Background Light gradient boosting machine (LightGBM) has become a popular choice in prediction models due to its high efficiency and speed. However, the "black box" issues in machine learning models lead to poor model interpretability. At present, few studies have evaluated the severity of occupational injuries from the perspective of LightGBM model and model interpretability. Objective To evaluate the application value of LightGBM models and model interpretability methods in occupational injury prediction. Methods The Mine Safety and Health Administration (MSHA) occupational injury data set of mining industry workers from 1983 to 2022 was used. Injury severity (death/fatal occupational injury and permanent/partial disability) was used as the outcome variable, and the predictor variables included the month of occurrence, age, sex, time of accident, time since beginning of shift, accident time interval from shift start, total experience, total mining experience, experience at this mine, cause of injury, accident type, activity of injury, source of injury, body part of injury, work environment type, product category, and nature of injury. Feature sets were screened using least absolute shrinkage and selection operator (Lasso) regression. A LightGBM model was then employed to predict occupational injury, with area under curve (AUC) of the model serving as the primary evaluation metric; an AUC closer to 1 indicates better predictive performance of the model. The interpretability of the model was evaluated using Shapley additive explanations (SHAP). Results Through Lasso regression, 7 key influencing factors were identified, including accident time interval from shift start, experience at this mine, cause of injury, accident type, body part of injury, nature of injury, and work environment type. A LightGBM model, constructed based on feature selection via Lasso regression, demonstrated good predictive performance with an AUC value of 0.9941 (95%CI: 0.9917, 0.9966), accuracy of 0.9743, specificity of 0.9781, and sensitivity of 0.9640. The predicted probability of fatal occupational injuries showed high consistency with the actual probability of fatal occupational injuries. In the occupational injury prediction model, the importance of each indicator was analyzed through its SHAP value, and it was found that the body part of injury and the nature of injury were the two main features that affected the prediction results of the model, and the impacts of other features were relatively small. The distribution of SHAP values across body part of injury was broad, with significant impacts on the model's prediction of fatal risk, particularly for injuries to the head and neck, as well as multi-part injuries. The nature of injury also exerted influences on the model in different directions, with suffocation/drowning, crushing, and multi-part injuries having a greater impact on the risk of fatal occupational injuries. Conclusion LightGBM model is capable of efficiently processing large-scale data and providing high-precision prediction results. Research on model interpretability aids in more accurately exploring and analyzing various key risk factors for fatal occupational injuries among mining workers, and further reveals the complex interactions among these factors. This, in turn, enables better preventive intervention and protection measures, as well as optimal resource allocation for labor workers.

Objective:To investigate the combination of internal fixation for periprosthetic fractures of the proximal femur (PFFF) after hip arthroplasty.Methods:The data of 58 patients with periprosthetic fractures after hip arthroplasty from May 2008 to March 2022 were retrospectively analyzed, including 31 males and 27 females. The average age was 75.5±18.2 years (range, 35-95 years). There were 39 total hip arthroplasty and 19 hemiarthroplasty; 37 biological prosthesis and 21 cemented prosthesis. Intraoperative periprosthetic fractures occurred in 6 cases and 52 cases postoperatively. Unified classification system (UCS): UCS IV.3A1 type 2 cases, 3A2 type 1 case, 3B1.1 type 19 cases, 3B2.1 type 25 cases, 3B3 type 2 cases, 3C type 9 cases. Fracture site: 3 cases in zone A (greater trochanter), 46 cases in zone B (around the femoral stem), and 9 cases in zone C (distal to the tip of the femoral stem. Internal fixation is composed of primary and secondary fixation, the main fixation method was the cerclage of steel wire or titanium cable, locking compression plate, and locking attachment plate fixation. The secondary fixation method was the cerclage of titanium cable, which was required to cover three zones A, B and C to form an overall balanced fixation. The modified Harris hip scores (mHHS), plate length, working length and screw number of different internal fixation combinations were compared.Results:The follow-up time was 54.2±21.6 months (range, 11-86 months). All patients showed signs of fracture healing at 10.2±1.5 weeks (range, 7-13 weeks) after operation, and bony union was observed at 19.6±1.3 weeks (range, 17-22 weeks) after operation. No delayed union or nonunion was observed. After operation, one case had a stress fracture and was revised with double-plate internal fixation; one case had a failed internal fixation and was revised with double-plate internal fixation and a large allograft bone graft. The mHHS score of UCSIV.3B2.1 group (80.3±4.6) was the lowest at 6 months after operation, and the difference between the groups of different types was statistically significant ( F=256.72, P<0.001). The score of simple internal fixation group (91.6±4.2) was higher than that of revision combined with internal fixation group (81.9±4.1), and the difference was statistically significant ( t=8.32, P<0.001). The plate length and working length were 24.9±2.5 cm and 12.6±1.7 cm for UCS IV.3B1.1, 25.4±2.6 cm and 13.6±1.8 cm for 3B2.1 and 28.1±2.5 cm and 4.9±1.9 cm for 3C, respectively ( F=5.33, P=0.005; F=6.78, P<0.001). The number of screws in zone A was significant difference among different UCS types ( F=52.67, P<0.001); UCS IV.3B1.1 (6.5±2.3) and 3B2.1 (6.7±2.2) were more than 3B3 (3.5±1.5) and 3C (3.7±1.6). The number of screws in zone B was significant difference among different UCS types ( F=42.15, P<0.001); The number of UCS IV.3B1.1 (2.3±1.6) and 3B2.1 (2.8±1.9) were significantly more than that of 3B3 (1.0±0.5) and 3C (1.2±0.6). The number of screws in zone C was significant differences among different UCS types ( F=39.62, P<0.001); The number of UCS IV.3B1.1 (3.8±1.9) and 3B2.1 (3.9±1.7) were more than that of 3B3 (2.0±0.5), the difference was statistically significant ( P<0.05). Conclusion:The function of hip after simple internal fixation of proximal femoral periprosthetic fractures was better than that of those who underwent revision at the same time; the number of screws of UCSIV.B1 and B2 is more than that of B3.

From September to December 2019, the author participated in the exchange project between Soochow University and the Pflgewerk nursing home in Berlin, Germany for research and development of home care courses for the disabled elderly and intelligent elderly care. During the study and exchanges, the author was impressed by the perfect home care system in Germany, the development and application of advanced aids suitable for the aged, systematic and standardized caregiver training courses, a strong atmosphere of humanistic care and multidisciplinary team cooperation. Based on the personal experience of learning and exchange, this article considered some of the shortcomings in my country's current aging society, hoping to provide reference for establishing a complete long-term care system, so as to achieve healthy aging and active aging.

Clinical data of 120 patients undergoing transurethral resection of the bladder sidewall tumors (TURBt) were retrospectively analyzed.Before TURBt the obturator nerve was blocked under the guide of the nerve stimulator in 46 cases (block group) and not blocked in 74 cases (unblock group).The incidence of obturator nerve reflex and bladder perforation in block group was significantly lower than that in unblock group(7％ vs.35％,P =0.000 and 0 vs.19％,P =0.002,respectively).The operation time and the duration of bladder continuous saline irrigation after operation in block group were shorter than those in unblocked group [(32.2 ± 12.5) vs.(43.2 ± 24.5) min,P =0.001 and (8.9 ± 6.4) vs.(13.3 ±10.8) h,P =0.013,respectively].The efficiency value of TURBt in block group was better than that in unblock group [(5.8 ±3.9) vs.(9.3 ± 7.0) min/cm2,P =0.001].The obturator nerve block guided by the nerve stimulator can improve the safety and the efficiency of TURBt.

OBJECTIVETo study the molecular mechanism of tetramethylpyrazine to induce human promyelocytic HL-60 leukemia cells differentiation.

METHODThe cell proliferation was determined by MTT. The differentiation of the cells was detected by NBT reduction test. Cellular morphology was observed by Wright's staining. Cell cycle distribution and the distribution of CD11b, CD14 were detected by flow cytometry. Then RT-PCR and Western blot assay were employed to detect the expressions of c-myc, p27, CDK2 and cyclinE1 in HL-60 cells after exposure to TMP.

RESULTTMP inhibited the proliferation in a dose and time dependent manner. TMP at the concentration of 200 mg x L(-1) to 300 mg x L(-1) induced unterminal differentiation of HL-60 cell and synergistically blocked the cell cycle progression of HL-60 cells in G0/G1 phase. The expression of c-myc was down-regulated as well as the protein expression of cyclin E and CDK2, while the mRNA and protein expression of P27 were remarkably up-regulated.

CONCLUSIONSmall doses of TMP induces differentiation of HL-60 cells throughout the cell cyde, as detected by a slower rate of accumulation in G0/G1, possibly by regulating the expression and activity of G1/S phase-related molecules.

Cell Cycle Proteins ; genetics ; metabolism ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Gene Expression Regulation, Leukemic ; drug effects ; HL-60 Cells ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; genetics ; metabolism ; physiopathology ; Pyrazines ; pharmacology