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 relationship between hyperuricemia and outcome in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to Department of Neurology, Putuo Hospital, Shanghai University of Tranditional Chinese Medicine between January 2020 and September 2020 were enrolled retrospectively. The modified Rankin Scale (mRS) score was used to evaluate the clinical outcome 3 months after the onset. ≤2 was considered as good outcome, and >2 was considered as poor outcome. The demography and baseline characteristics were compared between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent influencing factors of the outcome. Results:A total of 210 patients were included, their age was 69.87±62.62 years. There were 125 males (59.52%) and 85 females (40.48%). The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 4. The serum uric acid level in 169 patients (80.48%) was normal and 41 (19.52%) had hyperuricemia; 120 patients (57.14%) had a good outcome, and 90 (42.86%) had a poor outcome. Blood glucose level, serum uric acid level, baseline NIHSS score and the proportions of diabetes mellitus, history of stroke or transient ischemic attack, hyperuricemia in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that diabetes mellitus (odds ratio [ OR] 2.735, 95% confidence interval [ CI] 1.461-5.121; P=0.002), hyperuricemia ( OR 2.400, 95% CI 1.102-5.228; P=0.027), and higher baseline NIHSS score ( OR 1.233, 95% CI 1.118-1.360; P<0.001) were the independent risk factors for poor outcome in patient with acute ischemic stroke. Conclusion:Hyperuricemia is an independent risk factor for poor outcome in patients with acute ischemic stroke.

Objective To investigate sun protection behavior among middle-aged and elderly women in Beijing.Methods The central (Xuanwumen district) and peripheral areas (Yanqing district) of Beijing city were selected for investigation from May to June in 2016.By random sampling and field investigation,interviewees completed questionnaires with the help of dermatologists.Results A total of 400 females aged 40-90 years were investigated,including 190 in the Xuanwumen district and 210 in the Yanqing district.Among all the subjects,the average duration of outdoor activities was 2 hours.Moreover,117 (29.2％) of the 400 interviewees had the active sun exposure habit,including 38 (18.1％) in the Yanqing district and 79 (41.6％) in the Xuanwumen district,and the proportion of subjects with the active sun exposure habit significantly differed between the two districts (x2 =26.582,P ＜ 0.001).In addition,67 (16.8％) interviewees had a sunburn history,and 130 (32.5％) were used to applying sunscreen.The proportion of sunscreen users was significantly higher in moderately or highly educated women (103 [45.2％]) than in lowly educated women (28/172 [16.3％],P ＜ 0.001).The proportion of sunscreen users in women with skin type Ⅲ (41.2％ [70/170]) was significantly higher than that in those with skin type Ⅳ (26.5％ [61/230],P =0.002).The scores for facial skin aging and dorsal hand skin aging were both significantly lower in sunscreen users than in non-users (Z =18.536,10.731,P =0.002,0.026,respectively).Conclusion The active sun exposure habit in the middle-aged and elderly women differs between the central and peripheral areas of Beijing,and the use of sunscreen is associated with education level.

In order to improve the teaching of biochemistry and molecular biology experiment course and improving students' mastery of theoretical knowledge and comprehensive quality,we made a series of reform in the teaching of biochemistry and molecular biology experiment course,including enriching of teaching content (for example,updating content,setting up experiments,adding design/comprehensive experiments),reforming teaching mode (for example,increasing teaching methods and demonstration teaching),perfecting the system of teaching evaluation (matching laboratory report and experiment assessment).Through the questionnaire after the teaching reform,it was found that the students are more enthusiastic about the experiment course than before,and their experiment technology is more proficient.In addition to that,the teaching effect of biochemistry and molecular biology experiment course has been obviously improved.The methods and effects of the above reforms in recent years are summarized in order to provide useful reference for the experimental teaching of Biochemistry and molecular biology in medical colleges.

Objective To study the influence of clinical nutritional support on the effects of mechanical ventilation (MV), and to find the factors affecting the outcome of patients undergoing MV. Methods A case-control study was conducted. The clinical data of 235 patients undergoing MV admitted to intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2017 were retrospectively analyzed. The patients were divided into two groups according to whether weaning successfully within 7 days. The clinical data of patients in the two groups were collected including gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, underlying disease, nutritional indicators, nutritional support, and complications. The outcome of withdrawal within 7 days was served as a dependent variable, all observed indicators were served as independent variables, and Logistic regression analysis was carried out to screen the influencing factors of the weaning results within 7 days. Results 235 patients undergoing MV were enrolled, 128 patients were successfully withdrawn within 7 days, and 107 were unsuccessfully withdrawn. Compared with the successful weaning group, the patients of weaning failure group were older, and had higher APACHEⅡ score and lower albumin (Alb) and hemoglobin (Hb), more patients with internal medical underlying diseases and receiving parenteral nutrition (PN) and mixed nutrition, and the incidences of secondary infection, vomiting, abdominal distension, abnormal bowel sound, gastric retention, and diarrhea were higher. However, there was no statistical significance in gender between the two groups. The variables of statistical significance in univariate analysis were enrolled in the multifactor analysis model showing that age [odds ratio (OR) = 1.269, 95% confidence interval (95%CI) = 1.119-1.439, P < 0.001], APACHEⅡ score (OR = 1.643, 95%CI = 1.423-1.897, P < 0.001), internal medical underlying diseases (OR = 6.298, 95%CI = 4.012-9.887, P < 0.001), secondary infection (OR = 8.323, 95%CI = 2.568-26.975, P < 0.001), abdominal distension (OR = 3.368, 95%CI = 1.586-7.152, P = 0.002), abnormal bowel sounds (OR = 2.856, 95%CI = 1.215-6.713, P = 0.017), gastric retention (OR = 1.996, 95%CI = 1.183-3.368, P = 0.010), diarrhea (OR = 3.035, 95%CI = 1.337-6.890, P = 0.008) were risk factors for unsuccessful weaning,and compared with PN, enteral nutrition (EN; OR = 0.191, 95%CI = 0.098-0.372, P < 0.001) and mixed nutrition (OR = 0.375, 95%CI = 0.150-0.938, P = 0.037) were protective factors of successful weaning. The gender, Alb and Hb before and after MV, vomiting, gastrointestinal hemorrhage were not associated with weaning outcome within 7 days. Conclusions Elder, high APACHEⅡ score, internal medical underlying diseases, or secondary infection, abdominal distension, abnormal bowel sounds, gastric retention, diarrhea were risk factors of weaning failure within 7 days in patients undergoing MV. Compared with PN, EN and mixed nutrition were protective factors for successful weaning. For patients undergoing MV, EN should be performed early in the case of full recovery, hemodynamic stability, and serious metabolic disorders.

Objective To construct the teaching model of medical statistics in universities of TCM through the questionnaire of knowledge,attitude and practice structure.Methods Medical statistics KAP questionnaire survey was conducted among postgraduates using proportional stratified sampling according to the grade.It describes the present situation and calculates the knowledge loss coefficient,knowledge demand index and behavioral application intensity of medical statistics.The Chi-square test was used to analyze the differences among different grades.Results 109 questionnaires were withdrawn.The recovery was 83.84％.45 cases (41.3％) were first year postgraduate,33 cases (30.3％) were 2nd year postgraduate,and 31 cases (28.4％) were 3rd year postgraduate.At the knowledge level,the knowledge loss coefficient of the second year postgraduates was 0.635,and there was no statistical difference (P=-0.651) vs the first year postgraduate (0.638).At the attitude level,Knowledge demand index had no statistical significance difference (P=0.213)between postgraduates in grade two (96.87％) and grade three (75.00％).Most medical postgraduates held positive attitudes toward medical statistics,hoping to strengthen the training of their application ability such as medical statistics in design and research thinking (29.18％),the statistical methods selection and the interpretation of the results (31.53％) and the statistical software operation (36.07％).At the practice level,the percentage of application intensity with statistical methods of third-year postgraduates (100.00％) was higher than the second-year postgraduates (37.50％),and the second-year postgraduates higher than the first-year postgraduates (20.45％).And with the growth of year,the percentage of application intensity was gradually increasing (P=O.O03).Among them,published scientific papers accounted for 16.5％,and 58.6％ paper grade concentrated in the core journals.Conclusion Application development should be enhanced by modularization teaching with practical issues.

Objective: To investigate the CRISPR genotypes (clusters) and regional distribution of Yersinia pestis in Qinghai-plateau. Methods: One hundred and two isolates of Y. pestis isolated from human plague patients, host animal and insect vectors from Qinghai-plateau were selected. The DNAs were extracted using the traditional sodium dodecyl sulfate decomposition and phenol-chloroform method. Three CRISPR loci YPa, YPb and YPc of 102 isolates of Y. pesits were amplified and sequenced, and then the CRISPR sequence analysis was carried out by comparing the latest published CRISPR spacer dictionary and the NCBI database to identify the spacer and spacer array. CRISPR genotyping of isolates of Y. pesits were finally conducted according to the polymorphism of the spacer arrays and the regional distribution pattern of isolates of Y. pesits in Qinghai-plateau was described. Results: Forty spacers including 22 of YPa, 13 of YPb and 5 of YPc were observed among 102 isolates of Y. pestis in Qinghai-plateau, of which 5 spacers (a1', a103, a104, b4'' and b4''') were firstly identified. Meanwhile, 16, 10, and 5 different spacer arrays were obtained in YPa, YPb and YPc respectively, including 11 new spacer arrays detected in this study. One hundred and two isolates were divided into 24 CRISPR genotypes and classified into 9 CRISPR clusters (Cb4, Cb4', Cb2, Ca37, Ca7, Ca7', CaΔ5', Ca35' and Cc3'). Each dominant cluster presented significant aggregation geographically: Ca7 were found in Yushu, Nangqian, Chenduo, Zaduo, Zhiduo and Qumalai countries. Ca7' were found in Xunhua, Tongren, Zeku, Tongde, Maqin and Guinan countries. CaΔ5' were restricted to Qilian, Gangcha, Menyuan and Datong countries. CaΔ35' were found in Huangyuan, Haiyan, Gangcha, Tianjun, Delingha, Wulan, Doulan, Gonghe, Xinghai, Guide and Tongde countries. Conclusion CRISPR-based genotyping analyses showed complicated population of Y. pestis in Qinghai-plateau. Four clusters, Ca7, Ca7', CaΔ5' and Ca35' were the most epidemic dominant four clusters and presented obvious regional distribution patterns, which instructed us to strengthen the surveillance and prevention and control by CRISPR-genotyping technique.

Sal-like 4 (SALL4) plays an important role in promoting the cellular proliferation and maintaining the pluripotency of embryonic stem cells and tumor cells.In fully differentiated cells,the expression of SALL4 is silenced or down-regulated.However,the expression of SALL4 is found to be restored or up-regulated in a variety of non-germ cell tumors.Besides,the expression of SALL4 is often associated with disease progression,treatment effect and prognosis.Therefore,examining the expression level of SALL4 will be of great importance in the diagnosis of disease and monitoring the disease progression for non-germ cell tumors.

Objective To explore the primary teeth caries status of preschoolers in Pudong community and its relevant factors of parental knowledge-belief-practice (KBP).Methods Using stratified random cluster sampling,a total of 1 179 children from 9 kindergartens in Hudong community in Pudong new area were examined.Oral cavity check-ups and parental questionnaire survey were conduced to understand the primary teeth caries rate of preschoolers and its related influencing factors.Results The prevalence rate of primary teeth caries was 53.2％ and DMFT 2.79.The prevalence rate of primary teeth caries had statistical significance in different age groups (P ＜ 0.05).Multi-factor analysis showed that the influencing factors of primary teeth caries were age (P ＜ 0.05),parental education level (P ＜ 0.05),parental assistance of teeth brushing (P ＜ 0.05),children eating sweets before bedtime (P ＜ 0.05) and parental awareness for treating primary teeth (P ＜ 0.05).Conclusions The prevalence rate of primary teeth caries is high among the preschoolers of Pudong.And age,parental education level,parental preventive knowledge of teeth caries and poor eating habits are significant factors correlated with the incidence of dental caries in children.

Objective To explore the correlation between social support and the self-efficacy among community patients with chronic obstructive pulmonary diseases ( COPD ) .Methods From October 2008 to March 2009 ,320 community patients with COPD were recruited from a community health service center by using a convenience sampling.The research data were taken by questionnaires and scale .The Spearman’s correlation analysis was done to analyze the correlation of social support and the self-efficacy.Results The total score of social support of the patients with COPD was ( 37 .64 ±5 .96 ) , which was lower than the national norm (40.80 ±7.64), and the total score of self-efficacy was (74.24 ±9.50).The number of patients with medium-level self-efficacy was 286 (89.4%).The overall social support was positively correlated with self-efficacy (r=0.553,P<0.01), and it was also positively correlated with the various dimensions of self-efficacy (r=0.190-0.515,P <0.05).Conclusions Social support and the self-efficacy are closely related.It is important to promote patients ’ self-efficacy and mobilize the social and family support by various approaches .