Objective To analyze the incidence of prehypertension (PHTN) and hypertension of male workers in a coal mine and investigate the influencing factors. Methods A total of 10 155 male workers in a coal mine in Shanxi Province were selected as the study subjects using the judgment sampling method. Occupational medical examination was carried out to examine the prevalence of abnormal blood pressure (including PHTN and hypertension) and its influencing factors. Results The prevalence of abnormal blood pressure was 69.9%, with a PHTN prevalence of 44.2% and a hypertension prevalence of 25.7%. The results of multinomial logistic regression analysis showed that the risk of PHTN and hypertension increased with age, drinking frequency and body mass index (all P<0.05). Workers with a pulse rate≥100 times/min had a higher risk of PHTN and hypertension than those with a pulse rate of 60-100 times/min (all P<0.05). The risk of PHTN and hypertension in workers exposed to noise, silica dust or other dust was higher than those without such occupational hazard exposure (all P<0.05). The risk of hypertension in workers with abnormal blood glucose was higher than that in workers with normal blood glucose (P<0.05). Exposure to organic solvents was associated with a higher risk of hypertension (P<0.05). Conclusion The prevalence of PHTN and hypertension among male coal miners in this mine is relatively high. The individual factors such as age, alcohol consumption, pulse rate, and body mass index, along with occupational exposure factors such as noise, silica dust, and other dusts, are influencing factors for PHTN and hypertension.

Objective To analyze the prevalence of chronic diseases and its influencing factors of dust-exposed male workers in a coal mine. Methods A total of 9 782 dust-exposed male workers from a coal mine in Shanxi Province were selected as the study subjects using the purposive sampling method. Their occupational health examination results were collected to analyze the prevalence of chronic diseases and its influencing factors. Results The prevalence of dyslipidemia, hyperuricemia, hypertension and diabetes were 40.3%, 30.7%, 23.5% and 5.6%, respectively. The prevalence of chronic diseases was 64.8%. Among them, the prevalence of having one, two, three or more chronic diseases were 36.5%, 21.6% and 6.7%, respectively. The prevalence of comorbid chronic diseases was 28.3%, with the highest prevalence of concurrent dyslipidemia and hyperuricemia of 11.0%. The results of binary logistic regression analysis showed that the risk of chronic disease was higher in workers <40 years old, smoking, overweight, obesity and total working years >20 years (all P<0.05). The results of multinomial logistic regression analysis showed that workers <40 years old, overweight, obesity and total working years >20 years were risk factors for having one chronic disease (all P<0.05). The workers <40 years old, smoking, overweight, obesity and total working years >20 years were risk factors for having two chronic diseases (all P<0.05). The workers <40 years old, smoking, alcohol consumption, overweight, obesity, other types of work, and working years >20 years were risk factors for having three or more chronic diseases (all P<0.05). Conclusion The prevalence of chronic diseases is high and the comorbidity of chronic diseases is common among dust-exposed male workers. The main influencing factors were age, smoking, alcohol consumption, overweight, obesity, type of work, and working year. Workers with more contributing factors have higher risk of chronic comorbidities.

Objective To investigate the onset of liver inflammation and related predictive factors in patients with HBeAg-positive chronic hepatitis B virus (HBV) infection who have normal alanine aminotransferase (ALT) and a high viral load. Methods A retrospective analysis was performed for the clinical data of 183 patients with HBeAg-positive chronic HBV infection who had normal ALT and a high viral load and were treated from October 2008 to May 2015, and according to the results of liver biopsy, they were divided into hepatitis group and non- hepatitis group. The t -test or Mann-Whitney U testwas used for comparison of normally distributed continuous data between groups, the chi-square test was used for comparison of categorical data. The predictive factors were analyzed by univariate binary logistic regression, the multivariate binary logistic regression was carried out by stepback method, and the cut-off values were analyzed by receiver operating characteristic curve (ROC) and Jordan index. Results There were 37 patients (20.2%) in the hepatitis group and 146 patients (79.8%) in the non-hepatitis group. Compared with the non-hepatitis group, the hepatitis group had a significantly lower proportion of male patients (45.9% vs 68.5%, χ 2 =6.508, P =0.011), a significantly higher level of aspartate aminotransferase [24 (21.25~35.55) U/L vs 21.2 (18.08~ 24.65) U/L, Z =-3.344, P =0.001], and a significantly lower log(HBsAg) value [4.4(4.28~4.49) vs 4.46(4.4~4.74), Z =-2.184, P =0.029]. Log(HBsAg) value was a predictive factor for hepatitis (odds ratio=0.077, P =0.017), and the cutoff value of HBsAg was 33884.4I U/mL. Conclusion Among the patients with HBeAg-positive chronic HBV infection who have normal ALT and a high viral load, 20.2% have liver inflammation, and HBsAg may be a predictive factor for liver inflammation.

Objective To investigate the clinical features and autoantibody characteristics of patients with drug-induced liver injury (DILI). Methods A retrospective analysis was performed for the patients with abnormal liver function who were admitted to Beijing Ditan Hospital, Capital Medical University, from September 2014 to September 2018 and were diagnosed with DILI based on RUCAM score, and related data on admission were collected, including baseline liver function, renal function, routine blood test results, five immune indices, autoantibody, and liver biopsy results. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used to compare the detection rate of autoantibody between the patients with different sexes or types of liver injury. A logistic regression analysis was used to investigate whether autoantibody had a regression relationship with sex, age, and type of injury, and an ordinal logistic regression analysis was performed with baseline laboratory results as independent variables and anti-nuclear antibody (ANA) titer as the dependent variable. Results A total of 419 patients with DILI were enrolled in the study, with a median age of 47 (35-55) years, among whom male patients accounted for 32.5% (136/419) and female patients accounted for 67.5% (283/419). Among these 419 patients, 88 (21.5%) had hepatocellular-type liver injury, 87 (21.2%) had mixed-type liver injury, and 235 (57.3%) had cholestasis-type liver injury. The detection rate of autoantibodies was 50.6% (212/419), and the detection rate of ANA was 42.9% (180/419), with a titer of mainly 1∶ 100 (104/180). There was no significant difference in the detection rate of autoantibodies between the patients with different sexes ( χ 2 =2.658, P =0.103) or different types of injury ( χ 2 =0.859, P =0.651). The binary logistic regression analysis showed that autoantibody did not have a regression relationship with sex, age, and type of injury (all P > 0.05) There were significant differences in prothrombin time activity (PTA) and international normalized ratio (INR) between the positive autoantibody group and the negative autoantibody group ( t =2.161, P =0.031; Z =-3.010, P =0.003). The ordinal logistic regression analysis showed that INR (odds ratio [ OR ]=3.101, P =0.040) and IgG ( OR =1.043, P =0.014) were associated with ANA grade. Conclusion There is a relatively high detection rate of autoantibodies in patients with DILI, and the detection rate of autoantibodies is not associated with sex, age, or type of injury. There are differences in PTA and INR between autoantibody-positive patients and autoantibody-negative patients, and the levels of INR and IgG are correlated with antibody titer.

Objective:To establish a method of serum detection by Raman spectroscopy for the diagnosis of gastric cancer.Methods:Between April and November 2019, 110 patients with gastric cancer [73 males, 37 females, age (57.4±10.3) years] and 74 patients with colorectal cancer [48 males and 26 females, aged (58.3±12.2) years] were collected at the First Affiliated Hospital of Army Military Medical University, along with 100 healthy subjects [59 males and 41 females, aged (55.6±10.61) years] during the same period. Fasting venous blood serum samples were collected from the subjects. A Raman spectrometer XploRA PLUS was used in this experiment, with an excitation light source of 532 nm, a field of view of 100 times, and a spectrum range of 200-2 000 cm -1, etc. The serum samples were detected by nondestructive and non-contact rapid detection, and the Raman spectra of serum samples were collected. Using the Raman spectrum acquisition and processing supporting software LabSpec6 to smooth, baseline, and normalize the obtained Raman spectrum. Multivariate statistical analysis software SIMCA14.1 were applied to import and analyze the obtained Raman spectrum data by principal component analysis (PCA), orthogonal partial least squares discriminant analysis (OPLS-DA), and other methods for statistical analysis. An operating characteristic curve (ROC) was constructed to evaluate the model analysis effect between serum samples of healthy people and those with gastric cancer. Serum samples from the colorectal cancer group were used to verify the reliability of the model. Results:Six Raman peaks with good repeatability were detected in serum samples in health and gastric cancer group, and peaks were located at 1 001.17, 1 154.63, 1 337.89, 1 446.85, 1 515.33, and 1 658.34 cm -1, respectively. Raman intensities at six Raman peaks were significantly different between healthy and gastric cancer groups. At the displacement of 1 001.17, 1 154.63, and 1 515.33 cm -1, the Raman intensity in the healthy group was higher than that in the gastric cancer group. At 1 337.89, 1 446.85, and 1 658.34 cm -1 displacement, the Raman intensity of the gastric cancer group was higher than that of the healthy group. An OPLS-DA model was constructed to analyze the serum samples of the healthy group and the gastric cancer group. In the model, R 2 is the fitting power, and Q 2 is the predictive ability. The closer the values of R 2 and Q 2 are to 1, the better the performance of the model, and the obtained model's R 2X(cum)=0.809, R 2Y(cum)=0.819, Q 2(cum)=0.758. ROC characteristic curve was drawn based on the OPLS-DA model. The area under the curve (AUC) of the gastric cancer group was 0.998. Six peaks with good repeatability were detected in the serum Raman spectra of gastric cancer stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ, which were located at the displacement of 1 001.85, 1 155.07, 1 338.36, 1 445.75, 1 515.92, and 1 657.68 cm -1, respectively, and at the displacement of 1 155.07 and 1 515.92 cm -1. The Raman intensity of gastric cancer stage Ⅳwas significantly higher than that of gastric cancer stages Ⅰ, Ⅱ, and Ⅲ. Conclusions:According to the model reliability verification, the healthy group, gastric cancer group and colorectal cancer group can also be effectively separated based on OPLS-DA results; it showed a good performance in separating the healthy group from the gastric cancer group. It is possible to detect serum samples from healthy people and gastric cancer patients unlabeled by combining Raman spectroscopy and the OPLS-DA method in multivariate statistics.

Coronavirus disease 2019 (COVID-19) epidemic is the most widespread global pandemic in the past 100 years. Person-to-person transmission of COVID-19 infection leads to the major threat of human safety and health. At 00:00 on January 24th, 2020, Tianjin City launched the first-level response to the COVID-19 epidemic. At 18:00 on the same day, Management Committee of Dongjiang Free Trade Port Zone of Tianjin received areport that there were 15 people who had fever on the Costa Crociere carrying 4 806 people from Japan back to the home port of Tianjin Dongjiang Cruise. At the same time, there are more than 140 Chinese Hubei tourists. Tianjin Municipal Committee and Government, Tianjin Customs, Binhai New Area District Committee Government, Tianjin Health Commission, Tianjin Binhai New Area Health Commission formed an emergency command center immediately to deal with the epidemic comprehensively. At 06:40 on January 25th, 2020, the medical investigation team made up by Tianjin Binhai New Area Health Commission and Tianjin East Administration of Customs boarded the cruise ship. With reference to the customs inspection and quarantine regulations, in accordance with the Diagnosis and treatment of pneumonia caused by novel coronavirus (trial version 3) for mulated by the National Health Commission of the People's Republic of China and the Novel coronavirus infected pneumonia port control and technology plan (first version) formulated by the General Administration of Customs, combined with the actual situation of cruise ships, the medical investigation team developed the inspection standards, including door-to-door inspections, temperature measurement and epidemiological investigations on all persons on board of the cruise ship. A total of 4 806 person-times were investigated in the affected area, including 3 706 tourists and 1 100 crew members. Seventeen people at high risk of COVID-19 were identified, including three Wuhan tourists. The reports of 2019 novel coronavirus (2019-nCoV) nucleic acid detection on throat swab samples for those who were identified as high risk were returned as all negative at 14:54 on the same day. At 19:30, the medical investigation team completed the investigation and evacuated the cruise ship. The temperature measurement, medical observation and resettlement of passenger were handed over to relevant personnel. After 2 weeks, the follow-up result of 2019-nCoV nucleic acid of 17 high risk people were all negative. The overall command and comprehensive coordination of the onshore command center together with the rigid principles and excellent responds ability of the on-site epidemic investigation team ensured the successful completion of the epidemic investigation work, and also provided reference for further improving the management and disposal capacity of public health emergencies at sea.

Objective To analyze the clinical significance of endometrial abnormalities in patients with breast cancer after oral administration of tamoxifen, and to determine the risk factors for endometrial malignancy. Methods We collected data from 135 patients with breast cancer who underwent surgery for endometrial abnormalities after oral administration of tamoxifen at the Department of Gynecology from September 2011 to December 2017. According to the pathological results obtained, the patients were divided into groups A (benign endometrial lesion) and B (precancerous and malignant endometrial lesion). The relationships between endometrial malignancy and factors including age, menopausal status, body mass index, endometrial thickness, abnormal uterine bleeding, oral dose of tamoxifen, duration of oral medication, and complications (hypertension and diabetes) were compared between the groups. Results There were 124 patients in group A and 11 patients in group B. The difference in the incidence of abnormal uterine bleeding, which was a risk factor for endometrial malignancy, was significant different between the groups (P ＜ 0.05). Conclusion Physicians should pay close attention to abnormal uterine bleeding in patients taking tamoxifen after surgery for breast cancer. Hysteroscopy should be used to confirm the nature of lesions, and patients without symptoms should be followed up.

Endometrial cancer is a common malignancy of the female reproductive system. Despite improvement in living standards, the incidence of endometrial cancer is increasing due to the lack of effective screening. Early detection of endometrial cancer and precancerous lesions can significantly improve prognosis and survival. At present, China lacks a method for screening endometrial lesions comparable to that for cervical cancer screening. A recently introduced endometrial sampler has the advantages of simple operation, low cost, and minimal trauma, and is gradually being accepted for clinical screening of endometrial cancer and precancerous lesions in other countries.This study aims to explore current screening methods for endometrial cancer and precancerous lesions and the clinical application of an endometrial sampler for screening.

Tumor-derived exosomes (TEXs) are small membrane vesicles secreted by tumor cells.They contain various proteins and RNA which make they serve as functional mediators in cell interaction.TEXs can alter the components of extracellular matrix and induces epithelial-mesenchymal transition of tumor cells,which enhance the invasiveness of tumor cells.TEXs regulate immunity through multiple pathways,allowing circulating tumor cells to escape immune surveillance.TEXs promote pre-metastatic microenvironment in target organ before metastasis and induce angiogenesis after circulating tumor cells colonization.Understanding the role and mechanism of TEXs in this process can effectively block relevant signaling pathways which may provide new targeted therapies for clinic.

OBJECTIVE To study the changes of symptoms and signs of laryngopharyngeal reflux diseases(LPRD) after treatment with esomeprazole.METHODS The suspected LPRD patients were treated with esomeprazole for 8 weeks.Reflux finding score(RFS) and reflux symptoms index(RSI) score were evaluated before and after treatment.RESULTS In RSI,84％ of the patients had the symptom of hoarseness or a problem with voice,87％ had clearing of throat,71％had excess throat mucus,58％ had difficulty swallowing food,52％ had coughing after eat or after lying down,68％ had breathing difficulties or chocking episodes,79％ had troublesome or annoying cough,92％ had lump in your throat or sensation of something sticking in throat,and 32％ had heartburn,chest pain,indigestion or stomach acid coming up.In the RFS,45％ of the patients had pseudosulcus,57％ had ventricular obliteration,94％ had erythema/hyperemia,85％ had vocal cord edema,82％ had diffuse laryngeal edema,83％ had posterior commissure hypertrophy,10％ had granuloma/granulation,and 58％ had thick endolaryngeal mucus.The RSI and RFS score had statistical difference before and after treatment(P＜0.001).CONCLUSION The main symptoms of LPRD were lump in throat or sensation of something sticking in throat,clearing of throat and hoarseness or a problem with voice.The main signs of LPRD were erythema/hyperemia,vocal cord edema and posterior commissure hypertrophy.The PPI has marked improved in symptoms and signs of LPRD.