Objective To investigate and analyze the occupational stress levels and influencing factors among radiation workers in China, and provide a reference for alleviating occupational stress and promoting mental health. Methods Using the general situation questionnaire, Effort-Reward Imbalance questionnaire, and radiation protection knowledge questionnaire, a convenience sampling method was adopted to investigate the occupational stress of 243 radiation workers in Liaoning, Fujian, Guangdong, and Xinjiang provinces. The independent samples t-test, one-way analysis of variance, chi-square test, and binary logistic regression were used to analyze the influencing factors. Results The average score of Effort-Reward Imbalance was 0.97 ± 0.22, and 100 (41.15%) radiation workers had occupational stress. There were significant differences in the detection rate of occupational stress among radiation workers of different ages, working years in radiation positions, monthly incomes, daily sleep durations, and daily working hours (P < 0.05). Logistic regression analysis identified daily working hours as a factor contributing to occupational stress. Conclusion The occupational stress among radiation workers in China is relatively severe. It is recommended to pay attention to the associated risks and implement targeted intervention measures to reduce the impact of occupational stress.

The organization of the brain follows a topological hierarchy that changes dynamically during development. However, it remains unknown whether and how cognitive training administered over multiple years during development can modify this hierarchical topology. By measuring the brain and behavior of school children who had carried out abacus-based mental calculation (AMC) training for five years (starting from 7 years to 12 years old) in pre-training and post-training, we revealed the reshaping effect of long-term AMC intervention during development on the brain hierarchical topology. We observed the development-induced emergence of the default network, AMC training-promoted shifting, and regional changes in cortical gradients. Moreover, the training-induced gradient changes were located in visual and somatomotor areas in association with the visuospatial/motor-imagery strategy. We found that gradient-based features can predict the math ability within groups. Our findings provide novel insights into the dynamic nature of network recruitment impacted by long-term cognitive training during development.
Child ; Humans ; Cognitive Training ; Magnetic Resonance Imaging ; Brain ; Brain Mapping ; Motor Cortex

Objective To investigate the surgical method and clinical outcome using the free anterolateral thigh flap with the medial gastrocnemius artery as the recipient artery for the repair of complex wounds in the lower leg. Methods A retrospective analysis was conducted on the clinical data of 11 patients with complex wounds in the lower leg admitted to Suzhou Ruihua Orthopedic Hospital from October 2020 to September 2022. All patients had extensive skin and subcutaneous soft tissue defects in the lower leg and received free anterolateral thigh flap repair with the medial gastrocnemius artery as the recipient artery. The skin of donor site was directly sutured. Results All 11 free skin flap survived in 11 patients, and both the donor and recipient sites healed in stage I. All patients were followed up after discharge, with a follow-up time of 12 to 35 months. The follow-up results at 12 months postoperatively showed good wound healing, good flap appearance and elasticity, restoration of normal knee and ankle joint function, and independent living ability. The donor site wounds healed well without significant scar hyperplasia. At the last follow-up, the flap sensory function was graded as S₃ in 2 patients and S₂ in 9 patients. The functional score of the affected limb was excellent in 5 patients and good in 6 patients, with an excellent and good rate of 100%. Conclusion The medial gastrocnemius artery has a suitable vessel caliber for anastomosis and a constant location. The use of the free anterolateral thigh flap with this artery as the recipient artery for the repair of severe wounds in the lower leg can effectively cover soft tissue defects and avoid injuring the residual main vessels in the lower leg, resulting in satisfactory outcomes.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Objective:To explore the clinical effects of free anterolateral thigh perforator flap pedicled with descending genicular artery in repairing wounds after lower leg limb-sparing surgery.Methods:A retrospective observational study was conducted. From January 2019 to June 2021, 12 patients with wounds after lower leg limb-sparing surgery who met the inclusion criteria were admitted to Suzhou Ruihua Orthopedic Hospital, including 6 males and 6 females, aged 17 to 74 years, with original wound area ranging from 17 cm×9 cm to 40 cm×15 cm. Five patients had infection in wounds. The wounds were all repaired by free anterolateral thigh perforator flap from contralateral thigh, with area of 18 cm×10 cm to 37 cm×9 cm. The artery of flap was anastomosed with the descending genicular artery, and the wounds in donor areas were sutured directly. Seven patients were transplanted with split-thickness skin grafts from the contralateral thigh to cover the remaining wounds that can not be covered by flap and the wounds in donor areas were covered with gauze. During the operation, the types of perforating branch carried by flap and the types of arteries and veins in recipient areas were recorded. The survival and occurrence of vascular crisis of flap, the survival of skin graft, the wound healing in donor and recipient areas, and the length of hospital stay after flap transplant surgery were recorded. During follow-up, the color and texture of flap, reinfection in lower leg, and fracture healing were recorded. At the last follow-up, the limb salvage function of patients was evaluated according to the functional evaluation criteria of Chen Zhongwei's amputated limb replantation.Results:The types of perforating branches carried by flaps were as follows: 6 cases of only carrying the descending branch of the lateral circumflex femoral artery, 3 cases of only carrying the oblique branch of the lateral circumflex femoral artery, and 3 cases of carrying the descending branch of the lateral circumflex femoral artery and oblique branch of the lateral circumflex femoral artery after internal pressurization anastomosis. The types of arteries in the recipient area of flap were as follows: one case of main trunk of the descending genicular artery, 8 cases of the saphenous branch of the descending genicular artery, and 3 cases of the articular branch of the descending genicular artery. The types of veins in the recipient area of flap were as follows: 8 cases of one accompanying vein of the descending genicular artery and one branch of the great saphenous vein, and 4 cases of two branches of the great saphenous vein. All the flaps survived without vascular crisis, and all the skin grafts also survived. The wounds in the donor and recipient areas were all healed. The length of hospital stay of patient after flap transplant surgery ranged from 13 to 79 days. During the follow-up of 6 to 23 months, the color and texture of flap were both good, with no infection in lower leg wound. Internal or external fixation were removed after fracture healing in 5 patients, and bone graft internal fixation was performed in 7 patients whose fractures were not healed after surgery and all the incisions healed without infection. At the last follow-up, the limb salvage effect of patients was evaluated as followings: excellent in 7 patients, good in 4 patients, and fair in one patient.Conclusions:Free anterolateral thigh flap pedicled with descending genicular artery can effectively repair the wounds after lower leg limb-sparing surgery and control infection with short length of hospital stay, while not increasing the risk of secondary injury of distal limb vessels. Thus, it can obtain satisfactory limb salvage effect which is worthy of clinical promotion.

Objective:To explore the factors influencing the pulmonary function of persons with mild to moderate adolescent idiopathic scoliosis (AIS).Methods:Forty-four persons with AIS were tested for their pulmonary ventilation functioning. The indicators were the percentage of forced vital capacity (FVC%), the percentage of forced expiratory volume in the first second (FEV1%) and the percentage of maximum chase volume (MVV%). Data including age, gender, course of disease, dancing habits, exercise habits, body mass index (BMI), Cobb angle, rotation angle, diaphragm thickness, and diaphragm excursion (DE) were also collected. Linear regressions were evaluated to analyze the factors best predicting pulmonary functioning. Spearman correlation coefficients were computed to quantify the correlation between respiratory muscle functioning and pulmonary functioning.Results:The univariate analysis showed that dancing and DE independently influence FVC%, FEV1%, and MVV%. DE was the only independent factor significantly predicting pulmonary functioning for mild to moderate AIS patients. DE was also significantly positively correlated with average FVC%, FEV1% and MVV%.Conclusions:Respiratory training aimed at enhancing DE is necessary to improve the pulmonary ventilation of persons with AIS.

Objective:To investigate clinical effect of the descending genicular periosteal free flap combined with bone graft in the treatment of tibial nonunions.Methods:From January, 2014 to June, 2018, 15 cases of tibial nonunions were treated with the descending genicular corticoperiosteal free flaps combined with bone graft after soft tissue coverage. All patients had Gustilo III C fracture. In 6 cases, the descending genicular artery of periosteal flap was anastomosed with the branch of anterior tibia artery, 6 cases anastomosed with the branch of posterior tibia artery, other 3 cases had Flow-through anastomosis with the main trunk of anterior tibia artery. The accompanying vein of descending geniculate artery was anastomosed with the vein of anterior tibia or posterior tibia artery. Routine treat- ment, step-by-step functional recovery exercises, monthly X-ray examination were conducted together with close ob- servation of the healing of fracture.Results:All cases were followed-up from 6 to 29 (average, 11) months. Bone u- nion was achieved in 14 cases with the averager time of healing in 5 months. According to the evaluation criteria of Paley fracture healing, 12 cases were excellent, 2 were good and 1 was poor. Fourteen cases were able to take daily normal activities, and 1 case failed to take the daily activities because the fracture was not healed. Six months later, according to the results of Paley functional evaluation, 2 cases were scored excellent, 12 scored good and 1 scored poor.Conclusion:The method of the descending genicular periosteal free flap combined with bone graft in the treatment of tibial nonunions can effectively improve the fracture union rate and reduce the patient treatment time with hidden donor area and simplicity of operation. It is helpful for the patients to take early exercises for the recovery of functions.

Objective: To evaluate the preliminary efficacy and safety of the 5-fluorouracil/leucovorin, irinotecan, and oxaliplatin (FOLF-OXIRI) and capecitabine, irinotecan, and oxaliplatin (CAPIRINOX) regimens as first-line therapy for unresectable advanced colorectal cancer. Methods: Between January 2013 and November 2018, 73 patients with metastatic colorectal cancer (mCRC) were analyzed. All patients received first-line chemotherapy. Of them, 45 patients were administered FOLFOXIRI, and the remaining 28 patients were ad-ministered CAPIRINOX. The clinical outcomes and safety profiles were evaluated according to the objective response rate (ORR), con-version resection rate, and adverse effects. Results: The ORR, median progression-free survival (mPFS), and R0 resection rate in the FOLFOXIRI group were not statistically different from those in the CAPIRINOX group (60% vs. 57.1%, 7.7 months vs. 9.6 months, 24.4% vs . 17.9% , respectively; P>0.05). No treatment-related deaths occurred. The major adverse events were leukopenia, neutropenia, fa-tigue, nausea, vomiting, diarrhea, alopecia, aspartate aminotransferase/alanine aminotransferase elevation, and neurotoxicity. The to-tal rate of grade 3/4 adverse events in the FOLFOXIRI group was 33.3% (15/45), while the total rate of grade 3/4 adverse events in the CAPIRINOX group was 46.4% (13/28). Toxicities between the two groups were not statistically significant (P=0.263). Conclusions: Both the FOLFOXIRI and CAPIRINOX regimens are effective as first-line treatment for metastatic colorectal cancer. The triple-agent chemo-therapy was associated with good efficacy and tolerable toxicity.

Objective: To investigate the effect of manganese chloride (MnCl₂) or 1-methyl-4-phenylpyridinium (MPP ⁺) on oxidative stress and autophagy in human neuroblastomaSK-N-SH cells and the mechanism of the neurotoxicity of manganese. Methods: SK-N-SH cells were treated with MnCl₂ or MPP⁺ at doses of 0.062 5, 0.125, 0.25, 0.5, 1.0, and 2.0 mmol/L for 24 hours, and MTT assay was used to measure cell viability. The cells weretreated with MnCl₂ or MPP⁺ at doses of 0.125, 0.25, and 0.5 mmol/L for 24 hours, and flow cytometry was used to measure the content of reactive oxygen species (ROS) in cells, a laser scanning confocal microscope was used to observe autophagosome in cells, and Western blot was used to measure the expression of autophagy-related proteins P62 and LC3-II/LC3-I. Results: Compared with the control group, the 0.0625-2.0 mmol/L MnCl₂ and 0.125-2.0 mmol/L MPP ⁺ treatment groups had significant reductions in the viability of SK-N-SH cells, and the 0.25-2.0 mmol/L MnCl₂ treatment groups had significantly lower viability than the groups treated with the same doses of MPP⁺ (all P<0.05) . Compared with the control group, the 0.125-0.25 mmol/L MnCl₂ and 0.125-0.5 mmol/L MPP⁺ treatment groups had significant increases in the content of ROS, and the 0.25-0.5 mmol/L MPP⁺ treatment groups had significantly higher content of ROS than the groups treated with the same doses of MnCl₂ (all P<0.05) . Compared with the control group, the 0.25-0.5 mmol/L MnCl₂ andMPP⁺ treatment groups had significant increases in autophagy-related proteins LC3-II/LC3-I and significant reductions in P62 expression; the 0.125-0.5 mmol/L MPP⁺ treatment groups had significantly higher LC3-II/LC3-I than the groups treated with the same doses of MnCl₂, and the 0.125 and 0.25 mmol/L MPP ⁺ treatment groups had significantly lower P62 expression than the groups treated with the same doses of MnCl₂ (all P<0.05) . Conclusion Both MnCl₂ and MPP⁺ can induce oxidative stress and autophagy in SK-N-SH cells, and MPP⁺ has a significantly greater inductive effect on autophagy of SK-N-SH cells than MnCl₂.

Objective To observe the effect and safety of Mailuoning Injection(MLN) in treating patients with type 2 diabetes mellitus accompanying lower extremity atherosclerotic obliterans.Methods The selected patients were assigned by randomized digital table to a treated group (120 cases treated with MLN) and a control group (60 cases treated with alprostadil). The clinical efficacy was assessed after 4 weeks of treatment. Results The total effective rate in the treated group was 95.0%, better than that in the control group,83.3%(P＜0.01).Conclusion MLN has the effect of activating blood circulation.dissolving stasis and dredging collaterals, reducing the formation of thrombi. MLN is effective and safe when applied in clinical practice for the treatment of lower extremity diabetic atherosclerotic obliterans.