Objective To analyze the current situation of the knowledge-attitude-practice among noise-exposed workers at an airport apron. Methods A total of 494 noise-exposed workers from an airport apron were selected as the study subjects using the judgmental sampling method. A self-designed "Occupational Protection Knowledge, Attitudes, and Practices Questionnaire" was used to assess the current situation of knowledge-attitude-practice on occupational protection. Results Regarding the awareness of noise hazards among the study subjects, the awareness rates of noise-induced impairment on digestive function and reproductive system were the lowest (44.9% and 37.7%, respectively). The awareness rate of noise-induced negative emotions increased with length of service (P<0.01). Regarding the occupational protection knowledge for noise, the awareness rate of occupational noise-induced deafness was “incurable” was the lowest (39.1%). The support rate for five kinds of occupational protection attitudes for noise was generally >85.0%, while only 58.3% of the study subjects consistently or frequently wearing earplugs during work. The most common source of noise hazard and protection knowledge was pre-employment training (76.9%), followed by occupational disease prevention and control campaigns (76.1%). Conclusion Noise-exposed workers in this airport apron have incomplete awareness of non-auditory system hazards caused by noise, and the awareness of knowledge of some occupational protection is relatively low. Although their attitudes toward occupational protection are positive, many workers still fail to consistently wear personal protective equipment at work.

The announcement of the 9th edition of TNM staging system for thymic tumors was one of the highlights at the World Conference on Lung Cancer 2023. The revision, based on a larger and more detailed database, provides changes and confirmation from the last system. The 9th edition of TNM staging system aims to balance statistical significance and clinical feasibility. The birth of an improved TNM staging system heralds the changes that will follow in clinical practice and scientific research.

Background As the population ages, there has been a growing focus on the decline in fertility. Research has identified age and fertility history as the primary influencing factors. Nevertheless, there is a deficiency in fundamental data regarding the fertility status among different industries. Objective To investigate the fertility status and influencing factors among female workers aged 22-35 years in different industries. Methods From July 2020 to February 2021, a cross-sectional survey was conducted using a staged sampling approach. This survey specifically targeted 22-35-year-old married female workers with a history of pregnancy in industries such as education, healthcare, finance, and telecommunications, totaling 22903 participants. The survey encompassed industry, demographic characteristics, pregnancy history, time to pregnancy (TTP), and other influencing factors. The influencing factors of decline in fertility were identified by chi-square test and Cox proportional hazards regression. Subsequent industry-specific Cox proportional hazards regression models were used to compared fertility decline patterns across a spectrum of industries after selected influencing factors were adjusted. Results Among the 22903 respondents, 19194 valid questionnaires were collected, with a valid recovery rate of 83.8%. The cumulative pregnancy rates (CRP) of 1-6 months and 1-12 months for the 22-35-year-old female workers were 67.23% and 91.33% respectively. The multivariate analysis showed that region, age, education level, personal annual income, housework time, coping style, gravidity, parity, and spontaneous abortion were influencing factors of fertility decline (P<0.05). Female workers with ≥3 gravidities and ≥2 spontaneous abortions had a higher risk of fertility decline, with hazard ratios (HR) and associated 95% confidence interval (95%CI) of 0.633 (0.582, 0.688) and 0.785 (0.670, 0.921) respectively (P<0.01). Compared to the education industry, the healthcare and finance industries showed a higher risk of fertility decline, with HR (95%CI) values of 0.876 (0.834, 0.920) and 0.909 (0.866, 0.954), respectively (P<0.05). These two HR (95%CI) values remained statistically significant [0.899 (0.852, 0.948) and 0.882 (0.833, 0.934) respectively, P<0.05)] after further adjustment with nine influencing factors such as region and age. Conclusion Regions, age, education level, personal annual income, housework time, coping style, pregnancy and childbirth times, and natural abortion times are influencing factors of fertility decline in female workers. Compared to the education industry, the healthcare and finance industries have a higher risk of declining fertility.

ObjectiveTo observe the effect of Xiaoke drink on insulin resistance in ob/ob mice and explore the mechanism. MethodEighteen ob/ob mice were randomly assigned into model， Xiaoke drink （17.68 g·kg^-1）， and atorvastatin （0.01 g·kg^-1） groups （n=6）， and six C57BL/6 mice were selected as the normal group. Mice in the normal and model groups were administrated with the same amount of distilled water. Fasting body weight， weekly food intake， and weekly water intake were measured at a fixed time. Fasting plasma glucose （FPG） and 2-hour post-load plasma glucose （2 hPG） were measured before and after 8-week intervention. After intervention， total cholesterol （TC）， triglyceride （TG）， fasting insulin （FINS）， Homeostasis Model Assessment-Insulin Resistance （HOMA-IR）， blood routine， and alkaline phosphatase （ALP） were measured. Western blot was employed to determine the expression levels of ubiquitin-specific protease 20 （USP20） and 3-hydroxy-3-methylglutaryl coenzyme A reductase （HMGCR） in the liver. The pancreas was stained with hematoxylin-eosin for observation. ResultCompared with the model group， the Xiaoke drink group showed decreased body weight of ob/ob mice （P<0.05， P<0.01）， declined growth trend of body weight （P<0.05， P<0.01）， reduced weekly average water intake， lowered levels of FPG， 2 hPG， TC， and HOMA-IR （P<0.05， P<0.01）， and down-regulated expression level of USP20 in the liver （P<0.05）. HMGCR content was positively correlated with USP20 expression. In addition， Xiaoke drink promoted the recovery of islet tissue morphology and function in ob/ob mice. ConclusionXiaoke drink can ameliorate insulin resistance in ob/ob mice by inhibiting USP20/HMGCR expression， reversing cholesterol biosynthesis process， and reducing cholesterol level.

Objective To investigate the current status of routine practice and perspective of anesthesiologists regarding ventilation strategies during cardiac surgery, and to analyze whether there is a gap between the clinical application and theoretical understanding of lung-protective ventilation (LPV) strategies. Methods We conducted a multi-institutional cross-sectional survey of anesthesiologists working at high-volume (>1000 cardiac procedures each year) Chinese hospitals. The electronic questionnaire was designed and distributed from September 2021 to February 2022. Results A total of 323 replies were collected and 297 (92.0%) replies were valid. Among the respondents, 84.8% (252/297) performed the combination of low tidal volume (VT), positive end-expiratory pressure (PEEP) and alveolar recruitment maneuver (ARM) during non-CPB period. The vast majority of respondents (90.6%, 269/297) ventilated patients with the VT of 6-8 mL/kg. 92.3% (274/297) of respondents applied PEEP, among those 57.9% (172/297) set a PEEP level <5 cm H2O. Most of the respondents (67.3%, 200/297) performed intraoperative ARM, and manual ARM was used by 86.2% (256/297) of anesthesiologists. During CPB, 89.9% (267/297) of respondents withdrew mechanical ventilation, and 29.6% (88/297) performed ARM. Conclusion This national survey in China showed that the majority of anesthesiologists adopted LPV strategy with the combination of low VT, PEEP and ARM during cardiac surgery. Except VT, the intraoperative ventilator settings varied widely from one anesthesiologist to another. Meanwhile, there is a gap between the clinical practice and theoretical understanding of LPV.

Background A large body of cross-sectional studies have indicated a correlation between exposure to benzene series and increased rates of menstrual abnormalities in female workers, but these findings are confusing as evidence in the field of preventive medicine. Objective To provide a more rigorous scientific basis for early prevention of reproductive function impairment through systematic review of independent studies. Methods A comprehensive search was conducted for scientific articles published between January 1987 and July 2022, encompassing databases such as PubMed, Medline, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and CQVIP. A meta-analysis was conducted on literature that met the stringent criteria for case-control studies, featuring well-defined and consistent datasets. A meticulous investigation was executed to ascertain the collective odds ratio (OR) linked to menstrual abnormalities, encompassing diverse categories such as component, dosage, cumulative exposure dosage, and age groups. The prevalence and corresponding risk fractions were estimated by calculating frequency distributions and attributing risk percentages (AR). Results A total of 53 papers of case-control studies were included in the meta-analysis, involving 27068 benzene series-exposed female workers and 22857 control female workers. During inhalation exposure to benzene series, benzene, toluene, and xylene all increased the risk of female menstrual abnormalities (OR=3.46, 95%CI: 2.79, 4.30, AR=29.37%). The OR value elevated with the increase of joint exposure concentration (OR=2.57-4.33), the OR value of the low cumulative exposure group was lower than that of the high cumulative exposure group (OR=2.81 vs 3.86, P < 0.01), and the OR value of the group aged 18 to 36 years old was higher than that of the group aged 18 to 45 years old (OR=5.83 vs 2.93, P < 0.01). The OR value discrepancy was apparent among the groups with single and multi-components of benzene, toluene, and xylene at different concentrations (OR=2.39-6.42, 95%CI: 1.26, 9.06). The symptom dimensions of menstrual abnormalities with a higher AR were abnormal menstrual volume (AR=47.12%), followed by abnormal menstrual cycle (AR=38.68%). The symptoms that were greatly influenced by the exposures were: irregular menstrual cycle (OR=3.33, 95%CI: 2.94, 3.79, AR=51.25%, n=1103), menorrhagia (OR=3.02, 95%CI: 2.76, 3.30, AR=46.73%, n=2262), dysmenorrhea (OR=3.22, 95%CI: 2.69, 3.84, AR=44.18%, n=3183), and prolonged menstrual duration (OR=2.20, 95%CI: 1.99, 2.43, AR=37.02%, n=1452). Conclusion Through inhalation exposure to benzene series, a higher concentration of combined benzene, toluene, and xylenes may increase the risk of menstrual abnormalities in female workers of childbearing age. The OR value of menstrual abnormalities is varied by chemical composition, exposure dose, cumulative exposure dose, and age. Volume and cycle of menstruation are affected by the exposure, and the most common symptoms are dysmenorrhea, menorrhagia, irregular cycle.

Objective:To investigate the incidence and prothrombotic risk factors of postoperative venous thromboembolism(VTE) in Cushing′s disease and to further develop an assessment model to identify those at high risk of postoperative VTE events.Methods:A retrospective study was performed in 82 patients who were admitted to Huashan Hospital, Fudan University during January 2019 and January 2020 and diagnosed with Cushing′s disease. These patients underwent the evaluation about their clinical, hormonal, and coagulation parameters, as well as ultrasonography and pulmonary angio-CT when necessary. The least absolute shrinkage and selection operator(LASSO) regression analysis was used to screen independent risk factors, and a nomogram model for postsurgical VTE risk assessment in Cushing′s disease was initially established, and Bootstrap method was used for internal verification. Finally, the predictive model was evaluated for calibration and clinical applicability in the study cohort.Results:Nineteen patients(23.17%) developed VTE events, with 14 cases occurring after endoscopic transsphenoidal surgery. Compared to patients without VTE, those in the VTE group were older( P<0.001), had longer postoperative bed rest, higher rates of current infection, higher HbA 1C levels, and more severe glucose tolerance impairment(all P<0.05). Through LASSO regression analysis, two independent risk factors for postoperative VTE were identified: Age and current infection. Then a VTE risk assessment nomogram model was established to predict the patients at high risk of VTE. In the nomogram model for VTE risk assessment, the area under the receiver operating characteristic curve was 0.868(95% CI 0.787-0.949), with the calibration curve closely aligning with the ideal diagonal line and the clinical decision curve exceeding the two extreme curves. Conclusions:Advanced perioperative assessment needs to be taken to screen those with high VTE risks in patients diagnosed with Cushing′s disease. Additionally, during the perioperative period, patients with Cushing′s disease should undergo mandatory physical activity or prophylactic anticoagulant therapy.

Objective The oxidative damage of DNA can be caused by excessive levels of Reactive oxygen species(ROS).Monitoring of DNA oxidative damage enables effective evaluation of ROS damage effects.Although the detection of DNA damage effects based on microbial sensor allows quantitative analysis of oxidative damage,the ROS clearance mechanism existed in bacterial will affect the sensitive of detection.The work of this article is to knockout the key genes of ROS clearance mechanism and construct an antioxidant gene-knock-out microbial sensor.The microbial sensor can realize sensitive monitoring of DNA damage effects and then evaluates the damage effects of cells by ROS.Methods The antioxidant damage genes of bacterial ahpCF,katE and katG were knocked out by λ-Red homologous recombination and antioxidant gene-knockout microbial sensor was constructed.The nalidixic acid sodium salt and UV irradiation were used to characterize the performance for monitoring of DNA damage effects.Results The antioxidant gene-knockout microbial sensors ΔahpC,ΔahpCF/ΔkatEG and ΔahpCF/ΔkatE/ΔkatG were constructed successfully.The results showed that the microbial sensor ΔahpCF/ΔkatE/ΔkatGl had the highest sensitive of damage effects and the limit of detection for nalidixic acid sodium salt was 0.40 μmol/L.In addition,1.80 min of UV irradiation(254 nm)was sufficient to induce a significant fluorescent expression effect in the engineered bacteria.Conclusion In this article,antioxidant gene-knockout microbial sensors had been constructed to realize active and sensitive monitoring of DNA damage effects such as DNA damage reagents and UV irradiation.The sensors could provide an active,effective,and sensitive potential monitoring method for future evaluation of radiation effects in space.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.