Search

The rapid development of new technologies such as artificial intelligence and large language models has brought new transformations to clinical medical practice. Both domestically and internationally, research and practical exploration of intelligent general practitioners have begun, but a consensus has yet to be formed. Against this backdrop, experts and scholars from Tsinghua University Vanke School of Public Health, Peking University School of Public Health, Chinese Association of General Practitioners of Chinese Medical Doctor Association and several other domestic institutions collaboratively developed a consensus. The background of these experts spans multiple disciplines, including general medicine, public health, artificial intelligence, and evidence-based medicine. Based on extensive literature review both domestically and internationally and through multiple rounds of expert discussions, the Chinese Expert Consensus on Artificial Intelligent General Practitioner (AIGP) was finally formulated. It includes 17 core consensus concerning the definition, characteristics, applications, challenges and recommendations of AIGP. This consensus aims to provide scientific references to promote the empowerment of general practitioners with intelligent technology and enhance the smart service level of primary healthcare.

Proteins with specific functions and characteristics play a crucial role in biomedicine and nanotechnology. De novo protein design enables the customization of sequences to produce proteins with desired structures that do not exist in the nature. In recent years, with the rapid development of artificial intelligence (AI), deep learning-based generative models have increasingly become powerful tools, enabling the design of functional proteins with atomic-level precision. This article provides an overview of the evolution of de novo protein design, with focus on the latest algorithmic models, and then analyzes existing challenges such as low design success rates, insufficient accuracy, and dependence on experimental validation. Furthermore, this article discusses the future trends in protein design, aiming to provide insights for researchers and practitioners in this field.

Visual detection is a technique for evaluating the results through visual judgment without relying on complex optical detection systems. It obtains results quickly based on signals, such as visible light, changes in air pressure, and migration distance, that can be directly observed by naked eyes, being widely used in the in vitro diagnostics industry. The CRISPR-Cas system has the potential to be used in the development of point of care testing (POCT) technologies due to the advantages of mild reaction conditions, no need for thermal cycling or other control measures, and a robust signal amplification capability. In recent years, the combination of visual detection and CRISPR-Cas has significantly reduced the need for laboratory infrastructures, precision instruments, and specialized personnel for nucleic acid detection. This has promoted the development of POCT technology and methods for nucleic acids. This article summarizes the signal output modes and characteristics of the visual detection of nucleic acid by CRISPR-Cas and discusses the issues in the application. Finally, its future clinical translation is envisioned with a view to informing the development of CRISPR-Cas visualization assays.

Objective: To explore the impact of baseline remnant cholesterol levels at a single time point and cumulative remnant cholesterol exposure on the progression trajectories of arterial stiffness. Methods: This prospective cohort study included 2 401 eligible participants from the Beijing Health Management Cohort who consecutively attended health examinations in 2010-2011, 2012-2013, and 2014-2015. The remnant cholesterol value measured in 2014-2015 served as the baseline remnant cholesterol level at a single time point. The cumulative exposure indices were calculated based on remnant cholesterol values from three health examinations from 2010 to 2015, including cumulative exposure, cumulative exposure burden, and duration of high remnant cholesterol exposure. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). The follow-up continued until December 31, 2019, with annual check-ups. During the follow-up period, a group-based trajectory model was employed to construct the progression trajectories of baPWV. The associations between the baseline remnant cholesterol level, cumulative exposure indices of remnant cholesterol and baPWV trajectories were examined using ordinal logistic regression models, adjusting for traditional cardiovascular risk factors and low-density lipoprotein cholesterol (LDL-C) levels. Results: The age of the 2 401 participants was 61 (54, 69) years, with 1 801 (75.01%) being male. The group-based trajectory model indicated that the best-fit model categorized the participants into three subgroups: low-rising group (1 036 individuals, 43.15%), moderate-rising group (1 137 individuals, 47.36%), and high-rising group (228 individuals, 9.50%). After adjusting for traditional cardiovascular risk factors, baseline remnant cholesterol levels at a single point ( OR= 1.170, 95% CI : 1.074-1.274), cumulative remnant cholesterol exposure ( OR= 1.194, 95% CI : 1.096-1.303), cumulative remnant cholesterol exposure burden ( OR= 1.270, 95% CI : 1.071-1.507), and high-remnant cholesterol exposure duration (6 years: OR= 1.351, 95% CI : 1.077-1.695) were significantly associated with the risk of developing a poor baPWV progression trajectory. These results remained significant after adjusting for cumulative average LDL-C levels. The association between baseline remnant cholesterol levels and baPWV progression became insignificant after adjusting for cumulative remnant cholesterol levels ( OR= 1.053, 95% CI : 0.923-1.197), while the association between cumulative remnant cholesterol exposure and baPWV progression remained significant after adjusting for baseline remnant cholesterol levels ( OR= 1.145, 95% CI : 1.008-1.305). Conclusions: Higher levels of baseline remnant cholesterol and cumulative remnant cholesterol are independent risk factors for the progression of arterial stiffness. These associations remain significant even after adjusting for traditional cardiovascular risk factors and LDL-C levels. Furthermore, the effect of cumulative remnant cholesterol levels on the progression of arterial stiffness was stronger than the effect of baseline remnant cholesterol levels.

This study investigated the etiological characteristics and whole genome sequencing of clostridium perfringens (CP) from a food poisoning outbreak. Multiplex real-time PCR was employed to screen pathogens in collected samples. Based on the preliminary screening results, the isolation, cultivation, and identification of suspected pathogenic CP bacteria were performed. The nucleic acid tests were conducted for CP-related virulence genes on CP isolates, anal swab specimens and food samples. The molecular typing of CP isolates was analyzed by using pulsed-field gel electrophoresis (PFGE). A phylogenetic tree was established to analyze nucleotide and amino acid homology after sequencing the PLC gene. The whole genome sequencing and gene annotation on the representative strain QD2022FB4-CP4 were performed to explore its drug resistance, toxin genes and biological characteristics. The analysis revealed that the food poisoning was triggered by F-type Clostridium perfringens, which infected the consumers by contaminating'roujiamo' sandwiches. The whole genome sequencing of the strain QD2022FB4-CP found that it had active metabolic processes, multiple virulence genes and multidrug resistance characteristics.

To achieve early warning of dengue fever from multiple sources and improve the ability to detect and identify dengue fever outbreaks timely, we took Hangzhou as an example and proposed the possibility of early warning of dengue fever. This study divided early warning of dengue fever into three stages: early warning of epidemic source, epidemic symptom, and epidemic. The early warning of epidemic source and epidemic symptom were emphasized to provide reference for other similar studies. Our findings showed that the staged warning of dengue fever was meaningful. Combining the source early warning with the symptom early warning could improve the sensitivity of the warning. Monthly warning can be used as a supplement to weekly warning.

Objective: To analyze the temporal trends of the incidence rate of tuberculosis (TB) in Shaanxi Province and provide a reference for WHO to control the prevalence of TB effectively. Methods: Joinpoint regression was used to analyze the trend of the incidence rate of TB in Shaanxi Province from 2004 to 2022, and the seasonal autoregressive moving average model was used to forecast the incidence rate of TB in Shaanxi Province to 2030. Results: The incidence rate of TB in Shaanxi Province decreased from 90.896/100 000 in 2004 to 35.364/100 000 in 2022, showing a general downward trend (AAPC=-7.72%, P <0.001). From 2014 to 2019, the reduction trend slowed down (APC=-0.69%, P =0.814), of which the largest decline occurred from 2019 to 2022 (APC=-13.26%, P =0.010). The predicted incidence rate of TB in Shaanxi Province from 2020 to 2022 was higher than the reported incidence rate, with the expected incidence rate of 51.342/100 000 in 2022 and 43.468/100 000 in 2030. Conclusion: The incidence rate of TB in Shaanxi Province shows a downward trend from 2004 to 2022, but the decline has shrunk in recent years. It is predicted that the downward trend will continue to slow down by 2030.

Neonatal birth weight is a crucial indicator of intrauterine growth and development with important implications for child development and adult health. The birth weight of a newborn is closely linked to the nutrition and health of the mother during pregnancy as well as genetic factors. Therefore, assessing the metabolic status of the fetus in utero is greatly significant for understanding the mechanisms responsible for abnormal birth weight. While previous studies often analyzed the impact of maternal metabolism on fetal development using umbilical cord blood from pregnant women, such blood may not accurately reflect the actual intrauterine environment owing to the barrier function of the placenta; moreover, obtaining biological samples during the fetal period is challenging. Meconium, the first feces excreted by a newborn, provides ideal biological material for studying maternal and infant health. Metabolomics can reveal metabolic changes in living organisms by analyzing small molecules in biological samples; hence studying meconium samples using metabolomics technology is expected to reveal fetal metabolic changes during pregnancy, thereby providing new insights into fetal nutritional intake, growth, and development, as well as metabolic pathways related to birth weight. To gain a deeper understanding of the metabolic changes associated with birth weight, this study collected metabolomic data from the meconium of 484 newborns in the established Xiaogan birth cohort using an untargeted metabolomics technique based on liquid chromatography-high resolution mass spectrometry (LC-HRMS) and analyzed the association between meconium metabolites and birth weight. This cohort exhibited incidence rates of low birth weight (<2500 g) and macrosomia (>4000 g) of 3.3% and 7.2%, respectively, which were roughly equivalent to the national average. Orthogonal partial least squares discriminant analysis revealed significant differences between the meconium metabolomes of the low birth weight and macrosomic groups when compared to the normal weight group. We discovered significant distinctions between the differential metabolites of newborns of low birth weight and those of normal weight, as well as between macrosomic and normal weight newborns that point to disparate biological pathways. Newborns with low birth weight exhibited significantly lower levels of critical amino acids, such as glutamate and proline, compared to the normal weight group, which may be associated with placental dysfunction and maternal nutritional deficiencies. Conversely, the meconium of macrosomic newborns contained significantly elevated levels of hormone metabolites such as estrone that reflected the pathophysiological state associated with maternal metabolic diseases or excessive placental hormone levels. Our study suggests that the metabolomic profile of the meconium reflects the metabolic pathways and regulatory mechanisms at play during fetal growth and development, and offers potential metabolic biomarkers and directions for future in-depth research into diseases related to fetal development. However, this study was based solely on the Xiaogan birth cohort, which was limited to specific regions and populations. A multicenter, multiethnic, and multiregional study is expected to help validate the universality of our research findings.

Objective: To explore the related factors of vascular complications after liver transplantation in children. Methods: This is a retrospective case series research. The clinical data of 89 pediatric liver transplant patients admitted to the Organ Transplantation Center, the Affiliated Hospital of Qingdao University from January 2016 to March 2024 were collected retrospectively. This study included 44 males and 45 females,aged from 4 months to 17 years. The ratio of graft to recipient weight was 0.6% to 7.7%. The primary diseases included 48 cases of biliary atresia and 41 cases of non-biliary atresia. The Wilcoxon rank sum test, χ test, and Fisher's exact probability method were used for data analysis. Multivariate Logistic regression was used to analyze the related factors of vascular complications. 2 All 89 children with liver transplantation completed surgery successfully. There were 8 cases of arterial complications after surgery, including 6 cases of hepatic artery thrombosis and 2 cases of hepatic artery stenosis. There were 16 cases of portal vein complications after surgery, including 9 cases of portal vein stenosis and 7 cases of portal vein thrombosis. The results of univariate analysis showed that the age of the recipient ≤1 year was the relevant factor for hepatic arterial complications( Results: All 89 children with liver transplantation completed surgery successfully. There were 8 cases of arterial complications after surgery, including 6 cases of hepatic artery thrombosis and 2 cases of hepatic artery stenosis. There were 16 cases of portal vein complications after surgery, including 9 cases of portal vein stenosis and 7 cases of portal vein thrombosis. The results of univariate analysis showed that the age of the recipient ≤1 year was the relevant factor for hepatic arterial complications( χ 2 =0.029). The age of the recipient ≤1 year, the age of the donor, the hepatic phase, and the time of cold ischemia were the relevant factors for the occurrence of portal vein complications( P =0.029). The age of the recipient ≤1 year, the age of the donor, the hepatic phase, and the time of cold ischemia were the relevant factors for the occurrence of portal vein complications( χ 2 =7.270, Z =388.500, Z =838.000, Z <0.05). The results of multivariate analysis showed that age(≤1 year P >1 year) and duration of cold ischemia(every additional 1 hour) were independent related factors for portal vein complications after liver transplantation in children(both vs. >1 year) and duration of cold ischemia(every additional 1 hour) were independent related factors for portal vein complications after liver transplantation in children(both P <0.05). Conclusion: Children aged ≤1 year and with prolonged cold ischemia are more likely to develop portal vein complications after liver transplantation.

The etiology of rheumatoid arthritis (RA), a chronic inflammatory systemic disease, remains unclear. It is characterized by symmetrical and invasive joint inflammation, primarily affecting distal small joints such as those in the hands and feet. This inflammation can lead to joint deformity and loss of function, and often accompanied by involvement of extra-articular organs like the lungs and heart. Currently, anti-rheumatic drugs only provide symptom improvement but have toxic side effects that require optimization. Therefore, it is crucial to thoroughly analyze the mechanisms underlying RA development for the identification of new drug targets. Programmed cell death (PCD) has been extensively studied in recent years and proved to be one of the key pathogenic factors in RA. Dysregulation of PCD is particularly evident in synoviocytes, immune cells, and osteocytes. This review summarizes various forms of PCD including apoptosis, NETosis, autophagy, pyroptosis, necroptosis, ferroptosis, cuproptosis, as well as their regulatory roles in fibroblast synoviocytes, immune cells and osteocytes. These findings hold significant theoretical implications for optimizing clinical treatment options for RA and developing new target drugs.

Objective: To analyze the 5-year relative survival rate of cancer in Henan province based on cancer registration data. Methods: Cancer survival data were extracted from the cancer registration database of Henan province with the diagnosis date between January 1, 2010 and December 31, 2019 were included. The closing date of follow-up was set as December 31, 2019. The 5-year relative survival rate of cancer was calculated using the period survival analysis method and the Ederer II method in the R package "periodR", and the interest period was between 2015 and 2019. Results: During the period of 2015-2019, the overall 5-year relative survival rate of cancer patients in Henan province was 43.6%, and after age-standardization, it was 40.2%. The overall 5-year relative survival rate showed the characteristics of higher survival rate in females than males (45.9% vs 34.7%, Z =39.60, P ＜0.001) and higher survival rate in urban areas than rural areas (44.9% vs 39.1%, Z =12.97, P ＜0.001). The 5-year relative survival rate for cancer patients among children aged 0-14 was 60.2%, and for adults aged 15 and above, it was 43.5%, which was standardized to 40.2% after age adjustment. There are two types of cancers with a standardized 5-year relative survival rate exceeding 70% (thyroid cancer at 82.2% and breast cancer at 71.6%), and four cancers with a rate below 30% (pancreatic cancer at 18.2%, liver cancer at 19.6%, lung cancer at 24.0%, and gallbladder cancer at 26.6%). Conclusion: The cancer 5-year survival rate in Henan Province is lower than that of the national average, indicating the need for continued enhancement of cancer prevention and control measures.

Objective: To investigate the health status and the influencing factors of abnormal lung function of welding fumes exposure workers in Tianjin from 2020 to 2022, and to provide theoretical basis for the protection and intervention of key occupational diseases. Methods: In October 2023, the relevant data of occupational health examination of welding fumes exposure workers in Tianjin from 2020 to 2022 (10831, 10758 and 21717 in 2020, 2021 and 2022, respectively) were collected from the China Disease Prevention and Control Information Platform. The electrocardiogram, chest radiograph and lung function abnormalities of workers in each year were analyzed, as well as the association between lung function abnormalities and gender, age, working age, region, etc. With gender, age and years of service as independent variables, logistic regression analysis was performed year by year on the influencing factors of abnormal lung function. Results: From 2020 to 2022, electrocardiogram, chest radiograph and lung function abnormality rates of workers exposed to welding fumes had statistical significances (χ(2)=301.79, 7.87, 1614.54, P <0.05), and the lung function abnormality rate showed a downward trend year by year (χ(2)(trend)=1516.19, P <0.001). The abnormal rates of lung function in male workers exposed to welding fumes were higher than those in female workers (χ(2)=61.65, 8.04, 15.22, P <0.05). With the increase of age, the abnormal rate of lung function showed an increasing trend (χ(2)(trend)=6.47, 10.81, 4.72, P <0.05). The abnormal rates of lung function in the four districts around the city in each year were 22.05% (318/1442), 8.91% (171/1919) and 6.48% (273/4212), respectively. Year by year logistic regression analysis showed that females were the protective factors for abnormal lung function ( OR =0.369, 0.568, 0.546; 95% CI : 0.298-0.458, 0.367-0.879, 0.388-0.767; P <0.05) . Conclusion: Attention should be paid to the health status of welding fumes workers in Tianjin, focusing on the protection of middle-aged male workers, and effective prevention measures should be taken for key areas and industries such as the four districts around the city.

Objective: The current study aimed to evaluate the possible protective effects of N-acetylcysteine (NAC) against Indum-tin oxide (ITO) nanoparticle (Nano-ITO) -induced pulmonary alveolar proteinosis (PAP) in rats, especially via modulation of nuclear factor kappa B (NF-κB) signaling. Methods: In October 2019, 50 adult male Sprague-Dawley rats were randomly allocated into five groups (10 rats each) as follows: blank control group, saline control group, NAC control group (200 mg/kg), Nano-ITO group (receiving a repeated intratracheal dose of 6 mg/kg Nano-ITO) and NAC intervention group (pre-treated intraperitoneally with 200 mg/kg NAC 1.5 h before the administration of an intratracheal dose of 6 mg/kg Nano-ITO). The rats were exposed twice a week for 12 weeks. Rats were then euthanized under anesthesia, and their lungs were removed for histopathological and immunohistochemical analysis. The comparison of indicators reflecting oxidative stress and pulmonary inflammation among groups was conducted using one-way analysis of variance (ANOVA) and Bonferroni's test. The effect of NAC on Nano-ITO induced NF-κB signaling pathway in rats was analyzed. Results: Histopathological examination of Nano-ITO exposed rats revealed diffuse alveolar damage, including PAP, cholesterol crystals, alveolar fibrosis, pulmonary fibrosis, and alveolar emphysema. Immunohistochemical results of Nano-ITO exposed rats showed strong positive for nuclear factor κB p65 (NF-κB p65) and nuclear factor Kappa B inhibitory factor kinase (IKK-β) and weak positive for nuclear factor κB inhibitory protein α (IκB-α) in the nuclei of bronchiolar and alveolar epithelial cells. Compared with blank control group, saline control group and NAC control group, the level of total protein (TP) in bronchoalveolar lavage fluid of rats in Nano-ITO group was significantly increased ( P <0.05), and the activities of lactate dehydrogenase (LDH), superoxide dismutase (SOD), malondialdehyde (MDA) content and total antioxidant capacity (T-AOC) were significantly increased ( P <0.05), the levels of proinflammatory cytokines interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) were significantly increased ( P <0.05), and the levels of NF-κB p65, IKK-β, inducible nitric oxide synthase (iNOS) and reactive oxygen species (ROS) in lung tissue were significantly increased ( P <0.05). Compared with Nano-ITO group, the levels of TP, T-AOC, MDA and TNF-α in bronchoalveolar lavage fluid of rats in NAC intervention group were significantly decreased ( P <0.05), and the levels of NF-κB p65 and ROS in lung tissue were significantly decreased (P<0.05). Western blot results showed that compared with the control groups, the protein expressions of NF-κB p65 and IKK-β in the lung tissue of Nano-ITO group were increased, while the protein expression of IκB-α was decreased ( P <0.05). Compared with Nano-ITO group, the protein expressions of NF-κB p65 and IKK-β in lung tissue of rats in NAC intervention group were decreased, while the protein expression of IκB-α was increased ( P <0.05) . Conclusion: The study demonstrated that Nano-ITO might induce pulmonary toxicity through the activation of NF-κB signaling pathway, and NAC could antagonize the pulmonary toxicity of Nano-ITO by inhibiting the NF-κB signaling pathway.

This article introduces the occupational disease diagnosis of work-related musculoskeletal disorders such as lumbar and spinal injuries in Germany, and focuses on the research and standard values of the maximum pressure tolerance of intervertebral discs. This article mainly introduces the dose model limits and their applications proposed by the Mainz Dortmund Dosis model (MDD), the judgment of the German Social Court (Bundessozialgericht, BSG), and the German Spinal Research Re evaluation (Deutsche Wirbels ulentudieⅡ, DWSⅡ) ; X-ray manifestations and measurements of intervertebral disc injury; Problems in actual cases and diagnosis. In order to provide reference and inspiration for the occupational diseases diagnosis of work related musculoskeletal disorders in China.

Objective: To describe the epidemiological distribution of hemorrhoids in a physical examination population in China, which could provide evidence for precision prevention and early intervention of hemorrhoids., Methods: Chinese subjects over 18 years of age who underwent a physical examination in a nationwide chain of physical examination centers in 2018 were studied in a cross-sectional design, which collected information by a questionnaire and physical examination results from each subject. The epidemiological distribution of hemorrhoids was described using Logistic models. The gender-, age-, and region-detection rates of hemorrhoids were standardized to the Sixth National Population Census of the People's Republic of China (2010)., Results: A total of 2 940 295 adult subjects were included in the study, of whom the average age was (41.7±14.0) years, and 52.6% were females. The standardized detection rate of hemorrhoids was higher for females (43.7%) than that for males (17.7%; P < 0.001) in this study. In the females, the age distribution of hemorrhoids was inverted U-shaped, with the highest standardized detection rate of hemorrhoids in the age group of 30-39 years (63.5%). In the males, the standardized detection rate of hemorrhoids increased along with age, with the highest percentage of 17.2% in the age group of 50-59 years, and the standardized detection rate of hemorrhoids in the age group of 60 and above decreased slightly ( P < 0.001 for trend test). The participants with hypertension had a higher standardized detection rate of hemorrhoids than those with normal blood pressure in both males and females ( P < 0.001). The standardized detection rate of hemorrhoids showed a positive correlation with body mass index ( P < 0.001 for trend test in males)., Conclusion: The detection rate of hemorrhoids varied to gender, age, obesity, and hypertension status, which could help to identify the risk factors and the high-risk sub-groups, and hence to strengthen health education and early detection accordingly, which could eventually reduce the incidence of hemorrhoids and improve the quality of life and health in the Chinese population. This study was conducted in a physical examination population, and the conclusions of this study should be extrapolated with caution.

Objective: To assess the reliability, and validity of the Chinese version of a short-form of Health Literacy Dental scale (HeLD-14) in 3-6 years old preschool children's parents., Methods: The study population consisted of those eligible 3-6 years old preschool children's parents in Yanqing District, Beijing, China in 2021. A total of 1 479 preschool children's parents were surveyed by questionnaire to understand the general situation of parents and oral health literacy related content. SPSS 21.0 and Mplus 7.4 were used for statistical analysis. Through Cronbach's α coefficient, confirmatory factor analysis, Pearson correlation calculation, Student's t test and other methods, the internal consistency reliability, structure validity, calibration validity and discrimination validity of the scale were evaluated., Results: The Cronbach's α coefficient of Chinese version HeLD-14 scale was 0.958, and Cronbach's α coefficient of different constructs ranged from 0.778 to 0.963. The confirmatory factor analysis showed that the factor loadings of each item of the Chinese version HeLD-14 scale were between 0.719 and 0.977 ( P < 0.001), root-mean-square error of approximation (RMSEA)=0.04, comparative fix index (CFI)=0.992, Tucker-Lewis index (TLI)=0.988, and the model had good goodness of fit. The total score of the Chinese version HeLD-14 scale and the scores of the dimension of concerning, understanding, supporting, financial burden, medical treatment, communication, and application were all positively correlated with general self-efficacy, and the correlation coefficients were 0.439, 0.406, 0.370, 0.344, 0.346, 0.367, 0.373, 0.390, respectively ( P all < 0.05). For parents in the high group with the top 27% HeLD-14 score, the average HeLD-14 score was 69.27±1.06, which was higher than the low group with the bottom 27% HeLD-14 score, 41.29±11.09 ( t =48.13, P < 0.01)., Conclusion: The Chinese version HeLD-14 scale has good reliability and validity in the 3-6 years old preschool children's parents, and can be used as a tool to assess the oral health literacy of parents of preschool children.

Objective: To assess the impact of exposure to particulate matter with aerodynamic diameter ≤2.5 μm (PM 2.5 ) on non-accidental mortality under different apparent temperature levels and to further explore the modification effect of apparent temperature., Methods: This study used time-series design. Tianjin and Ningbo from China, Bangkok and Chiang Mai from Thailand were selected as the research sites, and the apparent temperature was applied as the exposure index. Through the quantitative estimation of the threshold temperature, the corresponding pollutant concentration was divided into high and low levels, and the generalized Poisson additive model was used to evaluate the association between PM 2.5 exposure and non-accidental death of residents at different temperature levels., Results: The ave-rage concentrations of PM 2.5 in Tianjin, Ningbo, Bangkok, and Chiang Mai during the study period were (73.6±35.6), (48.0±32.1), (33.5±28.4) and (32.6±28.6) μg/m 3 , respectively; the average daily non-accidental death counts were 148, 57, 28, and 8. The analysis of the generalized Poisson additive model showed that the daily non-accidental death counts increased by 0.43% (95% CI : 0.33%-0.54%) per 10 μg/m 3 increase of PM 2.5 in lag 0 day in Tianjin of China; 0.27% (95% CI : 0.08%-0.46%) per 10 μg/m 3 increase of PM 2.5 in lag 2 days in Ningbo of China. The effect was magnified in high temperature levels in Tianjin and in low temperatures in Ningbo and Bangkok. The mortality effect of PM 2.5 in various temperature levels stayed still in co-pollutant regression models., Conclusion: Exposure to fine particulate matter had an adverse effect on non-accidental mortality, which reminded us to give further attention to the pollution control. The findings also indicated that apparent temperature might modify mortality effects of PM 2.5 and the modification effect varied in different regions. Protective policies due to regional differences should be made and more scientific and social attention on mutual effect of air pollution and climate change needs to be appealed.

Objective: To evaluate the nutritional status of vitamin A (VitA) in breast milk and its influencing factors among lactating women in the Weihai, Yueyang, and Baotou of China., Methods: From May to July 2014, 403 lactating mothers at (42±7) d postpartum were recruited from three Chinese cities, Weihai in Shandong Province, Yueyang in Hunan Province, and Baotou in Inner Mongolia. Basic information of lactating women and newborns and fish intake information of the lactating women in the last month were collected. The concentration of retinol in breast milk was collected and measured using high-performance liquid chromatography to determine the levels of VitA. According to the breast milk retinol concentration, the nutritional status of breast milk VitA among the lactating women was divi-ded into deficiency (< 1.05 μmol/L) and sufficient (≥1.05 μmol/L). The multivariate quantile regression was used to calculate the adjusted breast milk retinol concentrations. The Kruskal-Wallis H test and the Mann-Whitney U test were used to test the difference of breast milk retinol concentration according to the characteristics of the lactating women. The Logistic regression was used to analyze the effect of characteristics of lactating women on breast milk VitA deficiency., Results: The M ( P 25 ) of breast milk retinol concentration among the Chinese lactating women was 1.15 (0.83, 1.49) μmol/L. Multivariate analysis showed that the adjusted breast milk retinol concentration was related to the regions, maternal age, ethnicity, education levels, body mass index (BMI), parity, gestational age, delivery modes, breastfeeding practice, fish intake and birth weight of the infants. The prevalence of VitA deficiency in breast milk among all the lactating women was 41.9%. In Weihai, Yueyang, and Baotou, the prevalence rates were 34.8%, 39.6%, and 51.5%, respectively. Compared with the women in Weihai, the adjusted P 75 ) of breast milk retinol concentration among the Chinese lactating women was 1.15 (0.83, 1.49) μmol/L. Multivariate analysis showed that the adjusted breast milk retinol concentration was related to the regions, maternal age, ethnicity, education levels, body mass index (BMI), parity, gestational age, delivery modes, breastfeeding practice, fish intake and birth weight of the infants. The prevalence of VitA deficiency in breast milk among all the lactating women was 41.9%. In Weihai, Yueyang, and Baotou, the prevalence rates were 34.8%, 39.6%, and 51.5%, respectively. Compared with the women in Weihai, the adjusted OR for breast milk VitA deficiency among those having junior high school and below education were 2.16 (95% CI : 1.05-2.92). Compared with the women having college and above education, the adjusted OR for breast milk VitA deficiency among those having junior high school and below education were 2.16 (95% CI : 1.10-4.24). Compared with women with low fish intake, the adjusted OR for breast milk VitA deficiency among those with high fish intake were 0.55 (95% CI : 0.36-0.84)., Conclusion: The prevalence of breast milk VitA deficiency among the Chinese lactating women was 41.9%, suggesting that breast milk VitA deficiency in lactating women and inadequate VitA intake for infants were common in China. The women in Baotou, low educational status and low fish intake increased the risk of breast milk VitA deficiency, suggesting that attention should be paid to the nutritional status of lactating women in underdeveloped regions such as inland region, and education for health should be enhanced and food containing VitA such as fish intake should be increased.

Objective: To delve into the intricate relationship between common genetic variations across the entire genome and the risk of non-syndromic cleft lip with or without cleft palate (NSCL/P)., Methods: Utilizing summary statistics data from genome-wide association studies (GWAS), a thorough investigation to evaluate the impact of common variations on the genome were undertook. This involved assessing single nucleotide polymorphism (SNP) heritability across the entire genome, as well as within specific genomic regions. To ensure the robustness of our analysis, stringent quality control measures were applied to the GWAS summary statistics data. Criteria for inclusion encompassed the absence of missing values, a minor allele frequency ≥1%, P -values falling within the range of 0 to 1, and clear SNP strand orientation. SNP meeting these stringent criteria were then meticulously included in our analysis. The SNP heritability of NSCL/P was calculated using linkage disequilibrium score regression. Additionally, hierarchical linkage disequilibrium score regression to partition SNP heritability within coding regions, promoters, introns, enhancers, and super enhancers were employed, and the enrichment levels within different genomic regions using LDSC (v1.0.1) software were further elucidated., Results: Our study drew upon GWAS summary statistics data obtained from 806 NSCL/P trios, comprising a total of 2 418 individuals from the Chinese population. Following rigorous quality control procedures, 490 593 out of 492 993 SNP were deemed suitable for inclusion in SNP heritability calculations. The observed SNP heritability of NSCL/P was 0.55 (95% CI : 0.28-0.82). Adjusting for the elevated disease pre-valence within our sample, the SNP heritability scaled down to 0.37 (95% CI : 0.19-0.55) based on the prevalence observed in the general Chinese population. Notably, our enrichment analysis unveiled significant enrichment of SNP heritability within enhancer regions (15.70, P =0.04) and super enhancer regions (3.18, P =0.03)., Conclusion: Our study sheds light on the intricate interplay between common genetic variations and the risk of NSCL/P in the Chinese population. By elucidating the SNP heritability landscape across different genomic regions, we contribute valuable insights into the genetic basis of NSCL/P. The significant enrichment of SNP heritability within enhancer and super enhancer regions underscores the potential role of these regulatory elements in shaping the genetic susceptibility to NSCL/P. This paves the way for further research aimed at uncovering novel genetic pathogenic factors underlying NSCL/P pathogenesis.

Objectives: To investigate the prevalence of tension-type headache (TTH) in children and adolescents aged 0-19 years globally in 1990-2021, and to provide a basis for the prevention and treatment of TTH., Methods: Based on the Global Burden of Disease Study data, the age-standardized prevalence distribution of TTH and its changing trend were analyzed among the children and adolescents aged 0-19 years, with different sexes, age groups, sociodemographic index (SDI) regions and countries/territories., Results: The age-standardized prevalence rate (ASPR) of TTH in children and adolescents aged 0-19 globally in 2021 was 17 339.89/100 000, which was increased by 1.73% since 1990. The ASPR in females was slightly higher than that in males (1990: 17 707.65/100 000 vs 16 403.78/100 000; 2021: 17 946.29/100 000 vs 16 763.09/100 000). The ASPR in adolescence was significantly higher than that in school-aged and preschool periods (1990: 27 672.04/100 000 vs 10 134.16/100 000; 2021: 28 239.04/100 000 vs 10 059.39/100 000). Regions with high SDI exhibited a higher ASPR than the other regions, with significant differences in prevalence rates across different countries. From 1990 to 2021, there was a slight increase in global ASPR, with an average annual percentage change (AAPC) of 0.06%. Females experienced a smaller increase than males based on AAPC (0.04% vs 0.07%). There was reduction in ASPR in preschool and school-aged groups, with an AAPC of -0.02%, while there was a significant increase in ASPR in adolescence, with an AAPC of 0.07%. ASPR decreased in regions with low-middle and low levels of SDI, with an AAPC of -0.02% and -0.04%, respectively, while it increased in regions with middle SDI, with an AAPC of 0.24%., Conclusions: There is a consistent increase in the ASPR of TTH in children and adolescents aged 0-19 years globally, with significant differences across sexes, age groups, SDI regions and countries/territories.

Objectives: To explore the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with risk of congenital heart disease (CHD) in offspring., Methods: The parents of children with simple CHD aged 0 to 1 year ( n =683) were recruited as the case group, while the parents of healthy children aged 0 to 1 year ( n =740) served as the control group. A case-control study was conducted, and a questionnaire was used to collect information on perinatal exposures. After controlling for relevant confounding factors using multivariate logistic regression analysis and propensity score matching, the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with CHD were examined, as well as the cumulative effects of smoking and drinking on CHD risk., Results: Maternal active smoking ( OR =2.91, 95% CI : 1.60-5.30), passive smoking ( OR =1.94, 95% CI : 1.56-2.42), and alcohol consumption ( OR =2.59, 95% CI : 1.89-3.54), as well as paternal smoking ( OR =1.52; 95% CI : 1.22-1.90) and drinking ( OR =1.48, 95% CI : 1.19-1.84), were associated with an increased risk of CHD in offspring. There was no interaction between parental smoking and drinking behaviors during the periconceptional period concerning the risk of CHD in offspring ( P >0.05). The more parents' smoking and drinking behaviors during the perinatal pregnancy, the higher the risk of CHD in their offspring ( OR =1.50, 95% CI : 1.36-1.65)., Conclusions: Parental smoking and alcohol consumption during the periconceptional period are associated with the occurrence of CHD in offspring, and there is a cumulative effect on CHD risk, suggesting that reducing tobacco and alcohol exposure during the periconceptional period may lower the incidence of CHD.

Non-governmental organization (NGO) is one of the important non-state actors in global health governance. The importance of NGO's participation in the global health governance tend to be more prominent due to its flexibility, professionalism, voluntariness and autonomy. The World Health Organization (WHO) established a Civil Society Commission (CSC) in 2023 aiming at strengthening dialogue, facilitating collaboration so as to play its bigger role in the global health governance. This paper is to make analysis to the importance of NGO in global health governance, WHOCSC's organizational structure and operational mechanism, current status and problem of Chinese health-related NGO's participation in the global health governance, and to provide policy suggestions for strengthening Chinese health-related NGOs' participation in global health governance, including incubating Chinese NGOs into national strategy for global health, strengthening resources mobilization and coordination, as well as advocating transparency and society involvement, emphasizing international humanitarian, public welfare and propaganda.

Patients with chronic kidney disease (CKD) have a relatively high risk of cardiovascular disease (CVD). Risk stratification guided by CVD risk prediction models is essential for managing CKD populations. We reviewed the outcome events, predictive variables, modeling methods, and predictive performance of CVD risk prediction models in CKD populations. We found a large variability in predictive outcomes, number of predictors, and sample sizes across studies. The models tended to overestimate the CVD risk of CKD populations. There are few independently validated or constructed CVD risk prediction models for CKD populations in developing countries, and in particular, there is a lack of independent external validation studies of model calibration. Future studies should comply with the reporting standards of risk prediction models to better support the application of CVD risk prediction models for CKD populations.

Objective: To analyze the survival status and death factors of confirmed HIV-infected patients in Hangzhou to provide a basis for the formulation of AIDS prevention and treatment strategies. Methods: A retrospective cohort study was conducted. The data were from the HIV/AIDS Comprehensive Response Information Management System of the Chinese Disease Control and Prevention Information System.Epidemiological characteristics of HIV-infected patients were comparied in Hangzhou City from 2004 to 2023 by using chi-square Test. The survival rate of HIV-infected patients in Hangzhou was calculated by the life table method, the survival curves of different subgroups were described by the Kaplan-Meier method, and the Cox proportional hazard regression model was used to analyze the influencing factors of death risk. The SPSS 26.0 software was used for statistical analysis. Results: Among the 9 457 subjects, the total follow-up time was 58 004.18 person-years, 494 patients died, fatality rate of all-cause cases was 0.85 per 100 person-years.The average survival time was 18.59 (95% CI :18.40-18.78) years. Malignant neoplasms and pneumocystis pneumonia were the first (14.37%,71/494) and second (10.73%, 53/494) causes of death, respectively. Death within 6 months after diagnosis accounted for 42.51% (210/494), and suicide accounted for 4.25% (21/494). Multivariate Cox regression analysis showed that compared with those who received antiviral treatment (ART) within 3 months of diagnosis, those who received ART outside 3 months and those who did not receive ART had a 1.65 (95% CI :1.25-2.19) and 20.68 (95% CI :15.80-27.06) times risk of death, respectively. The HIV-infected patients with high CD4 + T lymphocytes (CD4) counts for the first time had a lower risk of death. The risk of death of patients with baseline CD4 counts of 200-349 cells/µl, 350-499 cells/µl, and ≥500 cells/µl was 0.38 (95% CI :0.29-0.49), 0.26 (95% CI :0.19-0.36), 0.21 (95% CI :0.14-0.31) times higher than that of baseline CD4 counts <200 cells/µl, respectively. Conclusions: The overall survival of the HIV-infected patients was good in Hangzhou from 2004 to 2023. Early detection of HIV infection and timely mobilization to participate in ART was the key to improving the survival rate of patients. At the same time, given the suicide problem of HIV-infected patients, suicide surveillance and depression and anxiety screening of HIV-infected patients should be further strengthened, and targeted psychological intervention policies should be implemented.

To investigate the associations of serum gamma-glutamyl transferase (GGT) levels with the risk of cardiovascular disease (CVD) and its subtypes in patients with type 2 diabetes mellitus (T2DM) in Jiangsu Province. Methods: The participants were enrolled in the Comprehensive Research project regarding 'Prevention and Control of Diabetes' in Jiangsu Province. The baseline survey was conducted from 2013 to 2014, and follow-up until December 31, 2021. After excluding the participants who self-reported with chronic liver disease/stroke/coronary heart disease at baseline survey and those with incomplete information on GGT, a total of 16 147 T2DM patients were included in the final analysis. Cox proportional hazard regression models were used to calculate the hazard ratio ( HR ) and their 95% CI of GGT for CVD, myocardial infarction, and stroke. Restricted cubic spline models were applied to analyze the dose-response relationship between GGT and the risk of CVD and its subtypes. Results: During the median follow-up time of 8.02 years, 2 860 CVD cases were registered, including 196 cases of myocardial infarction and 2 730 cases of stroke. Multivariate Cox proportional risk regression model indicated that compared to the lowest serum GGT level group, the highest GGT level group had a 24% increased risk of CVD ( HR =1.24, 95% CI : 1.09-1.41) and a 23% increased risk of stroke ( HR =1.23, 95% CI : 1.08-1.40). The restricted cubic spline model showed a nonlinear dose-response relationship between GGT and the risk of CVD, myocardial infarction, and stroke in T2DM patients. Conclusions: High levels of GGT may be associated with an increased risk of cardiovascular disease in T2DM patients, which needs further exploration and validation in future clinical practice.

Objective: To construct a risk prediction model for diabetes kidney disease (DKD). Methods: Patients newly diagnosed with type 2 diabetes mellitus (T2DM) between January 1, 2015, and December 31, 2022, were selected as study subjects from the Yinzhou Regional Health Information Platform in Ningbo City. The Lasso method was used to screen the risk factors, and the DKD risk prediction model was established using Cox proportional hazard regression models. Bootstrap 500 resampling was applied for internal validation. Results: The study included 49 706 subjects, with an median ( Q 1 ) age of 60.00 (50.00, 68.00) years old, and 55% were male. A total of 4 405 subjects eventually developed DKD. Age at first diagnosis of T2DM, BMI, education level, fasting plasma glucose, glycated hemoglobin A1c, urinary albumin, past medical history (hyperuricemia, rheumatic diseases), triglycerides, and estimated glomerular filtration rate were included in the final model. The final model's C-index was 0.653, with an average of 0.654 after Bootstrap correction. The final model's area under the receiver operating characteristic curve for predicting 4-year, 5-year, and 6-year was 0.657, 0.659, and 0.664, respectively. The calibration curve was closely aligned with the ideal curve. Q 3 ) age of 60.00 (50.00, 68.00) years old, and 55% were male. A total of 4 405 subjects eventually developed DKD. Age at first diagnosis of T2DM, BMI, education level, fasting plasma glucose, glycated hemoglobin A1c, urinary albumin, past medical history (hyperuricemia, rheumatic diseases), triglycerides, and estimated glomerular filtration rate were included in the final model. The final model's C-index was 0.653, with an average of 0.654 after Bootstrap correction. The final model's area under the receiver operating characteristic curve for predicting 4-year, 5-year, and 6-year was 0.657, 0.659, and 0.664, respectively. The calibration curve was closely aligned with the ideal curve. Conclusions: This study constructed a DKD risk prediction model for newly diagnosed T2DM patients based on real-world data that is simple, easy to use, and highly practical. It provides a reliable basis for screening high-risk groups for DKD.

Objective: To investigate the association between solid fuel use for heating, smoking, and respiratory diseases. Methods: This study is based on the Qingdao project of the China Kadoorie Biobank. After screening, 26 165 individuals were included in the study. We employed Cox proportional hazards regression models, stratified by risk age (in 5-year intervals) and sex while adjusting for confounding variables such as occupation and physical activity level to analyze the association between solid fuel use for heating, smoking, and increased risk of respiratory diseases. Results: Among the 26 165 participants, the average age of those using solid fuel for heating was (52.57±10.31) years, with females constituting 58.04% and former/current smokers accounting for 65.38%. The results indicated that both the solid fuel group and the former/current smoking group had a higher risk of respiratory diseases, with hazard ratios ( HR ) (95% CI ) of 1.21 (1.04-1.41) and 1.41 (1.16-1.71), respectively. For the duration of solid fuel use, the HR (95% CI ) for 20 years or more, it was 1.27 (1.07-1.51). The multiplicative interaction term between solid fuel use and smoking was statistically significant. Conclusions: The use of solid fuel for heating and smoking significantly increases the risk of respiratory diseases, and there may be a multiplicative interaction between solid fuel use and smoking.

Objective: To analyze the association between air pollution, genetic susceptibility, and the risk of all-cause mortality and cardiovascular outcomes in patients with atrial fibrillation (AF). Methods: AF patients aged between 40-69 years old registered in the United Kingdom Biobank from 2006 to 2010 were included. After excluding those lost to follow-up or with incomplete data during follow-up, 5 814 subjects were analyzed. Long-term exposure to air pollution was estimated at the geocoded residential address of each participant. Genetic risk scores for all-cause mortality, cardiovascular disease, heart failure, myocardial infarction, and stroke were constructed separately for each object to assess the corresponding genetic susceptibility. The Cox proportional hazards model was used to analyze the association between air pollution, genetic susceptibility, and the risk of all-cause mortality and cardiovascular outcomes in AF patients. Results: During a median follow-up of 12.4 years, there were 929 of all-cause mortality (15.98%) and 1 772 of cardiovascular events (30.48%). Multivariable-adjusted analyses revealed that higher exposure to PM 2.5 , PM 10 , NO x , and NO 2 was associated with an increased risk of cardiovascular disease mortality, heart failure, myocardial infarction, and stroke, with hazard ratios ( HR s) ranging from 1.26 to 1.48. Specifically, for each interquartile range ( IQR ) increase in PM 2.5 exposure, the HR s for the outcomes mentioned above were 1.33 (95% CI : 1.14-1.54), 1.42 (95% CI : 1.31-1.54), 1.46 (95% CI : 1.30-1.64), and 1.43 (95% CI : 1.27-1.61), respectively. Both NO x and NO 2 exposures were associated with a 9% increased risk of all-cause mortality per IQR increment, with corresponding HR s of 1.09 (95% CI : 1.02-1.17) and 1.09 (95% CI : 1.01-1.17), respectively. Individuals with high genetic susceptibility to AF had a higher risk of myocardial infarction and stroke compared to those with low genetic susceptibility, with corresponding HR s of 1.39 (95% CI : 1.04-1.87) and 1.46 (95% CI : 1.09-1.95), respectively. Compared to AF patients with low air pollution exposure, those with high air pollution exposure have adjusted population attributable fractions of up to 33.57% (95% CI : 17.87%-46.26%) for cardiovascular mortality, 28.61% (95% CI : 20.67%-35.75%) for heart failure, 33.35% (95% CI : 20.97%-43.79%) for myocardial infarction, and 42.29% (95% CI : 30.05%-52.71%) for stroke. Furthermore, there was an additive interaction between PM 2.5 , NO x , and NO 2 exposure and high genetic susceptibility on the incidence of myocardial infarction. An additive interaction was also observed between NO x , NO 2 exposure, and high genetic susceptibility on the incidence of heart failure (all P <0.05). Conclusions: Both air pollution and genetic susceptibility increase the risk of all-cause mortality and cardiovascular outcomes in AF patients.

Objective: To examine the associations of pre-pregnancy body mass index (BMI), gestational weight gain, and gestational diabetes mellitus (GDM) with early childhood BMI trajectories. Methods: A total of 1 227 mother-child pairs from the Peking University Birth Cohort in Tongzhou were included in this study. In the cohort, maternal pre-pregnancy weight, height, gestational weight gain, and GDM diagnosis were collected. The children were followed up at birth and at 1, 3, 6, 9, 12, 18, 24, 30, and 36 months of age to obtain height/length and weight data. The longitudinal data-based k -means clustering algorithm was used to identify early childhood BMI trajectory groups. The associations of maternal pre-pregnancy BMI, gestational weight gain, and GDM with early childhood BMI trajectories were analyzed using the logistic regression model. We further explored whether there is an interaction effect between pre-pregnancy overweight/obesity and excessive gestational weight gain on the risk of the high BMI trajectory in early childhood through multiplicative and additive interaction analyses. Results: The prevalence rates of overweight and obesity before pregnancy were 21.2% (260 cases) and 6.6% (81 cases) respectively. The prevalence of excessive gestational weight gain and GDM was 57.7% (708 cases) and 30.9% (379 cases). The early childhood BMI trajectories were named low, medium, and high trajectories, accounting for 30.5%, 45.4% and 24.1%, respectively. After controlling potential confounding factors, it was found that pre-pregnancy overweight ( OR =1.54, 95% CI : 1.12-2.12), obesity ( OR =2.33, 95% CI : 1.41-3.85), and excessive gestational weight gain ( OR =1.47, 95% CI : 1.10-1.97) were risk factors for being in the high BMI trajectory in early childhood. GDM was not significantly associated with early childhood BMI trajectories ( P >0.05). Compared with the independent effects of pre-pregnancy overweight/obesity ( OR =1.90, 95% CI : 1.17-3.09) and excessive gestational weight gain ( OR =1.45, 95% CI : 1.03-2.04), the risk of being in the high BMI trajectory in early childhood was greater when the two factors coexisted ( OR =2.38, 95% CI : 1.60-3.54). However, both the multiplicative and additive models showed no interaction effect between pre-pregnancy overweight/obesity and excessive gestational weight gain. Conclusions: Maternal pre-pregnancy overweight/obesity and excessive gestational weight gain are independent risk factors for children being in the high BMI trajectory in early childhood, providing scientific evidence for obesity prevention.

Objective: To analyze the dynamic development of physical, psychological, and cognitive degenerative multimorbidity among middle-aged and older Chinese adults (≥45 years old) while estimating the longitudinal association between socioeconomic status (SES) and the progression of multimorbidity. Methods: Based on data from the China Health and Retirement Longitudinal Study (2011-2020), the Sankey diagram was used to show the dynamic development of physical, psychological, and cognitive degenerative multimorbidity from 2011 to 2020. SES was constructed based on the level of education and total household wealth. Logistic regression was used to estimate OR and 95% CI to evaluate the association between SES and the progression of multimorbidity. Results: Of the 5 393 participants included, 4 484 (83.14%) of them developed new diseases, and the prevalence of physical, psychological, and cognitive degenerative multimorbidity increased from 38.04% to 74.23%. Compared to those with no reported disorders at baseline, participants with psychological disorder (for newly developed physical-cognitive multimorbidity: OR =4.59,95% CI : 2.89-7.29), cognitive disorder (for newly developed physical-psychological multimorbidity: OR =2.24,95% CI : 1.40-3.60), or their multimorbidity at baseline were more likely to progress to physical, psychological, and cognitive degenerative multimorbidity. After adjusting covariates, individuals with low SES were more likely to develop physical diseases ( OR= 1.45, 95% CI : 1.11-1.89), cognitive disorder ( OR= 1.84, 95% CI : 1.16-2.91), physical-psychological multimorbidity ( OR= 1.87, 95% CI : 1.37-2.56), physical-cognitive multimorbidity ( OR= 3.58, 95% CI : 2.54-5.06), psychological-cognitive multimorbidity ( OR= 5.66, 95% CI : 3.04-10.55), and physical-psychological-cognitive multimorbidity ( OR= 3.21, 95% CI : 2.06-5.01) in comparison to those with high SES. There is a dose-response relationship between SES and the multimorbidity progression (all trend P <0.001). Conclusions: The prevalence of physical, psychological, and cognitive degenerative multimorbidity increased significantly among middle-aged and older Chinese adults. Lower SES was associated with multiple patterns of physical, psychological, and cognitive disorders progression.

The disease risk prediction model is the basis of precision prevention and an essential reference for clinical treatment decisions. The development of risk prediction models requires the support of a large amount of high-quality data. A large population cohort study is an important basis for this study. The United Kingdom Biobank (UKB), as a mega-population cohort and biobank, has played an essential role in the exploration of disease etiology and research related to disease prevention and control, with its rich baseline and follow-up data and concepts and mechanisms shared globally. This study followed PRISMA guidelines and included 210 articles with corresponding authors from 18 countries, of which 58 (27.62%) were from the UKB. A total of 491 disease risk prediction models were extracted for cancer, cardiovascular and cerebrovascular diseases, endocrine and metabolic diseases, respiratory diseases, and other diseases and their subgroups, of which 132 were developed by UKB without validation, 183 were developed by UKB with internal validation, 17 were developed by UKB with external validation, and 159 were developed by external development with UKB validation. A total of 188 models used only macro variables (38.29%), and 303 models combined macro and micro variables (61.71%). Model construction methods included survival outcome models, logistic regression, and machine learning. Survival outcome models were dominated by Cox proportional risk regression models and a few models considering competitive risk, accelerated failure models, or different baseline risk functions. Machine learning models included random forest, XGBoost, CatBoost, support vector machine, convolutional neural network, and other methods. The UKB is an essential resource for multiple disease risk prediction modeling studies.

Temporomandibular disorders (TMD) are a heterogeneous group of diseases that affect the temporomandibular joint, chewing muscle system, dental occlusion, and even various structures throughout the body, with significant characteristics of biological-psychological-social pattern. TMD related chronic pain, as the most important clinical symptom, can result in negative emotions seriously affecting patients' quality of life and physical and mental health. Although a variety of therapies have been previously reported to treat TMD related chronic pain, there is a lack of widely recognized therapies. Professor Jason W Busse (from Michael G DeGroote National Pain Centre, McMaster University, Hamilton ON, Canada) took the lead and collaborated with multiple internationally renowned schools/hospitals of stomatology to develop an international consensus on the management of chronic pain associated with TMD, a clinical practice guideline, which took two years and was published in December 15th, 2023 in a global top journal of clinical research The British Medical Journal . This clinical practice guideline explored the comparative effectiveness of available therapies for chronic pain associated with TMD, conditionally recommended the specific intervention for different treatment or pain relief, proposed a comprehensive, agreed, and standardized clinical practice guideline. This present article describes the methodology and key elements of the clinical practice guideline to help clinicians fully understand and appropriately apply this guidance, which could provide the references for clinical practice of TMD associated chronic pain in China.

The study used the Delphi method to conduct two rounds of expert consultations involving 23 experts nationwide, aiming to establish the comprehensive index system for field epidemiological investigations of viral respiratory infectious diseases and determine the weights assigned to each index through the hierarchical analysis. Both rounds of consultation witnessed a 100% participation rate among all experts, with a coefficient of authority (Cr) reaching 0.89. The Kendall's W coefficients for assessing the importance and feasibility in both rounds were 0.108, 0.234, 0.439 and 0.427, respectively. Finally, an index system consisting of seven first-level indicators, 18 second-level indicators, and 36 third-level indicators was constructed for the technical guidelines governing field epidemiological investigations into viral respiratory infectious diseases, and the weight of each indicator was established. The index system constructed in this study has a high degree of scientificity, reliability and operability, but it still needs to be further adjusted and improved in combination with the epidemiological characteristics of viral respiratory infectious diseases.

Objective: To investigate the pollution levels and influencing factors of polybrominated diphenyl ethers (PBDEs) in household dust in five cities in northern China. Methods: Based on the "Chinese Indoor Environment and Health Surveillance" project carried out by the National Institute of Environmental Health, Chinese Center for Disease Control and Prevention in 2018-2019, during the warm season (April 2018 to September 2018) and the cold season (November 2018 to March 2019), Lanzhou in Northwest China, Shijiazhuang in North China, Panjin in Northeast China, Luoyang in Central China, and Qingdao in East China were selected as the research sites. A total of 87 families were recruited to study residences in real-life scenarios. At the same time, dust samples were collected to detect the concentration of PBDEs. The level of household environmental indicators was measured, and the residential building characteristics and family behavior habits were collected through questionnaires. A total of 142 valid dust samples and 140 valid questionnaires were obtained. The differences in PBDE concentrations across seasons, wind zones, residential building characteristics, and family habits were analyzed. The exploratory factor analysis was performed to investigate the possible sources of PBDEs, and multivariate linear regression was used to explore the factors influencing PBDEs in household dust. Results: The M ( Q ) of total PBDE concentrations in 142 household dust samples in five cities was 144.51 (106.61, 222.65) ng/g in the warm season and 145.10 (98.57, 180.65) ng/g in the cold season, respectively. There were seasonal differences in the concentration of ∑ 1, Q <0.01). The concentration of BDE-71 was highest among PBDE homologues, followed by BDE-66 and BDE-47. Three factors were extracted by exploratory factor analysis in the warm season, and the cumulative variance contribution rate was 67.90%. The multivariate linear regression showed that the house completion less than ten years [ 3 ) of total PBDE concentrations in 142 household dust samples in five cities was 144.51 (106.61, 222.65) ng/g in the warm season and 145.10 (98.57, 180.65) ng/g in the cold season, respectively. There were seasonal differences in the concentration of ∑ 12 PBDEs in Luoyang and Shijiazhuang ( P <0.01). The concentration of BDE-71 was highest among PBDE homologues, followed by BDE-66 and BDE-47. Three factors were extracted by exploratory factor analysis in the warm season, and the cumulative variance contribution rate was 67.90%. The multivariate linear regression showed that the house completion less than ten years [ β (95% CI ): 0.186 (0.013, 0.359)], infrequent home cooking [ β (95% CI ):-0.342 (-0.570, -0.114)], and increased residential PM 10 concentration [ β (95% CI ): 0.001 (0.000, 0.002)] during the warm season, as well as the house far from driveway [ β (95% CI ): 0.093 (0.013, 0.172)], house area less than 90 m 2 [ β ):-0.006 (-0.011, -0.001)] during the cold season might be related to the elevated concentrations of ∑ CI ):-0.138 (-0.264, -0.013)], and lower residential xylene concentration [ β The pollution of PBDEs in household dust in five northern cities is at a medium to high level. Years of house completion, frequency of cooking at home, residential PM CI ):-0.006 (-0.011, -0.001)] during the cold season might be related to the elevated concentrations of ∑ 12 PBDEs in household dust. Conclusion: The pollution of PBDEs in household dust in five northern cities is at a medium to high level. Years of house completion, frequency of cooking at home, residential PM 10 concentration, distance from house to driveway, house area, and residential xylene concentration may influence household PBDE concentrations.

Objective: To investigate the effect and potential mechanism of exposure to 20 nm polystyrene nanoplastics (PS-NPs) on lipid metabolism in mice liver. Methods: An animal experimental model was designed, which was completed from September 2022 to July 2023 on the exposure omics platform of the School of Public Health at Capital Medical University and the Key Laboratory of Environment and Population Health at the Chinese Center for Disease Control and Prevention.1 mg/kg and 10 mg/kg PS-NPs tail vein mice exposure models were constructed. After exposure 7 d, serum was collected to measure the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and air flow assisted desorption electrospray ionization-mass spectrometry imaging (AFADESI-MSI) analysis were used to analyze the mRNA levels of fatty acid esterification related genes ( Dgat1 and Dgat2 ) and lipid transport related genes ( ApoB , Cd36 , ApoE and Mttp ) and metabolites' spatial changes in liver tissue. In vivo imaging system (IVIS) and tissue shake sections were employed to observe the fluorescence biological distribution of PS-NPs. t -test or one-way ANOVA was used to explore the difference between groups. Results: The serum ALT levels were (83.97±4.58), (91.17±13.69) and (142.43±6.09) U/L in the control group, 1 mg/kg PS-NPs exposure group and 10 mg/kg PS-NPs exposure group respectively ( F =37.281, P <0.05). The relative mRNA levels of Dgat1 , Dgat2 , ApoB , Cd36 and ApoE were (1.49±0.63, 2.53±0.32, 2.45±0.54), (1.07±0.38, 1.86±0.83, 2.23±0.73), (1.01±0.13, 1.58±0.43, 2.03±0.52), (1.01±0.14, 1.55±0.37, 1.52±0.51), (1.01±0.17, 2.11±0.27, 2.39±0.93) in these three groups respectively. The differences were statistically significant ( F =11.54, 6.95, 14.90, 5.98 and 14.68, P <0.05). AFADESI-MSI analysis found that PS-NPs exposure led to a significant decrease in the levels of glutarylcarnitine and O-Linoleoylcarnitine ( t =4.12 and 3.35, P <0.05), which were associated with lipid beta oxidation. The content of triglycerides (TG) (m/z 921.726 4, t =8.69, P <0.05; m/z 919.711 4, t =3.20, P <0.05), phosphatidylic acid (PA) (m/z 895.712 3, t =3.60, P <0.05; m/z 821.526 6, t =3.36, P <0.05), lysophosphatidylcholine (LysoPC) (m/z 560.310 6, t =3.35, P <0.05; m/z 582.295 3, t =6.28, P <0.05), phosphatidylcholine (PC) (m/z 778.533 9, t =3.53, P <0.05; m/z 804.549 6, t =3.60, P <0.05; m/z 820.523 1, t =3.37, P <0.05), phosphatidylethanolamine (PE) (m/z 772.523 3, t =3.08, P <0.05) showed a significant increase in the PS-NPs exposure group. In vivo and in vitro imaging and in situ cell localization revealed that PS-NPs were mainly enriched in hepatic stellate cells and hepatic Kupffer cells in liver tissue. Conclusion: Exposure to PS-NPs induces disorder of liver lipid metabolism, which may be related to the accumulation of PS-NPs in hepatic stellate cells and hepatic Kupffer cells, providing basis for searching early biomarkers of PS-NPs exposure and further mechanism research.

Lead is one of the most important occupational hazards in China, and occupational exposure is the leading cause of lead poisoning. Lead can be absorbed by the body through air, food, drinking water and skin, and accumulate in multiple organs in the body, posing health risks to humans, especially to lead workers. Many previous studies have shown that lead can affect the function of glial cells such as microglia, astrocytes and oligodendrocytes, resulting in irreversible neurological damage. This article provides an overview of the neurotoxic mechanism induced by lead through glial cells, elucidates that lead can induce neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis, and reviews the relationship between lead and glial cells, in order to provide reference for further research on the neurotoxic mechanism of lead on glial cells.

Objectives: To investigate the screening status of warning signs for mental and behavioral development (WS) and influencing factors of infants and young children (IYC) in poverty eliminated regions of Henan Province. Methods: This study was a cross-sectional study. A total of 15 680 IYC aged 6-23 months from 51 poverty eliminated counties in Henan province from June to September of 2023 were selected through a multi-stage random sampling method. IYC's early warning signs were screened using the WS checklist (WSC). Children's socio-demographic characteristics, maternal information, birth status, and illness conditions such as fever and diarrhea within 2 weeks were measured through a uniformly designed questionnaire. All participants also received the measurement of height, weight, and hemoglobin concentration level. Logistic regression model was used to explore the influencing factors of positive WSC and conducted sensitivity analyses. Results: Among the sample of 15 680 IYC, there were 8 462 boys (53.97%) and 7 218 girls (49.03%), with their age of (15±5) months. A total of 291 (1.86%) IYC were positive in WSC. Parenting risk ( OR =5.07, 95% CI 3.93-6.52, P <0.001) and preterm birth ( OR =1.63, 95% CI 1.06-2.52, P =0.027) were both positively associated with the odds of WSC's positivity. Being girls ( OR =0.66, 95% CI 0.52-0.85, P =0.001), age (12-17 months, OR =0.47, 95% CI 0.35-0.62, P <0.001; 18-23 months, OR =0.40, 95% CI 0.30-0.54, P <0.001), and maternal educational level (junior high school, OR =0.46, 95% CI 0.32-0.66, P <0.001; senior high school or vocational high school, OR =0.35, 95% CI 0.23-0.56, P <0.001; college and above, OR =0.36, 95% CI 0.23-0.57, P <0.001) were all negatively associated with the risk of WSC's positivity. Sensitivity analyses demonstrated that, after excluding anemic children, the association between preterm birth and WSC's positivity was not significant ( OR =1.54, 95% CI 0.95-2.49, P =0.081). Despite this situation, being girls, age and maternal educational level were still negatively associated with the odds of WSC's positivity (all P <0.05); preterm birth, parenting risk were remained positive associated with the risk of WSC's positivity (all P <0.05) either by excluding children with protein-energy malnutrition or 2-week morbidity, or using prevalence ratio instead of OR . Conclusions: Among the IYC in poverty eliminated regions of Henan Province, the risk of positivity of WSC was higher for those IYC with parenting risk, preterm birth, boys, younger age, and lower maternal education level. These influencing factors, such as gender, age, preterm birth, parenting risk and maternal educational level, were in certain stability across different IYC characteristics and estimation models.

Ferroptosis is a form of regulated cell death that depends on iron and reactive oxygen species.Different from apoptosis,necrosis,and autophagy,ferroptosis is characterized by the accumulation of lipid peroxides in cells.Studies have discovered that ferroptosis is closely associated with the occurrence and development of tumors and inducing ferroptosis in tumor cells can enhance the therapeutic effects of drugs on tumors.This article summarizes the latest research progress in ferroptosis regarding its mechanisms and associations with tumors,aiming to provide a reference for further understanding the interaction mechanisms between ferroptosis and tumors and offering new insights and targets for the treatment of tumors.

Objective To explore the effect and mechanism of uric acid (UA) in regulating the larval growth and development of Drosophila melanogaster . Methods A total of 1350 newly hatched first-instar larvae of wild-type Drosophila melanogaster (W1118) were collected,and the Drosophila melanogaster model of hyperuricemia was constructed with a high purine diet.The larvae were assigned into three groups ( n =150):control (standard corn meal medium),low-dose adenine (corn meal medium containing 0.05% adenine),and high-dose adenine (corn meal medium containing 0.10% adenine),and two parallel groups were set up.The growth and development of larvae in each group was observed,and the UA and hormone levels were measured.In addition,the expression levels of genes involved in growth and development were determined. Results Compared with the control group,the low- and high-dose adenine groups showed elevated UA levels (both P <0.001) and prolonged developmental period ( P =0.024, P <0.001).The high-dose adenine group showed decreased survival rate,pupation rate,and eclosion rate and elevated levels of juvenile hormone (JH) and 20-hydroxyecdysone (20E) (all P <0.001).The PCR results showed that compared with the control group,high-dose adenine upregulated the mRNA levels of reactive oxygen species (ROS),forkhead box O (FOXO),and mammalian target of rapamycin (mTOR) while downregulating the mRNA levels of Sestrin,mTOR complex 1(mTORC1),and AMP-activated protein kinase (all P <0.001). Conclusion High concentrations of UA may promote the expression of ROS/FOXO/mTORC1/mTOR signaling pathway by regulating the levels of JH and 20E,thereby inhibiting the larval growth and development of Drosophila melanogaster .

Age-related hearing loss (ARHL) is a common chronic disease that poses a serious threat to the physical and mental health of the elderly in an aging society.It is a sensorineural hearing loss characterized by the loss of auditory hair cells,stria vascularis lesions,apoptosis of spiral ganglia,and degeneration of the auditory central nervous system,reducing the quality of life of the patients.This article reviews the research progress in the relationship of ARHL with Alzheimer's disease,depression,and frailty,as well as the daily intervention in ARHL.This review aims to improve people's awareness and attention to the health hazards of ARHL and to delay the occurrence and development of ARHL by implementing daily intervention measures to form a healthy lifestyle.

Objective: To investigate the molecular mechanism and distribution characteristics of RhD negative phenotypes in Han population of blood donors in Wuhu city., Methods: A total of 210 RhD - samples from August 2021 to August 2022 were screened by serological test and collected from Wuhu Central Blood Station for the voluntary blood donor population. Exons 1 and 10 of the RHD gene were amplificated by PCR to determine whether the samples had the RHD gene. Exons 1-10 of the RHD gene were amplificated by PCR and zygosity analysis were performed in 82 samples containing D gene, and Sanger sequencing was performed on 55 samples containing all RHD exons to determine the genotype., Results: Among 210 RhD - specimens, 128 cases (60.38%) had RHD gene deletion. 27 cases had partial exons of RHD , including 2 cases with RHD*DVI.3/RHD*01N.01 , 24 cases with RHD*01N.04/RHD*01N.01 , and 1 case with RHD-CE(2-10)/RHD*01N.01 . 55 cases had retained all of 10 exons, including 4 cases with RHD*01/RHD*01N.01 , 6 cases with RHD*15/RHD*01N.01 , 1 case with RHD*01W.72/RHD*01N.01 , 1 case with RHD*15/RHD*01EL.01 , 39 cases with RHD*01EL.01/RHD*01N.01 , and the remaining 4 cases were determined to have no RHD gene deletion by zygosity analysis and sequencing showed the presence of 1227G>A mutation loci., Conclusion: There is polymorphism in the molecular mechanism of RhD - D gene in Wuhu blood donor population, among which RHD*01EL.01 and RHD*15 are the main variants in this region. The results of this study provide a theoretical basis for RhD blood group identification and clinical blood transfusion in this region.

Objective To develop the knowledge,attitude,and practice evaluation scale for teachers' early childhood sex education and analyze the reliability and validity of the scale,providing evaluation tools for the research on teachers' early childhood sex education. Methods On the basis of relevant guidelines,publications,and the theory of knowledge,attitude,and practice,a preliminary pool of items for the scale was formed by group discussions.The scale was drafted after two rounds of Delphi expert consultation.In May 2023,stratified cluster sampling was conducted,and 535 preschool teachers from Changshou District,Chongqing were selected for a survey.Cronbach's α coefficient,split-half reliability,exploratory factor analysis,and content validity were adopted to assess the reliability and validity of the scale. Results An evaluation scale for teachers' early childhood sex education was formulated,involving 27 items in 3 dimensions of knowledge,attitude,and practice.The total Cronbach's α coefficient of the scale was 0.875,and that of the knowledge,attitude,and practice dimensions were 0.902,0.743,and 0.879,respectively.The total split-half reliability of the scale was 0.937,and that of the knowledge,attitude,and practice dimensions were 0.934,0.821,and 0.912,respectively.The content validity of the scale was good,with a factor loading range of 0.500-0.836 and a cumulative variance contribution rate of 61.57.The average score of teachers' knowledge,attitude,and practice in sex education was 72.85±7.13,with a good rate of 70.84%. Conclusions The developed scale for evaluating teacher's early childhood sex education demonstrates good reliability and validity,and it can be used to evaluate the teachers' knowledge,attitude,and practice in early childhood sex education.The evaluation results indicate that teachers have low levels of knowledge,attitude,and practice in sex education,and relevant departments need to carry out training on the sex education for young children.

Objective: To explore the relationship between the hypertensive snowbirds' length of migratory stay and their blood pressure control and blood pressure levels. Methods: This study was a cross-sectional study. A population of snowbirds with hypertension was recruited between October and November 2022, and a structured questionnaire was used to collect their self-measured blood pressure and length of stay in Hainan Province. The blood pressure control status is determined based on self-measured blood pressure. According to the self-measured blood pressure to determine whether the blood pressure was well controlled. The associations between snowbirds' length of stay and their blood pressure control as well as their self-measured blood pressure were analyzed using restricted cubic splines. Results: A total of 362 research subjects were included, 169(46.7%) of whom were male, and their age was (69.7±7.0) years old. The participants' self-measured systolic blood pressure and diastolic blood pressure were (129.1±16.2) mmHg (1 mmHg=0.133 kPa) and (78.9±10.1) mmHg, respectively. Overall, 174 (48.1%) participants attained adequate blood pressure control. The median length of stay in Wuzhishan City was 7(6, 7) months. There was an inverted U-shaped association between snowbirds' length of stay and blood pressure control (overall: P= 0.023; nonlinearity: P =0.014), where participants with a length of stay of 7 months had the highest rate of blood pressure control. There is a U-shaped curve relationship between length of stay and systolic blood pressure (overall: P= 0.001; nonlinearity: P =0.033), and a linear negative correlation with diastolic blood pressure ( β =-1.19, P =0.003). Conclusions: Compared with hypertensive snowbirds with too long or too short lengths of stay, snowbirds who stayed in Wuzhishan City for seven months have better blood pressure control, and systolic blood pressure is also lower.

Objective: To further explore the role and mechanism of hsa&#95;circ&#95;0001776 and mir-1265 in lung squamous carcinoma by verifying the expression level of hsa&#95;circ&#95;0001776 in plasma, tissues, and cells of lung squamous carcinoma. Methods: Plasma was collected from patients with lung squamous carcinoma treated at Tangshan People's Hospital and healthy individuals from 2020 to 2022. Lung squamous carcinoma tissue microarrays purchased from Shanghai Xinchao Biotechnology Company in 2022. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of hsa&#95;circ&#95;0001776 in lung squamous carcinoma plasma, tissues, and cells, and fluorescence in situ hybridization was used to verify the expression of hsa&#95;circ&#95;0001776 in lung squamous carcinoma. The localization of hsa&#95;circ&#95;0001776 in NCI-H1703 was verified by fluorescence in situ hybridization. The lung squamous carcinoma cells NCI-H1703 and NCI-H226 were cultured in vitro and divided into the circ-negative control (NC) group, hsa&#95;circ&#95;0001776 overexpression group, miR-NC group, miR-1265 mimic group, hsa&#95;circ&#95;0001776+miR-NC group, and hsa&#95;circ&#95;0001776+miR-1265 mimic group.The cell proliferation, motility and apoptosis were detected by the cell counting kit-8 (CCK-8) method, clone formation, Transwell invasion and migration, and scratch assay, and flow cytometry, respectively. The downstream of hsa&#95;circ&#95;0001776 was predicted by circular RNA interactome website, and the interaction between hsa&#95;circ&#95;0001776, miR-1265 was further determined by dual luciferase reporter gene assay, and nude mice subcutaneous tumorigenesis assay detected the growth of transplanted tumors. Results: Fluorescence in situ hybridization results showed that the fluorescence intensity of hsa&#95;circ&#95;0001776 in lung squamous carcinoma tissues was lower than that in paracancerous tissues, and the fluorescence intensity of miR-1265 in lung squamous carcinoma tissues was higher than that in paracancerous tissues (both P ＜0.05). The expression level of hsa&#95;circ&#95;0001776 in the plasma of lung squamous carcinoma patients was lower than that in the plasma of healthy people, and the expression level of miR-1265 was higher than that in the plasma of healthy people (both P ＜0.05). The expression levels of hsa&#95;circ&#95;0001776 in lung squamous carcinoma cells NCI-H1703, NCI-H226 and SK-MES-1 were lower than that in bronchial epithelial cells BEAS-2B (all P ＜0.05), and the relative expression levels of miR-1265 in NCI-H1703 and NCI-H226 were higher than that in human bronchial epithelial cells BEAS -2B (all P ＜0.05). The expression of hsa&#95;circ&#95;0001776 was correlated with age, lymph node metastasis, clinical stage, and tumor stage in patients with lung squamous carcinoma (all P ＜0.05). Fluorescence in situ hybridization results showed that hsa&#95;circ&#95;0001776 was mainly expressed in the cytoplasm. The results of dual-luciferase reporter assay showed complementary binding of miR-1265 to hsa&#95;circ&#95;0001776. The absorbance values of the hsa&#95;circ&#95;0001776 overexpression group in NCI-H1703 and NCI-H226 cells were lower than that of the circ-NC group ( P ＜0.05). The number of cell clones in the hsa&#95;circ&#95;0001776 overexpressed group was (52±3) and (53±4), the number of migrating cells was (476±17) and (113±7), the number of invading cells was (100±2) and (184±2), and the cell migration rate was (25.00±4.36)% and (36.02±5.55)%, which were lower than those of the circ-NC group [(104±4) and (106±2), (783±29) and (517±16), (657±45) and (473±9), (48.95±8.69)% and (48.70±1.57)%, all P ＜0.05]. The apoptosis rates in the overexpression hsa&#95;circ&#95;0001776 group were (24.77±2.303)% and (19.67±1.16)%, respectively, both higher than those in the circ-NC group [(11.83±1.15)% and (9.50±0.66)%, respectively, both P ＜0.05]. MiR-1265 mimic group had a higher apoptotic rate in the NCI-H1703 and NCI-H226 than those of the miR-NC groups ( P ＜0.05). miR-1265 mimic group had (56±13) and (51±8) cell clones, (556±13) and (405±6) migrating cells, (486±6) and (359±7) invading cells, cell migration rates of (68.56±5.51)%, (81.74±8.04)%, were higher than those of miR-NC group [(31±4) and (21±8), (154±19) and (186±5), (227±6) and (176±7), (25.83±4.26)% and (53.12±4.14) %, all P ＜0.05]. The apoptotic rates in the miR-1265 mimic group were (11.83±2.55)% and (17.50±1.05)%, respectively, which were lower than those in the miR-NC group [(32.67±4.44)% and (39.90±2.88)%, respectively, both P <0.05]. The absorbance values of NCI-H1703 and NCI-H226 in the overexpression of hsa&#95;circ&#95;0001776+miR-1265 mimic group were higher than those of the overexpression of hsa&#95;circ&#95;0001776+miR-NC group ( P <0.05). The overexpression of hsa&#95;circ&#95;0001776+miR-1265 mimic group had (128±15) and (133±8) cell clones, (623±10) and (310±7) migrating cells, (643±16) and (420±7) invading cells, (66.39±4.46)% cell migration rate and (68.60±3.53)%, were higher than those of the hsa&#95;circ&#95;0001776+miR-NC group [(86±7) and (80±16), (380±11) and (115±5), (152±7) and (94±4), respectively, (31.41±5.91)% and (30.94±0.67)%, all P ＜0.05]. The apoptotic rates in the overexpression of hsa&#95;circ&#95;0001776+miR-1265 mimic group were (19.27±0.15)% and (11.53±0.75)%, respectively, both lower than those in the overexpression of hsa&#95;circ&#95;0001776+miR-NC group [(27.77±1.29)% and (18.43±0.71)%, both P ＜0.05]. The results of the subcutaneous tumorigenesis assay in nude mice showed that the volume of tumors in the overexpression of hsa&#95;circ&#95;0001776 group was lower than that in the circ-NC group ( P ＜0.05). Conclusion: hsa&#95;circ&#95;0001776 is downregulated in lung squamous cell carcinoma, and hsa&#95;circ&#95;0001776 can inhibit the development of lung squamous cell carcinoma by targeting miR-1265.

Objective: To analyze epidemiology of gastric cancer five-year survival distribution in Zhejiang population-based cancer registration. Methods: The follow-up data of registrated gastric cancer cases diagnosed from 2008 to 2019 in 22 national cancer registry areas of Zhejiang Province were collected and divided into three diagnostic periods: 2008-2011, 2012-2015 and 2016-2019 to calculate five-year observed survival rates (OSRs), five-year relative survival rates (RSRs) and five-year age-standardized relative survival rates (ARSRs). The distribution of population characteristics (including gender, urban/rural, age group and occupation) and clinical characteristics (including the highest diagnostic institution, sub-site, pathological type and degree of differentiation) of gastric cancer survival rates in each period were analysed. Results: 51 663 new cases of gastric cancer in 2008-2019 in the cancer registration area of Zhejiang Province were included in the analysis, and the ARSR of gastric cancer in 2008-2011, 2012-2015 and 2016-2019 showed an increasing trend (39.2%, 41.3% and 44.7%, respectively). In 2016-2019, the ARSR was similar across gender and urban and rural areas (44.4% for men and 45.7% for women; 44.9% in urban areas and 44.2% in rural areas); Among people with different occupations, the ARSR was highest among business and service workers (55.3%), the agriculture, forestry, animal husbandry and fisheries, water conservancy production workers and domestic workers were lower (41.5% and 43.2%, respectively). The highest diagnostic institution was the provincial hospital with a higher gastric cancer survival rate (47.0%) than the municipal (43.4%) and district (43.6%) levels. The ARSR for gastric cancer was relatively high in the lesser curvature (59.7%), pylorus (50.4%), antrum (49.3%), and greater curvature (48.7%), and lowest in cardia (38.9%). Among the major pathological types, adenocarcinoma (NOS) had an ARSR of 48.1%, mucinous adenocarcinoma 41.3%, imprinted cell carcinoma 39.4%, and squamous carcinoma 33.4%. The ARSR for highly differentiated, moderately differentiated, poorly differentiated and undifferentiated gastric cancers were 80.6%, 57.9%, 43.2% and 36.8%, respectively. Conclusion: The 5-year survival rate of gastric cancer in Zhejiang Province is high and on the rise, with similar survival rates in different genders, urban and rural areas, and significant differences in the survival rates of gastric cancer patients with different occupational groups, highest diagnostic institutions, tumour sub-sites, pathological types and differentiation degrees.

The rapid development of digital intelligence technologies is providing a powerful boost to the high-quality development of the healthcare system. Considering the current state of our healthcare services and guided by General Secretary Xi Jinping's insights on new quality productive forces and the directives from Third Plenary Session of Communist Party of China's 20th Central Committee, the high-quality development of the healthcare service system should focus on digital intelligence technologies such as cloud computing, big data, privacy computing, blockchain, Internet of Things (IoT), mobile computing, and AI. The key measures should include the optimization of production factors, services, and governance. Emphasis should be placed on enhancing the efficient and intensive development of the development model, ensuring the high-quality and continuous integration of the supply model, and transitioning to scientific and modern management methods. Herein, we analyzed the "factor optimization-service optimization-governance optimization" development mechanism driven by digital intelligence and proposed corresponding implementation pathways, intending to provide references for establishing a high-quality and efficient healthcare service system with Chinese characteristics., Competing Interests: 利益冲突　本文作者潘杰和张伟是本刊编委会编委。该文在编辑评审过程中所有流程严格按照期刊政策进行，且未经其本人经手处理。除此之外，所有作者均声明不存在利益冲突。, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Office of Journal of Sichuan University (Medical Sciences).)

Objective: To make a preliminary investigation of the effect of the immune pathway mediated by live Lacticaseibacillus paracasei N1115 on the development of primary hippocampal neurons cultured in vitro ., Methods: Live Lacticaseibacillus paracasei N1115 suspension of an appropriate concentration was used as the experimental group. Peptidoglycan (PGN) and lipopolysaccharide (LPS) were used as positive controls, and RPMI1640 medium served as the blank control. These were co-cultured with RAW264.7 cells to obtain the co-culture mediums and the total cellular RNA, and to measure the expression and secretion of cytokines. After centrifugation, the supernatants were co-cultured with primary hippocampal neurons at appropriate ratios. The co-culture mediums were collected, and the total cellular RNA was extracted to measure the expression of genes related to synaptic development in neurons. Following immunofluorescence staining of the primary hippocampal neurons, the presynaptic and presynaptic membrane-associated proteins, including synaptophysin (SYP) and the postsynaptic density protein 95 (PSD95), and neuronal cell maturation markers, including microtubule-associated protein 2 (MAP-2), and doublecortin (DCX) were quantitatively analyzed. Additionally, the morphological development of the neurons were measured., Results: Compared with the blank control, the mRNA expression levels of interleukin (IL)-6 and tumor necrosis factor- α (TNF-α) increased by 7471% and 926%, respectively, after the RAW264.7 cells were treated with live Lacticaseibacillus paracasei N1115, while their secretion levels increased by 184.16 pg/mL and 12320.76 pg/mL, respectively, all showing statistically significant differences ( P <0.05). The activation ability of N1115 live bacteria was stronger than that of PGN but weaker than that of LPS, showing statistically significant differences ( P <0.05). Compared with the blank control, following the intervention with the supernatant from the co-culture of N1115 live bacteria and RAW264.7 cells, the viability of primary hippocampal neurons in the 10% supernatant intervention group increased by 19.25%, showing statistically significant differences ( P <0.05), and the mRNA expression of SYP and PSD95 increased by 137% and 159%, respectively, showing statistically significant differences ( P <0.05). The total neurite length (489.88 μm) of the neurons of the group intervened with the supernatant of N1115 live bacteria was increased compared to that of the blank control group (381.51 μm), and the cell body area (2092.22 μm 2 ), maximum neurite length (184.78 μm), total neurite length, average neurite length (108.38 μm), and branching points (4.84 s) were higher than those in the two positive control groups, showing statistically significant differences ( P <0.05)., Conclusion: Lacticaseibacillus paracasei N1115 can significantly activate the immune regulatory function of macrophages, thereby promoting the morphological development and synaptic function of nerve cells., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Office of Journal of Sichuan University (Medical Sciences).)

Objective: To investigate the effects of long-term exposure to chrysotile and crocidolite on miRNAs and epithelial mesenchymal transformation (EMT) -related gene expression in human pleural mesothelial cells. Methods: In November 2020, fluorescence quantitative polymerase chain reaction (RT-qPCR) was used to detect the expressions of EMT-related genes in human pleural mesothelioma cells (NCl-H2052 cells, NCl-H2452 cells) and human normal mesothelial cells (Met-5A cells). MiRNAs with abnormal expression in human pleural mesothelioma cells were screened out from the previous miRNA chip data of research group, and target genes of differentially expressed miRNAs were predicted using miRWalk database (http: //mirwalk.umm.uni-heidelberg.de). RT-qPCR was used to verify the abnormal expression of EMT-related miRNAs in cell lines. Met-5A cells were treated with 5μg/cm(2) chrysotile and crocidolite respectively for 48 h a time, once a week and a total of 10 times. Chrysotile group, crocidolite group and control group were set up. And the control group was added with the same volume of PBS. The expression changes of EMT-related genes and abnormal expression miRNAs in each group were detected by RT-qPCR. The differences among the groups were compared by one-way ANOVA, and the differences between the control group and the experimental group were compared by dunnet- t test. Results: Compared with Met-5A cells, the expression levels of Vimentin and Twist genes were increased, and the expression level of E-cadherin genes was decreased in NCl-H2052 cells and NCl-H2452 cells ( P <0.001). Target genes of miRNAs with abnormal expression in miRNA chip were predicted, and the results showed four abnormally expressed miRNAs associated with EMT and verified the expression of these four miRNAs in the cell lines. Compared with Met-5A cells, the expression level of hsa-miR-155-5p was increased in NCl-H2052 cells and NCl-H2452 cells, the expression levels of hsa-miR-34b-5p, hsa-miR-34c-5p and hsa-miR-28-5p were decreased in NCl-H2052 cells and NCl-H2452 cells ( P <0.001), which was consistent with the results of chip analysis. After exposure of Met-5A cells, it was found that compared with the control group, the expression levels of Vimentin and Twist genes, hsa-miR-155-5p, hsa-miR-34b-5p and hsa-miR-34c-5p in the crocidolite group were increased, while the expression level of E-cadherin gene was decreased ( P <0.05). Compared with the control group, the expression levels of Vimentin, Twist and E-cadherin genes in chrysotile group were increased, while the expression levels of hsa-miR-34b-5p, hsa-miR-34c-5p and hsa-miR-28-5p were decreased ( P <0.05) . Conclusion: Long-term exposure to chrysotile and crocidolite could cause Met-5A cells to produce miRNAs and EMT-related gene expression changes similar to mesothelioma cells.

Pulmonary fibrosis is a difficult to treat fibrotic disease with multiple triggering factors and complex pathogenesis. It is characterized by diffuse inflammatory damage, tissue structure destruction, and persistent fibrosis, resulting in irreversible damage to lung function. The Hippo signaling pathway is involved in regulating various biological processes such as cell proliferation, differentiation, migration, apoptosis, and is closely related to the occurrence of pulmonary fibrosis. In order to further explore the mechanism of pulmonary fibrosis, this paper comprehensively analyzes the Hippo signaling pathway and its cellular and pathological imbalance related to pulmonary fibrosis, revealing the influence of Hippo signaling pathway in pulmonary fibrosis and its possible mechanism of action, which is expected to provide new targets and strategies for the prevention and treatment of pulmonary fibrosis.