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.

Under the influence of the coronavirus disease 2019 epidemic, the disadvantages of traditional blended teaching, which has been developed for 20 years, are gradually being revealed. With the help of modern network technology and under the guidance of minimalism, the new blended teaching model adheres to the principle of systematic, holistic, ecological, and collaborative reform and thus can not only efficiently realize the teaching goal of "improvement in self-learning ability and high-order thinking ability", but also achieve innovation and inheritance of "excellent teaching concepts and methods". On this basis, this study forms the "151 framework and BASIC mechanism", which will promote the reform and upgrading of blended teaching from point to surface and then to a three-dimensional structure and ensure that blended teaching has stronger vitality in the new era.

Objective:To summarize the morphological characteristics of diffuse large B-cell lymphoma (DLBCL) cells and investigate the prognosis value of the characteristics and the number of DLBCL cells in bone marrow.Methods:Retrospective study. We collected 79 cases newly diagnosed with DLBCL in the First Affiliated Hospital of Zhengzhou University from January 2020 to August 2022. 30 cases newly diagnosed without bone marrow involvement were selected as controls, whose mean age 58 years (30-82 years). The DLBCL cells were evaluated by the bone marrow smear, biopsy and flow cytometry separetely.The detection rate of DLBCL cells in the bone marrow was compared, to analyse the relationship between the morphological characteristics of DLBCL in the smear, clinical characteristics and flow cytometry parameters, and the prognostic value of DLBCL detected in the bone marrow smear and its quantity was analyzed. Logistic regression was used to analyze the correlation between the detection of DLBCL cells in bone marrow smears and the age, clinical stage, and the number of extraderules involved organs. Multivariate Cox regression was used to analyze the influence of DLBCL cells detection and its number on the prognosis of patients.Results:(1) The positive rates of DLBCL cells in bone marrow biopsy, bone marrow smear and flow cytometry were 4.86%, 5.14% and 9.27% respectively. (2) The morphological characteristics of 79 cases in bone marrow smears were described: more than 2 times the volume of the cell body of the lymphocyte, the shape was different, round or quasi-round or irregular shape, can be seen pseudopodia or protrusion; The volume of cytoplasm was moderate, vacuoles were visible, and a few perinuclear areas were visible. The nucleus were different in shape, round or quasi-round or irregularly shaped, with a majority of them having multiple nuclei and a few of them having delicate and loose chromatin. Most nucleoli were medium or large obviously, with a majority of them having 1-2 nucleoli and a few having more than 3.Sergiosomes and hemophagocytosis were observed in some DLBCL cases, tumor cell aggregation phenomenon was observed in a few DLBCL cases, occasionally pathological mitosis.(3) DLBCL cells in bone marrow smear was positively related to the age of patients, clinical stage and the number of extranodal organs involved(regression coefficient were 2.012, 2.754, 2.028, P<0.05);The volume of DLBCL cells in bone marrow smear was positively correlated with the ratio of CD4 and CD8(regression coefficient is 2.545, P<0.05);The vacuoles in cytoplasm and the pseudopod of tumor were both negative relationship with the quantity of CD38 expressed on DLBCL cells(regression coefficient was -2.465, -3.045, P<0.05); (4) DLBCL cells in bone marrow smear was an independent risk factor for PFS and OS( RR=7.059, P<0.05); RR=5.409, P<0.05). Conclusion:The appearace of DLBCL cells in bone marrow smear with prognosis, and could be used for clinical staging.

Objective:To use a self-developed, prefabricated cap for making interocclusal records in implant-supported fixed prosthetic treatment, and to evaluate its effect of clinical application and accuracy of transferring intra-oral intercuspal position.Methods:Series of prefabricated caps for occlusal recording of implant-supported fixed prostheses were designed based on the healing abutments, and fabricated with three-dimensional (3D) printing. According to the inclusion and exclusion criteria, 12 partially edentulous patients who visited the Department of Prosthodontics, Peking University School and Hospital of Stomatology between November 2020 and September 2021, had lost no fewer than 2 contiguous teeth in distal extension (Kennedy Class Ⅰ or Ⅱ), and had received implant placement 3 months ago were enrolled. Self-control study design was used. Two occlusal records of each included case were obtained by the following 2methods:for the test group, appropriate prefabricated caps were used; and for the control group, polyvinyl siloxane occlusal record was directly set on the healing abutments. The working casts were mounted on the mechanical articulator using the 2 groups of occlusal records successively. Accuracy of occlusal relationship of the mounted casts was evaluated. Diagnostics test was performed to obtain the sensitivity and positive predictive value, which were determined in photographs by comparing the intra-oral occlusal contact points with those in the mounted casts, point-by-point. Virtual casts were taken by intraoral and extraoral scans in intercuspal position and imported to Geomagic Studio 2014. Then the root mean square values of occlusal clearance space between the upper and lower occlusal surfaces of remaining posterior teeth, and the deviations of the interocclusal position of the occlusal surfaces of the remaining teeth in the mandibular arches when superimposing the maxillary arches of the intraoral and extraoral scans were calculated. As a self-control design, paired t test was used. Results:Twelve participants were enrolled, including 3 men and 9 women aged (52.6±12.1) years, and 36 missing teeth. The prefabricated caps could fit on the healing abutments with good retention and stability. The sensitivity of the test group (0.73±0.14) was significantly better than that of control group (0.63±0.12, P<0.01), with no significant difference in positive predictive value between the 2 groups ( P>0.05). The deviations of the interocclusal position of the occlusal surfaces of the remaining teeth were (357.0±140.2) μm for the test group, and (399.4±206.3) μm for the control group, with no significant difference between them ( P>0.05). Conclusions:Interocclusal position record based on prefabricated cap in this study for implant-supported fixed prosthetic treatment can improve the consistency between the intra-oral occlusion and the occlusion in dental casts. This technique has good accuracy, clinical convenience and usability.

Objective The aim of this study was to investigate the relationship between STAT1,STAT3 gene promoter CpG island methylation status and prognosis of patients with colorectal cancer(CRC)and the prognostic factors of CRC patients. Methods The cohort study was conducted to biosamples and follow up 239 patients with primary colorectal cancer pathologically diagnosed in Cancer Hospital of Harbin Medical University(Tumor Hospital). The methylation status of STAT1,STAT3 gene promoter CpG island was analyzed by methylation specific high-resolution melting curve(MS-HRM). Results The survival rates of 239 patients with colorectal cancer at 1 year,3 years and 5 years were 94. 90% ,86. 00% and 67. 20% ,respectively. The methylation status of STAT1 and STAT3 genes was not associated with postoperative survival in colorectal cancer patients( STAT1:HR=0. 85,95% CI:0. 55 ~1. 30,P=0. 44;STAT3:HR=0. 75,95% CI:0. 36~1. 58,P=0. 45). Dukes stage(HR=1. 31,95% CI:1. 14~1. 51,P<0. 01)and intraoperative intestinal stapler use(HR=1. 98,95% CI:1. 25 ~3. 14,P<0. 01) were important factors affecting the prognosis of colorectal cancer patients. The risk of death in patients with stage D and Dukes was significantly higher than that in stages A and B (HR=1. 31,95% CI:1. 14~1. 51,P<0. 01). Intestinal anastomosis was used during operation. The patient′s prognosis was better than that of patients without an intestinal stapler. However,gender,age,tumor location,gross tumor type,histological classification and postoperative chemotherapy were not associated with the prognosis of colorectal cancer. Conclusion Dukes stage is an independent factor affecting the prognosis of colorectal cancer. The prognosis of patients with intestinal stapler is better than that of non-users. The methylation status of STAT1 and STAT3 in peripheral blood is not a biomarkers for the prognosis of patients with colorectal cancer.

Objective To explore the effect of timosaponin B-II ( TB-II) on the differentiation of neural stem cells (NSCs) into tyrosine hydroxylase (TH) positive neurons in neonatal rats. Methods The biological functions of self-proliferation and multi-differentiation of NSCs were identified by primary culture, cell proliferation counting,morphological observation and immunology. NSCs of SD rats were cultured in vitro and treated with different concentrations of TB-II (10 μg/ml,30 μg/ml ,100 μg/ml) for 7 days. Immuno-histochemistry was used to detect the effect of TB-II on the differentiation of NSCs into TH-positive neurons, and Western blot was used to detect the expression of TH protein in neurons. Results ( 1) The cultured cells had the ability to self-proliferation,expressed nestin protein and differentiated into neurons and glial cells. So the cultured cells were conformed to the biological function of neural stem cells. (2)Compared with the control group,the TH positive cell ratio of TB-II 30 μg/ml group and TB-II 100 μg/ml group increased ((10. 03± 1. 36)%),( 20. 01± 3. 37)%),(31. 32± 3. 98)%) ,the difference was significant ( t=6. 15, 16. 54,both P<0. 05). There was no significant difference between TB-II 10 μg/ml group and control group (P>0. 05). (3)Western results showed that the relative expression of TH protein in TB-II 30 g/ml group and TB-II 100 μg/ml group was higher than that in control group,the difference was statistically significant (con-trol group: (1. 02±0. 24),TB-II 30μg/ml group: (3. 64±1. 78),TB-II 100 μg/ml group: (5. 88±2. 34);t=12. 58,9. 15,both P<0. 05). There was no significant difference between TB-II 10 μg/ml group and con-trol group (P>0. 05). Conclusion TB-II can promote the differentiation of NSCs into TH-positive neurons.

Objective To investigate whether fetal growth restriction (FGR) could be used as an indicator for severe early-onset preeclampsia.Methods A retrospective analysis was conducted on 591 women with early-onset preeclampsia and their fetuses and newborns in Departments of Obstetrics and Gynecology,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,and the Third Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2017.These cases were divided into two groups according to whether they were complicated by FGR (n=206,FGR group) or not (n=385,non-FGR group).Clinical datas were analyzed by t test or Chi-square test.Results (1) There was no significant difference between the two groups in terms of average maternal age,the ratio of primipara,the proportion of women with hypertension history,abnormal blood glucose or who received regular antenatal examination,gestational age at onset and termination or cesarean section rate.No maternal death was reported.(2)The systolic blood pressure and the incidence of hemolysis,elevated liver enzyme,low platelet count (HELLP) syndrome in the FGR group were lower than those in the non-FGR group [(167.0±21.5) vs (174.0±21.8) mmHg,t=-3.729 (1 mmHg=0.133 kPa);6.8％ (14/206) vs 13.8％ (53/385),x2=6.486].Although the incidence of absent or reverse diastolic umbilical artery flow in the FGR group was significantly higher [24.3％ (50/206) vs 14.5％ (56/385),x2=8.625],and the amniotic fluid index and placental weight were lower than those in the non-FGR group [(77.82±29.78) vs (90.53±43.83) mm,t=-2.837;(302.83±80.01) vs (330.98±61.01) g,t=-2.823],the stillbirth rate was lower[2.4％ (5/206) vs 6.5％ (25/385),x2=4.605] (all P ＜ 0.05).(3) Platelet counts in the FGR group were higher than those in the non-FGR group [(189.96 ± 65.43) vs (173.77 ± 62.88)× 109/L,t=2.923],while serum creatinine and D-dimer were lower [(70.99±22.97) vs (78.98±50.87) μ mol/L,t=-2.109;(491.01 ±401.98) vs (635.67±386.21) μg/L,t=-2.276] (all P ＜ 0.05).There was no significant difference in 24-hour urine protein excretion between the two groups.Conclusions FGR should not be used as an indicator for severe early-onset preeclampsia.

Objective: To evaluate the visual outcomes of patients with visual impairment after resecting skull base tumor via an endoscopic endonasal approach, and to analyze the factors affecting visual recovery. Methods: One hundred and fifty-three patients with skull base tumor who suffered from preoperative visual impairment from Skull Base Surgery Center of Xuanwu Hospital were operated through an endoscopic endonasal approach. Both preoperative and postoperative visual function outcomes as well as factors that might have affected their visual recovery were analyzed retrospectively by Chi square test and Logistic regression analysis. Results: Complete resection was achieved in 85.6% of the patients using this technique. The rate of postoperative visual recovery in the female group (86.1%) was higher than that in the male group (73.9%), the benign group (90.2%) higher than the malignant group (20.0%), the group without optic atrophy (97.1%) higher than the one with (51.2%), and the acute group (96.6%) higher than the chronic group (80.0%). Significant differences were found between the abovementioned groups (χ² value was 5.849, 87.860, 79.757, 4.745, respectively, all P<0.05). The degree of optic atrophy and the property of tumors were significantly associated with visual improvement after treatment (Wold χ² value was 18.597 and 35.623, all P<0.001). Conclusions Our results indicate that endoscopic endonasal surgery shows its ability both to resect skull base tumors and to improve visual function in the majority of patients. The timing of treatment for patients suffered from preoperative visual impairment should be selected in early stage before optic atrophy occurs.

Objective:To determine the changes of the main components after compatibility of compound Mailuqishen(MLQS), and to explore its anti-tumor effect in the H22 tumor-bearing mice.Methods:The contents of ginsenoside and amino acid in MLQS were detected by HPLC, and the content of polysaccharide was detected by phenol-sulfuric acid.A total of 144 female Kunming mice were randomly divided into normal control group, model group, positive control group, low dose of MLQS group, medium dose of MLQS group, high dose of MLQS group, ginseng geng group, ginseng group and antler plate group (n=16).Except normal control group, the mice in the other eight groups were used to establish the H22 tumor-bearing mouse models, then the mice were treated with drugs at next day.The tumor weights, inhibitory rates of tumor, spleen and thymus indexes of the H22 tumor-bearing mice were detected 10 d after administration.The morphological changes of tumor and spleen tissue were examined by HE staining, and the apoptotic rates of H22 tumor cells were tested by flow cytometry.Results:As calculation with the ginseng and antler plate single herb, the contents of ginsenosides, polysaccharides and amino acids in MLQS were significantly higher than those of single herbs (P<0.05).Compared with model group, the inhibitory rates of tumor in various administration groups were significantly increased(P<0.01);the spleen indexes and thymus indexes of the mice in different doses of MLQS groups were significantly increased(P<0.01);the apoptotic rates of tumor cells were markedly increased(P<0.05).Compared with model group, the tumor tissue of the mice in various administration groups was destroyed, the cells were sparse and irregular, and the tumor presented necrotic lesions;the morphology of spleen tissue was normal with discernible fringe, and the lymphocytes arranged densely.Conclusion:The contents of ginsenosides, polysaccharides, and amino acids in compound MLQS are significantly increased compared with those of single herbs, and its anti-tumor effect is stronger than the single herbs.

Objective:To compare the concordance between subjective experience and clinician-rated in different treatment phrase of elderly patients with depressive disorder,and to explore the relevant factors.Methods:Sixty-nine consecutive elderly patiems with depressive disorder diagnosed with International Classification of Diseases-10 criteria were included.The Visual Scale for Depression(VSD) were used to evaluate subjective experience of depression,while the Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA),Minimum Mental State Examination (MMSE) were used by clinician to evaluate depression symptom,anxiety symptom and cognition at baseline,2-,4-and 52-week of the treatment respectively.Results:Compared with baseline,VSD scores were increased at 2 weeks and 4 weeks [(2.7 ± 1.6),(5.3 ± 2.0) vs.(7.0 ± 1.8),P ＜ 0.001],HAMD scores were decreased at 2 weeks and 4 weeks [(36 ± 11),(17 ±9) vs.(9 ±8),P ＜0.001],HAMA scores were decreased at 2 weeks and 4 weeks [(27 ± 10),(14 ±8) vs.(7 ±6),P ＜0.001].No significant differences were found between 4 weeks and 52 weeks.There was no correlation between VSD and HAMD scores at baseline and 2 weeks.There were significant correlations among scores of VSD and HAMD(r =-0.31,-0.74,Ps ＜ 0.05),HAMA (r =-0.36,-0.76,Ps ＜ 0.05) at 4 weeks and 52 weeks.Using logistic regression analysis,the concordance between VSD and HAMD related with the factors of HAMD,higher scores of anxiety/somatization factor were associated with lower concordance (OR =0.87),and higher scores of weight factor (OR =1.86),diurnal variation factor (OR =2.00),hopelessness factor (OR =1.13) were associated with higher concordance.Conclusion:Compared with acute depression phase,concordance between subjective experience and clinician-rated for depression may be higher at depression remission phase in elderly patients with depression,which suggests that characteristics of depression symptom may have a certain impact on the self-awareness for depression experience.