Objective To evaluate cardiac involvement in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) using echocardiography combined with electrocardiography. Methods A retrospective analysis was performed on the detailed medical records of AAV patients treated in Jining First People’s Hospital between January 2020 and December 2024. Eighty patients were enrolled in the AAV group, and the risk of heart disease was compared between the AAV group and a control group with 80 subjects matched for age, sex, and cardiovascular disease risk factors. Results Electrocardiographic abnormalities were observed in 78.75% of patients in the AAV group, while significant electrocardiographic abnormalities only occurred in symptomatic patients in the control group. There were no differences in left atrial enlargement or interventricular septal thickening between the AAV group and the control group. The overall left ventricular systolic function in the AAV group was lower than that in the control group (8.75% vs. 0). The incidence of reduced diastolic function in the AAV group was significantly higher than that in the control group (37.5% vs. 15%). The incidence rates of tricuspid regurgitation, mitral regurgitation, aortic regurgitation, and pericardial effusion in the AAV group were significantly higher than those in the control group. Pericardial thickening, aortic stenosis, pulmonary hypertension, and rare periaortic granulomas were found in the AAV group, but not in the control group. Conclusion Echocardiography and electrocardiography are important examination methods for evaluating cardiac involvement in AAV. These methods have key roles in disease screening, diagnosis and treatment, follow-up, and prognosis judgment.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To construct a hypoglycemia random forest prediction model for older adults with type 2 diabetes, and assess the model′s prognostication performance through internal and external verification.Methods:From August 2022 to January 2023, 300 older adults with type 2 diabetes in Beijing Hospital were selected. The demographic characteristics, medical history, laboratory tests, and other data of the patients were collected, and the data set was randomly divided into the training set and verification set in a ratio of 7∶3. The hypoglycemia prediction model for older adults with type 2 diabetes was constructed and optimized based on the random forest algorithm. The calibration curve was used to evaluate the model′s calibration, and the ROC was used to evaluate the model′s discrimination. The clinical applicability of the model was assessed by the decision curve analysis. The risk factors for hypoglycemia in the older adults were explored by prioritizing the contributions of variables in prediction. The Bootstrap method was used for internal validation, and the validation set was used for external validation.Results:Among the 300 older adults with type 2 diabetes, 128 cases (42.67%) experienced hypoglycemia within one week. The predictive contributions of risk factors in the model were ranked as follows: the number of episodes of hypoglycemia in one month, HDL-C, heart disease, diabetes knowledge and education, combination therapy, age, duration of diabetes, staple food restriction, glycosylated hemoglobin, and gender. The internal and external calibration curves of the hypoglycemia random forest model for the older adults with type 2 diabetes fluctuated around the diagonal, indicating that the calibration degree of the predictive model is good. The AUROC of internal verification was 0.823 (95% CI 0.752-0.894), the sensitivity and specificity were 0.867 and 0.698, respectively. The external verification was 0.859 (95% CI 0.817 - 0.902), and sensitivity and specificity were 0.789 and 0.804, respectively, showing that the overall discrimination of the prediction model was good. The DCA curves were far from the all-positive line and all-negative line, which indicated that the prediction model had good clinical applicability. Conclusions:The predictive effect of this model is good, and it is suitable for predicting the risk of hypoglycemia in older adults with type 2 diabetes, and it provides a reference for early hypoglycemia screening and predictive intervention for this kind of patients.

Objective:To assess the effects of low-dose ionizing radiation on the thyroid of medical radiation workers.Methods:Based on the inclusion and exclusion criteria, 27 articles, involving 22 937 individuals, were screened finally from relevant literature published from 1996 to 2022. Meta-analysis was carried out using Stata 16.0 for serum levels of triiodothyronine (T 3), free triiodothyronine (FT 3), thyroid hormone (T 4), free thyroid hormone (FT 4), thyrotropin-stimulating hormone (TSH) and thyroid nodule rates. As well, subgroup analysis were carried out of thyroid function in different types of radiation workers. Results:The standardized mean difference (SMD) at T 3 and T 4 levels for radiation workers was -0.19 (-0.37, -0.01) and -0.34 (-0.38, -0.30), lower than that of control group ( Z=2.07, -16.06, P<0.05). The SMD at FT 4 levels for radiation workers was 0.22 (0.06, 0.39), higher than control group ( Z=2.61, P<0.05). The relative risk of thyroid nodules in radiation workers was 1.47 (1.19, 1.82), higher than that of control group ( Z=-3.58, P<0.05). The analysis result for subgroup showed that the SMD for T 3, T 4 and TSH levels in the interventional radiology workers were -0.29 (-0.51, -0.07), -0.31 (-0.47, -0.15) and -0.43 (-0.73, -0.13) ( Z=-2.55, -3.86, -2.82, P<0.05), respectively, and the SMD for T 4 levels in the nuclear medicine workers was -0.26 (-0.45, -0.07), which meaned a reduced risk compared to the control group ( Z=-2.70, P<0.05). Conclusions:Long-term low doses of ionising radiation may have adverse effects on thyroid hormone and thyroid nodule in radiation workers, particularly in interventional radiology workers, and attention should be focused on their radiation protection.

Objective:To understand the lens condition of radiation workers in a city, explore the factors affecting lens opacity, and provide basis for strengthening the radiation protection management of radiation workers.Methods:In December 2020, according to the national radiation health monitoring project, the occupational health examination data of radiation workers in an occupational health examination institution in a city from December 2018 to November 2020 were collected, including the basic information of radiation workers and ophthalmic examination results. The lens conditions of radiation workers in different subgroups were analyzed, and the influencing factors of lens opacity were analyzed by multifactor logistic regression.Results:A total of 4452 radiation workers were included, of which 439 (9.9%) had lens opacity. The lens opacity rate of male radiation workers was higher than that of female radiation workers ( P<0.05) . With the increase of age and length of service, the lens abnormalities of radiation workers increased ( rs=0.269, 0.212, P<0.01) . The lens opacity rate of radiation workers engaged in nuclear medicine was high (12.7%, 9/71) . The rate of lens opacity in off-the-job medical examination radiation workers was high (18.3%, 26/142) . By multivariate logistic regression analysis, the risk of lens opacification in the age ≤30-year-old group and the >30-<50-year-old group were 0.087 times (95% CI: 0.058-0.132) and 0.076 times (95% CI: 0.054-0.107) that in the age ≥50-year-old group, respectively. The risk of lens opacification in the age ≤10-year-old group, >10-<20-year-old group and 20-30-year-old group were 0.293 (95% CI: 0.189-0.456) , 0.413 (95% CI: 0.256-0.666) and 0.318 (95% CI: 0.204-0.497) times, respectively. Conclusion:The lens opacity rate of radiation workers is related to age and working age.Attention should be paid to high-age and long-term radiation workers to ensure their health.

Objective:To understand the lens condition of radiation workers in a city, explore the factors affecting lens opacity, and provide basis for strengthening the radiation protection management of radiation workers.Methods:In December 2020, according to the national radiation health monitoring project, the occupational health examination data of radiation workers in an occupational health examination institution in a city from December 2018 to November 2020 were collected, including the basic information of radiation workers and ophthalmic examination results. The lens conditions of radiation workers in different subgroups were analyzed, and the influencing factors of lens opacity were analyzed by multifactor logistic regression.Results:A total of 4452 radiation workers were included, of which 439 (9.9%) had lens opacity. The lens opacity rate of male radiation workers was higher than that of female radiation workers ( P<0.05) . With the increase of age and length of service, the lens abnormalities of radiation workers increased ( rs=0.269, 0.212, P<0.01) . The lens opacity rate of radiation workers engaged in nuclear medicine was high (12.7%, 9/71) . The rate of lens opacity in off-the-job medical examination radiation workers was high (18.3%, 26/142) . By multivariate logistic regression analysis, the risk of lens opacification in the age ≤30-year-old group and the >30-<50-year-old group were 0.087 times (95% CI: 0.058-0.132) and 0.076 times (95% CI: 0.054-0.107) that in the age ≥50-year-old group, respectively. The risk of lens opacification in the age ≤10-year-old group, >10-<20-year-old group and 20-30-year-old group were 0.293 (95% CI: 0.189-0.456) , 0.413 (95% CI: 0.256-0.666) and 0.318 (95% CI: 0.204-0.497) times, respectively. Conclusion:The lens opacity rate of radiation workers is related to age and working age.Attention should be paid to high-age and long-term radiation workers to ensure their health.

Objective: To pre-assess the occupational hazards in a waste ecological landfill project using comprehensive exposure index with analogy method,and to provide reference for improvement of protective measures and prevention of occupational diseases. Methods: Some enterprises which were comparable with the project in landfill storage capacity,disposal scale,techniques,occupational hazards and occupational health management were selected to carry out on-site occupational health survey,and were evaluated by occupational exposure limits（OEL）. The risk of occupational hazards of the project was assessed by analogy and comprehensive index method. Results: The occupational hazards of analogous enterprises were hydrogen sulfide,ammonia,other dust and noise in ash solidification workshop,paving post in landfill area,spraying post and inspection post in sewage disposal area;manganese and its inorganic compounds,welding fume and arc light in welding post. Except for the noise intensity of spraying post exceeding the national OEL,the other items were qualified. The results of the pre-assessment of the project showed that in the posts with vacant OEL,the hazards of paving compaction post exposed to high temperature in summer,spraying post exposed to high temperature in summer,cypermethrin and machine repairing post exposed to heat,ozone and noise were at moderate risk;in the posts qualified by OEL,the hazards of paving compaction and sewage disposal posts exposed to noise were neglectable,paving compaction and transportation post exposed to other dust were at low risk,others were at moderate risk;unqualified spraying post exposed to noise was at moderate risk. Conclusion Medium-risk occupational hazards exist in paving compaction,spraying,sewage disposal and machine repairing posts. Comprehensive index method combined with analogy method can comprehensively achieve the occupational hazard pre-assessment of a proposed project.

Objective To investigate the clinical effect of 125I seeds implantation on bone metastasis from radioactive iodine-refractory differentiated thyroid carcinoma (RAIR-DTC).Methods A total of 9 RAIR-DTC patients with bone metastases (4 males,5 females,age range:42-87 years) between April 2014 and December 2016 were enrolled in this prospective study.Treatment plan was developed through treatment planning system (TPS).125I seeds implantation was performed under CT guidance.After 2 and 4 months,metastasis size,serum thyroglobulin (Tg) and verbal rating scale (VRS) pain score changes were recorded.Paired t test and two-sample t test were used for data analysis.Results VRS pain score decreased 2 months post-treatment comparing with that before treatment (2.56±0.88 vs 5.22±2.44;t =4.28,P＜0.01).VRS pain score at 4 months post-treatment was 1.78±0.83,which was lower than that at 2 months post-treatment (t =3.48,P＜0.01).The maximum tumor diameters before the implantation and 2 months post-treatment were (6.47± 1.84) cm and (5.08±2.11) cm,respectively (t =9.14,P＜0.01).The maximum tumor diameter at 4 months post-treatment showed a decreasing trend but it was not statistically different compared to that at 2 months post-treatment:((4.52±2.16) cm;t =2.19,P＞0.05).Serum Tg level reduced 2 months after the implantation (lgTg:2.71±0.85 vs 2.94±0.82;t =4.82,P＜0.01).Serum Tg level at 4 months post-treatment (lgTg:2.56±0.81) was lower than that at 2 months post-treatment (t =2.69,P＜0.05).Conclusions 125I seeds implantation is an effective method for treating bone metastasis from RAIR-DTC.It can help to shrink bone metastasis,alleviate pain and improve patients' quality of life.

Objective To investigate the effect of autophagy on the proliferation and migration of cervi-cal cancer cells ,as well as the underlining mechanisms .Methods Rapamycin was used to induce the autophagy in HeLa cells,formation of autophagosomes was observed by staining with acridine orange under fluorescence mi -croscope.Western blot was used to detect the expression of LC 3 and PI3K/Akt/mTOR in HeLa cells.The LC3 plasmid was transfected into HeLa cells .The distribution of LC3 in cells and the expression of LC3 was identified by fluorescence microscope and Western blot ,respectively.The autophagy was inhibited with 3-methyladenine(3-MA )in HeLa cells.The cell proliferation was monitored by RTCA real -time instrument.Transwell chamber was carried out to assess cell migration .Results After 6h of rapamycin treatment ,the expression of LC3B was in-creased in HeLa cells ( P<0 .05 ) .The proliferative and migration ability were weakened compared to wild type HeLa cells(P<0.05).The same results in the presence of 3-MA.The expression of PI3K/AKT/mTOR path-way proteins were activated by rapamycin treatment and LC 3 overexpression(P<0.05).Conclusion Autophagy can suppress the proliferation and migration in cervical cancer cells ,which may relate to PI3K/Akt/mTOR path-way.

Objective To study the effect of pluripotency factor Nanog on the expression of the cell cy-cle related proteins,and then to explore its effect on the proliferative ability of HepG 2 cells.Methods TALENs gene editing tool was employed to induce mutation and downregulation expression of Nanog .T7 endonuclease 1 and genomic sequencing was used to analyze the mutation efficiency of Nanog .RT-PCR and western blot were used to determine the expression of mRNA and protein of Nanog ,respectively .Real-time cell based assay system was used to measure the proliferative ability of wild -type HepG2 cells and monoclonal HepG 2 cells with Nanog mutation.Results TALENs successfully induced mutation of Nanog gene .The targeting efficiency of mixed cells was analyzed by T7 endonuclease 1 approached 40%after two transfection with plasmid of Nanog -TALENs.Ad-ditionally,the Nanog mRNA expression level of monoclonal HepG 2 with Nanog mutation was downregulated by 3.4 times compared to the wild type HepG 2 cells,and the Nanog protein expression level was downregulated by 3.6 times.The cell cycle related proteins CyclinD1/D3,CyclinE1 and CDK2 expression were downregulated in monoclonal HepG2 with Nanog mutation in comparison to the wild type HepG 2 cells.Conclusion Nanog plays a role in influencing the proliferative ability of HepG 2 cells through modulating the expression of the cell cycle re-lated proteins CyclinD1/D3,CyclinE1 and CDK2.The downregulation expression of Nanog can inhibit the prolif-erative capacity of HepG 2 cells via the regulation of the cell cycle related proteins .