Background Nitrogen dioxide (NO₂) is one of the main air pollutants, and though China's NO₂ pollution has been improving year by year, it maintains at a high level, threatening the health of the population. Objective To investigate the effect of short-term exposure to atmospheric NO₂ on the coagulation indexes in obese and normal-weight young individuals and potential modification effect of temperature. Methods Based on a parallel control panel study design, this study recruited 53 normal-weight and 44 obese young individuals. Three prospective follow-ups were conducted. Air pollution data were obtained from the fixed monitoring station closest to the participant's residences, and personal air pollution exposure was simulated based on time-activity log and infiltration factor for the week before every follow-up. Temperature was collected from China Meteorological Data Service Center. Venous blood samples were taken to measure platelet (PLT) count, mean platelet volume (MPV), soluble CD40 ligand (sCD40L), soluble P-selectin (sP-selectin), platelet aggregation rate (PAgT), and plasminogen activator inhibitor type-1 (PAI-1) during every follow-up. A linear mixed-effect model was used to assess the association between short-term atmospheric NO₂ exposure and the coagulation indexes of weight grouped young individuals, and a stratified analysis was used to explore potential modification effect of temperature. Results The median [interquartile range (IQR)] of personal atmospheric NO₂ exposure concentrations was 21.47 (8.01) µg·m⁻³. Short-term exposure to atmospheric NO₂ was significantly associated the increase of sCD40L and PAgT in the obese individuals, while the most significant association appeared at 5 d lag, and for each IQR increase in the average sliding exposure concentration of atmospheric NO₂ with a 5 d lag, sCD40L increased by 27.4% (95%CI: 4.2%, 56.6%) and PAgT increased by 37.5% (95%CI: 12.2%, 68.6%); short-term exposure to atmospheric NO₂ was significantly associated with the decrease of PLT and PAgT in the normal-weight individuals, while the most significant association appeared at 5 d lag or 7 d lag, and for each IQR increase in the average sliding exposure concentration of atmospheric NO₂ with a 5 d lag, PLT decreased by 11.8% (95%CI: −17.8%, −5.3%), and for each IQR increase in the average sliding exposure concentration of atmospheric NO₂ with a 7 d lag, PAgT decreased by 16.8% (95%CI: −30.6%, −0.4%). We didn't find statistically significant association of short-term exposure to atmospheric NO₂ with PLT in the obese individuals or sCD40L in the normal-weight individuals, nor statistically significant association between short-term exposure to atmospheric NO₂ and PAI-1, MPV, and sP-selectin in different weight grouped individuals. The stratified analysis found that short-term exposure to atmospheric NO₂ was significantly associated with PAgT in the normal-weight individuals, or with PLT, sCD40L, and sP-selectin in the obese individuals only at high temperature. Conclusions Short-term exposure to atmospheric NO₂ has adverse effects on the coagulation indexes of different weight grouped young individuals, and the obese individuals are more sensitive to it than the normal-weight individuals. High temperature can enhance the adverse health effect of short-term exposure to atmospheric NO₂.

Background The health effects of forest therapy have been widely recognized, while the previous studies mostly focused on a single activity mode of forest walks. The effects of different types of forest therapy activities remain unclear. Objective To explore the effects of short-term forest therapy on cardiopulmonary health, psychological health, and sleep quality, and the health effects of different types of forest therapy activities, aiming to provide population empirical study data for the development of forest therapy. Methods A self-control study was conducted in a national forest park in suburb of Beijing from August to September 2018. A total of 31 healthy college students were recruited as the study subjects, with a total forest stay for 3 days and 2 nights. During the period of study, each subject practiced walking therapy, sitting therapy with five senses experience (sitting therapy thereafter), and handmade work therapy, successively. Each type of forest therapy lasted about 2 h. Changes of blood pressure, oxygen saturation (SpO₂), lung function, and fractional exhaled nitric oxide (FeNO) were estimated by measuring corresponding indicators before and after the forest therapy. Psychological health and sleep quality were assessed by Profile of Mood States and Pittsburgh Sleep Quality Index respectively at the same time. Mixed effects models were used to analyze the changes of these health indicators. The health effects of different types of forest therapy activities were further analyzed. Results The average age and body mass index of subjects in this study were (24.5±2.6) years and (20.7±1.7) kg·m⁻², respectively. After a short-term forest therapy, the selected indicators of cardiopulmonary health, psychological health, and sleep quality of subjects were all improved. In particular, the pulse pressure (PP) and FeNO decreased by 3.02 mmHg and 1.10 ppb, respectively, while the SpO₂ and peak expiratory flow (PEF) increased by 0.65% and 0.50 L·s⁻¹, respectively, and the negative emotion and global sleep quality also presented significant positive changes (all P<0.05). Furthermore, different therapy activities presented differential effects in the health indicators. Walking therapy significantly improved pulmonary function, SpO₂, and confusion (CON) emotion, in which the SpO₂, forced expiratory volume in the first second (FEV₁), and forced vital capacity (FVC) increased by 0.48%, 0.14 L, and 0.12 L, respectively, and the score of CON decreased by 0.97 (all P<0.05). Sitting therapy significantly reduced blood pressure and tension (TEN) emotion of subjects, including a decrease of the systolic blood pressure (4.45 mmHg), PP (4.19 mmHg), and the score of TEN (0.84) (all P<0.05). The diastolic blood pressure (DBP) increased slightly after handmade work therapy (ΔDBP=2.44 mmHg, P=0.016), but there were no significant changes in other indicators. Conclusion Short-term forest therapy could significantly improve cardiopulmonary health, psychological health, and sleep quality of young healthy individuals, and different types of forest therapy activities may have differential health effects.

Humans ; Air Pollutants ; Sleep Apnea, Obstructive ; Polysomnography ; Sleep ; Pulmonary Disease, Chronic Obstructive

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Background Essential and non-essential elements have an important impact on the development of the central nervous system during fetal development. Due to their less developed brain, preterm infants are more sensitive to element exposure, and are high-risk groups of neurodevelopmental abnormalities. However, it is not clear whether the effects of element exposure in utero on postpartum neurodevelopment are different between full-term infants and preterm infants. Objective To evaluate the effects of element exposure levels during pregnancy on neurodevelopment of children aged 6-24 months (of corrected age), and compare the effects between preterm and full-term children. Methods A prospective study design was adopted and this study was conducted based on the Maoming Birth Cohort Study (MBCS) in Maoming City, Guangdong Province. Twenty elements in cord blood of 197 preterm infants and 297 full-term infants were measured, including 11 essential trace elements [vanadium (V), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), selenium (Se), strontium (Sr), tin (Sn), and iron (Fe)], and 9 non-essential trace elements [aluminum (Al), arsenic (As), thallium (Tl), lead (Pb), uranium (U), cerium (Ce), antimony (Sb), cadmium (Cd), and yttrium (Y)]. The neurodevelopment of the children at 6, 12, and 24 months were evaluated by the Ages and Stages Questionnaires-the Third Edition (ASQ-3). A generalized estimating equation (GEE) model was adopted to evaluate the associations between elements and neurodevelopment in full-term and preterm children separately. Results The positive rates of 10 elements (Mn, Cu, Zn, Se, Sr, Fe, Sb, Tl, Pb, and As) in cord blood were greater than 80%. Among the preterm birth children, the results of GEE analysis showed that after adjusting for the covariates, for each increase of interquartile range (IQR) in ln-transformed concentration, As was associated with problems/delay in the communication and problem-solving sub-scales, with the adjusted odds ratios (OR) and 95% confidence intervals (CI) of 1.36 (1.03-1.80) and 1.55 (1.10-2.20), respectively; the adjusted OR (95%CI) of problems/delay in the fine motor and problem-solving sub-scales were 1.44 (1.00-2.07) and 1.76 (1.09-2.84) for Sb, respectively; the adjusted OR (95%CI) of problems/delay in the communication sub-scale was 1.37 (1.09-1.74) for Se. No statistically significant associations between umbilical cord blood element concentrations and neurodevelopment indicators were observed among full-term children. The results of stratified analysis by sex showed that the associations between umbilical cord blood element concentrations and neurodevelopment problems/delay were only significant among female preterm children. Conclusion Exposures to As, Se, and Sb during pregnancy may increase the risk of neurodevelopment problems/delay in preterm children aged 6-24 months, and female seem to be more vulnerable.