[Objective] To evaluate the clinical efficacy and safety of different chemotherapeutic regimens combined with sintilimab as first-line treatment for Her-2 negative advanced gastric cancer. [Methods] We retrospectively collected the clinical data of patients with Her-2 negative advanced gastric cancer treated with albumin-bound paclitaxel plus S-1 combined with sintilimab (n=40) and oxaliplatin plus S-1 combined with sintilimab (n=36) at The Affiliated Hospital of Xuzhou Medical University from September 1, 2021 to July 1, 2023. The clinical efficacy and adverse reactions were evaluated separately in patients treated with albumin-bound paclitaxel plus S-1 combined with sintilimab and in those treated with oxaliplatin plus S-1 combined with sintilimab. Factor analysis was made on two sets of clinical data separately. [Results] The objective response rate (ORR) of albumin-bound paclitaxel group and oxaliplatin group was 57.5% and 52.8%, respectively. The disease control rate (DCR) of albumin-bound paclitaxel group and oxaliplatin group was 85.0% and 80.6%, respectively. The median progression-free survival (PFS) of patients in albumin-bound paclitaxel group and oxaliplatin group was 8.3 months and 9.0 months. The incidence of adverse reactions in albumin-bound paclitaxe group was 87.5% (35/40), and that in the oxaliplatin group was 91.7% (33/36). Factor analysis of the clinical data of albumin-bound paclitaxel group and oxaliplatin group revealed that liver metastasis was an independent risk factor for PFS. [Conclusion] Both albumin-bound paclitaxel combined with S-1 and sintilimab, and oxaliplatin combined with S-1 and sintilimab show promising efficacy and manageable side effects when used as first-line treatment for Her-2 negative advanced gastric cancer.

Objective:To explore the construction and application of the multi-course evaluation system of Pathogen Biology and Immunology under the mode of online and offline mixed teaching.Methods:A total of 104 students from two classes of clinical major of Grade 2022 in Quanzhou Medical College were studied,and combined online and offline teaching mode was adopted for teaching.A curriculum evaluation system was constructed,including process evaluation,assessment evaluation and summative evaluation.Self-efficacy,self-learning ability,course questionnaire and other aspects were statistically analyzed before and after the course.Results:The students'normal grades could be reflected objectively by the new curriculum assessment and evaluation system.The final compre-hensive grades were better,and the course passing rate was higher.The paired t-test analysis demonstrated statistically significant improvements in students'learning motivation,learning management,and self-efficacy after the course(P<0.05).However,the differ-ences in information literacy and cooperation ability were not statistically significant compared with those before the course(P>0.05).Course questionnaire survey found that 89.4%students had a high evaluation of the new course evaluation system,which was condu-cive to promoting learning.Conclusion:The newly constructed curriculum assessment system is more scientific and reasonable,which is conducive to improving students'self-efficacy and autonomous learning ability,and promoting students'learning.

Background The converter stations of high-voltage direct current (HVDC) transmission lines generate special total electric fields. At present, few investigations have been conducted on total electric fields in the workplace of converter stations from an perspective of occupational health. Objective To understand the current situation of total electric field strength in the workplace of converter stations. Methods Using purposive sampling, a calibrated HDEM-1 direct current (DC) total electric field strength measurement system was used to measure the total electric fields of 12 converter stations serving 6 DC lines in Southeast and Southwest China according to the Measurement method for total electric field strength and ion current density of the converter stations and DC transmission lines (DL/T 1089—2008). The results were evaluated according to occupational exposure limits recommended by The limits of electromagnetic environment at ±800 kV UHV DC converter station (DL/T 275—2012), the American Conference of Governmental Industrial Hygienists (ACGIH), and the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Results A total of 615 check points were planned, the total electric field strength was 0.05-37.05 kV·m⁻¹, and the median was 10.45 kV·m⁻¹. The total electric field strength of 39 check points (6.3%) exceeded 25 kV·m⁻¹ (the limits of ACGIH and ICNIRP), and the total electric field strength of 12 check points (2.0%) exceeded 30 kV·m⁻¹ (the limit of DL/T 275—2012). There were statistically significant differences in the total electric field strength values and the proportions of exceeding 25 kV·m⁻¹ between the neutral regions and the positive regions and between the neutral regions and the negative regions (P < 0.01). The proportion of total electric field strength exceeding 30 kV·m⁻¹ in the negative regions was higher than that in the positive regions (P < 0.01). There were no significant differences in the total electric field strength of converter stations at different voltage levels and different altitudes (P > 0.05). There were no significant differences in the proportions of total electric field exceeding 25 kV·m⁻¹ and exceeding 30 kV·m⁻¹ in converter stations at different voltage levels and different altitudes (P > 0.05). Conclusion The total electric field in some workplace of converter stations exceeds selected limits. Converter station operators may be exposed to high-strength total electric field for a short time.

Objective: To analyze the current status of work-related musculoskeletal disorders (WMSDs), work fatigue and musculoskeletal pain in Chinese occupational population, and to study the relationship between work fatigue and musculoskeletal pain and WMSDs. Methods: A total of 66 961 employees from 323 enterprises in 15 key industries in China were selected as the study subjects using stratified cluster sampling method. The incidence of WMSDs in the past year was investigated using the Chinese version of the Musculoskeletal Disorders Questionnaire, and the work fatigue and musculoskeletal pain were investigated using Borg 6-20 Rating of Perceived Exertion Scale and visual analogue scale. The data were standardized using the age composition data of 18 to 60 years from the seventh national population census. Results: The standardized annual incidence of WMSDs was higher in the front-line workers than that in the administrative and other supportive staff (38.82% vs 36.30%). The detection rates of work fatigue and musculoskeletal pain in the study subjects were 44.54% and 63.08%, respectively. The result of S-curve fitting showed that the risk of WMSDs increased with the level of work fatigue (P<0.01). Among the front-line workers, the average of monthly fatigue frequency in the neck, shoulder, lower back, upper back, wrist/hand, foot and ankle, knee, leg, and elbow were higher in the group with WMSDs compared to those without WMSDs (all P<0.01). The pain degree of musculoskeletal pain was higher in all nine sites in the fatigued group than in the no-fatigue group (all P<0.01). The standardized detection rate of musculoskeletal pain was higher in the fatigued group than in the non-fatigued group (80.38% vs 25.71%). The work fatigue was moderate and positively correlated with musculoskeletal pain in all seven sites except the lower back and elbow, with Kendall Tau-b correlation coefficients ranging from 0.423 to 0.546 (all P<0.01). Conclusion: There is a good correlation between work fatigue and local musculoskeletal pain, work fatigue and WMSDs in Chinese occupational population. Implementing ergonomic interventions to control the development of work fatigue can be an effective measure for preventing WMSDs.

Objective: To analyze the status of noise hazard in workplace of key industries in Guangdong Province. Methods: A total of 1 061 enterprises from 14 key industries in 21 prefecture-level cities in Guangdong Province were selected as the research subjects using stratified sampling method. The occupational health survey was carried out, and the noise intensity in the workplace was detected. Results: There were 12 606 workplaces and 5 570 work sites involved among 1 061 enterprises. The median and the 0-100th percentile value ［M (P₀-P₁₀₀)］ of noise intensity in workplace were 82.6 (46.5-112.6) dB(A), and 35.03% of the workplace exceeded the national noise intensity standard. The regions and industry with the highest rate of noise exceeded the national noise intensity standard in workplace were in the northern part of Guangdong and the stone processing industry respectively. The M (P₀-P₁₀₀) of noise intensity in the work sites was 83.7 (47.5-106.2) dB(A), and 36.00% of the work sites exceeded the national noise intensity standard. The regions and industry with the highest rate of noise exceeded the national noise intensity standard in work sites were in the Pearl River Delta region and the ferrous metal mining and dressing industry respectively. The rate of noise protection facilities setting was 66.45%, and the validity of personal protection was 61.73%. The occupational medical examination was performed in 73.24% of the research subjects, and 3.25% of the result was abnormal. The industry with the highest occupational medical examination rate was nonferrous metal smelting and rolling processing, and the industry with the highest abnormal rate of occupational medical examination was stone processing industry. Conclusion: Noise hazards in workplaces of key industries in Guangdong Province are relatively severe, necessitating strengthened supervision and management, noise control measures, and efforts to reduce noise exposure levels in workplaces and work sites.

Objective:To investigate the effects of long-term high-fat diet on bone mineral density and intestinal flora in mice.Methods:Sixteen male C57BL/6 mice were randomly divided into control group (NC group) and high-fat group (HF group). After 24 weeks of high-fat feeding, biochemical indicators such as blood glucose and blood lipids were detected, bilateral femurs were taken and bone microstructure was analyzed with micro-computered tomography (micro-CT), and changes of intestinal microbial composition and proportion were revealed using 16S rDNA sequencing technology.Results:Compared with the control group, the serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in HF group were significantly increased. Micro-CT uncovered that the bone mineral density (Tb.BMD), bone volume fraction (BV/TV) and the number of trabecular bone (Tb.N) decreased, yet structural model index (SMI) and the trabecular fraction (Tb.Sp) increased in the HF group mice. The gut microbiota 16S rDNA sequence analysis showed that the proportion of Proteobacter was significantly increased and the proportions of pachycete, warty microbacterius, and actinomycete were reduced in HF group at the phyla level. The proportion of Bacteroidetes S24-7_norank in the NC group was significantly higher than that in the HF group, and the multilevel discriminant analysis of species differences (LEfSe) identified that the difference was significant, yet the proportion of Bacteroides, Pseudo-Prevotella, Desulfovibrio, Altobacter, and Helicobacter in the HF group were higher than those in the NC group, which were significant differences in Altobacter and Helicobacter at genus level.Conclusion:Long-term high-fat feeding can cause the destruction of femoral trabecular structure, decrease in the number of trabeculus bones, and bone mineral density in C57BL/6 mice. It also leads to significant changes in the composition and proportion of the intestinal flora.

Relying on the practice platform of P2 laboratory, researchers reform and explore the contents and forms of experimental teaching for pathogenic biology and immunology, creating an innovative experimental teaching system suitable for training medical students' professional quality and innovative ability. By improving teaching conditions (construction of P2 laboratory), improving teaching methods and innovating experimental teaching contents, and introducing comprehensive design experiment, students' consciousnesses of service and biosafety have been strengthened, meanwhile, their ability to analyze and solve problems has been improved, and their critical and creative thinking has been cultivated.

OBJECTIVE: To determine the prevalence and influencing factors of work-related musculoskeletal disorders(WMSDs) among workers in a shipyard. METHODS: A total of 496 workers in a large shipyard in Guangdong Province were selected as research subjects using the convenient sampling method. The Questionnaire of Musculoskeletal Disorders was used to investigate the prevalence of WMSDs in various regions of the body in the past year.Multivariate logistic regression was used to analyze the potential influencing factors of WMSDs in the frequently affected body parts. RESULTS: The prevalence of WMSDs was 70.2%(348/496). The prevalence rates of WMSDs in different body regions were: lower back/waist(43.1%), neck(29.4%), shoulder(29.0%), hand/wrist(25.4%), knee(22.4%), hip/leg(14.3%), ankle/foot(12.1%), upper back(11.3%) and elbow(9.3%). Multivariate logistic regression analysis results showed that increased risk of lower back/waist WMSDs occurred in workers who carry heavy objects>5.0 kg, who work in uncomfortable positions, who repeatedly perform the same work every day, and who repeatedly perform the same action using the lower limbs and ankles(P<0.05). Employees working ≤8 hours or more than 8 hours per day had higher risk of developing lower back/waist WMSDs compared with workers working 8-10 hours per day(P<0.05). CONCLUSION: The prevalence of WMSDs among workers in the shipyard is high.The lower back/waist WMSD is the most common one. The influencing factors include work organization and adverse ergonomic factors.

OBJECTIVE: To analyze the influence of noise measuring skills by continuous inter-laboratory comparison among occupational hygiene technical service organizations. METHODS: The results of 68, 55 and 50 occupational hygiene technical service organizations(reference organizations) participating in the inter-laboratory comparison of workplace noise measurement in 2014, 2017 and 2018 respectively were collected. The measurement operation and the calculation of equivalent sound level were evaluated according to the GBZ/T 189.8-2007 Measurement of Physical Agents in Workplace--Part 8: Noise.The measured results were analyzed by z score evaluation method. RESULTS: The results of noise measurement field operation of the reference organizations in the year 2014, 2017 and 2018 show that the accuracy rates of instrument setting was 89.7%, 98.2% and 100.0%, the accuracy rates of measuring position were 52.9%, 81.8% and 94.0%, the accuracy rates of sound level meter holding were 54.4%, 80.0% and 92.0%, the accuracy rates of microphone pointing were 98.5%, 98.2% and 94.0%, and the accuracy rates of noise type recognition were 83.8%, 92.7% and 84.0%, respectively. Among them, the accuracy of instrument setting, measurement position and sound level meter holding showed an increasing trend year by year(P<0.01). The pass rates of measurement results were 91.2%, 94.5% and 88.0% in 2014, 2017 and 2018 respectively. The pass rates of equivalent sound level calculation were 73.5%, 92.7% and 88.0%. The pass rates of comprehensive evaluation were 70.6%, 89.1% and 80.0% respectively. Among them, the pass rates of equivalent sound level calculation and comprehensive evaluation in 2017 were higher than that in 2014(P<0.017). There was no significant difference in the three-year comprehensive assessment total pass rate between private organizations and non-private organizations(84.0 % vs 75.5%, P>0.05). There was no significant difference in the total pass rate of three-year comprehensive evaluation between non-Pearl-River-Delta organizations and Pearl-River-Delta organizations(70.3% vs 81.6%, P>0.05). CONCLUSION: Continuous inter-laboratory comparison in occupational hygiene technical service organizations is beneficial to improve on-site noise measure capability.

OBJECTIVE: To analyze the characteristics of noise hazard in a nuclear power station. METHODS: The workplaces and working posts which exposed to occupational noise from two 1 000 MW power units in one nuclear power station in Guangdong Province was selected as study subjects using the convenience sampling method. Occupational health survey, noise measurement in the workplace and personal noise dosage measurement were used to monitor noise exposure, and to analyze the characteristics of occupational noise in the nuclear power station. RESULTS: The noise sources of the nuclear power plant were mainly distributed in the nuclear island, conventional island, and peripheral workshops. A total of 237 points of noise intensity were measured in the workplace. The intensity of noise ranged from 66.0 to 99.6 dB(A). The noise intensity in 62.4%(148/237) of points was equal or greater than 80.0 dB(A) and 34.2%(81/237) equal or greater than 85.0 dB(A). The percentage of detection points with noise intensity was equal or greater than 85.0 dB(A) from low to high were nuclear island, conventional island, and peripheral workshops with 22.0%, 37.5% and 53.8% respectively(P<0.01). The personal noise intensity of three positions including inspectors of operation department, preparation and main engine positions of mechanical department exceeded the occupational exposure limit(OEL), and the percentage of positions whose noise intensity exceeded the OEL was 9.7%(3/31). CONCLUSION: High-intensity noise sources of the nuclear power plant are widely distributed in the workshop areas of nuclear island, conventional island, and peripheral workshops. The noise level of some positions exceeded the standards of noise intensity. The prevention and control measures of noise hazards in posts with excessive noise should be strengthened.