Objective To investigate the awareness of radon exposure hazards among non-uranium miners in Chongqing, China. Methods A survey was conducted among 177 male miners from eight non-uranium metal mines in Chongqing to collect data on basic information, personal habits, and the rate of radon awareness. Factors affecting radon awareness were analyzed using chi-square test and logistic regression model. Results The awareness rate of radon among miners was 23.73%. The chi-square test indicated significant difference in the radon awareness rate among miners with different levels of education (χ² = 10.28, P < 0.05), while there was no significant difference across different ages, years of work, labor relations, job categories, and types of miners (P > 0.05). Binary logistic regression analysis showed that a college (junior college) or higher level of education, a high school level of education, and working in mines were factors affecting the radon awareness among miners (χ² = 4.030, 9.150, 11.776, P < 0.05). Conclusion Miners lack awareness of radon, and there is an urgent need to strengthen education and propaganda regarding the hazards of radon.

The traditional Chinese medicine （TCM） myocardial infarction （MI） unit is a standardized， regulated， and continuous integrated care unit guided by TCM theory and built upon existing chest pain centers or emergency care units. This unit emphasizes multidisciplinary collaboration and forms a restructured clinical entity without altering current departmental settings， offering comprehensive diagnostic and therapeutic services with full participation of TCM in the treatment of MI. Its core medical model is patient-centered and disease-focused， providing horizontally integrated TCM-based care across multiple specialties and vertically constructing a full-cycle treatment unit for MI， delivering prevention， treatment， and rehabilitation during the acute， stable， and recovery phases. Additionally， the unit establishes a TCM-featured education and prevention mechanism for MI to guide patients in proactive health management， reduce the incidence of myocardial infarction， and improve quality of life.

Objective To analyze the risk factors and survival status of Epstein-Barr virus(EBV)infection in pa-tients with aplastic anemia(AA)after haploid allogeneic hematopoietic stem cell transplantation(Haplo-HSCT).Methods Clinical data of 78 AA patients who underwent Haplo-HSCT in the hematology department of a hospital from January 1,2019 to October 31,2022 were analyzed retrospectively.The occurrence and onset time of EBV viremia,EBV-related diseases(EBV diseases),and post-transplant lymphoproliferative disorders(PTLD)were ob-served,risk factors and survival status were analyzed.Results Among the 78 patients,38 were males and 40 were females,with a median age of 33(9-56)years old;53 patients experienced EBV reactivation,with a total inci-dence of 67.9％,and the median time for EBV reactivation was 33(13,416)days after transplantation.Among pa-tients with EBV reactivation,49 cases(62.8％)were simple EBV viremia,2 cases(2.6％)were possible EBV di-seases,and 2 cases(2.6％)were already confirmed EBV diseases(PTLD).Univariate analysis showed that age 1＜40 years old at the time of transplantation,umbilical cord blood infusion,occurrence of acute graft-versus-host disease(aGVHD)after transplantation,and concurrent cytomegalovirus(CMV)infection were independent risk fac-tors for EBV reactivation in AA patients after Haplo-HSCT.Multivariate analysis showed that concurrent CMV in-fection was an independent risk factor for EBV reactivation in A A patients after Haplo-HSCT(P=0.048).Ritu-ximab intervention before stem cell reinfusion was a factor affecting the duration of EBV reactivation(P＜0.05).The mortality of EBV viremia,EBV diseases,and PTLD alone were 8.2％,50.0％,and 100％,respectively.The 2-year overall survival rate of patients with and without EBV reactivation were 85.3％,and 90.7％,respectively,difference was not statistically significant(P=0.897).However,patients treated with rituximab had 2-year lower survival rate than those who did not use it,with a statistically significant difference(P=0.046).Conclusion EBV reactivation is one of the serious complications in AA patients after Haplo-HSCT,which affects the prognosis and survival of patients.

Background::The 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guideline lowered the threshold defining hypertension to 130/80 mmHg. However, how stage 1 hypertension defined using this guideline is associated with cardiovascular events in Chinese adults remains unclear. This study assessed the association between stage 1 hypertension defined by the 2017 ACC/AHA guideline and clinical outcomes in the Chinese population.Methods::Participants with stage 1 hypertension ( n = 69,509) or normal BP ( n = 34,142) were followed in this study from 2006/2007 to 2020. Stage 1 hypertension was defined as a systolic blood pressure of 130–139 mmHg or a diastolic blood pressure of 80–89 mmHg. None were taking antihypertensive medication or had a history of myocardial infarction (MI), stroke, or cancer at baseline. The primary outcome was a composite of MI, stroke, and all-cause mortality. The secondary outcomes were individual components of the primary outcome. Cox proportional hazards models were used for the analysis. Results::During a median follow-up of 11.09 years, we observed 10,479 events (MI, n = 995; stroke, n = 3408; all-cause mortality, n = 7094). After multivariable adjustment, the hazard ratios for stage 1 hypertension vs. normal BP were 1.20 (95% confidence interval [CI], 1.13–1.25) for primary outcome, 1.24 (95% CI, 1.05–1.46) for MI, 1.45 (95% CI, 1.33–1.59) for stroke, and 1.11 (95% CI, 1.04–1.17) for all-cause mortality. The hazard ratios for participants with stage 1 hypertension who were prescribed antihypertensive medications compared with those without antihypertensive treatment during the follow-up was 0.90 (95% CI, 0.85–0.96). Conclusions::Using the new definition, Chinese adults with untreated stage 1 hypertension are at higher risk for MI, stroke, and all-cause mortality. This finding may help to validate the new BP classification system in China.

Objective To investigate the application value of 3.0T MR apparent diffusion coefficient(ADC)in prognosis and pathological types of endometrial carcinoma(EC).Methods A total of 114 EC patients were retrospectively selected,and the ADC values of different pathological types were compared.The correlation between ADC and EC prognosis was analyzed by dividing the ADC quintile(Q1-Q5).Results The ADC parameters of EC patients with different pathological types were significantly different(P＜0.05).With the increase of ADC value,the correlation effect size between ADC and EC prognosis also increased(Ptrend＜0.001).ADC had a better predictive effect on EC prognosis.International Federation of Gynecology and Obstetrics(FIGO)stage,myographic invasion and ADC value had interaction with EC prognosis(P interaction＜0.05).Conclusion ADC can be used to distinguish the patho-logical types of EC.Also,ADC is significantly associated with EC prognosis while its correlation effect size increases with the increase of ADC value.ADC value interacted with FIGO stage,as well as with the degree of myographic invasion in predicting EC prognosis.

Objective:To evaluate the safety and efficiency of robotic visualization system(RVS)-assisted microsurgical re-construction of the reproductive tract in male rats and the satisfaction of the surgeons.Methods:We randomly divided 8 adult male SD rats into an experimental and a control group,the former treated by RVS-assisted microsurgical vasoepididymostomy(VE)or vaso-vasostomy(VV),and the latter by VE or VV under the standard operating microscope(SOM).We compared the operation time,me-chanical patency and anastomosis leakage immediately after surgery,and the surgeons'satisfaction between the two groups.Results:No statistically significant difference was observed the operation time between the experimental and the control groups,and no anasto-mosis leakage occurred after VV in either group.The rate of mechanical patency immediately after surgery was 100％in both groups,and that of anastomosis leakage after VE was 16.7％in the experimental group and 14.3％in the control.Compared with the control group,the experimental group achieved dramatically higher scores on visual comfort(3.00±0.76 vs 4.00±0.53,P＜0.05),neck/back comfort(2.75±1.16 vs 4.38±1.06,P＜0.01)and man-machine interaction(3.88±1.55 va 4.88±0.35,P＜0.05).There were no statistically significant differences in the scores on image definition and operating room suitability between the two groups.Conclusion:RVS can be used in microsurgical reconstruction of the reproductive tract in male rats and,with its advantages over SOM in ergonomic design and image definition,has a potential application value in male reproductive system micosurgery.

Objective:To explore the impact of early and late antibody-mediated rejection (AMR) on treatment options and allograft outcomes after kidney transplantation (KT).Methods:From January 2013 to December 2022, the study retrospectively enrolled 141 KT allograft recipients receiving allograft biopsy and diagnosed as AMR according to the Banff 2019 criteria. Recipients with a diagnosis of AMR within 30 days post-KT were classified into early AMR group (n=19) while the remainders assigned as late AMR group (n=122). The outcome endpoints included recipient survival rate, death-censored graft survival rate, follow-up estimated glomerular filtration rate (eGFR) and immunodominant donor-specific antibody (DSA) intensity. Wilcoxon's test was utilized for assessing the differences in eGFR and DSA intensity while Kaplan-Meier curve and Log-rank test were employed for evaluating graft survival impact. Treatment regimens for AMR were collected and categorized.Results:The median follow-up duration was 2.6(1.2, 5.2) year. No graft failure was noted in early AMR group while 44 recipients in late AMR group experienced graft failure, with 34 cases (77.2%) due to AMR progression. The 5-year death-censored graft survival rate was significantly better in early AMR group than that in late AMR group [100% vs 60.1%(50.5%, 71.6%), P=0.002]. The one-year change in eGFR for early AMR group was significantly superior to that of late AMR group [19.3(-2.6, 38.1) vs -3.3(-14.0, 5.4), P=0.001]. One-year mean fluorescent intensity (MFI) of early AMR group was 1 158(401.5, 3 126.5). It was significantly lower than that when diagnosed with early AMR [3 120.5(2 392.8, 9 340.0)] and one-year MFI of late AMR group [8 094(2 251.5, 13 560.5)] ( P=0.005, P<0.001). Early AMR group primarily received standard treatment (3/19, 15.8%) and regimens centered on rituximab and/or bortezomib (7/19, 43.8%). Late AMR group mainly received standard (16/122, 13.1%) or intensified regimens (9/122, 7.4%) and regimens focused upon rituximab and/or bortezomib (32/122, 26.2%) and MP monotherapy (21/122, 17.2%). Conclusion:The outcome for early AMR is significantly better than that for late AMR. For early AMR, early and robust immunosuppression is recommended. For late AMR, early detection and timely treatment are crucial and individualized strategies should be implemented.

Objective To investigate the effect of Astragalus extract on oxidative stress in diabetic nephropathy rats by regulating nuclear factor E2-related factor 2(Nrf2)/antioxidant response element(ARE)signaling pathway.Methods The diabetic rat model was constructed by high-fat diet combined with intraperitoneal injection of streptozotocin,and was randomly divided into model group,experimental-L group,experimental-H group,experimental-H+ML385 group,with 12 rats in each group,and 12 rats were selected as blank group.Rats in blank group and model group were intragastric with equal volume of normal saline;rats in experimental-L,-H groups were intragastric with 50 mg·kg-1 astragalus extract and 100 mg·kg-1 Astragalus extract,respectively;rats in experimental-H+ML385 group were intragastric with 100 mg·kg-1 Astragalus extract and intraperitoneally injected with 20 mg·kg-1 ML385 once a day.Eight weeks in a row.The content of oxidative stress-related indexes in rat renal tissues was detected,the expression level of reactive oxygen species was detected by dihydroethidine staining,and the protein expression level of quinone oxidoreductase 1(NQO1),heme oxygenase 1(HO-1)and nuclear Nrf2 in rat renal tissues was detected by Western blot.Results Superoxide dismutase in blank group,model group,experimental-H group and experimental-H+ML385 group were(163.89±20.28),(71.35±12.72),(132.11±19.29)and(73.04±13.28)U·mg-1,respectively;glutathione peroxidase were(12.82±1.57),(4.91±1.18),(8.54±1.09),(5.10±1.43)U·mg-1,respectively;reactive oxygen species were 0.02±0.01,0.09±0.01,0.05±0.01 and 0.08±0.01,respectively;nuclear Nrf2 values were 0.63±0.09,0.28±0.06,0.60±0.08,0.32±0.05,respectively;the NQO1 values were 0.58±0.11,0.27±0.07,0.63±0.12 and 0.31±0.08,respectively;the HO-1 values were 0.53±0.08,0.23±0.06,0.59±0.09 and 0.28±0.05,respectively.Compared with the model group,the above indexes in the experimental-H group were statistically significant(all P＜0.05).The above indexes of the experimental-H+ML385 group were statistically significant compared with the experimental-H group(all P＜0.05).Conclusion Astragalus extract can alleviate oxidative stress damage in diabetic nephropathy rats,and the mechanism may be achieved by regulating Nrf2/ARE signaling pathway.

Objective To explore the value of ultrasonic quantitative measurement of hepatorenal index(HRI)for diagnosing non-alcoholic fatty liver disease(NAFLD)in children.Methods Abdominal ultrasound and upper abdominal MRI data of 70 obese children were retrospectively analyzed.ROI with different sizes and shapes of liver and right kidney were delineated on longitudinal and transverse ultrasound images,respectively,and the echo intensity of ROIs were measured to obtain HRIsmall ROI on longitudinal section,HRIsmall ROI on transverse section,HRIlarge ROI on longitudinal section and HRIlarge ROI on transverse section,i.e.HRI1,HRI2,HRI3,HRI4,while the gray,skewness and kurtosis of liver ultrasound image were recorded.Liver proton density fat fraction(PDFF)were measured based on MRI,and NAFLD was diagnoses taken PDFF≥6%as standard.The correlations of HRI with PDFF and liver ultrasound image related parameters were analyzed.Taken MRI as the standard,receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of HRI for NAFLD.Multivariate logistic regression analysis was performed taken age,sex,body mass index(BMI)percentile,HRI3 and liver ultrasound image related parameters as independent variables and MRI diagnosis of NAFLD as dependent variable to screen the predictors of MRI diagnosis of NAFLD.Results HRI1,HRI2,HRI3 and HRI4 obtained with ultrasound was 1.89±0.52,1.88±0.55,1.97±0.51 and 1.92±0.55,respectively.PDFF obtained with MRI was(12.53±3.14)%,and diagnosed NAFLD in 34 cases.HRI and PDFF had moderate positive correlation(r=0.51-0.61,all P＜0.01).The correlation between HRI3 and PDFF was the strongest(r=0.61),and HRI3 was weakly correlated with liver gray3(r=-0.270,P=0.020),with area under the curve(AUC)for diagnosing NAFLD of 0.93(P＜0.01).BMI percentile(OR=1.06),HRI3(OR=34.20)and liver gray3(OR=0.79)were all predictive factors for MRI diagnosis of NAFLD.Conclusion Ultrasonic quantitative measurement of HRI had high clinical value for diagnosing NAFLD in children.

Objective:To compare hamstring tendon graft (HTG), ligament advanced reinforcement system (LARS), and mixed HTG & LARS ligament in reconstruction of posterior cruciate ligament (PCL).Methods:A retrospective study was conducted to analyze the 59 patients with PCL rupture who had been admitted to Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University for arthroscopic PCL reconstruction between January 2018 and August 2021. The patients were divided into 3 groups: in the HTG group of 21 cases [14 males and 7 females aged (37.8±12.6) years], PCL was reconstructed by HTG; in the LARS group of 20 cases [12 males and 8 females aged (34.3±9.1) years], PCL was reconstructed by LARS; in the mixed group of 18 cases [13 males and 5 females aged (33.2±8.3) years], PCL was reconstructed by the mixed HTG & LARS ligament. The 3 groups were compared in terms of Lysholm knee score, International Knee Documentation Committee (IKDC) score, and laxity disparity between bilateral knees at 1 and 2 years after surgery.Results:There was no statistically significant difference in the preoperative general data between the 3 groups, indicating comparability ( P>0.05). One year after surgery, the mixed group had a significantly higher IKDC score [(90.0±6.5) points] than the HTG group [(78.1±5.7) points] and the LARS group [(84.1±7.3) points], and a significantly higher Lysholm score [(88.9±5.5) points] and a significantly smaller laxity disparity between bilateral knees [(2.8±1.7) mm] than the HTG group [(81.8±4.6) points, (4.7±2.4) mm] ( P<0.05). Two years after surgery, the mixed group had a Lysholm score of (93.0±4.5) points, a IKDC score of (92.5±5.7) points, and a laxity disparity between bilateral knees of (2.3±1.8) mm, all significantly better than those in the HTG group [(88.5±5.5) points, (82.7±5.7) points, and (4.2±2.5) mm] and in the LARS group [(89.0±5.2) points, (86.5±7.3) points, and (3.8±2.2) mm] ( P<0.05). In all the 3 groups, the knee function scores and laxity disparities between bilateral knees at 1 and 2 years after surgery were significantly improved compared with the preoperative values ( P<0.05). Conclusions:Satisfactory clinical outcomes can be obtained after arthroscopic PCL reconstruction using HTG, LARS or the mixed HTG & LARS ligament. However, the mixed ligament as a graft can achieve better clinical efficacy than the other two grafts.