随着对间质性肺疾病（ILD）研究的不断深入，相关的分类、术语和定义持续更新。2025年欧洲呼吸学会和美国胸科学会对间质性肺炎分类术语进行了重大修订，费莱舍尔学会和美国胸科学会也分别对ILD相关术语和肺间质异常提出新标准。准确理解和应用这些术语，对规范儿童ILD的诊断、分型、治疗以及开展多中心研究具有重要意义。.
Objective: To describe the clinical symptoms, obesity status and body composition distribution in children with osteogenesis imperfecta (OI). Methods: This retrospective cohort study included 45 children aged 0-18 years with OI, diagnosed by clinical and genetic testing at Children's Hospital, Zhejiang University School of Medicine, from October 2020 to February 2025. Clinical data were collected on age, sex, symptoms, imaging examinations and genetic testing results. According to body mass index (BMI) criteria or weight-for-length Z-score, the OI patients were divided into non-overweight or obese group and overweight or obese group. Concurrently, 60 children with simple overweight or obesity, matched for sex, age and BMI, were enrolled as a control group. The t-test and Mann-Whitney U test were used to compare the clinical characteristics between the 2 OI groups, and body composition (lean mass index (LMI)and fat mass index (FMI)) between the overweight or obese OI group and the control group. Fracture frequency distribution between the two OI groups were compared using the χ² test. Results: Of the 45 OI children, 26 were male and 19 female, with an average age of (7.2±3.9) years. Genetic variants involved COL1A1 or COL1A2 in 40 cases, IFITM5 in 3, SERPINF1 in 1, and BMP1 in 1. Of the OI patients, 18 (40%) were in the overweight or obesity group and 27 (60%) in the non-overweight or obesity group; 19 (42%) had short stature or growth retardation. Between the 2 OI groups, none of sex, osteocalcin, bone mineral density Z-score, or vitamin D level differed significantly (all P>0.05), whereas fracture frequency did differ significantly (P<0.05). Twenty seven OI children (13 in the overweight or obesity group and 14 in the non-overweight or obesity group) completed the dual-energy X-ray absorptiometry, and all of them had COL1A1 or COL1A2 genotypes. The FMI level was higher in the overweight or obese group than in the non-overweight or obese group (9.0 (6.1, 9.6) vs. 4.4 (3.7, 5.6) kg/m², Z=3.21, P=0.005), whereas LMI and abdominal-to-gluteal fat percentage ratio did not differ significantly (both P>0.05). In the OI overweight or obesity group, both FMI and LMI were lower than in the control group (9.0 (6.1, 9.6) vs. 10.4 (9.2, 11.7) kg/m², 12.1 (11.7, 12.9) vs. 13.9 (13.0, 15.1) kg/m², Z=3.45,3.72, both P<0.05). Conclusions: Overweight or obesity was prevalent among children with OI and was closely associated with fracture frequency. Among those with COL1A1 or COL1A2 variants, the overweight or obese OI children was characterized by higher FMI and lower LMI. 目的： 描述儿童成骨不全症（OI）的临床症状、肥胖及身体成分分布特征。 方法： 回顾性队列研究。选取2020年10月至2025年2月浙江大学医学院附属儿童医院通过临床和遗传检测确诊的45例OI患儿为研究对象，收集的年龄、性别、临床症状、影像学检查、基因检测等临床资料，按体质指数（BMI）标准或身长的体重Z评分分为超重肥胖组与非超重肥胖组，同期纳入60名性别、年龄、BMI匹配的单纯超重肥胖儿童作为对照组。采用t检验、Mann-Whitney U检验比较两组OI患儿之间临床特征、超重肥胖组与对照组之间身体成分［瘦质量指数（LMI）和脂肪质量指数（FMI）］的差异，采用χ2检验比较两组OI患儿骨折次数分布的差异。 结果： 45例OI患儿中男26例、女19例，年龄（7.2±3.9）岁，其中COL1A1或COL1A2基因型40例、IFITM5基因型3例，SERPINF1基因型1例，BMP1基因型1例；超重肥胖组18例（40%），非超重肥胖组27例（60%）；矮小或生长迟缓19例（42%）。OI患儿中超重肥胖组与非超重肥胖组性别、骨钙素、骨密度Z值、维生素D水平差异均无统计学意义（均P>0.05），骨折次数差异有统计学意义（P<0.05）。共27例OI患儿（超重肥胖组13例、非超重肥胖组14例）完成双能X线吸收法测定，均为COL1A1或COL1A2基因型，超重肥胖组FMI水平高于非超重肥胖组［9.0（6.1，9.6）比4.4（3.7，5.6）kg/m2，Z=3.21，P=0.005］，LMI和腹部脂肪百分比/臀部脂肪百分比差异均无统计学意义（均P>0.05）。超重肥胖组OI患儿FMI和LMI均比对照组更低［9.0（6.1，9.6）比10.4（9.2，11.7）kg/m2、12.1（11.7，12.9）比13.9（13.0，15.1）kg/m2，Z=3.45、3.72，均P<0.05］。 结论： OI患儿超重肥胖发生率高，与骨折次数密切相关。COL1A1或COL1A2基因型OI患儿中超重肥胖者身体成分表现为高FMI和低LMI的特征。.
Objective: To analyze the pathogen distribution and antimicrobial resistance profiles of severe community-acquired bacterial pneumonia (SCABP) in children admitted to the pediatric intensive care unit (PICU). Methods: This retrospective cohort study included 308 children with SCABP treated at the PICU of Children's Hospital of Shanghai Jiao Tong University between January 2018 and December 2024. A total of 426 non-duplicate pathogenic bacteria were isolated from bronchoalveolar lavage fluid and sputum specimens. Antimicrobial susceptibility testing was performed for all isolates. Patients were stratified by admission year and the trends in isolation rates were tested using the Cochran-Armitage trend test. Results: A total of 426 non-duplicate pathogens were isolated from the 308 pediatric patients (178 males, 130 females), comprising 330 strains (77.5%) Gram-negative and 96 strains (22.5%) Gram-positive bacteria. The 5 most common organisms were: Acinetobacter baumannii (AB, 84 strains, 19.7%), Haemophilus influenzae (HI, 76 strains, 17.8%), Streptococcus pneumoniae (SP, 49 strains, 11.5%), Staphylococcus aureus (SA, 47 strains, 11.0%), and Pseudomonas aeruginosa (PA, 39 strains, 9.2%). Over the study period, HI emerged as the leading pathogen in 2024, with its isolation rate rising significantly from 8.3% (6/72) in 2018 to 36.1% (22/61) in 2024. In contrast, the isolation rates of AB and SP declined significantly from 33.3% (24/72) and 16.7% (12/72) in 2018 to 4.9% (3/61) and 1.6% (1/61) in 2024, respectively (χ2 for trend=18.75, 27.50, 9.50, all P<0.05). The overall resistance rates of HI to ampicillin, trimethoprim-sulfamethoxazole (TMP-SMZ), azithromycin, and cefuroxime were 72.4% (55/76), 71.1% (54/76), 63.2% (48/76), and 60.5% (46/76), respectively, while it remained fully susceptible to ceftriaxone. No PA isolates exhibited resistance to amikacin or piperacillin-tazobactam throughout the study. SP was universally resistant to erythromycin and clindamycin, with 71.4% (35/49) resistance to TMP-SMZ, while remaining fully susceptible to amoxicillin-clavulanate. SA had an 85.1% (40/47) resistance rate to penicillin, but retained complete susceptibility to vancomycin, linezolid, minocycline, tigecycline, TMP-SMZ, and rifampicin. Conclusions: Gram-negative bacteria predominate in SCABP among PICU patients. The pathogen spectrum has shifted significantly over time, with HI emerging as the predominant causative agent and exhibiting high resistance to multiple antibiotics. Ongoing surveillance and susceptibility-guided antibiotics selection are essential in clinical management. 目的： 分析儿童重症社区获得细菌性肺炎（SCABP）病原菌分布特征及耐药性。 方法： 回顾性队列研究。收集2018年1月至2024年12月上海交通大学医学院附属儿童医院重症监护病房（PICU）收治的308例SCABP患儿的人口学特征、实验室指标等临床资料，对患儿支气管肺泡灌洗液和痰液标本中分离出的426株非重复病原菌进行菌种分布与药物敏感性分析。根据入院年份分组，线性变化趋势采用Cochran-Armitage趋势检验。 结果： 308例SCABP患儿（男178例、女130例）共分离非重复菌426株，其中革兰阴性菌330株（77.5%），革兰阳性菌96株（22.5%）。排名前5位的细菌依次为鲍曼不动杆菌（AB）84株（19.7%）、流感嗜血杆菌（HI）76株（17.8%）、肺炎链球菌（SP）49株（11.5%）、金黄色葡萄球菌（SA）47株（11.0%）和铜绿假单胞菌（PA）39株（9.2%）。HI于2024年成为SCABP首位致病菌，分离率由2018年的8.3%（6/72）升至2024年的36.1%（22/61），AB与SP的分离率分别由2018年的33.3%（24/72）和16.7%（12/72）降至2024年的4.9%（3/61）和1.6%（1/61），差异均有统计学意义（χ2趋势=18.75、27.50、9.50，均P<0.05）。HI对氨苄西林、甲氧苄啶磺胺甲噁唑（TMP-SMZ）、阿奇霉素及头孢呋辛的总耐药率高达72.4%（55/76）、71.1%（54/76）、63.2%（48/76）、60.5%（46/76），对头孢曲松则保持全敏感。在整个研究周期内未分离出PA对阿米卡星及哌拉西林他唑巴坦的耐药菌株。SP对红霉素、克林霉素全耐药，对TMP-SMZ总耐药率为71.4%（35/49），对阿莫西林克拉维酸全敏感。SA对青霉素的总耐药率高达85.1%（40/47），对万古霉素、利奈唑胺、米诺环素、替加环素、TMP-SMZ及利福平全敏感。 结论： SCABP以革兰阴性菌感染为主。病原菌谱发生动态变化，HI已成为SCABP主要致病菌且对多种抗菌药物保持高耐药率，临床应结合药敏结果合理选用抗菌药物。.
Objective: To analyze the relationship between occupational health literacy (OHL) and depressive symptoms among frontline workers in the shoemaking industry. Methods: From July to September 2022, a stratified cluster random sampling method was used to select 843 frontline workers from the shoemaking industry in Guangdong Province as the study subjects. The Occupational Health Literacy Questionnaire for National Key Populations and the Patient Health Questionnaire-9 (PHQ-9) were used to investigate OHL and depressive symptoms. Spearman correlation analysis and logistic regression model were used to analyze the correlation. Results: The overall OHL level of the subjects was 50.3% (424/843). The levels of the four dimensions-occupational health legal knowledge, basic knowledge of occupational health protection, basic skills of occupational health protection, and healthy working styles and behaviors-were 44.4% (374/843), 77.0% (649/843), 29.5% (249/843), and 66.0% (556/843), respectively. The detection rate of depressive symptoms was 56.6% (477/843) ; mild, moderate, moderate to severe, and severe depressive symptoms were detected in 414, 44, 12, and 7 individuals, with detection rates of 49.1%, 5.2%, 1.4%, and 0.8%, respectively. Spearman correlation analysis showed that OHL was negatively correlated with depressive symptoms (P<0.01). Multivariate logistic regression analysis showed that OHL was a factor associated with depressive symptoms (OR=0.53, 95%CI: 0.35-0.72, P<0.01) ; the dimensions of occupational health legal knowledge (OR= 0.39, 95%CI: 0.31-0.63, P<0.01) and basic skills of occupational health protection (OR=0.42, 95%CI: 0.29-0.62, P<0.01) were significantly associated with depressive symptoms. Conclusion: There is a correlation between OHL and depressive symptoms among frontline workers in the shoemaking industry. Improving OHL, especially legal knowledge and basic skills, may help reduce the risk of depressive symptoms. 目的： 分析制鞋业一线劳动者职业健康素养（occupational health literacy，OHL）与抑郁症状的关系。 方法： 于2022年7月至9月，采用分层整群随机抽样方法，选取广东省制鞋业843名一线劳动者为研究对象，采用《全国重点人群职业健康素养监测调查个人问卷》和《患者健康问卷抑郁症状群量表》（PHQ-9）调查其OHL和抑郁症状，采用Spearman相关分析和logistic回归模型分析两者的相关性。 结果： 研究对象总体OHL水平为50.3%（424/843），职业健康法律知识、职业健康保护基本知识、职业健康保护基本技能、健康工作方式和行为四个维度的水平分别为44.4%（374/843）、77.0%（649/843）、29.5%（249/843）、66.0%（556/843）。抑郁症状检出率为56.6%（477/843），其中轻、中、中重、重度抑郁症状分别检出414、44、12、7人，检出率分别为49.1%（414/843）、5.2%（44/843）、1.4%（12/843）、0.8%（7/843）。Spearman相关分析显示，OHL与抑郁症状呈负相关（r(s)=-0.18，P<0.01）。多因素Logistic回归分析显示，OHL是抑郁症状的关联因素（OR=0.53，95%CI：0.35~0.72，P<0.01）；其中职业健康法律知识维度（OR=0.39，95%CI：0.31~0.63，P<0.01）和职业健康保护基本技能维度（OR=0.42，95%CI：0.29~0.62，P<0.01）与抑郁症状的关联有统计学意义。 结论： 制鞋业一线劳动者OHL与抑郁症状存在相关性，提升OHL特别是法律知识和基本技能可能有助于降低抑郁症状的发生风险。.
Osteonecrosis of the jaw (ONJ) is one of the most challenging diseases in the field of oral and maxillofacial surgery, mainly including osteoradionecrosis of the jaw (ORNJ) and medication-related osteonecrosis of the jaw (MRONJ). With the continuous improvement in comprehensive treatment strategies for head and neck malignancies and the increasingly widespread clinical use of antiresorptive agents and antiangiogenic drugs, the incidence of ONJ has shown a gradual upward trend. Clinically, the disease is commonly characterized by exposed necrotic bone, chronic infection, progressive destruction of the jawbone, and functional impairment, which not only severely compromises patients' quality of life but also poses substantial challenges to clinical management. In recent years, significant progress has been achieved in the understanding of the pathogenesis of ONJ, the establishment of classification and staging systems, and the development of consensus guidelines for standardized diagnosis and treatment, leading to notable improvements in clinical management. Meanwhile, advances in precision medicine, digital surgery, and regenerative medicine have provided new perspectives and therapeutic strategies for the management of ONJ. Based on recent domestic and international research progress, this article discusses the clinical challenges, advances in diagnosis and treatment, and future development directions of ONJ, aiming to provide insights for further improving diagnostic and therapeutic strategies and promoting continued research in this field. 颌骨坏死（ONJ）是口腔颌面外科领域最具挑战性的疾病之一，主要包括放射性颌骨坏死（ORNJ）及药物相关性颌骨坏死（MRONJ）。随着头颈肿瘤综合治疗水平的不断提高，以及抗骨吸收药物、抗血管生成药物等临床应用的日益广泛，ONJ的临床发生率呈逐渐上升趋势。该疾病常表现为骨组织暴露、慢性感染、颌骨破坏及功能障碍，不仅严重影响患者生活质量，也给临床诊疗带来巨大挑战。近年来，随着对发病机制认识的不断深入、分类分期体系的逐步建立及规范化诊疗共识的发布，ONJ临床诊疗水平显著提升。同时，精准医学、数字化外科及再生医学等新技术的发展，为ONJ的治疗提供了新的思路和路径。本文结合近年来国内外研究进展，从临床挑战、诊疗突破及未来发展方向等方面进行探讨，旨在为推动ONJ诊疗理念的完善及相关研究的深入提供参考与思考。.
Silica dioxide is a widely prevalent hazardous dust in occupational environments, with respiratory exposure serving as the primary pathogenic factor for silicosis. Macrophage damage, chronic inflammation, and abnormal activation of the immune system play pivotal roles in the pathogenesis of silicosis. Numerous domestic and international studies have demonstrated that occupational silica dioxide exposure is associated with an increased risk of connective tissue diseases such as rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis. To systematically review the evidence linking occupational silica dioxide exposure to connective tissue diseases and elucidate its underlying pathogenic mechanisms, this article summarizes recent epidemiological research findings worldwide. It delineates the pathogenic pathway through which silica dioxide damages macrophages, induces persistent chronic inflammation, and triggers abnormal autoantibody production, thereby mediating systemic immune dysregulation. 二氧化硅是职业环境中广泛存在的有害粉尘，其呼吸道暴露是矽肺病的核心致病因素，而巨噬细胞损伤、慢性炎症与免疫系统异常激活在矽肺发病进程中发挥关键作用。国内外多项研究发现，职业性二氧化硅暴露与类风湿关节炎、系统性红斑狼疮、系统性硬化等结缔组织病的发病风险升高相关。为系统梳理职业性二氧化硅暴露与结缔组织病的关联证据、明确潜在致病机制，本文综述国内外相关流行病学研究进展，梳理二氧化硅通过损伤巨噬细胞、诱发持续慢性炎症、诱导自身抗体异常产生进而介导全身免疫紊乱的致病路径。.
患儿，女，8月龄，于7月龄时出现血糖持续升高，诊断为糖尿病，同时存在特殊面容，身材矮小，智力、运动发育落后，反复感染等表现，家系全外显子测序提示RNU4ATAC基因在n.18（exon1）G>A和n.13（exon1）C>T位点存在复合杂合变异，该变异导致次要剪接体的重要组分U4atac小核RNA功能异常，进而引发Roifman综合征。.
Objective: To investigate the rationality and effectiveness of using a parallel flow push-pull ventilation system to control nitrogen tetroxide gas in high-bay spaces. Methods: In May 2024, a nitrogen tetroxide-contaminated ignition test chamber at a research institute was selected as the study subject. Field investigations, environmental monitoring, computational fluid dynamics (CFD) simulations, and ventilation effectiveness evaluations were conducted to design a parallel flow push-pull ventilation system. The concentration changes of nitrogen tetroxide (measured as nitrogen dioxide) before and after the renovation were detected and compared, workplace toxicant control efficiency was calculated, and the ventilation system's performance was comprehensively assessed. Results: After the renovation, the overall airflow organization in the ignition test chamber and the breathing zone height exhibited a unidirectional southward flow. The time-weighted average concentration (C(TWA)) of nitrogen dioxide decreased from 8.53 to 1.45 mg/m(3). The short-term exposure concentration (C(STEL)) at 8 detection points in the test chamber decreased from 14.3-72.8 mg/m(3) to 3.2-9.8 mg/m(3). The control efficiency of nitrogen tetroxide at the position was all above 80% except for the detection point 1 directly facing the north gate of the test room. Conclusion: The parallel flow push-pull ventilation system can establish stable unidirectional laminar airflow in high-bay spaces, effectively resist ambient interfering airflow. It achieves efficient containment of nitrogen tetroxide gas while effectively protecting air quality in the work area, confirming its rationality and effectiveness in similar workplaces with highly toxic substance exposure. 目的： 探究高大空间采用平行流吹吸式通风系统控制四氧化二氮气体的合理性和有效性。 方法： 于2024年5月，选取某研究所四氧化二氮超标的点火试验间作为研究对象。采用现场调查、检测、流体力学仿真计算、通风设施有效性评估等方法，设计高大空间平行流吹吸式通风系统，检测对比改造前后四氧化二氮（以二氧化氮计）的浓度变化，计算岗位毒物控制效率，综合评估通风设施的控制效果。 结果： 改造后，点火试验间及人员呼吸带高度气流组织整体由北向南呈单向流动状态，二氧化氮时间加权平均浓度（C(TWA)）由8.53 mg/m(3)降至1.45 mg/m(3)；试验间8个检测点短时间接触浓度（C(STEL)）由14.3~72.8 mg/m(3)降至3.2~9.8 mg/m(3)；岗位四氧化二氮控制效率除正对试验间北门1检测点外，其余各点均大于80%。 结论： 平行流吹吸式通风系统在高大空间中可建立稳定的单向层流气流，有效抵抗环境干扰气流，在实现四氧化二氮气体高效控制的同时有效保护作业区域空气质量，验证了其在该类高毒物质作业场所应用的合理性与有效性。.
Objective: To explore age-adapted left ventricular ejection fraction (LVEF) diagnostic thresholds for heart failure with preserved ejection fraction (HFpEF) in children. Methods: In this multicenter retrospective cohort study, children with chronic heart failure were selected from 3 546 hospitalized pediatric heart failure patients across 30 medical centers in 20 provinces, autonomous regions and municipalities in China from January 2013 to December 2022. Children were divided into 3 groups based on LVEF:<50%, 50%-<55%, and ≥55%. Age-stratified analyses were performed using cutoffs at 9, 10, 11, 12, and 13 years of age. Intergroup comparisons were conducted using the chi-square test or Fisher's exact test, Wilcoxon rank-sum test or Kruskal-Wallis test. Multivariable linear regression was used to analyze the independent association between LVEF categories and cardiac structural parameters. Results: A total of 1 018 pediatric patients were included in the analysis. Among them, 527 (51.8%) were male and 491 (48.2%) were female, with an age of 1.2 (0.4, 7.1) years. There were 447 children in LVEF <50% group, 62 children in 50%-<55% group, and 509 children in ≥55% group. Statistical differences in baseline clinical characteristics were observed among the 3 groups, including age, heart rate, respiratory symptoms, systemic congestion symptoms, congenital heart disease, cardiomyopathy cardiovascular events, growth retardation (all P<0.05). Age-stratified analysis showed that when using 9, 10 and 11 years of age as cutoffs, left ventricular end-systolic diameter (LVESD) differed between the LVEF <50% and 50%-<55% groups in children aged at or above the respective cutoff (all P<0.05). When using 12 and 13 years of age as the cutoff, left atrial diameter differed between the LVEF 50%-<55% and ≥55% groups in children below 12 and 13 years of age (both P<0.05). After adjustment for covariates using multivariable linear regression, when using 10 and 11 years of age as the cut-offs, LVEF were correlated with LVESD in both children aged ≥10 years and those aged ≥11 years (β=11.62 and 10.94,95%CI 2.38-20.85 and 1.32-20.56, P=0.018 and 0.029). And when using 12 years of age as the cut-offs, LVEF was correlated with left atrial diameter in children aged <12 years of age (β=-1.82,95%CI -3.29--0.35,P=0.015). Conclusion: Age-related heterogeneity may exist in the LVEF thresholds for pediatric HFpEF, an LVEF threshold of 55% is recommended for children younger than 12 years, whereas 50% consistent with adult criteria, may be considered for those aged 12 years or older. 目的： 探索儿童射血分数保留的心力衰竭（HFpEF）的年龄适应性左心室射血分数（LVEF）诊断界值。 方法： 多中心回顾性队列研究。从2013年1月至2022年12月中国20个省、自治区、直辖市30个医疗中心的3 546例心力衰竭患儿中筛选出慢性心力衰竭患儿。根据LVEF水平分为<50%、50%~<55%和≥55% 3组，以9、10、11、12、13岁为节点进行年龄分层。组间比较采用χ²检验或Fisher确切概率法，Kruskal-Wallis H检验或Wilcoxon秩和检验。采用多因素线性回归模型分析不同LVEF分组与心脏结构指标的独立关联。 结果： 纳入分析的1 018例慢性心力衰竭患儿中男527例（51.8%），女491例（48.2%），年龄1.2（0.4，7.1）岁。LVEF<50%组447例，50%~<55%组62例，≥55%组509例。3组患儿基线临床特征包括年龄，心率，有呼吸道症状、体循环淤血症状、先天性心脏病、心肌病、心血管事件、生长发育迟缓比例差异均有统计学意义（均P<0.05）。年龄分层分析显示，以9、10和11岁为节点，≥年龄节点的患儿中LVEF<50%组与50%~<55%组左心室收缩末期内径（LVESD）差异均有统计学意义（均P<0.05）；以12、13岁为节点，<年龄节点的患儿中LVEF 50%~<55%组与≥55%组左心房内径差异均有统计学意义（均P<0.05）。多因素线性回归调整协变量后，以10、11岁为节点，≥10岁和≥11岁患儿中LVEF与LVESD均有关联（β=11.62、10.94，95%CI 2.38~20.85、1.32~20.56，P=0.018、0.029）；以12岁为节点，<12岁患儿中LVEF与左心房内径有关联（β=-1.82，95%CI -3.29~-0.35，P=0.015）。 结论： 儿童HFpEF的LVEF诊断界值可能具有年龄异质性，<12岁建议采用LVEF 55%作为界值，≥12岁患儿可考虑采用与成人一致的LVEF 50%作为界值。.
Objective: To analyze the distribution characteristics of blood lead levels and their influencing factors among lead-exposed workers in Tianjin City in 2022 through active monitoring, and to provide a scientific basis for the prevention and control of occupational lead poisoning. Methods: In January 2022, 141 workers who were exposed to lead and its inorganic compounds in four lead related enterprises in Binhai New Area, Dongli District, and Wuqing District of Tianjin City in 2022 were selected as the research subjects for active monitoring of occupational health and collection of relevant data. Mann Whitney U test was used for inter group comparison of non normally distributed quantitative data, while Kruskal Wallis H test was used for inter group comparison of multiple data; The influencing factors of elevated blood lead were analyzed using multiple unconditional logistic regression. Results: 141 lead workers had an average age of (36.9±7.0) years and an average lead exposure length of (5.4±5.1) years; The median and quartiles of blood lead concentration [M (Q(1), Q(3)) ] were 23.73 (12.04, 39.73) μg/L, with a geometric mean of 22.27 μg/L; 129 individuals (91.49%) had blood lead levels below 100 μg/L, 12 individuals (8.51%) had blood lead levels between 100-400 μg/L, and no individuals had blood lead levels above 400 μg/L. Univariate analysis showed that there were statistically significant differences in blood lead concentrations among workers from different regions, genders, ages, lead exposure years, industry categories, and enterprise sizes (P<0.05). Multivariate logistic regression analysis showed that gender, age, and industry category were independent risk factors for elevated blood lead levels in workers (OR=9.66, 4.87, 2.30, P<0.05) . Conclusion: The blood lead concentrations of lead workers in Tianjin City are influenced by factors such as gender, age, and industry category. Strengthened supervision and management should be implemented for key populations and industries. 目的： 分析2022年天津市铅作业工人主动监测血铅水平分布特征及其影响因素，为职业性铅中毒防控提供科学依据。 方法： 于2022年1月，以2022年天津市滨海新区、东丽区、武清区4家涉铅企业中所有接触铅及其无机化合物的141名劳动者为研究对象，开展职业健康主动监测并收集相关资料。非正态分布计量资料组间比较用Mann-Whitney U检验，多组间比较用Kruskal-Wallis H检验；血铅升高的影响因素用多因素非条件logistic回归分析。 结果： 141名铅作业工人平均年龄（36.9±7.0）岁，平均接铅工龄（5.4±5.1）年；血铅浓度中位数及四分位数[M（Q(1)，Q(3)）]为23.73（12.04，39.73）μg/L，几何均数为22.27 μg/L；血铅<100 μg/L者129人（占91.49%）、100~400 μg/L者12人（占8.51%）、无血铅> 400 μg/L者。单因素分析显示，不同地区、性别、年龄、接铅工龄、行业类别、企业规模的工人血铅浓度差异有统计学意义（P<0.05）；多因素logistic回归分析显示，性别、年龄、行业类别是工人血铅升高的独立危险因素（OR=9.66、4.87、2.30，P<0.05）。 结论： 天津市铅作业工人血铅浓度受性别、年龄、行业类别等因素影响。应加强对重点人群和重点行业的监督管理。.
Osteonecrosis of the jaw (ONJ) is an inflammatory and necrotic disease affecting the jawbones. The most prevalent forms include osteoradionecrosis of the jaws (ORNJ) following radiotherapy for head and neck malignancies, and medication-related osteonecrosis of the jaw (MRONJ) triggered by long-term use of antiresorptive, antiangiogenic, or corticosteroid agents. Although clinicians have explored diverse modalities, including pharmacotherapy, hyperbaric oxygen, and surgical intervention and several international guidelines have been published, a universal "gold standard" for ONJ management remains elusive. Significant challenges persist regarding the selection of treatment modalities for different disease stages, the timing of surgical intervention, and the restoration of jaw function. This review focuses on these clinical dilemmas, summarizes recent therapeutic advances to provide a refined reference for clinical decision-making. 颌骨坏死是颌骨组织的炎症坏死性疾病，其中口腔颌面-头颈部恶性肿瘤放疗后继发的放射性颌骨坏死（ORNJ），以及长期应用抗骨吸收、抗血管生成或激素类药物引发的药物性颌骨坏死（MRONJ）较常见。目前，针对颌骨坏死的“金标准”治疗策略仍未达成广泛共识。在疾病不同分期的治疗模式选择、手术干预的把控、颌骨功能恢复等关键问题上，仍面临诸多挑战。本文旨在聚焦临床治疗难点，对ORNJ和MRONJ的治疗方案进行比较，以期为临床决策提供参考。.
Objective: To investigate the clinical characteristics, serogroups and antimicrobial resistance of invasive non-typhoid Salmonella infection in children at Xi'an area. Methods: Retrospective cohort study. The clinical manifestations, treatment, prognosis, serogroups and antimicrobial drug resistance of 51 hospitalized children with invasive non-typhoid Salmonella infection confirmed by sterile body fluids or deep pus culture after operation at the Department of Infectious Diseases, the Department of General Surgery and the Department of Orthopedics in Xi'an Children's Hospital from January 2019 to December 2024 were retrospectively analyzed. The patients were divided into bloodstream infection group and local infection group according to the invasion site. The inflammatory markers, serogroups distribution and antimicrobial resistance were analyzed statistically by using Mann-Whitney U test and χ2 test. Results: Among the 51 children, there were 27 males and 24 females, with an onset age of 19 (14, 40) months. Nine cases (17%) were <1 year old, 28 cases (55%) under 1 - <3 years old, 7 cases (14%) under 3-<6 years old and 7 cases (14%) ≥ 6 years old. The onset time of 44 cases (86%) was from April to October. The diseases included 41 cases of bloodstream infection group, 10 cases of local infection group(including 6 cases of osteomyelitis involving the hip joint or humerus or pubis or navicular bone, 2 case of appendicitis with peritonitis and 2 cases of perianal or intra-abdominal abscess). The clinical manifestations were fever in 45 cases(88%), diarrhea and abdominal pain in 22 cases (43%), nausea and vomiting in 11 cases (22%), mesenteric lymphadenopathy in 4 cases (8%). Thirty-one cases (61%) were cured and twenty cases (39%) were improved by effective antibiotics treatment. White blood cell count in local infection group was significantly higher than that in bloodstream infection group (P<0.05).The serogroups of D (Salmonella enteritidis), C and B were the most prevalent among non-typhoid Salmonella isolates, accounting for 21 cases (41%), 10 cases (20%) and 10 cases (20%) respectively. Antibacterial drug sensitivity test showed that the sensitivity rates of piperaciratazobactam, ertapenem and imipenem all were 100% (51/51), those of ceftazidime, ceftriaxone and cefepime were 80% (41/51), 80% (41/51) and 86% (44/51), respectively. The drug resistance(including intermediate) rates of trimethoprim-sulfamethoxazole, aztreonam, ampicillin, ampicillin-sulbactam and ciprofloxacin were 24% (12/51), 16% (8/51), 57% (29/51), 57% (29/51) and 75% (38/51), respectively. There were no statistical differences in the drug resistance (including intermediate) rates of ceftazidime, ceftriaxone, cefepime, trimethoprim-sulfamethoxazole, ampicillin, ampicillin-sulbactam, aztreonam and ciprofloxacin between the bloodstream infection group and local infection group (all P>0.05). Conclusions: Invasive non-typhoid Salmonella infection in children at Xi'an area mainly occurred in infants younger than 3 years old. The main clinical manifestations are fever, abdominal pain and diarrhea.The serotypes are predominantly group D (Salmonella enteritidis). The third generation of cephalosporins is recommended as the drugs for empirical antibiotics treatment according to antimicrobial resistance and pediatric population. 目的： 探讨西安地区儿童侵袭性非伤寒沙门菌感染的临床特征、血清型及抗生素药物耐药性。 方法： 回顾性队列研究。分析2019年1月至2024年12月西安市儿童医院感染科、普通外科和骨科收治的经无菌体液或手术深部脓液培养确诊的51例侵袭性非伤寒沙门菌感染患儿的临床表现、治疗、预后、血清型及抗生素药物耐药性等资料。根据侵袭部位分为血流感染组和局部感染组，采用Mann-Whitney U和χ2检验对两组患儿的炎症指标、血清型分布及药物耐药性差异进行分析。 结果： 51例患儿中，男27例、女24例，就诊年龄19（14，40）月龄。<1岁9例（17%）、1~<3岁28例（55%）、≥3~6岁7例（14%）、≥6岁7例（14%）。4~10月份发病44例（86%）。血流感染组41例、局部感染组10例（髋关节或肱骨或耻骨或舟骨骨髓炎6例、阑尾炎伴腹膜炎2例、肛周或腹腔脓肿2例）。发热45例（88%），腹泻、腹痛22例（43%），恶心、呕吐11例（22%），肠系膜淋巴结肿大4例（8%）。经有效抗菌药物治疗，治愈31例（61%）、好转20例（39%）。局部感染组白细胞计数高于血流感染组（P<0.05）。非伤寒沙门菌血清型主要为D群肠炎沙门菌21例（41%）、C群10例（20%）、B群10例（20%）。抗生素药物敏感性试验显示对哌拉西林他唑巴坦、厄他培南和亚胺培南的敏感率均为100%（51/51），头孢他啶、头孢曲松、头孢吡肟的敏感率分别为80%（41/51）、80%（41/51）、86%（44/51），复方新诺明、氨曲南、氨苄西林、氨苄西林舒巴坦和环丙沙星的耐药（含中介）率分别为24%（12/51）、16%（8/51）、57%（29/51）、57%（29/51）和75%（38/51）。血流感染组与局部感染组对头孢他啶、头孢曲松、头孢吡肟、复方新诺明、氨苄西林、氨苄西林舒巴坦、氨曲南和环丙沙星的耐药（含中介）率差异均无统计学意义（均P>0.05）。 结论： 西安地区儿童侵袭性非伤寒沙门菌感染主要发生于3岁以下婴幼儿，主要表现为发热、腹痛、腹泻，血清型以D群肠炎沙门菌为主。根据抗生素药物耐药性和儿童群体特性，推荐第三代头孢菌素作为经验性抗感染治疗药物。.
3月龄患儿以腹泻、体重增长缓慢起病，临床表现为腹泻、生长障碍、贫血和低蛋白血症。全外显子组测序发现TMPRSS15基因检出c.863C>G（p.Ser288Ter）纯合变异，父母均携带c.863C>G（p.Ser288Ter）杂合变异，诊断为肠激酶缺乏症。予胰蛋白酶替代治疗及对症支持治疗后排便正常，体重逐渐增加。.
Objective: To investigate the risk factors of vascular function damage in children with primary hypertension and establish a risk prediction model. Methods: In this retrospective case-control study, a total of 117 children aged 6-17 years with primary hypertension, hospitalized at Capital Center for Children's Health, Capital Medical University, between February 2024 and October 2025 were included. Flow mediated dilation (FMD) and carotid-femoral pulse wave velocity (cfPWV) were used as indicators of vascular function impairment. The children were divided into a vascular function damage group and a normal vascular function group according to the presence or absence of vascular function damage. Independent samples t-test or Mann-Whitney U test was used for intergroup comparison of measurement data, χ2 test or Fisher's exact test was used for enumeration data. Differences in clinical, laboratory and vascular function-related indicators were compared between the two groups. Multivariate Logistic regression was employed to identify independent risk factors, based on which a nomogram was constructed. The predictive performance was verified by the receiver operating characteristic (ROC) curve. Results: Among 117 hypertensive children, there were 92 (78.6%) males and 25 (21.4%) females, with the age of (13.0±2.1) years at admission. There was 58 (49.6%) with vascular function damage. The body fat percentage, 24 h mean systolic blood pressure, daytime systolic blood pressure, nocturnal systolic blood pressure, low-density lipoprotein, total cholesterol, triglycerides, homocysteine, folic acid, fasting insulin, uric acid and cfPWV levels in the vascular function damage group (58 cases) were significantly higher than those in the normal group (59 cases), while the FMD level in the vascular function damage group was significantly lower than that in the normal group (all P<0.05). Multivariate Logistic regression identified that: nocturnal systolic blood pressure (SBP) (OR=1.06, 95%CI 1.01-1.10, P=0.019), serum low-density lipoprotein (LDL) (OR=5.51,95%CI 2.41-12.58,P<0.001), and homocysteine (OR=1.11,95%CI 1.03-1.19,P=0.005) were independent risk factors for vascular function damage. A nomogram prediction model was constructed accordingly, and the Logistic regression equation was: Logit(P)=-10.73+0.05×nocturnal systolic blood pressure+1.71×low-density lipoprotein+0.10×homocysteine. The ROC curve for the nomogram showed an area under curve of 0.82 (95%CI 0.74-0.89, P<0.001), with a sensitivity of 0.76 and a specificity of 0.71. Conclusion: Nocturnal systolic blood pressure, low-density lipoprotein and homocysteine are independent risk factors for vascular function damage in children with primary hypertension. 目的： 探讨原发性高血压患儿血管功能损伤的影响因素，构建风险预测模型。 方法： 病例对照研究。选取2024年2月至2025年10月在首都医科大学附属首都儿童医学中心住院的6~17岁原发性高血压患儿117例为研究对象，以血流介导的血管舒张功能（FMD）和颈-股动脉脉搏波传导速度（cfPWV）作为血管功能损伤的评估指标，根据患儿是否存在血管功能损伤分为血管功能损伤组与血管功能正常组，组间比较采用独立样本t检验、Mann-Whitney U检验、χ2检验或Fisher确切概率法，比较两组临床、实验室及血管功能相关指标的差异。采用多因素Logistic回归筛选独立危险因素并构建列线图模型，通过受试者工作特征（ROC）曲线评价预测效能。 结果： 117例患儿中男92例（78.6%），女25例（21.4%），就诊时年龄（13.0±2.1）岁。58例（49.6%）患儿存在血管功能损伤。血管功能损伤组（58例）患儿体脂率、24 h平均收缩压、日间收缩压、夜间收缩压、低密度脂蛋白胆固醇、总胆固醇、甘油三酯、同型半胱氨酸、叶酸、空腹胰岛素、尿酸以及cfPWV水平均高于血管功能正常组（59例），FMD水平低于血管功能正常组（均P<0.05）。多因素Logistic分析显示，夜间收缩压（OR=1.06，95%CI 1.01~1.10，P=0.019）、血清低密度脂蛋白胆固醇（OR=5.51，95%CI 2.41~12.58，P<0.001）和同型半胱氨酸（OR=1.11，95%CI 1.03~1.19，P=0.005）均为血管功能损伤独立危险因素。依此构建列线图预测模型，Logistic回归方程为：Logit（P）=-10.73+0.05×夜间收缩压+1.71×低密度脂蛋白胆固醇+0.10×同型半胱氨酸，ROC曲线显示曲线下面积0.82（95%CI 0.74~0.89，P<0.001），灵敏度和特异度分别为0.76和0.71。 结论： 夜间收缩压、低密度脂蛋白胆固醇、同型半胱氨酸是原发性高血压患儿血管功能损伤的独立危险因素。.
Objective: To evaluate the scientificity, transparency and applicability of the guidelines and consensus in the field of stomatology published by Chinese experts between 2023 to 2024. Method: Systematic searches were conducted in 8 databases including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, China Biomedical Literature Service System, Chinese Medical Journal Full-text Database, Wanfang Medical Network, PubMed, Web of Science, and Scopus. Guidelines and consensus led by Chinese scholars in the field of stomatology from 2023 to 2024 were included. The comprehensive evaluation of the included guidelines and consensus was conducted based on the scientific, transparent and applicable rankings (STAR) tool, followed by analyzation of the results. Results: Total of 4 guidelines and 33 expert consensuses were included. Calculated based on the total score of 100 points, the highest score was 32.15 while the lowest was 8.10, as well as the average score was 18.02 and the median score was 17.35. The top 3 STAR domains with the highest score rate were recommendations (48.0%), fundings (31.5%), and guideline development groups (31.5%), while the bottom 3 domains with the lowest score rate were registries (0), protocols (1.4%), and clinical questions (6.8%). Conclusions: The overall quality of guidelines and consensus in the field of stomatology in China needs to be improved. It is necessary to strengthen the planning of guideline and consensus formulation, standardize the formulation process. We emphasize that the guideline development group should include experts from multiple disciplines including evidence-based medicine or guideline methodology. 目的： 评价2023—2024年度期刊发表的中国口腔医学领域指南和共识的科学性、透明性和适用性。 方法： 系统检索中国知网、万方数据知识服务平台、中国生物医学文献服务系统、中华医学期刊全文数据库、万方医学网、PubMed、Web of Science、Scopus共8个中英文数据库，纳入2023—2024年度中国学者牵头发表的口腔医学领域指南及共识。基于指南科学性、透明性和适用性（STAR）评级工具对纳入的指南及共识进行综合评价，并对结果进行分析。 结果： 共纳入4部指南和33部专家共识。以100分为总分计算，纳入的指南和共识中，最高得分32.15分，最低8.10分，平均18.02分，中位得分17.35分。得分率最高的3个STAR领域为推荐意见（48.0%）、资助（31.5%）和工作组（31.5%），得分率最低的3个领域为注册（0）、计划书（1.4%）和临床问题（6.8%）。 结论： 中国口腔医学领域的指南和共识总体质量有待提升，需加强指南和共识制订的计划性、规范制订流程，强调制订工作组应包含循证医学或指南方法学在内的多学科专家共同参与。.
Some testing methods specified in the current national occupational health standard series GBZ/T 160 and GBZ/T 300 for the determination of toxic substances in workplace air fail to meet the requirements for the high-quality development of occupational health. The study collects the standards of GBZ/T 160 and GBZ/T 300, and summarizes the existing problems in their determination methods based on practical testing work. Among the current GBZ/T 160 and GBZ/T 300 standards, the standard determination methods for some toxic substances have multiple deficiencies: the sampling methods cannot satisfy the needs of green, low-carbon and ecological development; toxic substances in different existing states in workplace air cannot be collected accurately; personal sampling and long-term sampling are difficult to implement; the scope of application is limited; highly toxic and hazardous reagents are adopted; the correlation coefficients of standard curves are unsatisfactory; method minimum quantitative concentrations are relatively high; the accuracy and desorption efficiency are poor; the sample stability period is short; and only spectrophotometric methods requiring large amounts of organic solvents are formulated for certain substances. Therefore, the current standard determination methods for toxic substances in workplace air in China need further optimization and improvement. It is urgent to revise national occupational health standards, develop advanced, efficient and high-quality standard determination methods, so as to further boost the development of new quality productive forces in the occupational health industry of our country. 我国现行工作场所空气有毒物质测定的GBZ/T 160和GBZ/T 300系列标准中的部分标准检测方法难以满足当前职业健康高质量发展的需求。本研究收集GBZ/T 160和GBZ/T 300，并结合实际检测工作的开展情况，梳理归纳GBZ/T 160和GBZ/T 300测定方法存在的问题。现行的GBZ/T 160和GBZ/T 300中，部分有毒物质的标准测定方法存在采样方法不符合绿色、低碳的生态化发展需求，不能精准采集工作场所空气中不同存在状态的有毒物质，难以进行个体采样和长时间采样，方法应用范围受限，使用危害大的剧毒和高毒试剂，标准曲线的相关系数差，方法最低定量浓度偏高，准确度差，解吸效率低，样品稳定期限短或仅制定了使用大量有机溶剂的分光光度法等问题。因此，我国现行工作场所空气有毒物质标准测定方法存在待优化和完善的地方，亟需开展国家职业卫生标准修订工作，研发高技术、高效能和高质量的标准测定方法，以更好地助推我国职业健康事业新质生产力的发展。.
骨性Ⅲ类错(牙合)伴牙龈退缩不仅影响牙周健康和口腔美观，也可增加正畸治疗中及治疗后的牙周并发症风险。本文展示1例骨性Ⅲ类错(牙合)伴牙龈退缩的病例，正畸治疗前采用牙周表型改善疗法，即前庭沟切口骨膜下隧道技术联合去上皮结缔组织进行软组织增量，旨在为正畸治疗创造稳定的牙周环境。治疗后牙龈退缩区实现完全根面覆盖，牙龈厚度与角化龈宽度增加且唇侧骨板保持稳定。经5年牙周-正畸联合治疗随访观察，患者牙周健康并对美学效果满意，可为临床多学科联合治疗提供参考。.
Objective: To investigate the clinical characteristics and prognostic factors of pediatric precursor lymphoid neoplasms with KMT2A gene rearrangement. Methods: In this retrospective cohort study, clinical data of 47 children with KMT2A gene rearrangement precursor lymphoid neoplasms diagnosed at the Children's Hospital Affiliated to Zhengzhou University from January 2018 to November 2024 were collected, so as to describe their clinical characteristics. According to whether hematopoietic stem cell transplantation (HSCT) was performed during first complete remission (CR1), children were divided into CR1 transplantation group and CR1 chemotherapy group, survival rates comparison and prognostic factor analysis were performed between two groups. For relapsed children in the CR1 chemotherapy group, they were further subdivided into a transplantation salvage group and a chemotherapy salvage group based on salvage therapy modality, and post-relapse survival rates were compared between the two subgroups. Survival rates were calculated using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors were analyzed using the Cox proportional hazards regression model. Results: Among the 47 patients, there were 27 males and 20 females, with the age of 0.8 (0.4, 2.4) years. B-cell acute lymphoblastic leukemia accounted for 85% (40 cases). The initial white blood cell count was 89×10⁹ (27×10⁹, 302×10⁹)/L. Central nervous system leukemia was diagnosed in 10 children(22%, 46 children had central nervous system assessment). A total of 43 children were included in the efficacy evaluation, with a follow-up of 30.1 (13.8, 47.7) months. The 3-year overall survival and event-free survival (EFS) rates were (68.2±7.3) % and (51.7±8.0) %, respectively. The CR1 transplantation group (17 children) had significantly better 3-year overall survival and EFS rates than the CR1 chemotherapy group (26 children)(100.0% vs. (47.2±10.1) %, (84.7±10.3) % vs. (29.6±9.1) %, χ²=12.68 and 16.03, both P<0.001). The transplantation salvage group (4 children) had a higher 18-month overall survival rate than the chemotherapy salvage group (14 children) (100.0% vs. (8.9±8.4)%, χ²=10.07, P=0.002). Multivariate analysis showed that negativity of minimal residual disease detected by quantitative real-time PCR (qPCR-MRD) at week 12 of induction therapy (HR=0.29, 95%CI 0.10-0.83, P=0.022) and HSCT (HR=0.15, 95%CI 0.05-0.44, P<0.001) were both independent protective factors for EFS. Conclusion: Pediatric KMT2A gene rearrangement precursor lymphoid neoplasms are clinically highly aggressive and have a poor prognosis, but negative qPCR-MRD at week 12 of induction therapy and HSCT are independent protective factors for EFS. 目的： 探讨伴KMT2A基因重排儿童前体淋巴细胞肿瘤的临床特征及预后因素。 方法： 回顾性队列研究。收集并分析2018年1月至2024年11月郑州大学附属儿童医院收治的47例伴KMT2A基因重排前体淋巴细胞肿瘤患儿的临床特征。根据第1次完全缓解（CR1）期是否接受异基因造血干细胞移植（HSCT）治疗分为CR1期移植组与CR1期化学治疗（简称化疗）组，比较两组患儿的生存率并进行预后因素分析；根据挽救治疗方式将CR1期化疗组中复发患儿分为移植挽救治疗组与化疗挽救治疗组，比较两组患儿复发后的生存率。采用Kaplan-Meier法计算生存率并行Log-Rank检验，Cox比例风险回归模型分析预后因素。 结果： 47例患儿中男27例、女20例，年龄0.8（0.4，2.4）岁，急性B淋巴细胞白血病40例（85%），初诊时白细胞计数89×10⁹（27×10⁹，302×10⁹）/L。46例患儿评估中枢状态，10例（22%）合并中枢神经系统白血病。43例纳入疗效评估，随访30.1（13.8，47.7）个月，3年总生存率、无事件生存率（EFS）分别为（68.2±7.3）%、（51.7±8.0）%。CR1期移植组（17例）3年总生存率、EFS高于CR1期化疗组（26例）［100.0%比（47.2±10.1）%、（84.7±10.3）%比（29.6±9.1）%，χ²=12.68、16.03，均P<0.001］。移植挽救治疗组（4例）18个月总生存率高于化疗挽救治疗组（14例）［100.0%比（8.9±8.4）%，χ²=10.07，P=0.002］。多因素Cox回归分析显示，诱导治疗第12周实时荧光定量PCR检测的微小残留病（qPCR-MRD）阴性（HR=0.29，95%CI 0.10~0.83，P=0.022）与HSCT（HR=0.15，95%CI 0.05~0.44，P<0.001）是EFS的独立保护因素。 结论： 伴KMT2A基因重排的儿童前体淋巴细胞肿瘤呈高度侵袭性、预后差，但诱导治疗第12周qPCR-MRD阴性和HSCT是EFS的独立保护因素。.
Objective: To investigate the effects of hexavalent chromium exposure on lncRNA TERC and its target genes MYNN and SERPINC1 in BEAS-2B cells, and their roles in hexavalent chromium-induced malignant transformation. Methods: In September 2022, BEAS-2B cells were treated with different concentrations of hexavalent chromium, and the mRNA expression levels of lncRNA TERC, MYNN and SERPINC1 were detected by qPCR. After knockdown or overexpression of lncRNA TERC via transfection, the cells were exposed to hexavalent chromium and the gene expression changes were measured. Long-term continuous exposure to 0.5 μmol/L hexavalent chromium was performed, and malignant phenotypes were assessed by morphological observation, wound healing assay, plate colony formation assay and soft agar colony formation assay. In malignantly transformed cells, the effects of lncRNA TERC knockdown or overexpression on target gene expression and cell migration were evaluated. For inter-group data comparisons, if the data follow a normal distribution with homogeneous variances, one-way ANOVA is employed, followed by pairwise comparisons using the SNK test. Results: After 24 h exposure to 0.75 and 1 μmol/L hexavalent chromium, the mRNA expression levels of MYNN and SERPINC1 increased with the elevation of concentration (P<0.05). After exposure to 0.5 μmol/L hexavalent chromium for 1-7 d, the expression levels of both genes showed an overall upward trend with prolonged duration. Knockdown of lncRNA TERC significantly decreased SERPINC1 expression (P<0.05), while overexpression of lncRNA TERC elevated the expression of both MYNN and SERPINC1 (P<0.05). After long-term exposure to 0.5 μmol/L hexavalent chromium for 60 passages, the cells exhibited malignant phenotypic changes, with increased 48 h migration rate (P<0.05) and higher soft agar colony formation rate than the control group [ (0.20±0.04) vs (0.09±0.03), P<0.05]. The expression of TERC remained higher than that of the control group throughout the exposure (P<0.05). In malignantly transformed cells, the expression levels of MYNN and SERPINC1 were elevated (P<0.05). Knockdown of TERC decreased the expression of both genes and reduced cell migration (P<0.05), whereas overexpression of TERC markedly increased the expression of both genes (P<0.05) . Conclusion: Hexavalent chromium exposure induces alterations in MYNN and SERPINC1 expression in BEAS-2B cells, demonstrating concentration-and time-dependent effects. lncRNA TERC may promote cell migration by regulating the expression of MYNN and SERPINC1, playing a role in hexavalent chromium-induced malignant transformation. 目的： 探究六价铬暴露对BEAS-2B细胞长链非编码RNA（lncRNA）TERC及其靶基因MYNN和SERPINC1表达的影响，及其在六价铬诱导细胞恶性转化中的作用。 方法： 于2022年9月，以不同浓度六价铬处理BEAS-2B细胞，采用qPCR法检测lncRNA TERC及MYNN和SERPINC1的mRNA表达水平；通过转染实验敲减或过表达lncRNA TERC后进行染毒实验，检测上述基因表达变化；以0.5 μmol/L六价铬长期连续染毒，通过形态学观察、细胞划痕、平板克隆和软琼脂集落形成实验检测恶性表型；在恶性转化细胞中验证lncRNA TERC敲减或过表达对靶基因表达及细胞迁移的影响。多组间数据比较，若数据符合正态且方差齐，则采用单因素方差分析，进一步两两比较SNK检验。 结果： 0.75和1 μmol/L六价铬染毒24 h后，MYNN和SERPINC1的mRNA表达水平随浓度增加而升高（P<0.05）；0.5 μmol/L染毒1~7 d后，两基因表达随时间延长呈升高趋势。敲减lncRNA TERC后，SERPINC1表达明显降低（P<0.05）；过表达lncRNA TERC后，MYNN和SERPINC1表达均升高（P<0.05）。0.5 μmol/L六价铬长期染毒60代后，细胞出现恶性表型改变，48 h迁移率升高（P<0.05），软琼脂集落形成率高于对照组[（0.20±0.04）vs（0.09±0.03），P<0.05]，TERC表达始终高于对照组（P<0.05）。恶性转化细胞中MYNN和SERPINC1表达升高（P<0.05）；敲减TERC后两基因表达降低，迁移能力下降（P<0.05）；过表达TERC后两基因表达明显升高（P<0.05）。 结论： 六价铬染毒可引起BEAS-2B细胞MYNN和SERPINC1表达水平改变，呈浓度-效应和时间-效应关系；lncRNA TERC可能通过调控MYNN和SERPINC1表达促进细胞迁移，在六价铬诱导细胞恶性转化中发挥作用。.