Objective:To investigate the reasonable airflow organization and exhaust system facilities during the operation of the inspection workshop, and solve the problem of the accumulation of harmful gases such as ozone and nitrogen oxides in the workshop.Methods:In May 2023, computational fluid dynamics (CFD) technology was used to numerically simulate the diffusion of ozone and nitrogen oxides generated by industrial radiographic inspection operations, and the comparative detection method was used to analyze the ozone and nitrogen oxides concentrations before and after the renovation of the ventilation system of the inspection workshop.Results:After the renovation of ventilation system, the average concentration of ozone in the inspection workshop decreased from 0.81 mg/m 3 to 0.03 mg/m 3, and the average concentration of nitrogen oxides decreased from 0.42 mg/m 3 to 0.01 mg/m 3, and the differences were statistically significant ( t=20.51, 10.38, P<0.001) . Conclusion:The ventilation facilities of the inspection workshop are set up in the airflow organization mode of sending up and down the exhaust, and the ventilation pipes are scientifically designed through the calculation of ventilation hydraulic balance, which can effectively control the concentration of harmful gases in the inspection workshop.

Objective:To investigate the reasonable airflow organization and exhaust system facilities during the operation of the inspection workshop, and solve the problem of the accumulation of harmful gases such as ozone and nitrogen oxides in the workshop.Methods:In May 2023, computational fluid dynamics (CFD) technology was used to numerically simulate the diffusion of ozone and nitrogen oxides generated by industrial radiographic inspection operations, and the comparative detection method was used to analyze the ozone and nitrogen oxides concentrations before and after the renovation of the ventilation system of the inspection workshop.Results:After the renovation of ventilation system, the average concentration of ozone in the inspection workshop decreased from 0.81 mg/m 3 to 0.03 mg/m 3, and the average concentration of nitrogen oxides decreased from 0.42 mg/m 3 to 0.01 mg/m 3, and the differences were statistically significant ( t=20.51, 10.38, P<0.001) . Conclusion:The ventilation facilities of the inspection workshop are set up in the airflow organization mode of sending up and down the exhaust, and the ventilation pipes are scientifically designed through the calculation of ventilation hydraulic balance, which can effectively control the concentration of harmful gases in the inspection workshop.

Oxidative Phosphorylation ; Acetylglucosamine ; Uridine Diphosphate N-Acetylglucosamine/metabolism*

Objective:To analyze the risk factors for early ostomy complications after Miles surgery for rectal cancer and construct a nomogram model.Methods:A case-control study method was used to collect clinical data of 205 patients who underwent Miles surgery for rectal cancer at Xinxiang Central Hospital from January 2019 to January 2022. Patients were divided into early ostomy complications group and no early ostomy complications group based on whether early ostomy complications occurred. Single factor analysis and multivariate Logistic regression analysis were used to determine the influencing factors for early ostomy complications after Miles surgery for rectal cancer. R language was used to construct a nomogram model for early ostomy complications after Miles surgery for rectal cancer. The area under the receiver operating characteristic curve (ROC) was used to evaluate the predictive performance of the nomogram model. By drawing a calibration map for consistency testing, the Hosmer-Lemeshow test was used to determine the goodness of fit of the model. P>0.05 indicated a good fit of the model. R software was used to randomly select 30% of cases as validation groups for internal validation. Results:This study included a total of 205 patients, including 115 males and 90 females. Among them, 37 had early ostomy complications, with an incidence of 18.0%. The results of multivariate Logistic regression analysis showed that failure to receive rapid surgical rehabilitation nursing [ OR=2.779, 95% CI (1.144, 6.750) ], age ≥65 years old [ OR=2.862, 95% CI (1.186, 6.906) ], albumin<35 g/L [ OR=3.414, 95% CI (1.373, 8.488) ], and failure to locate the preoperative ostomy position [ OR=4.846, 95% CI (1.488, 15.776) ] were risk factors for early ostomy complications after Miles surgery for rectal cancer, and the differences were statistically significant ( P<0.05) . Based on this result, a prediction model was constructed, with an area under the ROC curve of 0.801 [95% CI (0.713, 0.868) ]. After internal validation, the area under the ROC curve of the validation group was 0.807 [95% CI (0.641, 0.973) ]. The calibration curves of the modeling group ( P=0.980) and the validation group ( P=0.981) showed a good coincidence between the predicted results and the actual results. Conclusions:Failure to receive rapid surgical rehabilitation nursing, age ≥65 years old, albumin<35 g/L, and failure to locate the preoperative ostomy position are risk factors for early ostomy complications after Miles surgery for rectal cancer. This study constructs a nomogram model based on the results of Logistic regression analysis, which can effectively predict the probability of early ostomy complications after Miles surgery for rectal cancer. For high-risk patients, individualized intervention should be carried out as soon as possible to reduce the incidence of ostomy complications and improve the patient's quality of life.

In China， the incidence of ischemic heart disease （IHD） is increasing year by year， which brings enormous burden to families and society. It is urgent to find preferable treatment methods and medical therapies. The Chinese ethnic minority medicine has gradually developed unique theoretical systems and therapeutic characteristics on the basis of clinical experience and thinking modes including image-number thinking and the holistic perspective. Consequently， it possesses huge application capacity and research value in prevention and treatment of IHD. Belonging to the medical system based on the view of nature and life， the Tibetan medicine， Mongolian medicine， and Dai medicine have respectively formed theories like "three elements" "three life-sustaining energies" "four elements and five skandhas （aggregates）" ， have put forward unique understandings of IHD and have formed corresponding therapeutic principles and methods， generating plentiful classic prescriptions represented by Sanwei Tanxiang powder， Bawei Chenxiang powder， Roukou Wuwei pills and Yajiao Hadun powder. They also contain characteristic ethnic medicine resources such as Choerospondiatis Fructus， Rhodiola Rosea and Draconis Sanguis. Aiming to provide enlightenment and reference for the clinical application and development of the Chinese ethnic minority medicine for the prevention and treatment of IHD， the authors try to summarize the related researches represented by Tibetan and Mongolian medicines， and then discuss the opportunities and challenges faced by such researches.

To establish the experts consensus on the management of delirium in critically ill patients.A special committee was set up by 15 experts from the Chinese Critical Hypothermia-Sedation Therapy Study Group.Each statement was assessed based on the GRADE (Grading of Recommendations Assessment,Development,and Evaluation) principle.Then the Delphi method was adopted by 36 experts to reassess all the statements.(1) Delirium is not only a mental change,but also a clinical syndrome with multiple pathophysiological changes.(2) Delirium is a form of disturbance of consciousness and a manifestation of abnormal brain function.(3) Pain is a common cause of delirium in critically ill patients.Analgesia can reduce the occurrence and development of delirium.(4) Anxiety or depression are important factors for delirium in critically ill patients.(5) The correlation between sedative and analgesic drugs and delirium is uncertain.(6) Pay attention to the relationship between delirium and withdrawal reactions.(7) Pay attention to the relationship between delirium and drug dependence/ withdrawal reactions.(8) Sleep disruption can induce delirium.(9) We should be vigilant against potential risk factors for persistent or recurrent delirium.(10) Critically illness related delirium can affect the diagnosis and treatment of primary diseases,and can also be alleviated with the improvement of primary diseases.(11) Acute change of consciousness and attention deficit are necessary for delirium diagnosis.(12) The combined assessment of confusion assessment method for the intensive care unit and intensive care delirium screening checklist can improve the sensitivity of delirium,especially subclinical delirium.(13) Early identification and intervention of subclinical delirium can reduce its risk of clinical delirium.(14) Daily assessment is helpful for early detection of delirium.(15) Hopoactive delirium and mixed delirium are common and should be emphasized.(16) Delirium may be accompanied by changes in electroencephalogram.Bedside electroencephalogram monitoring should be used in the ICU if conditions warrant.(17) Pay attention to differential diagnosis of delirium and dementia/depression.(18) Pay attention to the role of rapid delirium screening method in delirium management.(19) Assessment of the severity of delirium is an essential part of the diagnosis of delirium.(20) The key to the management of delirium is etiological treatment.(21) Improving environmental factors and making patient comfort can help reduce delirium.(22) Early exercise can reduce the incidence of delirium and shorten the duration of delirium.(23) Communication with patients should be emphasized and strengthened.Family members participation can help reduce the incidence of delirium and promote the recovery of delirium.(24) Pay attention to the role of sleep management in the prevention and treatment of delirium.(25) Dexmedetomidine can shorten the duration of hyperactive delirium or prevent delirium.(26) When using antipsychotics to treat delirium,we should be alert to its effect on the heart rhythm.(27) Delirium management should pay attention to brain functional exercise.(28) Compared with non-critically illness related delirium,the relief of critically illness related delirium will not accomplished at one stroke.(29) Multiple management strategies such as ABCDEF,eCASH and ESCAPE are helpful to prevent and treat delirium and improve the prognosis of critically ill patients.(30) Shortening the duration of delirium can reduce the occurrence of long-term cognitive impairment.(31) Multidisciplinary cooperation and continuous quality improvement can improve delirium management.Consensus can promote delirium management in critically ill patients,optimize analgesia and sedation therapy,and even affect prognosis.

Objective To evaluate the optimized efficacy of transversus abdominis plane (TAP) block combined with oxycodone in patients undergoing kidney transplantation.Methods Ninety patients of both sexes,aged 22-45 yr,weighing 45-75 kg,of American Society of Anesthesiologists physical status Ⅲ,scheduled for elective living donor kidney transplantation,were divided into 3 groups (n =30 each) using a random number table:blank control group (group C),TAP block group (group TAP) and TAP block combined with oxycodone group (group TAP+O).Ultrasound-guided lateral approach to TAP block was performed on the operated side with the mixture (20 ml) of 0.375％ ropivacaine and 5 rng dexamethasone at 30 min before induction of anesthesia in TAP and TAP+O groups.Anesthesia was induced by injecting midazolam,target-controlled infusion of remifentanil and propofol and injecting cisatracurium.The patients were mechanically ventilated after placement of the laryngeal mask airway,and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.Propofol and remifentanil were intravenously injected and sevoflurane was inhaled to maintain anesthesia,and cis-atracurium was intermittently injected to maintain muscle relaxation.Narcotrend value was maintained at 37-46 during operation.Oxycodone 0.1 mg/kg was intravenously injected at 20 min before the end of surgery in group TAP+O.Patient-controlled intravenous analgesia (PCIA) was performed with sufentanil 1.5 μg/kg in 100 ml of normal saline at the end of surgery,the PCIA pump was set up to deliver a 2 ml bolus dose,a 20 min lockout interval and background infusion at a rate of 1.5 ml/h,and visual analog scale score was maintained ≤4.The consumption of intraoperative remifentanil and effective pressing times of PCIA within 24 h after surgery were recorded.Blood samples were collected at 1 day before surgery and 2 and 5 days after surgery from the median cubital vein for determination of blood urea nitrogen and creatinine (Cr) concentrations in serum.The occurrence of nausea and vomiting,dizziness and headache,respiratory depression and TAP block-related complications (hematoma at puncture site,injury to abdominal organs,local anesthetic intoxication) was recorded within 24 h after surgery.Results Compared with group C,the consumption of intraoperative remifentanil was significantly reduced,the effective pressing times of PCIA within 24 h after surgery were decreased,and the concentrations of creatinine and blood urea nitrogen in serum were decreased at 2 days after surgery in TAP and TAP+O groups (P＜0.05).Compared with group TAP,the effective pressing times of PCIA within 24 h after surgery were significartly decreased,the concentrations of creatinine and blood urea nitrogen in serum were decreased at 2 days after surgery,and no significant change was found in the consumption of intraoperative remifentanil in group TAP+O (P＞0.05).TAP block-related complications were not found in TAP and TAP+O groups (P＞0.05).There was no significant difference in the incidence of nausea and vomiting or dizziness and headache among three groups (P＞0.05).Conclusion TAP block combined with oxycodone can reduce the intraoperative consumption of opioids,inhibit postoperative hyperalgesia and be helpful for early recovery of transplanted kidney function in patients undergoing kidney transplantation.

Objective To detect the level of 5-hydroxymethyl-cytosine (5-hmc)in melanoma tissues,and to analyze the correlation between 5-hmc and the invasion,metastasis and prognosis of melanoma.Methods A streptavidin-peroxidase immunohistochemical method was used to detect the level of 5-hmc in 67 melanoma tissues and 20 pigmented nevi tissues.Univariate and multivariate analyses were performed with the Cox's proportional hazards regression model to analyze the correlation between the expression of 5-hmc and the prognosis of melanoma.Results The expression rate of 5-hmc was significantly lower in melanoma tissues than in pigmented nevus tissues (40.30％ [27/67] vs.75％ [15/20],22 =7.428,P =0.006).According to American Joint Committee on Cancer (AJCC) TNM staging system,the expression level of 5-hmc was significantly lower in the stage Ⅳ melanoma tissues than in the stage Ⅱ and stage Ⅲ melanoma tissues (x2 =4.416,P =0.036).Patients with lymph node metastasis showed significantly lower expression of 5-hmc compared with those without lymph node metastasis (x2 =5.902,P =0.015),and the level of 5-hmc expression significantly decreased along with the increase of Clark grade (x2 =4.828,P =0.028).There were no significant differences in the level of 5-hmc expression between patients of different ages,genders or nationalities (P ＞ 0.05).Multivariate Cox regression analysis showed that distant lymph node metastasis (HR:2.67,95％ CI:1.22-5.84),not receiving surgical resection (HR:0.41,95％ CI:0.18-0.95),and low expression of 5-hmc (HR:3.54,95％ CI:1.09-11.43)were independent risk factors for poor prognosis of melanoma.Conclusion 5-Hmc may participate in the invasion and metastasis of melanoma,and be associated with the prognosis of melanoma.

Vitiligo is a common,acquired and chronic pigmentary disorder of discosmetic dermatosis,which can be found in adults and children.The disease is stubborn,easy to relapse.And there is no effective therapy.The pathogenesis of vitiligo is not clear until now.The current studies indicate that microR-NA is closely correlated with vitiligo.Therefore,this article will focus on the latest research progress between microRNA and the occurrence,development,stage,type and degree of pathological changes of vitiligo,enriching the molecular pathogenesis,and providing a new direction for the diagnosis and evaluation of the condition of vitiligo.

Objective To study the application of Internet of Things, wireless health monitor all-in-one machine, health management platform, energy consumption monitoring in employee health management. Methods Enrollment criteria were set based on employees' health examination data, 126 employees were enrolled in this study voluntarily, 97 were male, and 29 were female. The age was from 26 to 59 years, the average age was 43.7 ± 6.1 years. Using motion energy consumption monitor, wireless health monitor all-in-one machine and health management platform, employee's exercise, body weight, body mass index, fat and muscle mass, systolic blood pressure, diastolic blood pressure, cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), uric acid, fasting blood glucose etc. were monitored. Data were collected for before and after 3 months intensive intervention. Results After 3 month of intensive intervention, body weight ( (74.90 ± 9.95) kg, (71.77 ± 9.57) kg), body mass index ((25.94 ± 2.65) kg/m2, (24.96 ± 2.55) kg/m2), fat mass ((21.30 ± 4.31) kg, (18.89 ± 4.23) kg), muscle mass ((49.78 ± 7.12) kg, (49.07 ± 6.97) kg), systolic pressure ((129.72 ± 11.16) mmHg(1 mmHg=0.133 kPa), (118.32 ± 10.50) mmHg), diastolic blood pressure ((89.10 ± 8.28) mmHg, (76.94 ± 7.57) mmHg), cholesterol ((5.16±0.85) mmol/L, (4.96±0.90) mmol/L), triglyceride ((1.72±0.92) mmol/L, (1.43±0.64) mmol/L), uric acid ((353.00 ± 85.33) μmol/L, (345.00 ± 73.01) μmol/L) were decreased with statistical significance (t=10.92, 11.03, 6.75, 5.56, 4.23, 3.99, 4.26, 3.46, 1.98, P<0.05); and the value of HDL-C ((1.20 ± 0.24) mmol/L, (1.28 ± 0.25) mmol/L) increased significantly (t=-4.62, P<0.05); the value of LDL-C((2.54 ± 0.52) mmol/L, (2.66±0.58) mmol/L) increased and fast blood glucose ((5.05±0.73) mmol/L, (5.02±0.79) mmol/L) decreased, but there was no significant difference(t=-3.03, 0.14 respectively, P>0.05). Conclusion Health Internet of Things can help employees to develop scientific exercise habits , to correct unhealthy diet habits, and improve health. It will provide a new option for enterprise employee health management and can be recommended for health management programs by large enterprises with domestic and abroad projects.