Humans ; Vascular Stiffness ; Coal Mining ; Occupational Diseases/epidemiology* ; Risk Factors ; Coal ; Miners

Objective To explore the efficacy and safety of recombinant human anti-severe acute respiratory syn-drome coronavirus 2(anti-SARS-CoV-2)monoclonal antibody injection(F61 injection)in the treatment of patients with coronavirus disease 2019(COVID-19)combined with renal damage.Methods Patients with COVID-19 and renal damage who visited the PLA General Hospital from January to February 2023 were selected.Subjects were randomly divided into two groups.Control group was treated with conventional anti-COVID-19 therapy,while trial group was treated with conventional anti-COVID-19 therapy combined with F61 injection.A 15-day follow-up was conducted after drug administration.Clinical symptoms,laboratory tests,electrocardiogram,and chest CT of pa-tients were performed to analyze the efficacy and safety of F61 injection.Results Twelve subjects(7 in trial group and 5 in control group)were included in study.Neither group had any clinical progression or death cases.The ave-rage time for negative conversion of nucleic acid of SARS-CoV-2 in control group and trial group were 3.2 days and 1.57 days(P=0.046),respectively.The scores of COVID-19 related target symptom in the trial group on the 3rd and 5th day after medication were both lower than those of the control group(both P＜0.05).According to the clinical staging and World Health Organization 10-point graded disease progression scale,both groups of subjects improved but didn't show statistical differences(P＞0.05).For safety,trial group didn't present any infusion-re-lated adverse event.Subjects in both groups demonstrated varying degrees of elevated blood glucose,elevated urine glucose,elevated urobilinogen,positive urine casts,and cardiac arrhythmia,but the differences were not statistica-lly significant(all P＞0.05).Conclusion F61 injection has initially demonstrated safety and clinical benefit in trea-ting patients with COVID-19 combined with renal damage.As the domestically produced drug,it has good clinical accessibility and may provide more options for clinical practice.

Quercetin can mediate the activation of mitogen-activated protein kinase(MAPK)signaling pathways to prevent osteoporosis(OP).This paper comprehensively discusses the interrelationship between MAPK and osteoporosis-related cells based on the latest domestic and international research.Additionally,it elucidates the research progress of quercetin in mediating the MAPK signaling pathway for OP prevention.The aim is to provide an effective foundation for the clinical prevention and treatment of OP and the in-depth development of quercetin.

ObjectiveTo investigate the mechanism of Zexie Decoction （泽泻汤） in inhibiting neuroinflammation and improving cognitive impairment mediated by high-calorie diet. MethodsTwenty seven C57BL/J mice were randomly divided into control group （n = 9）， model group （n = 9） and Zexie Decoction group （n = 9）. The mice in the model group and the Zexie Decoction group were fed with high-calorie diet to establish the model of cognitive impairment. Meanwhile， the mice in Zexie Decoction group were also fed with 0.36 g/（kg·d）Zexie Decoction， and the mice in the control group and model group were fed with the same volume of normal saline for 8 weeks. The body weight of mice was recorded at the same time every week； after intervention， oral glucose tolerance test （OGTT） and insulin tolerance test（ITT） commenced； the cognitive level of mice was detected by Morris water maze， open field test， new object recognition test and Y maze； magnetic resonance spectroscopy （MRS） was used to detect the expression of N-acetylaspartate （NAA）， choline （CHO）， lactic acid （Lac）， creatine （Cr）， lipid （Lip）， and myoInositol （mI） in left hippocampus， hypothalamus and cortex. Western blotting was used to detect the expression of synaptophysin （SYN）， synaptosome associated protein-25 （SNAP-25）， postsynaptic dense protein-95 （PSD-95）， tumor necrosis factor-α （TNF-α）， nuclear factor kappa B （NF-κB p65） and its phosphorylated form （P-NF-B p65） in mouse brain； Nissl's staining was used to detect the morphological changes of hippocampal neurons. ResultsCompared with the control group， body mass， blood glucose in oral glucose tolerance test， and blood glucose in insulin tolerance test increased in the model group； in the Morris water maze experiment， the total distance travelled and escape latency of the model group mice increased， the time spent in the platform area and the number of times traversing the platform decreased on days 3 and 4； in the open-field experiment， the number of times the model group mice entered the central area， the ratio of the time in the central area to the total time， and the ratio of the distance travelled in the central area to the total distance significantly decreased； in the new object recognition test， the frequency of new object recognition and recognition index were significantly lower in the model group mice； in the Y-maze test， the spontaneous alternation rate of mice in the model group was significantly lower （P＜0.05 or P＜0.01）； in the left hippocampus， hypothalamus， and cortex of mice in the model group， the CHO/Cr， NAA/Cr significantly decreased， and the mI/Cr， Lac/Cr and Lip/Cr significantly increased； SYN/β-actin， SNAP-25/β-actin and PSD-95/β-actin values significantly decreased， and p-NF-κB p65/NF-κB p65 and TNF-α/β-actin values significantly increased in brain tissue （P＜0.05 or P＜0.01）. Compared with the model group， the above indexes of mice in the Zexie Decoction group significantly improved （P＜0.05 or P＜0.01）. The results of Nissl staining showed that compared with the control group， the neurons in the dentate gyrus of the hippocampus in the model group were scattered and sparsely arranged， the density was significantly reduced， the nuclei of the cells had consolidation and shrinkage， the number of Nissl vesicles was reduced， and the staining became lighter； compared with the model group， the density of neurons in the hippocampal dentate gyrus region of the Zexie Decoction group increased， the wrinkling of nuclei improved， the cell gap narrowed， and the arrangement was slightly tight. Concusion The ameliorative effect of Zexie Decoction on cognitive function in mice with high-calorie diet-induced cognitive impairment may relate to the restructuring of glucose metabolism homeostasis， inhibition of neuroinflammation， reduction of neuronal damage， and enhancement of synaptic plasticity.

Objective To study the quality comparability of human coagulation factor Ⅷ(FⅧ)produced before and after the change of factory site.Methods A comparative study was carried out on quality quantitative indexes,related im-purities and stability data of FⅧ produced before and after the change of factory site.Results The FⅧ quantitative quality before and after the change of factory site all met the quality standard,and the related impurities including aluminum resi-due,tributyl phosphate residue,polysorbate 80 residue and PEG residue all met the quality standard.Other impurities in-cluding human fibrinogen,fibronectin,plasminogen,IgA,IgM and IgG were extremely low in content and equivalent in quality.The content of VWF(von Willebrand factor)had no obvious change before and after the change of factory site,but was significantly higher than that of other domestic manufacturers'commercial products.The results of accelerated stability and long-term stability tests showed that the titer of FⅧ fluctuated within the methodological error range,and the results all met the quality standard.Conclusion The change of factory site of FⅧ has no effect on the quality.

Purpose::Internal iliac artery ligation (IIAL) has been used as a damage control procedure to treat hemodynamically unstable pelvic fracture for many years. However, there is ongoing debate regarding the effectiveness and safety of this hemostatic method. Therefore, we performed a systematic literature review to assess the efficacy and safety of IIAL for pelvic fracture hemostasis.Methods::Three major databases, PubMed, Embase, and Google Scholar, were searched to screen eligible original studies published in English journals. Two reviewers independently read the titles, abstracts, and full texts of all literature. Articles were included if they reported the use and effects of IIAL.Results::A total of 171 articles were initially identified, with 22 fully meeting the inclusion criteria. Among the analyzed cases, up to 66.7% of patients had associated abdominal and pelvic organ injuries, with the urethra being the most frequently injured organ, followed by the bowel. The outcomes of IIAL for achieving hemostasis in pelvic fractures were found to be satisfactory, with an effective rate of 80%. Hemorrhagic shock was the leading cause of death, followed by craniocerebral injury. Notably, no reports of ischemic complications involving the pelvic organs due to IIAL were found.Conclusion::IIAL has a good effect in treating hemodynamically unstable pelvic fracture without the risk of pelvic organ ischemia. This procedure should be considered a priority for hemodynamically unstable pelvic fracture patients with abdominal organ injuries.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Objective To investigate the effects of high-calorie diet and age on brain function of ApoE-/-mice.Methods A total of 20 adult ApoE mice(8 months old)and elderly ApoE-/-mice(18 months old)were randomly divided into normal diet adult group,normal diet elderly group,high-calorie diet adult group,and high-calorie diet elderly group,with 5 animals in each group.The mice were fed with corresponding standard diet and high-fat diet for 8 weeks.Their body mass was monitored,and blood glucose was detected with glucose tolerance test.The relative contents of NAA and Cho in the hippocampus and hypothalamus were detected by Magnetic resonance spectroscopy.Y-Maze and open field tests were performed to detect cognitive function,and West-ern blotting was applied to detect the expression of synaptic associated protein 25(SNAP-25),synaptophysin,postsynaptic dense protein-95(PSD-95),iNOS and IL-1β.Results Compared with the normal diet adult group,the NAA content in the hippocampus,Cho and NAA contents in the hypothalamus,spontaneous alternation rate,and expression levels of SNAP-25,synaptophysin and PSD-95 in brain tissue(P＜0.05,P＜0.01)were decreased,and the expression of iNOS and IL-1β(P＜0.01)was increased in the high-calorie diet adult group.The normal diet elderly group had reduced contents of NAA in the hippocampus and Cho in the hypothalamus,and expression levels of SNAP-25,synaptophysin and PSD-95(P＜0.05,P＜0.01),and elevated expression of iNOS and IL-1β(P＜0.01)when compared with the normal diet adult group.Compared with the normal diet elderly group,high-calorie diet resulted in decreased Cho and NAA in both hippocampus and hy-pothalamus,central distance/total distance and down-regulation of SNAP-25,synaptophysin and PSD-95(P＜0.05,P＜0.01),and enhanced expression of iNOS and IL-1β(P＜0.01)in the elderly mice.Compared with the high-calorie diet adult group,the high-calorie diet elderly group had reduced NAA in hippocampus,central distance/total distance and average speed,and decreased expression of synaptophysin(P＜0.05,P＜0.01),and increased expression of iNOS and IL-1β(1.61±0.10 vs 1.35±0.13,2.04±0.08 vs 1.54±0.11,P＜0.05,P＜0.01).Conclusion High-calorie diet results in metabolic disorders and neuroinflammation,inhibits the expression of syn-aptic proteins,and thus leads to cognitive dysfunction in ApoE mice.Long-term high-calorie diet and ageing promote the decline of brain function in ApoE mice.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

Objective To explore planning effect of AI-HIP assisted surgical planning system in primary unilateral total hip arthroplasty(THA)and its influence on clinical outcomes.Methods A retrospective analysis was conducted on clinical data of 36 patients who underwent their first unilateral THA from March 2022 to November 2022 and continuously used AI-HIP system(AI-HIP group),including 16 males and 20 females,aged from 43 to 81 years old with an average of(62.2±10.9)years old.According to the matching principle,36 patients who were planned by the traditional template method at the same period were selected as the control group,including 16 males and 20 females,aged from 40 to 80 years old with an average of(60.9±12.1)years old.The accuracy between two groups of prostheses were compared,as well as the combined eccentricity difference between preoperative planning and postoperative practice,lower limb length difference,osteotomy height from the upper edge of the lesser trochanter and top shoulder distance to evaluate planning effect.Harris score and visual analogue scale(VAS)were used to evaluate clinical efficacy.Results Both groups were followed up for 12 to 18 months with an average of(14.5±2.1)months.The complete accuracy and approximate accuracy of acetabular cup and femoral stalk prosthesis in AI-HIP group were 72.2％,100％,58.3％,88.9％,respectively,which were better than 44.4％,83.3％,33.3％,66.7％in control group(P＜0.05).There was no statistical significance in planning of femoral head prosthesis size(P＞0.05).The actual combined eccentricity difference and combined eccentricity difference(practical-planning)in Al-HIP group were 1.0(0.2,2.4)mm and 1.1(-2.1,3.2)mm,respectively;which were better than 3.0(1.4,4.9)mm and 3.5(-1.6,6.5)mm in control group(P＜0.05).There was no significant difference between two groups in actual osteotomy height of the upper margin of the lesser trochanter(P＞0.05).In AI-HIP group,the actual difference of lower extremity length after surgery,the difference of lower extremity length(practical-planning),osteotomy height from the upper margin of lesser trochanter(practical-planning),actual topshoulder distance after surgery,and topshoulder distance(practical-planning)were 1.5(0.2,2.8),1.1(-0.3,2.2),2.1(-2.3,4.1),(15.3±4.1),2.2(-4.8,0.3)mm,respectively;which were better than control group of 2.6(1.3,4.1),2.5(0.3,3.8),5.8(-2.4,7.7),(13.0±4.3),-5.7(-9.4,-2.2)mm(P＜0.05).At final follow-up,there were no significant differences in Harris scores of pain,function,deformity,total scores and VAS between two groups(P＞0.05).The range of motion score was 4.8±0.6 in AI-HIP group,which was higher than that in control group(4.4±0.8)(P＜0.05).Conclusion Compared with traditional template planning,AI-HIP assisted surgical planning system has good accuracy in predicting the prosthetic size of the acetabular cup and femoral stalk,restor-ing joint eccentricity,planning lower limb length,osteotomy height and top shoulder distance on the first unilateral THA,and the clinical follow-up effect is satisfactory.