Oral health is closely related to facial aesthetics, mastication, pronunciation, and systemic diseases. Flexible sensors can improve current deficiencies in clinical diagnosis and treatment through oral health monitoring. This paper reviews the research on and application of flexible sensors in oral health monitoring in recent years, providing a reference for the further development of flexible sensors in the oral field. The structural basis of flexible sensors includes a flexible substrate, stretchable electrodes, and an active layer, and each part is designed through material selection to adapt to the oral environment. The sensing mechanisms of sensors involve electricity, optics, electrochemistry, and immunology, among which electro-chemical, biological, and optical sensors are particularly prominent in the oral field. The monitored signals include physical signals such as orthodontic force, bite force, respiratory humidity, and implant temperature; chemical signals such as saliva metabolites and oral gases; and biological signals such as periodontal disease and oral cancer markers. At present, flexible sensors still face many challenges in this special oral environment. Future research directions include improving the biocompatibility, moisture resistance, and flexible fitting ability of sensors in the oral cavity; using temperature-insensitive materials and protective films to improve stability; and introducing artificial receptors and sensor arrays to improve factors such as selectivity. In addition, multi-disciplinary cooperation is crucial for breaking through current bottlenecks and achieving more accurate disease diagnosis and health monitoring. In the field of stomatology, finding specific biomarkers related to corresponding oral diseases is the key to sensor health monitoring. Through these efforts, flexible sensors are expected to gain more extensive applications in the field of oral health monitoring.

Objective : To investigate the prevalence of occupational injury and identify its influencing factors among workers in a steel enterprise in Gansu Province, so as to provide insights into prevention of occupational injury among steel workers. Methods: Workers were sampled from a steel enterprise in Gansu Province using a cluster sampling method from January to March 2022, and participants' demographics, occupational history and occupational injury were collected using questionnaire surveys. The type of job and site and type of injury were analyzed among workers with occupational injuries, and factors affecting workers' occupational injuries were identified using a multivariable logistic regression model. Results: A total of 12 089 questionnaires were allocated and 10 725 valid questionnaires were recovered, with an effective recovery rate of 88.71%. The respondents included 9 412 males (87.77%) and 1 312 females (12.23%), and had a median age of 36.00 (interquartile range, 15.00) years. Junior college and above was the predominant educational level (6 056 workers, 56.47%), and the respondents had a median length of service of 10 (interquartile range, 11) years. The prevalence of occupational injury was 5.25% among respondents. Overhaul worker was the main type of job (11.90%), and object strike was the predominant type of occupational injury (18.25%), while the lower limb was the predominant site of injury (27.82%). Multivariable logistic regression analysis identified men (OR=2.464, 95%CI: 1.580-3.843), age (30 to 39 years, OR=2.561, 95%CI: 1.643-3.993; 40 to 49 years, OR=5.197, 95%CI: 2.679-10.079; 50 years and older, OR=10.620, 95%CI: 6.788-16.615), exposure to high temperature (OR=1.400, 95%CI: 1.165-1.683), operating equipment failure (OR=1.291, 95%CI: 1.048-1.591), absence of personal safety protection equipment (OR=1.555, 95%CI: 1.064-2.273) and safety behavior scores (OR=0.967, 95%CI: 0.937-0.996) as factors affecting occupational injuries among workers in a steel enterprise. Conclusions Men and overhaul workers are at a high risk of occupational injuries in this steel enterprise. Objectstrike is the predominant type of injury and lower limb is the main site of injury. The risk of occupational injuries is affected by gender, age, working environments, equipment status and safety behaviors.

AIM:To investigate of the effect of Shenqifuzheng injection(SFI)combined with PD-L1 antibody on tumor immune microenvironment and its efficacy.METHODS:A subcutaneous transplanta-tion tumor model for B16F10-LUC melanoma was created.The expression of Ki67,CD31,CD8,CD16,CD163,FOXP3,LY6C,LY6G with labeling antibodies was used to detect CD8+T cells,Treg cells,NK cells,MDSCs cells,centrocytes,and granulocytes in the tumor tissues via immunohistochemistry.Flow cy-tometry was used to measure the ratios of CD11c+,IA/IE+,and CD80+cells in splenic tissue,as well as the ratios of CD8+T,CD4+T,and Treg cells in tumor tissue.Additionally,granulocyte count and NK cell expression were analyzed.RESULTS:The immuno-histochemistry results indicate that the drug admin-istration group effectively suppressed tumor angio-genesis and cell proliferation,while decreasing the expression level of immunosuppressive cytokines CD4+T cells,Treg cells,MDSCs and centroblasts.Ad-ditionally,CD8 and NK cell infiltration was promot-ed compared to the control group.The results of the flow analysis demonstrated a significant in-crease in the expression level of CD8+T cells within tumor tissues,as well as inhibition of CD4+T,Treg,and DC cell infiltration within the spleen in the drug administration group.Additionally,the tumor volume analysis indicated that the drug administra-tion group effectively inhibited tumor growth.The flow results illustrate that the group administering treatment exhibited significant increases in CD8+T cell expression levels in tumor tissue and DC cells in the spleen.Furthermore,the treatment effec-tively inhibited the infiltration of CD4+T and Treg cells.The results also indicate that the treatment significantly reduced tumor growth,with the tumor inhibition rate being better with PD-L1 antibody alone than with the SFI group.Additionally,combin-ing drugs resulted in superior results compared to the PD-L1 antibody group alone.CONCLUSION:SFI combined with a PD-L1 antibody can have synergis-tic anti-tumor effects,potentially enhancing DC cell infiltration and promoting T cell activation.Immu-nohistochemistry results indicate a positive impact on the tumor immune microenvironment.

Objective:To explore the behavioral intentions of pediatric nurses towards using vascular visualization devices in light of the theory of planned behavior.Methods:This was a qualitative study. From March to November 2023, 20 pediatric nurses from Peking University First Hospital were selected using purposive sampling for semi-structured interviews. The interview data were analyzed and themes were extracted using Colaizzi 7-step analysis method.Results:The behavioral intentions of pediatric nurses towards the use of vascular visualization devices could be summarized into nine themes based on the theory of planned behavior. Attitudes towards behavior included positive evaluations, negative evaluations, and unclear information. Subjective norms involved peers' attitudes as well as expectations and pressures from patients. Perceived behavioral control encompassed workload, level of knowledge, more limited equipment performance, and external resource support.Conclusions:The behavioral intentions of pediatric nurses towards the use of vascular visualization devices are influenced by their attitudes towards the behavior, subjective norms, and perceived behavioral control. Nursing managers should conduct standardized training on vascular visualization devices to enhance nurses' knowledge and skills, while also valuing the sources of various supports to create a supportive environment for the use of vascular visualization devices. This will improve the usage experience of pediatric nurses and promote the use of vascular visualization devices in pediatric nursing practice.

Objectives:To explore the feasibility of using hemodynamic phenotypes to guide antihypertensive treatment medication. Methods:This study prospectively included 100 hypertensive patients who received outpatient treatment at Haidian Hospital in Beijing from January 2021 to December 2021.Evaluation of blood pressure was conducted using laboratory and home blood pressure measurements,impedance cardiogram(ICG)detection was performed.Following hemodynamic phenotypes and therapeutic phenotypes were established:hyperkinetic phenotype(increased heart rate)using β-blockers,large artery phenotype(increased large artery resistance index)using calcium antagonists,peripheral vascular phenotype(increased peripheral vascular resistance index)using renin angiotensin system inhibitors,and high-volume phenotype(increased blood volume saturation)using diuretics.Patients were randomly divided into ICG group(n=50,medication treatment based on hemodynamic characteristics)and control group(n=50,treatment based on hypertension guidelines and clinical experience).Patients were followed up for 8 weeks and the blood pressure reduction amplitude and compliance rate were compare between the two groups. Results:There was no statistically significant difference in baseline data such as sex,age,height,weight,and hemodynamic parameters between the two groups(all P＞0.05).There was no statistically significant difference in the types of baseline medication between the two groups(P＞0.05).After medication adjustment,the types of medication increased,but the difference between the two groups was still not statistically significant(P＞0.05).Clinic blood pressure:After 8 weeks,decreases in systolic([8.38±27.78]mmHg,1 mmHg=0.133 kPa)and diastolic([3.94±18.15]mmHg)blood pressure were greater in the ICG group as compared to the control group(both P＜0.05).The blood pressure compliance rate(＜140/90 mmHg)was higher in the ICG group than that in the control group(66.0%vs.42.0%,P＜0.05).Family blood pressure:after 8 weeks,the reduction in systolic([8.22±21.31]mmHg,P＜0.01)and diastolic([4.76±13.88]mmHg,P＜0.05)blood pressure was greater in the ICG group compared to the control group.The blood pressure compliance rate(＜135/85 mmHg)was higher in the ICG group than that in the control group(70.0%vs.48.0%,P＜0.05).Changes in corresponding hemodynamic parameters before and after two different antihypertensive drugs:the heart rate,arterial resistance index,peripheral vascular resistance index,and blood volume saturation of the ICG group all significantly decreased compared to baseline(all P＜0.05).The control group showed a significant decrease in peripheral vascular resistance index compared to baseline(P＜0.05),while there was no statistically significant difference in heart rate,large artery resistance index,and blood volume saturation compared to baseline(all P＞0.05). Conclusions:By using impedance cardiogram to assess hemodynamic phenotypes and accurately guide the selection of antihypertensive drugs based on hemodynamic phenotypes,it is possible to more effectively lower blood pressure and improve blood pressure compliance.

Objective:To isolate and identify SARS-CoV-2 epidemic strains and analyze the sequence characteristics of the virus strains following serial passages.Methods:Eleven nasopharyngeal swabs positive for SARS-CoV-2 antigen were collected from December 2022. Quantitative real-time PCR was used to detect SARS-CoV-2 nucleic acid, and positive specimens were inoculated onto Vero cells for virus isolation. The isolated strains were identified by Western blot and indirect immunofluorescence assay. The morphology of the isolated strains was observed using transmission electron microscopy. Nucleic acid was extracted from the isolates and passaged viruses for further sequencing and analysis.Results:All 11 specimens tested positive for SARS-CoV-2 using quantitative real-time PCR. SARS-CoV-2 strains were successfully isolated from seven specimens, and could be adaptively cultured, passaged, and expanded on Vero cells, achieving a peak titer exceeding 10 6.25 50% cell culture infectious dose (CCID 50)/ml. Western blot and indirect immunofluorescence results showed that the isolates could be specifically recognized by monoclonal antibodies and convalescent serum against SARS-CoV-2. Transmission electron microscopy revealed oval-shaped viral particles with diameters of approximately 100 nm. Next-generation sequencing of the viral isolates demonstrated a sequence homology greater than 99.50% with the Wuhan-Hu-1 reference strain (NC_045512) and 99.98% among the seven isolated strains, and all of the isolates belonged to the Omicron BF.7 variant. Sequence analysis after continuous passage and plaque purification of the BJ-NVSI-20230005 isolate showed that compared with passages 1-3, passages 4-6 had one nucleotide site mutation (C→T) in the ORF1ab gene and a deletion of 3 bp in the E gene, which resulted in a change from leucine to phenylalanine and the deletion of valine, respectively. Polymorphisms were observed in the sequences of plaque-purified clones. Conclusions:The seven successfully isolated SARS-CoV-2 strains all belong to the SARS-CoV-2 BF.7 variant, which is consistent with the prevalence trend in mainland China in December 2022.

Myocardial dysfunction is the most serious complication of sepsis. Sepsis-induced myocardial dysfunction (SMD) is often associated with gastrointestinal dysfunction, but its pathophysiological significance remains unclear. The present study found that patients with SMD had higher plasma gastrin concentrations than those without SMD. In mice, knockdown of the gastrin receptor, cholecystokinin B receptor (Cckbr), aggravated lipopolysaccharide (LPS)-induced cardiac dysfunction and increased inflammation in the heart, whereas the intravenous administration of gastrin ameliorated SMD and cardiac injury. Macrophage infiltration plays a significant role in SMD because depletion of macrophages by the intravenous injection of clodronate liposomes, 48 h prior to LPS administration, alleviated LPS-induced cardiac injury in Cckbr-deficient mice. The intravenous injection of bone marrow macrophages (BMMs) overexpressing Cckbr reduced LPS-induced myocardial dysfunction. Furthermore, gastrin treatment inhibited toll-like receptor 4 (TLR4) expression through the peroxisome proliferator-activated receptor α (PPAR-α) signaling pathway in BMMs. Thus, our findings provide insights into the mechanism of the protective role of gastrin/CCKBR in SMD, which could be used to develop new treatment modalities for SMD.

{L-End}Objective To analyze the correlation between occupational burnout and sleep quality among steelworkers. {L-End}Methods A total of 11 491 steelworkers from a large steel enterprise in Gansu Province were selected as the research subjects using convenient sampling method. The Burnout Questionnaire and the Pittsburgh Sleep Quality Index Scale were used to investigate their occupational burnout and sleep quality. Hierarchical regression analysis was used to analyze the effects of occupational burnout on the sleep quality. {L-End}Results The detection rate of occupational burnout and sleep disorder were 50.4% and 39.0%, respectively. There was a positive correlation between the level of occupational burnout and the total score of sleep quality (Spearman correlation coefficient=0.454, P<0.05). The results of hierarchical regression analysis, adjusting for confounding factors such as gender, age, marital status, education level, alcohol consumption, exercise, weekly working hours, seniority, work shift, noise exposure, dust exposure, and high-temperature work, showed that the score of occupational burnout was positively related to the score of sleep quality(P<0.01), explaining 16.0% of the variance in the score of sleep quality among these steelworkers. {L-End}Conclusion The detection rate of occupational burnout and sleep disorders are relatively high among the steelworkers in this enterprise. Higher levels of occupational burnout are associated with poorer sleep quality. Alleviating occupational burnout among steelworkers may contribute to improving their sleep quality.

Background Steel workers are exposed to occupational hazardous factors such as dust, noise, and heat, and often work in shifts, making them prone to sleep disorders. Objective To explore potential influencing factors of sleep disorders among workers in a steel enterprise in Gansu Province, and provide a basis for reducing the risk of sleep disorders among them. Methods From January to March 2022, a self-made questionnaire combined with the Pittsburgh Sleep Quality Index (PSQI) were used to investigate the employees of a steel enterprise in Gansu Province. According to their PSQI scores, they were divided into a normal sleep group and a sleep disorder group. The general demographic variables of the two groups were balanced by 1∶1 propensity score matching (PSM). Multiple logistic regression was used to analyze the contributing factors of sleep disorders. Restricted cubic spline (RCS) model was used to analyze potential dose-response relationship between weekly working hours and sleep disorders. Results The prevalence of sleep disorders in the steel workers was 48.06% (6029/12544). After PSM, 5847 pairs were successfully matched, and the distributions of matched variables were well balanced between the two groups. The results of multiple logistic regression showed that hypertension (OR=1.39, 95%CI: 1.24, 1.56), diabetes mellitus (OR=1.34, 95%CI: 1.07, 1.66), three-shift system (OR=1.26, 95%CI: 1.12, 1.41), dust exposure (OR=1.14, 95%CI: 1.01, 1.29), noise exposure (OR=1.23, 95%CI: 1.09, 1.39), heat exposure (OR=1.16, 95%CI: 1.04, 1.29), and work injury (OR=1.22, 95%CI: 1.02, 1.46) increased the risk of sleep disorders. Compared with workers with < 10 years of service, those with 10-20 years (OR=1.31, 95%CI: 1.19, 1.44), 20-30 years (OR=1.34, 95%CI: 1.19, 1.52), and ≥30 years of service (OR=1.35, 95%CI: 1.19, 1.53) had a higher risk of sleep disorders. Compared with non-exercise workers, the risk of developing sleep disorders was lower in workers with occasional exercise (OR=0.61, 95%CI: 0.56, 0.66) and regular exercise (OR=0.55, 95%CI: 0.49, 0.62). The RCS model showed that the weekly working hours and sleep disorders in the steel workers showed a nonlinear dose-response relationship (P<0.05 for overall trend, P<0.05 for nonlinear test). The relationship between weekly working hours and sleep disorders showed a "U" shaped distribution, with a significant increase in the risk of sleep disorders when the weekly working hours exceeded 49 h. Conclusion The non-occupational influencing factors of sleep disorders of employees in the steel enterprise include hypertension, diabetes, physical exercise, and occupational influencing factors include length of service, weekly working hours, shifts, dust exposure, noise exposure, heat exposure, and work injuries. It is recommended to consider both occupational and non-occupational factors to formulate appropriate sleep disorder prevention and control measures for steel employees to reduce the risk of sleep disorders.

Pancreatic ductal adenocarcinoma (PDAC) is characterized by the highest mortality among carcinomas. The pathogenesis of PDAC requires elevated autophagy, inhibition of which using hydroxychloroquine has shown promise. However, current realization is impeded by its suboptimal use and unpredictable toxicity. Attempts to identify novel autophagy-modulating agents from already approved drugs offer a rapid and accessible approach. Here, using a patient-derived organoid model, we performed a comparative analysis of therapeutic responses among various antimalarial/fungal/parasitic/viral agents, through which econazole (ECON), an antifungal compound, emerged as the top candidate. Further testing in cell-line and xenograft models of PDAC validated this activity, which occurred as a direct consequence of dysfunctional autophagy. More specifically, ECON boosted autophagy initiation but blocked lysosome biogenesis. RNA sequencing analysis revealed that this autophagic induction was largely attributed to the altered expression of activation transcription factor 3 (ATF3). Increased nuclear import of ATF3 and its transcriptional repression of inhibitor of differentiation-1 (ID-1) led to inactivation of the AKT/mammalian target of rapamycin (mTOR) pathway, thus giving rise to autophagosome accumulation in PDAC cells. The magnitude of the increase in autophagosomes was sufficient to elicit ER stress-mediated apoptosis. Furthermore, ECON, as an autophagy inhibitor, exhibited synergistic effects with trametinib on PDAC. This study provides direct preclinical and experimental evidence for the therapeutic efficacy of ECON in PDAC treatment and reveals a mechanism whereby ECON inhibits PDAC growth.