The core idea of occupational health risk assessment models is to systematically evaluate occupational health risks according to target hazard characteristics and relevant exposure levels of workers. Occupational exposure assessment is based on concentration, frequency, exposure time, and other indicators that indicate actual exposure of workers to occupational hazards, which is a critical component of health risk assessment. However, the accuracy and comparability of assessment results are affected by differences in parameter assignment for exposure assessment across different studies, as well as insufficient emphasis on multiple occupational hazard exposure. This review aimed to explore the assignment and standardization of exposure assessment parameters for occupational health risk assessment modeling, and systematically sorted out the meaning, assignment methods, and sources of exposure assessment related parameters in commonly used occupational health risk assessment models, with the goal of providing researchers with standardized assessment tools to enhance the scientific rigor and practicality of occupational health risk assessments. Considering the individual differences and temporal fluctuations in occupational exposure, it is recommended that researchers should adopt appropriate sampling strategies, reasonably select sample subjects and time based on the division of similar exposure group (SEG), and conduct statistical inference on the obtained data to derive representative exposure parameters. For combined exposure to chemicals with similar toxic effects, the health risk assessment methods are relatively mature. However, the assessment of combined exposure to hazards with different properties and health effects still lacks scientific authority and needs further research and discussion.

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

Objective To explore the expression levels of serum glycerophospholipid metabolites lysophosphatidylcholine(LPC)18∶3 and lysophosphatidylethanolamine(LPE)16∶1 in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their correlation with clinical prognosis.Methods A total of 112 AECOPD patients diagnosed and treated in Tangshan People's Hospital from January 2019 to January 2022 were selected as the AECOPD group.According to the 3-month follow-up prognosis of the AECOPD group patients,they were divided into survival group(n=90)and death group(n=22).During the same period,60 stable COPD patients were selected as the stable period group,while 60 healthy individuals in the same period were selected as the control group.High performance liquid chromatography tandem mass spectrometry(HPLC-MS/MS)was used to detect serum LPC18∶3 and LPE16∶1 levels in each group.Pearson method was used to analyze their correlation.Logistic regression analysis was used to analyze factors affecting the prognosis of AECOPD patients.Receiver operating characteristic curve was drawn to evaluate the prognostic value of LPC18∶3 and LPE16∶1 in AECOPD patients.The prognosis of AECOPD patients with different serum LPC18∶3 and LPE16∶1 expression groups was compared by K-M curve.Results Serum LPC18∶3(21.67±4.35 μ mol/L),LPE16∶1(16.20±5.17 μ mol/L),PEF％pred,FEV1％pred,and FEV1/FVC％in AECOPD group were lower than those of stable phase group(43.24±6.17 μ mol/L,32.19±5.98 μmol/L)and the control group(68.14±8.78 μ mol/L,44.82±7.44 μ mol/L),with significant differences(F=461.240～1 102.534,all P＜0.05).The serum LPC18:3 and LPE16:1 levels in the AECOPD group were positively correlated with lung function indicators such as PEF％pred,FEV1％pred,and FEV1/FVC％(r=0.603～0.756,allP＜0.05).The course of COPD and PCT of AECOPD patients in the death group were higher than those in the survival group(t=3.961,2.509),while the PEF％pred,FEV1％pred,FEV1/FVC％,serum LPC18∶3(17.20±4.11μ mol/L),and LPE16∶1(10.15±3.03 μ mol/L)in the death group were lower than those in the survival group(22.76±4.35 μ mol/L,17.68±5.22 μ mol/L),with significant differences(t=4.141～6.490,all P＜0.05).Serum LPC18∶3(OR=0.691,95％CI:0.519～0.920)and LPE16∶1(OR=0.586,95％CI:0.382～0.901)were independent protective factors,while the course of COPD(OR=1.510,95％CI:1.203～1.895)and procalcitonin(OR=1.759,95％CI:1.159～2.671)were risk factors affecting the prognosis of AECOPD patients.The area under the curve(95％CI)of combined serum LPC18∶3 and LPE16∶1 for prognosis evaluation of AECOPD patients was better than that of serum LPC18∶3 and LPE16∶1 predicted separately[0.866(0.822～0.907)vs 0.794(0.748～0.830),0.786(0.739～0.836)](Z=3.957,4.195,P=0.002,＜0.001).The mortality risk of AECOPD patients in the low expression group of LPC18∶3 and LPE16∶1 was higher than that in the high expression group of LPC18∶3 and LPE16∶1(log rankx2=4.475,5.763,P=0.034,0.016).Conclusion The serum levels of glycerophospholipid metabolites LPC18∶3 and LPE16∶1 in AECOPD patients were decreased,which were related to lung function status.The combination of the two may effectively evaluate the prognosis of AECOPD patients.

Objective To investigate the changes in the levels of serum visinin-like protein-1(VILIP-1)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in patients with acute cerebral hem-orrhage(ACH)and their correlation with the degree of neurological deficits and prognosis.Methods Totally 115 cases of ACH patients admitted to this hospital from January 2021 to January 2023 were selected as the ACH group,and another 115 healthy volunteers with physical examination in the same period were selected as the control group.The ACH patients were divided into mild deficit group(39 cases),moderate deficit group(46 cases)and severe deficit group(30 cases)according to the degree of neurological deficit assessed by the national institutes of health stroke scale(NIHSS).Patients with ACH were divided into a poor prognosis group(27 cases)and a good prognosis group(88 cases)after 90 d of follow-up according to the prognosis as-sessed by the modified Rankin scale.Serum VILIP-1 and sTREM-1 levels were measured by enzyme-linked immunosorbent assay.Spearman correlation was used to analyze the correlation between NIHSS scores and se-rum VILIP-1 and sTREM-1 levels in ACH patients,a multifactorial Logistic regression model was set up to analyze the factors affecting the prognosis of ACH patients,and the predictive value of serum VILIP-1 and sTREM-1 levels in poor prognosis in ACH patients was analyzed by plotting the receiver operating character-istic(ROC)curve.Results Compared with the control group,serum VILIP-1 and sTREM-1 levels were ele-vated in the ACH group(P＜0.05).Serum VILIP-1 and sTREM-1 levels increased sequentially in the mild-deficiency,moderate-deficiency,and severe-deficiency groups(P＜0.05).Spearman correlation analysis showed a positive correlation between NIHSS scores and serum VILIP-1 and sTREM-1 levels in ACH patients(r=0.792 and 0.781,both P＜0.001).After 90 d of follow-up,the incidence of poor prognosis in 115 ACH patients was 23.48％(27/115).Multifactorial Logistic regression analysis showed that increased hematoma volume and elevated NIHSS score,VILIP-1,and sTREM-1 were independent risk factors affecting the progno-sis of patients with ACH(P＜0.05).ROC curve analysis showed that the area under the curve of serum VIL-IP-1 and sTREM-1 levels combined to predict poor prognosis in ACH patients was 0.872,which was greater than that of serum VILIP-1 and sTREM-1 levels alone,which were 0.784 and 0.772(P＜0.05).Conclusion Ele-vated serum VILIP-1 and sTREM-1 levels in ACH patients are closely associated with increased degree of neurological deficit and poor prognosis,and the combined detection of serum VILIP-1 and sTREM-1 has high predictive value for poor prognosis in ACH patients.

Osteosarcoma (OS) stood as the most prevalent primary malignant bone tumor among children and adolescents, characterized by its aggressive nature and high propensity for metastasis, thus earning its classification as a highly malignant disease. The primary routes of metastasis in osteosarcoma encompassed hematogenous dissemination (the most common metastasis was lung metastasis) and lymph node involvement, with lymph node metastasis carrying a notably poorer prognosis when contrasted with lung metastasis. However, it was noteworthy that, at that time, clinical practice often overlooked the crucial aspect of conducting regional lymph node screening for newly diagnosed osteosarcoma patients, and there remained a dearth of standardized treatment protocols for osteosarcoma lymph node metastasis. The intricate mechanisms at the heart of osteosarcoma lymph node metastasis primarily revolved around the infiltration of lymphatic vessels by osteosarcoma cells possessing metastatic capabilities and the induction of lymphatic vessel formation by these cells. Nevertheless, it was imperative to underscore that our understanding of the comprehensive mechanisms underpinning the initiation and progression of these processes still remained incomplete. Moreover, following the adaptive proliferation of osteosarcoma cells within regional lymph nodes, there existed a complex biological process that involved a myriad of cytokines and signaling pathways. This process facilitated the metastasis of osteosarcoma cells to distant target organs, most notably the lungs, by virtue of the intimate anatomical relationships between the lymphatic and circulatory systems. Consequently, that comprehensive review sought to provide an all-encompassing exposition on various facets of osteosarcoma lymph node metastasis. These facets included the direct invasion of surrounding lymphatic vessels by osteosarcoma cells, the osteosarcoma cell-induced development of lymphatic vessels through the VEGFC/VEGFR-3 signaling axis, the remodeling of the lymph node microenvironment by osteosarcoma cells via Hsp5B and the Wnt/β-Catenin signaling pathway to ensure their adaptation and survival, the epithelial-mesenchymal transition of osteosarcoma cells promoting metastasis from lymph nodes to the lung, and the utilization of small-molecule compounds in the battle against osteosarcoma lymph node metastasis. The aim was to provide a comprehensive and systematic elucidation of the intricate mechanisms governing osteosarcoma lymph node metastasis and to furnish invaluable insights for the development of therapeutic strategies.

Objective To investigate the characteristics and liver function of the population with occupational exposure to hepatotoxicants. Methods A total of 17 093 workers with occupational hepatotoxicants exposure who underwent occupational medical examination during their employment in a occupational medical examination institution of Shanghai in 2021 were selected as the research subjects by judgement sampling method. Occupational medical examination data were collected, and the prevalence of abnormal liver function and fatty liver were analyzed. The association between hepatotoxicants exposure and abnormal liver function were analyzed. Results The median and the 0th-100th percentiles of the duration of exposure to hepatotoxicants was 6.5(1.0-42.0) years. The prevalence of fatty liver was 48.4% and the incidence of abnormal liver function was 23.7%. Among the workers with fatty liver, the prevalence of abnormal liver function was higher in workers exposed to metals, metalloids and their compounds than in unexposed workers (33.9% vs 30.0%, P<0.01). The results of multivariate logistic regression analysis demonstrated that the risk of abnormal liver function increased with the number of different hepatotoxicants mixed exposures (all P<0.01), after correcting for confounding factors including gender, age, years of exposure, marital status, drinking, hypertension, fatty liver and blood sugar. Conclusion Exposure to hepatotoxicants is a risk factor for abnormal liver function. The more diverse types of hepatotoxicants an individual is exposed to, the stronger the association with this risk.

Objective:To investigate the effect of prospective intervention on emergence agitation and postoperative recovery in patients with chronic sinusitis during preoperative visits.Methods:A total of 80 patients with chronic sinusitis who underwent general anesthesia in Dayi County People′s Hospital of Chengdu City from December 2019 to October 2020 were selected and randomly divided into group D and group G, with 40 patients in each group. Group D received preoperative visit with conventional methods and group G received preoperative visit with prospective intervention methods. The hemodynamic changes of patients in the two groups at 30 min before the operation (T 1) and 1 (T 2), 5 (T 3), 10 (T 4) and 30 min (T 5) after tracheal tube extraction were recorded. The anxiety and depression scores of patients before the intervention and 1 d after the operation were compared between the two groups. The incidence of emergence agitation after the operation and complications during anesthesia awakening period were observed in the two groups, sino-nasal outcome test-20 (SNOT-20) was used to assess the postoperative recovery. Results:The incidence of emergence agitation in group G was lower than that in group D: 7.5%(3/40) vs. 25.0%(10/40), the difference was statistically significant ( χ2 = 4.50, P<0.05). There was no significant difference in systolic blood pressure, diastolic blood pressure and heart rate between the two groups at T 1 and T 5 ( P>0.05), but the level of above indicators in group G at T 2, T 3 and T 4 were significantly higher than those in group D ( P<0.05). The scores of State-Trait Anxiety Inventory(S-AI) and Self-Rating Depression Scale (SDS) in group G at the first day after the operation were significantly lower than those in group D: (35.45 ± 5.32) scores vs. (39.35 ± 4.91) scores, (35.42 ± 7.82) scores vs. (38.76 ± 5.21) scores, the differences were statistically significant ( P<0.05). The incidence of complications during anesthesia awakening period in group G was slightly lower than that in group D ( P>0.05). After the operation, the scores of sinusitis symptoms and nasal symptoms in the two groups were significantly decreased compared with those before the operation, and the scores of group G were significantly lower than those in group D ( P<0.05). Conclusions:Prospective intervention before anesthesia in patients with chronic sinusitis surgery can reduce stress response, improve bad mood, reduce the incidence of emergence agitation, and promote the postoperative recovery.

Cinnamomum migao plants often face different degrees of drought in karst habitats, which can lead to plants’ death, especially in the seedling stage. Widespread of arbuscular mycorrhizal (AM) fungi in karst soils have the potential to address this drought, which is a threat to C. migao seedlings. We inoculated C. migao seedlings with spores from Glomus lamellosum and Glomus etunicatum, two AM fungi widely distributed in karst soils, to observe seedling growth response after simulated drought. Our results showed that 40 g of G. lamellosum and G. etunicatum significantly promoted the growth of C. migao seedlings, 120 days after inoculation. Following a 15-day drought treatment, root colonization of the seedlings with G. lamellosum or G. etunicatum had lower the accumulation of malondialdehyde (MDA) and increased the accumulation of enzymes and osmotic substances in the seedlings. The relative water content in different organs (roots, stems, and leaves) of the drought-stressed seedlings was higher in plants with G. lamellosum or G. etunicatum than in plants without AM fungi colonization. Our results showed that inoculation with AM fungi was an effective means to improve the drought resistance of C. migao seedlings.

Cinnamomum migao plants often face different degrees of drought in karst habitats, which can lead to plants’ death, especially in the seedling stage. Widespread of arbuscular mycorrhizal (AM) fungi in karst soils have the potential to address this drought, which is a threat to C. migao seedlings. We inoculated C. migao seedlings with spores from Glomus lamellosum and Glomus etunicatum, two AM fungi widely distributed in karst soils, to observe seedling growth response after simulated drought. Our results showed that 40 g of G. lamellosum and G. etunicatum significantly promoted the growth of C. migao seedlings, 120 days after inoculation. Following a 15-day drought treatment, root colonization of the seedlings with G. lamellosum or G. etunicatum had lower the accumulation of malondialdehyde (MDA) and increased the accumulation of enzymes and osmotic substances in the seedlings. The relative water content in different organs (roots, stems, and leaves) of the drought-stressed seedlings was higher in plants with G. lamellosum or G. etunicatum than in plants without AM fungi colonization. Our results showed that inoculation with AM fungi was an effective means to improve the drought resistance of C. migao seedlings.

Objective:To investigate the pathology characteristics, so as to provide treatment experience of primary cardiac tumors for pediatric patients.Methods:A retrospective study was conducted for 135 patients with primary cardiac tumor between January 2004 and December 2017 in Shanghai Children′s Medical Center.The median age was 0.54 years (range, 0-14.36 years). Single tumor was discovered in 61 cases and multiple rumors were found in 74 cases.Forty-five patients presented obvious clinical symptoms, 4 patients with mild symptoms and 86 patients without symptoms.Forty-one patients underwent surgical treatment, including complete resection of the tumor in 24 cases, partial resection in 16 cases and heart transplantation in 1 case.Concomitant valvuloplasty was required in 13 patients.Ninety-four patients did not receive surgical treatment.Results:A total of 40 patients underwent surgical treatment in Shanghai Children′s Medical Center.Three patients died of low cardiac output (in-hospital mortality: 7.5%), and 2 patients recovered from postoperative low cardiac output.The hemodynamic status was stable in the remaining 35 cases.One patient who received heart transplantation in another hospital survived and had good cardiac function during 24 months follow-ups.There were no significant differences in the survival rate between partial resection and complete resection of benign tumors.One late death was observed in patients with malignant tumors for 2 years after operation.Surveillance was kept in 94 non-surgical patients, among whom 1 case died for the abandon of surgery and 1 case died when waiting for heart transplantation.Other 2 patients were waiting for heart transplantation and other 90 patients had no hemodynamic disorder.Conclusion:Most of primary cardiac tumors are benign and long time follow-up should be able to get on for pediatric patients.When patients develop hemodynamical obstruction, arrhythmia or malignant tumor, surgical treatment is necessary.The principle of surgical therapy in these patients is to restore normal hemodynamic status, instead of completely removing tumor.Heart transplantation is potentially the only way for patients whose tumor cannot be resected.