Post-traumatic growth among emergency nurses after COVID-19 in Shanghai, China: a qualitative study

OBJECTIVES

This study aims to investigate the post-traumatic growth of emergency nurses (ENs) in Shanghai, China, in 2022 following the COVID-19 pandemic.

DESIGN

A phenomenological qualitative research approach was employed, with 17 ENs being interviewed between July and August 2022. Data collection was conducted through semistructured, in-depth interviews, and data analysis was carried out using the Colaizzi's seven-step analysis method.

SETTING

A third-level hospital in Shanghai.

PARTICIPANTS

A total of 17 ENs were interviewed through face-to-face, semistructured, in-depth interviews.

RESULTS

Three main themes and eight subthemes were extracted from the data: (a) stress, (b) restructuring and (c) growth.

CONCLUSION

Significant stress was imposed on ENs by the Shanghai COVID-19 pandemic, but cognitive restructuring was successfully undergone by them, leading to the experience of growth. It is recommended that post-traumatic growth levels be enhanced through professional psychological counselling and tailored support measures for different stages.

The Role of Radiotherapy in Patients with Refractory Hodgkin Lymphoma after Brentuximab Vedotin and -/or Immune Checkpoint Inhibitors

PURPOSE/OBJECTIVE(S)

Brentuximab vedotin (BV) and immune checkpoint inhibitors (ICIs) had important roles in the treatment of relapse or refractory (R/R) Hodgkin lymphoma (HL). Treatment of refractory disease after BV and -/or ICIs remains a challenge. This study was conducted to evaluate the efficacy and safety of radiotherapy for R/R HL after failure to BV or ICIs.

MATERIALS/METHODS

We retrospectively analyzed patients in two institutions with R/R HL who had failed after first-line therapy, and were refractory to BV or ICIs, and received radiotherapy (RT) thereafter. The overall response rate (ORR), duration of response (DOR), progression-free survival (PFS) and overall survival (OS) were analyzed.

RESULTS

A total of 19 patients were enrolled. First-line systemic therapy consisted of ABVD (84.2%), AVD + ICIs (10.5%) and BEACOPP (5.3%), respectively. After first-line therapy, 15 patients (78.9%) were refractory, and 4 patients (21.1%) relapsed. After diagnosis of R/R HL, 8 patients (42.1%) received BV, and 17 patients (89.5%) received ICIs. RT was delivered in all 19 patients who failed after BV or ICIs. In 16 efficacy-evaluable patients, the ORR and CR rate were 100% and 100%. The median DOR was 17.2 months (range, 7.9 to 46.7 months). 3 patients progressed at outside of the radiation field. The in-field-response rate was 100%. The 12-month PFS and OS were 84.4% and 100%, respectively. No patients were reported with sever adverse events.

CONCLUSION

This study concluded that radiotherapy was effective and safe for refractory HL after BV or ICIs. Further prospective studies were warranted.

Promotion factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai: a qualitative study

BACKGROUND

Since March 2022, Shanghai, China, has experienced a severe wave of SARS-CoV-2 transmission caused by the Omicron variant strain. The pandemic has severely constrained the local healthcare system. After treating critically ill COVID-19 patients, emergency nurses may experience some positive changes due to new insights or gains in their work, even if they have had traumatic experiences. This study aimed to explore the promoting factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai. We hoped to provide a new perspective and theoretical basis for intervening in and promoting the psychological rehabilitation of medical staff after traumatic circumstances.

METHODS

This study employed a qualitative design based on the phenomenological approach. 18 participants from the emergency department of a third-level class-A hospital in Shanghai who participated in treating COVID-19 patients were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. The seven-step Colaizzi process was used for data analysis.

RESULTS

The investigation uncovered two themes and six subthemes. Internal factors contained self-affirmation, deliberate rumination, and cognitive restructuring, which constituted attitudes and behaviours that participants could subjectively determine. External factors included social support, transformational leadership, and role modelling, which constituted factors influenced by others or the environment.

CONCLUSIONS

The promoting factors of PTG of emergency nurses originated from different sources such as individuals, organizations, and society. In addition to good psychological adjustment of the individual, society, hospitals, and nursing managers should focus on establishing supportive PTG strategies. The ultimate purpose is to improve the retention rate and career growth of nurses.

Evaluation of a ^{88}Sr^{+} Optical Clock with a Direct Measurement of the Blackbody Radiation Shift and Determination of the Clock Frequency

We report on an evaluation of an optical clock that uses the ^{2}S_{1/2}→^{2}D_{5/2} transition of a single ^{88}Sr^{+} ion as the reference. In contrast to previous work, we estimate the effective temperature of the blackbody radiation that shifts the reference transition directly during operation from the corresponding frequency shift and the well-characterized sensitivity to thermal radiation. We measure the clock output frequency against an independent ^{171}Yb^{+} ion clock, based on the ^{2}S_{1/2}(F=0)→^{2}F_{7/2}(F=3) electric octupole (E3) transition, and determine the frequency ratio with a total fractional uncertainty of 2.3×10^{-17}. Relying on a previous measurement of the ^{171}Yb^{+} (E3) clock frequency, we find the absolute frequency of the ^{88}Sr^{+} clock transition to be 444 779 044 095 485.277(59) Hz. Our result reduces the uncertainty by a factor of 3 compared with the previously most accurate measurement and may help to resolve so far inconsistent determinations of this value. We also show that for three simultaneously interrogated ^{88}Sr^{+} ions, the increased number causes the expected improvement of the short-term frequency instability of the optical clock without degrading its systematic uncertainty.

Evaluation of safety and efficacy of inhaled ambroxol in hospitalized adult patients with mucopurulent sputum and expectoration difficulty

Background

Ambroxol is a widely used mucoactive drug in sputum clearance of respiratory diseases taken orally and by injection. However, there is a paucity of evidence for inhaled ambroxol in sputum clearance.

Methods

This study performed a multicenter, randomized, double-blind, placebo-controlled, phase 3 trial at 19 centers in China. Hospitalized adult patients with mucopurulent sputum and expectoration difficulty were recruited. Patients were randomized by 1:1 to receive inhalation of either ambroxol hydrochloride solution 3 mL (22.5 mg) + 0.9% sodium chloride 3 mL or 0.9% sodium chloride 6 mL twice daily for 5 days, with an interval of more than 6 h. The primary efficacy endpoint was the absolute change in the sputum property score after treatment compared to the baseline in the intention-to-treat population.

Results

Between 10 April 2018 and 23 November 2020, 316 patients were recruited and assessed for eligibility, of whom 138 who received inhaled ambroxol and 134 who received a placebo were included. Patients who received inhaled ambroxol had a significantly greater decrease in the sputum property score compared with patients who received inhalation of placebo (difference: -0.29; 95% CI: -0.53 to -0.05; p = 0.0215). Compared with the placebo, inhaled ambroxol also significantly reduced more expectoration volume in 24 h (difference: -0.18; 95% CI: -0.34 to -0.03; p  = 0.0166). There was no significant difference in the proportion of adverse events between the two groups, and no deaths were reported.

Discussion

In hospitalized adult patients with mucopurulent sputum and expectoration difficulty, inhaled ambroxol was safe and effective for sputum clearance compared with a placebo.

Clinical trial registration

[https://www.chictr.org.cn/showproj.html?proj=184677], Chinese Clinical Trial Registry [ChiCTR2200066348].

A mini-review on the emerging role of nanotechnology in revolutionizing orthopedic surgery: challenges and the road ahead

An emerging application of nanotechnology in medicine currently being developed involves employing nanoparticles to deliver drugs, heat, light, or other substances to specific types of cells (such as cancer cells). As most biological molecules exist and function at the nanoscale, engineering and manipulating matter at the molecular level has many advantages in the field of medicine (nanomedicine). Although encouraging, it remains unclear how much of this will ultimately result in improved patient care. In surgical specialties, clinically relevant nanotechnology applications include the creation of surgical instruments, suture materials, imaging, targeted drug therapy, visualization methods, and wound healing techniques. Burn lesion and scar management is an essential nanotechnology application. Prevention, diagnosis, and treatment of numerous orthopedic conditions are crucial technological aspects for patients' functional recovery. Orthopedic surgery is a specialty that deals with the diagnosis and treatment of musculoskeletal disorders. In recent years, the field of orthopedics has been revolutionized by the advent of nanotechnology. Using biomaterials comprised of nanoparticles and structures, it is possible to substantially enhance the efficacy of such interactions through nanoscale material modifications. This serves as the foundation for the majority of orthopedic nanotechnology applications. In orthopedic surgery, nanotechnology has been applied to improve surgical outcomes, enhance bone healing, and reduce complications associated with orthopedic procedures. This mini-review summarizes the present state of nanotechnology in orthopedic surgery, including its applications as well as possible future directions.

Study on the Relationship Between Bronchoalveolar Lavage Fluid Cell Count, Th1/Th2 Cytokines and Pulmonary Function in Patients with Cough Variant Asthma

OBJECTIVE

This study aimed to compare lung function and airway inflammation among cough variant asthma (CVA), chronic cough and classical asthma (CA) and investigate the relationship between these indicators and their possible mechanisms of action in the progression of CVA to CA.

METHODS

36 patients with chronic cough, 39 patients with CA, and 57 patients with CVA were included in this study. Pulmonary function tests, bronchial provocation tests and FeNO tests were performed. The patients' bronchoalveolar lavage fluid (BALF) was collected, the cells in BALF were counted, and the levels of Th1 and Th2 cytokines were detected.

RESULTS

The neutrophils, lymphocytes, and eosinophils in BALF in the CA and CVA groups were significantly higher than those in the chronic cough group. Also, they were negatively correlated with FEV1, FVC, and FEV1/FVC and positively correlated with IgE and FeNO. The expression of Th2-related cytokines was increased in CVA and CA patients, and it was positively correlated with FEV1, FVC and FEV1/FVC and negatively correlated with IgE and FeNO, while the results of Th1-related cytokines were the opposite of those for Th2-related cytokines.

CONCLUSION

CVA differs from asthma and chronic cough in terms of Th1/Th2 cytokines and lung function and provides a reference for understanding the disease mechanism of early clinical progression of CVA to CA.

Post-traumatic growth experience of first-line emergency nurses infected with COVID-19 during the epidemic period-A qualitative study in Shanghai, China

Background

In March 2022, Shanghai, China, was hit by a severe wave of SARS-CoV-2 transmission caused by the Omicron variant strain. The medical staff was greatly infected during this period, which posed a traumatic event for them. Meanwhile, they also experience post-traumatic growth under introspection and positive change. However, the psychological coping and growth after infection with COVID-19 among medical staff have rarely been investigated.

Objectives

To explore the process and influencing factors of post-traumatic growth among emergency nurses infected with coronavirus disease (COVID-19) so as to provide a new perspective and theoretical basis for psychological rehabilitation or intervention for medical staff who experienced traumatic events.

Methods

The study used a qualitative design based on the phenomenological approach. A purposive sampling method was used to explore the subjective feelings and post-traumatic growth among 13 first-line emergency nurses infected with COVID-19 in Shanghai, China. Semi-structured face-to-face interviews were conducted in June 2022. A Seven-step Colaizzi process was used for data analysis.

Results

Themes were described and extracted from the experience and insights at different stages during the fight against the virus. Three main themes, i.e., stress period, adjustment period, and growth period, as well as several sub-themes, were identified.

Conclusion

First-line emergency nurses infected with COVID-19 are a sensitive group that should be given more attention. Investigating how they achieve psychological adjustment and growth in the case of severe trauma can provide valuable references for nursing management and education in the future. Society, hospital and nursing managers should pay more attention to the PTG of nurses and establish supportive PTG strategies, which will benefit the retention rate and career development of nurses.

Occupational benefit perception of acute and critical care nurses: A qualitative meta-synthesis

Background

With the development of society, nurses have an increasingly more important role in the medical team. At the same time, due to various reasons, the number of active nurses is continuously decreasing, and the shortage of nursing personnel is becoming ever more serious. The COVID-19 pandemic made these clinical problems more serious. As the department with the greatest work pressure and the most intense pace, acute and critical care nurses are already facing serious problems related to job burnout and dismission. In the context of the COVID-19 pandemic, these problems should be solved urgently. Furthermore, with the rise of positive psychology, many scholars are turning their research direction to the positive professional experience of nurses so as to get inspiration to encourage nurses to face work with an optimistic attitude and guide nursing managers to better retain nursing talents.

Objective

The purpose of this paper is to summarize and evaluate the positive emotional experience and professional benefit of acute and critical care specialist nurses in the process of work. So as to better interpret their occupational benefit perception and guide nursing managers in adopting positive measures and promoting the development of high-quality nursing.

Methods

Cinahl plus, Embase, Medline and other twelve databases were searched for relevant literature. Meta-aggregation was used to synthesize the findings of the included studies.

Results

From a total of 12 articles included in this study, 55 main results were presented, 8 new categories were integrated, and three themes were formed: professional identity, social support, and personal growth. The professional identity included: being proud of professional ability and increasing professional value; social support included: friends and family support, organizational, environmental support, peer support, and support of patients and their families; personal growth included realizing self-worth and promoting self-development.

Conclusion

Hospital managers should pay attention to the positive emotional experience of nurses in work and based on this, provide practical and beneficial protection for nurses from the aspects of salary, learning opportunities, working environment, social support and internal personality, stimulate work enthusiasm, guide nurses to correctly face negative emotions and occupational pressure, and improve the sense of professional benefit.

Nursing students' experience during their practicum in an intensive care unit: A qualitative meta-synthesis

Background

Clinical practicum provides nursing students with more opportunities to learn their professional knowledge and develop basic nursing skills. Intensive care unit (ICU) is often used as one of the clinical practicum departments for nursing students. Due to the characteristic fast-paced working environments, high acuity of patient care, and technical complexities of an ICU, nursing students are more susceptible to experiencing stress and lack of confidence in these settings, which hinders their professionalization and affects patient care.

Objective

The study aimed to summarize and evaluate the nursing students' experience in an ICU during their practicum and to provide a supportive ICU clinical practicum environment for them. One of the main objectives was to increase the ICU specialty nurse reserve and improve nursing care in the ICU.

Methods

The following databases were searched for related qualitative publications in Chinese and English by systematic searches across January 2022, including the nursing students' experience in ICU during their practicum: PubMed, Cochrane Library, Web of Science, and so on. The qualitative meta-synthesis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Two reviewers independently selected these studies and carefully evaluated the quality of each study. Meta-synthesis was then used to summarize the results.

Results

Eleven sub-themes and 3 themes were revealed in 9 studies: challenges of clinical practicum in the ICU, the expectation of support from multiple sources, and the importance and necessity of practicum in the ICU.

Conclusion

Performing one's practicum in ICU was considered by the nursing students in this review as a beneficial practicum despite the challenges involved. The appropriate guidance and monitoring should be given by hospital managers and college educators.

Psychological resilience of emergency nurses during COVID-19 epidemic in Shanghai: A qualitative study

Background

In early 2022, an outbreak of Coronavirus Disease 2019 (COVID-19) occurred in Shanghai, China. The spread of the epidemic put a large amount of stress on the local healthcare system, especially emergency nurses (ENs), which may affect their well-being and performance. Enhancing the psychological resilience of ENs during COVID-19 pandemic may improve job satisfaction, retention, and public health emergency response. However, few studies have researched the perception and psychological resilience of ENs during COVID-19 pandemic.

Objective

To understand ENs' perception and psychological resilience and their coping strategies with adversity during COVID-19 in Shanghai, as well as factors associated with psychological resilience.

Methods

This qualitative study was conducted using a phenomenological approach. A total of 17 ENs from a 3rd level hospital in Shanghai were selected using a method of purposive sampling. Between April and May 2022, in-depth semi-structured interviews and Colaizzi seven-step method were performed for data collection and analysis.

Results

The investigation discovered three themes and nine subthemes. The first theme is "risk factors." Risk factors for ENs to remain resilience are sudden multiplication of workload, stressful of screening of infected patients, and the support nurses being unfamiliar with the procedure. The second theme is "promoting factors." ENs emphasized the importance of management assurance and humanistic care, as well as social support. They recognized adversity and resilience, and used self-management strategies to cope with the situation. The third theme is "motivated by altruism." ENs were driven by altruism to respond to adversity with a positive attitude. They realized their self-worth by helping patients with a sense of sacred mission.

Conclusions

Psychological resilience is not a stable psychological characteristic but a constantly changing process that is affected by internal and external factors. Enhancing resilience of ENs during the COVID-19 pandemic may improve work satisfaction, retention, and public health emergency response. Adequate preparation before a pandemic, reasonable arrangement, a trustworthy working atmosphere, encouragement and improvement of individual and collective strategies for nurses to cope with adversity, timely rewards, and nurse empowerment, as well as counseling and training, can be used to enhance psychological resilience of ENs.

Supply-demand matching of medical services at a city level under the background of hierarchical diagnosis and treatment - based on Didi Chuxing Data in Haikou, China

BACKGROUND

Implementation of the Healthy China Strategy and the hierarchical diagnosis and treatment system has injected new vitality into medical services. Given the insufficient supply of medical services and increasing demand for medical treatment, exploring the supply-demand pattern of medical services has become an urgent theoretical and practical problem to be solved. The equity of healthcare facilities has received widespread attention, but due to limited data, there is little research on the supply-demand pattern of medical services. This study focuses on evaluating the supply-demand matching pattern of medical services at different levels in Haikou City with big geographic data and promoting the realization of a balance between medical supply and demand.

METHODS

This study utilizes spatial data of medical institutions, Didi Chuxing Data, and population density data. Firstly, use the two-step floating catchment area method and GIS spatial analysis to explore characteristics of the supply-demand patterns of medical services at different levels in Haikou. Secondly, we mine residents' demand for medical treatment based on Didi Chuxing Data. Then combined with population density data, divide supply-demand matching of medical institutions into four types. Finally, propose optimization strategies for the problems.

RESULTS

The accessibility pattern of high-level medical institutions in Haikou presents high in the north and low in the south. The accessibility pattern of low-level medical institutions is the opposite. High-level medical institutions have a strong demand for medical treatment, which is less hampered by distance. The healthcare demand of low-level medical institutions is small, and they mainly are medium- and short-distance medical travel. The types of medical services at different levels are mainly "low supply - low demand" and "high supply - low demand" types.

CONCLUSIONS

Medical services at different levels in Haikou are mainly in supply-demand imbalance. Therefore, we put forward optimization strategies to promote the equity of primary medical services, such as propelling the establishment and improvement of the hierarchical diagnosis and treatment system, building a new model of medical and health service supply, and strengthening balanced coverage of primary medical institutions. The mining of big geographic data is beneficial to alleviate the mismatch between medical supply and demand, although the data and methods need to be improved.

[Interventional effect of asiaticosdide on rats exposed to silica dust]

Objective: To investigate the effect of asiaticoside for fibrosis in lung tissues of rats exposed to silica and to explore its possible mechanism. Methods: 144 SD male rats were randomly divided into control group, model group, positive drug control group, asiaticoside high-dose group, medium-dose group and low-dose group, each group included 24 rats. Rats in the control group were perfused with 1.0 ml of normal saline, and the other groups were given 1.0 ml 50 mg/ml SiO(2) suspension. Gavage of herbal was given from the next day after model establishment, once a day. Rats in the positive drug control group were administration with 30 mg/kg tetrandrine and rats in the low-dose group, medium-dose group and high-dose group were given 20 mg/kg, 40 mg/kg and 60 mg/kg asiaticoside for fibrosis respectively. Rats in the control group and the model group were given 0.9% normal saline. The rats were sacrificed in on the 14th, 28th and 56th day after intragastric administration and collect the lung tissues to detect the content of hydroxyproline, TGF-β(1) and IL-18, observe the pathological changes of the lung tissues by HE and Masson staining and determine the expressions of Col-I, a-SMA, TGF-β in lung tissues by Western Blot. Results: On the 14th day, 28th day and 56th day after model establishment, the lung tissues of rats in the model group showed obvious inflammatory response and accumulation of collagen fibers, and the degree of inflammation and fibrosis increased with time. The intervention of asiaticoside could effectively inhibit the pathological changes of lung tissues. The contents of hydroxyproline, IL-18 and TGF-β1 in lung tissues of model group were higher than those in the control group (P<0.05) , while the level of hydroxyproline, IL-18 and TGF-β1 in asiaticoside groups were significantly decreased, and the difference was statistically signicant (P<0.05) . Compared with the control group, the expression levels of Col-I, TGF-β1and α-SMA in lung tissue of model group were increased (P<0.05) , while the expression level of Col-I, TGF-β1 and α-SMA were decreased after the intervention of asiaticoside, and the difference was statistically signicant (P<0.05) . Conclusion: Asiaticoside can inhibit the increase of Col-I, TGF-β1 and α-SMA content in the SiO(2)-induced lung tissues of rats, reduce the release of TGF-β1 and IL-18 inflammatory factors in lung tissue, and then inhibit the synthesis and deposition of extracellular matrix in rat lung tissue, and improve silicosis fibrosis.

The expression of cytokeratin and apoptosis-related molecules in echinococcosis related liver injury

The study aimed to investigate the expression of cytokeratin and apoptosis-related molecules in the livers of two types of hepatic echinococcosis mice models and to preliminarily explore the relationship between the expression of cytokeratin and apoptosis in echinococcosis related liver injury. We established a mouse model infected by Echinococcus granulosus and Echinococcus multilocularis and observed the expression of cytokeratin and apoptosis related proteins in the two types of hepatic echinococcosis tissues during different stages by immunohistochemical staining. A co-culture model was established using normal hepatocytes and different concentrations of E. granulosus and E. multilocularis protoscoleces. Cell Counting Kit-8 was used to detect cell proliferation, flow cytometry was used to detect hepatocyte apoptosis, and western blot was used to quantify cytokeratin and apoptosis-related proteins, such as caspase3, caspase9, Bcl-2, and Bax. Surgical specimens were obtained from patients with hepatic echinococcosis to analyze the expressions of cytokeratin, caspase3, caspase9, Bcl-2, and Bax by western blot. The expressions of cytokeratin and caspase3 were analyzed by immunohistochemistry. The qRT-PCR method was used to determine the expression of CK8 and CK18 in the liver tissues. In vivo experiments showed that compared to that in the control group, the cytokeratin and caspase3 proteins in the liver tissues of the two types of hepatic echinococcosis were strongly expressed around the lesions of liver echinococcosis; there was a difference between cytokeratin expression of the two different echinococcosis parasites in the liver. Echinococcus granulosus and Echinococcus multilocularis in the co-culture model in vitro could promote the expression of CK, caspase3, caspase9, and Bax protein, decrease the expression of Bcl-2, promote hepatocyte apoptosis, and inhibit cell proliferation; in clinical samples, we found that compared with that in the normal tissues, the expression of cytokeratin, caspase3, caspase9, and Bax in echinococcus tissues was high, but that in Bcl-2 was low. Furthermore, the expression of CK8 and CK18 mRNA were higher in echinococcus tissues than that in the normal tissues and immunohistochemistry analysis also showed that cytokeratin and caspase3 levels were higher in echinococcus tissues than that in the normal tissues. The expression of cytokeratin and apoptosis-related molecules, reflecting liver damage, is high in the liver and is caused due to hepatic echinococcosis. This study provides the first evidence of cytokeratin could be useful for evaluating liver tissue damage caused by echinococcus infection.

[Interventional effect of metformin on pulmonary inflammation and pulmonary fibrosis in silicotic rats]

Objective: To investigate the interventional effect of metformin on pulmonary inflammation and pulmonary fibrosis in silicotic rats. Methods: In April 2019, 48 Wistar male rats of SPF grade were randomly divided into negative control group, metformin control group, silicon dioxide (SiO₂) model group, low, medium and high dose metformin intervention group according to the random number table method, 8 rats in each group. The SiO₂ model group and the low, medium and high dose metformin intervention groups were given 1 ml 50 mg/ml of SiO₂ by intratracheal instillation, the negative control group and the metformin control group were given 1 ml normal saline by intratracheal instillation. 24 hours later, the low, medium and high dose metformin intervention groups and the metformin control group were treated with 100, 200, 400 and 400 mg/kg metformin daily, the control and SiO₂ model groups received normal saline daily. Then the rats were sacrificed at the 28th day after SiO₂ exposure. The changes of rat body weight and pathological examination of rat lung tissue were observed, and the lung organ coefficient, the content of hydroxyproline (HYP) , the expression levels of inflammatory factors transforming growth factor beta1 (TGF-β1) , tumor necrosis factor-alpha (TNF-α) , interleukin-1beta (IL-1β) and the protein expression of E-cadherin (E-Cad) , Vimentin, α-SMA were detected. Results: Compared with the negative control group, SiO₂ model group had a significant decrease in the body weight of rats (P<0.05) , lung organ coefficient, alveolitis and fibrosis scores, HYP content and the levels of TGF-β1, TNF-α, IL-1β were all significantly increased (P<0.05) . Compared with the SiO₂ model group, the weights of the rats in the medium and high dose intervention group of metformin increased significantly (P<0.05) . And after intervention with different doses of metformin, the lung organ coefficient, alveolitis and fibrosis scores, HYP content and the levels of TGF-β1, TNF-α and IL-1β were significantly decreased (P<0.05) . Immunohistochemistry and Western blotting results showed that compared with the negative control group, the expression of E-Cad of the SiO₂ model group was decreased, and the expression levels of Vimentin and α-SMA were significantly increased (P<0.05) . After metformin intervention, the expression of E-Cad was significantly increased, the expression levels of Vimentin and α-SMA were significantly decreased (P<0.05) . Conclusion: Metformin can reduce lung tissue inflammation and fibrosis in rats exposed to SiO₂ dust, which may be related to reducing the expression of inflammatory factors in lung tissue and inhibiting the EMT process.

[Diagnosis, treatment and outcome of adnexal torsion at different gestational weeks during pregnancy]

Objective: To investigate the clinical characteristics, diagnosis, treatment and outcome of adnexal torsion at different gestational weeks during pregnancy. Methods: A retrospective analysis was conducted of the clinical data of 24 pregnancy patients with adnexal torsion, aged 21-38 (30.6±4.4) years old, who were admitted and delivered in Peking University Third Hospital from 2015 to 2019. According to the gestational age, all patients were divided into two groups:<28 weeks group (11cases) and ≥28 weeks group (13 cases), to compare the intergroup differences in clinical characteristics, treatment and outcome, and the differences of clinical data and outcome between two groups were compared. Results: The proportion of patients with twin pregnancy and assisted reproductive technology in the<28 weeks group was significantly higher than that in the ≥28 weeks group (5/11 vs 1/13, 8/11 vs 1/13, P<0.05). No significant differences between the two groups were recorded in terms of the size of the adnexal mass, the cycles of torsion and the duration from onset to operation. Compared with the≥28 weeks group, the adnexal removal rate of the<28 weeks group was lower (3/11 vs 6/13), but the difference was not statistically significant. The proportion of blood flow signals of ultrasound before operation, cases undergoing laparoscopic surgery and cases whose pathological findings were physiological cysts in the<28 weeks group were significantly higher than that in the ≥28 weeks group (8/11 vs 4/13, 8/11 vs 0, 8/11vs 4/13; P<0.05). Concerning the pregnancy outcomes, there was no difference in the mode of delivery, the delivery gestational age and the body weight of newborns between the two groups. Conclusions: The patients with adnexal torsion prior to 28 weeks(<28 weeks)of pregnancy were more likely to be conceived by assisted reproductive technologies, and the etiology was more likely to be ovarian physiological cysts. Both laparoscopy and laparotomy were safe and effective in the treatment of adnexal torsion with good outcome for mother and infant in the study.

[Investigation on occupational hazards in 20 automobile manufacturing enterprises in Shandong Province]

Objective: To investigate the current situation of occupational hazards in automobile manufacturing enterprises in Shandong Province. Methods: From February to May 2019, the convenience sampling method was adopted to conduct on-site occupational health surveys with 20 automobile manufacturing enterprises in Shandong Province as the survey subjects, to detect the occupational hazard factors in the workplaces and individual exposure levels, and to analyze the occupational health check results of operators. Results: There were 13 small-sized, 4 medium-sized and 3 large-sized enterprises among the 20 automobile manufacturing enterprises. The detection results of benzene and toluene in the workplaces met the occupational exposure limits, and the detection results of welding fumes, manganese and its compounds, and xylene exceed the occupational exposure limits. The maximum short-term exposure concentration (C(STE)) of welding fume in the air of workplaces was 24.23 mg/m(3), and the over-standard rate was 11.0% (16/146) . The maximum time-weighted average concentration (C(TWA)) of welding fume of operators is 10.60 mg/m(3), and the over-standard rate was 11.0% (8/73) . The maximum C(STE) of manganese and its compounds in the air of workplaces was 0.879 mg/m(3), and the of manganese and its compounds of operators was 0.175 mg/m(3), and the over-standard rate was 5.7% (4/70) . The maximum xylene C(STE) in the air of workplaces was 230.00 mg/m(3), and the over-standard rate was 3.9% (2/51) . The maximum xylene C(TWA) of operators was 70.40 mg/m(3), the over-standard rate was 3.6% (1/28) . Among the 4775 workers exposed to occupational hazards, 38 (0.80%) were suspected of electric welder's pneumoconiosis, 27 (0.57%) were suspected of manganese poisoning and 31 (0.65%) were suspected of chronic low-concentration benzene and benzene series poisoning. The detection rates of suspected occupational diseases among workers in small and medium-sized enterprises were relatively high, 2.86% (30/1048) and 4.51% (51/1132) respectively. There was a statistically significant difference in the detection rates of suspected occupational diseases among the operators of different scale automobile manufacturers (P<0.05) . Conclusion: The exposure levels of electric welding fumes, manganese and its compounds in welding jobs and xylene exposure levels in spray painting jobsin Shandong Province's automobile manufacturing enterprises are more serious. The supervision and management of occupational hygiene should be strengthened, the working environment should be improved, and the health of welding and painting workers should be protected.

Improved Limits for Violations of Local Position Invariance from Atomic Clock Comparisons

We compare two optical clocks based on the ^{2}S_{1/2}(F=0)→^{2}D_{3/2}(F=2) electric quadrupole (E2) and the ^{2}S_{1/2}(F=0)→^{2}F_{7/2}(F=3) electric octupole (E3) transition of ^{171}Yb^{+} and measure the frequency ratio ν_{E3}/ν_{E2}=0.932829404530965376(32), improving upon previous measurements by an order of magnitude. Using two caesium fountain clocks, we find ν_{E3}=642121496772645.10(8)  Hz, the most accurate determination of an optical transition frequency to date. Repeated measurements of both quantities over several years are analyzed for potential violations of local position invariance. We improve by factors of about 20 and 2 the limits for fractional temporal variations of the fine structure constant α to 1.0(1.1)×10^{-18}/yr and of the proton-to-electron mass ratio μ to -8(36)×10^{-18}/yr. Using the annual variation of the Sun's gravitational potential at Earth Φ, we improve limits for a potential coupling of both constants to gravity, (c^{2}/α)(dα/dΦ)=14(11)×10^{-9} and (c^{2}/μ)(dμ/dΦ)=7(45)×10^{-8}.

[Research progress of ferroptosis-related mechanism and diseases]

Ferroptosis is a new programmed cell death characterized by iron dependent and intracellular oxidative accumulation. Current studies have confirmed that ferroptosis is involved in the occurrence and development of neurotoxicity injury, tumors, cardiovascular diseases and other diseases. This paper reviews the mechanisms of ferroptosis and its role in related diseases based on recent studies.

Coherent Suppression of Tensor Frequency Shifts through Magnetic Field Rotation

We introduce a scheme to coherently suppress second-rank tensor frequency shifts in atomic clocks, relying on the continuous rotation of an external magnetic field during the free atomic state evolution in a Ramsey sequence. The method retrieves the unperturbed frequency within a single interrogation cycle and is readily applicable to various atomic clock systems. For the frequency shift due to the electric quadrupole interaction, we experimentally demonstrate suppression by more than two orders of magnitude for the ^{2}S_{1/2}→^{2}D_{3/2} transition of a single trapped ^{171}Yb^{+} ion. The scheme provides particular advantages in the case of the ^{171}Yb^{+} ^{2}S_{1/2}→^{2}F_{7/2} electric octupole (E3) transition. For an improved estimate of the residual quadrupole shift for this transition, we measure the excited state electric quadrupole moments Θ(^{2}D_{3/2})=1.95(1)ea_{0}^{2} and Θ(^{2}F_{7/2})=-0.0297(5)ea_{0}^{2} with e the elementary charge and a_{0} the Bohr radius, improving the measurement uncertainties by one order of magnitude.

Effect of miR-29c on renal fibrosis in diabetic rats via the AMPK/mTOR signaling pathway

OBJECTIVE

To explore the effect of micro-ribonucleic acid (miR)-29c on renal fibrosis in diabetic rats through the adenosine 5'-monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) signaling pathway, and to investigate its related mechanism by the research on the effect of miR-29c on the expression of fibrosis-related genes.

MATERIALS AND METHODS

The rat model of diabetic nephropathy (DN) was established, and the levels of fasting blood glucose (FBG), 24 h urine protein (24h-Pro), blood urea nitrogen (BUN), and serum creatinine (sCr) were monitored. After the rats were executed, kidney tissues were dissected, stained with paraffin and embedded in hematoxylin and eosin (H&E). Then, Western blotting was used to detect the levels of miR-29c, phosphorylated-AMPK (p-AMPK), α-smooth muscle actin (α-SMA), tumor necrosis factor-α (TNF-α), and macrophage migration inhibitory factor (MIF). The human renal tubular epithelial HK-2 cell line was treated with high glucose (HG) to simulate DN cell status in vivo. After that, the expressions of miR-29c and the renal fibrosis marker α-SMA were examined via Western blotting. Finally, the level of α-SMA was measured by Western blotting after HG treatment combined with miR-29c silencing.

RESULTS

The levels of FBG, BUN, sCr, and 24h-Pro in DN model rats were significantly higher than those in rats of control group. The data manifested that the DN model was successfully established. The expression level of miR-29c in DN model rats was markedly increased and that of the downstream protein p-AMPK also exhibited a significantly increasing trend. In addition, the levels of α-SMA, TNF-α, and MIF were elevated. The expression levels of miR-29c and α-SMA were increased markedly after the human renal tubular epithelial HK-2 cell line was treated with HG, but the expression of α-SMA was reduced after HG treatment combined with miR-29c silencing for 24 h.

CONCLUSIONS

MiR-29c is probably related to the occurrence and development of DN. Besides, miR-29c silencing may inhibit the DN renal fibrosis through AMPK/mTOR signals, so miR-29c may be an effective target for the treatment of DN renal fibrosis.

Effects of the prebiotic inulin-type fructans on post-antibiotic reconstitution of the gut microbiome

AIMS

Interventions using prebiotic inulin-type fructans (ITFs) are widely prescribed to modulate the gut microbiota composition and activity to promote health. However, the impacts of ITFs on post-antibiotic reconstitution of the gut microbiome remain incompletely understood. The aim of the present study was to investigate the effects of ITFs supplementation on intestinal inflammation, the composition of the intestinal microbiota and the colonic transcriptome after antibiotic treatment.

METHODS AND RESULTS

Male BALB/c mice were subjected to an antibiotic cocktail (ABx) treatment for 7 days, and their microbiomes were then reconstituted either spontaneously or with ITFs supplementation (5%) for 14 days. Our data showed that ITFs supplementation delayed the recovery of antibiotic-induced colitis compared with the spontaneous recovery. Neither ITFs supplementation nor spontaneous recovery could restore the microbial community composition at the genus level back to its initial composition. ITFs supplementation increased the relative abundance of some beneficial bacteria and butyrate levels, but resulted in selective blooms of some opportunistic pathogens and elevated the pathways associated with diseases linked to gut microbiota function. Both ITFs supplementation and spontaneous recovery could restore the colonic transcriptome nearly to the initial profile to a certain extent; however, ITFs supplementation delayed the restoration of the immunoglobulin genes compared to spontaneous recovery.

CONCLUSION

These data showed that post-antibiotic ITFs consumption did not always lead to beneficial effects but might lead to potential adverse effects in the context of dysbiosis.

SIGNIFICANCE AND IMPACT OF THE STUDY

These findings highlighted that caution is required when supplementing ITFs to restore intestinal homeostasis in the context of dysbiosis resulting from broad-spectrum antibiotics.

[Analysis of the relationship between the changes of lung function and serum proinflammatory cytokines in workers occupationally exposed to toluene diisocyanate]

Objective: To analyze the correlation between the changes of lung function and serum proinflammatory cytokines in workers occupationally exposed to toluene diisocyanate (TDI), and to explore the evaluation index of respiratory toxicity of TDI. Methods: In October 2014, 61 male workers engaged in TDI synthesis process, purification process, packaging process and the above production process in a TDI factory in western China were selected as TDI exposure group; 62 male enterprise managers who were not exposed to TDI and other known allergenic chemicals were selected as control group, which were matched at the age of workers in exposure group. The questionnaire survey obtained information such as gender, length of service, age, occupational history, exposed length of service and so on. The lung function indexes [forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC] and serum levels of interleukin (IL)-1 β, IL-6, IL-8, tumor necrosis factor (TNF)-α, macrophage inflammatory factor-1 β, monocyte chemoattractant factor-1 and vascular endothelial growth factor were measured. The urine was collected after the weekend shift, and the concentration of (TDA), the metabolite of TDI, was determined as the index of internal exposure. Spearman rank correlation was used to analyze the correlation between cytokines and lung function indexes, and multivariate linear regression was used to analyze the changes of lung function indexes and cytokines with TDI exposure concentration and time. Results: The median age (P₅-P₉₅) of the exposed group and the control group was 36.5 (24.0-51.0) and 38.0 (24.0-50.0) years, respectively. In the exposed group, the median length of service (P₅-P₉₅) was 6.94 (0.97-26.33) years, and the median concentration of TDA in urine was 15.56 (2.28-112.16) ng/ml. The three indexes of lung function, FVC, FEV1, FEV1/FVC and the levels of serum IL-8 and TNF-α were significantly lower than those in the control group (P<0.01). With the increase of exposure concentration and exposure time, the level of serum TNF-α, FVC and FEV1 decreased, and showed a good dose-effect and time-effect relationship (all P_trend values< 0.05). Serum IL-8 and TNF-α were positively correlated with FVC, FEV1 and FEV1/FVC (all P values<0.01). Conclusion: The levels of serum inflammatory factors IL-8 and TNF-α in worker exposed to TDI are related to lung function indexes, which can be used as early evaluation indexes of respiratory toxicity induced by TDI.

[An investigation of occupational exposure to welding fume, manganese, and manganese compounds in a large container manufacturing enterprise]

Objective: To investigate the current status of the occupational hazards of welding fume, manganese, and manganese compounds in the welding environment of a large container manufacturing enterprise, as well as the status of occupational health examination of workers, and to provide a basis for improving the welding environment of this enterprise. Methods: In August 2016, July 2017, and August 2018, convenience sampling was used to perform an on-site occupational hygiene survey of the welding workshop for three consecutive years, and welding fume, manganese and, manganese compounds (counted as manganese dioxide) were measured for their workplace exposure concentrations and exposure levels in workers. A comprehensive analysis was performed for the results of occupational health examination. Results: Welding fume, manganese, and manganese compounds in the welding environment gradually increased from 2016 to 2018 (χ(2)(trend)=5.14 and 5.54, P<0.05). The maximum over-standard rate of concentration-short term exposure limit was 43.3% (13/30) for welding fume and 40.0% (12/30) for manganese and its compounds, and the maximum over-standard rate of time-weighted average concentration was 26.7% (8/30) for welding fume and 23.3% (7/30) for manganese and its compounds. Abnormalities were observed in the occupational health examination of welding workers in 2016-2018, among which respiratory system abnormalities (cough, expectoration, and wheezing), nervous system abnormalities (dizziness, fatigue, sleep disorders, amnesia, hyperhidrosis, and palpitations), and electrocardiogram abnormalities (bundle conduction block) had an incidence rate of above 10.0%, and the incidence rate of abnormalities on posterior-anterior X-ray high-kV chest radiograph was close to 8.9% (30/336) . Conclusion: There is severe exposure to welding fume, manganese, and manganese compounds among workers in this enterprise, which cause great hazards to the health of workers. It is necessary to strengthen occupational health management, take measures to improve the welding environment, and enhance occupational disease prevention.

Effect of peak power enhancement of ferrite phase shifter from full-height to increased-height rectangular waveguide

In order to enhance the high-power performance of the ferrite phase shifter (PS), a method of increasing waveguide height is proposed and experimentally demonstrated. Dual-toroid geometry is utilized as a high-power structure. Two configurations of X-band PSs with full-height (FH) and increased-height (IH) waveguides are designed and fabricated while keeping other parameters consistent. Comparative analysis based on simulation and high-power experiments is conducted. The simulation results agree well with experiments. Compared with the FHPS, the IHPS can enhance the peak-power-capacity from 90 kW to 140 kW while maintaining almost the same insertion loss of 0.5 dB with a slight increase in differential phase shift from 360° to 380°.

Potential protein biomarkers for systemic lupus erythematosus determined by bioinformatics analysis

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disorder, and its pathogenesis in males and in cases without accompanying lupus nephritis (LN^-) is not fully understood. In this study, we identified 90 (82 up- and 8 downregulated) differentially expressed genes (DEGs) common to female LN^-, female LN⁺ and male LN⁺ using the GSE65391 and GSE49454 gene expression datasets from Gene Expression Omnibus database (GEO). The protein-protein interaction (PPI) network of 70 DEGs was constructed using STRING and cytoscape, and the Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis showed that the PPI network was significantly enriched in defense response to virus, cytosol, protein binding and measles. Sixteen hubgenes were identified from this PPI network, and Literature Mining Gene Networks molecular of GenCLiP 2.0 showed strong interaction between STAT1, DDX58 and IFIT1. Enrichment analysis of hubgenes in published literature showed the involvement of immune response and interferon-related genes in the pathogenesis of SLE. In addition, the transcription factors STAT1 & 2 and IRF6 & 9 had high Normalized Enrichment Score (NES). The 70 DEGs with PPI network and 16 hubgenes are potential biomarkers of SLE, and can help improve diagnosis and develop individualized therapies.

[Analysis of occupational health surveillance for workers on offshore platforms]

Objective: To understand the status of occupational health surveillance for workers on offshore platforms. Methods: The research period was from 2014 to 2016. From 2014 to 2016, a cross-sectional survey method was adopted to select 429 people for offshore oil production, drilling and operation platforms and their first-line workers to conduct workplace occupational hygiene. Investigation, occupational hazard factor testing, occupational health check of workers, collation and statistical analysis of surveys and test data, and comparison of occupational health surveillance among workers of different types of offshore platforms. Results: From 2014 to 2016, the results of chemical harmful factors detection of occupational diseases in the offshore platform were in line with the national occupational health exposure limit requirements. The noise of some platform posts exceeded the standard, such as: oil platform oil, oil and oil and gas processing workers, diesel engines for drilling and working platforms. Worker noise exceeds national occupational health limits p[L(ex, 8 h)>85 dB(A)].There was a statistically significant difference in the occupational health of workers on the same platform with the age and length of service (P<0.05). Conclusion: Workers on different platforms at sea may be subject to different levels of occupational health damage, and the occupational hazards brought by noise to platform workers are particularly prominent.

[Expression changes of miRNA-29b-3p and miRNA-34c-3p in lung tissue of rats exposed to silica and A549 cells]

Objective: To investigate the role of microRNA-29b-3p (miRNA-29b-3p) and miRNA-34c-3p in the process of pulmonary fibrosis, we detected the expression levels of miRNA-29b-3p and miRNA-34c-3p in the lung tissue of rats exposed to silica and A549 cells. Methods: SPF male Wistar rats were randomly divided into 1, 7, 14, 21, 28 d control group and silica (SiO(2)) dusting group, with 6 rats in each group. One-time non-exposure method was used to infuse 1ml SiO(2) suspension. The rat SiO(2) dusting group was established in the liquid, and the control rats were intratracheally injected with 1 ml of sterile physiological saline in the same manner. The lung tissues of each group were collected at the corresponding time points after dusting. Three of the rats were taken out for pathological observation, and the other three were used to screen differentially expressed miRNAs in lung tissue by miRNA microarray technology. A549 cells were cultured at the in vitro cell level and divided into control group, SiO(2) stimulation group and TGF-β(1) stimulation group, and cells were collected at 12, 24 and 48 h after treatment. The expression levels of miRNA-29b-3p and miRNA-34c-3p in rat lung tissue and A549 cells were verified by real-time PCR (qRT-PCR), target gene prediction of miRNA-29b-3p and miRNA-34c-3p and perform GO enrichment analysis and KEGG pathway analysis. Results: The weight growth rate of the control group was significantly higher than that of the SiO(2) dusting group. Compared with the control group, the lung mass and lung coefficient of the SiO(2) dusting group were significantly increased (P<0.05). The inflammatory response of the lungs in the control group was significantly reduced at 21 and 28 days, and the inflammatory cells infiltrated in the lung tissue of the SiO2 group. The rats in the control group had a small amount of collagen at 21 and 28 days. A large amount of collagen fiber deposition began to appear in the lung tissue of rats exposed to SiO(2) for 21 days. Compared with the control group, the expression levels of miRNA-29b-3p and miRNA-34c-3p in the SiO(2) dusting group were significantly down-regulated, and there was significant difference compared with the control group (P<0.05). The expression levels of miRNA-29b-3p and miRNA-34c-3p in A549 cells treated with SiO(2) and human recombinant TGF-β1 were significantly lower than those in the control group at 24 h and 48 h, and the difference was statistically significant (P<0.05). Conclusion: Down-regulation of miRNA-29b-3p and miR-34c-3p in rat lung tissue A549 cells may be associated with the development of early silicosis and is expected to be an indicator of early silicosis diagnosis and prognosis.

[Preliminary analysis of differential expression of miRNA-423-5p and miRNA-26a-5p in lung tissue of early silicotic rats]

Objective: To screen the changes of microRNA (miRNA) expression profiles in lung tissues of early silicosis rats, and provide a basis for functional analysis of differential microRNA. Methods: SPF Wistar male rats were randomly divided into a negative control group and SiO(2)-exposed groups, with 30 rats in each group. The model of silicosis in rats was established by intratracheal instillation of 1 ml SiO(2) suspension, and the control rats were treated with 1mL in the same way to sterilize normal saline. The lung tissues of two group were collected at the 1, 7, 14, 21, 28 d after SiO(2)-exposed. Three of the rat lung tissues were used for pathological observation, and the other three were used to screen differentially expressed miRNAs in lung tissue by miRNA microarray technology. miRNA chip screening and RT-qPCR were used to verify the expression levels of miRNA-423-5p and miRNA-26a-5p in the two groups. miRNA-423-5p and miRNA-26a-5p are predicted by target genes and analyzed by GO (gene ontology) enrichment analysis and KEGG (kyoto encyclopedia of genes and genomes) pathway analysis. Results: In the control group, the inflammatory response of lung tissue 21 and 28 days was significantly reduced compared with 1, 7 and 14 days, and the inflammatory cells infiltrated in the lung tissue of the SiO(2)-exposed rats. The rats in the control group had a small amount of collagen at 21 and 28 days, but a large amount of collagen fiber deposition began to appear in the lung tissue of rats exposed to SiO(2) after 21 days. Compared with the control group, the expression levels of micro RNA-423-5p was significantly up-regulated and the expression of microRNA-26a-5p was significantly down-regulated in the SiO(2)-exposed rats lung tissues dust at different time points (P<0.05) . Conclusion: The up-regulation of miRNA-423-5p and the down-regulation of miRNA-26a-5p in lung tissues of early silicotic rats may be related to the occurrence and development of early silicosis.

[Repair effect of adipose-derived mesenchymal stem cells on lung injury in rats exposed to silica]

Objective: To observe the repairing effect of adipose mesenchymal stem cells (ADSCs) on lung injury induced by silica in rats. Methods: Primary ADSCs-GFP was obtained from rats. ADSCs-GFP was injected into tail vein of silicosis model rats. The expression of green fluorescence in lungs was observed regularly to determine the homing ability of ADSCs. Primary ADSCs of rats were obtained and randomly divided into control group, exposure group, vehicle group and ADSCs group. Silicosis rat model was established by non-exposed tracheal drip method. 24 hours after silica exposure, rats in ADSCs group were injected with ADSCs of 1×10(6)/kg body weight through tail vein, and the pathological changes of lung tissue were observed and evaluated 28 days after intervention. To explore the early intervention mechanism of ADSCs on pulmonary fibrosis in silicosis model rats, apoptosis-related proteins were detected by immunohistochemistry. Results: 28 days after exposure to silica, rats in the exposure group showed obvious pulmonary fibrosis. Compared with exposure group and vehicle group, ADSCs group showed less pulmonary inflammation, less silica nodules and less collagen deposition area. Immunohistochemical results showed that the expression of Caspase-3 and cytochrome C protein decreased and Bcl-2 protein increased after ADSCs transplantation. Conclusion: ADSCs infusion has an obvious intervention effect on postponing early silicosis fibrosis in rats exposed to silica, and its mechanism is related to the regulation of apoptotic process.

[Research of relationship between occupational exposure to coal tar pitch workers and cytogenetic damage]

Objective: To investigate the effect of coal tar pitch occupational exposure on the cytogenetic damage. Methods: In July 2015, 691 workers exposed to coal tar pitch were selected as contact group. The administrative and the support crew 201 cases were selected as control group. Detect the tail DNA% and tail moment in peripheral blood lymphocyte as DNA damage degree by single cell gel electrophoresis (SCGE) . Detect the concentration of the metabolic product in urine by HPLC/MC as exposure levels. Results: The contact group were significantly higher than the control group in tail DNA% (contact group14.44%, control group 11.17%) and olive tail moment (contact group 2.85 μm, control group 1.95 μm) . The smoking one (contact group18.51%, control group13.43%) were significantly higher than the group not smoking (contact group12.69%, control group 11.71%) in tail DNA%. The coal tar pitch content in the air of workplace have correlation with worker, stail DNA% (r(s)=0.10) and olive tail moment (r(s)=0.11) . Conclusion: Occupational exposure to coal tar pitch and smoking can cause cytogenetic damage to workers.

Gastric Adenocarcinoma Predictive Long Intergenic Non-Coding RNA Promotes Tumor Occurrence and Progression in Non-Small Cell Lung Cancer via Regulation of the miR-661/eEF2K Signaling Pathway

Background/Aims: Long non-coding RNAs (lncRNAs) play vital roles in carcinogenesis as oncogenes or tumor suppressor genes. This study explored the biological function of lncRNA gastric adenocarcinoma predictive long intergenic non-coding RNA (GAPLINC) in human non-small cell lung cancer (NSCLC). Methods: GAPLINC expression in NSCLC specimens and cell lines was detected by qRT-PCR and Western blot. The effect of GAPLINC on cell proliferation was investigated using CCK8-assay, colony formation assay, and xenograft model. The effects of GAPLINC on apoptosis and cell cycle were determined using flow cytometry. The mechanism of GAPLINC involved in NSCLC was explored using Western blot, luciferase reporter assay, and RNA fluorescence in situ hybridization. Results: We found that GAPLINC expression was up-regulated in NSCLC tissues and cell lines. Overexpression of GAPLINC was associated with poor prognosis in patients with NSCLC. Silencing of GAPLINC significantly inhibited cell proliferation, promoted apoptosis, and induced cell cycle arrest in the G0/G1 phase. Results from xenograft transplantation showed that GAPLINC silencing inhibited the tumor growth in vivo. Interestingly, GAPLINC silencing decreased the expression of eukaryotic elongation factor-2 kinase (eEF2K) protein both in vivo and in vitro. Bioinformatic analysis and luciferase reporter confirmed that miR-661 targeted GAPLINC and eEF2K 3’-UTR and was negatively correlated with the expression of GAPLINC and eEF2K. Conclusion: Our findings indicate that GAPLINC promotes NSCLC tumorigenesis by regulating miR-661/eEF2K cascade and provide new insights for the pathogenesis underlying NSCLC and potential targets for therapeutic strategy.

[A case of systemic lupus erythematosus in pregnancy complicated by pulmonary hypertension]

To investigate the pathophysiology, screening, diagnosis and treatment of the systemic lupus erythematosus (SLE) in pregnancy complicated with pulmonary hypertension. Retrospective analysis was made of one case of SLE in pregnancy complicated with pulmonary hypertension in Peking University Third Hospital. Literature was reviewed to investigate the pathophysiology, screening, diagnosis and treatment of the SLE in pregnancy complicated with pulmonary hypertension. SLE is an autoimmune mediated diffuse connective tissue disease characterized by immunological inflammation. The incidence of SLE combined with pulmonary hypertension was low, but the risk was high with pregnancy, with a high perinatal mortality rate. Pulmonary hypertension is the leading cause of the death in patients with pregnancy complicated with SLE. This patient was diagnosed with SLE six years before and was hospitalized for 29 weeks of menopause, with fatigue five months and chest congestion one month. Ultrasonic cardiogram showed severe pulmonary hypertension, with pulmonary arterial systolic pressure being 96 mmHg. After admission, multidisciplinary consultation was organized to draw up a diagnosis and treatment plan. The patient received the treatment of rest,oxygen,blood gas and pulmonary artery pressure monitoring. Considering perioperative pulmonary hypertension crisis likely to occur, pulmonary artery catheter was placed preoperatively. In general anesthesia, the cesarean was performedfter operation,the patient was transferred to the intensive care unit, with the treatment of expanding blood vessels, reducing pulmonary artery pressure,administering anticoagulation and preventing infection. Ten days after operation, the patient was discharged from hospital with smooth condition. Strengthening the management of SLE patients in pregnancy, early detection, and cooperation of multidisciplinary teams can help improve maternal and fetal outcomes. Termination of pregnancy should be offered to the patients with severe pulmonary hypertension. Right cardiac catheterization is the gold standard for diagnosing pulmonary hypertension. Some patients are diagnosed in later stage of pregnancy, regular antenatal examination, interdisciplinary co-operation, assessment of cardiac function, monitoring the condition of the pregnant woman and fetus and timely termination of pregnancy are needed. Epidural anesthesia is the appropriate choice for cesarean delivery.

Global commitments and China's endeavors to promote health and achieve sustainable development goals

BACKGROUND

With its immense population and as the largest developing country in the world, China has made remarkable achievements in health promotion at a relatively low cost. However, China is still faced with challenges such as changes of disease spectrum, the coming era of an aging society, and the risk of environmental pollution.

MAIN TEXT

On October 25, 2016, China formally passed the blueprint of "Healthy China 2030," working towards the national goal of reaching a health standard on par with developed countries by 2030, which was also a response to realize the 2030 United Nations Sustainable Development Goals. "Healthy China 2030" is comprised of 29 chapters that cover five health areas. China is sparing no effort to transfer from being merely the most populous country, to becoming a leading nation in health education. In "Healthy China 2030," collaborated construction and resource sharing were clearly stated as the core strategy. A shift in concentration towards coordinated development of health-based economy from a previous pursuit of rapid economic growth was also underlined. There are also several major issues, such as severely aging population, the burden of chronic diseases, the insufficiency of health expenditure, and the great demand on health protection, waiting to be dealt with during the implementation process of "Healthy China 2030".

CONCLUSIONS

"Healthy China 2030" is a momentous move to enhance public health, which is also a response to the global commitments. We also need to rethink our approach to reach the living standards and maintain a better environment.

Protective influence of rosiglitazone against testicular ischaemia-reperfusion injury in rats

Testicular torsion is a urology urgent disease which causes testicular injury and potential sterility. In this study, we explored the protective influence of rosiglitazone on testicular ischaemia-reperfusion damage. There were 28 male Sprague Dawley rats in total, which were assigned randomly to four groups. Group A was blank control one; group B was testicular injury one; group C was rosiglitazone one; group D was rosiglitazone antagonist one. The testicles were counter-rotated after 2 hr and then underwent orchiectomy 24 hr later. We found that testicular tissue structure of rats was seriously damaged in groups B and D. However, group C had better testicular architecture. Similar findings were also shown for lipid peroxidation by evaluating the MDA activity (p < .05). Unlike group B or group D, the levels of inflammation by evaluating the MPO activity, the levels of TNF-a, IL-1 and IL-6 and the expressions of ICAM-1 were prominently lower in group C (p < .05) as well. So our researches demonstrated that rosiglitazone significantly decreased the amount of responsive oxygen radical and regulated inflammatory responses. Rosiglitazone had a protective influence against testicular ischaemia-reperfusion injury in rats and possibly depended on its anti-inflammatory and antioxidant traits.

Healthy China 2030, a breakthrough for improving health

China has the largest population in the world, and its health levels have greatly affected the healthy development of the population of the world. Healthy China 2030 is a breakthrough for ensuring that the Chinese population have access to health, through advocating the whole society's participation in the concept of "Health for All, and All for Health." The plan puts forward five strategies such as popularizing healthy life, optimizing the health service, improving health protection, building a healthy environment, and developing healthy industry, from the perspectives of health effects of personal life and behavior, health care and security, production, and the living environment. As a national guide for public health promotion, we briefly describe the main intentions of Healthy China 2030, and give some commentaries from a health promotion perspective.

Custom Repair of Mandibular Bone Defects with 3D Printed Bioceramic Scaffolds

Implanting artificial biomaterial implants into alveolar bone defects with individual shape and appropriate mechanical strength is still a challenge. In this study, bioceramic scaffolds, which can precisely match the mandibular defects in macro and micro, were manufactured by the 3-dimensional (3D) printing technique according to the computed tomography (CT) image. To evaluate the stimulatory effect of the material substrate on bone tissue regeneration in situ in a rabbit mandibular alveolar bone defect model, implants made with the newly developed, mechanically strong ~10% Mg-substituted wollastonite (Ca_90%Mg_10%SiO₃; CSi-Mg10) were fabricated, implanted into the bone defects, and compared with implants made with the typical Ca-phosphate and Ca-silicate porous bioceramics, such as β-tricalcium phosphate (TCP), wollastonite (CaSiO₃; CSi), and bredigite (Bred). The initial physicochemical tests indicated that although the CSi-Mg10 scaffolds had the largest pore dimension, they had the lowest porosity mainly due to the significant linear shrinkage of the scaffolds during sintering. Compared with the sparingly dissolvable TCP scaffolds (~2% weight loss) and superfast dissolvable (in Tris buffer within 6 wk) pure CSi and Bred scaffolds (~12% and ~14% weight loss, respectively), the CSi-Mg10 exhibited a mild in vitro biodissolution and moderate weight loss of ~7%. In addition, the CSi-Mg10 scaffolds showed a considerable initial flexural strength (31 MPa) and maintained very high flexural resistance during soaking in Tris buffer. The in vivo results revealed that the CSi-Mg10 scaffolds have markedly higher osteogenic capability than those on the TCP, CSi, and Bred scaffolds after 16 wk. These results suggest a promising potential application of customized CSi-Mg10 3D robocast scaffolds in the clinic, especially for repair of alveolar bone defects.

New strategies to improve the health of Chinese people by 2030

In October 2016, the leadership team of the Communist Party of China (CPC) adopted a plan aiming to build a healthy China over the next 15 years. The strategic tasks, mainly focused on promoting healthy lifestyles, optimising health services, improving health protection, building a healthy environment and developing the health industry, were proposed to deal with the health problems faced by China. According to the plan, China's health plan is likely to undergo a major change.

Changing nitrogen deposition with low δ15N−NH4 + and δ15N−NO3 − values at the Experimental Lakes Area, northwestern Ontario, Canada

Ammonium deposition at the International Institute for Sustainable Development Experimental Lakes Area (IISD–ELA), in northwestern Ontario, Canada, has doubled in the last 45 years and thus is no longer among the low nitrogen (N) deposition sites in North America. This may be related to the concurrent intensification of Manitoba agriculture to the west and upwind of the ELA. Large increases in ammonium deposition at the ELA were important in driving the observed trend and increased the NH4 + to NO3 − ratio of input to aquatic and terrestrial systems. Stable isotope analyses of two years of bulk (wet and dry) atmospheric deposition revealed very large ranges in δ15N−NH4 + (22‰ range), δ15N−NO3 − (18‰), and δ18O–NO3 − (19‰). Few other δ15N−NH4 +, δ15N−NO3 −, and δ18O–NO3 − values have been published for Canadian precipitation. Increases in δ15N of NH4 + and NO3 − in July occurred with increases in total N deposition. The wide range and seasonal trends of δ15N and δ18O values in ELA precipitation mean that studies characterizing N inputs to watersheds and lakes require an ongoing and comprehensive annual sampling regime. Global trends of declining δ15N of N deposition evident in lake sediment records may be a result of increases in NH4 + deposition with lower δ15N−NH4 + values. Similarly, the relationship in Lake Superior between increasing NO3 − and lower δ15N−NO3 − values may be explained by increased atmospheric deposition of N with low δ15N values.