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Abstract Background ECMO treatment for critically ill patients mostly requires family members to make surrogate decisions. However, the process and experience of family members’ participation in decision making have not been well described. Purpose To explore the experience of family members of critically ill patients who were asked to consent to ECMO treatment and to gain insight into the factors that promote and hinder their decision-making. Methods A descriptive qualitative study. Data were collected using a semi-structured interview method and analysed using traditional content analysis approaches. The cohort included nineteen family members of critically ill ICU patients from a general hospital in China. Results Eleven family members consented to ECMO treatment, and 8 refused. 4 themes and 10 subthemes emerged: (1) tough choices: the dilemma in the emergency situation, the guilt and remorse after giving up; (2) rationalisation of decision-making: ethics and morality guide decision-making, expected efficacy influences decision making, and past experience promotes decision making; (3) decision-making methods: independent decision-making, group decision-making, decision making based on patient preferences; (4) influencing factors of decision making: information and communication, social support. Conclusion The findings provide insights and a basis for promoting efficient ECMO decision-making in clinical practice. It may be difficult to improve the time it takes to make the decision without sacrificing the quality of the decision. Healthcare professionals should provide timely emotional support, informational support, and comprehensive social support to assist them in making efficient decisions while respecting the treatment preferences of the decision-makers.

Abstract Pinctada fucata martensii (P. f. martensii) is one of the main pearl oysters cultured in artificial seawater in China. However, it is highly susceptible to pathogen infection under intensive cultivation near the coast. MicroRNAs (miRNAs), as an innovative and potent regulator of immune function, play a pivotal role in the immune response of pearl oysters to external stimuli and are a potent marker for the response of P. f. martensii to infection. This study identified two novel miRNAs, novel-13 and novel-44, from the whole transcriptome of the P. f. martensii hemocyte before and after infection with Vibrio parahaemolyticus. The dual luciferase results showed that novel-13 negatively regulated LAAO and novel-44 negatively regulated ILK. The activity of antioxidant-related enzymes increased significantly in the synthetic miRNA (novel-13 and novel-44) inhibitors and decreased significantly in the synthetic miRNA mimics. In the challenge experiment, injection with miRNA inhibitor increased the relative survival percentage by 10% compared with the control group. In conclusion, the overexpression of novel-13 and novel-44 can decrease the activity of immune and antioxidant-related enzymes, possibly affecting immune regulation in P. f. martensii by negatively regulating the LAAO and ILK target genes.

BackgroundIn the context of the innovation-driven development strategy, occupational groups are facing increasing work pressure, and its impact on sleep quality and mental health deserves attention.ObjectiveTo explore potential mediating role of sleep quality between work stress and mental health status among occupational workers, and to provide a scientific basis for improving their mental health status. MethodsCluster sampling was used to select 2000 workers in Urumqi, Xinjiang Uygur Autonomous Region. They were divided into mental and physical worker groups according to their occupational types, and a questionnaire survey was conducted using General Information Survey Forms, Effort Reward Imbalance scale (ERI), Pittsburgh Sleep Quality Index (PSQI), and Symptom Check List-90 (SCL-90). Work stress level, sleep quality, and mental health were assessed and compared between mental and physical workers. Structural equation modelling was used to evaluate the relationship among work stress, sleep quality and mental health of the workers, and to explore the mediating effect of sleep quality. ResultsA total of 1979 survey questionnaires were collected, with a response rate of 99%, including 1500 (75.8%) mental workers and 479 (24.2%) physical workers. Linear correlations were confirmed between work stress, mental health, and sleep quality. The correlations of work stress with mental health and sleep quality scale scores were positive for both mental and physical workers (r=0.32, 0.31, P

This work took the kitchen wastes from Liuta Mining Area of Shendong Coal as example, to investigate the effects of hydrogen peroxide(H2O2) pretreatment on the performance of kitchen waste and the production efficiency of volatile fatty acid(VFAs) from anaerobic fermentation. Then the nitrogen and phosphorus removal effect of wastewater treatment with anaerobic fermentation slurry from kitchen waste as carbon source were investigated. Results indicated that the H2O2 pretreatment could promote the release of dissolved organic matters in kitchen wastes and enhance the fluidity of kitchen waste slurry. As a result, the VFAs production after H2O2 pretreatment increased from 10 810-18 131 mg/L to 21 000-28 000 mg/L, while the dominant fermentation products were converted from butyric acid to acetic acid. These suggested that the H2O2 pretreatment achieved a significant improvement in the production efficiency of VFAs. Furthermore, when the anaerobic fermentation slurry from pre-treated kitchen waste as carbon source of wastewater treatment plants, the concentration of NH4+-N and TP in the effluent was less than 1 mg/L and 0.5 mg/L, which was equivalent to the treatment effect when glucose was used as the carbon source. All these demonstrated that the kitchen waste in the mining area had good usability.

Abstract Photoacoustic imaging is a promising non-invasive functional imaging modality for fundamental research and clinical diagnosis. However, achieving capillary-level resolution, wide field-of-view, and high frame rates remains challenging. To address this, we propose a transparent ultrasonic transducer design using our developed transparent Pb(In1/2Nb1/2)O3-Pb(Mg1/3Nb2/3)O3-PbTiO3 crystals. Our fabrication technique incorporates quartz-glass-and-epoxy matching layers with low-resistance indium-tin-oxide electrodes through a brass-ring based structure, enabling a high frequency (28.5 MHz), wide bandwidth (78%), and enhanced pulse-echo sensitivity (2.5 V under 2-μJ pulse excitation). Our Pb(In1/2Nb1/2)O3-Pb(Mg1/3Nb2/3)O3-PbTiO3-based transparent ultrasonic transducer demonstrates a four-fold enhancement in photoacoustic detection sensitivity when compared to the LiNbO3-based counterpart, leading to a 13 dB improvement of signal-to-noise ratio in microvascular photoacoustic imaging. This enables dynamic monitoring of mouse cerebral cortex microvasculature during seizures at 0.8 Hz frame rates over a 1.5 × 1.5 mm2 field-of-view. Our work paves the way for high-performance and compact photoacoustic imaging systems using advanced piezoelectric materials.

This article summarized integrated Traditional Chinese and western medicine nursing interventions for a patient with COVID-19 complicated with chronic cough. Based on the nursing risk assessment and Traditional Chinese Medicine syndrome differentiation, a comprehensive nursing plan consisted of prone position ventilation, health education, emotion regulation and other interventions were carried out. In addition, Traditional Chinese Medicine nursing techniques such as dressing aromatherapy, Chinese herbal medicine ointment rubbing, acupoint application, auricular acupoint pressing and five-tone music therapy were carried out to relieve the negative emotion and cough symptoms, and improve patient’s quality of life. (本文总结1例新型冠状病毒感染合并慢性咳嗽患者的中西医结合护理体会。基于护理评估和中医辨证, 在俯卧位通气、健康宣教、情志护理等常规护理干预基础上, 开展衣冠疗法、中药膏摩、穴位贴敷、耳穴压丸、五音疗法等中医适宜技术, 有效改善患者负性情绪, 缓解咳嗽症状, 提高生活质量。)

Objectives: This study aimed to explore the effectiveness of the theory-based tailored mHealth physical activity (PA) intervention among patients with breast cancer undergoing chemotherapy. Methods: A quasi-experimental study design was adopted. A total of 60 breast cancer patients were selected from two tertiary hospitals in Shanghai and Hangzhou City from September 2019 to August 2021. According to the admission order, 30 patients were first included in the control group, followed by 30 patients in the intervention group. A smartphone application (app) named “Breast Care” was developed based on social cognitive theory, self-efficacy theory, and the theory of planned behavior. The app integrated various functions, including information browsing, PA monitoring and feedback, symptom reporting, and social interaction. Patients in the intervention group received three months of personalized online PA guidance in addition to routine care. The control group received routine care. Baseline and post-intervention investigations after three months were conducted in two groups using the Short Form of International Physical Activity Questionnaire, the Hospital Anxiety and Depression Scale, and the Functional Assessment of Cancer Therapy—Breast cancer. Results: After three months of intervention, compared to the control group, breast cancer patients in the intervention group showed significant improvements in walking, moderate PA, and overall PA (P

Objective To establish and improve the emergency recruitment strategy of voluntary blood donors under public health emergencies in Shenzhen and verify its effectiveness. Methods Blood donor recruitment strategies under routine, emergency and combined situation were developed. The blood collection data from 2017 to 2019 before the outbreak of COVID-19 pandemic was used as the control group, and those from 2020 to 2022 after the outbreak was used as the experimental group, and the feasibility and effectiveness of this emergency recruitment strategy was confirmed through statistical analysis of key indicators of blood collection and supply. Results Through the application of the emergency recruitment strategy for blood donors in Shenzhen under public health emergencies, statistical analysis of the experimental group and the control group showed a year-on-year increase of 14.11%(73 647.25/521 855.5) in whole blood collection, 42.33%(28 891.47/68 250.95) in platelet collection, 0.33%(529/161 033) in first-time donors, 33.25%(3 154/9 487) in repeated donors and 16.78%(32 585/194 149) in the number of 400 mL donors. The inventory of various types of red blood cell maintained between 6-18 days. After the implementation of the emergency recruitment strategy the blood donation population has shown characteristics as younger age, localization, increased repeated donation and a higher proportion of donors with college education or above. Conclusion The emergency recruitment strategy of blood donors under public health emergencies is feasible and effective, which can quickly and efficiently improve the blood recruitment ability.

This study is concerned with topological structure of the solution sets to evolution inclusions of neutral type involving measures on compact intervals. By using Górniewicz-Lassonde fixed-point theorem, the existence of solutions and the compactness of solution sets for neutral measure differential inclusions are obtained. Second, based on the Rδ{R}_{\delta }-structure equivalence theorem, by constructing a continuous function that can make the solution set homotopic at a single point, the Rδ{R}_{\delta }-type structure of the solution sets of this kind of differential inclusion is obtained.

IntroductionPolycystic ovary syndrome (PCOS) is a complex disorder characterized by metabolic and ovulatory dysfunctions, often associated with an imbalance in gut microbiota. Despite current treatments, effective management strategies targeting underlying mechanisms remain limited.MethodsIn this study, we used a rat model of PCOS induced by letrozole and a high-fat diet. The effect of intestinal AMP-activated protein kinase (AMPK) activation was evaluated through metformin administration, the most commonly used AMPK activator. We analyzed metabolic parameters, ovulatory functions, gut microbiota composition, and serum levels of Indole-3-carboxaldehyde (I3A), a metabolite involved in inflammation and apoptosis regulation.ResultsMetformin treatment significantly reversed metabolic disorders and restored ovulatory functions in PCOS rats. Moreover, metformin treatment led to notable improvements in gut microbiota composition and an increase in serum I3A levels, which have been shown to mitigate inflammation and apoptosis.DiscussionThis study highlights the therapeutic potential of targeting intestinal AMPK in managing PCOS. By improving both metabolic and reproductive health, activation of AMPK may offer a promising approach for restoring physiological balance in PCOS patients.

Objective We compared the protein structure and pathogenicity of clinically relevant variants of the COG4 gene with AlphaFold2 (AF2), Alpha Missense (AM), and ThermoMPNN for the first time.Methods and analysis The sequences of clinically relevant Cog4 missense variants (one novel identified p.Y714F and three pre-existing p.G512R, p.R729W and p.L769R from Uniprot Q9H9E3) were imported into AF2 for protein structural prediction, and the pathogenicity was estimated using AM and ThermoMPNN. Different pathogenicity metrics were aggregated with principal component analysis (PCA) and further analysed at three levels (amino acid position, substitution and post-translation) based on all possible Cog4 missense variants (n=14 915).Results Localised protein structural impact including change of conformation and amino acid polarity, breakage of hydrogen bond and salt-bridge, and formation of alpha-helix were identified among clinically relevant Cog4 variants. The global structural comparison with multidimensional scaling demonstrated variants with similar protein structures (AF2) tended to exhibit similar clinical and biological phenotypes. The Cog4 p.Y714F variant exhibited greater protein structural similarity to mutated Cog4 found in Saul‒Wilson syndrome (p.G512R) and shared similar clinical phenotype (congenital cataract and psychomotor retardation). PCA of included pathogenic metrics demonstrated p.Y714F occurred at a critical position in Cog4 amino acid sequence with disrupted post-translational phosphorylation.Conclusion Deep learning algorithms, including AF2, AM and ThermoMPNN, can be useful for evaluating variant of uncertain significance (VUS) by structural and pathogenicity prediction. Despite classified as VUS (American College of Medical Genetics and Genomics criteria: PM1, PP4), the pathogenicity in this Cog4 variant cannot be ruled out and warrants further investigation.

ObjectivePrevious observational studies suggest a potential link between gut microbiota, metabolites, and diabetic nephropathy. However, the exact causal relationship among these factors remains unclear.MethodWe conducted a two-sample bidirectional Mendelian randomization study using summary statistics from the IEU OpenGWAS Project database to investigate gut microbiota, metabolites, and diabetic nephropathy. A range of methods, including inverse variance weighting, MR-Egger, weighted median, and simple median, were applied to examine causal associations. Sensitivity analyses were performed to assess the robustness of the results. Additionally, reverse Mendelian randomization analysis was conducted, treating significant gut microbiota as the outcome, to evaluate effects and perform sensitivity testing. This comprehensive approach provided an in-depth assessment of the interactions among gut microbiota, metabolites, and diabetic nephropathy.ResultThe Inverse Variance Weighted estimates revealed that the abundance of Lachnospiraceae, Parasutterella, and Eubacterium exhibited negative causal effects on diabetic nephropathy, while Coprococcus, Sutterella, Faecalibacterium prausnitzii, and Bacteroides vulgatus showed protective causal effects against the condition. However, reverse Mendelian randomization analysis did not identify any significant associations between diabetic nephropathy and the identified gut microbiota. Furthermore, the estimates indicated that Cholesterol, Pyridoxate, Hexanoylcarnitine, X-12007, Octanoylcarnitine, 10-nonadecenoate (19:1n9), X-12734, and the average number of double bonds in a fatty acid chain had negative causal effects on diabetic nephropathy. In contrast, Methionine, Glycodeoxycholate, X-06351, 1-stearoylglycerol (1-monostearin), 5-dodecenoate (12:1n7), X-13859, 2-hydroxyglutarate, Glycoproteins, Phospholipids in IDL, and the concentration of small HDL particles demonstrated protective causal effects. Notably, sensitivity analyses did not detect any heterogeneity or horizontal pleiotropy, ensuring the robustness of the findings.ConclusionModulating gut microbiota diversity and composition offers a promising strategy for improving the incidence and prognosis of diabetic nephropathy. This highlights the need for future clinical trials focusing on microbiome-based interventions, potentially utilizing microbiome-dependent metabolites. Such approaches could transform the treatment and management of diabetic nephropathy and its associated risk factors, paving the way for more effective therapeutic strategies to combat this debilitating condition.

Summary: Background: Ovarian cancer (OC) is a heterogeneous malignancy with multiple histological subtypes, showing global variability in incidence. Temporal changes in diagnostic criteria and risk factors might influence the incidence and distribution of OC and its subtypes. Methods: This study analyzed incidence patterns (2013–2017) and trends (1988–1992 to 2013–2017) of OC and its subtypes across 65 and 40 countries, respectively. Data were extracted from the Cancer Incidence in Five Continents (CI5 Ⅻ) and CI5plus databases (accessed in June 2024). Annual percent changes were computed to describe trends in age-standardized rates (ASRs) of OC and its subtypes. Proportions of ASR for each subtype relative to the ASR of OC for individual countries were calculated. Findings: The incidence of OC displayed marked disparities across regions and Human Development Index (HDI), with the highest ASRs in Eastern and Central Europe and very high HDI regions, and the lowest in Africa, Asia, and medium HDI regions. Despite stable trend in ASRs of OC globally, notable declines were observed in Europe, America, and Oceania, in contrast to increases in Asian countries like Japan and South Korea. Globally, serous carcinomas remained the most prevalent subtype. European countries exhibited a higher proportion of serous carcinomas, while Asian countries had a higher proportion of endometrioid and clear cell carcinomas. Although trends in subtypes also remained stable, ASRs increased over time for serous carcinomas and germ cell tumor in most countries, while mucinous carcinomas and adenocarcinoma NOS showed a decline. Interpretation: Variations in global patterns and trends in OC incidence and its subtypes might be influenced by genetic and reproductive factors. Consequently, region-specific prevention strategies and ongoing surveillance are essential to mitigate the burden of OC. Funding: The National Key Research and Development Program of China (No.2022YFC2704205), the Natural Science Foundation of China (No.82073647, 82373674, and 82103914), Outstanding Scientific Fund of Shengjing Hospital, 345 Talent Project of Shengjing Hospital of China Medical University, the Max Planck – University of Helsinki Center from the Jane and Aatos Erkko Foundation (No.210046), the Max Planck Society (No.5714240218), the University of Helsinki (No.77204227), and the European Union (ERC Synergy, BIOSFER, 101071773).

Diseases of the digestive system are common in clinical practice, seriously affecting people's health and quality of life. Auricular acupoint pressing therapy has certain advantages in relieving symptoms of digestive disorders such as stomach pain, eructation and constipation. This paper reviewed studies on application and advantages of auricular acupoint pressing therapy in patients with diseases of the digestive system, and provided clinical practice of integrated traditional Chinese and western medicine nursing on the diseases of the digestive system. (消化系统疾病是临床常见病和多发病, 严重影响人们的健康和生活质量。耳穴压丸在缓解胃痛、呃逆、便秘等消化系统疾病症状方面有一定特色和优势。本研究就耳穴压丸在消化系统疾病中的应用进展进行综述, 总结特色和优势, 旨在为中西医结合干预提供参考。)

In this article, we investigate a class of measure differential inclusions of evolution type involving non-autonomous operator with nonlocal condition defined on the half-line. By fixed point theorem, we first obtain some sufficient conditions to ensure the solution set is nonempty, compact, and Rδ{R}_{\delta }-set on compact interval. Subsequently, by means of the inverse limit method, we generalize the results on compact interval to noncompact interval. Finally, an example is given to demonstrate the effectiveness of obtained results.

[Objective] The ecological environment of the Kuye River Basin plays a critical role in the larger context of the Yellow River Basin’s health. Understanding the ecosystem services it provides is crucial for sustainable development. [Methods] Using the InVEST model, researchers conducted a quantitative assessment of ecosystem service functions from 1990 to 2020. [Results] (1) There have been some notable changes in land management policy leading to shifts in land use patterns, particularly in construction land expansion and decreased unused land. Additionally, it seems like there’s been a positive impact on vegetation cover, with grassland dominating and overall vegetation coverage showing an upward trend, albeit with fluctuations. (2) The ecological service function of the Kuye River Basin showed a trend of first declining around 2000 and then fluctuating and increasing after 2010, and the habitat quality index was basically stable between 0.22~0.24, and the overall habitat quality was poor. (3) The soil conservation and habitat quality index in the watershed was dominated by the distribution of low-low aggregation cold spots, the spatial distribution of carbon storage and water conservation cold spots and hot spots was relatively scattered, and the high and low values were spatially staggered. The soil conservation and habitat quality index were mainly low-value aggregation, and the spatial distribution of carbon storage and water conservation was fragmented. (4) In the past 30 years, carbon storage and habitat quality were mainly affected by land use, and soil conservation and water conservation were mainly affected by topography, soil type and precipitation. [Conclusion] The findings of this study highlight the intricate interplay between land use, topography, soil type, precipitation, and their impacts on carbon storage, habitat quality, soil conservation, and water conservation in the Kuye River Basin. Understanding these dynamics is crucial for devising effective strategies to enhance ecological services and allocate appropriate soil and water conservation measures.

Abstract Stegosaurs are a minor but iconic clade of ornithischian dinosaurs, yet due to a poor fossil record, their early evolution is poorly understood. Here, we describe a new stegosaur, Baiyinosaurus baojiensis, gen. et sp. nov. from the Middle Jurassic Wangjiashan Formation of the Pingchuan District, Baiyin City, Gansu Province, China. The frontal of Baiyinosaurus possesses a unique characteristic among Stegosauria: it is wider than long and contributes to both the medial and anterior margins of the supratemporal fenestra. The character combinations of dorsal vertebrae of Baiyinosaurus are also different to other stegosaurs: its neural arches are not greatly elongated, its parapophyses are well developed, and its neural spines are axially expanded in lateral. The features of the frontal and vertebrae of Baiyinosaurus are reminiscent of basally branching thyreophorans, indicating that Baiyinosaurus is transitional in morphology between early thyreophorans and early-diverging stegosaurs. Systematic analysis shows that Baiyinosaurus is an early-diverging stegosaur.

With the increasing social pressure and academic competition, the mental health (for convenience, abbreviated as MH) problems of college students are becoming increasingly prominent, but there are often challenges that are difficult to accurately predict and intervene in a timely manner. The aim of this article is to address the early warning needs of college students’ MH problems and construct a model that can timely identify the MH problems of college students. The experiment collected MH related data from college students in S city, and analyzed and trained these data using the Long short-term memory (LSTM) network model. By changing the number of hidden layers, learning rate, batch size, and epoch times, the most suitable training effect was achieved. By using the time-series characteristics of the LSTM model, the selected parameters from the experiment can better capture the changing trends of college students’ MH status, thereby improving prediction accuracy. Finally, three stage indicators of low, medium, and high were set up for early warning of the predicted results, in order to effectively and timely take measures. The research results indicated that the constructed model achieved a minimum regularization loss of 0.0674 after training. Finally, the adjusted model was used to predict the test set, with an average accuracy of 0.852 and an average accuracy of 0.906. The LSTM-based MH risk model performed well in predicting college students’ MH problems and could identify potential risk factors in a timely manner.

Objective To establish the indicator and fuzzy evaluation model for the procurement demonstration of key instruments and equipment, in order to provide a scientific and reliable method for the procurement demonstration of equipment in blood centers. Methods Through literature review and Delphi method, the procurement evaluation indexes of key instruments and equipment in blood centers were established. The weights of each index were calculated using analytic hierarchy process (AHP) by sending questionnaires to experts. According to the established indicator and fuzzy comprehensive evaluation method, a scoring model of procurement demonstration of key instruments and equipment was constructed. The blood screening total laboratory automation was analyzed and verified using the established demonstration model. Results A total of 4 first-level evaluation indicators and 16 second-level evaluation indicators were established. The weights of urgency, social benefit, economic benefit and technical condition were 0.496, 0.300, 0.051 and 0.153, respectively. For the blood screening assembly line system to be procured, the evaluation value was 0.629, and it passed the procurement demonstration. Conclusion The quantitative and scientific evaluation of the procurement evaluation can be carried out by establishing the evaluation index and fuzzy comprehensive evaluation method for the key instruments and equipment of blood centers.

Abstract Increased circulating histones correlate with sepsis severity and are a potential therapeutic target. Pre‐clinical studies showed benefit with a histone‐neutralizing polyanion molecule (STC3141). We aimed to investigate the safety, tolerability, and pharmacokinetics of STC3141 in critically ill patients with sepsis. We studied 26 patients with sepsis divided into four cohorts of one, five, ten, and ten subjects, respectively. We conducted a dose‐adjusted, open‐label study to determine the safety, tolerability, and pharmacokinetics of STC3141 administered as an IV infusion for up to 72 h, with rate adjusted to estimated creatinine clearance. Four steady‐state concentrations were targeted. Twenty of the 26 subjects (77%) in the study experienced at least one adverse event (AE). The most frequently reported study drug‐related AE was a mildly prolonged aPTT (four events). Only one AE (pulmonary hemorrhage) led to discontinuation of the drug. After excluding patients receiving renal replacement therapy (RRT) patients, clearance ranged from 3.3 to 4.2 L/h across cohorts and was essentially completely renal in nature. Half‐life values ranged from 5 to 7 h. The mean (±SD) terminal half‐life for non‐RRT subjects and for whom it was possible to calculate was approximately 9 (±4.77) h but increased to 19 (±7.94) h for subjects on RRT. Overall, 18 (69.2%) patients completed the study to day eight in the ICU, and 22 (84.6%) survived to 28 days. STC3141 administration appeared to have an acceptable degree of safety and tolerability and expected pharmacokinetics. Cautious, larger randomized efficacy trials in sepsis appear justified.

ObjectiveTo study the epidemiological characteristics of foodborne disease outbreaks in China’s Mainland in 2017.MethodsThe foodborne disease data collected by National Foodborne Disease Outbreaks Surveillance System were analyzed.ResultsA total of 5 142 foodborne disease outbreaks were reported in 30 provinces， which caused 34 981 illnesses and 158 deaths. Among these events， 60.40% （3 106/5 142） were attributed to identifiable pathogens， with mushroom poisoning causing the highest number of events and fatalities， accounting for 45.40% （1 410/3 106） and 68.24% （101/148） respectively. Microbial factors were responsible for the highest number of cases， accounting for 51.29% （11 597/22 609）. The majority of events occurred in catering service establishments， comprising 54.24% （2 789/5 142） of the total. Outbreaks in households accounted for 92.41% （146/158） of the reported deaths.ConclusionCatering service establishments are the primary sites for bacterial foodborne diseases such as Vibrio parahaemolyticus and Salmonella. The highest number of reported deaths from foodborne disease outbreaks in households was primarily due to the consumption of poisonous mushrooms.

ObjectiveTo provide scientific basis for disease control and prevention， the regularity and epidemiological characteristic of foodborne disease outbreaks induced by the eggs and egg products was analyzed.MethodsThe epidemiological characteristics of foodborne disease outbreaks induced by the eggs and egg products from national foodborne disease outbreak reporting system during 2010—2020 was analyzed by descriptive method.ResultsDuring 2010 and 2020， 529 events， 3 609 cases and 3 deaths of foodborne disease outbreaks induced by the eggs and egg products were reported in China’s Mainland， and the annual average incidence was 2.4 per ten million population. It occurred mainly in the summer and autumn seasons， with July having the highest number of events， accounting for 20.6% （109/529）. The event was mainly distributed in the Southwest， east China， and central China regions， with the Southwest region having the highest number of events which accounted for 59.2% （313/529）. The number of events， morbidity and mortality caused by preserved eggs were the largest， accounting for 61.8% （327/529）， 41.2% （1 485/3 609） and 66.7% （2/3）， respectively. The pathogenic factors of preserved eggs were mainly Salmonella （60.9%， 199/327）， and the reason was mainly raw material pollution （20.5%， 67/327） and improper storage （11.0%， 36/327）. Among the events caused by preserved eggs， the number of families in southwest China was the largest， accounting for 42.5% （139/327）， followed by street stalls in southwest China， accounting for 18.7% （61/327）.ConclusionPreserved eggs are the high risk food， Salmonella is the main pathogenic factor， and raw material pollution and improper storage are the main pollution links. It is suggested that relevant regulatory departments should strengthen cooperation， strengthen the monitoring of preserved eggs and the management of street stalls， and implement health education on food safety in southwest China in high-risk seasons.

Genetically modified microorganism （GMM）， also known as recombinant DNA microorganism， means a micro-organism in which the genetic material has been altered in a way that does not occur naturally by mating and/or natural recombination. Given the fact that the safety management requirements for GMM and related products used in food industry differ among countries， different countries adopt different regulations. Chinese government attaches great importance to the management of GMM and related products used in food industry， and has successively issued a series of administrative regulations， departmental rules， announcements， and standards. This study systematically reviews the safety management requirements from international organizations and Western countries for GMM and related products used in food industry， and provides reference and experience for the management of relevant risks in China.

To evaluate the integrated traditional Chinese and western medicine nursing interventions in the treatment of chronic heart failure in the elderly. The hospital had established an integrated traditional Chinese and western medicine nursing model based onmulti-disciplinary team. Based on the treatment of acute exacerbation of chronic heart failure, comprehensive nursing interventions of integrated traditional Chinese and Western medicine were carried out including Traditional Chinese Medicine treatment by syndrome differentiation, Traditional Chinese Medicine characteristic nursing, nursing of insomnia, dietary nursing, Traditional Chinese Medicine enema, volume monitoring, skin care, extended care. (探讨适合我国国情的老年慢性心力衰竭的中西医结合治疗模式和特色护理模式。医院在老年慢性心力衰竭治疗中形成了以多学科合作为基础的中西医结合特色护理模式, 包括慢性心衰急性期治疗与护理、中医辨证施治、中医护理、失眠护理、叙事护理、饮食护理、中药灌肠、出入量监测、皮肤护理、延续性护理等。)

Objective To evaluate the psychological intervention combined with Traditional Chinese Medicine Ta stain therapy in nursing of patients with diabetic foot ulcer. Methods Totally 64 patients with diabetic foot ulcer were randomly divided into the control group and the observation group, with 32 cases in each group. All patients received local dressing change in addition to the comprehensive treatment such as blood glucose control and infection prevention. Patients in the observation group were given psychological intervention combined with wet compress of Traditional Chinese Medicine. The condition of swelling relief and wound repair were evaluated after intervention, and the degree of pain was measured by using Visual Analogue Scale (VAS). Results The total effective rates of swelling relief and wound repair in the observation group were higher than those in the control group(P＜0. 05). The VAS score was decreased in both two groups after intervention, and VAS score in the observation group was lower than that in the control group(P＜0. 01). Conclusion The psychological intervention combined with wet compress of Traditional Chinese Medicine is effective to improve the swelling relief and wound repair, and reduce the pain of patients with diabetic foot ulcer. (目的 探讨心理干预联合中药塌渍技术在糖尿病足溃疡患者护理中的应用效果。方法 采用随机数字表法将64例糖尿病足溃疡患者分为对照组和观察组, 各32例。两组患者在积极控制血糖和抗感染的基础上, 给予局部换药; 观察组增加中药塌渍治疗, 并强化患者心理干预。评估患者红肿伤口消肿情况和破溃伤口修复情况, 采用视觉模拟评分(VAS)评估患者足部疼痛感, 评价干预效果。结果 红肿伤口消肿和破溃伤口修复评价结果显示, 观察组干预效果均优于对照组, 差异有统计学意义(P＜0. 05)。干预后, 两组VAS量表评分均较干预前下降, 且观察组VAS量表评分低于对照组, 差异有统计学意义(P＜0. 01)。结论 在常规护理的基础上, 心理干预联合中药塌渍技术能有效促进糖尿病足溃疡患者红肿伤口消肿和破溃伤口的修复, 缓解足部疼痛感。)

Objective To investigate the effect of high-quality nursing services under the humanistic care nursing model for hospitalized elderly patients with chronic diseases. Methods Totally 70 elderly patients with chronic diseases admitted to the hospital from January 2022 to January 2023 were selected as the research objects. They were randomly divided into the study group and the control group, with 35 patients in each group. Patients in the control group received routing nursing interventions, and those in the study group were given high-quality nursing services under the humanistic care nursing model. The nursing quality evaluation criteria and self-made questionnaire were used to measure the quality of nursing service and patients’ satisfaction. Results The score of nursing quality evaluation criteria in the study group was higher than that in the control group, with a significant difference(P

This article summarized the postoperative nursing of integrated traditional Chinese and Western medicine for an elderly patient undergoing surgery for thyroid cancer. Comprehensive nursing interventions such as basic nursing, acupuncture massage, dietary nursing, exercise guidance and psychological care were carried out. A comprehensive nursing plan of integrated traditional Chinese and Western medicine had been made to relieve the negative emotion and pain of the patient, and improve the sleep quality and quality of life during rehabilitation. (本文总结1例老年甲状腺癌患者术后中西医结合护理经验。根据患者术后症状, 完善基础护理, 中西医联合用药, 并采用针灸按摩、饮食调护、运动指导、心理干预等护理方法, 内外结合, 提升患者治疗信心, 缓解其负性情绪, 减轻疼痛, 改善睡眠质量, 提高患者的生活质量。)

Objective To investigate the effect of humanistic nursing interventions on anxiety and depression of patients with diabetic foot. Methods A total of 100 patients with diabetic foot were randomly divided into the control group and observation group, with 50 cases in each group. All patients received comprehensive treatment of diabetes and routine care, and those in the observation group were given humanistic nursing interventions. The Self-rating Anxiety Scale and Self-rating Depression Scale were used to measure the negative emotions of patients. Results The SAS and SDS scores were significantly decreased after intervention, and SAS and SDS scores in the observation group were lower than those in the control group (P＜0. 01). Conclusion The humanistic nursing intervention is effective to relieve the anxiety and depression of patients with diabetic foot. It may help to enhance patient’s positive coping style and quality of life. (目的 运用人文关怀护理干预缓解糖尿病足患者焦虑抑郁情绪。方法 选取于2022年1月—2023年4月医院收治的糖尿病足患者100例为研究对象, 随机分组为对照组和观察组, 各50例。对照组接受常规治疗和护理, 观察组在对照组基础上增加人文关怀护理。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估患者焦虑抑郁情绪。结果 干预后, 两组SAS和SDS量表评分均较干预前下降, 且观察组SAS和SDS量表评分低于对照组, 差异有统计学意义(P＜0. 01)。结论 人文关怀护理能有效改善糖尿病足患者焦虑抑郁情绪, 增强积极应对方式, 从而有利于改善生活质量。)

Resource utilization of waste iron sludge from wastewater treatment plants can be achieved by leveraging iron sludge-based catalysts to construct Fenton-like systems. Notably，the pyrolysis temperature modulates the composition of metal and non-metal sites on the catalyst surface，thus affecting the activation of hydrogen peroxide（H2O2）. The catalysts prepared at different pyrolysis temperatures（400-700 ℃） were analyzed in terms of morphology，composition，structure and activity. It was found that the degradation efficiency of methylene blue（MB） could reach 92.0% within 100 min with the activation of H2O2 by the catalyst obtained at 700 °C. Additionally，the specific surface area and C content of the catalyst increased as the pyrolysis temperature increased from 400 ℃ to 700 ℃. The mechanistic investigation revealed that Fe0，C̿ C/C—C and C̿ O active sites on the catalyst surface were critical for the activation of H2O2，which facilitated MB degradation. Moreover，hydroxyl radicals（·OH） and singlet oxygen（1O2） were the dominant active species in the iron sludge-derived catalyst/H2O2 system，with superoxide radicals（O2·-） playing a minor role.

ObjectiveTo analyze the epidemiological characteristics of tetrodotoxin poisoning events in China from 2011 to 2020 and provide a scientific basis for precise measures to prevent and control tetrodotoxin poisoning.MethodsDescriptive epidemiological methods were used to analyze the epidemiological characteristics of tetrodotoxin poisoning incidents reported through the National Foodborne Disease Outbreak Monitoring System from 2011 to 2020.ResultsFrom 2011 to 2020， 92 cases of tetrodotoxin poisoning reports were received through the National Foodborne Disease Outbreak Monitoring System； 339 people were poisoned and 15 were dead， with a case fatality rate of 4.4%. Tetrodotoxin poisoning was mainly concentrated in the coastal areas of China. The food carriers of tetrodotoxin included pufferfish （71.7%， 66/92）， dried pufferfish （13.0%， 12/92）， Nassariidae （7.6%， 7/92）， horseshoe crabs （5.4%， 5/92）， and Acentrogobius nebulosus （2.2%， 2/92）. Each year， a high incidence of poisoning occurs from March to April.ConclusionTo effectively prevent and control tetrodotoxin poisoning， it is necessary to establish a method for detecting tetrodotoxins in biological samples， improve the ability to identify the pathogenic factors of tetrodotoxin poisoning， strengthen the supervision and popularization of science in the circulation process， and change the dietary habits of people who eat wild pufferfish.

ObjectiveTo obtain the occurrence time and regional distribution characteristics， place of occurrence， high-risk food and risk factors， the epidemiological characteristics of foodborne disease outbreaks caused by Vibrio parahaemolyticus from 2010 to 2020 in China’s Mainland was analyzed.MethodsThe data of foodborne disease outbreaks caused by Vibrio parahaemolyticus were collected from China disease outbreak surveillance system from 2010 to 2020 were analyzed statistically.ResultsFrom 2010 to 2020， a total of 1 772 outbreaks of foodborne diseases caused by Vibrio parahaemolyticus were reported， with a total of 27 212 cases， 5 944 hospitalized cases and 2 deaths. The peak time was from July to September. The incidence in developed areas （28.8 cases/million people） was higher than that in underdeveloped areas （8.2 cases/million people）， and the incidence in coastal areas （31.7 cases/million people） was higher than that in inland areas （9.2 cases/million people）. The main causes were aquatic food （61.2%） and meat （25.3%）. Hotels and restaurants accounted for 49.6% of the total. The main contamination links were incomplete cooking of aquatic food and raw and cooked cross-contamination of ready-to-eat meat and vegetable food.ConclusionIn order to reduce the risk of foodborne diseases caused by Vibrio parahaemolyticus， it is important to strengthen the supervision of processing and storage of aquatic food and meat in catering service places.

Abstract To compare the clinical efficacy of ultrasound cycloplasty (UCP) and endoscopic cyclophotocoagulation (ECP) in the treatment of secondary glaucoma. In a 12-month prospective single-center study, 22 patients with secondary glaucoma were treated by high-intensity focused ultrasound (HIFU), and 23 patients with secondary glaucoma were treated by a semiconductor laser. At the final follow-up, the two groups’ surgical outcomes were compared. A complete success was defined as an intraocular pressure (IOP) reduction of at least 20% from baseline and an IOP of > 5 mmHg and ≦ 21 mmHg, while a qualified success was defined as an IOP reduction of at least 20% from baseline and an IOP of > 5 mmHg. The secondary outcome was the average IOP, number of drugs, and complications at each follow-up compared with the baseline. The average preoperative IOPs in the UCP and ECP groups were 36.4 ± 9.5 mmHg (n = 2.3 drops, n = 0.2 tablets) and 34.5 ± 11.7 mmHg (n = 2.0 drops, n = 0.3 tablets), respectively. In the last follow-up, the success rate of UCP was 54% (with a decrease of 32%) and that of ECP was 65% (with a decrease of 35%), and the P-value between the two groups was > 0.05. However, there was a difference in the average IOP between these two groups 1 day and 1 week after the operation, and the IOP reduction efficiency in the ECP group was better. However, the amount of drug used after these two surgeries was significantly reduced. There were fewer postoperative complications in the UCP group (18 cases) than in the ECP group (35 cases). Both UCP and ECP can effectively reduce IOP in secondary glaucoma, and ECP has a better effect at the early stages. However, UCP has higher safety and tolerance for patients.

Electromagnetic shielding (EMS) fabric is an effective way to prevent electromagnetic (EM) radiation. However, the research about mechanism analysis of the fabrics’ structure, EM wave (EMW) incident direction, and EMW frequency on the EMS properties of knitted fabrics is discordant at present. Meanwhile, researchers are focused on improving the EMS efficiency of the fabric but rarely discussed the thermal-wet comfort of the fabric. Therefore, in this study a series of weft-knitted fabrics within stainless steel/cotton (30/70) blended yarns were knitted, and the effects of EMW incident direction, stitches, loop lengths, and frequency on EMS effectiveness (EMSE) were analyzed. Meanwhile, the EMS property, warmth retention property, air permeability, moisture permeability, and bursting strength were selected as the evaluation index to evaluate the comprehensive properties of the fabrics by fuzzy mathematics. The results showed that all factors had different degrees of influence on EMSE, and the weft inlay stitch had both the functionality and thermal-wet comfort, which was excellent EMSE in knitted fabric. These results are expected to provide a reference to the design of EMS weft-knitted fabrics.

Highly stable pulsed fiber lasers are key optical components in optical communication, optical sensing, and precision micromachining systems due to the high beam quality, high peak power, and compact configurations. However, the available optical modulators in the fiber laser suffer from the operation bandwidth limitations and poor long-term physicochemical stability. Here, we have investigated the broadband nonlinear optical absorption behavior of the chromium iodide (CrI3) film, which exhibits broadband saturable absorption towards the mid-infrared regime and excellent long-term stability. The conventional soliton fiber laser operating at telecom wavelength has been obtained from an Er3+-doped fiber laser (EDFL) utilizing CrI3 film with a signal-to-noise ratio (SNR) of 92.4 dB and a pulse width of 492 fs. In addition, a passively Q-switched operation around 2.8 μm has also been obtained from an Er3+-doped ZBLAN fiber laser (EDZFL) modulated by the CrI3 film with a SNR of 46.8 dB and a pulse width of 766 ns. The demonstration shows that the CrI3 film exhibits robust broadband optical modulation, and may make inroads for developing highly stable ultrafast optoelectronic devices.

After resection, abdominal drainage is generally used to drain the exudate at the surgical site timely and monitor possible postoperative complications. With the development of the concept of enhanced recovery after surgery, there is a great controversy about whether to place drainage tube and its retention time after hepatectomy. Based on the research progress at home and abroad, this article reviews whether to place drainage tubes after hepatectomy, commonly abdominal drainage devices in clinical practice, the timing and indications of drainage tube removal, possible complications and preventive measures caused by indwelling drainage tubes, and the improvement effect of intelligent drainage devices on drainage management. The above issues are reconsidered in order to improve the application and management of abdominal drainage after hepatectomy at the level of precision medicine.

Objective To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid （Gd-EOB-DTPA） enhanced MRI in evaluating the degree of esophageal varices. Methods Clinical data of 114 patients diagnosed with hepatitis B cirrhosis and Gd-EOB-DTPA enhanced MRI examination through clinical comprehensive diagnosis at Jiangsu Provincical Hospital of Chinese Medicine from September 2021 to June 2022 was retrospective analyzed. The patients were divided into non-varicose vein group, small varicose vein group and large varicose vein group based on the diagnostic threshold of 3 mm esophageal vein width. The signal intensity (SI) of liver, spleen and erector spinae muscles were measured in each group during the plain scan and hepatobiliary phase (20 minutes after enhancement). The relative liver enhancement (RLE), contrast uptake index （CUI）, and liver-to-spleen contrast index (LSI) were calculated. The differences in indicators between each group were compared, and the receiver operating characteristic curve (ROC) were drawn. The area under the curve (AUC) was used to evaluate the diagnostic efficacy of each indicator in diagnosing varicose veins. Results There was a significant difference in RLE, CUI, and LSI between the non-varicose vein group and the large varicose vein group (P＜0.05), while there was no significant difference in RLE, CUI, and LSI between the small varicose vein group, as well as between small varicose vein group and large varicose vein group (P>0.05). The AUC of RLE, CUI and LSI for diagnosing large varicose veins was 0.668 (95%CI: 0.558-0.793), 0.676 (95%CI: 0.567-0.804) and 0.685 (95%CI: 0.550-0.780), respectively. Conclusion Gd-EOB-DTPA enhanced MRI has certain value in evaluating the degree of esophageal varices.

ObjectiveAnalysis of the epidemiological and spatio-temporal clustering of aconite poisoning incidents in China from 2010 to 2020 was performed to provide a reference for the development of precise prevention and control measures and the construction of an early warning system.MethodsCollection of reports of aconite poisoning incidents in surveillance data from 2010 to 2020 with descriptive analysis and spatio-temporal scan analysis was performed.ResultsFrom 2010 to 2020， a total of 380 outbreaks of aconite poisoning with 1 889 illnesses and 75 deaths were reported in China， with a case fatality rate of 3.97% （75/1 889）. The highest number of outbreaks occurred from October to December with 787 cumulative illnesses， accounting for 41.66% （787/1 889） of all cases. More than 86.84% （330/380） of the outbreaks occurred in Yunnan Province and households accounted for 90.26% （343/380） of all outbreak locations. Improper processing resulting in 171 outbreaks， accounting for 45.00% （171/380）. The results of the spatio-temporal scan showed a total of five agglomerative regions， including a category one agglomeration centered in Kunming， Yunnan Province， with an agglomeration period from June 2015 to November 2020， as well as four second-class aggregation areas， including 20 municipalities.ConclusionWe should focus on prevention and control in areas with clusters of aconite poisoning， and publicize and popularize high-risk consumption methods to raise awareness on protection and reduce the occurrence of poisoning incidents before the arrival of the high months.

Abstract Disruption of disulfide homeostasis during biological processes can have fatal consequences. Excess disulfides induce cell death in a novel manner, termed as “disulfidptosis.” However, the specific mechanism of disulfidptosis has not yet been elucidated. To determine the cancer types sensitive to disulfidptosis and outline the corresponding treatment strategies, we firstly investigated the crucial functions of disulfidptosis regulators pan‐cancer at multi‐omics levels. We found that different tumor types expressed dysregulated levels of disulfidptosis regulators, most of which had an impact on tumor prognosis. Moreover, we calculated the disulfidptosis activity score in tumors and validated it using multiple independent datasets. Additionally, we found that disulfidptosis activity was correlated with classic biological processes and pathways in various cancers. Disulfidptosis activity was also associated with tumor immune characteristics and could predict immunotherapy outcomes. Notably, the disulfidptosis regulator, glycogen synthase 1 (GYS1), was identified as a promising target for triple‐negative breast cancer and validated via in vitro and in vivo experiments. In conclusion, our study elucidated the complex molecular phenotypes and clinicopathological correlations of disulfidptosis regulators in tumors, laying a solid foundation for the development of disulfidptosis‐targeting strategies for cancer treatment.

Objective To investigate the effect of comprehensive nursing interventions on relieving postoperative pain of patients after breast cancer surgery. Methods A total of 80 breast cancer patients were randomly divided into the study group and control group, with 40 cases in each group. All patients received routine nursing and pharmacologic treatment for postoperative pain, and those in the study group were given comprehensive interventions such as basic nursing, psychological nursing and positioning nursing. The degree of postoperative pain was measured by using Visual Analogue Scale (VAS), and patients’ satisfaction with nursing service was investigated by using a self-made questionnaire. Results The VAS score of the study group was significantly lower than that of the control group at 1 day, 3 days and 7 days after surgery(P＜0. 01). The satisfaction rate of the study group was higher than that of the control group, with a significant difference(P＜0. 01). Conclusion Comprehensive nursing interventions are effective to reduce the postoperative pain and improve the nursing satisfaction of patients after breast cancer surgery. (目的 探讨乳腺肿瘤患者术后疼痛的护理干预效果。方法 选取2020年6月—2022年12月医院收治的乳腺肿瘤患者80例为研究对象, 分为研究组(n=40)和对照组(n=40)。对照组采用常规护理和药物镇痛干预, 研究组在对照组基础上增加基础护理、心理护理、体位护理等综合护理干预措施。采用视觉模拟评分(VAS)评估患者术后疼痛, 采用自制量表对患者护理满意度进行评价。结果 研究组术后1 d、3 d和7 d的VAS评分低于对照组, 差异有统计学意义(P＜0. 01)。研究组护理满意度高于对照组, 差异有统计学意义(P＜0. 01)。结论 综合护理干预能进一步减轻乳腺肿瘤患者术后疼痛程度, 提升患者护理满意度。)

As an important resource on the demand side, air-conditioning load can flexibly participate in the power system and promote new energy consumption. In the process of air-conditioning load scheduling, there are differences in thermal comfort requirements and scheduling potential among different users. How to satisfy the user differentiated thermal comfort and tap their scheduling potential is a difficult problem to consider. In response to the above problem, the thermal comfort model is firstly introduced to comprehensively quantify the user′s thermal comfort experience. Secondly, according to the human parameters in the thermal comfort model, the K-means clustering method is used to divide the user groups with different characteristics of thermal tolerance. On this basis, the air-conditioning direct load control strategy based on user differentiated thermal comfort is proposed and validated by simulation. The example analysis shows that, compared with the traditional strategy, the strategy proposed in this paper fully taps the scheduling potential of different user groups on the basis of completing the consumption task, and guarantees the thermal comfort of them.

Carotid free⁃floating thrombus (CFFT) is significantly associated with ischemic stroke. Thrombosis occludes the artery or falls off, leading to massive cerebral infarction or multiple embolism. In severe cases, cerebral hernia or even death may occur. The diagnosis of CFFT is gradually based on CT angiography (CTA). Early identification can help in etiological treatment. This article reviews the progress of the diagnosis and treatment of CFFT, in order to improve chinical diagnosis and treatment.

Objective To construct a risk assessment scale for venous thromboembolism in adult burn patients, and to test its reliability and validity. Methods Based on systematic evaluation of the literature, Delphi method and hierarchical analysis were used to construct an initial scale for risk assessment of venous thromboembolism in adult burn patients. Then based on a cross-sectional study, the constructed initial scale and Caprini risk assessment model were applied to investigate 300 adult burn patients admitted to Institute of Burn Research of our hospital from January 2015 to December 2022. The scale was tested for reliability and validity and risk stratification. Results The constructed scale, "Risk Assessment Scale for Venous Thromboembolism in Adult Burn Patients", had 5 dimensions (such as burn injury factors, catheter placement status, and surgery-related factors) and 23 items. Exploratory factor analysis extracted 5 common factors with a cumulative variance explained of 58.959%. The dimensions of the scale and the total scale of the correlation coefficients were 0.572-0.868 (P < 0.01), and the inter-dimensional correlation coefficient was 0.186-0.545 (P < 0.01). The content validity index of each item in the scale was 0.857-1.00, and the content validity index of the unanimous scale was 0.826, and the content validity index of the average scale was 0.980. The correlation coefficient between the scale and the Caprini risk assessment model was 0.683 (P < 0.001). The total Cronbach's alpha coefficient for the scale was 0.839 and the area under the ROC curve was 0.840, which was greater than the area under the ROC curve for the Caprini risk assessment model (0.762). Conclusion Our constructed risk assessment scale can provide a reference to assess the risk of venous thromboembolism in adult burn patients. The patients having a scale score of 35-36 are considered as being at low risk, those of 37-43 as being at medium risk, and those of ≥44 as being at high risk.

Plastic products are a significant component of the manufacturing industry and the plastic industry is closely related to economic and social development. As constraints from resources and environment tighten, rational disposal and utilization of waste plastics becomes crucial for the sustainable economic and environmental development. Currently, the variety of plastic products becomes abundant, and disposal technologies and application challenges are constantly updated. Considering the demand for highquality development of the industry and increasingly strict environmental protection requirements, a systematic analysis of the research progress of waste plastic disposal and utilization becomes urgent. In this study, the waste plastic disposal and utilization technologies are categorized into mechanical disposal of waste plastics, energy and resource conversion, regeneration recycling, and new technologies for disposal and utilization. These four types of technologies are expounded from the aspects of technical features, applicable conditions, and research progress. On the basis, facing the technical challenges and referring to the existing experience of developed countries, suggestions are proposed from the aspects of source reduction, sorted recycling of waste plastics, and technological innovation and transformation, hoping to provide a reference for the clean disposal and recycling of waste plastics in China.

ObjectiveTo analyze the incidence trends and epidemiological characteristics of foodborne disease outbreaks caused by poisonous wild fruits in China from 2010 to 2020 and provide a scientific basis for the prevention and control of foodborne diseases.MethodsDescriptive epidemiological data of all foodborne disease outbreaks caused by poisonous wild fruits reported in China from 2010 to 2020， using data from the “National Foodborne Disease Outbreak Surveillance System” was analyzed.ResultsFrom 2010 to 2020， a total of 399 cases of food poisoning outbreaks were reported， with 1 585 poisoning cases and 7 deaths； the case fatality rate was 0.44%. The most frequent reports were in the second quarter. The number of incident reports and cases in May was the highest， accounting for 50.63%（202/399）and 42.08% （667/1 585）， respectively. Southwest， South China and Central China had the highest number of incident reports and cases， 94.49% （377/399） and 94.26% （1 494/1 585）， respectively. Guizhou， Yunnan and Sichuan Provinces had the highest number of incident reports and cases， accounting for 72.18% （288/399） and 62.65% （993/1 585）， respectively. A total of 132 cases in the families were reported， with 439 cases of illness and 6 deaths， accounting for 33.08%， 27.70%， and 85.71%， respectively. The highest proportion of reported incidents was due to Coriaria massoniana， accounting for 59.15% （236/399）， followed by C. sibirica， and M. leprae. The primary cause of the incidents was fruit misuse， accounting for 98.75%（394/399）， and 99.25% （396/399） had less than 30 patients per incident.ConclusionThe situation of outbreaks caused by poisonous wild fruits was serious in China. Therefore， it is necessary to improve the monitoring and rescue abilities of primary disease control and primary medical institutions. Health education should be reinforced in high-risk areas and key population groups during the high-risk season.

ObjectiveTo observe the effect of hot and cold Chinese medicine whirlpool bath combined with motor control training on patients with shoulder-hand syndrome (SHS) after stroke.MethodsA total of 40 patients with SHS after stroke in the Xuzhou Rehabilitation Hospital and Xuzhou Central Hospital from January to December 2020 were randomly divided into control group and observation group according to random number table method, with 20 cases in each group. Both groups received routine rehabilitation training such as physical agent modalities and occupational therapy. The control group received motor control training on the basis of routine rehabilitation training, 40 minutes a time, once a day, five times a week, lasting for four weeks; the observation group received hot and cold Chinese medicine whirlpool bath on the basis of control group, 40 minutes a time, once a day, five times a week, lasting for four weeks. Before and after four weeks of treatment, visual analogue scale (VAS) was used to evaluate the severity of shoulder pain; overflow method was used to evaluate the degree of hand swelling; Fugl-Meyer assessment upper extremity (FMA-UE) was used to evaluate motor function of the affected limb; modified Barthel index (MBI) was used to evaluate the activities of daily living; motor activity log-amount of use (MAL-AOU) and motor activity log-quality of movement (MAL-QOM) were recorded by the motor activity record sheet.ResultsCompared with those before treatment, VAS score and hand swelling value of both groups decreased significantly after treatment, while FMA-UE, MBI, MAL-AOU and MAL-QOM scores increased significantly after treatment, and the differences were statistically significant (PP

Abstract Objective To establish a prognostic signature for lung adenocarcinoma (LUAD) based on cuproptosis-related long non-coding RNAs (lncRNAs), and to study the immune-related functions of LUAD. Methods First, transcriptome data and clinical data related to LUAD were downloaded from the Cancer Genome Atlas (TCGA), and cuproptosis-related genes were analyzed to identify cuproptosis-related lncRNAs. Univariate COX analysis, least absolute shrinkage and selection operator (LASSO) analysis, and multivariate COX analysis were performed to analyze the cuproptosis-related lncRNAs, and a prognostic signature was established. Second, univariate COX analysis and multivariate COX analysis were performed for independent prognostic analyses. Receiver operating characteristic (ROC) curves, C index, survival curve, nomogram, and principal component analysis (PCA) were performed to evaluate the results of the independent prognostic analyses. Finally, gene enrichment analyses and immune-related function analyses were also carried out. Results (1) A total of 1,297 cuproptosis-related lncRNAs were screened. (2) A LUAD prognostic signature containing 13 cuproptosis-related lncRNAs was constructed (NIFK-AS1, AC026355.2, SEPSECS-AS1, AL360270.1, AC010999.2, ABCA9-AS1, AC032011.1, AL162632.3, LINC02518, LINC0059, AL031600.2, AP000346.1, AC012409.4). (3) The area under the multi-indicator ROC curves at 1, 3, and 5 years were AUC1 = 0.742, AUC2 = 0.708, and AUC3 = 0.762, respectively. The risk score of the prognostic signature could be used as an independent prognostic factor that was independent of other clinical indicators. (4) The results of gene enrichment analyses showed that 13 biomarkers were primarily related to amoebiasis, the wnt signaling pathway, hematopoietic cell lineage. The ssGSEA volcano map showed significant differences between high- and low-risk groups in immune-related functions, such as human leukocyte antigen (HLA), Type_II_IFN_Reponse, MHC_class_I, and Parainflammation (P

In this paper, the intergenerational development, component characteristics, and strengthening mechanism of carburized gear materials for aerospace power transmission systems are reviewed. The first-generation carburized gear steel is low-carbon medium/low-alloy steel, and the surface hardening of the carburized layer structure is realized by Fe3C carbides. Due to the low content of alloying elements, the tempering resistance of the first-generation carburized gear steel is poor, and the general service temperature range is within 200 ℃. Among the first-generation carburized gear steels, the content of carbide-formation elements of 16Cr3NiWMoVNbE material is relatively high. This material can be developed for the second-generation carburized gear steel with a wide-range service temperature through the critical saturation carburization process. The second-generation carburized gear steel is a low-carbon medium/high-alloy steel. Some M2C strengthening phases with high tempering resistance can be precipitated during the tempering process by further improving the alloying degree and appropriately increasing the content of Mo element with strong tempering resistance. The overall service temperature range is raised to 350 ℃. The third-generation carburized gear steel is low-carbon ultra-high alloy steel, and the “secondary hardening” effect works thoroughly via computational methods. Therefore, the material can be used in a temperature range below 500 ℃ for a long time. The existing alloy structural steel system can not avoid the problem of rapid strength decay after long-term service at high temperatures above 500 ℃. Therefore, the next-generation carburized gear materials will be developed based on iron-based alloys with excellent oxidation resistance.

ObjectiveTo analyze the epidemiological characteristics of foodborne disease outbreaks caused by takeaway in China’s Mainland from 2010 to 2020， and put forward relevant regulatory suggestions.MethodsThrough the National Foodborne Disease Outbreak Monitoring System， the data of foodborne disease outbreaks caused by takeaway in China’s Mainland from 2010 to 2020 were collected and analyzed， and descriptive epidemiological characteristics were performed.ResultsA total of 549 foodborne disease outbreaks caused by takeaway were reported in China’s Mainland （except Tibet Autonomous Region） from 2010 to 2020， resulting in 9 285 illnesses and 2 deaths. The largest number of outbreaks and illnesses was in the third quarter， accounting for 41.53% and 44.58% of the total respectively. Except the unknown pathogenic factors， the number of outbreaks and illnesses caused by microbial pathogenic factors were the highest， accounting for 39.16% and 60.26% of the total respectively. Except the unknown suspected food， the number of outbreaks and illnesses caused by mixed food and multiple food were higher， accounting for 21.86% and 15.12% of the outbreaks respectively， and accounting for 20.58% and 13.10% of the number of illnesses respectively. Except the unknown food source， the top 3 food source were school canteens， collective dining delivery units/central kitchens and fast food restaurants， the number of outbreaks accounted for 20.04%， 15.66% and 15.48% respectively， and the number of illnesses accounted for 35.30%， 17.52% and 10.57% respectively. Except the multiple factors and unknown factors， the number of outbreaks caused by improper storage were the highest accounting for 8.74%， and the number of illnesses caused by improper processing accounted for 7.74%.ConclusionMicrobial growth and reproduction due to improper storage and processing is the major cause of foodborne disease outbreaks caused by takeaway. It is suggested that the food safety supervision and administration departments should strengthen the whole process supervision and management of takeaway， establish and ensure catering services strictly abide by the good hygiene operations according to food raw in materials， production， transportation， distribution and other aspects， so as to effectively prevent and control the occurrence foodborne diseases.