Objective To analyze the epidemic characteristics of pneumoconiosis in Jingmen City from 2011 to 2022, and to provide theoretical basis for formulating the occupational disease prevention plan of the ^“14th Five-Year Plan^” in Jingmen City. Methods The data of pneumoconiosis cases in Jingmen City from 2011 to 2022 were collected from the Occupational Disease and Health Hazard Factors Monitoring Information System, and the information of disease classification, enterprise economic type, scale distribution, regional distribution, job distribution, dust exposure years and so on was statistically analyzed. Results A total of 260 cases of pneumoconiosis were reported in Jingmen City from 2011 to 2022, with an average of 13.81 years of exposure to dust, including 164 cases of coal workers' pneumoconiosis, 90 cases of silicosis and 6 cases of other pneumoconiosis. The cases were mainly distributed in Dongbao District with 160 cases (61.54%), Zhongxiang City with 72 cases (27.69%), and Duodao District with 18 cases (6.92%). The difference was statistically significant（χ²=217.846，P<0.05）. The cases were mainly distributed in private enterprises (76.54%, 199 cases). The enterprise sizes were mainly medium-sized (28.46%, 74 cases) and small (61.15%, 159 cases) enterprises, and the difference was statistically significant (χ²=46.025，P<0.05). Conclusion Coal workers' pneumoconiosis and silicosis are the main types of occupational pneumoconiosis in Jingmen area, which will become the key prevention and control targets in Jingmen City for a long time and should be paid attention to. The cases are mainly concentrated in joint-stock, private economic type enterprises and small and medium-sized enterprises, which should be monitored intensively.

Objective To observe the protection mechanism of Huaiqihuang Granules from diabetic kidneydisease(DKD)in rats and for renal cells in high-glucose environment.Methods(1)In vivo experiment:the rat model was constructed by high-fat diet feeding combined with STZ intraperitoneal injection.The experiment was divided into normal group,model group,Huaiqihuang Granules low-,medium-and high-dose groups and Losartan group,with 10 rats in each group.After corresponding treatment,the main biochemical indexes such as urinary microalbumin,fasting blood glucose,serum creatinine,total cholesterol and low density lipoprotein cholesterol were measured,and the pathological changes of renal tissue were observed by hematoxylin-eosin staining,periodic acid Schiff's staining and Masson staining,respectively.(2)In vitro experiments:a high glucose-induced renal tubular epithelial cell HK2 model was constructed.The experiment was divided into normal glucose group,high-glucose group,Huaiqihuang Granules group and mannitol group.After corresponding treatment,the cell proliferation was detected by MTT assay,and the generation of reactive oxygen species(ROS)in cells and mitochondria was detected by 2',7'-Dihydrodichlorofluorescein diacetate(DCFH-DA)method and MitoSOX/Hoechst 33342 staining method,respectively.Western Blot was used to detect the expressions of inflammasome-related proteins NOD-like receptor protein 3(NLRP3),cleaved-caspase-3 and interleukin-1β(IL-1β)and renal fibrosis-related proteins fibronectin(FN)and type Ⅳ collagen(Col Ⅳ).Results(1)In vivo experiments,Huaiqihuang Granules significantly improved the urinary microalbumin excretion and serum creatinine,hyperglycemia and lipid metabolism disorders in DKD rats,and reduced the pathological damage of renal tissue.(2)In vitro studies,Huaiqihuang Granules significantly inhibited proliferation and ROS overproduction of high-glucose-induced HK2 cells,reduced the activation of NLRP3 inflammasome and the expressions of renal fibrosis-related proteins FN and Col Ⅳ in high-glucose-induced HK2 cells.Conclusion Huaiqihuang Granules has an impovement effect on DKD in rats,and its protection mechanism for renal cells in high-glucose environment is relavent to inhibiting ROS generation,activation of NLRP3 inflammasome and expression of fibrosis-related proteins.

Objective: To investigate the molecular mechanism and identify potential drugs for subthreshold depression (SD), and elucidate the detalied mechanism of Danzhi Xiaoyao powder (DZXY) in SD. Methods: Using RNA-sequencing, we identified differentially expressed genes (DEGs) in leukocytes of SD compared to healthy controls, deciphered their functions and pathways, and identified the hub genes of SD. We also assessed changes in leukocyte transcription factor activity in patients with SD using the TELiS platform. The Connectivity Map database was retrieved to screen candidate drugs for SD. Based on network pharmacology, we elucidated the “multi-component, multi-target, and multi-pathway” mechanism of DZXY in the treatment of SD. Results: We identified 1080 DEGs (padj <0.05 and |log2 (fold change)| ≥ 1 & protein coding) in the leukocytes of patients with SD. These DEGs, including hub genes, were primarily involved in immune and inflammatory response-related processes. Transcription factor activity analysis revealed similarities between the leukocyte transcriptome profile in SD and the conserved transcriptional response to adversities in immune cells. Connectivity Map analysis identified 28 potential drugs for SD treatment, particularly SB-202190 and TWS-119. Constructing the “Direct Compounds-Direct Targets-Pathways” network for DZXY and SD revealed the curative mechanisms of DZXY in SD, primarily including inflammatory response, lipid metabolism, immune response, and other processes. Conclusion These results provide new insights into the characteristics and functional changes of leukocytes in SD, partially illustrate the pathogenesis of SD, and suggest potential drugs for SD. The curative mechanisms of DZXY in SD are also partially elucidated.

The implementation of amplicon sequencing and metagenomic sequencing methods in the whole-genome sequen-cing for MPXV testing was compared,to provide a technical reference for sequencing,tracing,and epidemic prevention and control of MPXV.For amplicon sequencing,targeted amplification of the viral whole genome was performed on MPXV DNA,and was followed by next-generation sequencing of the amplification products.For metagenomic sequencing,next-generation sequencing was performed directly on MPXV DNA.After the sequences were obtained,software such as CLC and IGV were used to analyze the effective data percentage,sequencing depth,and whole-genome sequencing coverage under different sequen-cing depths for both sequencing methods,to evaluate sequencing quality.Nextclade was used to analyze virus typing,muta-tions,and deletions.Subsequently,the similarity and completeness of sequences obtained through both sequencing methods were further compared.On the basis of mapping to the refer-ence sequence of strain MPXV-M5312_HM12_Rivers(Gen-Bank number NC_063383.1),the percentage effective data obtained from amplicon sequencing and metagenomic sequen-cing was 99.72％and 7.54％,respectively,with a sequencing depth range of 0× to 334 839 ×,and 44 × to 1 000 ×.On the basis of a sequencing depth of 10 ×,the site coverage of the above was 90.3％and 100％,respectively.IGV was used to validate the whole-genome coverage under different sequencing depths.The depth coverage of whole-genome sites for metagenomic sequencing was uniform,whereas that of the whole-genome sites for amplicon sequencing was uneven and significantly differed.Virus typing and sequence similarity analysis indicated that the viral sequences obtained with the two sequencing methods all belonged to the Ⅱb B.1 lineage of MPXV.Comparison with the reference sequence indicated that metagenomic sequencing identified 73 nucleotide mutation sites,whereas amplicon sequen-cing identified 68 mutation sites.Further analysis demonstrated that seven common mutation sites of Ⅱb B.1 were not detected in the amplicon sequencing,and two false positive private mutation sites were identified.Amplicon or metagenomic sequencing methods thus can be flexibly used in MPXV virus whole-genome sequencing.Amplicon sequencing yields more effective data,whereas metagenomic sequencing provides better uniformity of coverage and sequence accuracy.This study provides a prelimi-nary understanding of the efficacy of each method and may serve as a technical reference for improving the success rate of whole-genome sequencing of MPXV.

Objective:This study explored the designs of physicians'compensation incentives that were compatible with the reform of Diagnosis-related groups(DRG)payment,so as to provide a reference for optimizing policies related to medical insurance payment reform.Methods:We designed seven different physicians'compensation schemes that converted DRG payment incentives into salary incentives,using economic experiments.The total of 210 medical students and 65 doctors were recruited as subjects.We tested the quantity of medical services for patients that participants provided and the corresponding patient health benefits under different incentive schemes.Results:The two designs of feedback of DRG payment to physicians and linking DRG payment surplus to physicians'performance wages both could transmit the incentive of the payment methods to the service providers.On this basis,a quality-based pay-for-performance payment was introduced,and the deviation between the quantity of services provided by subjects and the optimal quantity of services decreased,and the loss ratio of patient health benefits also decreased.Conclusion:When transmitting DRG payment incentives to medical service providers,the physician compensation design combined with quality-based pay-for-performance payments is more conducive to improving patient health benefits.

Objective To investigate the changes in cerebral blood flow(CBF)and whole-brain functional connectivity(FC)in patients with neuromyelitis optica spectrum disorder(NMOSD)examined by conventional MRI.Methods Twenty-two patients with NMOSD and 25 matched healthy controls(HC)were included,and all subjects'conventional MRI sequences,arterial spin labeling(ASL),and resting-state functional magnetic resonance imaging(rs-fMRI)image data were acquired,and the brain regions with CBF differences between groups extracted based on ASL were used as seed points for whole-brain FC analysis,the FC differences between the groups were compared,and the correlation between the parameter values and the expanded disability status scale(EDSS)scores were analyzed.Results NMOSD patients exhibited a decrease in CBF value in the right supratemporal gyrus,bilateral calcarine fissure and right supplementary motor area,while the right middle temporal gyrus displayed an increase when compared to HC.Whole-brain FC analysis based on seed points revealed an increase in FC value between bilateral calcarine fissure and olfactory cortex,as well as between right supplementary motor area and left superior frontal gyrus.While FC value between the right supplementary motor area and left precentral gyrus,bilateral thalamus,right supraoccipital gyrus were decreased.The FC value between the right supratemporal gyrus and right inferior parietal lobule,left supratemporal gyrus,right precuneus lobes showed a decrease[Gaussian random field(GRF)-corrected,P＜0.05].There was a correlation between CBF values of bilateral calcarine fissure and EDSS scores in NMOSD patients(rs=-0.456,P=0.033).Conclusion There are CBF and FC abnormalities in multiple brain regions in NMOSD patients,which provide imaging basis and insights for the brain micropathological changes of NMOSD,and help to understand the pathology and neural mechanism of NMOSD.

Objective:To assess the association between diabetes mellitus and the risk of sudden cardiac death (SCD), and to identify potential contributing factors.Methods:This meta-analysis was an updated version of the original study Diabetes mellitus and the risk of sudden cardiac death： a systematic review and meta-analysis of prospective studies. The original review included all eligible case-control and cohort studies published in PubMed and Embase up to 2017 that investigated the association between diabetes and SCD risk. In this updated study, newly published studies were added, including those available in PubMed, Embase, China National Knowledge Infrastructure (CNKI), and WANFANG MED ONLINE up to December 3, 2023. Search terms included "diabetes""glucose""sudden cardiac death" "cardiac arrest" and their Chinese equivalent. The primary outcome was the risk of SCD, while factors such as country, ethnicity, skin color, follow-up duration, left ventricular ejection fraction (LVEF), baseline comorbidities, and other relevant variables were analyzed as potential influencing factors. Relative risk ( RR) was used as the summary measure. A random-effects model was used when significant heterogeneity was detected, otherwise a fixed-effects model was used. Cochran′s Q test was used for subgroup analysis to assess the influence of factors such as region, baseline diseases, LVEF, and ethnicity (based on skin color) on the outcomes. Results:A total of 32 cohort/case-control studies with a combined sample size of 3 252 954 individuals were included. The meta-analysis showed that the risk of SCD in patients with diabetes was double that of non-diabetics ( RR=2.00, 95% CI: 1.83-2.19, P<0.001). In Asian populations, the risk of SCD in diabetic patients was 1.78 times that of non-diabetic individuals ( RR=1.78, 95% CI: 1.51-2.10), 2.05 times that of in European populations ( RR=2.05, 95% CI: 1.79-2.34), and 2.12 times that of in American populations ( RR=2.12, 95% CI: 1.82-2.47), with no statistically significant heterogeneity between regions ( P=0.287). Among individuals without other baseline comorbidities, the risk of SCD was 2.12 times higher in diabetic patients than in those without diabetes ( RR=2.12, 95% CI: 1.89-2.38). In patients with baseline coronary heart disease, the risk was 1.75 times that of non-diabetics ( RR=1.75, 95% CI: 1.45-2.11). In those with baseline heart failure, the risk was 1.92 times that of non-diabetics ( RR=1.92, 95% CI: 1.51-2.43). In patients with baseline atrial fibrillation, the risk was 4.00 times that of non-diabetic individuals ( RR=4.00, 95% CI: 1.38-11.56). In patients undergoing hemodialysis due to renal failure, the risk was 1.76 times that of non-diabetic individuals ( RR=1.76, 95% CI: 1.25-2.48), with no statistically significant heterogeneity between groups ( P=0.262). In cardiac patients with LVEF>50%, the risk of SCD in diabetic patients was 2.08 times that of non-diabetic individuals ( RR=2.08, 95% CI: 1.57-2.75), and in those with LVEF<50%, the risk was 1.69 times that of non-diabetic individuals ( RR=1.69, 95% CI: 1.30-2.18), with no statistically significant heterogeneity between groups ( P=0.277). In yellow-skinned populations, the risk of SCD in diabetic patients was 1.80 times that of healthy individuals ( RR=1.80, 95% CI: 1.73-1.87), and in white-skinned populations, it was 2.18 times that of healthy individuals ( RR=2.18, 95% CI: 1.88-2.54), with statistically significant heterogeneity between groups ( P=0.014). Conclusions:Diabetes mellitus significantly increased the risk of SCD, and this effect may be more pronounced in white-skinned populations, while region, baseline comorbidities, and LVEF had no further effect.

Objective:To observe the effectiveness and safety of pars plana vitrectomy (PPV) combined with inner limiting membrane (ILM) removal and 41G microneedle subretinal injection of balanced salt solution (BSS) in the treatment of refractory macular hole.Methods:A prospective clinical study. From January to June 2023, 20 cases (20 eyes) of refractory macular hole patients diagnosed through examination at The Affiliated Eye Hospital of Nanchang University were included in the study. The basal diameter of the affected eye's basal diameter (BD) was >1 000 μm. Macular hole index (MHI) was <0.5. The affected eye received treatment with 23G PPV combined with ILM removal and 41G microneedle subretinal injection of BSS. Best corrected visual acuity (BCVA), microperimetry, and optical coherence tomography angiography (OCTA) were performed before and 1, 2, 3, and 6 months after surgery for the affected eye. BCVA examination was performed using standard logarithmic visual acuity chart, and convert it to logarithmic minimum resolution angle (logMAR) visual acuity for statistical purposes. MP-3 microperimetry was used for micro view examination, record the mean sensitivity (MS) of the retinal within a 12° range of the fovea. OCTA was used to measure the area of the avascular zone of the macula (FAZ), perimeter of the FAZ (PERIM), retinal vascular length density (VLD), and vascular perfusion density (VPD). The changes in BCVA, MS, FAZ area, PERIM, VLD, VPD before and after surgery were compared and analyzed. After the same time, the closure of macular hole and the occurrence of complications after surgery were observed. Single factor analysis of variance was used to compare the observation indicators at different times before and after surgery. The correlation between various observation indicators and preoperative minimum diameter (MD), BD, and hiatus height at 6 months after surgery were analyzed using Pearson correlation analysis.Results:Among the 20 cases with 20 eyes, there were 2 males with 2 eyes and 18 females with 18 eyes. Age was (61.45±8.56) years old. The logMAR BCVA, MS, FAZ area, PERIM, VLD, and VPD of the affected eye were 1.46±0.21, (16.20±5.81) dB、(0.40±0.17) mm 2, (2.89±0.99) mm, (6.23±3.59) mm -1, (0.17±0.10)%, respectively. Six months after surgery, out of 20 eyes, macular hole closure and incomplete closure were 18 (90.0%, 18/20) and 2 (10.0%, 2/20) eyes, respectively. The logMAR BCVA, MS, FAZ area, PERIM, VLD, and VPD were 0.80±0.20, (22.20±4.60) dB, (0.18±0.10) mm 2, (1.83±0.80) mm, (9.54±2.88) mm -1, (0.31±0.14)%. Compared with before surgery, the differences were statistically significant ( P<0.05). The correlation analysis results showed a positive correlation ( P<0.05) between preoperative BD and postoperative 6-month PERIM and VPD. There was a negative correlation between preoperative MD and postoperative VLD at 6 months ( P<0.05). There was a negative correlation between preoperative MHI and logMAR BCVA and VPD at 6 months after surgery ( P<0.05). No complications such as elevated or decreased intraocular pressure, damage to retinal pigment epithelium, retinal hemorrhage, endophthalmitis, or retinal detachment occurred after surgery in all affected eyes. Conclusion:Minimally invasive PPV combined with ILM removal and 41G microneedle subretinal injection of BSS can effectively improve the closure rate of refractory macular hole patients in the short term, improve vision, and have good safety.

Objective: This study aims to overcome challenges in lumbar spine imaging, particularly lumbar spinal stenosis, by developing an automated segmentation model using advanced techniques. Traditional manual measurement and lesion detection methods are limited by subjectivity and inefficiency. The objective is to create an accurate and automated segmentation model that identifies anatomical structures in lumbar spine magnetic resonance imaging scans. Methods: Leveraging a dataset of 539 lumbar spinal stenosis patients, the study utilizes the residual U-Net for semantic segmentation in sagittal and axial lumbar spine magnetic resonance images. The model, trained to recognize specific tissue categories, employs a geometry algorithm for anatomical structure quantification. Validation metrics, like Intersection over Union (IOU) and Dice coefficients, validate the residual U-Net’s segmentation accuracy. A novel rotation matrix approach is introduced for detecting bulging discs, assessing dural sac compression, and measuring yellow ligament thickness. Results: The residual U-Net achieves high precision in segmenting lumbar spine structures, with mean IOU values ranging from 0.82 to 0.93 across various tissue categories and views. The automated quantification system provides measurements for intervertebral disc dimensions, dural sac diameter, yellow ligament thickness, and disc hydration. Consistency between training and testing datasets assures the robustness of automated measurements. Conclusion Automated lumbar spine segmentation with residual U-Net and deep learning exhibits high precision in identifying anatomical structures, facilitating efficient quantification in lumbar spinal stenosis cases. The introduction of a rotation matrix enhances lesion detection, promising improved diagnostic accuracy, and supporting treatment decisions for lumbar spinal stenosis patients.

Objective: This study aims to overcome challenges in lumbar spine imaging, particularly lumbar spinal stenosis, by developing an automated segmentation model using advanced techniques. Traditional manual measurement and lesion detection methods are limited by subjectivity and inefficiency. The objective is to create an accurate and automated segmentation model that identifies anatomical structures in lumbar spine magnetic resonance imaging scans. Methods: Leveraging a dataset of 539 lumbar spinal stenosis patients, the study utilizes the residual U-Net for semantic segmentation in sagittal and axial lumbar spine magnetic resonance images. The model, trained to recognize specific tissue categories, employs a geometry algorithm for anatomical structure quantification. Validation metrics, like Intersection over Union (IOU) and Dice coefficients, validate the residual U-Net’s segmentation accuracy. A novel rotation matrix approach is introduced for detecting bulging discs, assessing dural sac compression, and measuring yellow ligament thickness. Results: The residual U-Net achieves high precision in segmenting lumbar spine structures, with mean IOU values ranging from 0.82 to 0.93 across various tissue categories and views. The automated quantification system provides measurements for intervertebral disc dimensions, dural sac diameter, yellow ligament thickness, and disc hydration. Consistency between training and testing datasets assures the robustness of automated measurements. Conclusion Automated lumbar spine segmentation with residual U-Net and deep learning exhibits high precision in identifying anatomical structures, facilitating efficient quantification in lumbar spinal stenosis cases. The introduction of a rotation matrix enhances lesion detection, promising improved diagnostic accuracy, and supporting treatment decisions for lumbar spinal stenosis patients.