Objective To establish a nomogram model for efficiently predicting overall survival(OS)and cancer-specific survival(CSS)in patients with CRCHBM.Method 2239 patients from 2010 to 2019 were retrospectively analyzed from the Surveillance,Epidemiology,and End Results Program(SEER)databases and Wuhan Union Hospital Cancer Center.SEER is randomly assigned to the training and internal validation cohorts,and the Wuhan database serves as the external validation.Cox regression analyses were used to determine the independent clinicopathological prognosis factors affecting OS and CSS,and a nomogram was constructed to predict OS and CSS.The clinical utility of columnar plots was assessed using calibration curves,area under the curve(AUC),and decision curve analysis(DCA).Result OS column line graphs were constructed based on nine independent predictors:age,tumor location,degree of differentiation,tumor size,TNM stage,chemotherapy,primary focus surgery,number of lymph nodes sampled,and serum carcinoembryonic antigen(CEA)level.The C-index of the nomogram to predict the 1-,3-,and 5-year OS were 0.764,0.790,and 0.805 in the training group,0.754,0.760,and 0.801 in the internal validation group,and 0.822,0.874,and 0.906 in the external validation group.CSS column line graphs were constructed based on 3 independent predictors of TNM staging,radiotherapy and chemotherapy.The 1-,3-,and 5-year CSS AUROC values of the training group were 0.791,0.757,and 0.782,respectively.0.682,0.709,0.625 in the internal validation group and 0.759,0.702,0.755 in the external validation group,respectively.The results of receiver operating characteristic curve(ROC),ROC and DCA showed that the use of our model was more effective in predicting OS and CSS than other single clinicopathological features.Conclusion In summary,the nomogram based on significant clinicopathological features can be conveniently used to predict OS and CSS individually in patients with CRCHBM.

Objective:To design a fully integrated multi-channel implantable brain-computer interface electrical stimulation system.Methods:The human-computer interaction interface of the upper computer was set by users, and the data was packaged via a self-built protocol. When parameters were transmitted to the field programmable gate array (FPGA) chip through the Bluetooth module, the stimulation chip was controlled after the parameter analysis was completed. Eventually the user-set current stimulation was output. To verify the system feasibility, the accuracy of the single-channel stimulation waveform, the multi-channel output capability, and the adjustable range of the parameter were tested separately.Results:It realized 16 channels of time-sharing differential stimulation current output, the output stimulation current waveform was dual-phase equal-width pulse, the amplitude ranged within 4~1 000 μA, the pulse single-phase width range was 10~1 000 μs, the cycle time was 1~1 000 ms, thus the current parameters could be accurately adjusted.Conclusions:A fully integrated multi-channel implantable brain-computer interface electrical stimulation system was completed.

Objectives:To investigate the association between social determinants of health(SDOH)and incident stroke and analyze the main risk factors for stroke among resident with different SDOH levels. Methods:From 2012 to 2015,30 036 residents(≥35 years old)from 30 districts in 14 provincial-level administrative divisions in China were enrolled this study based on stratified multi-stage-random-sampling method.The prevalence of cardiovascular diseases and related risk factors were investigated,and stroke events were followed up in 2018 to 2019.Principal component analysis was performed to establish SDOH scores based on 9 indicators related to socioeconomic and healthcare resources,participants were divided into low SDOH group(n=8 343)when it was≥-2.01 to<-1.14,middle SDOH group(n=7 257)when it was≥-1.14 to<0.10,and high SDOH group(n=8 457)when it was≥0.10 to≤5.79.Multivariate Cox regression was applied to estimate the association of SDOH levels with incident stroke.The random survival forest method was used to analyze the major risk factors in different SDOH levels. Results:A total of 24 057 participants were finally included,669(2.8%)participants developed stroke during a mean of(4.7±0.8)years follow-up.The incidence densities of stroke in the low,medium,and high SDOH groups were 468.39,628.85,and 700.39/100 000 person-years,respectively(Pdifference<0.05,Ptrend=0.01).Compared with individuals with low SDOH level group,fully HR for incident stroke among those with medium and high were 1.91(95%CI:1.54-2.36)and 1.59(95%CI:1.30-1.95),respectively(Ptrend<0.001).Advanced age is the primary risk factor for stroke in the population,especially in districts with high SDOH level.In districts with medium SDOH level,diabetes is an important risk factor for stroke.High blood pressure and alcohol consumption are important modifiable risk factors in low SDOH level districts. Conclusions:Present study shows that higher levels of SDOH are associated with increased risk of stroke.The main risk factors for stroke differ among participants with different SDOH level districts.Targeted interventions should be implemented to improve the prevention and treatment of stroke in populations with different levels of SDOH.

OBJECTIVE: This study aimed to explore the association between humidity exposure and the risk of cardiovascular disease (CVD), utilizing follow-up data and relative humidity (RH) metric assessments. METHODS: We extracted the baseline data from the China Hypertension Survey (CHS) of 24,510 enrolled participants aged ≥ 35 years without a history of CVD between 2012 and 2015 and followed them up from 2018 to 2019. The National Meteorological Information Center (NMIC) of the China Meteorological Administration (CMA) provided the quality-controlled relative humidity (RH) datasets. Cox proportional hazards models were used to estimate hazard ratios ( HRs) for CVD in relation to RH. RESULTS: During the follow-up period (2018-2019), 973 patients with CVD were identified. The HR of CVD risk was 1.17 (95% CI: 1.04-1.31) per 10% increase in summer mean RH. Compared with participants in the 3 ^rd quintile group, those in the 1 ^st and 5 ^th quintiles of RH had a higher risk of CVD. For summer mean RH, the HRs (95% CIs) for the 1 ^st and 5 ^th quintiles were 1.34 (1.04-1.71) and 1.44 (1.14-1.83), respectively. The relationship ("U" shape) between summer mean RH and the risk of CVD was nonlinear. Stratified analyses indicated that the risk of CVD was substantially influenced by the summer mean RH in female, older individuals, and those in southern China. CONCLUSION Unsuitable (too high or low) humidity environments affect the risk of CVD. Our study highlights those future policies for adapting to climate change should consider the humidity-CVD relationship.
Humans ; Humidity/adverse effects* ; Cardiovascular Diseases/etiology* ; Female ; Male ; Middle Aged ; Prospective Studies ; China/epidemiology* ; Adult ; Aged ; Risk Factors ; Proportional Hazards Models ; Seasons

In the face of a serious occupational disease prevention and control situation, the lack of efficient supervision and regulation methods has become a prominent contradiction. This paper reviewed the progress and application of occupational health grading and classification supervision methods for employers in China in recent years, and analyzed the characteristics and limitations of selected methods. The grading and classification supervision methods have gradually developed from considering only inherent health risk of occupational disease hazards, to considering both inherent attributes of occupational disease hazards and exposure duration. Some regional authorities introduced trial measures for grading and classification of occupational health supervision by embracing exposure level of an occupational disease hazard of interest, associated outcome severity, and occupational health management situation of targeted employers. In October 2022, the National Disease Control and Prevention Bureau issued the Notice on Carrying out Pilot Work of Occupational Health Classification Supervision and Law Enforcement, which further promoted the establishment of a differentiated occupational health supervision model. Grading and classification of occupational health supervision can improve the supervision efficiency of public health administration departments and promote employers to fulfill the main responsibility of occupational disease prevention and control.

Taking the course of Chinese traditional medicine as an example, this paper discusses the construction and implementation effect of online teaching mode from the following four aspects: online teaching curriculum design, teaching implementation, teaching effect evaluation, and teaching reflection, with a view to providing beneficial reference for the follow-up hybrid teaching and promoting the construction of hybrid first-class courses by summarizing the experience of online teaching.

Objective:To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD).Methods:A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as xˉ±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results:The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU ( OR=1.23, 95% CI 1.12-1.35) and macroalbuminuria ( OR=1.86, 95% CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions:The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.

Objective: To examine the associations of occupational stress and well-being with depressive symptoms among couriers. Methods: Four cities of Hangzhou, Ningbo, Jiaxing and Taizhou were sampled from Zhejiang Province according to the economic development level, and couriers were randomly sampled from 40 service stations assigned by 25 mainstream express transportation corporations in these four cities. Participants' occupational stress, well-being and depressive symptoms were evaluated using the Core Occupational Stress Scale (COSS), the World Health Organisation-Five Well-Being Index (WHO-5) and Chinese version of Patient Health Questionnaire-9 (PHQ-9). In addition, the associations of participants' occupational stress and well-being with depressive symptoms were examined using hierarchical linear regression analysis. Results: A total of 1 302 questionnaires were allocated, and 1 136 valid questionnaires were recovered, with an effective recovery rate of 87.25%. The participants included 839 males (73.86%), and 297 females (26.14%), and had a mean age of (33.34±8.17) years and a mean service length of (8.95±7.82) years. The detection rates of occupational stress, low well-being and depressive symptoms were 32.48%, 50.79%, and 31.87% among participants, respectively. After adjustment for educational level, income, marital status and smoking, hierarchical linear regression analysis showed that well-being (β=0.171), social support (β=-0.298), organization and reward (β=0.200), demand and effort dimensions of COSS (β=0.284) were statistically correlated with depressive symptoms (all P<0.001). Conclusion Occupational stress and low well-being may increase the risk of depressive symptoms among couriers.

The phenomenon of workers working beyond standard working hours is called long working hours. In recent years, more and more relevant studies at home and abroad have shown the association between long working hours and adverse health effects of occupational populations, such as increased risks of cardiovascular diseases, diabetes, and various psychological conditions such as depression and occupational stress. However, the current research has not yet reached a consistent conclusion. The main reason is that the physiological and psychological effects of exposure to long working hours need to be explored in depth. Therefore, based on the relevant research progress at home and abroad, this article introduced the health effects of long working hours from both physical and psychological aspects, including hypertension, cardiovascular diseases, diabetes, depression, and job burnout, expounded related mechanisms involved, and indicated deficiencies in current research on long working hours and the next research directions.

Objective:To explore the effect of Plantaginis semen on the expressions of AQP4 gene and protein in small intestine of diarrhea rats. Methods:Sixty Sprague-Dawley male rats were randomly divided into normal control group, model control group, hydrochlorothiazide group, and low-, medium-, and high-dose Plantaginis semen groups. Intragastric administration of Senna (20 ml/kg) was implemented in the morning for 5 groups except the normal group. The rats in the low-, medium-, and high-dose Plantaginis semen groups were intragastrically administered with 0.95, 1.9, 3.8 g/kg Plantaginis semen formula granule solution, while the rats in hydrochlorothiazide group were given hydrochlorothiazide suspension 9 mg/kg by gavage according to 1 ml/100 g body weight for 14 days. The loose stool rate, average ranking of loose stool, and diarrhea index were compared according to the fecal traits and stool times after 14 days of treatment, and the small intesine tissue were collected. Hematoxylin-eosin (HE) staining to observe the pathological morphological changes in small intestine, and Quantiative Real-time PCR and Western blot were applied to detect the gene and protein expressions of AQP4. Results:Compared with the model group, the loose stool rate (50.89% ± 6.17%, 41.14% ± 4.48%, 36.37% ± 4.81 % vs. 67.45% ± 7.35%), the average ranking of loose stool (2.16 ± 0.34, 1.73 ± 0.28, 1.52 ± 0.25 vs. 2.63 ± 0.29), and the diarrhea index (1.10 ± 0.19, 0.71 ± 0.11, 0.57 ± 0.12 vs. 1.77 ± 0.24) of rats in each group of Plantaginis semen significantly decreased ( P<0.05); the degree of intestinal mucosal injury, hyperemia and neutrophil infiltration were alleviated; the expressions of AQP4 mRNA (0.48 ± 0.10, 0.69 ± 0.12, 0.97 ± 0.15 vs. 0.21 ± 0.03), and the protein of AQP4 (0.59 ± 0.08, 0.64 ± 0.09, 0.78 ± 0.11 vs. 0.32 ± 0.05) in the small intestine tissue of Plantaginis semen groups significantly increased ( P<0.05). Conclusions:Plantaginis semen has antidiarrheal effect, and its mechanism is related to up-regulation the gene and protein expressions of AQP4, addition of water absorption and promotion of water and fluid metabolism.