Root-Codonopsis Root-Tangkuei-Chinese Magnolia Vine Fruit-Danshen Root-Prepared Rehmannia Root" was determined, which interacted with 47 common targets associated with pneumoconiosis. Further protein-protein interaction (PPI) analysis identified 18 core targets, and MR analysis confirmed that Caspase-3 (CASP3) and Cathepsin B (CTSB) were risk factors for pneumoconiosis ( OR=1.35, 1.44; P=0.038, 0.038) . Conclusion:The core drug combination for the treatment of pneumoconiosis with TCM is "Astragalus Root-Codonopsis Root-Tangkuei-Chinese Magnolia Vine Fruit-Danshen Root-Prepared Rehmannia Root". The medication mainly focuses on tonifying lung qi, moistening dryness and stopping coughing, circulating blood and transforming stasis, which are supplemented with herbs for nourishing yin and moistening dryness, warming yang and dissipating cold. Finally, the key targets for treating pneumoconiosis are screened out, providing an important basis for the development of therapeutic drugs for it.

Objective:To compare the clinical and radiological outcomes between the ankle dislocation exposure versus the traditional posterolateral approach exposure in the treatment of complex posterior ankle malunion.Methods:This retrospective study analyzed the 50 patients (50 feet) with posterior ankle malunion who had been treated at Department of Foot and Ankle Orthopedics, Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from May 2015 to June 2023. This cohort included 18 males and 32 females, with an age of (46.2±12.0) years. The duration from injury to surgery averaged 7.0 (4.0, 12.2) months. The patients were divided into 2 groups based on the surgical exposure methods: an ankle dislocation group (22 cases) in which the posterior ankle malunion was exposed by ankle dislocation before reduction and fixation, and a traditional posterolateral approach group (28 cases) in which the posterior ankle malunion was exposed by the traditional posterolateral approach before reduction and fixation. Evaluation indices included operative time, ankle arthritis grading, incidence of complications, as well as pre-operative and last follow-up recordings of distal tibial articular angle and joint step-off, visual analogue scale (VAS) pain score, and ankle-hindfoot score of American Orthopaedic Foot and Ankle society (AOFAS).Results:There was no significant difference in the baseline data between the 2 groups, indicating comparability ( P>0.05). The average follow-up was (39.4±17.9) months. The operative time in the dislocation group [(95.8±9.9) min] was significantly shorter than that in the posterolateral approach group [(121.9±14.3) min] ( P<0.05). The step-off on the distal tibial articular surface at the last follow-up in the dislocation group [0.3 (0.0, 0.9) mm] was significantly lower than that in the posterolateral approach group [1.0 (0.3, 1.1) mm] ( P<0.05). The grading of ankle arthritis was significantly worse in the posterolateral approach group than that in the dislocation group ( P<0.05). There were no differences in distal tibial articular angle, VAS pain score, AOFAS ankle-hindfoot score, or postoperative complications between the 2 groups at the last follow-up ( P>0.05). Conclusions:Both ankle dislocation exposure and traditional posterolateral approach exposure yield satisfactory clinical and radiological outcomes in patients with complex posterior ankle malunion. However, the ankle dislocation exposure offers a novel method for direct visualization of the malunion on multiple planes, which is more advantageous for restoration of the anatomical consistency of the distal tibial articular surface.

Glyphosate is an organophosphorus herbicide with a large global production volume and wide application. It is commonly present in the environment and has a relatively long residual period. Its long-term toxicity, carcinogenic potential and other health effects deserve attention and further research. Glyphosate exposure has toxic effects on a variety of organs, including but not limited to hepatotoxicity, reproductive toxicity, neurotoxicity, etc., and is associated with the occurrence and development of different types of cancer. This article summarizes the physicochemical properties of glyphosate, its usage and pollution status in China, sorts out and summarizes its population load situation, and focuses on discussing the hepatotoxic effects of glyphosate under various exposure scenarios, including the acute poisoning situation and the progress of long-term low-dose exposure in the general population, and long-term high dose exposure condition in the occupational population. The hepatotoxic effects of glyphosate on mammals, fish, and organs and cells in vitro experiments were deeply analyzed. The possible toxicological mechanism of glyphosate hepatotoxicity was analyzed from oxidative stress, mitochondrial dysfunction, inflammation and other aspects, aiming to explore the effects of glyphosate exposure on liver health and provide a reference for scientific guidance on the rational use of glyphosate.

Objective:To explore the formulation patterns and potential targets of traditional Chinese medicine (TCM) in the treatment of pneumoconiosis using data mining, network pharmacology, and Mendelian randomization (MR) .Methods:In November 2023, prescription data for TCM compound treatments of pneumoconiosis from the past five years were retrieved from the China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases. The formulation patterns of TCM for pneumoconiosis were analyzed based on drug frequency, association rules, and cluster analysis, followed by the identification of core drugs. Network pharmacology and MR analysis were then applied to determine the potential targets for pneumoconiosis treatment.Results:A total of 100 TCM prescriptions were included, involving 182 herbs, with 15 high-frequency herbs. A total of 24 strong association rules were identified, including 16 herbs. Cluster analysis identified three groups of drug combinations. The core drug combination, "Astragalus Root-Codonopsis Root-Tangkuei-Chinese Magnolia Vine Fruit-Danshen Root-Prepared Rehmannia Root" was determined, which interacted with 47 common targets associated with pneumoconiosis. Further protein-protein interaction (PPI) analysis identified 18 core targets, and MR analysis confirmed that Caspase-3 (CASP3) and Cathepsin B (CTSB) were risk factors for pneumoconiosis ( OR=1.35, 1.44; P=0.038, 0.038) . Conclusion:The core drug combination for the treatment of pneumoconiosis with TCM is "Astragalus Root-Codonopsis Root-Tangkuei-Chinese Magnolia Vine Fruit-Danshen Root-Prepared Rehmannia Root". The medication mainly focuses on tonifying lung qi, moistening dryness and stopping coughing, circulating blood and transforming stasis, which are supplemented with herbs for nourishing yin and moistening dryness, warming yang and dissipating cold. Finally, the key targets for treating pneumoconiosis are screened out, providing an important basis for the development of therapeutic drugs for it.

Objective:To compare the clinical and radiological outcomes between the ankle dislocation exposure versus the traditional posterolateral approach exposure in the treatment of complex posterior ankle malunion.Methods:This retrospective study analyzed the 50 patients (50 feet) with posterior ankle malunion who had been treated at Department of Foot and Ankle Orthopedics, Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from May 2015 to June 2023. This cohort included 18 males and 32 females, with an age of (46.2±12.0) years. The duration from injury to surgery averaged 7.0 (4.0, 12.2) months. The patients were divided into 2 groups based on the surgical exposure methods: an ankle dislocation group (22 cases) in which the posterior ankle malunion was exposed by ankle dislocation before reduction and fixation, and a traditional posterolateral approach group (28 cases) in which the posterior ankle malunion was exposed by the traditional posterolateral approach before reduction and fixation. Evaluation indices included operative time, ankle arthritis grading, incidence of complications, as well as pre-operative and last follow-up recordings of distal tibial articular angle and joint step-off, visual analogue scale (VAS) pain score, and ankle-hindfoot score of American Orthopaedic Foot and Ankle society (AOFAS).Results:There was no significant difference in the baseline data between the 2 groups, indicating comparability ( P>0.05). The average follow-up was (39.4±17.9) months. The operative time in the dislocation group [(95.8±9.9) min] was significantly shorter than that in the posterolateral approach group [(121.9±14.3) min] ( P<0.05). The step-off on the distal tibial articular surface at the last follow-up in the dislocation group [0.3 (0.0, 0.9) mm] was significantly lower than that in the posterolateral approach group [1.0 (0.3, 1.1) mm] ( P<0.05). The grading of ankle arthritis was significantly worse in the posterolateral approach group than that in the dislocation group ( P<0.05). There were no differences in distal tibial articular angle, VAS pain score, AOFAS ankle-hindfoot score, or postoperative complications between the 2 groups at the last follow-up ( P>0.05). Conclusions:Both ankle dislocation exposure and traditional posterolateral approach exposure yield satisfactory clinical and radiological outcomes in patients with complex posterior ankle malunion. However, the ankle dislocation exposure offers a novel method for direct visualization of the malunion on multiple planes, which is more advantageous for restoration of the anatomical consistency of the distal tibial articular surface.

The contents recorded in the rotation registration manual is not only the quantitative indicators for evaluating the quality of residency training, but also the important basis for training assessment and issuance of training certificates. In order to solve the problems of data authenticity, information delay, and repeated entry in the rotation registration manual for residency training, Shanghai East Hospital, Tongji University, launched a project to dock the electronic rotation registration manual with the hospital information system. Through the establishment of the project team, the development of working mechanisms, and the implementation of the project, data analysis was used for process reformation and system optimization, so as to continuously improve management efficiency and medical safety while solving problems and form a set of implementation system with reference significance in practice.

In recent years， the incidence of pulmonary nodules has kept rising. To give full play to the advantages of traditional Chinese medicine （TCM） in the treatment of pulmonary nodules and identify the breakthrough points of integrating TCM with Western medicine， the China Association of Chinese Medicine organized medical experts in TCM and western medicine to carry out in-depth discussion regarding this disease. The discussion encompassed the modern medical advances， TCM theories of etiology and pathogenesis， the role and advantages of TCM in the whole course management of pulmonary nodules， contents and methods of research on pulmonary nodules， and science popularization work， aiming to provide a reference for clinical practice and scientific research. After discussion， the experts concluded that the occurrence of pulmonary nodules was rooted in the deficiency of the lung and spleen and triggered by phlegm dampness， blood stasis， and Qi stagnation. TCM can treat pulmonary nodules by controlling and reducing nodules， improving physical constitution， ameliorating multi-system nodular diseases， reducing anxiety and avoiding excessive diagnosis and treatment， and serving as an alternative for patients who are unwilling or unfit for surgical treatment. At present， the optimal diagnosis and treatment strategy for pulmonary nodules has not been formed， which needs to be further studied from multiple perspectives such as clinical epidemiology， biology， and evidence-based medicine. The primary task of current research is to find out the advantages， effective prescriptions， and target populations and determine the effective outcomes of TCM in the treatment of pulmonary nodules. At the same time， basic research should be carried out to explore the etiology and biological behaviors of pulmonary nodules. The expert consensus on the diagnosis and treatment of pulmonary nodules with integrated TCM and Western medicine needs to be continuously revised to guide clinicians to conduct standardized， scientific， and accurate effective diagnosis and treatment.