Objective:To understand the non-uranium miners′ awareness of radon and health risks in China and analyze the relevant influencing factors, in order to provide research basis for radiological protection institutions and employers to carry out radon health education.Methods:Male miners in 32 typical non-uranium mines from 11 provinces were selected by using cluster random sampling method from June 2020 to December 2021. The awareness of radon and health risks was investigated, and the influencing factors were analyzed by binary logistic regression model.Results:A total of 1 184 non-uranium miners were investigated, and the radon awareness rate of them was 19.17%. 36.56% of the non-uranium miners heard about radon knew the radon health risks accurately, and 18.06% could identify the measures to reduce radon concentration correctly. Univariate analysis showed that the radon awareness rate of non-uranium miners varied with different education levels, labor relations, post categories, and regions ( χ2=55.92, 21.89, 64.31, 11.26, P<0.05 ). The result of logistic regression analysis showed that a bachelor degree or above, regular employee, administrative personnel and technical personnel were influencing factors of the radon awareness level ( χ2=12.81, 6.58, 5.66, 21.44, P<0.05 ). There was no statistically significant difference of radon awareness rate in different ages, working years, regions, and smoke groups ( P>0.05 ). Conclusions:The awareness level of radon and health risks of non-uranium miners was relatively low in China. Radiological protection institutions and employers should strengthen education and training of radon related knowledge in non-uranium miners through mass media, on-duty training, contract notification and workplace publicity board notification, so as to improve their personal protection consciousness.

Objective:To investigate and analyze the eye lens dose to interventional radiology workers in China from 2019 to 2021.Methods:The monitoring data on eye lens dose to interventional radiology workers from 31 province-level units during 2019-2021 were collected through the National Radiological Health Information Platform. The eye lens dose evaluation indicator was Hp(3), with each monitoring period of no more than 3 months. Kusall-Wallis H test was used for the comparison of multiple groups and pairwise. Results:A total of 6 643 interventional radiology workers were investigated from 2019 to 2021. The average annual eye lens dose was 1.03 mSv, with the median of 0.17 mSv and the maximum of 94.88 mSv. The annual eye lens dose to 59 workers exceeded 20 mSv. It was also found that the annual eye lens dose to the doctors in 2019 and 2020 was slightly higher than that to nurses (rank mean difference=118.29, 129.71, P<0.01), and the lens dose to interventional radiology workers who performed cardiac interventions in 2019 was higher than that to workers who performed peripheral vascular interventions (rank mean difference=46.52, P<0.05). Conclusions:The lens dose to interventional radiology workers is lower than the limits given in Chinese national standard currently in effect, but exceed the latest internationally recommended limit for a few ones. In order to protect the occupational health of interventional radiology workers, the monitoring of lens dose should be strengthened.

BACKGROUND: Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients. METHODS: Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes. RESULTS: Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (<70 mmHg) was associated with increased risk of in-hospital mortality (HR = 2.16, 95% CI: 1.53-3.05, Z = 4.37, P <0.01), invasive mechanical ventilation (HR = 1.65, 95% CI: 1.32-2.05, Z = 19.67, P <0.01), and ICU admission (HR = 1.45, 95% CI: 1.24-1.69, Z = 22.08, P <0.01) in the overall cohort. Similar findings were observed in subgroups with or without CVDs, except for invasive mechanical ventilation in the subgroup with CVDs. When DBP was further categorized in 5-mmHg increments from <50 mmHg to ≥100 mmHg, and 75 to <80 mmHg was taken as reference, HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs; higher DBP was not associated with the risk of in-hospital mortality. CONCLUSION: Low on-admission DBP, particularly <70 mmHg, was associated with an increased risk of adverse outcomes among inpatients with AECOPD, with or without CVDs, which may serve as a convenient predictor of poor prognosis in these patients. CLINICAL TRIAL REGISTRATION Chinese Clinical Trail Registry, No. ChiCTR2100044625.
Humans ; Blood Pressure ; Pulmonary Disease, Chronic Obstructive/therapy* ; Cohort Studies ; Respiration, Artificial ; Inpatients ; Hospital Mortality

To explore the pharmacogenomic markers that affect the platinum-based chemotherapy response in non-small-cell lung carcinoma (NSCLC), we performed a two-cohort of genome-wide association studies (GWAS), including 34 for WES-based and 433 for microarray-based analyses, as well as two independent validation cohorts. After integrating the results of two studies, the genetic variations related to the platinum-based chemotherapy response were further determined by fine-mapping in 838 samples, and their potential functional impact were investigated by eQTL analysis and in vitro cell experiments. We found that a total of 68 variations were significant at P < 1 × 10^-3 in cohort 1 discovery stage, of which 3 SNPs were verified in 262 independent samples. A total of 541 SNPs were significant at P < 1 × 10^-4 in cohort 2 discovery stage, of which 8 SNPs were verified in 347 independent samples. Comparing the validated SNPs in two GWAS, ADCY1 gene was verified in both independent studies. The results of fine-mapping showed that the G allele carriers of ADCY1 rs2280496 and C allele carriers of rs189178649 were more likely to be resistant to platinum-based chemotherapy. In conclusion, our study found that rs2280496 and rs189178649 in ADCY1 gene were associated the sensitivity of platinum-based chemotherapy in NSCLC patients.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) in elderly and patients with chronic respiratory diseases (COPD) had a poor prognosis. COPD is one of the most common chronic respiratory diseases. We explore the epidemiological characteristics of patients with severe COVID-19 with COPD patients in order to provide medical evidence for the prevention and treatment of severe COVID-19. METHODS: We retrospectively analyzed the clinical baseline characteristics, treatment strategies, disease progression and prognosis of 557 severe COVID-19 patients admitted to the West Court of Union Hospital of Huazhong University of Science and Technology from January 29, 2020 to April 8, 2020. RESULTS: A total of 465 patients with severe COVID-19 were enrolled in the study, including 248 (53.3%) males and 217 (46.7%) females. The median age of severe COVID-19 patients was 62.0 years, and 53 patients were complicated with COPD. Common symptoms at the onset included fever (78.5%), dry cough (67.1%), shortness of breath (47.3%) and fatigue (40.9%). Compared with non-COPD patients, patients with COPD had significantly lower levels of SpO2 in admission (90.0% vs 92.0%, P=0.014). In terms of laboratory examinations, patients with COPD had higher levels of C-reactive protein, interleukin-6, procalcitonin, total bilirubin, blood urea nitrogen, serum creatinine, lipoprotein (a), high-sensitivity troponin I, and D-dimer, while had lower levels of platelet counts, albumin and apolipoprotein AI. Severe COVID-19 patients with COPD had higher Sequential Organ Failure Assessment scores [3.0(2.0, 3.0) vs 2.0(2.0, 3.0), P=0.038] and CURB-65 score [1.0(1.0, 2.0) vs1.0(0.0, 1.0), P<0.001], and a higher proportion of progressing to critical illness (28.3% vs 10.0%, P<0.001) with more complications [e.g. septic shock (15.1% vs 6.1%, P=0.034)], had higher incidence rates of antibiotic therapies (90.6% vs 77.2%, P=0.025), non-invasive (11.3% vs 1.7%, P<0.001) and invasive mechanical ventilation (17.0% vs 8.3%, P=0.039), ICU admission (17.0% vs 7.5%, P=0.021) and death (15.1% vs 6.1%, P=0.016). Cox proportion hazard model was carried out, and the results showed that comorbid COPD was an independent risk factor for severe COVID-19 patients progressing to critical type, after adjusting for age and gender [adjusted hazard ratio (AHR)=2.38(1.30-4.37), P=0.005] and additionally adjusting for chronic kidney diseases, hypertension, coronary heart disease [AHR=2.63(1.45-4.77), P<0.001], or additionally adjusting for some statistically significant laboratory findings [AHR=2.10(1.13-3.89), P=0.018]. CONCLUSIONS Severe COVID-19 patients with COPD have higher levels of disease severity, proportion of progression to critical illness and mortality rate. Individualized treatment strategies should be adopted to improve the prognosis of severe COVID-19 patients.
Male ; Female ; Humans ; Aged ; Middle Aged ; COVID-19/complications* ; SARS-CoV-2 ; Retrospective Studies ; Critical Illness ; Pulmonary Disease, Chronic Obstructive/epidemiology*

Objective To investigate the changes in gastrointestinal hormones during the progression of liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD), and to provide a basis for digestive function impairment. Methods A prospective analysis was performed for 326 patients with NAFLD who attended the outpatient service and were hospitalized and treated in Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from October 2018 to June 2020, and FibroTouch was used to measure liver stiffness measurement (LSM). According to the presence or absence of liver fibrosis, they were divided into non-liver fibrosis group (group A, 161 patients with LSM < 7.3 kPa) and liver fibrosis group (group B, 165 patients with LSM ≥7.3 kPa). According to the fibrosis degree, the patients were further divided into F0-1 group (LSM < 7.3 kPa), F2 group (7.3 kPa ≤LSM < 9.7 kPa), F2-3 group (9.7 kPa ≤LSM < 12.4 kPa), F3-4 group (12.4 kPa ≤LSM < 17.5 kPa), and F4 group (LSM ≥17.5 kPa). Related data were collected, including age, sex, liver function parameters, and gastrointestinal hormones. The independent samples t -test and the one-way analysis of variance were used for comparison of normally distributed continuous data between groups, and the nonparametric Mann-Whitney U test and the Kruskal-Wallis H test were used for comparison of non-normally distributed continuous data between groups. A Spearman correlation analysis was used to investigate the correlation between LSM and liver function parameters. Results Comparison of liver function and gastrointestinal hormones showed that there were significant differences between groups A and B in alanine aminotransferase (ALT) ( Z =-3.778, P < 0.001), aspartate aminotransferase (AST) ( Z =-3.320, P =0.001), gamma-glutamyl transpeptidase (GGT) ( Z =-3.040, P =0.002), cholecystokinin (CCK) ( t =-2.944, P =0.003), and lipopolysaccharide (LPS) ( Z =-2.317, P =0.020). There were significant differences in ALT ( χ 2 =23.113, P < 0.001), AST ( χ 2 =23.415, P < 0.001), ALP ( χ 2 =15.962, P =0.003), GGT ( χ 2 =20.172, P < 0.001), and CCK ( F =2.687, P =0.031) between the F0-1 group with 161 patients, the F2 group with 89 patients, the F2-3 group with 46 patients, the F3-4 group with 16 patients, and the F4 group with 14 patients. LSM was positively correlated with direct bilirubin, ALT, AST, alkaline phosphatase, and GGT ( r =0.128, 0.266, 0.225, 0.137, and 0.213, all P < 0.05). Conclusion Liver fibrosis progression in NAFLD can affect gallbladder contraction function and gastrointestinal function, and measurement of the serum levels of CCK and LPS has an important clinical value in the early diagnosis and treatment of digestive diseases related to gallbladder contraction function and gastrointe stinal function in NAFLD patients with liver fibrosis.

Objective To investigate whether the progression of liver fibrosis affects endothelial function in patients with nonalcoholic fatty liver disease (NAFLD), and to early identify the warning of cardiovascular diseases caused by endothelial dysfunction by liver fibrosis progression. Methods A total of 280 patients who attended the outpatient service or were hospitalized in Department of Liver Disease, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, from April 2019 to October 2020 were enrolled, and they were diagnosed with fatty liver disease by ultrasound and met the diagnostic criteria for NAFLD. General information and related serological markers were collected and recorded. FibroTouch technique was performed for the NAFLD patients diagnosed by ultrasound to record their fat attenuation parameter (FAP) and liver stiffness measurement (LSM), and according to LSM, the patients were divided into non-progressive fibrosis group (239 patients with LSM < 11 kPa) and progressive fibrosis group (41 patients with LSM ≥11 kPa) to analyze the association between liver fibrosis progression and endothelin-1 (ET-1)/nitric oxide (NO) in NAFLD. The t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the Spearman method was used for correlation analysis. Results There were no significant differences between the non-progressive fibrosis group and the progressive fibrosis group in the expression levels of ET-1( Z =-0.190, P =0.849) and NO( Z =-1.509, P =0.131), and there were significant differences between the two groups in body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) ( Z =-3.977, -4.162, -3.471, -3.201, -3.202, and -3.311, all P < 0.05). The Spearman analysis showed that LSM was not correlated with ET-1, NO, and NO/ET-1 ( r s =-0.046, 0.086, and 0.104, all P > 0.05). Further analysis of the correlation of ET-1 and NO with each index showed that ET-1 was not correlated with age, NO, ALT, AST, GGT, total cholesterol, TG, HDL-C, low-density lipoprotein cholesterol (LDL-C), FAP, and BMI ( r s =-0.017, 0.054, -0.067, -0.016, -0.031, 0.004, 0.051, -0.084, -0.030, 0.080, and 0.044, all P > 0.05), and NO was not correlated with age, ET-1, ALT, AST, GGT, total cholesterol, TG, HDL-C, LDL-C, FAP, and BMI ( r s =0.004, 0.054, 0.011, 0.052, 0.004, -0.051, -0.052, -0.012, -0.076, -0.013, and -0.021, all P > 0.05). Conclusion This study shows that liver fibrosis progression in NAFLD has no impact on ET-1 and NO, suggesting that fibrosis progression may have no influence on endothelial function.

Objective:To analyze distributions of dose range, occupational category, and causes of abnormal dose values from individual dose monitoring of radiation workers and to provide recommendations for improving the quality of individual monitoring data and occupational health management in medical institutions.Methods:The data of individual dose monitoring result exceeding 1.25 mSv in a single monitoring cycle, collected by Occupational Health System for Radiology Facilities’ on National Radiological Health Information Platform, was analyzed.Results:A total of 1 113 abnormal dose values were detected in 31 provinces in 2020, with an abnormal rate of 2.48‰, of which workers of diagnostic radiology and interventional radiology accounted for 68.01% and 18.78%, respectively. The dose distribution of abnormal dose values was mainly between 1.25 and 5 mSv. The abnormal dose values were mainly caused by improperly wearing or using personal dosimeters, accounting for 63.88%. Workers for whom the dose values was abnormal due to increased workload accounted for 12.32%, with an average annual individual dose of 5.14 mSv. There was no statistically significant difference in annual individual dose among radiation workers between different occupational groups( P>0.05). Conclusions:Education and training on radiation protection for radiation workers should be strengthened, and a specific and feasible system for radiation protection management, as well as a reward and punishment system, should be established in order to reduce the occurance of the improper wearing of personal dosimeters. Great attention should be paid to occupational exposure of workers in diagnostic radiology and interventional radiology, and a work shift system should be conducted to reduce individual dose levels. It is recommended that standard verification procedures for abnormal dose values from individual dose monitoring should be developed to improve the quality of individual monitoring data.

Objective:To investigate the allocation of radiation protection equipment and status of radiological protection management for radiation workers in hospitals nationwide.Methods:A descriptive analysis was conducted of the data reported from the investigated hospitals based the data for 2019 available from the National Radiological Health Information Platform.Results:A total of 3 806 hospitals were investigated in 2019, including 609 tertiary hospitals, 1 421 secondary hospitals, 1 776 primary and ungraded hospitals. Large differences had been shown in the number of radiation workers in different grade hospitals. The average number of radiation workers were found to be, respectively, 99 in tertiary hospitals, 19 in secondary hospitals, 2 in primary and/or ungraded hospitals. Interventional radiology and nuclear medicine workers were equipped seperately with 0.40 and 0.43 pieces of lead apron, 0.27 and 0.31 lead caps, 0.38 and 0.45 lead rubber neck sleeves, 0.18 and 0.08 pairs of lead rubber gloves and 0.31 and 0.22 pairs of lead glasses. No personal alarming dosimeter was available in 15.25% hospitals where radiotherapy was performed, nor radiation surveillance meter in 27.90% such hospitals. In the hospitals considered, 88.13% workers were granted the Radiation Worker Cetificate and 83.69% received the on-the-job radiation protection training. The number of monitored workers accounted for 99.20%, of which 0.40% received the personal annual dose Hp(10)≥20 mSv. The occupational health surveillance files that had been completed reached 98.05% of the total and the on-the-job radiation workers who had passed the occupational health examination made up to 96.00%. It was advised that, of 76 627 radiation workers who received the 2019 health examination, 0.88% should get out of radiation work for the being time and 0.11% should not continue for this work. Conclusions:The considerably large proportion of radiation workers in China have received individual dose monitoring and occupational health examination. Radiological diagnosis and therapy departments should enlarge the allocation of radiation monitoring and personal protection equipment for radiaton workers in their hospitals.

Nocardia is a genus of gram-positive,weakly acid-fast,filamentous aerobic actinomycetes,which mainly causes infection in immunocompromised persons. We reported a successfully treated fatal case of severe pneumonia caused by Nocardia farcinica in a hospital,then reviewed 25 domestic and abroad case reports about nocardiosis combined with severe pneumonia occurred since 2006,so as to improve health care workers'cognition on clinical manifestations,image features,pathogenic characteristics,and diagnostic and treatment schemes of se-vere pneumonia caused by Nocardia farcinica.