The trinity of physique-qi-spirit is a view of life in traditional Chinese medicine （TCM） that integrates both theoretical interpretation and technical operation. Its connotation includes two aspects， the three elements of physique， qi， and spirit composing human life， and these three elements exist as an inseparable unity. Based on the concept of the trinity of physique-qi-spirit， this article explores three key points from the technical operation level， defining "qi" as an intangible， non-physical substance； briefly analyzing the mechanism of the trinity of physique-qi-spirit from the perspective of qi theory； and discussing the state of life optimization achieved through their integration. Understanding the connotation of the trinity of physique-qi-spirit from a technical operation level helps to maximize its unique advantages in self-health management.

Objective To screen out the biomarkers linked to prognosis of breast invasive carcinoma based on the analysis of transcriptome data by random forest(RF),extreme gradient boosting(XGBoost),light gradient boosting machine(LightGBM),and categorical boosting(CatBoost).Methods We obtained the ex-pression data of breast invasive carcinoma from The Cancer Genome Atlas and employed DESeq2,t-test,and Cox univariate analysis to identify the differentially expressed protein-coding genes associated with survival prog-nosis in human breast invasive carcinoma samples.Furthermore,RF,XGBoost,LightGBM,and CatBoost mod-els were established to mine the protein-coding gene markers related to the prognosis of breast invasive cancer and the model performance was compared.The expression data of breast cancer from the Gene Expression Omnibus was used for validation.Results A total of 151 differentially expressed protein-coding genes related to survival prog-nosis were screened out.The machine learning model established with C3orf80,UGP2,and SPC25 demonstrated the best performance.Conclusions Three protein-coding genes(UGP2,C3orf80,and SPC25)were screened out to identify breast invasive carcinoma.This study provides a new direction for the treatment and diagnosis of breast invasive carcinoma.

Objective:To investigate the clinical advantages of absorbable barbed wires in laparoscopy combined with choledochoscopy treatment of gallbladder polyps.Methods:The clinical data of 103 patients with gallbladder polyps who received laparoscopy combined with choledochoscopy treatment in The First People's Hospital of Lianyungang from February 2016 to March 2018 were retrospectively analyzed. Sixty-five patients in the observation group underwent gallbladder wall sutures with absorbable barbed wires, and thirty-eight patients in the control group underwent gallbladder wall sutures with common absorbable wires. The operative time, gallbladder wall suture time, intraoperative blood loss, average hospitalization time, and postoperative bile leakage were compared between the two groups.Results:There were no significant differences in intraoperative blood loss and average hospitalization time between the two groups ( P = 0.312, P = 0.114). In the observation group, gallbladder wall suture time and operative time were (5.58 ± 1.14) minutes and (60.71 ± 11.03) minutes, respectively, which were shorter than (6.32 ± 1.04) minutes and (68.24 ± 9.61) minutes in the control group ( t = 3.23, 3.50, P = 0.002, 0.001). No bile leakage occurred in the observation group and bile leakage occurred in four (10.5%) patients in the control group. There was a significant difference in bile leakage between the observation and control groups ( χ2 = 4.57, P = 0.032). Conclusion:Absorbable barbed wires for gallbladder wall sutures during operation in laparoscopy combined with choledochoscopy treatment of gallbladder polyps is safe and feasible. It can markedly shorten gallbladder wall suture time and operative time, decrease the incidence of bile leakage, and has a clinical advantage over common absorbable wires.

Objective:To discuss the effect of low-dose ionizing radiation on the health of radiation workers, and provide a basis for occupational health risk assessment of radiation workers.Methods:In January 2020, 3165 radiation workers who performed radiation occupational health examinations in Guangzhou Prevention and Treatment Hospital for Occupational Disease from January 2017 to December 2019 were selected as the research objects, and compared and analyzed the health status of radiation workers with different examination types (pre-job, in-job and off-job) , types of work, gender, and length of service.Results:The off-job occupational radiological health examination was rare at 2.3% (74/3165) . The abnormal detection rate of chest radiographs, renal function, thyroid function, and blood routine of the radiation workers in-job group was higher than that of the pre-job group ( P<0.05) . No statistical difference was found in the abnormal detection rate of the examination items during the in-job group and the off-job group ( P>0.05) . The blood routine abnormality detection rate of medical application group and industrial application group were higher than those of nuclear fuel group ( P<0.05) . The abnormal detection rate of blood pressure and renal function of male radiation workers was higher than that of females, while the abnormal detection rate of blood routine of females was higher than that of males ( P<0.05) . The abnormal detection rate of electrocardiogram, chest radiograph, blood pressure, renal function, thyroid function, and blood routine of radiation workers increased with increasing working age ( P<0.05) . Conclusion:Occupational health status of radiation workers is not optimistic. Radiation occupational health monitoring should be strengthened, special attention should be paid to off-job radiation occupational health examination, focusing on the sensitive indicators of sensitive personnel, improving radiation protection conditions, and effectively protecting the occupational health of radiation workers.

Objective:To discuss the effect of low-dose ionizing radiation on the health of radiation workers, and provide a basis for occupational health risk assessment of radiation workers.Methods:In January 2020, 3165 radiation workers who performed radiation occupational health examinations in Guangzhou Prevention and Treatment Hospital for Occupational Disease from January 2017 to December 2019 were selected as the research objects, and compared and analyzed the health status of radiation workers with different examination types (pre-job, in-job and off-job) , types of work, gender, and length of service.Results:The off-job occupational radiological health examination was rare at 2.3% (74/3165) . The abnormal detection rate of chest radiographs, renal function, thyroid function, and blood routine of the radiation workers in-job group was higher than that of the pre-job group ( P<0.05) . No statistical difference was found in the abnormal detection rate of the examination items during the in-job group and the off-job group ( P>0.05) . The blood routine abnormality detection rate of medical application group and industrial application group were higher than those of nuclear fuel group ( P<0.05) . The abnormal detection rate of blood pressure and renal function of male radiation workers was higher than that of females, while the abnormal detection rate of blood routine of females was higher than that of males ( P<0.05) . The abnormal detection rate of electrocardiogram, chest radiograph, blood pressure, renal function, thyroid function, and blood routine of radiation workers increased with increasing working age ( P<0.05) . Conclusion:Occupational health status of radiation workers is not optimistic. Radiation occupational health monitoring should be strengthened, special attention should be paid to off-job radiation occupational health examination, focusing on the sensitive indicators of sensitive personnel, improving radiation protection conditions, and effectively protecting the occupational health of radiation workers.

Objective: To explore the impact of welding operations on the health status of workers with low working age, and provide a basis for occupational health risk assessment for workers of low working age. Methods: Used the method of cluster sampling to randomly selected workers from an automobile manufacturing plant in Guangzhou as research subjects: 982 workers with welding posts of 1 year ≤working age ≤5 years were welding groups, 707 workers with simple exposure noise of 1 year ≤working age ≤5 years were assembly groups, and 717 workers in pre-job medical examinations were pre-job groups from June 2017 to September 2018. Then conducted occupational health checks on all subjects, investigated and detected the occupational hazards in welding posts and assembly posts. Results: There was no statistical difference between the noise over-standard rate of welding posts' (59.3%, 16/27) and the assembly posts' (47.4%, 9/19) (P>0.05) . The over-standard rate of welding fume, manganese and its inorganic compounds in welding posts was 11.11% (3/27) . The results of occupational health examination showed that the detection rate of disease or abnormal of the welding group was 78.4% (770/982) higher than 70.2% (496/707) in the assembly group and 53.0% (380/717) in the pre-job group (the value of 2 were 14.92 and 122.37, respectively, P<0.05) . The rate of hearing loss of the assembly group and the welding group were 14.7% (104/707) and 19.3% (190/982) , respectively, which was higher than that of the pre-job group (10.5%, 75/717) , and the hearing loss rate gradually increased with the increase of working age (the value of linear-by-linear association were 12.04 and 44.67, respectively, P<0.01) . Compared with the hearing loss rate of each working age of the assembly group, the hearing loss rate of each working age of the welding group was higher, and when the working age was 3 years, the risk of hearing loss in the welding group was 2.70 times that of the assembly group (P<0.01) . The rate of pulmonary dysfunction in the welding group was 19.2% (189/982) higher than that in the pre-job group (12.6%, 90/717) , and it increased with the increase of working age (the value of linear-by-linear association was 15.97, P<0.01) . Conclusion Welding work seriously damages the health of workers with low working age, increases the hearing loss of workers and the occurrence of pulmonary dysfunction; manganese and its compounds increases noise-induced damage to the hearing system.

Objective: To explore the relationship between occupational stress, psychological capital and depressive symptoms among electronic manufacturing female workers in the Pearl River Delta region. Methods: Using cluster sampling method, 845 female workers from 5 electronic manufacturing enterprises in the Pearl River Delta region were selected as research subjects from June to August 2017. The Effort Reward Imbalance questionnaire (ERI) , Psychological Capital questionnaire-24 (PCQ-24) and Patient Health questionnaire-9 (PHQ-9) were applied to measure the level of occupational stress, psychological capital and depressive symptoms in female workers. Results: Effort (r=0.197, P<0.01) and over commitment (r=-0.260, P<0.01) were positively correlated with the score of depressive symptoms, and the rewards was negatively correlated with depressive symptoms (r=-0.211, P<0.01) . The reward and over-commitment for depressive symptoms were accounted for 8.2%. Psychological capital was negatively correlated with depressive symptoms, and plays a partly mediating role in the relationship between occupational stress and depressive symptoms of female workers. The psychological capital for depressive symptoms was accounted for 8.7%. Conclusion Occupational stress can affects the depressive symptoms of electronic manufacturing female workers, or indirectly affect depressive symptoms through psychological capital, reduce occupational stress and improve psychological capital as a way to relieve the depressive symptoms of female workers.

Objective: To investigate the clinical effects of perforating branch flaps of medial vastus muscle in repairing secondary wounds in donor sites of free anterolateral femoral perforator flaps. Methods: From August 2014 to December 2016, 12 patients (8 males and 4 females, aged 35-72 years) with skin and soft tissue defects of extremities associated with tendon and bone exposure were treated in Hanzhong Central Hospital. The sizes of the primary wounds after debridement were 10 cm×8 cm-22 cm×14 cm, and the wounds were repaired with 12 cm×10 cm-24 cm×16 cm free anterolateral femoral perforator flaps. The anterolateral femoral donor sites, which were 8.0 cm×4.0 cm-14.0 cm×7.5 cm in the secondary wounds after skin extensional suture, were repaired with perforating branch flaps of medial vastus muscle in the size of 9.0 cm×5.0 cm-15.0 cm×8.5 cm. The medial femoral donor sites were sutured directly. Results: All the perforating branch flaps of medial vastus muscle and free anterolateral femoral perforator flaps survived in 12 patients. Following up for 6 to 12 months, the medial femoral perforator flaps had good local shape and texture. The flaps of 8 patients without cutaneous nerve transection were sensitive. The sensation of the flaps of the other 4 patients gradually recovered, and the functions of the ipsilateral knee joints were normal. Conclusions The medial femoral perforator flap has a stable anatomy and abundant blood supply, which can be used to repair the secondary wound in the donor site of the free anterolateral femoral perforator flap conveniently. It is safe and easy to be popularized. Moreover, it has a good shape and function after operation.

Objective To investigate radioactive source term dose monitoring and estimation results in a manufacturing enterprise of ion-absorbing type rare earth ore and the possible ionizing radiation dose received by its workers.Methods Ionizing radiation monitoring data of the posts in the control area and supervised area of workplace were collected,and the annual average effective dose directly estimated or estimated using formulas was evaluated and analyzed.Results In the control area and supervised area of the workplace for this rare earth ore,α surface contamination activity had a maximum value of 0.35 Bq/cm2 and a minimum value of 0.01 Bq/cm2;β radioactive surface contamination activity had a maximum value of 18.8 Bq/cm2 and a minimum value of 0.22 Bq/cm2.In 14 monitoring points in the workplace,the maximum value of the annual average effective dose of occupational exposure was 1.641 mSv/a,which did not exceed the authorized limit for workers (5 mSv/a),but exceeded the authorized limit for general personnel (0.25 mSv/a).The radionuclide specific activity of ionic mixed rare earth oxides was determined to be 0.9.Conclusion The annual average effective dose of occupational exposure in this enterprise does not exceed the authorized limit for workers,but it exceeds the authorized limit for general personnel.We should pay attention to the focus of the radiation process,especially for public works radiation.

Objective To investigate radioactive source term dose monitoring and estimation results in a manufacturing enterprise of ion-absorbing type rare earth ore and the possible ionizing radiation dose received by its workers.Methods Ionizing radiation monitoring data of the posts in the control area and supervised area of workplace were collected,and the annual average effective dose directly estimated or estimated using formulas was evaluated and analyzed.Results In the control area and supervised area of the workplace for this rare earth ore,α surface contamination activity had a maximum value of 0.35 Bq/cm2 and a minimum value of 0.01 Bq/cm2;β radioactive surface contamination activity had a maximum value of 18.8 Bq/cm2 and a minimum value of 0.22 Bq/cm2.In 14 monitoring points in the workplace,the maximum value of the annual average effective dose of occupational exposure was 1.641 mSv/a,which did not exceed the authorized limit for workers (5 mSv/a),but exceeded the authorized limit for general personnel (0.25 mSv/a).The radionuclide specific activity of ionic mixed rare earth oxides was determined to be 0.9.Conclusion The annual average effective dose of occupational exposure in this enterprise does not exceed the authorized limit for workers,but it exceeds the authorized limit for general personnel.We should pay attention to the focus of the radiation process,especially for public works radiation.