As global greenhouse gases continue rising, the urgency of more ambitious action is clearer than ever before. China is the world's biggest emitter of greenhouse gases and one of the countries affected most by climate change. The evidence about the impacts of climate change on the environment and human health may encourage China to take more decisive action to mitigate greenhouse gas emissions and adapt to climate impacts. This article aimed to review the evidence of environmental damages and health risks posed by climate change and to provide a new science-based perspective for the delivery of sustainable development goals. Over recent decades, China has experienced a strong warming pattern with a growing frequency of extreme weather events, and the impacts of climate change on China's environment and human health have been consistently observed, with increasing O ₃ air pollution, decreases in water resources and availability, land degradation, and increased risks for both communicable and non-communicable diseases. Therefore, China's climate policy should target the key factors driving climate change and scale up strategic measures to curb carbon emissions and adapt to inevitable increasing climate impacts. It provides new insights for not only China but also other countries, particularly developing and emerging economies, to ensure climate and environmental sustainability whilst pursuing economic growth.
Climate Change ; China ; Humans ; Greenhouse Gases ; Air Pollution ; Sustainable Development ; Environment

Objective To investigate the mechanism of nootkatone(NKT)in mitigating depression-like behavior caused by blast traumatic brain injury(TBI).Methods The rat bTBI depression-like model was established by simulating the shock wave parameters of blast overpressure(BOP of 60 kPa,90 kPa,and 120 kPa)with a biological shock wave tube.After 14 days of exposure,we evaluated the depression-like behavior of rats using the tail suspension test and forced swimming test.We identified that the BOP(120 kPa)condition caused the most noticeable depressive behavior and used this condition for subsequent experiments.Thirty male SD rats were randomly divided into sham operation group,bTBI group(BOP of 120 kPa),and bTBI+NKT group[at 1 d after exposure to BOP of 120 kPa,giving NKT 10 mg/(kg·d)orally for 14 days],10 in each group.After 14 days of exposure,the depression-like behavior of rats was evaluated by tail suspension test and forced swimming test.The expression levels of protein kinase A(PKA),phosphorylated cyclic adenosine monophosphate effector binding protein(pCREB),and brain-derived neurotrophic factor(BDNF)in the hippocampus of rat were determined by Western blotting.Immunohistochemistry was used to detect the generation of proliferating cell nuclear antigen(PCNA)-labeled neurons in the hippocampal dentate gyrus(DG).Results BOP of 90 kPa can cause depression-like in rats and BOP of 120 kPa can cause the most noticeable depressive behavior(P<0.05).Therefore,we selected the BOP exposure of 120 kPa for subsequent experiments.After 14 days of BOP exposure,compared with sham operation group,the immobility time of tad suspension test in bTBI group was prolonged(P<0.05),the latency of for ced swimming test was shortened,the immobility time was prolonged(P<0.05),the expression levels of PKA,pCREB and BDNF protein in hippocampus were lowered(P<0.05),and the number of PCNA-labeled neurons in hippocampal DG area was reduced(P<0.05);compared with the bTBI group,the immobility time of tail suspension test in bTBI+NKT group was shortened(P<0.05),the latency of forced swimming test was prolonged,the immobility time was shortened(P<0.05),the expression levels of PKA,pCREB and BDNF protein in hippocampus were increased(P<0.05),and the number of PCNA-labeled neurons in hippocampal DG area was increased(P<0.05).Conclusions Early treatment with NKT can improve depression-like behavior in mild bTBI rats.The mechanism may be related to the up-regulation of the PKA-CREB-BDNF signaling pathway and increased expression levels of pCREB and BDNF in the hippocampus,which results in increased neuron numbers in the DG region of the hippocampus.

Osteoporosis is an important cause of internal fixation loosening after spinal surgery.Cement-augmented pedicle screw instru-mentation(CAPSI)technique is the most widely used technique in clinical practice to improve the stability of pedicle screw,mainly applied in osteoporosis and revision surgery,which included conventional solid pedicles crews and fenestrated/cannulated pedicle screws technique.CAPSI technique may cause cement leakage and pulmonary embolism,and there is no consensus on its indications or technical points.Therefore,this article reviews the research progress of CAPSI,in order to provide relevant reference for clinical practice.

Abstract: Objective To investigate the epidemiological characteristics of pathogens causing bloodstream infection in hematology patients during treatment and to compare the effects of allogeneic hematopoietic stem cell transplantation (HSCT) on them, so as to provide evidence for the diagnosis and treatment of bloodstream infection. Methods A total of 292 cases with bloodstream infection in hematology wards of the PLA General Hospital were collected from 2017 to 2021, which were divided into HSCT group and N-HSCT group according to whether performed HSCT or not. The epidemiological characteristics and influence of pathogenic bacteria in blood stream infection were analyzed and compared between the two groups. Results A total of 362 strains of pathogenic bacteria were collected from 292 cases, including 106 strains in HSCT group (84 cases) and 256 strains in N-HSCT group (208 cases). Bloodstream infections were more common in acute myeloid leukemia (130/392, 44.52%), followed by non-Hodgkin's lymphoma (74/292, 25.34%). The rate of once bloodstream infection in HSCT group was higher than that in N-HSCT Group, but the rate of twice bloodstream infections in N-HSCT group was higher. Gram-negative Bacilli were the most common pathogens (56.08%), with Escherichia coli being absolutely dominant (109/362, 30.11%), followed by Klebsiella pneumoniae (39/362, 10.77%). Coagulase-negative staphylococci (CoNS) (107/362, 29.56%) were the most common Gram-positive cocci. The detection rate of fungi in HSCT group (10/106, 9.43%) was significantly higher than that in N-HSCT Group (3.52%). The drug resistance rate of the common pathogenic bacteria was at a high level, and there was a certain proportion of multi-drug resistant strains (except for Pseudomonas aeruginosa). The resistance rates of CoNS to penicillin, gentamicin, moxifloxacin, clindamycin and rifampicin in HSCT group were higher than those in N-HSCT Group. The resistance rate of Escherichia coli to piperacillin/tazobactam, cephalosporins and etapenem in HSCT group was significantly higher than that in N-HSCT group. Conclusions The pathogens of blood stream infection in hematology patients are complicated and various. It is difficult for clinical diagnosis and treatment to detect multiple infections and multiple pathogens. HSCT patients have a higher risk of fungal bloodstream infection and more multi-drug resistant strains detected. Therefore, the identification of bloodstream infection and multi-drug resistant strains associated with HSCT patients should prompt surveillance.

Objective - To analyze the prevalence and influencing factors of work related musculoskeletal disorders (WMSDs) Methods among painters in the manufacturing industry. A total of 639 painters from one shipbuilding enterprise, one automobile manufacturing enterprise and three wooden furniture manufacturing enterprises in Guangdong Province were selected as the research subjects using typical sampling method. The Chinese version of Musculoskeletal Disorders Questionnaire was Results used to investigate the prevalence of WMSDs in the past one year, and the influencing factors were analyzed. The total prevalence rate of WMSDs among painters in the manufacturing industry was 37.4%. The prevalence of WMSDs in different vs vs P industries from high to low was shipbuilding, automobile and furniture manufacturing (50.0% 38.7% 29.0%, <0.01). The prevalence of WMSDs in different parts of the body from high to low was neck, ankle/foot, shoulder, low back, upper back, knee, vs vs vs vs vs vs vs vs P hand/wrist, hip/leg and elbow (20.7% 19.2% 17.4% 15.8% 14.1% 13.8% 13.5% 9.5% 6.6%, <0.01). Multivariate logistic regression analysis results showed that working in uncomfortable postures was a risk factor for neck, ankle/ P P foot and shoulder WMSDs (all <0.01); long time head turning was a risk factor for neck and shoulder WMSDs (both <0.05); P overweight and obesity, and bending and turning frequently at the same time were risk factors for ankle/foot WMSDs (all <0.05); P adequate rest time was a protective factor for neck and ankle/foot WMSDs (both <0.01); participated in physical exercise more P than once a week was a protective factor of neck and shoulder WMSDs in painters (all <0.05), after excluding the influence of Conclusion confounding factors. The prevalence of WMSDs in manufacturing painters was high, and the main body parts E mail 4813545@qq.com E mail wangzhongxu2003@163.com· · 中国职业医学 年 月第 卷第 期 ， ， ， 482 2022 10 49 5 Chin Occup Med October 2022 Vol.49 No.5 involved were neck, ankle/foot and shoulder. The influencing factors include individual factors, poor ergonomics factors and unreasonable work organization.

OBJECTIVE: To evaluate the reporting quality of randomized controlled trials (RCTs) of acupuncture for vascular dementia. METHODS: The RCTs of acupuncture for vascular dementia were systematically retrieved from the Cochrane Library, PubMed, EMbase, CNKI, SinoMed, VIP and Wanfang databases from the date of establishment to October 31, 2018. The reporting quality of RCT was evaluated based on the internationally-recognized Consolidated Standards for Reporting of Trials (CONSORT) statement and Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). RESULTS: A total of 33 RCTs were included. According to the CONSORT statement, 12 items had a reporting rate of 0%, including important changes to methods after trial commencement, sample size, blind method, trial registry, etc.; 5 items had a reporting rate of below 10%, including trial design, type of randomization, random allocation sequence, randomization implementation and participant flow. The reporting rate was 36.36% for baseline data and 57.58% for randomization sequence generation. According to the STRICTA statement, the reporting rate was 21.21% for description of acupuncture depth, 60.61% for description of acupuncture response, 27.27% for description of additional intervention details and 0% for qualification of acupuncturists, respectively. CONCLUSION At present, the reporting quality of RCTs of acupuncture for vascular dementia is generally low. In the future, the RCTs of acupuncture for vascular dementia should be normatively reported according to the CONSORT statement and STRICTA statement.

OBJECTIVE: To systematically review the effect of acupuncture on emotional disorder in the patients with migraine and knee osteoarthritis and its effect time limit. METHODS: The randomized controlled trials of acupuncture for migraine or knee osteoarthritis were retrieved from the databases, starting from the time of establishment through to December, 2018, i.e. the Cochrane Library, PubMed, EMbase, CNKI, SinoMed, VIP and Wanfang. The bias risk assessment tool of Cochrane Review Manual 5.1.0 was adopted to evaluate the quality of trials in methodology. RevMan 5.3 software was used for the Meta-analysis. RESULTS: A total of 12 articles were included, with 2450 cases. Regarding the immediate effect, the score of the emotional function subscale of migraine-specific quality-of-life questionnaire (MSQ) in the acupuncture group was higher than the control group (6.38[2.78,9.98], =25%). In view of the emotional function subscale of the short-form of health survey (SF-36/SF-12), and the scores of the mental function and negative mode scale in Spain's index of quality of life (PQLC), there were no significant differences in the scores between the acupuncture group and the control group. In 3 months of treatment, the score of the emotional function subscale of MSQ in the acupuncture group was higher than the control group (9.66 [3.06,16.25], =44%). The difference in the score of the mental health subscale of SF-36 and SF-12 was not significant between the acupuncture group and the control group. In 3 to 6 months of treatment, as well as in over 6 months of treatment, the score of every scale was not different statistically between the acupuncture group and the control group. CONCLUSION Acupuncture effectively maintains the healthy emotion in the patients with migraine and the effect is sustainable for 3 months after treatment. But the improvement of acupuncture is not remarkable in emotional disorder induced by knee osteoarthritis.
Acupuncture Therapy ; Chronic Pain ; psychology ; therapy ; Emotions ; Humans ; Migraine Disorders ; psychology ; therapy ; Osteoarthritis, Knee ; psychology ; therapy ; Quality of Life ; Treatment Outcome

OBJECTIVE: To summarize the research status and influencing factors of the time-effect of acupuncture and to explain and analyze the optimal effect timing of acupuncture, and provide reference for obtaining the best clinical therapeutic effect. METHODS: Literature regarding the studies of the time-effect of acupuncture published from January 2000 to August 2018 was searched, concluded and analyzed in CNKI, WANFANG, VIP and PubMed databases. RESULTS: A total of 43 papers were included. The time-effect relationship of acupuncture was studied from various aspects: immediate effect, post-effect and total time-effect. The influencing factors of time-effect of acupuncture included needle retention time, acupoint types, number of acupoints and frequency of acupuncture treatment. CONCLUSION Even though preliminary achievements have been made in the study of the time-effect of acupuncture, there are many limitations and deficiency. These studies are mostly isolated and unsystematic, and the observation time of needle retention time and post-effect is not long enough to observe the exact best induction period, half-life period and residual effect period of acupuncture.In the future, we should combine the existing research experience and achievements to formulate a more reasonable research plan and observe the entire period of acupuncture in a longitudinal direction.
Acupuncture Points ; Acupuncture Therapy ; Needles ; PubMed

Subjective cognitive decline(SCD),a clinical condition in the early stage of Alzheimer's disease,manifests as a continuous decrease in the individual's self-conscious cognitive function but with normal objective cognitive indicators. Research on SCD helps to identify individuals at high risk of senile dementia and explore the effective prevention and intervention strategies. This article reviews the recent research advances in SCD,with an attempt to provide evidence for early intervention in patients with SCD.
Alzheimer Disease ; Cognition ; Cognitive Dysfunction ; Humans

PURPOSE: To compare the effect of apixaban and low molecular weight heparin (LMWH) in the prevention and treatment of deep venous thrombosis (DVT) after total knee arthroplasty in older adult patients. MATERIALS AND METHODS: A total of 220 patients (average age of 67.8±6.4 years) undergoing total knee arthroplasty were randomly selected as research subjects and were divided into apixaban and LMWH groups (110 in each group). RESULTS: The incidence of DVT was lower in the apixaban group than in the LMWH group (5.5% vs. 20.0%, p=0.001). Activated partial thromboplastin times (35.2±3.6 sec vs. 33.7±2.2 sec, p=0.010; 37.8±4.6 sec vs. 34.1±3.2 sec, p<0.001; 39.6±5.1 sec vs. 35.7±3.0 sec, p=0.032) and prothrombin times (14.0±1.0 sec vs. 12.8±0.9 sec, p<0.001; 14.5±1.2 sec vs. 13.0±1.1 sec, p<0.001; 15.3±1.4 sec vs. 13.2±1.3 sec, p=0.009) in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were higher than those in the LMWH group. Platelet and fibrinogen levels in the apixaban group were lower than those of the LMWH group. Also, capillary plasma viscosity and erythrocyte aggregation in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were lower than those in the LMWH group. CONCLUSION: Apixaban, which elicits fewer adverse reactions and is safer than LMWH, exhibited better effects in the prevention and treatment of DVT after total knee arthroplasty in older adults.
Adult ; Arthroplasty, Replacement, Knee ; Blood Platelets ; Capillaries ; Erythrocyte Aggregation ; Fibrinogen ; Heparin, Low-Molecular-Weight ; Humans ; Incidence ; Plasma ; Prothrombin Time ; Research Subjects ; Thromboplastin ; Venous Thrombosis ; Viscosity