Background The high work intensity and possible subsequently increased susceptibility to occupational hazards of calcium carbide plants may lead to hypertension in workers, but there are few studies on the relationship between occupational hazard exposure and hypertension in workers involving the production process of calcium carbide. Objective To explore the influence of occupational hazards on the incidence of hypertension in calcium carbide plants. Methods Using historical cohort design, the employees of a calcium carbide factory in the western part of Inner Mongolia Autonomous Region were selected as research subjects. According to the pre-determined inclusion and exclusion criteria, the study population comprised an exposure group of 377 employees (including furnace workers, inspection workers, and maintenance workers) exposed to dust, noise & carbon monoxide, and a control group of 388 employees (including central control workers, electricians, and administrative personnel) without above-mentioned exposure. The total sample size was 765 participants. The follow-up period was from April 2011 to October 2022, and the study endpoint was defined as the conclusion of the follow-up period or diagnosed hypertension in annual occupational health examination. Information on general demographic characteristics, living habits, and work status was collected from all study subjects. Cox proportional hazards regression model was used to analyze the association between occupational hazard exposure and the risk of hypertension among the calcium carbide plant employees. Results The average age, mean systolic and diastolic blood pressure, proportion of males, smoking rate, and alcohol consumption rate in the exposure group were higher than those in the control group (P<0.05). Compared to baseline, both systolic and diastolic blood pressure levels increased in the exposure group and the control group at the end of the follow-up (P<0.05). At the end of the follow-up, the average differences between systolic/ diastolic blood pressure and baseline values in the exposure group were higher than those in the control group (P<0.05). During the follow-up period, a total of 223 cases of hypertension occurred, with a total follow-up of 2785 person-years, resulting in an incidence density of 8007.18 per 100000 person-years, an average age of onset of (35.90±8.22) years, and an average working age of onset of (2.69±1.97) years. The incidence density in the exposure group was 128.71% higher than that in the control group, and the risk of hypertension in the exposure group was 2.115 times that of the control group. The risk of hypertension was 2.199 times higher for men than for women, 1.344 times higher for those aged 30 and above than for those under 30, 1.546 times higher for smokers than for non-smokers, and 1.750 times higher for drinking workers than for non-drinking ones. The results of Cox proportional hazards regression modeling indicated that the hazard ratio (95%CI) of hypertension among the employees exposed to dust, noise, and carbon monoxide was 2.254 (1.703, 2.982), 1.594 (1.107, 2.295), and 1.567 (1.079, 2.274), respectively, when different covariates (gender, age, smoking, and alcohol consumption) were included. The results of Log-rank test showed that there were statistically significant differences in the distribution of disease-free survival between the exposure group and the control group (P<0.05). Conclusion Occupational exposures to dust, noise, and carbon monoxide may increase the risk of hypertension among calcium carbide plant workers.

Objective:To measure the retinal structural and functional parameters of adult Macaca fascicularis, and explore the similarity of the retinal structural and functional parameters between non-human primates and normal human retinas.Methods:Six eyes of 3 5-year-old adult Macaca fascicularis were examined by in vivo detection including color fundus photography, retinal optical coherence tomography (OCT) and electroretinogram (ERG) to determine the thickness of the inner/outer retina at the fovea and 1 000/2 000 μm away from the nasal, temporal, superior and inferior regions of the fovea, the thickness of the retinal nerve fiber layer (RNFL), the area of optic disc, the area of optic cup, the area ratio of cup to disc and the biological parameters of flash ERG.Differences in the above parameters between left and right eyes were analyzed.The similarity of parameters between Macaca fascicularis and human was compared with reference to published literature.The use and care of animals complied with the Regulation on the Management of Experimental Animals.The study protocol was approved by the Institutional Animal Care and Use Committee of Hubei Topgene Biotechnology (NO.IACUC-2019-012). Results:The foveal thickness, optic disc area, cup-disc area ratio, and average RNFL thickness in normal adult Macaca fascicularis were (252.31±4.79)μm, (1.89±0.05)mm 2, 0.14±0.01, and (103.53±0.58)μm, respectively.The b-wave amplitude of dark-adapted 0.01 ERG was (66.75±7.29)μV.The a- and b-wave amplitudes of dark-adapted 3.0 ERG response were (57.15±15.01) and (122.10±25.51)μV, respectively.The a- and b-wave amplitudes, the amplitude of oscillation potentials, and the latency of dark-adapted 10.0 ERG response were (72.98±20.14)μV, (131.67±13.78)μV, (49.98±10.08)μV, and (30.02±5.76)ms, respectively.The a- and b-wave amplitudes of light-adapted 3.0 ERG were (9.16±2.75) and (40.43±5.57)μV, respectively.The latency and the amplitude of the light-adapted 30 Hz flicker was (26.61±1.19)ms and (24.72±5.10)μV, respectively.There was no significant difference in the parameters between left and right eyes (all at P>0.05). The retinal thickness in central fovea, mean RNFL thickness, waveform and amplitude of ERG of Macaca fascicularis were similar to normal human. Conclusions:The structure and function of the retina of adult Macaca fascicularis are similar to those of normal humans.As a laboratory animal for preclinical drug research, in vivo studies of Macaca fascicularis can refer to normal human retinal parameters.

Dementia in traditional Chinese medicine （TCM） mainly presents amnesia and dullness. Alzheimer's disease and vascular dementia belong to the category of dementia in TCM. These progressive neurological diseases have a complex etiology and a long course， and the drugs that can reverse the disease course remain to be developed. Therefore， early intervention plays a vital role in delaying the disease progression. Apathy refers to a lack of motivation that leads to the attenuation or disappearance of goal-directed behaviors， cognitive functions， and emotional responses. Clinical studies have suggested that apathy exists in the early stage of a variety of neurodegenerative diseases， being one of the key symptoms to the early diagnosis of dementia. The severity of apathy is related to the severity of dementia. Therefore， early diagnosis and treatment of apathy are of great significance to the prevention and treatment of dementia. The preclinical research on apathy in dementia is still in its infancy， and the systematic evaluation method has not been prescribed. The clinical diagnosis and treatment are also in the exploratory stage， and the complex pathophysiological mechanisms of apathy and dementia development have not been fully elucidated. This article reviews the research progress of apathy in dementia， the apathetic behaviors of dementia animal models， the behaviors of patients with apathy， and the treatment methods in recent years and summarizes the research status of apathy in dementia. This review aims to provide a theoretical basis for exploring the behavior of apathy in dementia and conducting preclinical research and evaluation of the pathogenesis and to lay a foundation for the treatment of apathy in dementia.

Objective To investigate the impact of healthy eating patterns on the mortality rate and in-cidence rates of end-stage kidney disease(ESKD)and cardiovascular disease(CVD)in the patients with chronic kidney disease(CKD)by meta analysis.Methods The studies on the relationship between the dietary patterns on the mortality,and the incidence rates of ESKD and CVD in the patients with CKD were retrieved from PubMed,Embase,Cochrane Library,CNKI,Wanfang Database and VIP Database.The retrieval time was from the database establishment to January 2023.The two researchers independently screened the literatures,ex-tracted the data and conducted the literature quality evaluation.The RevMan5.3 software was used for the meta-analysis of the included literatures.Results A total of 10 studies were included in this study,involving 27 291 patients.The results showed that the mortality(HR=0.70,95％CI:0.57-0.87,Z=3.18,P=0.001)and the ESKD incidence rate(HR=0.80,95％CI:0.71-0.91,Z=3.44,P＜0.001)and CVD inci-dence rate(HR=0.77;95％CI:0.61-0.97,Z=2.21,P=0.003)had statistical differences between the pa-tients with high dietary score and the patients with low dietary score.Conclusion Persisting in the healthy dieta-ry patterns could decrease the mortality rate,and incidence rates of ESKD and CVD in the patients with CKD.

Head and neck malignant tumor is one of the most heterogeneous diseases.The multi-disciplinary team(MDT)is an essen-tial component for personal precise diagnosis,treatment and integrated care management of oncologic diseases including head and neck malignant tumor.MDT clinical practice is also an important teaching mode for head and neck malignant tumors,but it is limited by time and space in actual teaching.An internet visualization platform was constructed based on the Internet,hospital HIS/PACS/LIS/EMR system,medical visualization screen,oral endoscope,remote consultation platform and other accessible audio and video terminals,and has been applied in MDT clinical teaching of head and neck malignant tumors,allowing medical students to participate in MDT through a networked visualization platform.Medical students will achieve deep learning for the most heterogeneous malignant tumor.MDT sup-ported by the internet visualization platform provides a new pathway for clinical medical education.

Objective To Explore the feasibility and value of deep learning technology for quality control of echocardiography images.Methods A total of 180985 echocardiography images collected from Sichuan Provin-cial People's Hospital between 2015 and 2022 were selected to establish the experimental dataset.Two task models of the echocardiography standard views quality assessment method were trained,including intelligent recognition of seven types of views(six standard views and other views)and quality scoring of six standard views.The predictions of the models on the test set were compared with the results of the sonographer's annotation to assess the accuracy,feasibility,and timeliness of the runs of the two models.Results The overall classification accuracy of the stan-dard views recognition model was 98.90%,the precision was 98.17%,the recall was 98.18%and the F1 value was 98.17%,with the classification results close to the expert recognition level;the average PLCC of the six standard views quality scoring models was 0.933,the average SROCC was 0.929,the average RMSE was 7.95 and the average MAE was 4.83,and the prediction results were in strong agreement with the expert scores.The single-frame inference time after deployment on the 3090 GPU was less than 20 ms,meeting real-time requirements.Conclusion The echocardiography standard views quality assessment method can provide objective and accurate quality assessment results,promoting the development of echocardiography image quality control management towards real-time,objective,and intelligent.

Schimke immuno-osseous dysplasia (SIOD)caused by SMARCAL1 gene mutations is a rare genetic disorder characterized by multi-system involvement, including T-cell dysfunction, skeletal dysplasia, disproportionate short stature, nephrotic syndrome, and kidney failure. This multidisciplinary consultation involved a 9-year-old boy with intrauterine growth retardation, presenting with short stature, T-cell lymphopenia, proteinuria, and degenerative bone and joint disease. Treatment primarily focused on symptomatic and supportive care. Through the multidisciplinary rare disease consultation, holistic support was provided to the patient, offering comprehensive care from various specialtiesx.We also aim to use this case report to enhance clinicians′ under-standing of SIOD and improve the management and treatment of rare diseases.

Objective:To explore the molecular mechanism of NF-κB signaling pathway mediated by MCP-1/CCR2 axis in the migra-tion of dental pulp stem cells(DPSCs)stemulated by inflamation factor.Methods:DPSCs of SD rats were in vitro cultured,and identified by flow cytometry.The inflammation model of DPSCs was established by LPS treatment,Western blot and Q-PCR were used to detect the expression of MCP-1 and CCR2 in DPSCs of the groups.The inflamatory DPSCs were treated by NF-κB pathway activator TNF-α and NF-κB pathway inhibitor BMS-345541 respectively,the activation of P65 in inflammatory DPSCs was detected by immuno-fluorescence.Scratch experiment was used to detect the migration ability of DPSCs.Results:Higher expression of MCP-1 and CCR2 genes was observed in LPS-induced DPSCs than in the controls,TNF-α treated DPSCs showed higher expression of MCP-1 and CCR2 genes than the LPS tread and the NF-κB pathway inhibitor BMS-345541 treated cells.TNF-α treated DPSCs showed higher scratch healing effect than LPS treated and BMS-345541 treated cells.Conclusion:The expression of MCP-1 and CCR2 genes in DPSCs is higher in inflammatory state,and the activation of NF-κB signaling pathway can enhance this expression,which can ultimately promote the migration ability of DPSCs in inflammatory state.

Objective To observe clinical and imaging findings of Kaposiform hemangioendothelioma(KHE)involved bone.Methods Data of 10 children with KHE involved bone diagnosed by surgery or biopsy pathology who underwent X-ray and non-contrast CT examination of the lesion site were retrospectively analyzed,among them 3 received enhanced CT and 9 received non-contrast MR examination.Clinical and imaging findings were observed,and the lesions were classified into type Ⅰ(confined to only bone)and type Ⅱ(involved both bone and surrounding soft tissue)according to CT findings.Results Single bone involvement was detected in 7 cases(7/10,70.00％),while multiple bone involvements were noticed in 3 cases(3/10,30.00％).CT type Ⅰ and Ⅱ were identified each in 5 cases.The median age of onset was 88.0 months,and the median course of disease was 4.0 months in type Ⅰ,all involved single bone,and the main clinical manifestations were pain but without Kasabach-Merritt phenomenon(KMP).The median age of onset was 5.0 months and the median course of disease was 1.0 months in type Ⅱ,including 3(3/5,60.00％)cases of multiple bone involvements,with swelling and limited movement of the lesion site,and KMP was observed in 2 cases(2/5,40.00％).X-ray shown most of the lesions with uneven bone density(8/10,80.00％)or lamellar low density(1/10,10.00％),while no obvious abnormality was found in 1 case(1/10,10.00％).On non-contrast CT,all affected bones in 10 cases present as worm erosion or osteolytic bone destruction,which could be accompanied by peripheral bone hyperplasia and sclerosis(8/10,80.00％),while significantly enhancement occurred in 2 cases with type Ⅱ lesion(2/3)on enhanced CT,while no obvious enhancement was found in 1 case with type Ⅰ lesion(1/3).Soft tissue involvement presented in 5 cases(5/10,50.00％),with borderless diffuse slightly low-density,including 2 cases of lesions significantly enhanced after enhancement.Non-contrast MRI showed that the affected bone presented equal T1 or slightly lower T1,mixed T2 or slightly higher T2 signal,while the affected soft tissue were found with equal T1 and slightly higher T2 signal.Conclusion Clinical and imaging findings of KHE involved bone had certain characteristics.

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.