Effect of miR-141-5p/ZNF705A on adhesion of bone marrow mesenchymal stem cells in chronic myeloid leukemia cell-derived exosomes / 中国药理学通报

Aim To investigate the effect of miR-141-5p/ZNF705A in chronic myeloid leukemia(CML)cell-derived exosome(Exo)on the adhesion of bone marrow mesenchymal stem cells(BMSCs). Methods The morphology and size of Exo in peripheral blood from CML patients and K562 cells were examined by electron microscopy and NTA particle size analysis. The expressions of Exo and BMSCs marker molecules and adhesion proteins in K562 cells were detected by qRT-PCR and Western blot before and after transfection. The adhesion ability of BMSCs was detected by cell adhesion assay, and the cellular activity of BMSCs was examined using CCK-8. miR-141-5p binding to ZNF705A was detected by luciferase assay. Results qRT-PCR results showed that miR-141-5p expression was significantly reduced in both CML patients and K562 cell-derived Exo. qRT-PCR, Western blot and other results showed that BMSCs in CML patients had significantly reduced the expression of adhesion proteins CD44 and CXCL12, and were able to phagocytose K562 cell-derived Exo. Further, K562-derived Exo was found to reduce CD44 and CXCL12 expression and adhesion in Exo-promoted BMSCs compared with CD34+ cells. Meanwhile, the results of dual luciferase reporter assay verified that miR-141-5p targeted binding to ZNF705A. Finally, we found ZNF705A could be targeted by up-regulating miR-141-5p expression in Exo of K562 cells, which in turn inhibited the adhesion of BMSCs. Conclusions K562 cells down-regulate miR-141-5p expression in Exo and inhibit the adhesion function of BMSCs by targeting ZNF705A, thus regulating the bone marrow hematopoietic function in CML patients.

Baimai Ointment relieves chronic pain induced by chronic compression of dorsal root ganglion in rats by regulating neuroactive ligand-receptor interaction and HIF-1 signaling pathway / 中国中药杂志

The Baimai Ointment with the effect of relaxing sinew and activating collaterals demonstrates a definite effect on Baimai disease with pain, spasm, stiffness and other symptoms, while the pharmacodynamic characteristics and mechanism of this agent remain unclear. In this study, a rat model of chronic compression of L4 dorsal root ganglion(CCD) was established by lumbar disc herniation, and the efficacy and mechanism of Baimai Ointment in the treatment of CCD were preliminarily explored by behavioral tests, side effect evaluation, network analysis, antagonist and molecular biology verification. The pharmacodynamic experiment indicated that Baimai Ointment significantly improved the pain thresholds(mechanical pain, thermal pain, and cold pain) and gait behavior of CCD model rats without causing tolerance or obvious toxic and side effects. Baimai Ointment inhibited the second-phase nociceptive response of mice in the formalin test, increased the hot plate threshold of normal mice, and down-regulated the expression of inflammatory cytokines in the spinal cord. Network analysis showed that Baimai Ointment had synergistic effect in the treatment of CCD and was related to descending inhibition/facilitation system and neuroinflammation. Furthermore, behavioral tests, Western blot, and immunofluorescence assay revealed that the pain-relieving effect of Baimai Ointment on CCD may be related to the regulation of the interaction between neuroactive ligand and receptors(neuroligands) such as CHRNA7, ADRA2A, and ADRB2, and the down-regulation of the expression of NOS2/pERK/PI3K, the core regulatory element of HIF-1 signaling pathway in spinal microglia. The findings preliminarily reveal the mechanism of relaxing sinew and activating collaterals of Baimai Ointment in the treatment of Baimai disease, providing a reference for the rational drug use and further research of this agent.

Signal detection and analysis of the adverse events of ustekinumab based on OpenFDA database / 中国药房

OBJECTIVE To analyze the risk of adverse drug reaction of ustekinumab， so as to provide reference for rational drug use in clinic. METHODS The adverse events （AE） reports related to ustekinumab included in the FDA public data program （OpenFDA） database were analyzed after marketing （from September 25th 2009 to December 30th 2021）. The risk signals were mined for top 100 AE by the method of reporting odds ratio （ROR） and proportional reporting ratio （PRR）. RESULTS A total of 62 356 AE reports related to ustekinumab were retrieved， male patients （51.79%） were more than female patients （39.51%）. Results of ROR method and PRR method showed that 31 suspicious signals were mined， mainly infections and infectious diseases （9 kinds）， general disorders and administration site conditions （5 kinds）， skin and subcutaneous tissue disorders diseases （4 kinds）， musculoskeletal and connective tissue disorders （4 kinds）， etc. Fourteen suspicious signals were not included in the instructions， such as hepatic enzyme increase， basal cell carcinoma， pericarditis， pemphigus， hair loss， synovitis， glossodynia， etc. CONCLUSIONS During clinical dosing of ustekinumab， in addition to ADR mentioned in package inserts， great attention should be paid to the patient’s liver function， skin status， hair loss and cardiovascular-related risks，which is helpful to discover AE early and ensure the safety medication of patients.

Mechanism of Schisandra Chinensis-mediated microglia phenotypic transformation by regulation of the TLR4 pathway based on miR-124 / 药学学报

To investigate the mechanism by which Schisandra Chinensis mediates the phenotypic transformation of microglia via microRNA-124 (miR-124)-based regulation of the Toll-like receptor 4 (TLR4) pathway, a model was established using lipopolysaccharide (LPS) stimulation of BV2 cells. Cells were treated with different doses of Schisandra Chinensis extract (SCE). MiR-124 inhibitors and negative control sequences (NC inhibitor) were transfected into LPS-induced BV2 cells and treated with SCE. The MTT assay was used for cell activity detection; an NO kit was used to measure NO release; ELISA kits were used to measure the levels of interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α). Microglia markers, including ionized calcium binding adapter molecule-1 (IBA-1) and arginase-1 (Arg-1), and the nuclear translocation of nuclear factor-kappa B (NF-κB) were evaluated by immunofluorescent staining. NF-κB p65, IBA-1, Arg-1, TLR4, myeloid differentiation primary factor 88 (MyD88), inhibitor of nuclear factor-kappa B kinases-α (IKK-α), IL-10, TNF-α were detected by immunoblot. SCE at concentrations ranging from 31.25 to 250 μg·mL-1 had no significant effect on cell activity. SCE treatment significantly inhibited NO release induced by LPS (P < 0.001, P < 0.01), increased the level of IL-10 (P < 0.05), and decreased the level of TNF-α (P < 0.001). In addition, SCE significantly reduced the expression of TNF-α, IBA-1, TLR4, and MyD88 (P < 0.01, P < 0.001) and elevated the expression of IL-10, Arg-1, NF-κB P65 and IKK-α (P < 0.001, P < 0.01, P < 0.05). SCE treatment could also promote the expression of miR-124 (P < 0.01). However, transfection with the miR-124 inhibitor increased TNF-α (P < 0.001), decreased the level of IL-10 (P < 0.05), increased the mRNA level and the protein expression of TNF-α and IBA-1 (P < 0.05, P < 0.01, P < 0.001), and decreased the mRNA level and protein expression of IL-10 and Arg-1 (P < 0.001, P < 0.01). In addition, the inhibition of TLR4 and MyD88 was attenuated. In conclusion, SCE appears to inhibit the activation of TLR4 signaling pathway by upregulating miR-124 so as to inhibit microglia M1 polarization and promote microglia M2 polarization.

CircFhit Modulates GABAergic Synaptic Transmission via Regulating the Parental Gene Fhit Expression in the Spinal Dorsal Horn in a Rat Model of Neuropathic Pain / 神经科学通报·英文版

Effective treatments for neuropathic pain are lacking due to our limited understanding of the mechanisms. The circRNAs are mainly enriched in the central nervous system. However, their function in various physiological and pathological conditions have yet to be determined. Here, we identified circFhit, an exon-intron circRNA expressed in GABAergic neurons, which reduced the inhibitory synaptic transmission in the spinal dorsal horn to mediate spared nerve injury-induced neuropathic pain. Moreover, we found that circFhit decreased the expression of GAD65 and induced hyperexcitation in NK1R+ neurons by promoting the expression of its parental gene Fhit in cis. Mechanistically, circFhit was directly bound to the intronic region of Fhit, and formed a circFhit/HNRNPK complex to promote Pol II phosphorylation and H2B monoubiquitination by recruiting CDK9 and RNF40 to the Fhit intron. In summary, we revealed that the exon-intron circFhit contributes to GABAergic neuron-mediated NK1R+ neuronal hyperexcitation and neuropathic pain via regulating Fhit in cis.

CiteSpace knowledge map of research hotspots and frontiers of traditional Chinese medicine intervention in psoriasis in recent ten years / 中国中药杂志

This study aimed to investigate the development status of traditional Chinese medicine(TCM) intervention in psoriasis in recent ten years, analyze the research hotspots, and summarize the development trends to provide reference materials for scholars in this field. Taking the available literature related to the field of TCM intervention in psoriasis as the research object, the trends, contents, and source publications were statistically analyzed based on bibliometrics. The research cooperation and co-occurrence of keywords in this field were studied by the knowledge map analysis method based on CiteSpace. The total number of Chinese papers was 2 993 and English papers 285. In terms of publication trend, the annual publication of English papers was low but showed an obvious upward trend, while the increase in Chinese papers fluctuated and tended to be flat. In terms of the content of Chinese papers published, TCM ranked first according to the discipline(2 415). In English papers, the number of publications in pharmacology and pharmaceutical science was the highest(87). Literature source analysis showed that the Chinese and English journals with the most publications were China Journal of Traditional Chinese Medicine and Pharmacy and Evidence Based Complementary and Alternative Medicine, respectively. Beijing University of Chinese Medicine published the most dissertations in China(99). The authors with the most publications in Chinese and English were LI Bin(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine) and LU Chuan-jian(Guangdong Hospital of Traditional Chinese Medicine). As revealed by the CiteSpace analysis of the research cooperation network, there were four mature and stable core teams in this field, but the cooperation intensity between different teams was weak. According to the keywords co-occurrence knowledge graph constructed by CiteSpace, the current hot keywords in this field are as follows: psoriasis, blood-heat syndrome, blood-stasis syndrome, fire needle, blood-dryness type, imiquimod, TCM bath, etiology and pathogenesis, cytokines, cupping therapy, etc. In summary, Chinese scholars have conducted active exploration and research in the field of TCM intervention in psoriasis in recent ten years. The overall development trend is good, and the breadth and depth of the research are constantly extending. It is suggested that relevant research should be free from discipline restrictions and strive for interdisciplinary integration.

General anesthesia versus deep sedation for dental treatment in children: comparison of parental acceptance, oral health-related quality of life, and treatment efficacy / 南方医科大学学报

OBJECTIVE@#To compare the parental acceptance of dental treatment under general anesthesia and deep sedation in children and assess the changes in postoperative oral health-related quality of life and treatment efficacy.@*METHODS@#The parents of 131 children undergoing dental treatment in the Department of Stomatology of Sichuan Provincial People's Hospital from January, 2022 to June, 2022 were surveyed using a questionnaire of children's advanced oral behavior management, and 83 children receiving general anesthesia or deep sedation for dental treatment between January, 2018 and December, 2021 were also investigated for changes in quality of life after the treatment using a questionnaire. The treatment efficacy was assessed at the 1-year follow-up visit in 149 children who received dental treatment under general anesthesia or deep sedation during the same period.@*RESULTS@#The survey of perantal acceptance showed that 62.6% of the parents preferred deep sedation, 29.01% preferred general anesthesia, and 8.4% preferred compulsory treatment. Dental treatments under general anesthesia and deep sedation both significantly improved oral health-related quality of life of the children. While dental surgeries under general anesthesia resulted in the most significant improvement of pain symptoms, deep sedation was associated with both obvious relief of the children's pain symptoms and reduction of the parents' pressure level. No significant difference was found in the efficacy of treatments under general anesthesia and deep sedation at the 1-year follow-up.@*CONCLUSION@#Dental treatment in children under deep sedation has the highest parental acceptance, followed by treatment under general anesthesia, and the acceptance of compulsory treatment is the lowest. The treatments under general anesthesia and deep sedation significantly improve the quality of life of the children and their parents and both have good treatment efficacy.

Risk factors for complications of endoscopic full-thickness resection of upper gastrointestinal submucosal tumors / 中华胃肠外科杂志

Objective: To analyze the risk factors for complications of endoscopic full-thickness resection (EFTR) of upper gastrointestinal submucosal tumors (SMTs). Methods: This was a retrospective observational study. The indications for EFTR included: (1) SMTs originating from the muscularis propria layer and growing out of the cavity or infiltrating the deep part of the muscularis propria layer; (2) SMTs diameter <5 cm; and (3) tumor identified as closely adherent to the serous layer during endoscopic submucosal dissection or endoscopic mucosal resection. This study included patients with SMTs originating from the muscularis propria layer in upper digestive tract, diagnosed preoperatively by endoscopic ultrasonography or computed tomography, who were successfully treated with EFTR. Those with incomplete clinical data were excluded. The clinical data of 154 patients with upper gastrointestinal SMTs who underwent EFTR at the Department of Gastroenterology, First Affiliated Hospital of Soochow University from January 2016 to January 2022 were retrospectively analyzed. Post-EFTR complications (such as delayed perforation, delayed bleeding, and postoperative infection, including electrocoagulation syndrome) were monitored and the risk factors for them were analyzed. Results: Among the 154 study patients, 33 (21.4%) developed complications, including delayed bleeding in three (1.9%), delayed perforation in two (1.3%), and postoperative infection in 28 (18.2%). One patient with bleeding was classified as having a major complication (hospitalized for more than 10 days because of complication). According to univariate analysis, complication was associated with tumor diameter >15 mm, operation time >90 minutes, defect closure method(purse string suture), and diameter of resected specimen ≥20 mm (all P<0.05). Multivariate logistic regression analysis showed that operation time >90 minutes (OR=6.252, 95%CI: 2.530-15.446, P<0.001) and tumor diameter >15 mm (OR=4.843, 95%CI: 1.985-11.817, P=0.001) were independent risk factors for complications after EFTR in patients with upper gastrointestinal SMTs. The independent risk factors for postoperative infection in these patients were operation time>90 minutes (OR=4.993, 95%CI:1.964-12.694, P=0.001) and purse string suture (OR=7.142, 95%CI: 1.953-26.123, P=0.003). Conclusion: Patients with upper gastrointestinal SMTs undergoing EFTR with tumor diameter >15 mm or operation time >90 minutes have a significantly increased risk of postoperative complications. Postoperative monitoring is important for these patients with SMTs.

Clinical analysis of 31 cases of fetal umbilical artery thrombosis / 中华妇产科杂志

Objective: To analyze the ultrasonic manifestations, clinical features, high risk factors and key points of pregnancy management in prenatal diagnosis of umbilical artery thrombosis (UAT). Methods: The data of 31 pregnant women of UAT diagnosed by prenatal ultrasonography and confirmed after birth from July 2017 to July 2022 at the Women's Hospital, Zhejiang University School of Medicine were retrospectively analyzed, including the maternal characteristics, pregnancy outcomes and fetal complications. In addition, the baseline data and pregnancy outcomes were compared in 21 patients who continued pregnancy after diagnosis of UAT. Of the 21 UAT cases that continued pregnancy, 10 cases were treated with low molecular weight heparin (LMWH; LMWH treatment group), while the other 11 patients had expectant treatment(expectant treatment group). Results: The age of the 31 pregnant women was (30.2±4.7) years, of which 5 cases (16%,5/31) were advanced age pregnant women. The gestational age at diagnosis was (32.9±4.0) weeks, and the gestational age at termination of pregnancy was (35.6±2.9) weeks. In 31 fetuses with UAT, 15 cases (48%) had fetal distress, 11 cases (35%) had fetal growth restriction, and 3 cases (10%) had intrauterine stillbirth. There were 28 cases of live births, including 26 cases by cesarean section and 2 cases by vaginal delivery. There were also 3 stillbirths, all delivered vaginally. Four neonates had mild asphyxia and two newborns had severe asphyxia. Among the 31 cases, 10 cases were terminated immediately after diagnosis, the gestational age at diagnosis was (35.9±2.9) weeks. Another 21 pregnancies continued, and their gestational age at diagnosis was (31.4±3.7) weeks. The median prolonged gestational age in LMWH treatment group was 7.9 weeks (4.6-9.4 weeks), and all were live births. The median prolonged gestational age in the expectant treatment group was 0.6 weeks (0.0-1.0 weeks), and 2 cases were stillbirths. There was a statistically significant difference in prolonged gestational age (P=0.002). Conclusions: Ultrasound is the preferred method for prenatal detection of UAT. Clinicians need to be vigilant for UAT when a newly identified single umbilical artery is detected by ultrasound in the second or third trimesters. The decision to continue or terminate the pregnancy depends on the gestational age and the condition of fetus. Attention should be paid to fetal movements as the pregnancy continues. The treatment of LMWH as soon as possible after diagnosis of UAT may improve the pregnancy outcome.

Prescription and medication rules of traditional Chinese medicine for prevention and treatment of diabetic microangiopathy based on literature mining / 中国中药杂志

This study explored the prescription and medication rules of traditional Chinese medicine(TCM) in the prevention and treatment of diabetic microangiopathy based on literature mining. Relevant literature on TCM against diabetic microangiopathy was searched and prescriptions were collected. Microsoft Excel 2021 software was used to establish a prescription database, and an analysis was conducted on the frequency, properties, flavors, meridian tropism, and efficacy classifications of drugs. Association rule analysis, cluster analysis, and factor analysis were performed using SPSS Modeler 18.0 and SPSS Statistics 26.0 software. The characteristic active components and mechanisms of action of medium-high frequency drugs in the analysis of medication rules were explored through li-terature mining. A total of 1 327 prescriptions were included in this study, involving 411 drugs, with a total frequency reaching 19 154 times. The top five high-frequency drugs were Astragali Radix, Angelicae Sinensis Radix, Poria, Salviae Miltiorrhizae Radix et Rhizoma, and Rehmanniae Radix. The cold and warm drugs were used in combination. Drugs were mainly sweet, followed by bitter and pungent, and acted on the liver meridian. The majority of drugs were effective in tonifying deficiency, clearing heat, activating blood, and resolving stasis. Association rule analysis identified the highly supported drug pair of Astragali Radix-Angelicae Sinensis Radix and the highly confident drug combination of Poria-Alismatis Rhizoma-Corni Fructus. The strongest correlation was found among Astragali Radix, Angelicae Sinensis Radix, Poria, and Salviae Miltiorrhizae Radix et Rhizoma through the complex network analysis. Cluster analysis identified nine categories of drug combinations, while factor analysis identified 16 common factors. The analysis of active components in high-frequency drugs for the treatment of diabetic microangiopathy revealed that these effective components mainly exerted their effects by inhibiting oxidative stress and suppressing inflammatory reactions. The study found that the pathogenesis of diabetic microangiopathy was primarily characterized by deficiency in origin, with a combination of deficiency and excess. Deficiency was manifested as Qi deficiency and blood deficiency, while excess as phlegm-heat and blood stasis. The key organ involved in the pathological changes was the liver. The treatment mainly focused on supplementing Qi and nourishing blood, supplemented by clearing heat, coo-ling blood, activating blood, and dredging collaterals. Commonly used formulas included Danggui Buxue Decoction, Liuwei Dihuang Pills, Erzhi Pills, and Buyang Huanwu Decoction. The mechanisms of action of high-frequency drugs in the treatment of diabetic microangiopathy were often related to the inhibition of oxidative stress and suppression of inflammatory reactions. These findings can provide references for the clinical treatment of diabetic microangiopathy and the development of targeted drugs.

Mechanism of Mongolian drug Naru-3 in initiation of neuroinflammation of neuropathic pain from MMP9/IL-1β signaling pathway / 中国中药杂志

Neuropathic pain(NP) has similar phenotypes but different sequential neuroinflammatory mechanisms in the pathological process. It is of great significance to inhibit the initiation of neuroinflammation, which has become a new direction of NP treatment and drug development in recent years. Mongolian drug Naru-3 is clinically effective in the treatment of trigeminal neuralgia, sciatica, and other NPs in a short time, but its pharmacodynamic characteristics and mechanism of analgesia are still unclear. In this study, a spinal nerve ligation(SNL) model simulating clinical peripheral nerve injury was established and the efficacy and mechanism of Naru-3 in the treatment of NPs was discussed by means of behavioral detection, side effect evaluation, network analysis, and experimental verification. Pharmacodynamic results showed that Naru-3 increased the basic pain sensitivity threshold(mechanical hyperalgesia and thermal radiation hyperalgesia) in the initiation of SNL in animals and relieved spontaneous pain, however, there was no significant effect on the basic pain sensitivity threshold and motor coordination function of normal animals under physiological and pathological conditions. Meanwhile, the results of primary screening of target tissues showed that Naru-3 inhibited the second phase of injury-induced nociceptive response of formalin test in mice and reduced the expression of inflammatory factors in the spinal cord. Network analysis discovered that Naru-3 had synergy in the treatment of NP, and its mechanism was associated with core targets such as matrix metalloproteinase-9(MMP9) and interleukin-1β(IL-1β). The experiment further took the dorsal root ganglion(DRG) and the stage of patho-logical spinal cord as the research objects, focusing on the core targets of inducing microglial neuroinflammation. By means of Western blot, immunofluorescence, agonists, antagonists, behavior, etc., the mechanism of Naru-3 in exerting NP analgesia may be related to the negative regulation of the MMP9/IL-1β signaling pathway-mediated microglia p38/IL-1β inflammatory loop in the activation phase. The relevant research enriches the biological connotation of Naru-3 in the treatment of NP and provides references for clinical rational drug use.

Overview of work-related diseases and occupational injury surveillance system in the UK / 环境与职业医学

The UK's work-related diseases and occupational injury surveillance system consists of Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), Labour Force Survey (LFS), The Health and Occupation Research network in General Practice (THOR-GP), and Reporting to The Health and Occupation Research network by specialist physicians. This article briefly described the scope, content, and methods of each surveillance programme in the UK work-related diseases and occupational injury surveillance system, and summarized their advantages and disadvantages. Among them, employers are required to report to relevant law enforcement authorities by RIDDOR, data are highly accessible but with a concern of serious underreport, and it is the only data source of fatal occupational injuries; LFS, a representative national household sample survey, covering occupational injuries and work-related diseases, is the primary data source of non-fatal occupational injuries and work-related diseases such as stress, anxiety, and depression, but collects non-clinically proven data based on self-perception; general practitioners report clinically confirmed work-related diseases, which is more scientific in attribution and is a good secondary source of work-related diseases; specialist physicians report clinically confirmed cases of higher severity, which is the primary source of data on conditions such as asthma and dermatitis, but may underestimate morbidity. Each surveillance programme of the system has its own characteristics, intersects, and complements each other, which can provide reference for the construction of occupational injury surveillance system in China.

Framework and enlightenment of European Union's Occupational Injury Surveillance System / 环境与职业医学

In order to promote the development of China's occupational injury surveillance system, this paper presented the legal basis, project overview, reporting procedures, definitions and stati statistical scope, data sources and collection standards, statistical data management and analysis points of the European Statistics on Accidents at Work (ESAW), and combined with existing research and related surveillance management system in China, five key points were proposed for constructing China's occupational injury surveillance system: 1) Establish and improve laws and regulations related to occupational injury surveillance; 2) Promote utilization of nation-level data systems; 3) Establish and optimize a sound national occupational injury surveillance system; 4) Provide standardized protocols for data collection and data application of occupational injury statistics; 5) Strengthen supervision and law enforcement targeting industries and enterprises.

Joint application of active and passive surveillance of occupational injuries: Based on UK HSE data / 环境与职业医学

Background The United Kingdom (UK) adopts active surveillance and passive surveillance to jointly collect occupational injury data, and builds a relatively complete occupational injury surveillance system, which can provide reference for the construction of China's occupational injury surveillance system. Objective To compare the results of active surveillance and passive surveillance of occupational injuries in the UK, and to explore the joint application value of active and passive surveillance methods in the field of occupational injury prevention and control. Methods The non-fatal occupational injury active surveillance data from Labor Force Survey were used to calculate indicators such as number of reported cases, reporting rate, lost workdays per year, lost workdays per capita, and average lost workdays per case. The fatal passive surveillance data reported by the employers were used to calculate number of reported deaths, reported mortality, and other indicators. Join-point regression was used to estimate the reported trends of fatal and non-fatal occupational injuries from 2004 to 2020, and the annual percentage change (APC) and average annual percentage change (AAPC) were calculated. Results The active surveillance data showed that from 2004 to 2020, the number of reported cases of absenteeism ≥0 d due to occupational injury decreased from 89.7 (95%CI: 85.2, 94.2) per ten thousand to 44.1 (95%CI: 39.1, 49.2) per ten thousand, and the reporting rate of occupational injury decreased from 32100/100000 (95%CI: 3050/100000, 3370/100000) to 1410/100000 (95%CI: 1250/100000, 1570/100000), showing a linear downward trend (both APC and AAPC were −3.88%, P<0.05); the average lost workdays per case in 2019 was 9.1 (95%CI: 6.8, 11.5) d. The passive surveillance data showed that from 2004 to 2020, the number of reported deaths due to occupational injury decreased from 223 to 142, and the reporting rate of occupational injury decreased from 0.78/100000 to 0.44/100000, showing a linear downward trend (both APC and AAPC were −4.59%, P<0.05). Conclusion The reporting rates of fatal and non-fatal occupational injuries in the UK are showing a linear downward trend. The active surveillance method based on Labor Force Survey provides more surveillance indicators for non-fatal occupational injuries, and the passive surveillance method based on employer report has more advantages in assessment of fatal occupational injuries. Jointly applying the two surveillance modalities and the combination of trend analysis indicators, such as AAPC, provide a more comprehensive picture of the epidemiological characteristics of occupational injuries.

Application of lost workdays in surveillance and assessment of non-fatal occupational injuries: Based on European Statistics on Accidents at Work / 环境与职业医学

Background The severity of occupational injury in countries such as the United Kingdom, the United States, and Germany is usually analyzed using lost workdays, but in existing occupational injury surveillance research in China, the application of this index is rare. Objective To evaluate the application value of lost workdays in non-fatal occupational injury surveillance, and provide a reference for the construction of occupational injury surveillance index system. Methods The public data of European Statistics on Accidents at Work (ESAW) from 2010 to 2019 on non-fatal injury accidents in 27 member states of the European Union were used. Non-fatal occupational injury is defined as an injury event during occupational activities or at work resulting a victim's absence from work for ≥4 d. According to the European Statistics on Accidents at Work-Summary methodology, the lost workdays were divided into 8 categories (4-6 d, 7-13 d, 14-20 d, 21-30 d, 31-91 d, 92-182 d, 183 d and above, and unknown). Annual percentage change (APC) and the average annual percentage change (AAPC) were used to evaluate the overall trend changes in the incidence rate of non-fatal occupational injury accidents in different lost workdays from 2010 to 2019, and the non-fatal occupational injury accidents in key industries. The characteristics of the occurrence of non-fatal occupational injuries were analyzed in conjunction with the changes in non-fatal occupational injuries in different lost workdays in the industry. Results From 2010 to 2019, the overall incidence of non-fatal occupational injury accidents in the European Union showed a downward trend, and the AAPC was −1.0% (P<0.05). The accident rates of lost workdays of 4-6 d and 92-182 d showed an upward trend, and the AAPC were 7.9% and 5.8% respectively (P<0.05). The average annual accident rates of non-fatal occupational injuries (≥4 d) in Categories C (manufacturing industry), E (water supply, sewage treatment, waste management and remediation), and F (construction industry) showed a linear downward trend, and the AAPC were −3.0%, −2.5%, and −1.5%, respectively (P<0.05). However, among them, the rate of non-fatal occupational injury accidents with 92-182 d of lost workdays in the manufacturing industry showed a significant upward trend, with an AAPC of 3.7% (P<0.001). Conclusion Using lost workdays combined with APC and AAPC by Join-point linear regression analysis can measure the severity and trend changes of non-fatal occupational injury accidents in different industries and different lost workdays. This indicator has an important practical significance in evaluating the effectiveness of occupational injury prevention and control strategies adopted by countries and enterprises.

Trend and prediction of fatality due to occupational injuries in China / 环境与职业医学

Background Occupational injury is one of the important causes of death among the working population and a worldwide hot topic, but there are few relevant studies on the trend and prediction of occupational injury attributable deaths in China. Objective To analyze the trend of occupational injury attributable deaths in China from 2000 to 2019, predict the deaths of occupational injuries in China from 2020 to 2024 by contructing a gray GM(1,1) model, and provid a reference for surveillance and assessment of occupational injuries. Methods Mortality, crude mortality rates, and standardized mortality rates of occupational injuries in China by year, sex, and age groups were calculated using data of the Global Burden of Disease (GBD) 2019 study. Join-point model was used to analyze possible trend of standardized mortality rate from 2000 to 2019, and calculate annual percentage change (APC) and average annual percentage change (AAPC). After a gray model GM(1,1) was established, the accuracy of the model was evaluated by posterior error ratio (C) and small error probability (P) and rated as Level 1 (good, C≤0.35 and P≥0.95) or Level 2 (qualified, 0.35<C≤0.50 and 0.80≤P<0.95). Then the gray model was further used to predict the number of deaths and standardized mortality rates of occupational injuries in China from 2020 to 2024. Results From 2000 to 2019, the deaths due to occupational injuries in China showed a downward trend, the number of deaths decreased from 111557 to 61780, the crude mortality rate decreased from 8.58/100000 to 4.34/100000, the standardized mortality rate decreased from 7.67/100000 to 3.65/100000, and the AAPC of standardized mortality rate was −4.0% (P<0.05); the number of male deaths decreased from 87760 to 49192, and the male standardized mortality rate decreased from 11.78/100000 to 5.68/100000; the number of female deaths decreased from 23797 to 12588, and the female standardized mortality rate decreased from 3.34/100000 to 1.55/100000; the AAPCs of male and female standardized mortality rate were −3.9% and −4.1% respectively. The accuracy of the established gray model for deaths (C=0.09, P=1) was rated as Level 1, and that for standardized mortality rate (C=0.41, P=0.9) was rated as level 2, which allowed for prediction extrapolation. The model showed that from 2020 to 2024, the number of occupational injury attributable deaths would be 76039, 73849, 71721, 69655, and 67649, and the standardized mortality rate would be 4.23/100000, 4.07/100000, 3.92/100000, 3.77/100000, and 3.62/100000, respectively. Conclusion From 2000 to 2019, the standardized mortality rate of occupational injuries in China showed a downward trend, and it is predicted that the standardized mortality rate from 2020 to 2024 will still show a downward trend, but the number of deaths will remain high, so it is necessary to continue to strengthen prevention and control of occupational injuries.

Disease burden of deaths attributable to occupational injuries in China from 1990 to 2019 / 环境与职业医学

Background Occupational injuries are one of the leading causes of death or disability in occupational populations. According to the World Health Organization and the International Labour Organization, occupational injuries were the occupational contributor responsible for the largest loss of disability-adjusted life years (DALY) globally in 2016. Objective To analyze the burden of deaths attributed to occupational injuries in Chinese population from 1990 to 2019, and provide a reference for further construction of occupational injury surveillance system. Methods Using the results and data of the Global Burden of Disease 2019 (GBD 2019), this study estimated the burden of deaths attributable to occupational injuries by year, sex, and age groups, and the indicators included deaths, years of life lost (YLL), mortality, and YLL rates. Age-standardized rates of deaths and YLL rates were calculated using a world standard population presented by GBD 2019. Annualized rate of change (ARC) was use to evaluate changes in the indicators over time. All results were presented as point estimates with 95% uncertainty intervals (95%UI). Results In 2019, the deaths attributable to occupational injuries among women in China accounted for 33.16% of that among world's women, their YLL accounted for 31.88%, and the two indicators among Chinese men accounted for 17.98% and 17.09%, respectively. Compared with 1990, the standardized mortality rate and the standardized YLL rate attributable to occupational injuries in China in 2019 decreased, among which the ARCs of the standardized mortality rate in the whole population, men, and women were −0.68 (95%UI: −0.78, −0.51), −0.68 (95%UI: −0.80, −0.47), and −0.68 (95%UI: −0.82, −0.46), respectively. The ARCs of the standardized YLL rate in the whole population, men, and women were −0.68 (95%UI: −0.78, −0.51), −0.67 (95%UI: −0.80, −0.48), and −0.68 (95%UI: −0.81, −0.44), respectively. Absolute values of the ARCs of the standardized mortality rate and the standardized YLL rate attributable to occupational injuries from 1990 to 2010 were higher than those from 2010 to 2019. The ARCs of the standardized YLL rate for road injuries, falls, and drowning from 1990 to 2010 were −0.55 (95%UI: −0.67, −0.36), −0.57 (95%UI: −0.73, −0.38), −0.77 (95%UI: −0.84, −0.63), and the ARCs from 2010 to 2019 were −0.27 (95%UI: −0.46, −0.02), −0.07 (95%UI: −0.34, −0.26), −0.06 (95%UI: −0.32, −0.29), respectively. In 2019, the standardized mortality rate attributable to occupational injuries among Chinese men was 5.68/100000 (95%UI: 3.89/100000, 8.23/100000), and the standardized YLL rate was 286.27/100000 (95%UI: 197.58/100000, 411.38/100000); the standardized mortality rate attributable to occupational injuries among Chinese women was 1.55/100000 (95%UI: 0.99/100000, 2.36/100000), and the standardized YLL rate was 80.85/100000 (95%UI: 51.61/100000, 122.07/100000). Conclusion From 1990 to 2019, the burden of deaths attributable to occupational injuries in China is declined, but the rate of decline is slowed down in the last decade. The burden of deaths attributable to occupational injuries among women in China still accounts for a high proportion of the global burden among women. The burden of deaths attributable to occupational injuries among Chinese men is higher than that among Chinese women.

Applicability of feature selection combined with Boosting algorithm in severity prediction of non-fatal occupational injuries in miners / 环境与职业医学

Background Identification and analysis of influencing factors of occupational injury is an important research content of feature selection. In recent years, with the rise of machine learning algorithms, feature selection combined with Boosting algorithm provides a new analysis idea to construct occupational injury prediction models. Objective To evaluate applicability of Boosting algorithm-based model in predicting severity of miners' non-fatal occupational injuries, and provide a basis for rationally predicting the severity level of miners' non-fatal occupational injuries. Methods The publicly available data of the US Mine Safety and Health Administration (MSHA) from 2001 to 2021 on metal miners' non-fatal occupational injuries were used, and the outcome variables were lost working days < 105 d (minor injury) and ≥ 105 d (serious injury). Four different feature sets were screened out by four feature selection methods including least absolute shrinkage and selection operator (Lasso) regression, stepwise regression, single factor + Lasso regression, and single factor + stepwise regression. Logistic regression, gradient boosting decision tree (GBDT), and extreme gradient boosting (XGBoost) were selected to construct prediction models by training with the four feature sets. A total of 12 prediction models of severity of miners' non-fatal occupational injuries were built and their area under the curve (AUC), sensitivity, specificity, and Youden index were calculated for model evaluation. Results According to the results of four feature selection methods, age, time of accident occurrence, total length of service, cause of injury, activities that triggered injury occurrence, body part of injury, nature of injury, and outcome of injury were identified as influencing factors of non-fatal occupational injury severity in miners. Feature set 4 was the optimal set screened out by single factor+stepwise regression and the GBDT model presented the best predictive performance in predicting the severity of non-fatal occupational injuries. The associated specificity, sensitivity, and Youden index were 0.7530, 0.9490, and 0.7020, respectively. The AUC values of logistic regression, GBDT, and XGBoost models trained by feature set 4 were 0.8526 (95%CI: 0.8387, 0.8750), 0.8640 (95%CI: 0.8474, 0.8806), and 0.8603 (95%CI: 0.8439, 0.8773), respectively, higher than the AUC values trained by feature set 2 [0.8487 (95%CI: 0.8203, 0.8669), 0.8110 (95%CI: 0.8012, 0.8344), and 0.8439 (95%CI: 0.8245, 0.8561), respectively] . The AUC values of GBDT and XGBoost models trained by feature set 4 were higher than that of logistic regression model. Conclusion The performance of the prediction models constructed by predictors screened out by two feature selection methods is better than those by single feature selection methods. At the same time, under the condition of optimal feature set, the performance of model prediction based on Boosting is better than that of traditional logistic regression model.

Influencing factors of lower urinary tract symptoms in patients with prostate hyperplasia after transurethral holmium laser enucleation / 中华全科医师杂志

A total of 360 patients with prostate hyperplasia underwent transurethral holmium laser enucleation of the prostate in Department of Urology of Jinhua People′s Hospital from July 2019 to December 2022. Among 360 patients, lower urinary tract symptoms occurred one month after operation in 40 cases with an incidence rate of 11.11%. The age, body mass index (BMI), course of disease, nature of disease, preoperative prostate volume, postoperative prostate volume, preoperative IPSS score, postoperative IPSS score, preoperative maximum urine flow rate, postoperative maximum urine flow rate, preoperative residual urine volume, postoperative residual urine volume, postoperative urinary tract infection, operative time, postoperative catheter retention time were compared between patients with lower urinary tract symptoms (study group) and those without (control group). There were significant differences in the course of disease, preoperative prostate volume, preoperative IPSS score, preoperative maximum urine flow rate, preoperative residual urine volume, postoperative urinary tract infection and postoperative catheter retention time between two groups ( t=28.01, 6.35, 8.79, 17.92, 34.84, 11.45;all P<0.05). Multivariate logistic analysis showed that the course of disease, preoperative prostate volume, preoperative IPSS score, postoperative urinary tract infection, and postoperative catheter retention time were independent risk factors for postoperative lower urinary tract symptoms ( OR=6.964, 3.442, 1.944, 4.836, 4.225, 4.894; all P<0.05); while the preoperative maximum urinary flow rate was the protective factor( OR=0.043, P<0.05). The incidence of postoperative lower urinary tract symptoms in patients undergoing transurethral holmium laser enucleation of prostate is high. Effective protective measures should be taken based on the risk factors to reduce the incidence of postoperative lower urinary tract symptoms and to promote the early recovery of patients.