OBJECTIVE To provide a reference for pharmaceutical care in patients with hemorrhagic transformation after cerebral infarction complicated with atrial fibrillation. METHODS Clinical pharmacists participated in the treatment practice of a patient with hemorrhagic transformation after cerebral infarction complicated with atrial fibrillation. Because the patient had a hemorrhagic transformation after cerebral infarction after stent implantation and arterial thrombolysis， the clinical pharmacists recommended stopping antiplatelet drugs and giving plasma and cold precipitation； because D-dimer was significantly elevated， the clinical pharmacists recommended anticoagulant therapy with low-molecular heparin. Due to the patient’s recurrence of hemorrhagic transformation after cerebral infarction， the clinical pharmacists recommended discontinuing rivaroxaban and administering human prothrombin complex concentrate. RESULTS The physician adopted the clinical pharmacists’ recommendation. After treatment， the patient’s condition tended to improve steadily and was allowed to be discharged with medication. CONCLUSIONS The clinical pharmacists assessed the individualized risk and optimized the patient’s medication regimen by suggesting discontinuation of antiplatelet and anticoagulant drugs， carrying out pharmaceutical care such as coagulation index monitoring， determining the time and indications for restarting anticoagulation， and pharmaceutical monitoring， to ensure the safety and efficacy of the patient’s medication.

Objective:To conduct quantitative evaluation on the revise requirements of Specifications of Air Sampling for Hazardous Substances Monitoring in the Workplace (GBZ 159-2004) , clarify the problems and suggestions during its implementation for improvement, and provide a basis for the revision of the standard.Methods:From April to September 2021, stratified convenient sampling method was adopted and semi-open questionnaire was used to investigate the occupational health personnel in CDC, occupational prevention and control institutes, employers, third-party technical service institutions and universitie. The entropy weight of each index and the score based on entropy weight of GBZ 159 were calculated. Spearman rank correlation analysis was used to describe the correlation between the two indexes and radar chart was drawn for comprehensive evaluation.Results:A total of 151 questionnaires were received from the respondents, of which 147 were valid, with an effective recovery rate of 97.35%, involving 29 provinces, autonomous regions and municipalities. The median G scores of the necessity and urgency of GBZ 159 revision based on entropy weight were 2.84 and 3.17, respectively, and the difference was statistically significant ( M=-25.50, P<0.001) . The trend of the score G of necessity and urgency based on entropy weight was basically the same for all secondary items ( rs=0.9998, P<0.001) , and the score G of urgency based on entropy weight was higher than that of necessity. The highest score G of necessity and urgency based on entropy weight was "3.13 long time sampling", which were 7.56 and 8.23 respectively. This was followed by "3.12 short time sampling", which were 7.19 and 7.13 respectively. Conclusion:GBZ 159 has encountered some new problems and challenges in the implementation process, and some of its technical indicators have been out of line with the actual practice of occupational health at present. These are the two items that urgently needs to be revised and improved, such as "3.13 long time sampling" and "3.12 short time sampling" and other items need to be revised and improved.

Systematically evaluate the implementation of Specifications of Air Sampling for Hazardous Substances Monitoring (GBZ 159-2004) , so as to provide technical basis for the future standard revision. The semi-structured interview method was used to interview the industry experts from centers for disease control and prevention, occupational disease prevention and control hospitals/institutes, employers, third-party technical service institutions and universities, and the induction method was used to refine the topics and relevant suggestions. Some technical indicators of GBZ 159 are not suitable for the current actual work of occupational health, and need to be revised and improved urgently. The revised GBZ 159 should comply with the current situation of China's industrial development and the development of occupational health testing equipment in the new era, and improve the relevant technical requirements of sampling quality control.

Objective To observe the value of ultrasound-guided intra-articular injection of hypertonic glucose(HG)for treating knee osteoarthritis in plateau area.Methods Ninety-one patients with knee osteoarthritis in plateau area(124 affected knee joints)were enrolled.The knee joints were divided into 20％HG group(n=67),25％HG group(n=42)or sodium hyaluronate group(n=15)based on the medication.Clinical and ultrasound scores were compared before and after treatment,and the efficacy of injection of HG was evaluated.Results At the 12th and 48th weeks after treatment,visual analog scale(VAS)scores decreased in all 3 groups(all P＜0.05),and Lysholm scores of 20％HG group and 25％HG group increased compared to those before treatment(all P＜0.05).The difference of Lysholm score before and in the 12th week after treatment,and of VAS score before and in the 48th week after treatment of 25％HG group were higher than those of 20％HG group(both P＜0.05).The joint exudation score of 20％HG group decreased in the 48th week after treatment compared to that before treatment(P＜0.05),and the synovial blood flow score decreased in the 12th and 48th weeks after treatment compared to those before treatment(both P＜0.05).The joint exudation score of 25％HG group decreased in the 48th week after treatment compared to that before treatment(P＜0.05),and the synovial hyperplasia and synovial blood flow score decreased in the 12th and 48th weeks after treatment compared to before treatment(all P＜0.05).The joint exudation score of sodium hyaluronate group decreased in the 48th week after treatment compared to that before treatment(P＜0.05),and the synovial hyperplasia score decreased in the 12th and 48th weeks after treatment compared to that before treatment(both P＜0.05).Conclusion Ultrasound-guided intra-articular injection of HG,esp.25％HG,had certain value for treating knee osteoarthritis in plateau area.

Metabolomics, including targeted metabolomics and non-targeted metabolomics, is a method to study endogenous small molecule metabolites in organisms. The process of metabolomics analysis generally includes sample collection and pre-treatment, sample detection, data preprocessing, metabolite identification, data statistical analysis, and others. At present, metabolomics technology has been applied to study toxicological mechanism of occupational hazards, early detection and diagnosis of occupational diseases, screening biomarkers of occupational exposure, and others. The application of metabolomics technology to explore the relationship between workers' metabolites and exposure to occupational hazardous, assess the potential impact of occupational exposure on workers' health, and search for ideal biomarkers or therapeutic targets is conducive to early warning and monitoring of occupational health hazards, and assistance in the early diagnosis and prognosis of occupational diseases.In the future, further research is needed in the field of occupational health using metabolomics to establish more complete and standardized workflows and experimental methods, combine big data technology to explore potential biomarkers, utilize metabolic information to provide precise occupational health services, and use artificial intelligence models for data mining and disease diagnosis in metabolomics.

Objective:To explore the application and potential optimization of the collaborative and competitive learning model in the Health Education course. Methods:Undergraduate medical students participating in Health Education course practice tasks were selected to conduct discussions and reach consensus according to research objectives based on the e fast anonymous consensus-forming tool (eFAST). The meeting records were analyzed for theme identification using the keyword classification method. Results:Nine medical students participated in eFAST discussions. The students considered the following five aspects as the most important for undertaking Health Education course practice tasks using the collaborative and competitive learning model: timely communication, problem evaluation, report content enrichment, reasonable task allocation within groups, and task topic selection by group members together. They also proposed suggestions on improvement of the assessment method, including teacher involvement in scoring, intra-group scoring based on inter-group scoring, all students participating in inter-group scoring, and using mobile applications for scoring and summarization. Conclusions:The collaborative and competitive learning model can be used in the teaching of Health Education, but further optimization is needed in course task design, implementation, reporting, and assessment.

Objective:To screen for regulatory cell death and senescence genes with differential prognostic significances in the gastric cancer through bioinformatics methods,and to analyze the effect of phosphodiesterase 1B(PDE1B)on the survival prognosis of the gastric cancer patients.Methods:The gastric cancer gene expression data and clinical data were downloaded from the TCGA Public Database.Fifty gastric cancer patients were randomly selected from the local database,and their clinical informations and paraffin samples,including gastric cancer tissue and adjacent normal tissue,were collected.The R software"limma"package was used to screen differentially expressed genes(DEGs);univariate COX analysis and Kaplan-Meier survival analysis were used to screen DEGs with predictive survival value.The intersection genes affecting the survival prognosis of gastric cancer patients were obtained,and the gene most associated with clinical pathological features PDE1B was screened.The TCGA Database and Kaplan-Meier survival analysis were used to detect the expression levels of PDE1B mRNA in adjacent normal and gastric cancer tissues and their relationships with survival period of the gastric cancer patients.Gene Ontology(GO)functional and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses were used to enrich the biological functions of PDE1B.The CIBERSORT algorithm,Tumor Immunity Database(TISIDB),and GSCA online website were used to analyze the correlation between PDE1B and tumor microenvironment,immune characteristic molecules,and drug sensitivity.The real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the PDE1B mRNA expression levels in gastric cancer tissue and adjacent normal tissue of the gastric cancer patients.Results:A total of 716 DEGs were screened,among which 505 DEGs were upregulated(P<0.05),and 211 DEGs were downregulated(P<0.05).There were 10 intersection genes affecting survival prognosis.The PDE1B mRNA expression level was most closely related to the clinical pathological characteristics of the gastric cancer patients,being associated with age,tumor grade,tumor stage,and tumor T,N,and M stages(P<0.05).Compared with G1-G2,stage Ⅰ,T1-T2,N0,and M0 stage gastric cancer patients,the PDE1B mRNA expression levels in G3-G4,stage Ⅱ-Ⅳ,T3-T4,N1-N3,and M1 stage gastric cancer patients were significantly increased(P<0.05).Compared with adjacent normal tissue,the PDE1B mRNA expression level in gastric cancer tissue was significantly decreased(P<0.05).Compared with the patients with low PDE1B expression,the patients with high PDE1B expression had a significantly lower overall survival rate(P<0.01).PDE1B expression,age,and tumor stage were the risk factors for the prognosis of gastric cancer patients(P<0.05).After adjusting for gender,age,tumor grade,and tumor stage,PDE1B expression was an independent risk factor affecting the prognosis of the gastric cancer patients(P<0.05).PDE1B was mainly enriched in the biological process(BP),such as immunoglobilin production,second-messenger,mediated signaling transduction and calcium ion transport,cellular component(CC),such as Tlymplocytes receptor complex,plasma membrance signaling receptor complex and collagen-containing extracellular matrix,and molecular function(MF),such as antigen binding,glycosaminoglycan binding,and extracellular matrix structural constituents.PDE1B was mainly involved in the pathways such as neuroactive ligand-receptor interaction,calcium signaling pathway,cGMP-PKG signaling pathway,and cytokine-cytokine receptor interaction.PDE1B was positively correlated with regulatory T lymphocytes(r=0.488),myeloid-derived suppressor cells(r=0.474),and macrophages(r=0.617)(P<0.01).Compared with the patients with low PDE1B expression,the patients with high PDE1B expression promoted the significant increase of infiltration of regulatory T lymphocytes,monocytes,and M2 macrophages(P<0.05).The PDE1B mRNA expression levels were positively correlated with the immunosuppressive agents transforming growth factor-β1(TGF-β1)(r=0.535),colony-stimulating factor 1 receptor(CSF1R)(r=0.519),immune activator ectonucleoside triphosphate diphosphohydrolase 1(ENTPD1)(r=0.593),and CXC chemokine ligand 12(CXCL12)(r=0.646)(P<0.01).The gastric cancer tissue with high PDE1B expression was more sensitive to the drugs such as fluorouracil(-0.3

Objective Explore the comprehensive emotion adjustment pattern that combines non-contact physiological and psychological detection methods in fasting and low metabolism scenarios.This study aims to verify the accuracy of non-contact physiological and psychological detection algorithms and evaluate the effectiveness of multimodal emotion adjustment schemes for addressing negative emotional states such as depression and anxiety.Methods Deploy non-contact physiological and psychological detection algorithms and emotion adjustment plans to build a multimodal emotion adjustment system.Collect physiological and psychological data from volunteers participating in the 15-days complete fasting human low metabolism experiment of"Green Star Travel Ⅷ".Utilize finger clip oximeters and scales to verify the accuracy of existing non-contact physiological and psychological methods within the system.Design an emotion adjustment experiment featuring four groups:sound adjustment,acupoints adjustment,magnetism adjustment,and combination adjustment.Compare the volunteers'scale scores before and after the adjustments to verify the effectiveness of the system's emotion adjustment capabilities.Results The experimental results demonstrate that the average difference in the Bland-Altman plot for the non-contact heart rate detection model is ﹣0.497 bpm,with 95.3%of the error values falling within the 95%consistency interval.The non-contact psychological detection model achieved an accuracy rate of over 80%in identifying stress,anxiety,and depression,and an accuracy rate of over 70%in identifying fatigue and anger.Following emotion adjustment,the stress levels of the subjects significantly improved(P?

Objective To analyze differential metabolites (DMs) in the urine of workers with occupational nickel exposure using non-targeted metabolomics, and to screen differential metabolic pathways. Methods A total of 30 nickel exposed workers were selected as the exposure group, and 30 administrative staff from the same factory were selected as the control group using the judgment sampling method. Urine samples of the individuals from the two groups were collected. The ultra-high performance liquid chromatography with quadrupole time-of-flight mass spectrometry and non-targeted metabolomics were used to detect and identify metabolites. The differential metabolic profiles were compared between workers of the two groups, and key differential metabolic pathways and potential biomarkers were screened. The association of DMs and urinary nickel level were evaluated by Spearman correlation coefficients. The sensitivity and specificity of biomarkers were assessed by receiver operating characteristic (ROC) curve analysis. Results A total of 418 metabolites were identified in the urine of worker in the exposure and control groups. The result of principal component analysis and orthogonal partial least squares analysis showed that there were 128 DMs in the urine of workers in the exposure group compared with the control group. These DMs were mainly enriched in glutathione metabolism, carnitine synthesis, and amino acid and nucleotide metabolism pathways, including glycine and serine metabolism. The result of correlation analysis and ROC curve analysis revealed that 4-methylcatechol, 4-vinylphenol sulfate, 2-hydroxyphenylacetone sulfate, 2-dodecylbenzenesulfonic acid, and decylbenzenesulfonic acid could be the potential biomarkers for nickel exposure (all area under the ROC curve >0.800). Conclusion There were significant differences in the urinary metabolic profiles of workers with occupational nickel exposure. The five DMs including 4-methylcatechol, 4-vinylphenol sulfate, 2-hydroxyphenylacetone sulfate, 2-dodecylbenzenesulfonic acid, and decylbenzenesulfonic acid. These DMs could be potential biomarkers of occupational nickel exposure.

Biotoxins, which include bacterial, fungal, marine, plant, and animal toxins, are widespread in living and occupational environments, posing potential threats to human health. Rapid detection of biotoxins in blood is crucial for preventing health hazards and enabling timely disease diagnosis and treatment. Biosensors and immunoassay technologies have critical advantages in the rapid detection of biotoxins in blood. Common biosensors, such as surface plasmon resonance biosensors and fluorescent biosensors, enhance sensitivity and reduce detection limits through signal amplification. Common immunoassay methods, such as colloidal gold immunochromatography, fluorescence immunochromatography, and chemiluminescence immunoassay, improve detection efficacy and sensitivity through specific antibody-antigen binding and nanotechnology. However, current rapid detection technologies of bitoxins in blood face challenges such as matrix interference and insufficient specificity, and they fall short in high-throughput detection of multiple toxins simultaneously. Future developments should focus on improving sample pretreatment, innovating signal amplification methods, enhancing specificity on recognition of elements, and designing portable detection devices and high-throughput platforms for simultaneous toxin analysis. These advancements aim to improve the sensitivity and reliability of detection methods, providing more accurate and convenient solutions for biotoxin detection in blood.