Objective　To explore the characteristics of toxic heavy metal pollution in atmospheric PM2.5 (Particulate matter 2.5) during winter in Nanning City and to evaluate the health risks for the population. Methods　Atmospheric PM2.5 samples were continuously collected in the urban areas of Nanning from January to February 2019. The concentrations of seven toxic heavy metals, including cadmium (Cd), arsenic (As), chromium (Cr), lead (Pb), nickel (Ni), mercury (Hg), and manganese (Mn) in atmospheric PM2.5 were analyzed by X-ray fluorescence spectrometry. The pollution characteristics of toxic heavy metals were studied by geo-accumulation index and enrichment factor methods, and their health risks to children and adults were assessed using the health risk assessment model of the United States Environmental Protection Agency. Results　The mass concentration of atmospheric PM2.5 in Nanning in winter 2019 was (44±29) μg/m3, which was generally at a low level. Different degrees of pollution were found for Hg, Cd, As, Cr, and Pb in PM2.5, with Hg and Cd being more seriously polluted. Hg and Cd were highly enriched in PM2.5, followed by Pb with moderate enrichment. These three elements mainly originated from man-made pollution. As, Cr and Ni were mildly enriched and affected by both natural and anthropogenic sources. The non-carcinogenic risks were in the order of As>Pb>Hg>Cr>Cd>Mn>Ni. The total non-carcinogenic risks for the three populations were all less than 1, which is within acceptable limits. The carcinogenic risks were ranked as Cr>As>Cd>Ni, with Cr, As, and Cd posing carcinogenic risks to children and adults ranging from 1×10-6 to 1×10-4. Moreover, the total carcinogenic risks of heavy metals (Cr, As, Cd, and Ni) were higher than 1×10-4 for children, indicating a potential carcinogenic risk. Conclusions　The mass concentration of PM2.5 and heavy metal elements in Nanning City during the winter of 2019 was relatively low, but the pollution of heavy metals still exists. The non-carcinogenic risk of heavy metals is within an acceptable range, but the carcinogenic risk poses a potential danger to children.

Objective:To investigate the efficacy and safety of endoscopic resection of infratemporal fossa mass and to determine the indications for surgery.Methods:A retrospective case series study was conducted, including a total of 29 patients who underwent endoscopic surgery to treat infratemporal fossa mass in the Department of Rhinology of Beijing Tongren Hospital, Capital Medical University, from April 2008 to December 2021. Ten males and 19 females were included in the study, with age of (46.5±13.7) years. Pre-and post-operative sinus CT, sinus or nasopharyngeal enhanced MRI were evaluated, respectively. The main outcome measurements were the total resection of mass and the incidence of surgery-related complications.Results:Among the 29 cases of infratemporal fossa mass, 22 were schwannomas, 3 were cysts, 2 were neurofibromas, 1 was pleomorphic adenoma and 1 was basal cell adenoma. Preoperative imaging showed well-defined lesion boundaries, and postoperative pathology confirmed the benign nature of all cases. The endoscopic transnasal approach was used in 28 patients, while the combination of the transnasal approach and the transoral approach was used in 1 patient. Complete tumor removal was achieved in all cases with a 100% resection rate. The average follow-up time was 38 months (7-168 months), and no tumor recurrence was observed.Conclusions:The Endoscopic transnasal approach is a safe and effective surgical approach for the treatment of benign tumors or masses in the infratemporal fossa.

Objective:To analyze the efficacy of endoscopic surgery for frontal sinus meningoencephalocele and cerebrospinal fluid (CSF) leaks, and to explore endoscopic surgical strategy.Methods:A total of 35 patients with frontal sinus meningoencephalocele and CSF leaks who underwent endoscopic transnasal surgery at Beijing Tongren Hospital, Capital Medical University between May 2007 and December 2023 were enrolled in this retrospective case series, including 29 males and 6 females, with the age of (35.23±15.76) years. High-resolution sinus CT and magnetic resonance cisternography were undertaken before surgery. The primary outcome measure was the success rate of endoscopic surgical repair. Statistical analysis was conducted using SPSS 27 and GraphPad Prism 8 software.Results:Of the 35 cases, 21 (60.0%) were traumatic, and 14 (40.0%) were non-traumatic. The most common defect was in the posterior frontal sinus wall (24 cases, 68.6%), with a defect size of (10.4±4.8) mm 2. Twenty-six cases (74.3%) underwent endoscopic transnasal Draf Ⅱa-Ⅲ frontal sinusotomy, and 9 cases (25.7%) underwent endoscopic transnasal Darf Ⅱb-Ⅲ frontal sinusotomy combined with frontal trephination. The average follow-up time was (84.72±57.42) months. The success rate of one-time endoscopic repair was 97.1% (34/35). One patient required a second procedure, resulting in an overall success rate of 100%. Thirty-three patients had a widely patent frontal sinus ostium postoperatively, while two experienced stenosis. Conclusions:Endoscopic surgery is effective for treating frontal meningoencephalocele and CSF leaks while preserving frontal sinus drainage. Combined frontal trephination is recommended for defects that are difficult to repair using the conventional transnasal approach.

Humans ; Female ; Breast Neoplasms/pathology* ; Multiomics ; Trastuzumab ; Receptor, ErbB-2/genetics* ; Machine Learning

Parkinson's disease (PD) is one of the hotspots in the research field of neurodegenerative diseases, and its pathogenesis is still controversial. Trace metal elements play an important role in normal growth and development of the human body. Metal ions can cross the blood-brain barrier and enter the brain, leading to α-synapnuclein aggregation, mitochondrial dysfunction, and degeneration of dopaminergic neurons, and then inducing the occurrence of PD. This article mainly reviewed the potential mechanisms of metal elements in PD, discussed the role of metabolic imbalance of common trace metals (copper, iron, manganese, and zinc) in PD, and put forward new insights into the treatment of PD.

Objective:To understand the molecular epidemic characteristics and genes of human astrovirus (HAstV) in infantile diarrhea patients in Jilin province from 2017 to 2020.Methods:Fecal samples of hospitalized infants with diarrhea under 5 years of age from January 2017 to December 2020 were collected. The nucleic acids of fecal samples were amplified by reverse transcription-polymerase chain reaction (RT-PCR), the positive amplification products were sequenced, and the phylogenetic tree was constructed.Results:A total of 2 019 fecal samples were collected, of which 71 were positive for HAstV, with a positive rate of 3.5%. Among the cases with positive samples of HAstV, 42 had mixed infection with other viruses causing diarrhea, accounting for 59.2% of the total number of positive cases, half of which were mixed infection with rotavirus and HAstV. From 2017 to 2020, the positive rates of HAstV were 4.69%, 1.98%, 5.93% and 0.43% per year, respectively. There were two epidemic peaks every year and one epidemic peak year every two years. The positive rate of 36-47 months old was the highest, followed by 0-2 months old. A total of 55 sequences were obtained in this study. Phylogenetic tree analysis showed that they all belonged to classical HAstV, including 42 HAstV-1a subtypes, 8 HAstV-1b subtypes and 5 HAstV-5 subtypes.Conclusions:HAstV is one of the important pathogens of diarrhea in children under 5 years of age in Jilin province. The epidemic law has obvious seasonal and age differences. The dominant strain is HAstV-1a.

Objective:To investigate the longitudinal changes and influencing factors of out-of-hospital functional exercise compliance in patients with lumbar disc herniation treated conservatively based on patient-based compliance curve (PBCC) .Methods:From April to September 2020, the convenient sampling method was used to select 88 patients with lumbar disc herniation treated conservatively in Hangzhou Hospital of Traditional Chinese Medicine as the research objects. The score of out-of-hospital functional exercise compliance questionnaire of patients with lumbar disc herniation was measured from the time of discharge, once every 2 weeks, and the PBCC of functional exercise was drawn after continuous measurement to the 24th week , taking time as independent variable ( x) and functional exercise compliance index as dependent variable ( y) . Univariate and multiple linear regression analyses were used to explore the influencing factors of 24-week compliance index. A total of 88 questionnaires were distributed, among which 3 patients withdrew due to surgery and 11 patients were lost to follow-up. A total of 74 valid questionnaires were finally recovered, with an effective recovery rate of 84.09% (74/88) . Results:Within 24 weeks of discharge, the PBCC formula of the total functional exercise score of patients was y=0.005 x3-0.196 x2+1.436 x+59.197 ( R2=0.898, F=26.517, P<0.01) . The PBCC formula of physical exercise was y=0.008 x3-0.337 x2+3.616 x+56.153 ( R2=0.878, F=21.570, P<0.01) . The formula of exercise effect supervision PBCC was y=-0.006 x3+0.309 x2-5.315 x+76.371 ( R2=0.910, F=30.458, P<0.01) . The PBCC formula of actively seeking advice was y=0.012 x3-0.460 x2+3.931 x+44.071 ( R2=0.865, F=19.217, P<0.01) . Except for the PBCC of effect supervision, the changes of other PBCC showed a trend of first increasing and then decreasing. The average compliance index in 24 weeks was (57.73±8.20) , the high peak appeared in the 4th week and the index was (64.08±8.91) . The low peak appeared in the 18th week and the index was (52.42±7.81) . The results of univariate analysis showed that there were statistically significant differences in the compliance level of rehabilitation exercise in patients with lumbar protrusion in different age, education level, course of lumbar protrusion, pain degree, accompanying symptoms, functional exercise methods and disease knowledge ( P<0.05) . The results of multiple linear regression analysis showed that the main influencing factors of functional exercise compliance of patients were disease knowledge, pain degree, course of lumbar protrusion and functional exercise method ( P<0.05) . Conclusions:The functional exercise compliance of lumbar disc herniation patients shows a horizontal "S" -like dynamic change. During the period of decreased compliance, regular rehabilitation guidance and health education, pain management and prevention of recurrence are necessary measures to improve functional exercise compliance of patients.

Objective:To investigate the therapeutic effect and signaling pathway of ginsenoside Rb1 on myocardial injury in mice with Kawasaki disease.Methods:BALB/C mice aged 5-6 weeks were randomly divided into control group, model group, aspirin group, ginsenoside Rb1 low dose group(50 mg/kg) and high dose group(100 mg/kg), with 12 mice in each group.Except the control group, other groups were treated with intermittent intraperitoneal injection of 10% bovine serum albumin saline solution to induce Kawasaki disease myocardial injury pathological model with a total of 6 days(twice a day); aspirin group, Rb1 low and high-dose group were given corresponding drugs by gavage for 20 days after modeling.The pathological changes of myocardial tissue were observed by hematoxylin eosin staining.The levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6) and cardiac troponin I(cTnI) in serum and myocardial tissue were detected by ELISA.The activities of creatine kinase(CK), creatine kinase isoenzyme(CK-MB), lactate dehydrogenase(LDH), α-hydroxybutyrate dehydrogenase(α-HBDH) and aspartate aminotransferase(AST) in serum were detected by enzyme coupling method.The expression levels of janus kinase 2/signal transducer and activator of transcription 3(JAK2/STAT3) signaling pathway related proteins in myocardial tissue were detected by Western blot.Results:High dose of Rb1 significantly improved myocardial fiber rupture and tear, inflammatory infiltration and necrosis induced by myocardial injury in model group.ELISA results showed that, compared with the model group, high-dose Rb1 could significantly inhibit the high expression of tumor necrosis factor-α, interleukin-1β, interleukin-6, which were restored to the level of the control group, and there was a dose-dependent relationship between the low and high-dose groups( P<0.05). The results of enzyme coupling method showed that creatine kinase, creatine kinase isoenzyme-MB, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase, and aspartate aminotrasferase in Rb1 high-dose group were restored to the level in control group, and there was a dose-dependent relationship between low and high-dose group( P<0.05). At the same time, compared with model group, Rb1 high-dose group significantly down regulated the expression level of cardiac troponin I( P<0.05). Western blot results showed that, compared with the model group, Rb1 significantly increased the relative expression levels of p-JAK2/JAK2, p-STAT3/STAT3 and B-cell lymphoma-2(Bcl-2)/β-actin, and significantly decreased the expression levels of Cleaved caspase-3/β-actin in a dose-dependent manner( P<0.05). Conclusion:Ginsenoside Rb1 can effectively reduce the myocardial injury induced by Kawasaki disease mice.The high-dose group of Rb1 can recover to the level of the control group, and the curative effect is related to the dosage of Rb1.Ginsenoside Rb1 may activate JAK2/STAT3/Bcl-2 signaling pathway, thus down regulate the expression of Cleaved caspase-3, and inhibit cardiomyocyte apoptosis and inflammation.

Objective: To investigate effects of personal innovation behaviors, self-efficacy and colleague solidarity of nurses on career success, and to provide the basis for career planning and management of clinical nurses. Methods: A total of 441 registered nurses from eight grade three and first-class hospitals in Tianjin were measured with personal innovation behaviors scale, self-efficacy scale, colleague solidarity of nurses' scale and career success scale. Results: The total score of personal innovation behavior was (21.58±4.81). The total score of self-efficacy was (27.68±6.53). The total score of colleague solidarity of nurses was (95.12±9.42). The total score of career success was (35.75±9.27). The personal innovation behaviors, self-efficacy, colleague solidarity of nurses career success and each dimension showed positive correlation(r=0.115-0.915, P<0.05). Multiple linear regression analysis showed that innovation behaviors, self-efficacy and academic solidarity entered career success regression equation(β=0.090-0.554, P<0.05), and explained 49.7% of the total variation.Path analysis model showed innovative behavior, self-efficacy and colleague solidarity of nurses were positively predictive of career success, and the path coefficients were 0.62, 0.18 and 0.12.Hierarchical regression analysis showed both self-efficacy and colleague solidarity of nurses played mediating roles between innovative behavior and career success(β=0.207-0.104, P<0.05). Conclusion Hospital managers should take measures to improve nurses' innovative behavior, self-efficacy and colleague solidarity of nurses to promote their career success.

Objective: To investigate the effect of H-uvulopalatopharyngoplasty(H-UPPP) combined with tongue base radiofrequency ablation in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS). Methods: Sixty-two patients with moderate or severe OSAHS, whose obstructive plane located in the oropharynx and tongue base were divided into two groups two groups according to the patient′s independent choice under the condition of fully informed before the operation. The control group of 30 cases underwent H-UPPP, while the experimental group of 32 patients underwent improved H-UPPP and tongue base radiofrequency. The clinical efficacy between the two groups was compared. Results: There was no significant difference between the two groups before operation. After the operation, the total effective rate of the experimental group was 71.9%, significantly higher than that of the control group (46.7%, χ²=4.09, P<0.05), the difference was statistically significant. After operation, in the control group, AHI was (19.4±8.1)/h, LSaO₂ was 0.767±0.052. In the experimental group, AHI was (17.8±7.8)/h, LSaO₂ was 0.790±0.059. There was significant difference in both groups before and after surgery (P<0.001), with statistical significance. In the experimental group, after operation, the minimum diameter of oropharyngeal cavity was (10.6±2.4) mm, there was obvious increase compared with the diameter of oropharyngeal cavity (9.9±2.2) mm before operation, the difference was statistically significant (t=2.64, P<0.05). In the control group, after operation, the minimum diameter of oropharyngeal cavity was(10.0±2.4) mm, there was no obvious increase compared with the diameter of oropharyngeal cavity (9.9±2.5) mm before operation, the difference was not statistically significant (P>0.05). Compared between control group and experimental group, the differences of AHI, LSaO₂, the minimum anteroposterior diameter of oropharyngeal cavity before and after operation were not statistically significant (P>0.05). Conclusion The effect of same time H-UPPP and radiofrequency ablation surgery is definitive.