This paper systematically summarizes the practical experience of the 2025 Dingri earthquake emergency medical rescue in Tibet. It analyzes the requirements for earthquake medical rescue under conditions of high-altitude hypoxia, low temperature, and low air pressure. The paper provides a detailed discussion on the strategic layout of earthquake medical rescue at the national level, local government level, and through social participation. It covers the construction of rescue organizational systems, technical systems, material support systems, and information systems. The importance of building rescue teams is emphasized. In high-altitude and cold conditions, rapid response, scientific decision-making, and multi-party collaboration are identified as key elements to enhance rescue efficiency. By optimizing rescue organizational structures, strengthening the development of new equipment, and promoting telemedicine technologies, the precision and effectiveness of medical rescue can be significantly improved, providing important references for future similar disaster rescues.

Objective To investigate the levels of gross α and gross β activities in different water types within a 40-kilometer radius around the Zhangzhou Nuclear Power Plant prior to its operation. Methods In 2018, drinking water samples were collected from the area surrounding the nuclear power plant during both the wet and dry seasons, including source water, treated water, tap water, and well water. The gross α and gross β activity concentrations were measured using a low-background α/β counter, followed by statistical analysis. Results A total of 80 water samples from different sources around the Zhangzhou Nuclear Power Plant were collected. The average gross α and gross β activity concentrations during the wet season were (0.110 ± 0.036) Bq/L and (0.643 ± 0.028) Bq/L, respectively, while those during the dry season were (0.124 ± 0.032) Bq/L and (0.624 ± 0.026) Bq/L, respectively. There were no significant differences in the gross α and gross β activity concentrations between the wet and dry seasons for the overall sample set (P > 0.05). However, there were statistically significant differences in the gross α and gross β activity concentrations between the wet and dry seasons for source water and well water (Z_wet = −2.005, −2.123; Z_dry = −1.943, −3.090; P < 0.05). Conclusion The radioactivity levels in different water types within various ranges around the Zhangzhou Nuclear Power Plant before its operation were determined. The measured activity concentrations were at the same level as those from previous investigations in other regions of Fujian Province.

Objective To understand the infection status of patients with maintenance hemodialysis(MHD)in Guizhou Province,and provide basis for the prevention and control of hemodialysis-related infection.Methods MHD patients in hemodialysis centers of 124 secondary and or higher grade medical institutions in Guizhou Province from July to December 2022 were surveyed.Survey content included the general conditions of patients,hemodialysis-related conditions,infection of pathogens of blood-borne diseases,and other infection-related conditions.Results A total of 15 114 MHD patients were surveyed,with age mainly ranging from 36 to＜60 years old(55.83％).Hemodialysis history ranged mainly from 1 year to＜5 years(59.37％),and the frequency of hemodi-alysis was mainly 3 times per week(73.91％).Autologous arteriovenous fistula(AVF)was the major vascular access for dialysis,with a total of 12 948 cases(85.77％).The main primary disease was chronic renal failure(99.89％).The infection rates of hepatitis B virus(HBV),hepatitis C virus(HCV),human immunodeficiency vi-rus(HIV),and Treponema pallidum in MHD patients were 5.29％,0.64％,0.24％,and 1.70％,respectively.HBV infection rates among MHD patients of different ages,different numbers of dialysis hospitals,and dialysis in-stitutions of different scales showed statistically significant differences(all P＜0.05).HCV infection rates among MHD patients of different ages,with different dialysis times and from institutions of different scales were signifi-cantly different(all P＜0.05).TP infection rates among MHD patients of different ages and different numbers of dialysis hospitals were all significantly different(all P＜0.05).Infection rates of HBV and HCV in MHD patients aged from 36 to 60 years old(not included)were relatively higher(6.10％and 0.84％,respectively).Patients with dialysis time ≥10 years had a higher HCV infection rate(1.64％).Infection rates of HCV,HIV,and TP in pa-tients dialyzed in medical institutions with ≥90 dialysis beds were relatively higher(0.74％,0.28％,and 1.94％,respectively).Medical institutions with＜30 dialysis beds had the highest HBV infection rate(18.64％).There were 9 cases(0.06％)of vascular puncture infection,12 cases(0.08％)of bloodstream infection,7 cases(0.05％)of vascular access-related bloodstream infection,and 30 cases(0.20％)of pulmonary infection.Vascular access-re-lated bloodstream infection rate and pulmonary infection rate among MHD patients with different types of vascular access showed statistically significant difference(all P＜0.05).Vascular access-related bloodstream infection rate(0.37％)and pulmonary infection rate(1.10％)of patients with non-cuffed catheters vascular access were higher than those of other types.Conclusion MHD patients in Guizhou Province are mainly middle-aged and young peo-ple,with more males than females.The dialysis frequency is mostly 3 times per week,and AVF is the major vascu-lar access.MHD patients are prone to complications such as infections of HBV,HCV,HIV,and TP,as well as bloodstream infection and pulmonary infection.

Objective:To analyze and predict the future trend of the premature mortality of major chronic and non-communicable diseases in Anhui Province, evaluate the implementation of the "Healthy China 2030" Plan, and explore its influencing factors.Methods:Using data from death-cause surveillance and statistical yearbooks in Anhui, the trend prediction and analysis on influencing factors were conducted by using methods such as time series accumulation and logarithmic linear Joinpoint regression, principal component regression.Results:In Anhui, 28.10% of the deaths were premature ones, of which 84.40% were attributed to chronic and non-communicable diseases. In premature deaths attributed to chronic and non-communicable diseases, the deaths caused by malignant tumor and cardiovascular disease accounted for 45.88% and 41.65% respectively. The prediction results showed that the premature mortality of major chronic and non-communicable diseases would decrease in Anhui in the future, and by 2030, the goal in the "Healthy China 2030" Plan would be reached only in rural area. To reduce premature death, it is necessary to pay attention to the prevention and control of malignant tumor and cardiovascular disease. Men in urban area are the key population. Factors that reflect urban infrastructure had a significant impact on premature mortality of major chronic non-communicable diseases, such as garden and green space area per capita. Factors such as concentration of PM 2.5 had a negative impact on premature mortality of chronic non-communicable diseases, while factors such as garden and green space area per capita had a positive impact. Conclusions:Disease burden caused by chronic and non-communicable diseases, such as malignant tumor, exits in Anhui. Men in urban area are key population in the prevention and control of chronic and non-communicable diseases in the future.

AIM:To investigate the improvement effect of blood flow-limited resistance training on renal fibro-sis in type 2 diabetes mellitus(T2DM)rats and its potential mechanism to attenuate renal fibrosis by inhibiting the trans-forming growth factor β1(TGF-β1)/Smad3 signaling pathway.METHODS:The T2DM model was prepared by combining a high-fat diet and streptozotocin(STZ),and after successful modeling,the rats were randomly divided into a T2DM con-trol group,a low-load resistance training group,a high-load resistance training group,a blood flow restriction group and a blood flow restriction combined with resistance training group for 8 weeks of exercise.The renal index,fasting blood glu-cose(FBG),serum creatinine(SCr),and blood urea nitrogen(BNU)were recorded in each group.The morphological changes of the kidneys were observed by hematoxylin and eosin(HE)and Masson's trichrome staining,and the collagen volume fraction was calculated.The mRNA expression levels of renal Klotho,TGF-β1,and α-smooth muscle actin(α-SMA)were detected by RT-qPCR.The protein expression levels of renal Klotho,TGF-β1,Smad3,phosphorylated Smad3(p-Smad3),α-SMA and connective tissue growth factor(CTGF)were detected using Western blot.RESULTS:Compared with the other groups,FBG,SCr,BNU,and renal collagen volume fraction were significantly decreased in the blood flow restriction combined with resistance training group of rats(P<0.05),Klotho expression was significantly in-creased(P<0.05),and the expression of TGF-β1,p-Smad3,CTGF and α-SMA was significantly decreased(P<0.05),and there was no significant change in the expression level of Smad3(P>0.05).CONCLUSION:Blood flow restriction combined with resistance training attenuates renal fibrosis in T2DM rats,the mechanism of which may be related to the up-regulation of Klotho expression,disruption of the TGF-β1/Smad3 signaling pathway,and inhibition of the deposition of epi-thelial-mesenchymal transformation.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

OBJECTIVE To study the relationship between frequency specific free-field tone burst cortical auditory evoked potentials(CAEP)and aided behavioral audiometry to provide rapid,reliable insights for predicting hearing intervention efficiency in hard to cooperate cochlear implant patients.METHODS The study comprised of 22 cochlear implant pediatric patients(22 ears)free-field tone burst CAEP P1 response thresholds,free-field behavioral thresholds determined within the group across frequencies 0.5,1,2 and 4 kHz were collected for correlation analysis.RESULTS The free-field tone burst CAEP P1 response thresholds and free-field behavioral audiometric thresholds in cochlear implant pediatric patients for testing frequencies 0.5,1,2,4 kHz were compared and r correlation coefficients found were 0.567,0.670,0.637 and 0.762 across the frequencies respectively(P<0.01).The mean difference between free-field CAEP P1 response threshold and free-field behavioral thresholds for cochlear implant patients differ by 5-8 dB with statistical significance.CONCLUSION Free-field tone burst CAEP can be used for cochlear implant programming validation in patients that fail to cooperate in behavioral testing,thus is applicable in cochlear implant programming clinical practice.

Objective:To investigate the predictive value of MRI balanced steady-state free precession(b SSFP)synergistic voxel incoherent motion diffusion weighted imaging(IVIM-DWI)and Gd-DTPA enhanced scanning for the status of extramural vascular invasion(EMVI)in rectal cancer before surgery.Methods:A total of 105 rectal cancer patients from the People's Hospital of Lujiang County,Anhui Province,were retrospectively selected and included.All patients were confirmed by postoperative pathology and underwent preoperative b SSFP sequences,IVIM-DWI functional imaging,and Gd-DTPA-enhanced multiparameter MRI scans.Three seven-point schemes based on individual b SSFP sequences,IVIM-DWI functional imaging,and Gd-DTPA en-hancement,two-by-two synergy,and multi-sequence combined diagnosis were utilized in con-junction with conventional MRI sequences for preoperative prediction of EMVI status.The diag-nostic efficacy of T2WI and b SSFP sequences was compared with that of postoperative patho-logic results.ROC curves were plotted to obtain the corresponding area under the ROC curve(AUC),specificity,and sensitivity.Results:The AUC for predicting the preoperative vascular status outside the rectal wall was 0.572(95％CI:0.408～0.737)for the conventional T2 lipid sup-pression sequence,with a specificity of 0.811 and a sensitivity of 0.667.The AUC for the b SSPF sequence was 0.817(95％CI:0.680～0.954),with a specificity of 0.900 and a sensitivity of 0.733.All of the statistical parameters were higher than the diagnostic efficacy of conventional T2 lipid suppression sequences.The multi-sequence MRI co-diagnosis had an AUC of 0.961(95％CI:0.886～1.000),with a specificity of 0.988 and a sensitivity of 0.875(P＜0.05).Conclusion:Mag-netic resonance b SSFP sequence synergized with IVIM-DWI and Gd-DTPA-enhanced multipa-rameter scanning has high clinical application value for the preoperative prediction of EMVI inva-sion in rectal cancer.

Objective To investigate the correlation of platelet-to-lymphocyte ratio (PLR) with depression in patients with maintenance hemodialysis (MHD) based on propensity score matching (PSM). Methods General information such as age, gender and underlying diseases, biochemical indicators, and Beck Depression Inventory (BDI) scores of patients in hemodialysis centers of 20 Grade Ⅲ and Level A hospitals in Guizhou Province from June to August 2023 were collected. Patients were divided into depression group and non-depression group based on the occurrence of depression, and differences in clinical characteristics were compared between the groups. A 1 to 1 propensity score matching was used to obtain patients with similar baseline data (gender, age, education level) in the depression and non-depression groups, and differences in clinical characteristics between the two groups were compared. Participants were divided into Q1, Q2, Q3 and Q4 groups according to the quartiles of PLR, and differences in clinical characteristics among the groups were compared. Logistic regression analysis was used to evaluate the relationship between PLR and depression in MHD patients. Receiver operating characteristic (ROC) curve was used to assess the value of PLR in predicting depression in MHD patients. Results A total of 2, 081 MHD patients were included in this study, including 1, 286 males (61.8%), with a mean age of (54.3±14.7) years. A total of 368 patients (17.7%) had depression, and 359 pairs were successfully matched after propensity score matching. The depression group had higher rates of diabetes and PLR, but lower serum creatinine and hemoglobin levels (P < 0.05). The risk of depression in the PLR Q4 group was 22.654 times than that of the Q1 group (95%CI, 12.713 to 40.369, P < 0.001). After initially adjusting for age, diabetes, and hypertension, the risk of depression in the PLR Q4 group was 28.272 times than that of the Q1 group (95%CI, 15.390 to 51.937, P < 0.001). After further adjusting for serum creatinine, hemoglobin, albumin, white blood cell count, total cholesterol, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, and neutrophil-to-lymphocyte ratio, the risk of depression in the PLR Q4 group was 10.557 times than that of the Q1 group (95%CI, 3.461 to 32.201, P < 0.001). The ROC curve analysis results indicated that the sensitivity of PLR in predicting depression in MHD patients was 78.0%, the specificity was 73.5%, the optimal threshold was 114.14, and the area under the curve was 0.798 (95%CI, 0.765 to 0.832, P < 0.001). Conclusion PLR is an independent risk factor for depression and has a high predictive value for depression in MHD patients.

Objective:To evaluate the relationship between preoperative plasma trimethylamine oxide (TMAO) concentrations and postoperative delirium (POD) in elderly patients.Methods:One hundred and eighty patients, aged ≥65 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with body mass index of 17-30 kg/m 2, scheduled for elective hip replacement, were enrolled in this study. Venous blood samples were collected at 1 day before surgery, and the plasma TMAO concentrations were measured by high throughput liquid chromatography-tandem mass spectrometry. The patients were divided into 3 groups according to the concentrations of TMAO: low-concentration TMAO group (group L, ≤1.2 μmol/L), moderate-concentration TMAO group (group M, 1.3-1.9 μmol/L), and high-concentration TMAO group (group H, ≥2.0 μmol/L). All patients received superior inguinal fascia iliaca compartment block combined with intravenous general anesthesia. POD was identified by the Confusion Assessment Method-Chinese Reversion scale at 1, 2, 3 and 7 days after operation. The patients were divided into POD group and non-POD group according to whether POD occurred. Binary logistic regression analysis was used to evaluate the relationship between different plasma TMAO concentrations and POD. The receiver operating characteristic curve was used to evaluate the efficacy of plasma TMAO concentrations in predicting the occurrence of POD. Results:There were 60 cases in L group, 67 cases in M group and 53 cases in H group, and the incidence of POD was 12%, 22% and 32% in L, M and H groups, respectively. The incidence of POD was significantly higher in group H than in group L ( P<0.05). The plasma TMAO concentration was significantly higher in POD group than in non-POD group ( P<0.05). Logistic regression analysis showed that the risk of POD was 3.91 times higher in group H than in group L ( P<0.05). The area under the receiver operating characteristic curve of preoperative plasma TMAO concentrations in predicting POD was 0.754 (95% confidence interval 0.671-0.838, P<0.05). When the Youden index was 0.426, the optimal cut-off value of plasma TMAO concentrations was 1.625 μmol/L, and the specificity and sensitivity were 0.795 and 0.631, respectively. Conclusions:Elevated preoperative plasma TMAO concentration is associated with an increased risk of POD in elderly patients, and it has a good predictive value for POD.