[Preoperative prediction of HER-2 expression status in breast cancer based on MRI radiomics model].

Objective: This study aims to explore the predictive value of T2-weighted imaging (T2WI), apparent diffusion coefficient (ADC), and early-delayed phases enhanced magnetic resonance imaging (DCE-MRI) radiomics prediction model in determining human epidermal growth factor receptor 2 status in breast cancer. Methods: A retrospective study was conducted, involving 187 patients with confirmed breast cancer by postsurgical pathology at Zhenjiang First People's Hospital during January 2021 and May 2023. Immunohistochemistry or fluorescence in situ hybridization was used to determine the HER-2 status of these patients, with 48 cases classified as HER-2 positive and 139 cases as HER-2 negative. The training set was used to construct the prediction models and the validation set was used to verify the prediction models. Layers of T2WI, ADC, and early-delayed phase DCE-MRI images were used to delineate the volumeof interest and 960 radiomic features were extracted from each case using Pyradiomic. After screening and dimensionality reduction by intraclass correlation coefficient, Pearson correlation analysis, least absolute shrinkage, and selection operator, the radiomics labels were established. Logistic regression analysis was used to construct the T2WI radiomics model, ADC radiomics model, DCE-2 radiomics model, DCE-6 radiomics model, and the joint sequence radiomics model to predict the HER-2 expression status of breast cancer, respectively. Based on the clinical, pathological, and MRI image characteristics of patients, univariate and multivariate logistic regression analysis wasused to construct a clinicopathological MRI feature model. The radscore of every patient and the clinicopathological MRI features which were statistically significant after screening were used to construct a nomogram model. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of each model and the decision curve analysis wasused to evaluate the clinical usefulness. Results: The T2WI, ADC, DCE-2, DCE-6, and joint sequence radiomics models, the clinicopathological MRI feature model, and the nomogram model were successfully constructed to predict the expression status of HER-2 in breast cancer. ROC analysis showed that in the training set and validation set, the areas under the curve (AUC) of the T2WI radiomics model were 0.797 and 0.760, of the ADC radiomics model were 0.776 and 0.634, of the DCE-2 radiomics model were 0.804 and 0.759, of the DCE-6 radiomics model were 0.869 and 0.798, of the combined sequence radiomics model were 0.908 and 0.847, of the clinicopathological MRI feature model were 0.703 and 0.693, and of the nomogram model were 0.938 and 0.859, respectively. In the training set, the combined sequence radiomics model outperformed the clinicopathological features model (P＜0.001). In the training and validation sets, the nomogram outperformed the clinicopathological features model (P＜0.05). In addition, the diagnostic performance of the nomogram was better than that of the four single-modality radiomics models in the training cohort (P＜0.05) and was better than that of DCE-2 and ADC models in the validation cohort (P＜0.05). Decision curve analysis indicated that the value of individualized prediction models was higher than clinical and pathological prediction models in clinical practice. The calibration curve showed that the multimodal radiomics model had a high consistency with the actual results in predicting HER-2 expression. Conclusions: T2WI, ADC and early-delayed phase DCE-MRI imaging histology models for HER-2 expression status in breast cancer are expected to provide a non-invasive virtual pathological basis for decision-making on preoperative neoadjuvant regimens in breast cancer.

[Evaluation of anticoagulant effect and predicted dose of low molecular weight heparin in hemodialysis by anti-â ©a factor activity].

The purpose of this study was to explore the reasonable dose of low molecular weight heparin (LMWH) in hemodialysis (HD) and the strategy of preventing extracorporeal circuit coagulation (ECC). A retrospective case-control study included patients who used LMWH for anticoagulation during maintenance hemodialysis (MHD) in the Hemodialysis Center of Beijing Hospital from December 2020 to January 2021. Basic data such as weight, height, basic kidney disease, dialysis age and anti-Ⅹa factor activity before, during and after dialysis were collected. A total of 46 patients were enrolled in this study, including 5 patients in coagulation group (10.9%) and 41 patients in non-coagulation group (89.1%). The anti-Ⅹa factor activity reached its peak at 0.5 h after the start of HD. The level of anti-Ⅹa factor was incorporated into the receiver operating characteristic curve (ROC curve). The results showed that the area under the ROC curve (AUC) was 0.802 (95% confidence interval: 0.651-0.54, P=0.029), and the cutoff was 0.31 IU/ml (sensitivity 1, specificity 0.683). It is suggested that the body surface area should be used as the basis to estimate the anticoagulant dose of LMWH in HD, and the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml, which is of diagnostic value for ECC. In addition, the results of binary logistic regression analysis showed that dialysis age was an independent risk factor for ECC (OR value 1.319, 95%CI 1.052-1.654, P=0.017). In summary, this study reveals that dialysis age may be a risk factor for ECC and that the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml can be used as a potential diagnostic cut-off point for ECC in HD patients, which provides a scientific basis for monitoring strategies to prevent blood coagulation in HD filters.

[Risk factors of systemic allergic reactions caused by subcutaneous allergen immunotherapy].

Objective: To investigate the incidence and risk factors of systemic allergic reactions induced by subcutaneous immunotherapy (SCIT) in patients undergoing SCIT injections in Peking Union Medical College Hospital (PUMCH). Methods: This is a single center retrospective cohort study. Using the outpatient information system of PUMCH, the demographic information and injection-related reaction data of patients undergoing SCIT injection in Allergy Department of PUMCH from December 2018 to December 2022 were retrospectively analyzed to count the incidence and risk factors of systemic allergic reactions caused by SCIT. Mann-Whitney nonparametric test or chi-square test was used for single-factor analysis, and multiple logistic regression was used for multiple-factor analysis. Results: A total of 2 897 patients received 18 070 SCIT injections in Allergy Department during the four years, and 40 systemic allergic reactions occurred, with the overall incidence rate of 0.22%. The incidence of systemic allergic reaction was 0.37% when using imported dust mite preparation and 0.15% when using domestic multi-component allergen preparation. The risk factors significantly related with SCIT-induced systemic allergic reactions in patients using imported dust mite preparation were age less than 18 years old (OR=3.186,95%CI: 1.255-8.085), highest injection concentration (OR value could not be calculated because all patients with systemic reactions were injected with highest concentration), and large local reaction in previous injection (OR=22.264,95%CI: 8.205-60.411). The risk factors for SCIT-induced systemic allergic reactions in patients using domestic allergen preparation were 5 or more types of allergens (OR=3.455,95%CI: 1.147-10.402), highest injection concentration (OR=3.794,95%CI: 1.226-11.740) and large local reaction in previous injection (OR=63.577,95%CI: 22.248-181.683). However, SCIT injection in pollen allergic patients during the pollen season did not show a correlation with systemic allergic reaction. Conclusion: The incidence of SCIT-induced systemic allergic reactions was low in the Chinese patient population of this study. Patients with one or more risk factors, such as multiple allergen injection, highest injection concentration, large local reaction in previous injection, should be given high attention and vigilance against systemic allergic reactions.

[Factors influencing the clinical phenotype of hepatolenticular degeneration].

Hepatolenticular degeneration is an autosomal recessive genetic disease caused by mutations in the ATP7B gene. More than 800 mutations have been identified in the ATP7B gene so far, with significant differences in clinical phenotypes among different mutation sites. Totally different clinical phenotypic mutations can even exist in the same gene. Although copper accumulation due to gene mutation is the basis of the pathogenesis of hepatolenticular degeneration, more and more evidence demonstrates that it is difficult to explain the diversity of clinical manifestations solely from the perspective of gene mutation. Therefore, this article reviews the research progress on the factors influencing genotype, modifier genes, epigenetics, age, gender, diet, and other factors on the phenotype of patients with hepatolenticular degeneration.

[Application of augmented reality navigation combined with indocyanine green fluorescence imaging technology in the accurate guidance of laparoscopic anatomical segment 8 liver resection].

Objective: To investigate the application value of augmented reality navigation combined with indocyanine green(ICG) fluorescence imaging technology in laparoscopic anatomical segment 8 liver resection. Methods: Clinical and pathological data from 8 patients with hepatocellular carcinoma located in segment 8 of the liver admitted to the First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University from October 2021 to October 2022 were collected restrospectively. Among them,there were 5 males and 3 females,aged between 40 and 72 years. During the operation,the self-developed laparoscopic augmented reality surgical navigation system was used to integrate the three-dimensional liver model with the laparoscopic scene,and ICG fluorescence imaging technology was used to guide the anatomical liver resection of segment 8. The predicted liver resection volume and actual liver resection volume,related surgical indicators and postoperative complications were analyzed. Results: Among the 8 patients, 4 underwent laparoscopic anatomical segment 8 liver resection,1 underwent laparoscopic anatomical ventral subsegment of segment 8 liver resection,2 underwent laparoscopic anatomical ventral subsegment combined with medial subsegment of segment 8 liver resection, and 1 underwent laparoscopic anatomical dorsal subsegment of segment 8 liver resection. All operations were completed under the guidance of augmented reality navigation combined with ICG fluorescence imaging,without conversion to open surgery. The operation time was (276.3±54.8)minutes(range:200 to 360 minutes). Intraoperative blood loss was (75.0±35.4)ml(range:50 to 150 ml). No blood transfusion was performed during the operation. The length of postoperative hospital stay was (7.6±0.8)days(range:7 to 9 days). There were no deaths or postoperative complications such as bleeding or biliary fistula during the perioperative period. Conclusion: Augmented reality navigation combined with ICG fluorescence imaging technology can guide the implementation of laparoscopic anatomical segment 8 liver resection.

[Analysis of work-related musculoskeletal disorders among automobile manufacturing logistics workers in Guangzhou].

Objective: To investigate the occurrence of work-related musculoskeletal disorders (WMSDs) in logistics workers of automobile manufacturing enterprises in Guangzhou, and explore their potential categories and influencing factors, so as to provide basis for the prevention and control of WMSDs in logistics workers of automobile manufacturing enterprises. Methods: From April to May 2020, a convenient sampling method was adopted to select 1442 logistics workers in 2 automobile manufacturing enterprises in Guangzhou as the research objects. The incidence of WMSDs among them was investigated by using the Nordic Musculoskeletal Disorders Questionnaire, and the incidence pattern of WMSDs among the subjects was analyzed by the method of potential category analysis. Chi-square test and multiple logistic regression model were used to analyze the influencing factors of the disease. Results: The total prevalence of WMSDs was 42.9% (619/1442). The three parts with high prevalence of WMSDs were neck (23.5%, 339/1442), shoulder (21.3%, 307/1442) and lower back (19.1%, 275/1442). 69.0% (427/619) of the patients showed simultaneous disease in two or more sites. The subjects were divided into four latent groups by the analysis of latent categories: the group with multiple body parts (4.51%), the group with very low or no disease (70.39%), the group with shoulder and neck and upper back (11.37%), and the group with limbs and lower back (13.73%). Multivariate logistic regression showed that compared with the "very low or no disease group", the risk factors of multiple body parts of automotive logistics workers suffering from WMSDs mainly included: Working posture uncomfortable (OR=3.10, 95%CI: 1.44~6.70, P=0.004), often bend and turn (OR=2.36, 95%CI: 1.05~5.29, P=0.037), bend your knees homework for a long time (OR=2.29, 95%CI: 1.17~4.47, P=0.015) ; Working posture uncomfortable (OR=2.26, 95%CI: 1.51~3.38, P<0.001), bending the neck (OR=1.68, 95%CI: 1.03~2.74, P=0.036), neck minister time keep the same position (OR=1.81, 95%CI: 1.22~2.67, P= 0.003) It is a risk factor for shoulder, neck and upper back WMSDs; Risk factors for limb-lower back WMSDs include: Length > 10 years (OR=2.16, 95%CI: 1.24~3.78, P<0.001), the working position uncomfortable (OR=2.38, 95%CI: 1.63~3.48, P<0.001), bending the neck (OR=1.66, 95%CI: 1.03~2.68, P=0.039) . Conclusion: The prevalence rate of WMSDs among logistics workers in automobile manufacturing enterprises is high, which has obvious characteristics of classification and comorbis, and is closely related to individual characteristics such as sufficient rest time and working posture of workers.

Dietary calcium levels regulate calcium transporter gene expression levels in the small intestine of broiler chickens.

1. This study investigated the effect of dietary calcium (Ca) levels on growth performance, bone development and Ca transporter gene expression levels in the small intestine of broiler chickens.2. On the day of hatch, 350, Ross 308 male broilers were randomly allotted to one of five treatments with five replicate pens each and 14 birds per pen. Dietary Ca levels in feed were 5.0, 7.0, 9.0, 11.0 and 13.0 g/kg, in which 9.0 g/kg was in the control diet. All diets contained 4.5 g/kg non-phytate phosphorus (NPP).3. The increase in dietary Ca levels from 5.0 to 13.0 g/kg did not affect the growth performance of 1- to 18-day-old broilers (P > 0.05).4. Increasing the Ca levels linearly increased the ash weight and the contents of ash, Ca and phosphorus (P) in the tibia of broilers at 18 days of age (P < 0.05). The contents of ash, Ca and P in broilers fed with 9.0 g/kg Ca were higher than those in birds fed with 5.0 g/kg Ca (P < 0.05).5. Increasing the Ca levels linearly decreased mRNA expression levels of the Ca-binding protein 28-kDa (CaBP-D28k), plasma membrane Ca-transporting ATPase 1b (PMCAlb), sodium (Na)/Ca exchanger 1 (NCX1), nuclear vitamin D receptor (nVDR) and membrane vitamin D receptor (mVDR) in the duodenum of broilers at 18 d of age (P < 0.05). Similar results were seen in the jejunum and ileum. Broilers fed 9.0-13.0 g/kg Ca in feed had lower mRNA expression levels of CaBP-D28k and PMCAlb in the small intestine than birds fed 5.0 g/kg Ca in feed (P < 0.05).6. The data indicated that low levels of dietary Ca stimulated its transporter gene transcription and promoted absorption, but high levels of Ca inhibited transporter gene expression and prevented excessive absorption in the small intestine of broiler chickens.

[Role of personalized 3D printing in brain protection after decompressive craniectomy].

Objective: To explore the application value of personalized three-dimensional (3D) printed protective cap in brain protection after decompressive craniectomy (DC). Methods: Fourty-five patients who underwent DC from January 2021 to October 2021 were selected, including 26 males and 19 females, aged 5-73 (50±13) years old. The brain CT data were imported into 3D Slicer software to rebuild the protective cap through 3D printing. The cap was worn on the head of the patient, thereby preventing secondary braindamage. The follow-up results were compared with 53 patients without protective capduring the same period. Results: There were no statistically significant differences in age, skull defect location and follow-up time between the two groups (all P>0.05).Among 45 patients, 47 brain protective caps (2 cases with bilateral skull defects) were successfully designed. The time for image post-processingand 3D printing was (21.2±6.0) min and (62.4±8.3) min, respectively. There were 6 cases of low compliance, 9 cases of moderate compliance, 32 cases of high compliance, respectively. Six cases with low conformity were redesigned and printed, 2 of 9 cases with moderate conformity were redesigned and printed, and the remaining 7 cases reached high compliance after grinding and packaging. In the current study, 45 patients with brain protective caps were followed up for 3 months, and no secondary brain injury occurred. However, among 53 patients without brain protective caps during the same period, 4 patients had secondary accidental brain compression. The incidence of injury was 7.5 %, and the difference was statistically significant (P<0.001). Conclusion: Brain protective cap designed based on cranial CT and 3D printing can be used in patients with skull defects to protect the brain tissue from secondary crush damage and has certain clinical value.

[Updates in diagnosis, treatment, and prevention of anaphylaxis to neuromuscular blocking agents and their antagonists].

Anaphylaxis to perioperative drugs has an insidious and rapid onset, can be life-threatening, and often results in the suspension of surgery. Neuromuscular blocking agents (NMBAs) are currently considered to be the most common cause of anaphylactic reactions among anesthetic drugs. With the increasing amount of anesthesia and surgery in the world, there are more and more NMBAs use, and the corresponding allergic risk is also increasing. With the use of NMBAs, their antagonists, such as neostigmine and sugammadex, are often used too, which have more and more allergy reports in clinical practice. Due to the complex mechanism of allergy caused by NMBAs and their antagonists, it is difficult to find out the culprit drug. The cross-reactivity between NMBAs is common, so it is often difficult to choose alternative drugs. This article summarized the epidemiology, pathological mechanisms, diagnostic methods and procedures, immediate treatment, and prevention strategies of anaphylaxis caused by these drugs.

[Status of HVPG clinical application in China in 2021].

Objective: The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China. Methods: This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems. Results: According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%). Conclusion: Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

[Clinical application analysis of a method for locating scalp projection of intracranial lesions based on neuroimaging].

Objective: To explore the feasibility of a method based on neuroimaging and surface markers for locating scalp projection of intracranial lesions. Methods: The clinical data of 46 patients who were used 'double-circle method' for locating scalp projection of intracranial lesions at Department of Neurosurgery,the First Affiliated Hospital of Xiamen University from January to June 2021 were retrospective analyzed. All patients with 2 electrodes(artificial fiducials) randomly attached to scalp had been examed thin-layer brain CT. The distances from the center of each fiducial to the root of the nose and tragus were measured through the images. A compass was used to draw two arcs with the root of nose and the tragus as the center and the pre-measured distance as the radius on patient's scalp. Then two arcs' intersection on the scalp was the fiducial. The method was named 'double-circle method'. Two neurosurgeons were arranged to perform fiducial identification with double-circle method, and record the error between the result and the actual fiducial point.Independent sample t test was used for data comparison, and Kappa test was used to analysis the inter-group consistency. Results: Ninety-two fiducial points of 46 patients were collected. Time consuming of doctor A was (8.1±2.3) minutes(range:5 to 15 minutes)and doctor B was (8.9±3.5) minutes(range:4 to 17 minutes).The positioning error from the doctor A was (4.4±2.4)mm(range:0 to 12 mm) and doctor B was(4.2±2.6) mm(range:0 to 14 mm)(t=-0.575,P=0.567),the difference was not statistically significant. The Kappa value of the consistency test of error between two doctors was 0.517(P=0.001).The consistency was moderate.Eight patients used 'double-circle method' and neuronavigation for locating scalp projection of intracranial lesions at the same time. The diameter of the lesions was (3.8±0.9)cm (range: 2.6 to 5.1 cm), and the positioning error of the 'double-circle method' and navigation was (4.0±1.9) mm(range: 1 to 6 mm), and all patients were confirmed to be accurately located during surgery. Conclusion: 'Double-circle method' is a simple,convenient and accurate way in locating intracranial lesions and has certain clinical significance.

Genome-wide association study of fleece traits in Inner Mongolia Cashmere goats.

Inner Mongolia Cashmere goat is a well-known local cashmere goat breed in China. It is famous for excellent fleece quality and a significant advantage in cashmere yield compared to other cashmere goat breeds. In this study, a genome-wide association study was used to investigate fiber length, fiber diameter, and cashmere yield of 192 Inner Mongolia Cashmere goats using the Illumina GoatSNP52K Beadchip panel. We discovered that four single nucleotide polymorphisms (SNPs) reached genome-wide significance levels. These SNPs were located in some genes, e.g. FGF12, SEMA3D, EVPL, and SOX5, possibly related to fleece traits in Inner Mongolia Cashmere goat. Gene ontology enrichment analysis revealed that these genes were enriched in several biological pathways that were involved in hair follicle development in cashmere goats. In summary, the identified significant SNPs and genes provide useful information to explore genetic mechanisms underlying the variation in fleece traits and genomic selection of Chinese cashmere goat.

[Evaluation of methods for fitness of removable partial denture].

OBJECTIVE: To compare the differences and indications of three evaluation methods for fitness evaluation of removable partial denture (RPD). METHODS: A RPD was fabricated and seated on the stone cast of a partially edentulous mandible, and the spaces between RPD and stone cast were recorded with polyvinyl siloxane (PVS) impression material forming PVS replicas. Using cross sectional measurement, the average thicknesses of PVS replicas were measured under stereomicroscope with different numbers of selected measuring points in the denture base, major connector, occlusal rest of the RPD, and the average thicknesses of the PVS replicas measured with different numbers of measuring points were compared using one-way analysis of variance (ANOVA) and independent sample t test. Three kinds of method, including cross sectional measurement, three-dimensional analysis on the stone cast, and three-dimensional analysis on the polyether cast, were applied to measure the average thicknesses of the PVS replicas, and the average thicknesses of the PVS replicas measured by these three evaluation methods were compared with ANOVA. RESULTS: For cross sectional measurement, statistically significant differences were found in the average thicknesses of the PVS replicas in the denture base and the major connector among the different numbers of measuring points (P < 0.05), but no differences were found in the average thicknesses of the PVS replicas in the occlusal rest (P>0.05). There were significant differences among the average thicknesses of the PVS replicas measured by these three evaluation methods in each component of the RPD (P < 0.01). The average thickness measured by three-dimensional analysis on the stone cast and three-dimensional analysis on polyether cast were smaller than that measured by cross sectional measurement (P < 0.05). And there were no differences between the average thicknesses of PVS replicas measured by three-dimensional analysis on stone cast and three-dimensional analysis on polyether cast (P>0.05). CONCLUSION: For cross sectional measurement, the average thickness of the PVS replicas was influenced by the number of measuring points, and the measurement accuracy of cross sectional measurement was not reliable enough. Three-dimensional analysis on stone cast which is suitable for evaluation in vitro and three-dimensional analysis on polyether cast which is suitable for evaluation in vivo can evaluate the fitness of RPD more comprehensively and effectively than that of cross sectional measurement.

[Comparison of autopsy and magnetic resonance imaging of triangular fibrocartilage complex structure].

Objective: To evaluate the reliability and accuracy of magnetic resonance imaging (MRI) on describing the structure of triangular fibrocartilage complex (TFCC) in 7 cadavers with autopsy being the golden standard. Methods: In total, 7 healthy cadavers were included (4 males, 3 females, the average age was 51 years). All cadavers were preserved under -30 ℃ condition and thawed out before the experiment. The autopsy was performed by the same group of hand surgeons immediately after the MRI examination (3.0 tesla, wrist coil,"superman"position). The integrity of triangular fibrocartilage (TFC), proximal component/distal component of distal radioulnar ligament (DRUL), ulnocarpal ligament (UCL) was evaluated, and the thickness of central portion of TFC was measured during the autopsy. The sensitivity, specificity, positive/negative predictive value (PPV/NPV) and positive/negative likelihood ratio (PLR/NLR) of MRI were calculated. The intraclass correlation coefficient (ICC) was calculated between the thickness of central portion of TFC on MRI and autopsy results. Results: With autopsy being the golden standard, the ICC of MRI= 0.838 (95%CI: 0.33-0.97, P<0.01). In evaluating the condition of central portion of TFC by MRI, sensitivity= 1, specificity=1, PLR=+∞, NLR=0. In evaluating the condition of proximal component/distal component of DRUL by MRI, sensitivity=1, specificity=0.83, PLR=6, NLR=0. The sensitivity, specificity, PPV, NPV, PLR, NLR of integrity of UCL in MRI was 0.33, 0.75, 0.50, 0.75, 1.33, 0.89, respectively. Conclusion: The 3.0T MRI can be a useful tool in diagnosis of the injury of TFC and proximal/distal component of DRUL, as it has a good description of TFCC's subtle structure.

[Appropriate protocol of treatment modulation for seasonal allergic rhinitis caused by cypress pollens].

Objective: To investigate appropriate protocol of treatment modulation for seasonal allergic rhinitis (AR) patients, in order to promote the implementation of personalized medicine. Methods: Total of 124 AR patients allergic to cypress pollens were recruited from January to February 2020 in Department of Allergy in Peking Union Medical College Hospital, 43 males and 81 females with an average age of (41±9) years. The patients were divided into two groups with block randomization method. In the first group, treatment was modulated every two days according to the average daily rhinoconjunctivitis symptom score of the last two days (short-term symptom-score group); while in the second group, therapy regimen was adjusted every week based on the Allergic Rhinitis Control Test (ARCT) score of the last week (long-term ARCT group). The treatment level was up-regulated when the cypress pollen count increased and stayed at a high level (step-up pharmacotherapy stage); and treatment was down-regulated while the pollen count decreased (step-down pharmacotherapy stage). Daily symptom scores, medicine scores, and ARCT scores of the two groups were recorded and compared. Results: During the whole cypress pollen season, the daily rhinoconjunctivitis symptom score of short-term symptom-score group was significantly lower than that in long-term ARCT group(2.4±1.0 vs 2.7±1.0, P<0.01), and the difference between the two groups was more pronounced in the step-up pharmacotherapy stage than that in the step-down pharmacotherapy stage, while there was no statistical difference between the daily medicine scores of the two groups (P>0.05). During the pollen rising period, the ARCT score of short-term symptom-score group was significantly better than that of long-term ARCT group (21(19, 22) vs 20 (17, 21), P=0.049); while in the pollen peak period and decreasing period, the ARCT scores of the two groups showed no statistical difference (P>0.05). The proportion of incompliance with doctor's advice was higher in long-term ARCT group compared to that in short-term symptom-score group (30.1% vs 6.7%, P<0.001). Conclusion: The protocol of treatment modulation for seasonal AR patients allergic to pollens should be developed flexibly according to the variation trend of pollen allergen exposure, so as to implement the idea of personalized medicine.

[Expression and clinical significance of CXC chemokine ligand 10 in glioma].

Objective: To analyze the expression of CXC chemokine ligand 10 (CXCL10) in glioma and its clinical significance through bioinformatics. Methods: The expression level of CXCL10 in glioma, and its prognostic significance, gene ontology (GO) function annotation, Kyoto Encyclopedia of Genes and Genome (KEGG) pathway enrichment and the correlation of tumor cell purity were analyzed in TCGA, CGGA, MetaScape, TIMER databases. In addition, 34 clinical glioma tissues were collected for Western Blot and immunohistochemistry to further verify the correlation between CXCL10 and glioma. Results: CGGA and TCGA database analysis showed that with the increase of WHO grade, the expression of CXCL10 in gliomas increased (P<0.01). The overall survival rate of patients with high CXCL10 expression was significantly lower than that of patients with low expression (χ2 =148.1,P<0.05). Among patients with grade Ⅳ glioblastoma who received radiotherapy or chemotherapy, the patients with low CXCL10 expression were associated with good survival (χ2 =6.714,P<0.05;χ2 =5.618,P<0.05). Moreover, GO and KEGG analysis showed that genes co-expressed with CXCL10 were mainly enriched in the biological processes such as cytokine-mediated signaling pathways, regulating adaptive immune responses and inflammatory responses. Furthermore, TIMER database analysis showed that CXCL10 was negatively correlated with the purity of glioma cells (LGG: r=-0.129;GBM: r=-0.165;P<0.05). Similarly, clinical sample analysis also showed that the expression level of CXCL10 increased in glioma, and it increased with the grade of glioma (all P<0.05). Conclusion: The expression of CXCL10 is up-regulated in glioma as well as it increased with the malignant degree of glioma. At the same time, the high expression of CXCL10 in glioma is closely related to the poor prognosis of patients.

[The effect on patient life quality of prophylactic treatment to seasonal allergic rhinitis and related transcriptomics research].

Objective: The preseason prophylactic treatment of seasonal allergic rhinitis (AR) caused by pollens could alleviate AR symptoms during the pollen season. This study aimed to evaluate the effect of prophylaxis usage of suplatast tosilate on the life quality of AR patients in the pollen season, and investigate the potential mechanism of action through transcriptomic analysis. Methods: This is a randomized controlled study. AR patients allergic to weed pollens were recruited from Allergy Clinic of Peking Union Medical College Hospital from January 2020 to June 2020, and divided into prophylactic group who started to take suplatast tosilate as prophylaxis 2 weeks before the spread of weed pollens[n=10, 4 men and 6 women with age range of (34±6) years old] and control group who did not use any prophylactic treatment[n=24, 12 men and 12 women with age range of (33±9) years old]. The differences of age (t=0.381, P=0.706) and gender (χ²=0.595, P=0.715) distribution between the patients of two groups were not statistically significant. All the subjects filled in the rhinoconjunctivitis quality of life questionnaire (RQLQ) while onset of AR symptoms, and peripheral blood was drawn for transcriptomic analysis 1 month before and during the pollen season. Differences between groups were statistically analyzed through chi-square test and t test. Results: There was no significant difference in visual analogue scale of rhinitis symptom in the last pollen season between prophylactic group and control group[ 8.0 (6.4, 9.3) vs 7.3 (6.1, 8.0), Z=1.180, P=0.254]. The RQLQ score of prophylactic group was superior to that of control group in the weed pollen season (2.9±0.9 vs 3.7±0.9, t=-2.438, P=0.026). 210 differentially expressed genes of fold change ≥2 were identified, with 147 genes upregulated and 63 genes downregulated in the prophylactic group compared to the control group. Gene Ontology annotation showed that IL-12 and IL-23 related pathways were downregulated in prophylactic group (P=0.006 48). Polymerase Chain Reaction (PCR) verification of differentially expressed genes indicated that the relative expression level of HLA-G in prophylactic group was significantly lower than that in control group (0.23±0.19 vs 1.00±0.49,t=4.016, P=0.006). Conclusion: The prophylactic treatment of suplatast tosilate showed some benefit to the life quality of seasonal AR patients during the pollen season, and the potential mechanism might be related with the downregulation of IL-12 and IL-23 pathways and decreased expression of HLA-G.

[An investigation of musculoskeletal disorders at multiple sites and related influencing factors among workers in an automobile assembly shop].

Objective: To investigate the current status of work-related musculoskeletal disorders (WMSDs) in automobile assembly workers, as well as the distribution of WMSDs at multiple sites and related influencing factors. Methods: From March to July 2019, cluster sampling was performed to select 663 male automobile assembly workers as respondents, and the musculoskeletal injury questionnaire was used to investigate their general status and working condition. A multinomial logistic regression analysis was used to analyze the influencing factors for WMSDs at multiple sites. Results: The detection rate of WMSDs within the past 7 days was 37.9% (251/663) among the automobile assembly workers, and the detection rate of WMSDs within the past 1 year was 51.9% (344/663) . Of all workers, 13.6% (90/663) had WMSDs involving only 1 site, while 38.3% (254/663) had WMSDs involving 2 or more sites. The multinomial logistic regression analysis showed that frequent turns during work was a risk factor for WMSDs involving 1-3, 4-6, and 7-9 sites (odds ratio [OR]=1.65, 2.47, and 3.65, respectively) . Repeated action of lower extremities and ankles was a risk factor for WMSDs involving 4-6 and 7-9 sites (OR=2.15 and 2.98, respectively) . Working in an uncomfortable position was a risk factor for WMSDs involving 1-3, 4-6, and 7-9 sites (OR=1.95, 2.67, and 3.04, respectively) . Prolonged standing during work was a risk factor for WMSDs involving 1-3 and 4-6 sites (OR= 1.87 and 1.79, respectively) . Working overtime was a risk factor for WMSDs involving 7-9 sites (OR=5.48) . Adequate time for rest was a protective factor against WMSDs involving 1-3 and 4-6 sites (OR=0.50 and 0.31, respectively) . Conclusion: There is a high detection rate of WMSDs in automobile assembly workers, and WMSDs at multiple sites are more common than WMSDs at a single site. Poor position and organizational management factors are risk factors for occupational WMSDs at multiple sites.

[Analysis on prevalence status and the influencing factors of work-related musculoskeletal disorders among workers in an automobile manufacturing enterprise in Guangzhou City].

Objective: To analyze the detection and influencing factors of work-related musculoskeletal disorders (WMSDs) of workers in an automobile manufacturing enterprise in Guangzhou City. Methods: In April 2020, a total of 7065 workers of an automobile manufacturing enterprise in Guangzhou City were selected as research subjects using cluster sampling method. The Nordic Musculoskeletal Questionnaire (NMQ) was used to investigate the detection of WMSDs. Multiple logistic regression analysis was used to analyze the influencing factors of WMSDs. Results: The detection rate of WMSDs was 43.9% (3102/7065) , among which the detection rate of multiple WMSDs was 31.4%. The detection rates of WMSDs in different parts from high to low were as follows: neck (24.5%) , shoulder (21.1%) and ankle (20.1%) . Multivariate logistic regression analysis showed that working experience of 3-8 years, >8 years, age>30 years old, repetitive work every day, multiple repetitions per minute, uncomfortable work posture, frequent overtime work and lack of staff in the department were risk factors for multi-site WMSDs (P<0.05) . Adequate rest time was a protective factor for multi-site WMSDs (P<0.05) . Conclusion: The detection rates of WMSDs in neck, shoulder, ankle, and multisite in automobile manufacturing enterprise are relatively high. The primary risk factors include adverse ergonomic factors and unreasonable organization of labour factors, optimize the work breaks can effectively reduce the risk of disease, effective ergonomic interventions should be carried out to prevent the occurrence of WMSDs among workers in the automobile manufacturing industry.

[Analysis of influencing factors of work-related musculoskeletal disorders of workers in a cabinet factory].

Objective: To investigate the occurrence of work-related musculoskeletal disorders (WMSDs) in the cabinet factory workers, and explore the influencing factors of workers' WMSDs. Methods: A cross-sectional survey method was used to investigate the risk factors such as basic conditions, labox dnganiza, ergonomics load and occurrence of WMSDs of 821 workers in a cabinet factory of a furniture manufacturing company in Guangdong Province using the electronic version of the Musculoskeletal Injury Questionnaire from October to December 2019. χ(2) test and logistic regression were used to analyze the risk factors leading to WMSDs. Results: The incidence of WMSDs in cabinet production workers reached 51.5% (423/821) , and the top three incidences were shoulder (28.4%, 233/821) , neck (28.1%, 231/821) , and wrist (25.9%, 213/821) . The incidence of neck WMSDs was statistically significant among different types of work (P<0.05) . Multiple repetitive operations per minute (OR=1.70) , torso often maintaining the same posture (OR=1.61) , turning heads for a long time (OR=1.58) and frequent heavy lifting (OR=1.44) were risk factors for the occurrence of shoulder WMSDs (P<0.05) . Frequent maintenance of the same posture in the neck (OR=1.91) , repeated operations per minute (OR=1.87) , shortage of department staff (OR=1.65) and turning head for a long time (OR=1.48) were risk factors for the occurrence of neck WMSDs (P<0.05) . Long-term bending of the wrist (OR=2.25) , grasping objects tightly (OR=2.13) , working hard on the upper limbs or hands (OR=1.91) , shortage of department personnel (OR=1.84) , repeated operations per minute (OR=1.68) and the use of vibration tools (OR=1.51) were risk factors for the occurrence of WMSDs in the wrist (P<0.05) . Conclusion: The incidence of WMSDs in cabinet factory is relatively high, the occurrence of WMSDs in the shoulders, necks and wrists is more serious. Reasonable labor organization and reducing the load of poor ergonomics in the workplace, can reduce the occurrence of WMSDs in production workers.