Objective: To explore the effects of short-term exposure to four air pollutants, namely fine particulate matter (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2) and ozone (O3), on death and years of life lost (YLL). Methods: Air pollutants and meteorological data in Jindong District and Wucheng District of Jinhua City, Zhejiang Province from 2014 to 2021 were collected through Jinhua Environmental Monitoring Center and Jinhua Meteorological Bureau. Death data of residents during the same period was collected through Zhejiang Province Chronic Disease Monitoring Information Management System. The effects of short-term exposure to four air pollutants on death and YLL were analyzed using a generalized additive model. Results: The results of single-pollutant model analysis showed that the lagged effect of short-term exposure to PM2.5 on death and YLL was the largest at cumulative lags of 2 days, with effect size of 1.064% (95%CI: 0.450%-1.682%) and 2.084 (95%CI: 1.003-3.165) person-years, respectively; the effect of short-term exposure to SO2 on YLL was the largest on the same day, with an effect size of 2.432 (95%CI: 0.610-4.254) person-years; short-term exposure to NO2 and O3 had no statistically significant effects on death and YLL (both P>0.05). The results of gender- and age-stratified analysis showed that short-term exposure to PM2.5 had significant lagged effects on death and YLL among females and residents aged 65 years and above at cumulative lags of 2 days; short-term exposure to SO2 had significant effects on YLL among females and residents aged 65 years and above on the same day (both P<0.05). The results of dual-pollutant model analysis showed that after the inclusion of NO2 in PM2.5 and SO2, the effects on death and YLL were statistically significant, with the effect size being higher compared to the single-pollutant model; after the inclusion of SO2 or O3 in PM2.5, the effects on death and YLL were statistically significant, with the effect size being lower compared to the single-pollutant model (all P<0.05). Conclusion Short-term exposure to PM2.5 may increase the risk of death and YLL, and short-term exposure to SO2 may increase the risk of YLL among residents, with more significant impacts on female and residents aged 65 years and above.

Background Electroplating technology is widely used in the mechanical manufacturing industry. Electroplating workers may be exposed to occupational hazards such as chromium, zinc, cyanides, and sulfuric acid. With the continuous improvement of protective conditions, occupational hazards have been effectively controlled, but there is less focus on the potential acute occupational poisoning that may occur during the electroplating process. Objective To identify causes of an acute chromium poisoning accident occurred during the cleaning process of electroplating tank in a hardware processing plant, and to formulate relevant prevention and control measures to avoid similar poisoning accidents. Methods Occupational history, medical history, and treatment process of the poisoned worker were inquired in detail, his inpatient medical records were consulted , and his blood samples were tested. Occupational health investigation and testing were carried out at the scene of the poisoning accident. Results The air concentration of peak exposure (CPE) and permissible concentration-time weighted average (CTWA) of chromium and its compounds in the workplace were 0.49 mg·m⁻³ and 0.31 mg·m⁻³ respectively. The results of auxiliary test were Serum chromium 4175.85 μg·L⁻¹, serum creatinine 1370.2 μmol·L⁻¹, urea 42.28 mmol·L⁻¹, and urine osmotic pressure 248 mosm·L⁻¹. The final diagnosis was occupational acute severe toxic nephropathy (chromium and its compounds) and occupational chemical skin moderate burn (chromic acid, sulfuric acid). The prescribed treatment included right lower limb expansion skin grafting, hemodialysis and symptomatic support. The patient’s condition was stable and gradually improved after the treatment. Conclusion The main causes of the poisoning accident include weak awareness of the employer of occupational disease prevention and control; failures in fulfilling legal obligations of occupational disease prevention and control, implementing effective occupational disease prevention measures, and providing proper occupational health and safety training and effective personal protective equipment. In order to protect the health of workers, the relevant government departments and employers should attach great importance to the prevention and control of occupational diseases, such as strengthening training and education, increasing the intensity of occupational health supervision, and urging employers to implement occupational disease prevention measures in accordance with the law.

OBJECTIVE To establish and apply a method for simultaneous determination of the contents of dicentrine， protopine and coptisine in Tibetan Corydalis pallida of different origins， and to provide reference for origin determination and quality control of the kind of medicinal materials. METHODS Ultra performance liquid chromatography-tandem quadrupole mass spectrometry method was used. The determination was performed on Agilent EC-C18 column （100 mm×2.1 mm， 2.7 μm） with mobile phase consisted of acetonitrile-0.1% formic acid by gradient elution. The flow rate was 0.2 mL/min， and the column temperature was set at 35 ℃ . MS detection was carried out by electrospray ionization in positive modes， multiple reaction monitoring mode was used for quantitative analysis. RESULTS The injection mass concentrations of dicentrine， protopine， coptisine ranged from 5.88 to 117.60， 53.70 to 1 074.00， and 4.85 to 97.00 ng/mL， respectively， showing a good linear relationship with their respective peak areas （r＝0.998 2， 0.991 9， and 0.999 6， respectively）. The limits of quantitation were 2.35， 1.07 and 1.46 ng/mL； the limits of detection were 1.17， 0.54， 0.49 ng/mL， respectively. RSDs of precision， stability （24 h） and repeatability tests were all lower than 2.0％. The average recovery rates were 97.41%， 98.89% and 105.44%（ all RSDs＜5.0％， n＝6）. CONCLUSIONS The established method has good selectivity and high accuracy， and is suitable for the rapid analysis of dicentrine， protopine and coptisine in Corydalis. The total contents of three alkaloids in different original medicinal materials are from high to low in order of C. chrysosphaera， C. mucronifera， C. pygmaea， C. hendersonii and C. conspersa. The alkaloid contents in C. chrysosphaera and C. mucronifera are relatively similar， but no dicentrine has been detected in C. conspersa and C. hendersonii.

Objective:To explore the inconsistent and consistent classifications for lesions ≤2 cm by contrast-enhanced ultrasound(CEUS) Liver Imaging Reporting and Data System(LI-RADS) v2017 and contrast-enhanced computed tomography/contrast-enhanced magnetic resonance imaging(CECT/MRI) LI-RADS v2018.Methods:The focal liver lesions ≤2 cm underwent CEUS and CECT/MRI within 1 month were enrolled in this retrospective study.Each nodule was categorized according to the CEUS LI-RADS v2017 and CECT/MRI LI-RADS v2018. Intermodality agreement between the CEUS LI-RADS and CECT/MRI LI-RADS for each lesion was assessed with Cohen′s Kappa. Lesions with inconsistent classification for CEUS LI-RADS and CECT/MRI were analyzed.Results:A total of 145 lesions with a size of (1.65±0.33)cm in 145 patients were included. The numbers of lesions in LR-3, 4, 5 and M were 16, 23, 90 and 16 on CEUS LI-RADS, 25, 31, 87 and 2 on CECT/MRI, respectively. And 73.1% lesions were classified as LR-5 or M on CEUS, while 61.4% lesions were classified as LR-5 or M on CECT/MRI ( P=0.033). The incidences of HCC in LR-3, 4 and 5 were 37.5%, 52.2% and 97.8% on CEUS LI-RADS, 56.0%, 64.5% and 96.6% on CECT/MRI LI-RADS respectively. Among the 145 lesions, 56 lesions had inconsistent classifications of CEUS and CECT/MRI LI-RADS. Twenty-eight lesions in CECT/MRI LR-3 and 4 were escalated to LR-4 and 5 by CEUS and 82.1% of them were found to be HCC. Fourteen lesions on CEUS LR-3 and 4 were escalated to LR-4 and 5 by CECT/MRI and 85.7% of them were found to be HCC. Conclusions:The LR-5 of the CEUS and CECT/EOB-MRI LI-RADS has a comparable incidence of HCC. However, the inter-modality agreement of the LI-RADS category between CEUS and CECT/EOB-MRI is poor. The proportion of lesions in CEUS LR-5 and M is much higher than that in CECT/MRI LR-5 and M, while the proportion of lesions in CECT/MRI LR-3 and 4 is high than that in CEUS LR-3 and 4.

Objective : To investigate the characteristics and the chronic health risks of metals in fine particulate matter（PM2.5） of Wucheng District,Jinhua . Methods: The PM2.5 samples were collected in Wucheng District of Jinhua from the year 2015 to 2017.Chromium(Cr), manganese (Mn),nickel(Ni),arsenic(As),selenium(Se),cadmium(Cd),antimony(Sb),lead(Pb),beryllium(Be),aluminum(Al),thallium（Tl）and mercury（Hg） were measured by inductively coupled plasma mass spectrometry（ICP-MS）. The health risks of the metals were assessed based on the standard method recommended by United States Environmental Protection Agency . Results: From 2015 to 2017,the average concentration of PM2.5 in Wucheng District was（53.42±26.95）μg/m3,and the average concentration of PM2.5 in each season and each year were significantly different（P<0.05）. The median（interquartile range）concentration of metal elements in PM2.5 was 136.66（117.14）ng/m3,with higher concentration of Al,Pb,Mn,Cd and Se. From 2016 to 2017,the average concentration of Cd exceeded the reference limit（5.00 ng/m3）. The median （interquartile range） concentration of metal elements in PM2.5 in winter was 175.12（132.45）ng/m3,the highest,and in summer was 92.55（52.81）ng/m3,the lowest. The total hazard quotient（HQ）of nine kinds of metal elements in PM2.5 was 2.90;the HQ of As,Be,Ni,Se,Hg,Al,Mn and Sb were all less than 1,except Cd. The total carcinogenic risk of five kinds of metal elements in PM2.5 was more than 10-6,among which the carcinogenic risk of As and Cd were more than 10-6,and the carcinogenic risk of Be,Pb and Ni were less than 10-6 . Conclusion The concentrations of Al,Pb,Mn,Cd and Se in PM2.5 of Wucheng District were higher and the concentration of Cd exceeded the reference limit. The non-carcinogenic and carcinogenic risk of Cd were both higher,the carcinogenic risk of As was also higher.

Objective: To study the impact of inhalable particles（PM10）on the daily respiratory disease mortality in Jinhua,and to provide basis for health evaluation and protection for susceptible population. Methods: The data of air pollutants and meteorological factors in Jinhua from 2014 to 2018 were collected. The concentrations of the air pollutants were compared with the secondary standard of GB 3095-2012 Environmental Air Quality Standard,and the seasonal distribution characteristics of PM10 were analyzed. The generalized linear models（GLM）of single pollutant and multi-pollutants were built to analyze the impact of atmospheric PM10 on the number of death from respiratory diseases. Results: A total of 4 891 cases died of respiratory diseases from 2014 to 2018 in Jinhua. The median of PM10 concentration was 58 μg/m3,showing high in winter and spring but low in summer and autumn. In single pollutant models,the mortality risks of respiratory diseases of two-day lag among whole population and people aged 65 years or over increased by 1.23%（95%CI：0.27%-2.20%）and 1.24%（95%CI：0.26%-2.23%）with every increase of 10 μg/m3 in PM10. In multi-pollutants models,when introduced SO2,NO2,or SO2+NO2 with PM10,the mortality risks of respiratory diseases of two-day lag among whole population and people aged 65 years or over were higher than that in single pollutant models（P<0.05）. When introduced SO2 or SO2+NO2 with PM10,the mortality risks of respiratory diseases in males were higher than that in single pollutant models（P<0.05）. Conclusion Ambient PM10 can increase the mortality risk of respiratory diseases,especially for the elderly people aged 65 years or over.

Objective: To understand the health risk of drinking water in rural areas of Jinhua and to provide evidence for water sanitary management in rural areas. Methods: Totally 2 032 samples of drinking water in rural areas of Jinhua were collected from 2016 to 2018. According to GB/T 5750-2006 Standard Examination Methods for Drinking Water,five chemical carcinogens（As,Cd,Cr6+,CHCl3 and CCl4）and twelve non-carcinogenic chemicals（Pb,Hg,Se、CN-、F-、NO3-、Al、Fe、Mn、Cu、Zn and NH3-N）were detected. The health risk assessment in rural drinking water was conducted by United States Environmental Protection Agency（USEPA）model. Results: The total health risk,total carcinogenic risk and total non-carcinogenic risk of rural drinking water caused by the seventeen chemicals were 34.8×10-6/a,34.80×10-6/a and 6.65×10-9/a,respectively. The carcinogenic risk of five chemical carcinogens accounted for 99.98% of the total health risk,and the carcinogenic risk of Cr6+ accounted for 89.95% of the total health risk. The total health risk of the fully processed,partially processed and unprocessed water samples were 31.68×10-6/a,34.78×10-6/a and 34.77×10-6/a,respectively. The total health risk of finished water and peripheral water were 34.79×10-6/a and 34.82×10-6/a. Conclusion The health risk of drinking water in rural areas of Jinhuacaused by chemicals is low. The hexavalent chromium has the highest health risk and need more attention to be paid on.

Hepatocellular carcinoma (HCC) accounts for approximately 75%-85% of primary liver cancer cases and is one of the most frequently diagnosed malignancies worldwide. Immunotherapy is currently considered to be the most promising treatment to prevent the progression and postoperative recurrence of HCC. At present, the treatment strategies of immunotherapy for HCC are classified as active immunotherapy and passive immunotherapy, including tumor vaccine therapy, immune checkpoint inhibitors, and adoptive cell therapy. Here we review the current clinical progression and discuss the future perspective on immune therapy for HCC.

Objective To study the relationship of microRNA-145(miR-145) and CD44 in the hepatocellular carcinoma(HCC).Methods 13 clinical samples of HCC tissues and corresponding normal liver tissues were collected at department of General Surgery,Second Affiliated Hospital of Fujian Medical University from October 2015 to June 2016.The patients with positive expression of CD44 were studied.The expression levels of miR-145 and CD44 in HCC tissues and corresponding normal tissues were detected by real-time quantitative PCR.Western blot was performed to detect the expression of CD44 in HCC cells Hep G2 and SNU423.Biological information methods predicted whether miR-145 and CD44 have a targeted relationship.CD44 expression levels were detected after high expression of miR-145 in HCC cell line with positive expression of CD44.The vector and luciferase reporter genes were constructed to verify the interaction between miR-145 and CD44.The effects of miR-145 on proliferation in HCC cell lines with positive and negative CD44 expression were examined by tetramethylazoazole salt (MTT) assay.Results 8 of the 13 patients showed positive CD44 expression in HCC tissues.Compared with normal liver tissues,the relative expression of miR-145 in HCC tissues was significantly lower (0.998±0.010 vs.0.503±0.046,P＜0.05),and the relative expression of CD44 was higher (0.996±0.005 vs.1.878±0.108,P＜0.05).Bioinformatics suggested that miR-145 had a targeted relationship with CD44.High expression of miR-145 can significantly reduce the expression level of CD44 mRNA in HCC cell SNU423 (0.941±0.010 vs.0.515±0.021,P＜0.05) and down-regulate the expression of CD44 protein.Confirmed by luciferase reporter assay,CD44 is the target gene of miR-145.After transfection with miR-145 mimics,the proliferation of CD44 positive cell SNU423 was significantly inhibited (P＜0.05).Conclusions miR-145 can affect the proliferation of CD44 positive HCC cells by regulating the expression of CD44,which may be one of the pathogenesis of HCC.

Objective To establish the item pool of quality of life questionnaire of Chinese medicine for postoperative patients with colorectal cancer;To conduct preliminary item screening. Methods With the guidance of Chinese culture background and TCM theory, systematic retrospective studies on medical records, interviews, TCM syndrome entries, and entries from EORTC QLQ-CR38 were used, and theoretical structure was extracted to form the primary item pool. Item selection and entry were optimized through the investigation, and the item pool was established through expert consultation. Results Item pool was composed of 70 entries, and the pre-questionnaire scale was formed. Conclusion Extraction of item pool ensures the reliability and scientificity of soft index, also has the characteristics of Chinese medicine.