Changes of mercury and methylmercury content and mercury methylation in Suaeda salsa soil under different salinity.

In this paper, we studied the changes of Hg and MeHg contents in Liaohe estuarine Suaeda salsa soils under anaerobic conditions by simulated indoor incubation at constant temperature and whether the changes of salinity (CK, 0.5%, 1.0%, 1.5%, 2.0%) affected SRB and dominated the formation of MeHg. The lowest Hg content is found in the subsurface Suaeda salsa soils at 2.0% salinity. The MeHg content in the soil also showed a general trend of increasing and then decreasing with increasing flooding salinity, and the MeHg content was higher at 0.5-1.0% flooding salinity. SRB was present in the soil under all salinity conditions and reached the maximum value at 15 days of incubation. The SRB content was higher under CK, S1 and S2 conditions, and the soil MeHg content showed a significant positive correlation with the number of SRB bacteria, indicating that the formation of MeHg was related to SRB which is of great significance to the study of estuarine wetlands.

A chimeric influenza virus vaccine expressing fusion protein epitopes induces protection from human metapneumovirus challenge in mice.

Human metapneumovirus (HMPV) is a common virus associated with acute respiratory distress syndrome in pediatric patients. There are no HMPV vaccines or therapeutics that have been approved for prevention or treatment. In this study, we constructed a novel recombinant influenza virus carrying partial HMPV fusion protein (HMPV-F), termed rFLU-HMPV/F-NS, utilizing reverse genetics, which contained (HMPV-F) in the background of NS segments of influenza virus A/PuertoRico/8/34(PR8). The morphological characteristics of rFLU-HMPV/F-NS were consistent with the wild-type flu virus. Additionally, immunofluorescence results showed that fusion proteins in the chimeric rFLU-HMPV/F-NS could work well, and the virus could be stably passaged in SPF chicken embryos. Furthermore, intranasal immunization with rFLU-HMPV/F-NS in BALB/c mice induced robust humoral, mucosal and Th1-type dominant cellular immune responses in vivo. More importantly, we discovered that rFLU-HMPV/F-NS afforded significant protective efficacy against the wild-type HMPV and influenza virus challenge, with significantly attenuated pathological changes and reduced viral titers in the lung tissues of immunized mice. Collectively, these findings demonstrated that chimeric recombinant rFLU-HMPV/F-NS as a promising HMPV candidate vaccine has potentials for the development of HMPV vaccine.

Triptolide inhibits IFN-γ signaling via the Jak/STAT pathway in HaCaT keratinocytes.

Interferon-gamma (IFN-γ) signaling in keratinocytes plays an important role in IFN-γ-mediated skin inflammation involved in psoriasis. Blocking IFN-γ signal transduction in keratinocytes could be a strategy for controlling inflammatory skin disorders. Tripterygium wilfordii Hook. F. (T. wilfordii) has been used effectively in psoriasis treatment in China. Its therapeutic mechanism on IFN-γ-dependent inflammation has not been elucidated. Triptolide is one of main components of T. wilfordii's antiinflammatory and immune effects. This study aimed to explore the effects of triptolide on an rhIFN-γ-stimulated human keratinocyte cell line (HaCaT) in culture. The expression of IFN-γ receptor α (IFN-γRα), phospho-Janus kinase2 (pJak2), phospho-signal transducer and activator of transcription 1 (pSTAT1) and suppressor of cytokine signaling 1 (SOCS1) was detected by western blotting. The expression of intercellular adhesion molecule-1 (ICAM-1) on the HaCaT cell surface was determined by cell-surface ELISA. The results demonstrated that triptolide inhibited the expression of IFN-γRα (IC50 = 1.37 × 10⁻8 M), pJak2 (IC50 = 2.82 × 10⁻9 M) and pSTAT1 (IC50 = 1.29 × 10⁻9 M) in HaCaT cells. The expression of SOCS1 was up-regulated (ED50 = 3.32 × 10⁻¹¹ M). Triptolide also significantly reduced the expression of ICAM-1 on the HaCaT cell surface (IC50 = 5.82 × 10⁻¹° M). This study suggests that triptolide may contribute to the therapeutic value of T. wilfordii by modulating the IFN-γ signal pathway in IFN-γ-dependent skin inflammatory diseases, including psoriasis.

Heterostructured TiO2@HKUST-1 for the enhanced removal of methylene blue by integrated adsorption and photocatalytic degradation.

Aiming at exploring an effective photocatalytic adsorbent for organic dye removal, a series of heterostructured TiO2@HKUST-1 photocatalysts, by incorporating HKUST-1 with different TiO2 nanoparticles loading, were prepared by single-step hydrothermal method. The morphology and surface characteristics of the as-prepared TiO2@HKUST-1were analyzed using SEM, HRTEM, XRD, FTIR, UV-vis DRS, and Photoluminescence techniques. The adsorption-photocatalytic degradation of the model dye methylene blue (MB) on the catalysts was investigated. It was indicated that the introduction of a certain amount of TiO2 on the surface of HKUST-1 could improve the transfer and separation of the photogenerated charge carriers, resulting in the enhanced photocatalytic activity. The optimal 0.02TiO2@HKUST-1 exhibited the highest MB removal rate with about 4.4 and 19.3 times as high MB removal efficiency as that of HKUST-1 and TiO2, respectively. Heterostructured TiO2@HKUST-1 materials for the removal of MB involved the integrated adsorption and visible light photocatalysis. Meanwhile, the composite exhibited good reusability in the process of cyclic experiments. Therefore, this work provides a potential MOF-based photocatalytic adsorbent for organic dye removal.

Dilemma and promotion strategy of “dual channel”management policy for China’s medical insurance negotiated drugs / 中国药房

OBJECTIVE To provide reference for the smooth implementation of the “dual channel” management policy for China’s medical insurance negotiated drugs. METHODS Based on Smith policy implementation process model， the dilemmas for the implementation of “dual channel” policy for medical insurance negotiated drugs were analyzed from four aspects： implementation details and regulatory system， drug selection， drug provision and quality control， the situation of medical insurance funds and information technology capabilities. The corresponding promotion strategies were put forward. RESULTS & CONCLUSIONS The “dual channel” policy for medical insurance negotiated drugs in China might face implementation difficulties such as a lack of clear implementation rules and a full process supervision system， the suitability and operability of some medical insurance negotiated drugs need to be considered in the “dual channel” management， difficulties in drug allocation and quality control， differences in the management and operation of medical insurance funds in different regions， and insufficient informatization capability. In this regard， this study suggests that measures， such as improving the implementation rules of the “dual channel” policy， enhancing the rationality of the “dual channel” drug catalog， establishing a dynamic exit mechanism for “dual channel” pharmacies， promoting professional delivery services， and improving the electronic prescription circulation platform， which can be taken to enhance the implementation effect of the “dual channel” policy.

Review of methods for establishing limbal stem cell deficiency in animal model / 中华实验眼科杂志

Limbal stem cell deficiency (LSCD) is a common ocular surface disease.Severe LSCD can cause irreversible vision loss and the only effective treatment for severe LSCD is keratoplasty, which is limited by the number of donors.Exploring new effective treatments in lieu of keratoplasty remains a hot topic in current research.Since new treatments need to be critically evaluated in reliable animal models that reflect the pathological mechanisms of human LSCD, the establishment of an appropriate animal model is crucial in any experiment.Up to now, the main modeling methods for LSCD are mechanical method, thermal injury, chemical method, chemical method combined with surgery, and gene knock-down.Mechanical method is mature, reliable and widely used, but it can cause serious mechanical damage.Rotate burr tool could be the best mechanical method because of uniform damage and the small trauma, but it requires accumulation of experience.Cornea suffered from thermal injury performs stable, but the operation is complicated and uncontrollable.Chemical method is quick and simple, and the etiology is highly consistent with clinical cases, but the depth and extent of injury are uncontrollable.The chemical method combined with surgery could ensure the smoothness and flattening of the corneal surface, but the thickness of the central cornea and the limbus may be inconsistent, which affects neovascularization.The gene knockdown method is not widely used because of its complicated operations.Although there are different types of methods, the quality of modeling in different studies is not consistent.Therefore, selecting a reliable and efficient animal model of LSCD is not convenient for researchers.This review discussed current methods to establish LSCD model, including their advantages and disadvantages, therefore to provide inspiration for future model improvement.

Scoping review of research on mobile app-based weight management in patients with breast cancer / 中华健康管理学杂志

Objective:To conduct a scoping review of mobile app-based weight management studies in patients with breast cancer.Methods:The studies related to weight management in patients with breast cancer based on mobile apps in nine Chinese and English databases, including PubMed, Embase, Cochrane, EBSCOhost, Scopus, Sinomed, VIP database, Wanfang Database and China National Knowledge Infrastructure (CNKI), were systematically searched with the terms of “breast cancer” “weight management” “mobile health” and “weight”. The search period was from the establishment of the databases to July 29, 2022. The literature was screened, and data were extracted and summarized based on the Omaha system.Results:A total of 7 literatures were included, all were in English. The mobile apps included in the studies varied with sample sizes, ranging from 10 to 356 cases. Six of the studies involved breast cancer patients who had completed surgery or chemoradiotherapy, and none of the studies involved breast cancer patients undergoing chemotherapy. Forms of intervention included exercise or diet alone and a combination of both exercise and diet, and most studies had shown good intervention effects. According to the Omaha intervention system, the most commonly extracted intervention component was self-management advice, which was offered to patients in six studies, and none of the intervention studies included intervention components related to case management.Conclusions:An intervention for weight management based on mobile apps in breast cancer patients has a good effect and is feasible. However, there is a limited number of related studies, and there is a lack of interventional research specifically targeting patients during chemotherapy, which still needs to be actively carried out.

Advances in drug therapy for primary sclerosing cholangitis / 临床肝胆病杂志

Primary sclerosing cholangitis （PSC） is a cholestatic disease characterized by chronic progressive bile duct inflammation and has a low incidence rate and poor prognosis in China. There is still no drug therapy that can change the course of PSC， and liver transplantation is the only effective treatment for PSC， with a 5-year survival rate of 85% after transplantation. Drug therapy for PSC is facing great challenges based on the current status of PSC. At present， drugs for the treatment of PSC are in the stage of clinical trials and have shown certain application prospect， among which ursodeoxycholic acid is the most widely studied and commonly used drug. In addition， there are many emerging drugs in the pipeline. This article summarizes the latest advances in drug therapy for PSC.

High salt diet leads to abnormal mitochondrial function in mouse ovarian tissue / 中国医科大学学报

Objective To analyze the effect of a high salt diet on ovarian mitochondrial function.Methods Twenty female ICR mice were randomly divided into a normal salt diet(NSD)group and a high salt diet(HSD)group(n = 10 each).The NSD group was given a normal salt diet and the HSD group was given an 8%NaCl diet for 4 weeks.A high salt-treated cell model was established by inducing COV-434 cells cultured in vitro with NaCl.Western blotting was used to detect the protein expression of superoxide dismutase(SOD)and ComplexesⅠ-Ⅴ.The activity of SOD and succinate dehydrogenase(SDH)was detected kinetically.A chemiluminescence assay was used to detect adenosine triphosphate(ATP)levels.Results Compared with the NSD,the HSD significantly reduced the expression level of ComplexⅠin ovarian mitochondria(P＜0.01),significantly increased the expression level of ComplexⅤ(P＜0.05),and significantly reduced the activity of SDH and content of ATP(P＜0.01).The expression level of ComplexesⅠandⅡdecreased significantly(P＜0.05),expression level of ComplexⅤ increased significantly(P＜0.05),activity of SDH decreased significantly(P＜0.01),and content of ATP was insufficient(P＜0.01)in COV-434 cells cultured under high salt conditions.Conclusion High salt can lead to mitochondrial dys-function in the mouse ovary,such as imbalanced oxidative homeostasis,changed expression level of electron transport chain complexes,blocked tricarboxylic acid cycle,and insufficient ATP level.

Evaluation of the therapeutic efficacy of Scarf osteotomy in treating metatarsal varus type adolescent hallux valgus / 中华骨科杂志

Objective:To investigate the efficacy of the Scarf osteotomy in treating adolescents with metatarsus adductus-type hallux valgus.Methods:A retrospective analysis was conducted on 20 patients (30 feet) treated with the Scarf osteotomy for metatarsus adductus-type hallux valgus at the Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, from July 2022 to August 2023. This group included 10 patients with bilateral conditions and 10 with unilateral, comprising 4 males and 16 females, with an average of 16.2±2.4 years (range, 14-19 years). The procedure involved the release of the lateral capsule, sesamoid ligaments, and adductor hallucis before osteotomy. After osteotomy, shortening and wedge resection were performed, along with translation and rotation of the distal osteotomy to reposition the first metatarsal beside the second and thereby reduce metatarsus adductus. The outcomes included preoperative, immediate postoperative, and final follow-up angles: hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal adduction angle (MAA), and the angle between the second to fifth metatarsals.Results:All 20 patients successfully underwent surgery with good wound healing and no infections; the average clinical healing time of osteotomy site was 5.1±0.7 weeks (range, 4.1-6.6 weeks). Follow-up lasted for 12.0±5.4 months (range, 2-18 months). Significant differences were observed in HVA, which was from 35.40°±5.45° preoperatively to 6.93°±3.60° immediately postoperatively, and 9.83°±2.65° at final follow-up; IMA, which was from 11.50°(9.75°, 14.00°) preoperatively to 1.50°(0.00°, 2.00°) immediately postoperatively, and at final follow-up; MAA, which was from 22.80°±2.60° preoperatively to 20.63°±2.27° immediately postoperatively, and 20.67°±2.20° at final follow-up; the angle between the second to fifth metatarsals,which was from 19.03°±1.85° preoperatively to 15.37°±1.33° immediately postoperatively, and 16.03°±1.73° at final follow-up. Visual analogue scale (VAS) also significantly decreased from 2.60±1.64 preoperatively to 1.30±0.92 at 6-8 weeks postoperatively. No cases of transfer metatarsalgia or recurrence of hallux valgus were reported.Conclusion:The Scarf osteotomy for metatarsus adductus-type hallux valgus effectively corrects the first metatarsal adduction and improves the adduction state of the remaining metatarsals to various degrees.

Multimodal analgesia in the treatment of a case of pediatric primary erythromelalgia with infection and pharma-ceutical care / 中国药房

OBJECTIVE To explore a multimodal analgesia regimen based on spinal cord electrical stimulation for children with primary erythromelalgia and the key points of pharmaceutical care. METHODS Clinical pharmacists participated in the treatment of a child with primary erythromelalgia complicated with skin infection. After reviewing domestic and foreign literature， multimodal analgesia was formulated and pharmaceutical care was carried out to address the difficulties in treating the patient’s illness. RESULTS The treatment team applied multimodal analgesia based on spinal cord electrical stimulation for the child， including a multi-drug combination involving different analgesic pharmacological targets， multiple administration routes （oral， intravenous， epidural， percutaneous）， multiple technologies （spinal cord electrical stimulation， local nerve block， patient- controlled analgesia）， individualized schemes of adjuvant therapy， and the child was monitored for the safety of drug use. The pain was controlled during the treatment and follow-up period， the wound was healed， and no serious adverse drug reactions occurred. CONCLUSIONS Multimodal analgesia based on spinal cord electrical stimulation is a safe and effective treatment for children with primary erythromelalgia.

Analysis of clinical features of 87 hospitalized children with pertussis / 中国现代医生

Objective To investigate the clinical features of hospitalized children with pertussis.Methods The clinical data of 87 hospitalized children with pertussis admitted to Women and Children's Hospital Affiliated to Xiamen University from January 2019 to December 2022 were retrospectively analyzed.According to the age of the children,they were divided into group A(≤3 months of age,35 cases),group B(4-12 months of age,36 cases)and group C(>12 months of age,16 cases).The clinical features of children at different ages were compared.Results The majority of children with pertussis were<1 year old(81.61%),and August was the month of high incidence.Spastic cough(72.41%)was the main clinical manifestation.Other manifestations included redness or cyanosis,vomiting after coughing,crow echo,etc.There were statistically significant differences in the incidence of spastic cough,redness or cyanosis and the contact history of patients with chronic cough among three groups(P<0.05).There were significant differences in the incidence of pneumonia and the average length of hospital stay among three groups(P<0.05).There was significant difference in C-reactive protein level among three groups(P<0.05).Among 87 children with pertussis,37 cases(42.53%)were infected with other pathogens,among which virus infection was the most common.The treatment is effective with macrolides and compound sulfamethoxazole.Conclusion Pertussis is more common in infants under 1 year of age,and the incidence is high in August.Chronic cough patients with close contact may be the source of infection.Spastic cough is the main clinical symptom of children;the younger,the more common symptoms such as spastic cough,redness and cyanosis,the higher incidence of pneumonia and the longer hospital stay.

Research progress on social alienation of patients with gynecological malignant tumors / 中国实用护理杂志

To review the research status, assessment tools, influencing factors and intervention measures of social grooming in patients with gynecological malignant tumors, so as to provide a theoretical basis for improving the social alienation of patients with gynecological malignant tumors and better integrating into society.

Deep learning technology for quality control of echocardiography images / 实用医学杂志

Objective To Explore the feasibility and value of deep learning technology for quality control of echocardiography images.Methods A total of 180985 echocardiography images collected from Sichuan Provin-cial People's Hospital between 2015 and 2022 were selected to establish the experimental dataset.Two task models of the echocardiography standard views quality assessment method were trained,including intelligent recognition of seven types of views(six standard views and other views)and quality scoring of six standard views.The predictions of the models on the test set were compared with the results of the sonographer's annotation to assess the accuracy,feasibility,and timeliness of the runs of the two models.Results The overall classification accuracy of the stan-dard views recognition model was 98.90%,the precision was 98.17%,the recall was 98.18%and the F1 value was 98.17%,with the classification results close to the expert recognition level;the average PLCC of the six standard views quality scoring models was 0.933,the average SROCC was 0.929,the average RMSE was 7.95 and the average MAE was 4.83,and the prediction results were in strong agreement with the expert scores.The single-frame inference time after deployment on the 3090 GPU was less than 20 ms,meeting real-time requirements.Conclusion The echocardiography standard views quality assessment method can provide objective and accurate quality assessment results,promoting the development of echocardiography image quality control management towards real-time,objective,and intelligent.

Changes in intestinal flora of coal workers' pneumoconiosis patients after tetrandrine intervention / 环境与职业医学

Background Pneumoconiosis is a widespread occupational disease in China at present. As a type of lung diseases, its pathological damage is mainly irreversible fibrotic changes in the lungs. Several studies have shown that the occurrence and development of lung diseases such as coal workers' pneumoconiosis are closely related to intestinal flora. Objective To observe intestinal flora of coal workers' pneumoconiosis patients based on the results of 16SrDNA high-throughput sequencing and evaluate the changes of intestinal flora after treatment with tetrandrine tablets. Methods A total of 80 patients with coal workers' pneumoconiosis attending the outpatient clinic of the Department of Occupational Diseases of the Emergency General Hospital from April to July 2022 were enrolled. All patients were treated with tetrandrine tablets for 4 weeks, with group A before the treatment of tetrandrine tablets and group B after the treatment. In the same period, 24 healthy controls (group C) were set up. Stool samples were collected before and after the treatment. Using 16SrDNA high-throughput sequencing, gene V3-V4 sequencing technology, and bioinformatic analysis platform, we evaluated the intestinal flora after treatment by groups. Results The dominant flora at the phylum level and genus level were the same across three groups. The relative abundances of phylum Bacteroidetes, Bifidobacterium, Bacteroides, and Facealibacterium in groups B and C were higher than those in group A, and the relative abundances of phy-lum Actinobacteria, genus Blautia, and genus Romboutsia in groups B and C were lower than those in group A (P＜0.05). The relative abundances of genus Clostridium, genus Megamonas, and genus Lactobacillus in group C was lower than that in groups A and B (P＜0.05). The alpha diversity analysis showed that the Chao1 index was higher in group A than in group C (P＜0.01). Compared with group A, the Shannon index was higher in group B, and the increases of Simpson index were all statistically significant in stage I patients (P＜0.05), but the differences in Chao1 index were not statistically significant (P＞0.05). The differences in the values of Chao1 index, Shannon index, and Simpson index in stage Ⅱ and stage III patients were not statistically significant (P＞0.05). The beta diversity analysis showed that the difference in flora structure between group A and group C was statistically significant (P＜0.05); the differences in flora structure before and after treatment in the same stage patients were statistically significant (P＜0.05). The partial least squares discriminant analysis (PLS-DA) showed that there were significant differences between group A and group C, and between group A and group B. The LEfSe analysis showed that the significant markers contributing to the differences were basically the same in stage I, stage Ⅱ, and stage Ⅲ after treatment, which were mainly phylum Bacteroidetes and its subordinate groups, class Negativicutes, or-der Selenomonas, and genus Facealibacterium. Conclusion There are differences in the distribution of flora between coal workers' pneumoconiosis patients and healthy individuals, and the structure and relative abundance of intestinal flora are changed and the number of beneficial flora is increased after treatment with tetrandrine tablets.

Multi-slice spiral computerized tomography image characteristics of coal workers with pneumoconiosis / 环境与职业医学

Background Multi-slice spiral computerized tomography (MSCT) can be used as an auxiliary diagnosis of chest radiography in diagnosis of pneumoconiosis, but there are few studies on the correlations between interstitial images and stage classification of coal workers' pneumoconiosis in the existing literature. Objective To present MSCT imaging manifestations and distribution characteristics of coal workers' pneumoconiosis and complications, evaluate correlations between coal workers' pneumoconiosis stages and pulmonary interstitial lesions, and provide a reliable imaging diagnosis basis for pneumoconiosis interstitial lesions. Methods From June 2022 to June 2023, a total of 1002 patients with coal workers' pneumoconiosis confirmed by the pneumoconiosis diagnostic and identification group in the Department of Occupational Diseases of the Emergency General Hospital were enrolled. MSCT was used to observe the abnormal imaging manifestations of the lungs of coal workers' pneumoconiosis patients and the diseases of pulmonary fibrosis related to their own diseases (thickening of the interlobular septum, bronchial perivascular interstitial mass thickening, parenchymal banding, subpleural line, intralobular interstitial thickening, honeycomb, and subpleural interstitial thickening), the occurrence of coal workers' pneumoconiosis and complications (old tuberculosis, active tuberculosis, pneumonia, atelectasis, lung cancer, bronchiectasis), and the density, size, and location of pneumoconiosis nodules. Imaging data were analyzed and statistically processed. Results All 1002 patients were male, with an average age of (60.71±6.87) years and an average dust exposure time of (23.01±7.80) years. Among them, there were 470 patients with stage I, 422 patients with stage II, and 110 patients with stage III. There were significant differences in the distribution of thickening of the interlobular septum, bronchial perivascular interstitial mass thickening, parenchymal banding, intralobular interstitial thickening, subpleural interstitial thickening, and honeycomb across different stages (P<0.05). Statistically significant differences in p, q, and r subsets of round nodules were found in patients with pneumoconiosis at different stages (P<0.05). Observed nodule types included solid nodules, pure ground-glass shadow nodules, and partial solid nodules. There were statistically significant differences in pulmonary tuberculosis and bronchiectasis among different stages of coal workers' pneumoconiosis (P<0.05). There were statistically significant differences in interstitial shadows and patches combined with interstitial shadows among different stages of pneumoconiosis complicated with pneumonia (P<0.05). Conclusion MSCT provides images of the progression of coal workers' pneumoconiosis and have a certain relationship with the stages of coal workers' pneumoconiosis, which is conducive to the formulation of reasonable treatment plans in the early clinical stage. Therefore, in the diagnosis and treatment of pneumoconiosis, a great attention should be paid to the imaging technology of chest computerized tomography, especially the use of MSCT examination.

Application evaluation of cardiopulmonary exercise test to guide comprehensive pulmonary rehabilitation in patients with pneumoconiosis / 环境与职业医学

Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO2/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO2), maximum metabolic equivalent (METs), and maximum work (Wmax). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO2/kg, AT, EqCO2, METs, or Wmax between the two groups (P>0.05). At the end of the trail, the indicators like pVO2/kg [(19.81±2.38) mL·(min·kg)−1], AT [(14.48±2.33) mL·(min·kg)−1], METs (5.64±0.69), and Wmax [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)−1, (11.70±1.94) mL·(min kg)−1, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO2 between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.

Differential metabolites of bronchoalveolar lavage fluid from coal worker's pneumoconiosis patients / 环境与职业医学

Background It is a research hotspot to study the changes of metabolites and metabolic pathways in the process of coal worker's pneumoconiosis (CWP) by metabonomics and to explore its pathogenesis. Objective To study the change of metabolites in bronchoalveolar lavage fluid (BALF) of patients with CWP and explore the metabolic regulation mechanism of the disease. Methods Patients with CWP who met the national diagnostic criteria according to Diagnosis of occupational pneumoconiosis (GBZ 70-2015) and underwent massive whole lung lavage were selected as the case group, and patients with tracheostenosis who underwent bronchoscopy were selected as the control group. BALF samples were collected from the cases and the controls. After filtering out large particles and mucus, the supernatant was stored in a −80 ℃ refrigerator. The samples were detected and analyzed by liquid chromatography-mass spectrometry after adding extraction solution, cold bath ultrasonication, and high-speed centrifugation, and the metabolic profiles and related data of CWP patients were obtained. The differential metabolites related to the occurrence and development of CWP were screened by multiple statistical analysis; furthermore, we searched the Kyoto Encyclopedia of Genes and Genomes (KEGG) database for potential metabolic pathways involved in the progression. Results There was no significant difference in the general conditions of the subjects, such as weight, height, age, and length of service among the stage I group, the stage II group, the stage III group, and the control group (P˃0.05). When comparing the CWP stage I group with the control group, 48 differential metabolites were screened out, among which 14 were up-regulated and 34 were down-regulated. A total of 66 differential metabolites were screened out between the patients with CWP stage II and the controls, 14 up-regulated and 52 down-regulated differential metabolites. Compared with the control group, 63 differential metabolites were screened out in the patients with CWP stage III, including 11 up-regulated and 52 down-regulated differential metabolites. There were 36 differential metabolites that may be related to the occurrence of CWP, among which 11 differential metabolites were up-regulated, and 25 were down-regulated. Four significant differential metabolic pathways were identified through KEGG database query: linoleic acid metabolic pathway, alanine metabolic pathway, sphingolipid metabolic pathway, and glycerophospholipid metabolic pathway. Conclusion The metabolomic study of BALF show that there are 36 different metabolites in the occurrence and development of CWP, mainly associating with linoleic acid metabolism, alanine metabolism, sphingolipid metabolism, and glycerophospholipid metabolism pathways.

State of clinical application of meloxicam / 中国临床药理学与治疗学

Meloxicam is a long-acting non-steroidal anti-inflammatory drug, which is mainly used in the treatment of chronic osteoarthritis and postoperative analgesia. Recent studies have found that the drug has great therapeutic potential in anti-tumor, improving cognitive impairment in Alzheimerls disease, mobilizing hematopoietic stem cells and so on. This paper reviewed the pharmacological mechanism of meloxicam, the adverse reactions in gastrointestinal tract, kidney, liver and cardiovascular aspects, summarized various forms of clinical application from the perspective of preparation, and summarized the current clinical treatment strategy of combining with Western medicine and Chinese medicine respectively.

The study on the correlation between serum uric acid and vascular calcification in middle-aged and elderly men / 中国医师进修杂志

Objective:To study the correlation between serum uric acid (SUA) and vascular calcification in middle-aged and elderly men.Methods:Using the Yiduyun electronic medical record retrieval system, a cross-sectional study was conducted on the clinical data of 2 786 male patients aged ≥40 years who underwent lung CT examinations in Dalian Central Hospital, Dalian University of Technology from January 2010 to October 2022. According to the degree of pulmonary CT vascular calcification, they were divided into vascular calcification group (1 296 cases)and non vascular calcification group (1 490 cases). The clinical data were collected and the correlation between SUA and vascular calcification were analyzed.Results:The levels os SUA in the vascular calcification group was higher than that in the non vascular calcification group: 311.50(270.25, 359.00) μmol/L vs. 284.00(251.00, 318.00) μmol/L, there was statistical difference ( F = 14.16, P<0.01). The constituent ratio of hyperuricemia in vascular calcification group was higher than that in non vascular calcification group : 25.62%(332/1 296) vs. 11.68%(174/1 490), there was statistical difference ( χ2 = 20.15, P<0.01). Spearman correlation analysis found a positive correlation between SUA level and vascular calcification in middle-aged and elderly men ( r = 0.489, P<0.01). Binary Logistic regression analysis results showed that SUA, body mass index (BMI), diastolic blood pressure(DBP), fasting plasma glucose(FPG) were positively correlated with vascular calcification ( P<0.01); after adjusting the influence of BMI, DBP and FPG on male vascular calcification, SUA was still a risk factor for vascular calcification. Conclusions:In the middle-aged and elderly male population, with the increase of blood uric acid, vascular calcification increase, and the elevated blood uric acid level is an independent risk factor for vascular calcification.