Background The prevalence of hyperuricemia (HUA) among Chinese residents has been increasing annually, with occupational populations facing a higher risk of HUA due to shift work or obesity. Objective To investigate the impact of shift work and obesity on HUA among coal miners, and to provide scientific data for the prevention of HUA in this occupational group. Methods A cross-sectional study was conducted with 25619 workers from a coal mining group in 2023 as the study population, using a questionnaire survey and occupational health check-ups. Workers who were retired or on medical leave, as well as those who provided incomplete responses to the questionnaire or did not complete anthropometric measurements or blood tests, were excluded. A total of 23173 participants were included in the study. An unconditional logistic regression model was used to analyze the association between HUA and selected factors such as shift work status, years of shift work, daily shift work hours, body mass index (BMI), waist-to-height ratio (WHtR), and visceral adiposity index (VAI), as well as the interaction between obesity and shift work on HUA. Restricted cubic spline functions were used to analyze the dose-response relationship between years of shift work, daily shift work hours, and HUA. Results The average age of the included workers was (42.38 ± 9.82) years. A total of 6735 workers reported positive HUA, with a positive rate of 29.1%, and the prevalence was higher in men compared to women (31.8% vs. 13.9%). After adjusting for confounding factors, the restricted cubic spline model revealed a nonlinear dose-response relationship between years of shift work, daily shift work duration, and HUA: ① When the years of shift work exceeded 3.25 years, the risk of HUA in workers gradually increased with longer work duration. At 20 years of shift work, the risk increase showed a "saturation effect," meaning that the risk of HUA no longer increased with additional years of shift work. ② When daily shift work duration was below 10 h, the risk of HUA increased with the length of shift work, but after exceeding 10 h, the risk stabilized. After adjusting for confounding factors, the logistic regression model showed that, compared to non-shift workers, shift workers, those with 10-20 years and over 20 years of shift work experience, as well as those working less than 8 h and more than 8 h per day, had a higher risk of HUA, with odds ratios (OR) of 1.14 (95%CI: 1.06, 1.22), 2.42 (95%CI: 2.20, 2.67), 2.23 (95%CI: 2.00, 2.48), 1.41 (95%CI: 1.29, 1.54), and 1.90 (95%CI: 1.75, 2.06), respectively. Additionally, compared to individuals with normal obesity indices, those with overweight and obesity based on BMI, high and very high VAI and excessive WHtR had a higher risk of HUA, with ORs of 2.01 (95%CI: 1.85, 2.17), 3.51 (95%CI: 3.20, 3.84), 1.42 (95%CI: 1.32, 1.54), 2.10 (95%CI: 1.91, 2.30), and 1.82 (95%CI: 1.69, 1.97), respectively. The interaction analysis showed no interaction between shift work and obesity index (both P_s < 0.001). Conclusion Shift work, longer shift work years, and longer daily shift work hours increase the risk of HUA among coal miners. Additionally, the role of obesity in the development of HUA cannot be ignored.

Background In recent years, the detection rate of thyroid nodules in China's occupational population has shown an upward trend. The prevalence of this disease needs to be taken seriously and targeted measures should be taken to address its influencing factors. Objective To analyze the detection and influencing factors of thyroid nodules among adult male workers in coal mining enterprises in Shanxi Province, and provide a theoretical basis for the prevention of thyroid nodules. Methods A total of 5195 adult male workers from coal mining enterprises who ordered physical examination provided by the Xishan Coal Electricity (Group) Corporation Occupational Disease Prevention and Control Institute in Taiyuan City, Shanxi Province from May 2023 to December 2023 were selected as research subjects. A questionnaire survey, physical examination, ultrasound examination, and biological sample collection and testing were conducted. Thyroid nodules were diagnosed based on ultrasound results, classified and evaluated according to the Chinese-Thyroid Imaging Reporting and Data System (C-TIRADS), and the crude detection rate and standardized detection rate of thyroid nodules in adult male coal mine workers in Shanxi Province wereestimated. Occupational history and occupational exposure information were retrieved from their annual occupational health examination reports provided by the employer. Logistic regression modeling was used to analyze the influencing factors of thyroid nodule. Results A total of 1688 cases of thyroid nodules were detected, with a crude detection rate of 32.49% and an age-standardized detection rate of 31.17%. The cases (constitution ratio) of thyroid nodules by category in the detected cases was as follows: 358 cases (21.21%) were classified as category 2, 1261 cases (74.70%) as category 3, 67 cases (3.97%) as category 4a, and 2 cases (0.12%) as category 4b. The results of logistic regression showed that the duration of exposure to occupational hazards for 11-20 years, 21-30 years, ≥31 years, average monthly working>26 days, and shift work were positively correlated with the detection of thyroid nodules (P<0.05), and the associated ORs (95%CIs) were 1.29 (1.01, 1.65), 1.55 (1.20, 1.99), 1.68 (1.26, 2.55), 1.19 (1.00, 1.40), and 1.15 (1.02, 1.29), respectively. Conclusion The duration of exposure to occupational hazards, average monthly working days, and shift work are influencing factors of thyroid nodules. Intervention measures should be developed based on these influencing factors to prevent the occurrence of thyroid nodules.

Objectives:To investigate the safety and efficacy of concomitant mitral valvuloplasty(MVP)and implantation of domestic third-generation magnetically levitated Corheart 6 left ventricular assist device(LVAD). Methods:Clinical data of 13 end-stage heart failure patients who underwent Corheart 6 LVAD implantation and MVP at Central China Fuwai Hospital of Zhengzhou University from October 2021 to March 2023 were retrospectively analyzed.Mortality and complication events during hospitalization and at follow-up were collected,and changes in myocardial injury biomarkers,renal function,hemodynamics,and echocardiographic indices were observed. Results:There were no perioperative deaths and no MVP-related complications in these patients.During a mean follow-up of(14.2±5.6)months,2 patients died due to COVID-19 pneumonia and cardiac arrest respectively,11 cases(84.6%)survived.There were no recurrences of moderate-to-severe mitral regurgitation in the survived patients.Compared with preoperative value,higher cardiac output,lower central venous pressure,pulmonary artery systolic pressure(PASP),and mean pulmonary artery pressure(PAMP)were evidenced at 24 h and 72 h postoperatively,estimated glomerular filtration rate was also reduced at 1 week post operation(all P<0.010).High-sensitive troponin T level was significantly increased at 1 week post operation and then reduced at 1 month post operation,but still not returned to pre-operative level([125.5±281.9]pg/ml at baseline,[1 295.6±654.6]pg/ml at 1 week post operation and[278.0±300.5]pg/ml at 1 month post operation).Echocardiography showed that compared with preoperative period,the left ventricular ejection fraction tended to be higher at 1 and 6 months postoperatively(both P>0.017),whereas left ventricular end-diastolic dimension,PASP,and PAMP were significantly reduced(all P<0.010). Conclusions:Domestic third-generation magnetically levitated Corheart 6 LVAD implantation with concomitant MVP is safe and feasible,there is no recurrence of moderate-to-severe mitral regurgitation,a significant reduction in pulmonary artery pressure,and significant hemodynamic improvement in early to mid-term postoperatively are observed in survived patients.

BACKGROUND:Temporomandibular joint osteoarthritis can cause severe pain,which significantly affects the patient's quality of life and psychological health.Studies have found that medical ozone can effectively alleviate pain due to temporomandibular joint osteoarthritis,but its analgesic effect and mechanism are still unclear. OBJECTIVE:To explore the effects of medical ozone on pain relief in temporomandibular joint osteoarthritis and the potential mechanisms. METHODS:Twenty-four Sprague-Dawley rats were randomly divided into four groups(n=6 per group):control group,model group,air group,and medical ozone group.A sodium iodate-induced rat model of temporomandibular joint osteoarthritis was established in all groups except for the control group.After 1 week of modeling,rats in the air group and medical ozone group were injected with clean air and medical ozone,respectively,in the temporomandibular joint.The injection frequency for the air group and medical ozone group was once a week for three times in total.The von Frey mechanized pain measurement technique was used to assess the mechanical pain threshold of the temporomandibular joint in rats before and 28 days after modeling.ELISA was utilized to detect interleukin-1β in both serum and temporomandibular joint fluid at 28 days after modeling.Histopathologic changes of the temporomandibular joint were evaluated through hematoxylin-eosin staining.Additionally,the expression levels of hypoxia-inducible factor 1α and cyclooxygenase 2 in the temporomandibular joint were analyzed using immunohistochemistry. RESULTS AND CONCLUSION:Compared with the control group,the mechanical pain thresholds of the temporomandibular joint in the model group were decreased at 1,3,7,14,21,and 28 days after modeling(P<0.01);and compared with the model and air groups,the mechanical pain thresholds of the temporomandibular joint in the medical ozone group were increased at 28 days after modeling(P<0.01).Compared with the control group,the level of interleukin 1β in the serum and joint fluid of rats in the model group was elevated(P<0.01);compared with the model and air groups,the level of interleukin 1β in the serum and joint fluid of rats in the medical ozone group was decreased(P<0.01).Hematoxylin-eosin staining results showed derangement and degeneration of the cartilage structure in the model group and the air group,while the derangement of the cartilage structure in the medical ozone group was less than that in the model group and the air group.Immunohistochemical staining showed that the expression of hypoxia-inducible factor 1α and cyclooxygenase 2 in the temporomandibular joints of rats in the model group was elevated compared with that in the control group(P<0.01);the expression of hypoxia-inducible factor 1α and cyclooxygenase 2 in the temporomandibular joints of rats in the medical ozone group was decreased compared with that in the model group and the air group(P<0.01,P<0.05).These findings suggest that medical ozone can alleviate the pain caused by osteoarthritis of the temporomandibular joints in Sprague-Dawley rats by reducing the expression of hypoxia-inducible factor 1α,interleukin 1β,and cyclooxygenase 2.

ObjectiveTo observe the effect of Youguiwan on the leptin/Janus kinase 2 （JAK2）/signal transducer and activator of transcription 3 （STAT3） signaling pathway in the lung tissue of the rat model of chronic obstructive pulmonary disease （COPD） due to kidney-Yang deficiency. MethodForty rats were modeled for COPD with the syndrome of kidney-Yang deficiency by intratracheal instillation of lipopolysaccharide on day 1 and day 14 and continuous fumigation for 6 weeks， during which hydrocortisone was injected intramuscularly at an interval of 3 days. The modeled rats were randomized into model， high- （11.7 g·kg^-1）， medium- （5.85 g·kg^-1）， and low-dose （2.93 g·kg^-1） Youguiwan， and aminophylline （0.054 g·kg^-1） group. In addition， 8 SD rats were set as the blank group. After the completion of modeling， the rats in each group were administrated with the corresponding drug by gavage for 28 consecutive days. After the last administration， samples were collected. A lung function analyzer was used to evaluate the lung function of rats. Enzyme-linked immunosorbent assay was employed to measure the levels of interleukin-17A （IL-17A）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in the bronchoalveolar lavage fluid （BALF）. Hematoxylin-eosin staining was employed to observe the pathological changes in the lung tissue， and Masson staining was employed to observe the deposition of blue collagen fibers around bronchi in the lung tissue and calculate the inflammation score. The immunofluorescence assay was employed to measure the protein content of collagen type Ⅰ （ColⅠ） and α-smooth muscle actin （α-SMA） in the bronchi. The protein and mRNA levels of leptin， IL-17A， JAK2， and STAT3 in the lung tissue were determined by Western blot and real-time fluorescence quantitative polymerase chain reaction， respectively. ResultCompared with the blank group， the model group showed decreased lung function （P<0.01）， elevated levels of IL-6， IL-17A， and TNF-α in the BALF （P<0.01）， and increased lung inflammation score， deposition of subcutaneous collagen fibers in the airway， and ColⅠ and α-SMA proteins （P<0.01）. Furthermore， the modeling up-regulated the proteins and mRNA levels of leptin， IL-17A， JAK2， and STAT3 in the lung tissue （P<0.01） and enhanced the phosphorylation of JAK2 and STAT3 （P<0.01）. Compared with the model group， high- and medium-dose Youguiwan improved the lung function， decreased the inflammation score， reduced collagen fiber deposition and ColⅠ and α-SMA proteins， lowered the levels of IL-6， IL-17A， and TNF-α in the BALF， down-regulated the mRNA and protein levels of leptin， JAK2， STAT3， and IL-17A， and weakened the phosphorylation of JAK2 and STAT3 （P<0.05， P<0.01）. The aminophylline group had higher IL-17A and TNF-α levels than the high-dose Youguiwan group， lower IL-17A level than the medium and low-dose Youguiwan groups， and lower TNF-α level than the low-dose Youguiwan group. Compared with the aminophylline group， the high- and medium-dose Youguiwan groups showed reduced deposition of collagen fibers and protein levels of ColⅠ and α-SMA around the bronchi in the lung tissue （P<0.05， P<0.01）， decreased inflammation score， and down-regulated protein and mRNA levels of leptin， JAK2， STAT3， and IL-17A in the lung tissue. ConclusionYouguiwan can prevent airway remodeling by inhibiting IL-17A to reduce inflammation and collagen deposition in COPD rats， which may be related to the inhibition of the leptin/JAK2/STAT3 signaling pathway.

Objective:To understand the genomic characteristics and evolutionary trends of three coxsackievirus (CV) subtypes, including CV-A2, CV-A4 and CV-A5, in Suzhou city.Methods:Totally 248 samples were collected during routine monitoring for hand, foot, and mouth disease in Suzhou city from January to June in 2022. The specimens were detected for CV genotypes using Real-time fluorescence-reverse transcription polymerase chain reaction (Real-time RT-PCR). The CV positive samples were sequenced using the Miseq high-throughput sequencing platform. After obtaining the whole genome sequences of CV strains, homology analysis was performed. An evolutionary tree was constructed using molecular evolutionary genetics analysis (MEGA) X. Sequence recombination regions were analyzed using SimPlot and BootScan.Results:During routine monitoring for hand, foot and mouth disease in Suzhou city from January to June in 2022, one strain each of CV-A2, CV-A4, and CV-A5 viruses were identified, and their complete genomes were sequenced. CV-A2 and CV-A4 were clustered with the current prevalent strains in China, and no new amino acid site mutations were found in the whole genome of CV-A2; CV-A4 had several new amino acid site mutations in the non-structural region compared with the prototype strain; CV-A5 belonged to the C1 subgenotype 3 lineage, and the genome of CV-A5 had several new amino acid mutation sites in the non-structural protein region and underwent recombination.Conclusions:The CV-A2 and CV-A4 strains are stable epidemic strains, the CV-A5 strain is recombinant strain in Suzhou city.

Objective To investigate the effect of medical ozone injection therapy on temporomandibular joint(TMJ)osteoarthritis and its pain in SD rats.Methods Fifity-four rats were randomly assigned according to a random number table into three groups:con-trol group,model group,and medical ozone group,with 18 rats in each group.In the control group,only physiological saline was in-jected during modeling;in the model group,only sodium iodoacetate was injected for modeling;in the medical ozone group,after in-jecting sodium iodoacetate into the joint cavity for modeling for one week,medical ozone was then injected into the joint cavity for inter-vention at a frequency of once a week,totaling 5 times.One week(week 2 after modeling),3 weeks(week 4 after modeling),and 5 weeks(week 6 after modeling)after medical ozone injections,6 rats from each group were euthanized.Mechanical withdrawal thresh-old of rats in each group was assessed before euthanasia,and the expression levels of interleukin-1β(IL-1β)in joint fluid of rats in each group were measured after euthanasia.Gross observation and modified Mankin's scoring were performed on TMJ cartilage of rats in each group after stained with Pelletier score and Safranin O-Fast Green.Results During the same time period,compared to the control group,the model group showed a significant decrease in the mechanical pain threshold of the TMJ in rats at 1 week,3 weeks,and 5 weeks(P＜0.01).The expression levels of IL-1β in the TMJ fluid increased(P＜0.01),and the Pelletier score and modified Mankin's score of TMJ cartilage increased(P＜0.01).In comparison to the model group,the medical ozone group exhibited a significant increase in the mechanical pain threshold of the TMJ in rats after 3 weeks and 5 weeks of medical ozone injections(P＜0.01).The expression levels of IL-1β in the TMJ fluid decreased(P＜0.01),and the Pelletier score and modified Mankin's score of TMJ cartilage decreased(P＜0.01).However,there were no statistically significant difference in the measured parameters in the TMJ cavity after 1 week of medical ozone injection(P＞0.05).Within the medical ozone group,compared to the 1-week treatment,the mechanical pain threshold of the TMJ increased(P＜0.01)and the expression levels of IL-1β in the TMJ fluid decreased at 3 weeks and 5 weeks(P＜0.01).However,there was no statistically significant difference in the Pelletier score and modified Mankin's score of TMJ cartilage(P＞0.05)between different treatment duration.Additionally,there were no statistically signif-icant differences in the mechanical pain threshold of the TMJ,expression levels of IL-1β in the TMJ fluid,Pelletier score,and modi-fied Mankin's score of TMJ cartilage between the medical ozone group at 3 weeks and 5 weeks(P＞0.05).Conclusion Medical ozone treatment for more than 3 weeks can improve temporomandibular joint osteoarthritis and its associated pain in rats.

Objective To investigate the mechanism of retinal injury in rats caused by light-emitting diodes(LEDs)with different color rendering indexes(CRIs).Methods Totally 20 Sprague-Dawley rats were randomly divided into nor-mal control(NC)group(sunlight),low CRI(CRI-L)group(blue light),medium CRI(CRI-M)group(conventional LED),and high CRI(CRI-H)group(full-spectrum LED),with 5 rats in each group,exposed to light for 12 hours daily for 4 consecutive weeks.Hematoxylin & eosin staining was used to assess morphological changes in the retina.Dihydroethidi-um staining was employed to detect the levels of reactive oxygen species(ROS)in retinal tissues.The messenger ribonu-cleic acid(mRNA)expressions of NOD-like receptor family pyrin domain containing protein 3(NLRP3),Gasdermin D(GSDMD)and Caspase-1 were analyzed by real-time quantitative polymerase chain reaction(RT-qPCR),and their protein expressions were measured through immunohistochemical staining.Environmental light spectra were measured using a spectroradiometer.Results Rats in the CRI-L group showed the thinnest retina,followed by the CRI-M group and CRI-H group.The fluorescence intensity of ROS in the NC group,CRI-L group,CRI-M group and CRI-H group was 1.000±0.046,25.060±1.732,14.530±3.776 and 1.821±0.587,respectively.The ROS level in the CRI-H group was significantly lower than that in the CRI-L group and CRI-M group(both P＜0.05).RT-qPCR showed that the relative mRNA expression of NL-RP3 in the NC group,CRI-L group,CRI-M group and CRI-H group was 1.004±0.005,4.004±0.716,2.027±0.303 and 0.741±0.069,respectively;the relative mRNA expression of Caspase-1 was 1.010±0.006,4.337±0.345,2.268±0.058 and 0.713±0.021,respectively;the relative mRNA expression of GSDMD was 1.000±0.000,2.938±0.559,1.955±0.166 and 1.213±0.051,respectively.Compared with the NC group,the relative expressions of NLRP3,Caspase-1 and GSDMD in the CRI-L group and CRI-M group significantly increased(all P＜0.05).The immunohistochemical staining results showed that the fluorescence intensity of NLRP3 in the retina of rats in the NC group,CRI-L group,CRI-M group and CRI-H group was 0.379 4±0.002 2,0.400 7±0.011 4,0.379 0±0.006 9 and 0.377 0±0.007 5,respectively;the fluorescence intensity of Caspase-1 was 0.367 2±0.005 8,0.442 6±0.041 1,0.382 4±0.011 9 and 0.380 6±0.006 5,respectively;the fluorescence intensity of GSDMD was 0.159 5±0.013 4,0.167 5±0.011 9,0.397 6±0.014 3 and 0.377 2±0.022 8,respec-tively.Compared with the NC group,rats in the CRI-L group showed increased fluorescence intensity of NLRP3 and Caspase-1,and rats in the CRI-M and CRI-H showed increased fluorescence intensity of GSDMD(all P＜0.05).The spec-tral comparison revealed that the CRI-H group had a broader spectral coverage and a distribution closer to natural light spectra.Conclusion Conventional LED exposure can induce a decrease in retinal thickness,upregulate the ROS expres-sion in retinal tissues,and increase the expression levels of NLRP3,Caspase-1 and GSDMD.High CRI full-spectrum LEDs can mitigate pyroptosis through the ROS/NLRP3 pathway by optimizing their spectral distribution,offering better biosafety.

Objective:To investigate whether octyl ester derivative of ginsenoside Rh2(Rh2-O)can induce immunogenic cell death of Huh-7 hepatocellular carcinoma cells and possible mechanism.Methods:Huh-7 cells were cultured in vitro,and divided into control group,Rh2-O group,positive control group(mitoxantrone treatment).Viability and apoptosis of cells were detected by CCK-8 and flow cytometry,respectively.Concentrations of high mobility family protein 1(HMGB1)and adenosine triphosphate(ATP)in supernatant were detected by ELISA and chemiluminescence assay,respectively.Membrane eversion of calreticulin(CRT)was detected by immunofluorescence assay.ROS level in cells was detected by fluorescence probe DCFH-DA,and expressions of proteins associated with endoplasmic reticulum stress signaling pathway were detected by Western blot.Results:Rh2-O treatment significantly reduced cell viability,promoted apoptosis,induced secretion of HMGB1,ATP,membrane eversion of CRT,increased accumulation of ROS in cells,and enhanced expressions of endoplasmic reticulum stress-related proteins PERK,eIF2α,p-eIF2α(all P<0.05).After addition of endoplasmic reticulum stress inhibitor 4-phenylbutyric acid(4-PBA),membrane eversion of CRT induced by Rh2-O was significantly inhibited(P<0.05).Conclusion:Rh2-O can induce immunogenic cell death in hepatocellular carcinoma cells,whose mechanism may be associated with activation of endoplasmic reticulum stress and promotion of CRT membrane eversion.

Objective:To investigate the management of patients with intravenous misplacement of nephrostomy tube following percutaneous renal surgery.Methods:The data of 6 patients with intravenous misplacement of nephrostomy tube during percutaneous nephrolithotomy (PCNL) treated in the two hospitals of Chenzhou from January 2006 to December 2020 were retrospectively analyzed. The median age was 41.0(38.5, 53.0) years old. There were 4 males and 2 females. Three patients had undergone contralateral upper urinary tract operation. One patient had undergone ipsilateral upper urinary tract operation. Two patients had not undergone upper urinary tract operation. Two of the 6 patients had a solitary kidney. Two patients were diagnosed with staghorn calculi (combined with mild hydronephrosis in 1 patient, moderate hydronephrosis in 1 patient). Four patients were diagnosed with ureteral calculus (combined with mild hydronephrosis in 2 patients, moderate hydronephrosis in 1 patient, severe hydronephrosis in 1 patient). In all 6 patients, the tract was dilated with fascial dilators. Immediately after dilator removal, brisk venous bleeding was noted. A nephrostomy tube was inserted promptly through the sheath to tamponade the tract and was immediately closed. Five cases were diagnosed by CT after operation, and 1 case was early diagnosed by intraoperative injection of contrast medium through nephrostomy tube. The nephrostomy tube was misplaced in 5 patients with left upper urinary tract calculi, and in 1 patient with right upper urinary tract calculi. The tip of nephrostomy tube was located in ipsilateral renal vein in 3 patients with left upper urinary tract calculus, inferior vena cava in 2 patients with left upper urinary tract calculus, and contralateral renal vein in 1 patient with right upper urinary tract calculus. No venous thrombosis of renal vein or inferior vena cava was founded in the 6 patients. All 6 patients were managed with strict bed rest, intravenous antibiotics, and one-step or two-step tube withdrawal under close monitoring. One step method referred to total removal of nephrostomy tube under ultrasonic monitoring. Two step method referred to retracting the end of nephrostomy tube into the renal sinus under CT monitoring in the first step, then the nephrostomy tube was completely removed under ultrasound monitoring.Results:All 6 patients were successfully managed with strict bed rest, intravenous antibiotics, and one-step or two-step tube withdrawal under close monitoring. The tube was withdrew by one-step method in 1 patient, by two-step method in 5 patients. The original operations were performed successfully under close observation in 4 patients during the same hospitalization and in 1 patient during the next hospitalization. Other type of operation in 1 patient was performed during the next hospitalization. The all 6 patients were discharged uneventfully. The stone was cleared.Conclusions:Intravenous misplacement of a nephrostomy tube is mainly diagnosed by CT. The nephrostomy tube should be sealed immediately after diagnosis. The intravenously misplaced nephrostomy tube can be successfully removed by one-step or two-step withdrawing under close monitoring. Upper urinary tract stones can be successfully treated at the same time or by stages.