[The effect of occupational stress on anxiety of nursing staff in a third-grade general hospital and mediating effect of job burnout].

Objective: To explore the mediating effect of job burnout of nursing staff in clinical departments on occupational stress and anxiety, and to provide scientific basis for the formulation of intervention measures to relieve anxiety. Methods: From November 2020 to January 2021, a cross-sectional survey was conducted to investigate the basic situation, occupational stress, job burnout and anxiety of 653 nursing staff in a third class A general hospital in Hebei Province. Spearman rank correlation was used to analyze the relationship between occupational stress, job burnout and anxiety, stepwise regression and mediating effect model were used to verify the mediating effect of job burnout on the relationship between occupational stress and anxiety. Results: 551 valid questionnaires were collected with effective recovery of 84.38%. The incidence of high occupational stress was 68.06% (375/551) , the incidence of job burnout was 63.70% (351/551) [high, moderate and moderate were 11.07% (61/551) and 52.63% (290/551) respectively], and the incidence of anxiety was 55.72% (307/551) [mild, moderate and severe were 38.11% (210/551) , 8.53% (47/551) and 9.08% (50/551) respectively]. Occupational stress was positively correlated with job burnout and anxiety (r=0.545, 0.479) , and job burnout was positively correlated with anxiety (r=0.542, P<0.05) . The mediating effect analysis showed that occupational stress had a statistically significant effect on anxiety (c=0.509, P<0.001) , and the mediating effect of job burnout on the relationship between occupational stress and anxiety accounted for 44.99% of the total effect. Conclusion: The anxiety level of the nursing staff in this third-class A general hospital was relatively high. Job burnout has a mediating effect between occupational stress and anxiety, and anxiety of nursing staff can be alleviated by reducing occupational stress or job burnout.

[The characteristics of spatial-temporal evolvement of pneumoconiosis in Hebei Province from 2009 to 2018].

Objective: To explore the temporal and spatial characteristics of pneumoconiosis in Hebei Province from 2009 to 2018, and to provide evidence for the policy development of pneumoconiosis prevention and control. Methods: In February 2019, a database of pneumoconiosis incidence from 2009 to 2018 in Hebei Province was built. The spatial-temporal distribution of pneumoconiosis in Hebei Province was displayed based on barycenter migration technology and spatial autocorrelation analysis. Results: A total of 6099 cases of pneumoconiosis were reported in Hebei Province from 2009 to 2018, the top 5 pneumoconiosis were silicosis(4399, 72.13%) , coal worker pneumoconiosis (1298 , 21.28%) , ceramics pneumoconiosis (224, 3.67%) , welding worker's pneumoconiosis(76, 1.25%) , and casting worker's pneumoconiosis(48, 0.79%). The focus of pneumoconiosis from 2009 to 2014 moved from Tangshan in the northeast to Zhangjiakou in the northwest, and moved to Chengde in the north from 2015 to 2017, and moved back to Tangshan in 2018. The incidence of pneumoconiosis was globally autocorrelation (P <0.05) from 2009 to 2011 and 2014 to 2018. The high-high gathering areas were located in Zhangjiakou, Chengde and other areas. Conclusion: The barycenter of pneumo- coniosis in hebei province from 2009 to 2018 is relatively stable, mainly locates in the northern part of Hebei Province over the years. There is an obvious regional aggregation, and the aggregation type is mainly high-high aggregation, which indicates that relevant departments should focus on strengthening the prevention and treat- ment of aggregation areas on the basis of overall planning.

[Using next generation sequencing technology to analyze gene mutations in patients with acute myeloid leukemia and the impact on prognosis].

Objective: To analyze the distribution of gene mutations in newly diagnosed acute myeloid leukemia (AML) patients, based on next generation sequencing technology (NGS) and to evaluate their value in AML risk stratification. Methods: The study analyzed 453 newly diagnosed AML(excluded acute promyelocytic leukemia, APL) patients from seven hospitals in Shanghai, from January 1st 2014 to December 31th 2017. RNA and DNA were extracted from pretreatment bone marrow mononuclear cells and targeted sequencing of AML genes were performed. The data of different groups was compared. Results: A total of 453 newly diagnosed AML patients were enrolled in the study, including 247 males and 206 females with a median age of 49.5 (range,11-85) years. A total of 540 mutations/fusion genes were detected in 289 patients, 29.1% (132/259) of whom with two or more mutations/fusion genes. In all patients, NPM1 was the most common mutation(12.8%), followed by ETO and TET2 mutation (11.92% and 11.04%, respectively) . And WT1 over-expression accounted for 10.6%. Patients over the age of 50 were with a higher frequency of mutations associated with epigenetic modification, 11.93% for ASXL1, 13.99% for DMNT3A, 6.58% for IDH1/IDH2, and 13.17% for TET2. The frequency of DMNT3A mutations was three times higher than that of patients under 50 years of age (P=0.017). In this study, a relatively low proportion of genetic mutations was observed in low-risk karyotype group. In the medium-risk karyotype group, the relatively high mutation frequencies were observed in NPM1, TET2, FLT3-ITD, DNMT3A, ASXL1, and CEBPA genes. In the poor-risk karyotype group, the mutation frequencies of ASXL1, TET2, DNMT3A and PHF6 genes were more than 10%, especially ASXL1 and PHF6 mutation frequencies were significantly higher than other molecular risk stratification groups (P<0.05). Of the 254 patients (56%) with normal karyotype AML (NK-AML), 56 patients were detected to have gene mutations about epigenetic modification. The median OS of this group was worse than that of patients without related mutations, while the median LFS had no significant difference. In patients with NK-AML older than 50 years, the OS and LFS of patients with epigenetic modification related gene mutations was 12 months and 10 months, versus 18 months and 12 months of patients without mutations. Conclusions: The gene mutations frequencies in AML patients with different age and molecular risk stratification groups are different. Epigenetics gene mutation frequencies, such as DNMT3A, ASXL1, IDH1/IDH2 and TET2,are higher in patients older than 50 years. A shorter OS can be observed in older patients(>50 years) with epigenetics gene mutation.

Optical properties of surface states in two-dimensional topological insulators.

We present a simple and tractable approach to investigate the optical properties of surface states in two-dimensional (2D) topological insulators (TIs). The analytic expression of optical conductivity of surface states in 2D TIs are obtained based on the kinetic equations. It is found that universal optical conductance can be observed in the high frequency region, which does not depend on the temperature, the chemical potential, or the bandgap of the systems. This universal optical conductance is similar to that in graphene. However, the optical absorption edge of such surface states strongly depend on the chemical potential and the bandgap of the systems. There are obvious optical absorption peaks at low temperature in the low frequency region, which are very different from that in graphene. The bandgaps in surface states can be accurately experimentally measured by the optical absorption edges or the peaks. We expect that our theoretical results offer transparent understandings for the experimental results and applications of 2D TIs.

[Application of occupational hazard risk index model in occupational health risk assessment in a decorative coating manufacturing enterprises].

Objective: To evaluate the occupational health risk of decorative coating manufacturing enterprises and to explore the applicability of occupational hazard risk index model in the health risk assessment, so as to provide basis for the health management of enterprises. Methods: A decorative coating manufacturing enterprise in Hebei Province was chosen as research object, following the types of occupational hazards and contact patterns, the occupational hazard risk index model was used to evaluate occupational health risk factors of occupational hazards in the key positions of the decorative coating manufacturing enterprise, and measured with workplace test results and occupational health examination. Results: The positions of oily painters, water-borne painters, filling workers and packers who contacted noise were moderate harm. And positions of color workers who contacted chromic acid salts, oily painters who contacted butyl acetate were mild harm. Other positions were harmless. The abnormal rate of contacting noise in physical examination results was 6.25%, and the abnormality was not checked by other risk factors. Conclusion: The occupational hazard risk index model can be used in the occupational health risk assessment of decorative coating manufacturing enterprises, and noise was the key harzard among occupational harzards in this enterprise.

Nramp1 gene expression in different tissues of Meishan piglets from newborn to weaning.

Natural resistance-associated macrophage protein gene 1 (Nramp1) plays an important role in the innate immune response of swine, and is believed to influence disease resistance. In this study, a real-time quantitative polymerase chain reaction technique was used to investigate Nramp1 expression in 12 different tissues in newborn and 7-, 14-, 21-, 28-, and 35-day-old Meishan piglets. Results indicated that Nramp1 was expressed to varying degrees in all sample tissues, although expression differed among growth stages. For example, Nramp1 was highly expressed in the spleen, but minimally expressed in heart, liver, and muscle tissues among the various piglet age classes. Overall, Nramp1 expression increased with age, reaching significant levels in 21- and 28-day-old animals. Nramp1 was expressed in all 12 tissues tested; however, expression in spleen, lung, kidney, and thymus tissues was highest among newborns, which is consistent with this gene's role in innate immunity improvement. Before and after weaning, Nramp1 was highly expressed in digestive (stomach) and intestinal (duodenum, jejunum, and ileum) tissues, further indicating a genetic role in both immune regulation to compensate for weaning stress and enhanced development of intestinal immunity.

LBP gene methylation involved in mRNA expression and resistance to E. coli F18 in weaned piglets.

Lipopolysaccharide binding protein (LBP) plays an important role in recognizing and regulating endotoxin. In this study, we aimed at clarifying the relationship between the methylation of LBP gene and it's expression, to identify mechanisms involved in resistance to E. coli F18 in Sutai weaned piglets. LBP expression was detected by real-time PCR in duodenum and jejunum tissues from E. coli F18-sensitive or -resistant piglets. The LBP methylation status of the regions with many CG sites upstream of the transcription start site was analyzed by Bbisulfite Sequencing PCR (BSP) +Miseq in jejunum and duodenum tissue. The results showed that LBP expression was significantly higher in the sensitive group than the resistant group in duodenum tissue (p<0.05). There was a negative correlation between the methylation of CpG islands upstream of the LBP transcription start site and its expression; the methylation at two CpG sites in particular was significantly correlated with reduced LBP expression (CpG-1 and CpG-2; p<0.05 and p<0.01, respectively). These indicated that the methylation of CpG-1 and CpG-2 sites in the LBP region is involved in the regulation of LBP expression, and may provide key contributions to resisting E. coli F18 in Sutai weaned piglets.

[Health literacy level and influence factors of occupational population in one province].

Objective: To understand health literacy (HL) status of occupational population in work place and provide the basis of developing for HL standards and specific intervention strategies. Methods: Being selected by stratified cluster sampling, 3507 employees in 13 companies wthin Hebei Province were investigated by questionnaire. Results: The survey was conducted with 3507 questionnaires, the valid rate was about 97.83%. There were a total of 2629 men (76.62%) and 802 women (23.38%) . The overall level of HL was 32.24%. Health literacy level (HLL) of three aspects are: basic knowledge and concepts 52.03%, healthy life-style and behavior 26.00%, and health related skills 40.25%, the HL rate of six health issues as scientific view of health, prevention of communicable diseases, prevention of chronic diseases, safety and first aid, basic medical care and health information are 61.59%, 28.62%, 21.95%, 75.20%, 32.99% and 49.17% respectively. The group aged 25-34 had the highest HLL (43.95%) ; the higher culture degree, the higher the level of health literacy (P<0.05) . The HLL of the occupational population in Hebei province was 32.24%, which was close to the HLL of the national occupational population, but higher than that of general population in Hebei province and in the whole country. Conclusions: The HLL of the occupational population in Hebei province which was close to the HLL of the national occupational population. HLL of basic knowledge and concepts is higher than that of healthy life-style and behavior and health related skills, the health literacy rate of prevention of communicable diseases and chronic diseases were low. Age, culture degree and type of industry are important influence factors.

[Application of means of surfaces with nonhomogeneity in estimating the incidence of pneumoconiosis].

Objective: To investigate the value of means of surfaces with nonhomogeneity (MSN) in esti-mating the incidence of pneumoconiosis. Methods: Based on the principal component analysis, all counties (districts) of Hebei Province, China, were divided into three categories according to the degree of pneumoconiosis hazards and the MSN model was used to estimate the incidence rate of pneumoconiosis and the number of pneu-moconiosis cases using the data of the incidence of pneumoconiosis in 2010. Results: With reference to the appli-cation requirements of the MSN model, results of the principal component analysis, and expert experience, the 172 counties (districts) in Hebei Province were divided into three categories with mild, moderate, and severe pneumoconiosis hazards. There were 74, 61, and 49 counties in the above categories, respectively, and 12, 12, and 25 counties were selected from them, respectively. The estimated number of pneumoconiosis cases in Hebei Province was 2105, and the incidence rate was 261.5 per hundred thousand, with a standard error of esti-mation of 389.9 per hundred thousand. Conclusion: The MSN model provides a new thought and method for es-timating the number of pneumoconiosis cases.

[Effect of occupational lead exposure on the blood pressure of lead-exposed workers].

Objective: To investigate the effect of occupational lead exposure on blood pressure and pro-vide supportive evidence of health protection on lead - exposed workers. Methods: 612 workers (452 lead - ex-posed workers, 160 workers as control) were recruited in the battery factory. The blood lead concentration and blood pressure were detected by occupational health examination and biological monitoring. The relationship of blood lead concentration and blood pressure wasanalyzed. Results: The blood lead concentration in the exposed group (249.84±137.74) µg/L was higher than that of the control group (117.25±70.15) µg/L, and the differ-ence was statistically significant (P<0.01) . The difference of abnormal blood pressure and diastolic pressure among the exposed and the control group was statistically significant (P<0.05) . The abnormal blood pressure rate, systolic pressure rate and diastolic pressure rate in the 400~726 µg/L group was higher than that of the 6~199 µg/L and 200~399 µg/L group, and the difference was statistically significant (P<0.01) . Multiple lin-ear regression analysis showed that the influencing factors of the systolic pressure followed by sex, age, length of service and blood lead concentration, diastolic pressure followed by sex, age, smoke and blood lead concen-tration. Conclusion: These findings suggest that long - term occupational lead exposure may result in the in-crease of blood lead concentration.

[Application of principal component analysis in comprehensive indicator screening for pneumoconiosis in different regions].

Objective: To investigate the application of principal component analysis in comprehensive indicator screening for pneumoconiosis in different regions. Methods: A principal component analysis was performed for the data of 11 factors associated with the prediction of pneumoconiosis hazard and collected in the investigation on occupational health status conducted in 172 counties (districts) in Hebei, China. The degree of pneumoconiosis hazard in different regions was obtained and intuitively presented by GIS. Results: The eigenvalues of 5 principal components of pneumoconiosis were 4.103, 2.341, 0.981, 0.943, and 0.726, respectively, and the contribution values were 37.299%, 21.286%, 8.919%, 8.572%, and 6.596%, respectively. According to the comprehensive value of principal components, GIS Natural Breaks was used to divide the degree of pneumoconiosis hazard in 172 counties (districts) in Hebei into mild, moderate, and severe grades. Of all the counties, 46 had severe pneumoconiosis hazard, 69 had moderate pneumoconiosis hazard, and 57 had mild pneumoconiosis hazard, and the ranges of the score of principal components were 0.30-1.15, -0.24 to 0.27, and -0.69 to -0.25, respectively. Conclusion: Principal component analysis can optimize the comprehensive indicators for the evaluation of regional pneumoconiosis. The comprehensive score of principal components can quantify and intuitively show the degree of pneumoconiosis hazard in different regions. Tangshan, Chengde, Shijiazhuang, and Handan have the most severe pneumoconiosis hazard.

[The relationship of vitamin D receptor gene and blood lead: a meta-analysis].

OBJECTIVE: The correlation of vitamin D receptor (VDR) gene polymorphism and blood lead level had been in doult, which allowed us to write this article. METHODS: Relevant studies about the blood lead and VDR B/b gene polymorphism which published from 1979-2015, were searched in multiple bibliographic databases, such as: CNKI, Wanfang Database, PUBMED. Of the ten references selceted, three were divided into two groups which were classified as different researches, so there were thirteen studies in the meta-analysis. According to the level of blood lead, the studies were analyzed by three groups: normal group, low dose grou and high dose group. The analysis was performed by stata 12.0 software. RESULTS: The blood lead level of VDR B/b genotype was significantly difference in all the three groups (P<0.05) , but there were apparent heterogeneity between normal group and low dose group (P<0.05, I(2)=84.2%; P<0.05, I(2)=88.9%) , except the high dose group (P>0.05, I(2)=12.7%) ; after adjusted, all showed no heterogeneity, and the results were still the same. CONCLUSION: The genotype of VDR may be correlated with blood lead, and the levels of blood lead varied with different genetypes.

[Application of benchmark dose on renal injury in people chronically exposed to lead].

Objective: To screen sensitive indicators of renal injury in lead workers using benchmark dose method. Methods: Of the 486 subjects,116 did not occupationally contact to lead as a control. The blood lead was considered as exposure biomarker, while Uß2-MG and UNAG as effect biomarkers for renal injury. The BMD and BMDL of blood lead were estimated at the 10% benchmark response using BMDS Version 2.6. Results: There was statistical rise in blood lead between the lead group and control group (P<0.05) ; and the blood lead level was divided into four groups by quarterback spacing method, among which UNAG was statistically different (P<0.05) . There was an increased prevalence of abnormal rates of Uß2-MG and UNAG with increasing blood lead concentration (P<0.05) , after trend chi-square test. BMD and BMDL of UNAG and Uß2-MG were 602.784/431.838 µg/L and 130.398/100.981 µg/L caculated by Log-Probit model, respectively. Conclusions: Occupational lead exposure may cause kidney damage, and UNAG could be as a more sensitive marker for monitoring early renal injury than Uß2-MG.

Multilayer photo-aligned thin-film structure for polarizing photonics.

In this Letter, an advanced multilayer photo-aligned liquid crystal polymer (LCP) thin-film structure with multiple optical functions is introduced. Within each LCP layer, a spatially distribution of local optical axes can be controlled by a patterned photo-alignment layer. As an embodiment of the proposed structure, a two-layer structure with pixelated controlled light-propagation directions and polarizations has been studied, which has shown the potential to be used as a photomask for generating multi-domain photo-alignment structures with a single exposure step. The combination of the multilayer structure with patterned photo-alignment technology provides a new perspective of designing optical structures for polarizing photonics applications.

High prevalence of developmental delay among children under three years of age in poverty-stricken areas of China.

OBJECTIVES: Poverty and its associated factors put children at risk for developmental delay. The aim of this study was to describe the neurodevelopment of children under three years of age in poverty-stricken areas of China and explore possible associated factors. STUDY DESIGN: A cross-sectional survey was conducted among 2837 children aged 1-35 months in poverty-stricken areas of China. METHODS: Characteristics of the child, caregiver, and family were collected through face-to-face caregiver interviews. Developmental delay was explored with the five-domain, structured, parent-completed Ages and Stages Questionnaire. The Zung Self-rating Depression Scale was used to assess depressive symptoms of the caregivers. The Chi-squared test and multivariate logistic regression analyses were used to explore associated factors. RESULTS: Of the children, 39.7% (95% confidence interval, 37.9-41.5) had developmental delay in at least one of the five domains. For the domains of communication, gross motor, fine motor, problem solving, and personal-social skills, the prevalence was 11.5%, 18.5%, 21.4%, 18.4%, and 17.9%, respectively. Significant predictors of increased odds of developmental delay included the child having no toys (odds ratio [OR] = 2.31), the caregiver having depression (OR = 2.24), insufficient learning activities (OR = 1.65), and more children in the family (OR = 1.16). CONCLUSIONS: The high prevalence of developmental delay in children younger than three years in poverty-stricken areas of China and the presence of risk factors for developmental delay such as inadequate learning resources and activities in the home, caregiver depression, and low family income highlight the need for early identification and interventions.

Efficacy and safety of camrelizumab combined with TACE for hepatocellular carcinoma: a systematic review and meta-analysis.

OBJECTIVE: Hepatocellular carcinoma (HCC) represents a highly lethal and recurrent neoplasm, with limited effective treatment regimens available. Camrelizumab, as a novel PD1 inhibitor combined with transcatheter arterial chemoembolization (TACE), has been widely used in the treatment of HCC. However, there remains a contentious debate regarding the clinical value of the TACE and camrelizumab combination. This study seeks to investigate the efficacy and safety of this combination treatment regimen in patients with HCC. MATERIALS AND METHODS: The related studies were retrieved from four online databases, including Pubmed, Cochrane Library, EMBASE, and Web of Science, up to June 1, 2023. The selection of studies was based on screening of titles, abstracts, and full-texts. The primary efficacy outcomes included complete response (CR), objective response rate (ORR), and disease control rate (DCR), while safety outcomes evaluated all treatment-related adverse events (AEs). Additionally, secondary outcomes such as overall (OS) and progression-free survival (PFS) were extracted for further survival analysis. The quality of the included trials was assessed using the MINORS tool. Publication bias was evaluated through funnel plot and Egger's test. RESULTS: A total of 17 publications involving 1,377 cases were included. The pooled CR rate, ORR, and DCR of the patients treated with TACE plus camrelizumab had a pooled CR rate of 8% (95% CI: 0.01-0.15, p=0.03), ORR of 47% (95% CI: 0.42-0.52, p<0.00001) and DCR of 82% (95% CI: 0.77-0.88, p<0.00001), respectively. Compared with a control group that did not receive TACE or camrelizumab, the pooled RR of CR rate, ORR, and DCR were 1.61 (95% CI: 1.27-2.04, p<0.0001), 1.56 (95% CI: 1.19-2.05, p=0.001) and 1.55 (95% CI: 1.19-2.03, p=0.001), respectively. Besides, the combination regimen can prolong the OS (HR=2.60, 95% CI: 2.25-3.02, p<0.00001) and PFS (HR=4.90, 95% CI: 1.94-12.38, p=0.0008). However, the incidence of treatment-related AEs was relatively high (77%), with 29% for grade 3 AEs. The most common AEs observed were pain (47%), fever (46%), hepatic function abnormalities (44%), hypoalbuminemia (39%), and hypertension (37%). The combination treatment did not increase the incidence of AEs compared to the control group, except for the hand-foot skin reaction (RR=0.85, 0.74-0.97, p=0.01), hepatic encephalopathy (RR=4.29, 2.51-7.35, p<0.00001) and nausea (RR=1.35, 1.13-1.61, p=0.001). CONCLUSIONS: Combination therapy of TACE plus camrelizumab has shown notable clinical benefits, improved survival, and a manageable safety profile in patients with HCC, but it is essential to monitor and manage the specific toxicities, especially for the camrelizumab-related AEs.

[Short-term substitution of calcineurin inhibitors (CNI) with recombinant humanized anti-CD25 monoclonal antibody (Basiliximab) as aGVHD prophylaxis in CNI intolerant patients after allogeneic hematopoietic stem cell transplantation].

Objectives: To investigate the efficacy of short-term substitution of recombinant humanized anti-CD25 monoclonal antibody (Basiliximab) as acute GVHD (aGVHD) prophylaxis in calcineurin inhibitors (CNI) intolerant patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: This study included 17 patients with refractory malignant hematological disorders who underwent salvage allo-HSCT at the Bone Marrow Transplantation Department of Shanghai Zhaxin Traditional Chinese and Western Medicine Hospital from August 2021 to August 2022 and were treated with Baliximab to prevent aGVHD due to severe adverse reactions to CNI. There were seven men and ten women, with a median age of 43 years (18-67). Following the discontinuation of CNI, Basiliximab was administered at a dose of 1 mg/kg once weekly until CNI or mTOR inhibitors were resumed. Results: Basiliximab was started at an average of 5 (1-32) days after HSCT. The median duration of substitution was 20 (7-120) days. All had neutrophil engraftment within a median of 12 (10-17) days. Thirteen patients had platelet engraftment after a median of 13 (11-20) days. Four patients did not develop stable platelet engraftment. Eight patients (47.1% ) developed Grade Ⅱ-Ⅳ aGVHD, while four (23.6% ) developed Grade Ⅲ/Ⅳ aGVHD. Only one patient died from aGVHD. Before the end of the followup period, seven of 17 patients died. The longest followup period of the survivors was 347 days, and the median survival rate was not met. The overall survival (OS) rate at six months was 62.6%. Among the 17 patients, 13 (76.4% ) experienced cytomegalovirus reactivation, 7 (41.2% ) experienced EB virus activation, and no cytomegalovirus disease was observed. Conclusions: When CNI intolerance occurs during allo-HSCT, short-term replacement with Baliximab can be used as an alternative to prevent aGVHD.