Objective To analyze the current situation of the knowledge-attitude-practice among noise-exposed workers at an airport apron. Methods A total of 494 noise-exposed workers from an airport apron were selected as the study subjects using the judgmental sampling method. A self-designed "Occupational Protection Knowledge, Attitudes, and Practices Questionnaire" was used to assess the current situation of knowledge-attitude-practice on occupational protection. Results Regarding the awareness of noise hazards among the study subjects, the awareness rates of noise-induced impairment on digestive function and reproductive system were the lowest (44.9% and 37.7%, respectively). The awareness rate of noise-induced negative emotions increased with length of service (P<0.01). Regarding the occupational protection knowledge for noise, the awareness rate of occupational noise-induced deafness was “incurable” was the lowest (39.1%). The support rate for five kinds of occupational protection attitudes for noise was generally >85.0%, while only 58.3% of the study subjects consistently or frequently wearing earplugs during work. The most common source of noise hazard and protection knowledge was pre-employment training (76.9%), followed by occupational disease prevention and control campaigns (76.1%). Conclusion Noise-exposed workers in this airport apron have incomplete awareness of non-auditory system hazards caused by noise, and the awareness of knowledge of some occupational protection is relatively low. Although their attitudes toward occupational protection are positive, many workers still fail to consistently wear personal protective equipment at work.

Objective To investigate the clinical manifestations,molecular genetics and gonadal pathol-ogy characteristics of patients with disorders of sex development(DSD),and to summarize the clinical experi-ence of identifying rare diseases from common symptoms.Methods The clinical data of 416 patients with DSD diagnosed and treated in the multidisciplinary center of DSD of Guangzhou Women and Children's Medical Cen-ter from May 2018 to August 2023 were retrospectively analyzed,summarized and discussed.Results Accord-ing to chromosome karyotype,416 cases of DSD were classified into three types:92 cases(22.1％)of abnormal sex chromosome karyotype,285 cases(68.5％)of 46,XY karyotype and 39 cases(9.4％)of 46,XX karyotype.Among the 92 patients with abnormal sex chromosome karyotype,59 cases were raised as males,18 cases(30.5％)complained of short penis with hypospadias and cryptorchidism.The most common karyotype was 45,X/46,XY(58 cases,63.0％).Among the 285 patients with 46,XY karyotype,238 cases were raised as males,and 63 cases(26.5％)complained of short penis and hypospadias;47 cases were raised as females,and 13 ca-ses(27.7％)complained of inguinal mass.A total of 216 patients with 46,XY karyotype were subjected to whole exome gene detection,and 155 cases(71.8％)were found to have molecular pathogenesis with the clinical phe-notype.Among the 39 patients with 46,XX karyotype,19 cases were raised as males,and 8 cases(42.1％)com-plained of short penis and hypospadias.In the 18 cases of gonad biopsy,17 cases showed testicular tissue in go-nads.Whole exome sequencing was performed in 14 cases.NR5A1 gene heterozygous mutation,SRY gene muta-tion and SOX3 gene mutation were found in 2 cases,respectively(14.3％).Twenty cases were raised as females,and 14 cases(70.0％)complained of clitoral hypertrophy.Gonad biopsy was performed in 8 cases,with 7 cases of ovotestis(87.5％)and 1 case of NR5A1 gene heterozygous mutation(14.3％).Conclusions The etiologies of DSD are complex and diverse,and the clinical manifestations are various,which can be manifested as hypospa-dias,micropenis,cryptorchidism and other common symptoms of the urinary system.Different etiologies have dif-ferent treatment options.Therefore,chromosome karyotype,molecular genetic testing and gonadal pathology can be used to clarify the cause of disease,especially for rare diseases,improve the detection rate,reduce the rate of missed diagnosis,and ensure reasonable treatment,especially sex selection.

Background::A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator (rhTNK-tPA) has previously shown its preliminary efficacy in ST elevation myocardial infarction (STEMI) patients. This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase (rt-PA) in Chinese patients with STEMI.Methods::In this multicenter, randomized, open-label, non-inferiority trial, patients with acute STEMI were randomly assigned (1:1) to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min. The primary endpoint was recanalization defined by thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3. The secondary endpoint was clinically justified recanalization. Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events (MACCEs) and safety endpoints.Results::From July 2016 to September 2019, 767 eligible patients were randomly assigned to receive rhTNK-tPA ( n = 384) or rt-PA ( n = 383). Among them, 369 patients had coronary angiography data on TIMI flow, and 711 patients had data on clinically justified recanalization. Both used a –15% difference as the non-inferiority efficacy margin. In comparison to rt-PA, both the proportion of patients with TIMI grade 2 or 3 flow (78.3% [148/189] vs. 81.7% [147/180]; differences: –3.4%; 95% confidence interval [CI]: –11.5%, 4.8%) and clinically justified recanalization (85.4% [305/357] vs. 85.9% [304/354]; difference: –0.5%; 95% CI: –5.6%, 4.7%) in the rhTNK-tPA group were non-inferior. The occurrence of 30-day MACCEs (10.2% [39/384] vs. 11.0% [42/383]; hazard ratio: 0.96; 95% CI: 0.61, 1.50) did not differ significantly between groups. No safety outcomes significantly differed between groups. Conclusion::rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery, a validated surrogate of clinical outcomes, among Chinese patients with acute STEMI.Trial registration::www.ClinicalTrials.gov (No. NCT02835534).

Mesenchymal stem cells (MSCs) are a type of adult stem cells derived from the mesoderm, with the ability for self-renewal and multidirectional differentiation. Mesenchymal stem cell-derived exosomes (MSCs-Exo) are bioactive extracellular vesicles secreted by various MSCs into body fluids. They offer advantages such as anti-inflammatory properties, tissue repair, promotion of cell proliferation and differentiation, and regulation of the hair growth cycle. Hair regeneration involves the interaction of various cells and cytokines. Dermal papilla cells (DPCs) are considered as a unique MSCs with the functional properties of autologous stem cells. As the signaling center of the hair follicle, it plays an important role in regulating hair growth. MSCs-Exo can promote the proliferation and differentiation of DPCs by regulating the hair growth cycle. In recent years, research on MSCs-Exo has provided a new strategy for hair regeneration. This article reviewed the research on the use of MSCs-Exo for hair regeneration, aiming to offer new insights for the treatment of alopecia.

Mesenchymal stem cells (MSCs) are a type of adult stem cells derived from the mesoderm, with the ability for self-renewal and multidirectional differentiation. Mesenchymal stem cell-derived exosomes (MSCs-Exo) are bioactive extracellular vesicles secreted by various MSCs into body fluids. They offer advantages such as anti-inflammatory properties, tissue repair, promotion of cell proliferation and differentiation, and regulation of the hair growth cycle. Hair regeneration involves the interaction of various cells and cytokines. Dermal papilla cells (DPCs) are considered as a unique MSCs with the functional properties of autologous stem cells. As the signaling center of the hair follicle, it plays an important role in regulating hair growth. MSCs-Exo can promote the proliferation and differentiation of DPCs by regulating the hair growth cycle. In recent years, research on MSCs-Exo has provided a new strategy for hair regeneration. This article reviewed the research on the use of MSCs-Exo for hair regeneration, aiming to offer new insights for the treatment of alopecia.

Objective:To evaluate the effect of the perioperative exercise program in patients with non-small cell lung cancer(NSCLC). Method:By convenience sampling,NSCLC patients who were admitted to the hospital in Anhui province from February to December in 2022 were selected and divided into groups based on their admission time.The control group received perioperative routine care.The intervention group received perioperative exercise interven-tion based on the perioperative routine care.The primary outcomes included pulmonary function,exercise toler-ance and early postoperative complications;the secondary outcomes included the symptom assessment,exercise self-efficacy for lung cancer patients,duration of postoperative chest drainage and hospital stay;and the safety outcomes(eg.adverse events). Result:A total of 166 NSCLC patients were included,with 88 in the control group and 78 in the interven-tion group.After the intervention,the intervention group had higher lung function,6MWD and exercise self-efficacy,and lower symptom scores compared to the control group(P＜0.05).However,there were no significant differences between the two groups in the incidence of early postoperative complications,duration of chest drainage,and hospital stay(P＞0.05).No exercise-related adverse events occurred throughout the perioperative period. Conclusion:The perioperative exercise program for NSCLC patients is effective and safe,contributing to the recovery of postoperative pulmonary function and exercise tolerance,improving postoperative symptoms and en-hancing the exercise self-efficacy.

Objective:To understand the status quo of postoperative exercise adherence in patients with non-small cell lung cancer (NSCLC) and analyze the pathways through which disease perception, exercise self-efficacy, and coping style influence postoperative exercise adherence based on the Revised Common Sense Model (CSM) .Methods:NSCLC patients who underwent surgery in the Department of Thoracic Surgery of the First Affiliated Hospital of Anhui Medical University from March to September 2023 were selected by convenience sampling. Data were collected using a general information questionnaire, the Postoperative Exercise Adherence Questionnaire for Lung Cancer Patients, the Brief Illness Perception Questionnaire (BIPQ), and the Exercise Self-Efficacy Scale for Lung Cancer Patients.Results:A total of 245 questionnaires were distributed, with 241 valid responses collected. The postoperative exercise adherence score among the 241 NSCLC patients was (39.70±9.55). Exercise self-efficacy and coping style partially mediated the relationship between disease perception and exercise adherence, accounting for 81.31% and 13.64% of the total indirect effects, respectively. Exercise self-efficacy and coping style also had a chain mediating effect between disease perception and exercise adherence, accounting for 5.05% of the total indirect effects.Conclusions:The level of exercise adherence in NSCLC patients needs improvement. Negative disease perception not only directly negatively affects exercise adherence but also indirectly affects it through the mediating roles of exercise self-efficacy and coping style. Clinical healthcare providers should focus on guiding patients to develop healthy disease perceptions, increase their confidence in participating in exercise, and encourage the adoption of positive coping styles to enhance exercise adherence levels.

With the continuous improvement of medical information and intelligence, multi-modal data fusion technology is increasingly widely used in the medical field. Multi-modal data not only has a large quantity, but also has rich information content, which can provide strong support for clinical nursing decision-making. However, due to the uneven level of informatization and intelligence development among medical institutions, the development and application of nursing decision support system is still in a fragmented state. Based on this, this study explores in depth the current application status and challenges faced by multi-modal data fusion in nursing decision support systems, with the aim of providing reference for the design and improvement of nursing decision support system at all levels of medical institutions in the future.

Objective To observe the imaging manifestations of paraganglioma of urinary bladder(PUB).Methods Data of 9 patients with single PUB confirmed by surgical pathology were retrospectively analyzed.Among 9 cases,8 cases underwent abdominal ultrasonography,6 underwent pelvic CT and 6 underwent pelvic MR examination.The imaging manifestations of PUB were observed.Results All 9 PUB lesions shaped round or ellipsoid,with wide base,clear boundary and regular shape,the diameters were 14-41 mm,with an average of(27.3±9.l)mm.Two lesions located at the left lateral wall,1 at the left anterior wall,2 at the right lateral wall and 4 at the right anterior wall of the bladder.Two dimensional ultrasound displayed hypoechoic lesions in all 8 cases(8/8,100％),and"bladder mucosa line"sign was detected in 6 cases(6/8,75.00％),while CDFI showed rich blood flow signals in 6 lesions(6/8,75.00％),spot and strip blood flow signal in 1 lesion(1/8,12.50％)but no blood flow signal in 1 case(1/8,12.50％).CT showed that all 6 lesions(6/6,100％)present as soft tissue densities,1(1/6,16.67％)with intratumoral cystic change and necrosis,while"bladder mucosa line"sign was found in 2 cases(2/6,33.33％).MRI showed all 6 lesions(6/6,100％)located under the bladder mucosa,and"bladder mucosa line"sign was clearly visible(6/6,100％).Four lesions(4/6,66.67％)present as slight hyperintensities,1(1/6,16.67％)as slight hypointensity and 1 as isointense(1/6,16.67％)on T1WI,5(5/6,83.33％)as slight hyperintensity(n=5)and 1 as isointense(1/6,16.67％)on fat suppression-T2WI,5(5/6,83.33％)as high signals but 1(1/6,16.67％)as slightly hyperintensity on diffusion weighted imaging.Significant enhancements of lesions(6/6,100％)were noticed on both enhanced CT and MRI.Conclusion The imaging manifestations of PUB had certain characteristics,which were helpful to diagnosis.

Objective:To investigate the influence of maternal autoimmune diseases and anticoagulants, including low-molecular-weight heparin (LMWH) and aspirin, on the fetal fraction of maternal plasma cell-free DNA of non-invasive prenatal testing (NIPT).Methods:A prospective cohort study was conducted on women with singleton pregnancies receiving NIPT in the Nanjing Drum Tower Hospital from March 2021 to July 2022. NIPT was carried out using a polymerase chain reaction (PCR)-free amplification platform. In this study, four types of maternal autoimmune diseases, which were antiphospholipid syndrome, undifferentiated connective tissue disease, Sj?gren's syndrome, and systemic lupus erythematosus (SLE), and two anticoagulants, LMWH and aspirin, were studied. Univariate and multivariate linear regression models were used to analyze the factors influencing fetal fraction of maternal plasma cell-free DNA.Results:A total of 4 102 singleton pregnant women were enrolled in the prospective cohort, and 3 948 were finally included after excluding the cases with unclear dosing time of LMWH or aspirin, other autoimmune diseases, conceiving through ovulation induction alone, and having true positive or failed NIPT result. There were 96 cases with antiphospholipid syndrome, 35 with undifferentiated connective tissue disease, 34 with Sj?gren's syndrome, and 18 with SLE. A total of 108 patients only received LMWH treatment, 121 only received aspirin treatment, and 113 received both LMWH and aspirin treatment. Univariate linear regression analysis showed that maternal body mass index at blood collection ( B=－0.423), conceived by assisted reproductive technology ( B=－0.803), male fetus ( B=－0.458), undifferentiated connective tissue disease ( B=1.774), and SLE ( B=3.467) had influence on the fetal fraction (all P<0.05). Multivariate linear regression analysis showed that maternal body mass index at blood collection ( B=－0.415), conceived by assisted reproductive technology ( B=－0.585), male fetus ( B=－0.322), SLE ( B=3.347) and undifferentiated connective tissue disease ( B=1.336) were factors influencing fetal fraction (all P<0.05). Conclusions:Maternal use of LMWH or aspirin does not affect fetal fraction when performing NIPT on a PCR-free amplification platform, but undifferentiated connective tissue disease and SLE are the influencing factors. Therefore, pregnant women should be informed before the NIPT that the fetal fraction of maternal plasma cell-free DNA may be affected by maternal autoimmune diseases.