Background Occupational disease diagnosis appraisal is an appeal procedure initiated when a party disagrees with the occupational disease diagnosis conclusion. It is a legal procedure to safeguard the health rights of employees and the legitimate rights and interests of employers. Objective To analyze the data of occupational disease diagnosis appraisal in Shanghai, identify existing problems, and provide suggestions for improving. Methods Statistical analysis was conducted on basic situation, characteristics of workers and employers, disease classification, and consistency between diagnosis and appraisal conclusions of all occupational disease diagnosis appraisal cases from 2012 to 2024. All diagnosis conclusions were named in accordance with the Classified Catalogue of Occupational Diseases included employers were classified according to the Measures for the Statistical Classification of Large, Medium, Small and Micro Enterprises" and the Notice on Adjusting the Provisions for Classifying Enterprise Registration Types; industry classification followed the Industrial Classification for National Economic Activities (GB/T 4754-2017). Results From 2012 to 2024, a total of 260 cases of occupational diseases diagnosis appraisal were closed. The main diagnosis were 138 cases of ear, nose, throat, and oral diseases (53.1%), chemical poisoning (18.8%), and pneumoconiosis and other respiratory diseases (16.2%). The proportion of ear, nose, throat, and oral diseases gradually increased (2022 excluded). The incidence of annual municipal and provincial cases decreased by 76.3% and 85.0% respectively (2024 vs 2012). The consistency rate of conclusions between appraisal and diagnosis gradually increased. The total consistency rates between final appraisals and diagnostic conclusions were 81.5%, and 79.7%, 87.8%, 100.0%, 85.0% for ear, nose, throat, and oral diseases, chemical poisoning, and pneumoconiosis and other respiratory system diseases, respectively. Specifically, the consistency rates were 80.1% and 80.0% for noise-induced deafness and chronic benzene poisoning. In terms of inconsistency reasons, "inconsistent interpretation of standards and excessive discretion in standard application" accounted for 43.8%, followed by "failure to correctly apply standards" (31.3%) and and "discrepancies in occupational exposure history recognition" (15.6%). Conclusion The revisions and improvements of the legal system for occupational disease diagnosis appraisal have played a positive role in improving the consistency of conclusions between appraisal and diagnosis of occupational diseases in Shanghai. It is suggested to further strengthening the publicity and training of occupational disease diagnosis standards to improve the quality of occupational disease diagnosis.

Objective:To construct a nursing management plan for prevention of acute bone loss in elderly patients with total hip arthroplasty, and to provide reference for clinical prevention of acute bone loss.Methods:From February to May 2023, a research group about acute bone loss was established, through literature review, semi-structured interviews, and group discussions, the first draft of acute bone disease prevention nursing management plan for elderly patients with total hip arthroplasty was formed. Fifteen experts were selected from 10 tertiary hospitals for 2 rounds of Delphi expert consultation, the plan was revised and improved based on expert opinions, and finally a nursing management plan for prevention of acute bone loss in elderly patients with total hip arthroplasty was constructed.Results:There were 15 experts involved, 7 males and 8 females with 36 - 60 years old. The effective recovery rate of the two-round consultation questionnaire were 15/15, the expert authority coefficients were 0.83 and 0.85, and the overall Kendall′s harmony coefficients were 0.143 and 0.165, respectively (both P<0.05). Finally, a nursing management plan for prevention of acute bone loss in elderly patients with total hip arthroplasty was constructed, including 3 first-level indicators, 11 second-level indicators, and 35 third-level indicators. Conclusions:The nursing management plan for prevention of acute bone loss in elderly patients with total hip arthroplasty is scientific, reliable and clinically practical, which provides a reference for clinical prevention of acute bone loss.

Objective:To construct a rehabilitation nursing program for total knee arthroplasty (TKA) patients with kinesiophobia based on capacity, opportuniy, motivation-behavior (COM-B) theoretical model, and to provide reference for clinical staff to implement rehabilitation treatment.Methods:From August to December 2023, literature analysis was used to construct a preliminary program, combined the COM-B theoretical model with the rehabilitation exercise guidelines and expert consensus. The rehabilitation nursing program for TKA patients with kinesiophobia was formed through 2 rounds of Delphi expert correspondence consultation, and the analytic hierarchy process was used to calculate the weight of each item.Results:A total of 15 experts were included, including 4 males and 11 females, aged (45.80 ± 5.72) years old. The effective recovery rate of the 2 rounds of expert correspondence questionnaires were 15/15, the expert authority coefficients were 0.860 and 0.875, and the Kendall coordination coefficients were 0.155 and 0.172, and the differences were statistically significant ( χ2 = 97.70, 105.91, both P<0.01). The final rehabilitation nursing program for TKA patients with kinesiophobia included 3 primary indexes, 8 secondary indexes and 25 tertiary indexes. Conclusions:The rehabilitation nursing program for TKA patients with kinesiophobia constructed based on COM-B theoretical model is scientific and practical, and can provide a practical basis for clinical staff.

Objective:To explore and analyze the characteristics and influencing factors of language development in children with attention deficit hyperactivity disorder (ADHD).Methods:A case-control study was used, from May 2021 to August 2023, patients diagnosed with attention deficit hyperactivity disorder (ADHD) were enrolled in the mental health clinic of the Children′s Hospital Affiliated to the Capital Institute of Pediatrics. The language ability of 272 children with ADHD and 117 healthy children who underwent physical examination in children′s health center during the same period were tested by Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive (DREAM-C), and the development levels of total language, receptive, expressive, semantics and syntax of the two groups were compared by independent sample t-test. The influential factors of language lag in children with ADHD were analyzed by univariate χ2 analysis and multiple logistic regression. Results:There were 272 children with ADHD, including 206 males and 66 females, with an age range of 6-8 (7.29±1.17) years. While in the control group, there were 117 healthy children, including 91 males and 26 females, with an age range of 6-8 (7.02±0.82) years. The average scores of total language, expressive and syntax of ADHD children were lower than those of healthy children [(92.73±12.47/96.36±11.04), t=-2.857, P<0.05; (84.49±13.24/87.78±15.25), t=-2.029, P<0.05; (87.93±10.26/90.27±11.05), t=2.022, P<0.05]. Univariate χ2 analysis showed that disharmonious family relationship ( χ2=4.183, P<0.05), the main caregivers were non-parents ( χ2=9.121, P<0.05), early screen exposure ( χ2=3.889, P<0.05), ADHD family history ( χ2=5.423, P<0.05) were influential factors of language development lag in ADHD children. The results of multivariate logistic regression model analysis showed that cesarean section ( OR=2.137, 95% CI: 1.078-4.379, P=0.030), disharmonious family relationship ( OR=2.659, 95% CI: 1.178-5.999, P=0.019), early screen exposure ( OR=3.556, 95% CI: 1.127-11.213, P=0.030), ADHD family history ( OR=1.959, 95% CI: 1.058-3.630, P=0.033) were risk factors for comorbidities of language development in children with ADHD. Conclusion:The total language ability, expressive and syntax scores of ADHD children lag behind those of healthy children. The delayed language development of ADHD children is related to delivery mode, family relationship, the main caregivers, early screen exposure, family history of ADHD.

Objective:To explore and analyze the characteristics and influencing factors of language development in children with attention deficit hyperactivity disorder (ADHD).Methods:A case-control study was used, from May 2021 to August 2023, patients diagnosed with attention deficit hyperactivity disorder (ADHD) were enrolled in the mental health clinic of the Children′s Hospital Affiliated to the Capital Institute of Pediatrics. The language ability of 272 children with ADHD and 117 healthy children who underwent physical examination in children′s health center during the same period were tested by Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive (DREAM-C), and the development levels of total language, receptive, expressive, semantics and syntax of the two groups were compared by independent sample t-test. The influential factors of language lag in children with ADHD were analyzed by univariate χ2 analysis and multiple logistic regression. Results:There were 272 children with ADHD, including 206 males and 66 females, with an age range of 6-8 (7.29±1.17) years. While in the control group, there were 117 healthy children, including 91 males and 26 females, with an age range of 6-8 (7.02±0.82) years. The average scores of total language, expressive and syntax of ADHD children were lower than those of healthy children [(92.73±12.47/96.36±11.04), t=-2.857, P<0.05; (84.49±13.24/87.78±15.25), t=-2.029, P<0.05; (87.93±10.26/90.27±11.05), t=2.022, P<0.05]. Univariate χ2 analysis showed that disharmonious family relationship ( χ2=4.183, P<0.05), the main caregivers were non-parents ( χ2=9.121, P<0.05), early screen exposure ( χ2=3.889, P<0.05), ADHD family history ( χ2=5.423, P<0.05) were influential factors of language development lag in ADHD children. The results of multivariate logistic regression model analysis showed that cesarean section ( OR=2.137, 95% CI: 1.078-4.379, P=0.030), disharmonious family relationship ( OR=2.659, 95% CI: 1.178-5.999, P=0.019), early screen exposure ( OR=3.556, 95% CI: 1.127-11.213, P=0.030), ADHD family history ( OR=1.959, 95% CI: 1.058-3.630, P=0.033) were risk factors for comorbidities of language development in children with ADHD. Conclusion:The total language ability, expressive and syntax scores of ADHD children lag behind those of healthy children. The delayed language development of ADHD children is related to delivery mode, family relationship, the main caregivers, early screen exposure, family history of ADHD.

Objective To explore the effects of two methods of video laryngoscope insertion on the success rate of tracheal intubation and postoperative pharyngeal complications.Methods We selected 80 elective surgerypatients with American Society of Anesthesiologists(ASA)classification Ⅰ to Ⅱ who had no difficult airway in preoperative assessment under general anesthesia with orotracheal intubation.They were aged 18 to 65 years old and there were no restrictions on height and weight.The patients were randomly divided into a group with laryngoscope inserted through the middle of the mouth(group M)and a group with laryngoscope inserted through the right corner of the mouth(group C),with 40 cases in each group.Observe the laryngoscope exposure grading,oropharyngeal mucosal bleeding,first-time intubation success rate,and occurrence of pharyngeal pain and hoarseness within 48 hours after surgery in both groups;record the patients'systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)among admission to the room(T0),after giving anesthesia drugs(T1),immediately after intubation(T2),1 min after intubation(T3),and 3 min after intubation(T4).Results The SBP of group M was lower than that of group C at T3(P＜0.05);There was no statistically significant difference in laryngoscope exposure grading between the two groups(P＞0.05).The intubation time,oropharynx mucosal bleeding and the cases of sore throat within 48 hours of group M were less than those in group C(P＜0.05).The success rate of primary intubation in group M was higher than that in group C(P＜0.05).Conclusion Inserting a video laryngoscope through the middle of the mouth can reduce oropharyngeal mucosal bleeding,improve the success rate of intubation,and reduce the incidence of postoperative pharyngeal complications.

Background: The impact of para-aortic lymphadenectomy (PALD) on prognosis and quality of life (QoL) for IB2-IIA2 cervical cancer patients remain controversial. And whether intraoperative frozen pathology exam on common iliac lymph nodes could help predict para-aortic lymph node (PALN) metastasis was unanswered with high-level evidence. Methods A multi-center, randomized controlled study is intended to investigate the effect of PALD on the prognosis and QoL in cervical cancer patients and to assess the value of intraoperative frozen pathological evaluation of common iliac nodes metastasis for the prediction of PALN metastasis. After choosing whether to receive intraoperative frozen pathological examination of bilateral common iliac lymph nodes, eligible patients will be randomly assigned (1:1) to receive PALD or not. The primary end point is 2-year progression-free survival (PFS). The secondary end points include 5-year PFS, 2-year overall survival (OS), 5-year OS, adverse events (AEs) caused by PALD, AEs caused by radiotherapy and QoL. A total of 728 patients will be enrolled from 8 hospitals in China within 3-year period and followed up for 5 years.

Objective:To investigate the clinical characteristics of patients with epithelioid glioblastoma (ep-GBM) and their influencing factors for survival.Methods:Sixteen ep-GBM patients admitted to Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University from August 2015 to March 2022 were chosen. Clinical data such as age, gender, maximum tumor diameter, degrees of tumor resection, treatments, and immunohistochemical staining-related indexes were obtained. Survival curves of the patients were plotted by Kaplan-Meier method, and differences of progression-free survival (PFS) and overall survival (OS) among patients with different clinical characteristics were compared. Log-rank test was used to compare the survival rates, and Cox proportional risk regression model was constructed to analyze the influencing factors for PFS and OS.Results:In these 16 patients, median OS was 11.8 months and median PFS was 7.0 months. Significant differences in PFS and OS were noted between groups of age<32 years and age≥32 years, between groups of maximum tumor diameter<4.8 cm and diameter≥4.8 cm, and between groups of positive p53 expression and negative p53 expression ( P<0.05). Log-rank test indicated that OS and PFS ratios were significantly different between groups of age<32 years and age≥32 years, between groups of maximum tumor diameter<4.8 cm and diameter≥4.8 cm, between S100 positive group and S100 negative group, between Olig-2 positive group and Olig-2 negative group, and between groups of positive p53 expression and negative p53 expression ( P<0.05). Cox proportional hazard regression model showed that age ( HR=1.070, 95% CI: 1.013-1.134, P=0.016), preoperative maximum tumor diameter ( HR=2.150, 95% CI: 1.142-4.055, P=0.018) and Olig-2 expression ( HR=0.040, 95% CI: 0.003-0.498, P=0.013) had influences in PFS; preoperative maximum tumor diameter ( HR=2.350, 95%CI: 1.149-4.798, P=0.019) and Olig-2 expression ( HR=0.080, 95% CI: 0.007-0.972, P=0.047) had influences in OS. Conclusion:Older ep-GBM patients are prone to progress after surgery; ep-GBM patients with larger tumor diameter and negative Olig-2 expression likely progress and have poor prognosis after surgery.

Leucine-rich alpha-2 glycoprotein 1 (LRG1) is a highly conserved member of the family of leucine-rich repeat (LRR) proteins. LRG1 has been reported to be closely related to the occurrence and development of malignant tumors. Recent studies have shown that LRG1 is abnormally expressed in many digestive system tumors, including esophageal cancer, gastric cancer, liver cancer, pancreatic cancer, and colorectal cancer. LRG1 has also been reported to be closely related to tumor cell proliferation, invasion, migration, apoptosis, and poor prognosis. This paper reviews the research progress of LRG1 in many digestive system tumors, providing new ideas for LRG1-based anti-tumor treatment.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies