[Analysis of influencing factors of high-frequency hearing loss among male noise workers in an automobile manufacturing enterprise]

Objective: To analysis of high-frequency hearing loss status and risk factors among male noise workers in an automobile manufacturing enterprise in Guangzhou. Methods: From February 2020, a cluster sampling method was used to select 3486 male workers exposed to noise in an automobile manufacturing enterprise in Guangzhou in 2018. After screening, 2608 were selected as the research objects. Pure tone hearing threshold test, noise exposure level test and questionnaire survey were conducted, and the cumulative noise exposure was calculated. Chi square test and unconditional logistic regression were used to analyze the correlation between various factors and high frequency hearing loss. Results: The detection rate of high-frequency hearing loss in noise exposed workers was 34.20% (892/2608) , there were significant differences in the two groups among age, marital status, years of noise exposure, noise exposure equivalent A sound level, CNE, different working hours and exposure to electromagnetic radiation (P<0.05) . Multiple logistic regression analysis showed that age, CNE and exposure to electromagnetic radiation were independent risk factors for high-frequency hearing loss (P<0.05) , three shifts and two shifts were the protective factors for the occurrence of high-frequency hearing loss (OR=0.523, P<0.01) . Conclusion: Noise exposure is the main influencing factor of high-frequency hearing loss of noise-receiving workers in automobile manufacturing enterprises. Enterprises should strengthen noise control in the workplace, improve the working environment of electromagnetic radiation, and implement a scientific and healthy work shift system.

[Real-world data studies of medical products in the context of special healthcare policy: study designs and key considerations]

Boao Lecheng International Medical Tourism Pilot Area is the only administrative area in China where the pilot application of real-world data is performed. Based on the special healthcare policy in Boao Lecheng, conducting real-world data study to provide real-world evidence for the clinical evaluations and approvals of innovated medical products has become an important field that supports the reform of China's evaluation and approval system of medical products. Trustworthy real-world evidence needs to rely on both high-quality real-world data and reasonable and rigorous study designs. Based on the real-world data research guidelines and specifications issued by relevant academic research and regulatory authorities both at home and abroad, combined with the special policy environment of Boao Lecheng and previous practice experience, this paper summarizes the study designs of real world data in Boao Lecheng and discusses the key considerations of different study design in the context of special healthcare policies in Boao Lecheng in order to provide reference for the further study of real-world data.

[Clinical effects of retrograde anterolateral thigh perforator flaps assisted with computed tomography angiography in repairing skin and soft tissue defects around the knee or in proximal lower leg]

Objective: To investigate the clinical effects of retrograde anterolateral thigh perforator flaps assisted with computed tomography angiography (CTA) in repairing skin and soft tissue defects around the knee or in proximal lower leg. Methods: A retrospective cohort study was conducted. From May 2015 to October 2019, 17 patients with skin and soft tissue defects around the knee or in proximal lower leg were admitted to the Department of Orthopedics of Jizhong Energy Xingtai Mig General Hospital, including 12 males and 5 females, aged 16-65 years, with an average age of 35 years. The areas of skin and soft tissue defects after debridement ranged from 6.0 cm×3.0 cm to 15.0 cm×9.0 cm. The retrograde anterolateral thigh perforator flaps were designed according to the origin and distribution of the perforating branches in flaps and the length of the vascular pedicle examined with CTA and the condition of the wound to repair the wounds. The areas of resected flaps ranged from 6.5 cm×3.5 cm to 15.5 cm×9.5 cm. The wounds in donor sites of flaps were sutured directly or covered with medium-thickness skin grafts from healthy upper leg. The sources of the perforating branches in flaps were recorded. The lateral circumflex femoral artery, its branches, and the relative length of the vascular pedicle were compared between preoperative CTA detection and intraoperative observation. The survivals of the flaps were observed. At the last follow-up, the effects of flaps in repairing wounds were evaluated according to evaluation standard of efficacy satisfaction; the motion ranges of flexion and extension of the knee joint were measured, and the knee joint function was evaluated according to the Hohl knee joint function evaluation standard; the sensory function in the flap area was evaluated according to the sensory function evaluation standard formulated by the British Medical Research Council; the wound healing and the occurrence of complication affecting motor function of limb of flap donor sites was observed. Data were statistically analyzed with paired sample t test. Results: The perforating branches in flaps originated from descending branches, oblique branches, and rectus femoris branches of lateral circumflex femoral artery in 7, 6, and 4 patients, respectively. The flaps with blood supply from descending branches, oblique branches, and rectus femoris branches of lateral circumflex femoral artery were type 1, 2, and 3 retrograde anterolateral thigh perforator flaps, respectively. The preoperative CTA examination of lateral circumflex femoral artery and its branches were consistent with those observed during operation. The relative lengths of vascular pedicles of type 1, 2, and 3 retrograde anterolateral thigh perforator flaps calculated after CTA examination were 0.32±0.13, 0.56±0.07, and 0.56±0.15, which were close to 0.35±0.12, 0.52±0.10, and 0.53±0.12 measured and calculated during operation, respectively (t=0.45, 0.80, 0.31, P>0.05). All flaps survived in 17 cases without vascular crisis. At the last follow-up, 16 patients were satisfied with effects of flaps in wound repair, with 1 patient feeling average about the effect; the flexion range of knee joint was 100-120°, and the extension range of knee joint was -2-0°; knee joint function was evaluated as excellent in 9 cases, good in 7 cases, and poor in 1 case; the sensory function of the flap area reached S₄ level in 2 cases, S₃ level in 8 cases, and S₂ level in 7 cases; the wounds in flap donor sites healed well; there was no adverse effect in motor function of limbs. Conclusions: Retrograde anterolateral thigh perforator flap is an effective method for repairing skin and soft tissue defects around the knee or in proximal lower leg. Preoperative CTA examination can fully show the anatomical characteristics of the branches of the lateral circumflex femoral artery and the perforating vessels of each branch, which can guide preoperative flap design and operation, thus shortening operation time and improving flap survival rate, with good clinical effects.

[Analysis of occupational health status of radiation workers in Guangdong Province]

Objective: To discuss the effect of low-dose ionizing radiation on the health of radiation workers, and provide a basis for occupational health risk assessment of radiation workers. Methods: In January 2020, 3165 radiation workers who performed radiation occupational health examinations in Guangzhou Prevention and Treatment Hospital for Occupational Disease from January 2017 to December 2019 were selected as the research objects, and compared and analyzed the health status of radiation workers with different examination types (pre-job, in-job and off-job) , types of work, gender, and length of service. Results: The off-job occupational radiological health examination was rare at 2.3% (74/3165) . The abnormal detection rate of chest radiographs, renal function, thyroid function, and blood routine of the radiation workers in-job group was higher than that of the pre-job group (P<0.05) . No statistical difference was found in the abnormal detection rate of the examination items during the in-job group and the off-job group (P>0.05) . The blood routine abnormality detection rate of medical application group and industrial application group were higher than those of nuclear fuel group (P<0.05) . The abnormal detection rate of blood pressure and renal function of male radiation workers was higher than that of females, while the abnormal detection rate of blood routine of females was higher than that of males (P<0.05) . The abnormal detection rate of electrocardiogram, chest radiograph, blood pressure, renal function, thyroid function, and blood routine of radiation workers increased with increasing working age (P<0.05) . Conclusion: Occupational health status of radiation workers is not optimistic. Radiation occupational health monitoring should be strengthened, special attention should be paid to off-job radiation occupational health examination, focusing on the sensitive indicators of sensitive personnel, improving radiation protection conditions, and effectively protecting the occupational health of radiation workers.

[Characteristics at different frequencies of hearing loss in noise exposure workers of the automobile manufacturing industry]

Objective: To analyze the effects of noise exposure on the hearing at different frequencies in workers from the automobile manufacturing industry. Methods: A total of 4723 noise workers in a large automobile manufacturing company in Guangzhou were chosen as the research object by using judgment sampling method between April and July, 2018, and carried out 0.5, 1.0, 2.0, 3.0, 4.0 and 6.0 kHz pure tone audiometry threshold to analyze the characteristics of the status of hearing loss at different frequencies and its relationship with the noise exposure time. Results: The detection rate of hearing loss in noise-exposed workers was 29.8% (1406/4723) . Among them, the binaural hearing loss was 21.2% (999/4723) , and single unilateral hearing loss accounted for 8.6% (407/4723) . The hearing loss detection rate of right ear was higher than that of the left ear (P<0.05) , especially in the 6.0 kHz (P<0.001) . The detection rate of increased speech frequency hearing threshold was 1.9% (90/4723) , and the detection rate of increased high-frequency hearing threshold was 28.9% (1366/4723) . The detection rate of increased threshold in both the left and the right ear increased with the increase of frequency (P<0.001) , the increased hearing threshold was the highest at the frequency of 6.0 kHz. The auditory threshold of left ear in 0.5 kHz were higher than that of right ear at the same frequency (P<0.05) . The detection rate of hearing loss increased with the increase of noise exposure time (P<0.001) , and the increased threshold of 3.0, 4.0 and 6.0 kHz from workers increased with the increase of noise exposure time (P<0.001) . Conclusion: There is a significant increased threshold in workers exposed to noise frequency of 6.0 kHz, right ear is more easily damaged than left ear, there is a dose-response relationship for the noise exposure time and high-frequency hearing loss.

[Efficacy and safety of endoscopic papillectomy of major duodenal papilla neoplasms]

Objective: To discuss the efficacy and safety of endoscopic papillectomy of major duodenal papilla neoplasms. Methods: The clinical-pathological data of 21 patients who were admitted to the Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and underwent endoscopic papillectomy of major duodenal papilla neoplasms from January 2014 to January 2020 were retrospectively studied, their postoperative outcomes and complication were also analyzed. Results: Tweenty-one patients were successfully performed endoscopic papillectomy of major duodenal papilla neoplasms. The resected lesions varied between 0.5-2.8 cm. Completed lesion was resected in 19 cases and lesion blocks in 2 cases. The incidence of postoperative complication was 52.4% (11/21), including 8 cases of postoperative bleeding (38.1%). Five patients stopped bleeding after endoscopic hemostasis and 3 patients stopped after interventional embolization. Two patients experienced perforation (9.5%) and recovered after conservative treatment including anti-inflammatory treatment and abdominal drainage. Five patients had pancreatitis (23.8%) and recovered after treatment with pre-somatostatin and anti-inflammatory rectal suppository. Preoperative pathological results of 21 patients suggested that 11 were high-grade intraepithelial neoplasia and 8 were low-grade intraepithelial neoplasia, and 2 were chronic inflammation. Postoperative pathological results suggested that 4 were adenocarcinoma, and the rest 17 were adenoma. The coincidence rate of preoperative biopsy results and postoperative pathology was 38.1%(8/21), and underestimate of the pathological stage occurred in 11 patients (52.4%) during the preoperative biopsy, overestimate occurred in two patients (9.5%). Four cases had a positive incisal margin. All patients had good prognoses and no death event occurred during the follow-up period. Conclusions: Early-stage major duodenal papilla neoplasms should be treated with aggressive resection. Endoscopic papillectomy of duodenal papilla neoplasms is safe, effective, and can be recommended as the preferred procedure for major duodenal papilla neoplasms.

[Analysis of the level of T lymphocyte subsets and the relationship with the prognosis of pulmonary fibrosis in patients with paraquat poisoning]

Objective: To analyze the levels of T lymphocyte subsets (CD3, CD4, CD8 and CD4/CD8) in patients with paraquat poisoning, and to explore the relationship between the changes of T lymphocyte subsets and the prognosis of pulmonary fibrosis. Methods: In October 2019, a total of 47 patients with oral 20% paraquat low water solvent poisoning in Guangzhou 12th people's Hospital from June 2018 to June 2019 were selected as the research objects. Patients were divided into early death group (16 cases died within 2 weeks) and non early death group (31 cases survived more than 2 weeks) . The non early death group was divided into pulmonary fibrosis group (23 cases) and normal lung group (8 cases) . 20 healthy people in the same period were randomly selected as the control group. The neutrophils (N) , C reaction protein (CRP) , alanine aminotransferase (ALT) , creatinine (Cr) , amylase (aAMY) , creatine kinase isoenzyme (CKMB) , pH, HCO(3)(-), blood oxygen saturation (SO(2)) and lactic acid (Lac) of patients poisoned within 3 d were examined every day. Independent sample t-test was used for inter group comparison, and paired sample t-test was used for intra group comparison. Results: Compared with non early death group, the levels of N, CRP, ALT, Cr, aAMY, CKMB and Lac in early death group increased (P<0.05) , while pH and HCO(3)(-) decreased (P<0.05) . Compared with the control group, the levels of CD3, CD4 and CD4/CD8 were decreased on the first day in the early death group and non early death group (P<0.05) , and the levels of CD3, CD4 and CD4/CD8 were decreased on the 15th day in the pulmonary fibrosis group (P<0.05) . Compared with the normal lung group, the levels of CD3, CD4 and CD4/CD8 in the pulmonary fibrosis group decreased on the 15th day (P<0.05) . Conclusion: The persistent low cellular immune function in patients with paraquat poisoning is related to the progress of pulmonary fibrosis, which is an important factor affecting the prognosis of patients with pulmonary fibrosis.

Serum metabolic markers and metabolic pathways in rats with metabolomic cecal ligation and puncture-induced sepsis

The aim of this study was to explore the dynamic changes in characteristic serum metabolic markers and pathways during early sepsis in rats. By using cecal ligation and puncture (CLP), we made rat models of sepsis, which were randomly divided into 5 groups with 10 rats in each group: group A, group B, group C, group D, and group E. We collected 2 mL of arterial blood at 0, 6, 12, 24, and 48 hours from rats in group A-E respectively and isolated serum via centrifugation. Next, adopting metabolomics analysis methods, we screened for metabolites from the animal serum with statistically and biologically significant abundance changes, and used the KEGG database to analyze the respective metabolic pathways. In all, our findings reveal that D-glucosamine 6-phosphate, D-glucosamine phosphate, α-D-glucosamine 1-phosphate, D-glucosamine 1-phosphate, and 5-hydroxy isocyanate decline continuously from 12 hours, while L-phenylalanine, (S) -α-amino-β-phenylpropionic acid, 5-methoxy indole acetic acid salt, 5-methoxy indole acetic acid, goose deoxyglycolic acid salt, goose deoxyglycolic acid, and Chen's deoxygenated sugar alcohol started to decrease from 6 hours. Additionally, 3.2,3-Bis-O-(geranyl geranyl)-sn-glycerol- 1-phosphoric acid-L-serine levels rose continuously from 12 hours. We found 13 differentially regulated ions, primarily ones involved in pathways responsible for the metabolism of sugar, amino acids, and lipids, which are related to the disorder of energy metabolism. Our findings mark serum-derived D-glucosamine and its phosphorous derivatives as characteristic metabolic markers of sepsis in rats.

[Clinicopathological features of the colorectal serrated adenoma and analysis on influencing factors of malignancy]

Objective: Serrated adenoma is recognized as a precancerous lesion of colorectal cancer, and the serrated pathway is considered as an important pathway that can independently develop into colorectal cancer. However, little is known about the related risk factors of carcinogenesis of serrated adenoma. The purpose of this study was to analyze the distribution characteristics and potential malignant factors of serrated adenoma in the colon and rectum. Methods: A retrospective case-control study was conducted to collect the clinical data of patients with serrated adenoma who underwent colonoscopy and were pathologically diagnosed in the Cancer Hospital of Chinese Academy of Medical Sciences from April 2017 to July 2019, and exclude patients with two or more pathological types of lesions. The clinical characteristics of serrated adenoma were summarized, and univariate and logistic multivariate regression analysis was conducted to explore the influencing factors for serrated adenoma to develop malignant transformation. Results: Among 28 730 patients undergoing colonoscopy, 311 (1.08%) were found with 372 serrated adenomas, among which 22 (5.9%) were sessile serrated adenomas/polyps, 84 (22.6%) were traditional serrated adenomas, and 266 (71.5%) were unclassified serrated adenomas according to WHO classification. The pathological results showed that 106 (28.5%) lesions were non-dysplasia, 228 (61.3%) lesions were low grade intraepithelial neoplasia, and 38 (10.2%) lesions were high grade intraepithelial neoplasia or cancer. There were 204 (54.8%) lesions with long-axis diameter <10 mm and 168 (45.2%) lesions with length long-axis ≥ 10 mm. 238 (64.0%) lesions were found in the left side colon and rectum and 134 (36.0%) lesions in the right side colon. Gross classification under endoscopy: 16 flat type lesions (4.3%), 174 sessile lesions (46.8%), 117 semi-pedunculated lesions (31.5%), 59 pedunculated lesions (15.9%). Narrow-band imaging international colorectal endoscopic (NICE) classification: 85 (22.8%) type I lesions, 280 (75.3%) type II lesions, 4 (1.1%) type III lesions. Univariate analysis showed that lesion size, lesion location, lesion site and different WHO classifications were associated with malignant transformation of colorectal serrated adenoma (all P<0.05). For the serrated adenomas with different NICE classifications, there were statistically significant differences in the distribution of malignant lesions among groups (P=0.001). Multivariate analysis showed that the long-axis diameter of the lesion ≥10 mm (OR=6.699, 95% CI: 2.843-15.786) and the lesion locating in the left side colorectum (OR=2.657, 95% CI: 1.042-6.775) were independent risk factors for malignant transformation. Conclusions: Serrated adenomas mainly locate in the left side colon and rectum, and are prone to malignant transformation when the lesions are ≥10 mm in long-axis diameter or left-sided.

[Analysis of clinical features, gene mutation, and prognostic characteristics in de novo acute myeloid leukemia patients with myelofibrosis]

目的

探讨初诊急性髓系白血病（AML）合并骨髓纤维化（MF）患者的基因突变、临床及预后特征。

方法

2016年1月1日至2020年2月1日河南省人民医院收治的初诊并同时行骨髓活组织检查的103例AML患者纳入研究，根据WHO（2016）骨髓纤维化分级标准将患者分为AML伴MF组（MF-1～3）与AML不伴MF组（MF-0），并对两组患者的临床特征、基因突变、疗效和预后进行回顾性比较。

结果

①103例患者中AML伴MF组46例（44.7％），其中MF-1 39例（84.8％），MF-2/3 7例（15.2％）；AML不伴MF组57例（55.3％）。和AML不伴MF组相比，AML伴MF组中位WBC显著增高［11.205（0.69～191.82）×10⁹/L对4.64（0.18～95.10）×10⁹/L，P＝0.024］；外周血出现有核红细胞的比例明显增高（43.5％对24.6％，χ²＝4.119，P＝0.042）；FAB分型：4例AML-M₀患者均在AML伴MF组，而AML不伴MF组AML-M₂所占比例更高（P＝0.014）。②AML伴MF组患者FLT3-ITD及NPM1基因突变率更高（15.2％对1.8％，P＝0.021；26.1％对10.5％，P＝0.039），而CEBPA基因突变率明显低于AML不伴MF组（2.2％对17.5％，P＝0.029）。③AML伴MF组完全缓解（CR）率显著低于AML不伴MF组（69.7％对93.2％，χ²＝7.412，P＝0.006）。多因素分析显示MF，尤其是纤维化程度是影响初诊AML患者CR的独立危险因素。④AML伴MF组3年总生存（OS）率明显低于AML不伴MF组（20.5％对72.2％，χ²＝4.032，P＝0.045）；亚组分析显示MF-1和MF-2/3两组患者的OS率、无进展生存（PFS）率显著低于AML不伴MF组（P＝0.001）。Cox多因素分析显示MF，尤其是MF-2/3是影响初诊AML患者OS和PFS的独立危险因素（P值分别为0.021和0.044）。

结论

AML合并MF患者具有较为独特的实验室及临床特征；MF是影响AML患者CR、OS和PFS的独立预后不良指标，MF的评估对初诊AML的疗效和预后判断具有重要意义。

[Long-term outcomes of Bryan artificial cervical disc replacement for degenerative cervical spondylosis]

Objective: To compare the long-term clinical effect and imaging results of Bryan artificial cervical disc replacement (ACDR) and anterior cervical discectomy and fusion (ACDF) and to explore whether ACDR can reduce the occurrence of postoperative adjacent segment degeneration (ASD) in the treatment of degenerative cervical spondylosis. Methods: It was a retrospective study. Total of 60 patients with degenerative cervical spondylosis, who had received operations by Bryan ACDR (n=27) and ACDF (n=33) in the Third Hospital of Hebei Medical University between January 2005 and December 2009 were enrolled in this study. The Japanese Orthopedic Association (JOA) scores, neck disability index (NDI), visual analogue scale (VAS), Odom's scale, cervical range of motion (ROM), surgical segment ROM, heterotopic ossification (HO) and ASD were used to evaluate the clinical and radiologic results. The indices abovementioned were compared between the two groups. Results: The VAS, NDI and JOA scores at each follow-up node in both ACDR and ACDF group were all significantly improved when compared with those before operation (all P<0.05), but there was no significant differences between the two groups (all P>0.05). Of all, 88.9%(24/27) of patients in ACDR group and 84.8%(28/33) of patients in ACDF group achieved excellent or good results, however, there was no significant difference in Odom's scale between the two groups (P>0.05). At the last follow-up, the cervical ROM in ACDR group was 43.2°±8.8°, which was slightly lower than that before operation (45.7°±10.4°), the difference was not statistically significant (t=0.954, P=0.345); the surgical segment ROM in ACDR group was 5.9°±3.6°, which was significantly reduced when compared with that before operation (8.8°±3.4°, t=3.043, P<0.01). However at the last follow-up, the cervical ROM in ACDF group was 36.4°±8.4°, which was significantly reduced when compared with that before operation (43.9°±11.1°), the difference was statistically significant (t=3.095, P<0.01). Although, there was no significant difference in the cervical ROM between the two groups before operation (t=0.643, P=0.523), and the difference was statistically significant at the last follow-up (t=3.054, P<0.01). At the last follow-up, the incidence of HO in ACDR group was 92.6%, and the high-grade HO was 37.0%. The incidence of ASD in ACDR group was 39.5%, which was much lower than that in ACDF group (61.1%, χ(2)=4.462, P=0.035). Conclusion: At minimum follow-up of 10 years, Bryan ACDR achieves a satisfactory clinical effect consistent with ACDF. In terms of advantages, ACDR could maintain the ROM of cervical and retain the ROM of the surgical segment, which reduces the occurrence of ASD by preserving motion.

[Impact of "Elaphurus davidianus return home project" on the transmission of schistosomiasis in Poyang Lake areas]

OBJECTIVE

To investigate the prevalence of Schistosoma japonicum infections in Elaphurus davidianus released to Poyang Lake areas and evaluate the impact of the project of "E. davidianus released to wild environments for natural reproduction and growth" "(E. davidianus return home project") on the transmission of schistosomiasis in Poyang Lake areas.

METHODS

During the period from April 2018 to December 2019, the population distribution, inhabiting activity and natural reproduction of E. davidianus released to Poyang Lake areas were investigated by means of GPS and artificial observations. The S. japonicum infection was identified in animal feces in E. davidianus inhabitats using a hatching test, and snail distribution was surveyed in E. davidianus inhabiting grass islands using a systematic sampling method.

RESULTS

A total of 51 E. davidianus were released to the Poyang Lake areas in 2018, which subsequently produced 5 E. davidianus habitats in Yinlong Lake, Longkou, Nanchi Lake, Lianzi Lake and Zhu Lake. E. davidianus was found to predominantly inhibit in grass islands, farmlands and forest lands in hilly regions around the Poyang Lake areas. The natural reproduction rate of E. davidianus was 25% in the habitats in 2019, and the mean density of snails was 0.009 to 0.039 snails/0.1 m² in E. davidianus inhabitats; however, no S. japonicum infection was identified in snails. In addition, the mean densities of wild E. davidianus and bovine feces were 4.6 samples/hm² and 2.1 samples/hm², Conclusions The E. davidianus released to Poyang Lake areas may get infections with S. japonicum, and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on and the prevalence of S. japonicum infection was 4.35% and 13.16% (P = 0.236), respectively; however, the intensities of S. japonicum infections were "+++" and "+", respectively.

CONCLUSIONS

The E. davidianus released to Poyang Lake areas may get infections with S. japonicum, and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on local schistosomiasis transmission and the response strategy requires to be investigated following the release of E. davidianus to lake regions, to ensure the achievement of the goal of schistosomiasis elimination and the successful implementation of the "E. davidianus return home project" in Poyang Lake areas.

[Effect of bone marrow mesenchymal stem cells on paraquat-induced pulmonary fibrosis in rats]

Objective: To study the effect of the injected bone marrow mesenchymal stem cells (BMSC) on rats with pulmonary fibrosis induced by paraquat (PQ) during different poisoning periods and explore the potential mechanism. Methods: From October to December 2018, BMSCs of SPF SD rats were isolated and purified by whole-bone marrow adherent culture method and cultured to the Third Generation (P3) . The surface antigens CD29, CD90, CD45 and CD34 of P3 BMSC were detected by Flow cytometry, the formation of alkaline phosphatase (ALP) , calcium nodules and fat droplets were observed by ALP, Alizarin Red staining and oil red O staining. At the same time, 36 SPF male rats were randomly divided into 6 groups: NC Group (Blank Control Group, injected with the same amount of saline) and PQ group (PQ model group, injected with 20% PQ solution 18 mg/kg intraperitoneally) , bMSC-A group, BMSC-B group, BMSC-C group and BMSC-D group were injected with BMSC suspension 1×10(6) cells/mice at 3 h、3 d、7 d and 14 d after PQ poisoning. After 28 days, the rats were killed, the lung organ coefficients were calculated, the hydroxyproline (HYP) content in lung tissue was calculated by alkaline hydrolysis, and the lung injury and fibrosis were observed by HE and Masson staining, serum TGF-1、TNF-α、MMP-9 and TIMP-1 were detected by Elisa. Results: High Purity BMSCs were successfully isolated and obtained. The P3 BMSC generation was positive expression of CD29、CD90、and negative expression of CD34、CD45, and had the potential of osteogenic and adipogenic differentiation. The results of HE staining and Masson staining showed that the alveolar structure in NC group was intact and homogeneous, in PQ group, the alveolar structure was severely damaged and a lot of collagen fibers and fibroblasts were deposited, and the degrees of lung injury in each BMSC intervention group were obviously less than in PQ group, in BMSC-A group and BMSC-B group, the degrees of reduction were obvious. Compared with NC group, the Lung organ coefficient, HYP content in lung tissue and TGF-β1, TIMP-1 levels in serum were significantly higher in PQ group (P<0.05) , while TNF-α and MMP-9 had no significant difference (P>0.05) . Compared with PQ group, the lung organ Coefficients, HYP, TGF-1 and TIMP-β1 in BMSC-A and BMSC-B groups were lower than those in PQ group (P<0.05) . The Lung organ coefficients, TGF-β1 and TIMP-1 in BMSC-C and BMSC-D groups were lower than those in PQ group, there was no significant difference (P>0.05) . Conclusion: Early BMSC injecting can alleviate pulmonary fibrosis induced by PQ. The mechanism may be that BMSC can reduce pulmonary fibrosis through reducing the level of TGF-β1 and regulating the balance of TIMP-1/MMP-9, threrby reducing inflammatory damage and increasing the degradation of extracellular matrix (ECM) .

[Detection of neuron-specific enolase in patients with subacute 1, 2-dichloroethane poisoning]

Objective: To investigate the changes of neuron-specific enolase (NSE) in serum and cerebrospinal fluid of patients with subacute 1, 2-dichloroethane (DCE) poisoning. Methods: Ten patients with subacute 1, 2-DCE poisoning hospitalized in Guangzhou 12th Municipal People's Hospital from December 2014 to March 2019 were taken as the subacute 1, 2-DCE poisoning group, 34 typical acute toxic encephalopathy patients hospitalized at the same time as typical acute toxic encephalopathy group, 40 healthy physical examinees as normal control group. The levels of serum NSE in patients of subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy group during onset and improvement were detected by chemiluminescence method, and the results were analyzed statistically. The level of NSE in cerebrospinal fluid of subacute 1, 2-DCE poisoning group was detected and analyzed its correlation with the level of NSE in serum. Using receiver operator characteristic (ROC) curve to analyze the diagnostic efficacy of NSE in subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy (area under curve, AUC) . Results: There was no significant difference between the serum NSE level of the patients with subacute 1, 2-DCE poisoning in the onset group and the normal control group and the improvement group (P>0.05) . The serum NSE level of subacute 1, 2-DCE poisoning in the improvement group was lower than those in the normal control group (P<0.01) . The serum NSE level of the subacute 1, 2-DCE poisoning in the onset group was lower than those in the typical acute toxic encephalopathy in the onset group (P<0.01) . There was no linear correlation between cerebrospinal fluid NSE and serum NSE in patients with subacute 1, 2-DCE poisoning (r=-0.183, P=0.52) . ROC curve showed that the AUC of serum NSE in diagnosing subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy were 0.661 and 0.726, respectively. Conclusion: There is no significant change in serum NSE in patients with subacute 1, 2-DCE poisoning.

[A 5-year follow-up study of pneumoconiosis patients with positive autoantibody]

Objective: To explore the progress of small shadow and the change of lung function in pneumoconiosis with positive autoantibody, so as to provide basis for clinical treatment of pneumoconiosis. Methods: A total of 756 patients were admitted to the pneumoconiosis department of the Guangzhou Occupational Disease Prevention Hospital from January 1, 2013 to June 1, 2019. The patients with combined infection were excluded. According to whether the autoantibody was positive, they were divided into positive group and negative group, 25 cases in each group. Follow-up observation of X-ray chest radiographs, chest CT, forced expiratory volume in one second (FEV(1)) and forced expired flow at 50% of FVC (MEF(50)) of pneumoconiosis patients for 5 years, to analyze the influence of positive autoantibody on the morphology of X-ray chest film, the pneumoconiosis promotion in 5 years and lung function. Results: There were 22 males and 3 females in the autoantibody positive group, aged 53.14±10.51 years. In the autoantibody negative group, there were 23 males and 2 females, aged 53.88±8.10 years. During the 5-year observation period, there was no significant difference of small shadow shape, pneumoconiosis stage, and the pneumoconiosis promotion in 5 years between the autoantibody positive group and the autoantibody negative group (P>0.05). However, the increment of small shadow area in the autoantibody positive group was higher than that in the autoantibody negative group (P<0.05). FEV(1) and MEF(50) of the autoantibody positive group were significantly lower than those of the autoantibody negative group in the fourth and third years, respectively (P<0.05). Positive autoantibody was negatively correlated with FEV(1) and MEF(50) (P<0.05). Conclusion: The positive autoantibody can't promote the progress of X-ray, but show more small shadows on chest CT; the positive autoantibody may aggravate the decline of lung function.

[Combined effect of noise and hand-transmitted vibration on noise-induced hearing loss in the automobile manufacturing industry]

Objective: To investigate the combined effect of noise and hand-transmitted vibration on noise-induced hearing loss (NIHL) in the automobile manufacturing industry. Methods: From September 2018 to January 2019, cluster sampling was used to select 998 workers in an automobile factory as study subjects, among whom 352 workers exposed to noise alone were enrolled as noise group, 342 workers exposed to noise and hand-transmitted vibration were enrolled as combined effect group, and 304 workers without exposure to occupational hazardous factors were enrolled as control group. A questionnaire survey and pure tone audiometry were performed for all study subjects. An analysis of variance was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a ordinal polytomous logistic regression analysis was used to investigate the influencing factors for NIHL (with 0.05 as the inclusion criteria and 0.10 as the exclusion criteria for independent variables) . Results: There was a significant difference in L(Aeq, 8 h) between groups (P<0.05) ; the noise group and the combined effect group had a significantly higher L(Aeq, 8 h) than the control group (P<0.05) , while there was no significant difference in L(Aeq, 8 h) between the noise group and the combined effect group (P>0.05) . The control group had a significantly lower detection rate of hearing loss than the noise group and the combined effect group (P<0.0125) , and the combined effect group had a significantly higher detection rate of hearing loss than the noise group (P<0.0125) . The ordinal polytomous logistic regression analysis showed that after adjustment for confounding factors such as age, working years, sex, smoking, and drinking, both noise exposure and exposure to both noise and hand-transmitted vibration had an influence on workers' hearing (P<0.05) , and the workers exposed to both noise and hand-transmitted vibration had a higher risk of hearing loss than those exposed to noise alone. Conclusion: There may be a combined effect of noise and hand-transmitted vibration in the automobile manufacturing industry, which can increase the risk of NIHL in workers.

[Analysis of quantitative changes of γδT cells in the peripheral blood of patients with chronic brucellosis]

Objective: To investigate the quantitative changes of γδT cells in peripheral blood before and after anti-Brucella treatment in patients with chronic brucellosis. Methods: A prospective design was used to 88 patients with chronic brucellosis who were admitted to the Second People's Hospital of Tianjin from September 2012 to April 2018. The patients took anti-brucella drugs, And the changes in the number of γδT cell, CD3(+), CD4(+), CD8(+)T lymphocytes and CD4/8 in peripheral blood before treatment, 6 weeks and 12 weeks after treatment were analyzed. Thirty volunteers were selected as the healthy control group from Tianjin Second People's Hospital employee health checkup in 2014. Results: After 6 weeks antibacterial therapy, the counts of CD3(+), CD4(+) and CD8(+)T lymphocytes were significantly lower than before treatment in patients with chronic brucellosis (P<0.05) . After 12 weeks antibacterial therapy, the counts of γδT cell, CD3(+), CD4(+) and CD8(+)T lymphocytes were significantly lower than before treatment (P<0.05) , but CD4/8 was higher than before treatment in patients with chronic brucellosis (P<0.05) . Compared with healthy control group, after 6 weeks antibacterial treatment, the γδT cell count was still significantly higher, but the CD4(+)T lymphocyte count was lower (P<0.05) . After 12 weeks treatment, the γδT cell count was still significantly higher than that of the healthy control group (P<0.01) . Conclusion: γδ T cells, CD4(+), CD8(+) and CD3(+)T lymphocytes may play a role in human body resistance to chronic Brucella infection.

[Effect of low dose ionizing radiation on peripheral blood cells of radiation workers in nuclear power industry]

Objective: To investigate the effects of long-term ionizing radiation on peripheral blood cells of nuclear power workers. Methods: In March 2019, a total of 530 radiation exposed workers in the nuclear power industry who underwent in-service radiation occupational health examination in Guangzhou occupational disease prevention and control hospital in 2018 and with service age ≥1 year were selected as the radiation group. At the same time, 545 workers in nuclear power industry were selected as control group. According to the methods and requirements of GBZ 235-2011 ＂technical specification for occupational health monitoring of radiation workers＂ and GBZ 98-2017 ＂health requirements for radiation workers＂, the occupational health monitoring data were collected, and the change rules of peripheral blood cells in the two groups were analyzed. Results: Compared with the control group, the total number of WBC, NEUT, LYMP, Hb, MCV and MCHC in radiation group were lower than those in control group (P<0.05) , and the difference was statistically significant (P<0.05) . The MPV increased significantly (P<0.05) . Compared with the control group, the abnormal rate of WBC and Hb in the radiation group was higher than that in the control group (P<0.01) , but there was no significant difference in the abnormal rate of RBC and PLT (P>0.05) . Conclusion: Low dose ionizing radiation has a certain cumulative damage effect on peripheral blood cells of radiation workers in nuclear power industry. The change rules of different cell subtypes are different, and the changes of WBC and PLT appear earlier.

[The clinical observation of external scleral plaque radiotherapy in patients with uveal melanoma]

Objective: To investigate the safety and efficacy of external scleral plaque radiotherapy (PRT) in the treatment of uveal melanoma (UM). Methods: This was a retrospective case series study. The data of 819 patients who underwent ophthalmic PRT from July 2007 to November 2017 at Tongren Hospital Affiliated to Beijing Capital Medical University was collected, including preoperative visual acuity, intraocular pressure and slit lamp microscope, color fundus photography, indirect ophthalmoscopy, color Doppler ultrasound, fundus fluorescein angiography, indocyanine green angiography, orbital nuclear magnetic resonance imaging, PRT times and time, complications, follow-up time, the maximum basal diameter and height of the tumor UM half a year after the applicator was removed, tumor metastasis rate, mortality and visual acuity observed at the last follow-up. The tumor growth was considered when the tumor height increased by 2.0 mm or the extension of any boundary of the tumor was 2.5 mm; otherwise, the treatment was defined as effective. The paired t test and Kaplan-Meier survival curve were used for statistical analysis. Results: There were 408 males and 411 females. The age ranged from 13 to 85 years (mean, 47 years). Nine patients had ciliary body melanoma, 43 patients had choroidal melanoma involving the ciliary body, and 767 patients had choroidal melanoma. In all 819 eyes, the tumor was medium-sized in 697 eyes and large in 110 eyes. All patients were treated with PRT only one time. The average radiotherapy time was 15 days (range, 6 to 50 d). All operations were successfully completed, with no active bleeding, infection, adjacent tissue injury and other related complications. At 6 months after the treatment, the maximum basal diameter of the tumor was (12.41±3.20) mm, which was significantly different from that before treatment (12.82±3.21) mm (t=2.40, P<0.01); the tumor height was (6.18±2.55) mm, which was significantly different from that before treatment (7.21±2.57) mm (t=4.05, P<0.01). The average follow-up time was (34±24) months (range, 1 to 125 months). Twenty-five patients lost follow-up at 2 years after the PRT, and 71 patients underwent enucleation. The effective rate of the PRT treatment was 88.3% (723/819), and the eyeball retention rate was 91.1% (723/794). The visual acuity remained stable in 393 eyes, decreased in 344 eyes, and improved in 82 eyes. Sixty patients had systemic metastasis (liver, bone or breast metastasis). Twenty-two patients died of tumor metastasis. The 5-year metastasis rate was 12.8%; the 5-year mortality rate was 5.8%; the 10-year metastasis rate was 20.6%; the 10-year mortality rate was 5.8%. Conclusions: PRT is safe and effective in the treatment for UM and can preserve some useful visual acuity. PRT can be used as the main treatment for medium-sized UM.(Chin J Ophthalmol, 2020, 56: 670-675).

[Probiotics enhance the efficacy of fecal microbiota transplantation in severe acute liver injury]

Objective: To observe the changes of gut flora in mice, and explore the outcome of fecal microbiota transplantation combined with probiotics in the intervention of severe acute liver injury. Methods: Forty male BALB/c mice were selected and randomly divided into blank control group (10 mice), model group (10 mice), ordinary fecal microbiota transplantation group (10 mice), and fecal microbiota + probiotics transplantation group (10 mice). An intraperitoneal injection of d-galactosamine (D-GalN 3.0g/kg) was given to every group except the blank control group to induce severe acute liver injury model. Simultaneously, ordinary fecal microbiota transplantation group and fecal microbiota + probiotics transplantation group and modeling group were given enema solutions (once a day). After 48 hours, fetched serum was taken to detect alanine transaminase, aspartate transaminase and total bilirubin, and liver tissue was taken for pathological detection. The colonic content was used to extract DNA for 16S V3-V4 high-throughput sequencing. The results of sequencing were analyzed by using bioinformatics analysis; including OTU cluster analysis, α diversity analysis, β diversity analysis, and linear discriminant analysis effect size (Lefse) to find the bacteria with different colonic content characteristics in different groups of mice. Differences in clinical biochemical indicators between groups were compared using t-test, and the differences between 16S V3-V4 region sequencing results were compared using Wilcoxon test. Results: Model group mice serum biochemical parameters were higher than the other three groups, and the difference was statistically significant (P < 0.05). HE staining of liver sections showed severe inflammatory changes under the microscope in the model group. Ordinary fecal microbiota transplantation group and fecal microbiota + probiotic microbiota transplantation group had low levels of inflammation than the model group. The analysis results of 16S rRNA high-throughput sequencing showed that there was no statistically significant difference in Shannon's index between the blank control and the other three groups. Observed Species difference was statistically significant, and the gut flora composition varied greatly. Species number in the mice gut flora was increased with fecal microbiota transplantation. The results of β - diversity analysis showed that the difference between the blank control group and the other three groups was greater than that between the disease groups. The difference in the structure of the gut flora of the diseased mice in the fecal microbiota + probiotic transplantation group was mostly butyrate-producing bacteria. Conclusion: Fecal microbiota + probiotics enhance the therapeutic effect of fecal microbiota transplantation, improve liver inflammation, and increase the number of butyrate-producing bacteria in the gut.

[Analysis of treatment response and prognostic factors of T-LBL patients treated with pediatric-like ALL therapy following HSCT]

目的

探讨经急性淋巴细胞白血病（ALL）儿童方案治疗达到完全缓解（CR）和部分缓解（PR）的T淋巴母细胞淋巴瘤（T-LBL）患者应用造血干细胞移植巩固治疗的疗效及预后因素。

方法

收集2013年1月至2017年1月于唐都医院血液病中心接受治疗的T-LBL患者的临床资料，将达到CR或PR的患者纳入研究，进行回顾性分析。

结果

①48例患者接受了ALL儿童方案治疗，经2个疗程的诱导化疗后39例达CR，9例达PR。其中接受自体造血干细胞移植（auto-HSCT）者14例，接受异基因造血干细胞移植（allo-HSCT）者7例，21例患者移植后造血功能均顺利重建。②中位随访时间31（9～16）个月。3年总生存（OS）率为61.0%（95% CI 53.7%～68.3%），3年无进展生存（PFS）率为54.8%（95% CI 47.1%～62.2%）。③移植组和未移植组3年OS率分别为84.7%和42.8%（P＝0.006），两组3年PFS率分别为75.4%和38.9%（P＝0.004）。④auto-HSCT组与allo-HSCT组患者的OS率、PFS率差异均无统计学意义（P值分别为0.320、0.597）。⑤骨髓侵犯、未接受造血干细胞移植是影响患者长期预后的独立危险因素［ HR＝5.804（95% CI 1.140～29.549），P＝0.034；HR＝5.871（95% CI 1.711～20.140），P＝0.005］。

结论

ALL儿童方案化疗序贯造血干细胞移植治疗T-LBL疗效确切，安全性好。auto-HSCT与allo-HSCT患者的OS率及PFS率差异均无统计学意义。骨髓侵犯、未接受造血干细胞移植是影响T-LBL患者长期预后的独立危险因素。

Spin-structures of the Bose-Einstein condensates with three kinds of spin-1 atoms

We have performed a quantum mechanic calculation (including solving the coupled Gross-Pitaevskii equations to obtain the spatial wave functions, and diagonalizing the spin-dependent Hamiltonian in the spin-space to obtain the total spin state) together with an analytical analysis based on a classical model. Then, according to the relative orientations of the spins S_A, S_B and S_C of the three species, the spin-structures of the ground state can be classified into two types. In Type-I the three spins are either parallel or anti-parallel to each other, while in Type-II they point to different directions but remain to be coplanar. Moreover, according to the magnitudes of S_A, S_B and S_C, the spin-structures can be further classified into four kinds, namely, p + p + p (all atoms of each species are in singlet-pairs), one species in f (fully polarized) and two species in q (a mixture of polarized atoms and singlet-pairs), two in f and one in q, and f + f + f. Other combinations are not allowed. The scopes of the parameters that supports a specific spin-structure have been specified. A number of spin-structure-transitions have been found. For Type-I, the critical values at which a transition takes place are given by simple analytical formulae, therefore these values can be predict.