Background Atherosclerotic cardiovascular disease (ASCVD) is a major contributor to the global burden of cardiovascular diseases. However, evidence from meta-analyses on the association between ambient ozone exposure and ASCVD risk remains relatively insufficient. Objective To explore the epidemiological association between ambient ozone exposure and ASCVD, providing scientific evidence for ASCVD prevention and control from the perspective of environmental risk factor management. Methods We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, CNKI, Wanfang Database, CBM, and VIP for published epidemiological studies on the relationship between ambient ozone exposure and ASCVD from January 2007 to December 2023. We performed quality assessment and data extraction of the included studies, and utilized meta-analysis to evaluate the effects of short-term and long-term ozone exposure on different ASCVD outcomes, including mortality and incidence of ischemic heart disease (IHD) and ischemic stroke (IS). Results A total of 24 studies were included based on a set of predetermined eligibility criteria. The meta-analysis results indicated that short-term ozone exposure was associated with an increased risk of ASCVD mortality and incidence. Specifically, short-term ozone exposure was significantly associated with an elevated risk of IHD mortality (combined RR=1.011, 95%CI: 1.008, 1.015; P < 0.05). Additionally, short-term ozone exposure was significantly linked to increased IS mortality (combined RR=1.005, 95%CI: 1.003, 1.008; P < 0.05) and incidence (combined RR=1.015, 95%CI: 1.003, 1.027; P < 0.05). Conclusion Short-term exposure to ambient ozone significantly elevates acute cardiovascular disease risk. However, the epidemiological association between long-term ozone exposure and ASCVD remains inconclusive. Future high-quality cohort studies with refined exposure assessment methods are warranted to elucidate the chronic cardiovascular effects of ozone exposure.

Volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs) are common organic compounds in indoor and outdoor air, and enter the human body primarily through the respiratory tract and directly damage the respiratory system. Previous studies have suggested that exposure to VOCs/SVOCs may associate with the prevalence, incidence, and progression of asthma, but the extent of the associations is still vague. Furthermore, biomarkers for efficient and simple asthma diagnosis, typing, and attack prediction remain unclear at this stage. From the perspective of the collection and detection methods of VOCs/SVOCs, this paper summarized the epidemiological associations and underlying biological mechanisms between VOCs/SVOCs exposure and the prevalence, incidence, and progression of asthma in children/adults. It also demonstrated the application of VOCs/SVOCs in recent years in assisting asthma diagnosis, such as distinguishing asthma patients from the healthy population, differentiating different asthma phenotypes, and predicting asthma acute exacerbations, aiming to provide a scientific basis for improving current asthma management.

OBJECTIVE By conducting evidence evaluation research on literatures,this study aims to reveal the o-verall characteristics and research hotspots in the field of combat trauma-related infections,ultimately providing data support for the prevention and control of such infections.METHODS Relevant research in this field was sys-tematically collected from open-source databases to construct a dataset.The overall characteristics,research hotspots,prevention and control strategies,and future challenges of trauma-related infections were summarized and analyzed.RESULTS From 2004 to 2024,184 papers were published.The United States contributed the most publications,with Uniformed Services University of the Health Sciences being the most productive research insti-tution and Professor Clinton K.Murray as the author with the highest number of publications.The top five key-words with the highest frequency were combat related injury,infection,Acinetobacter baumannii,epidemiology and management.Among the publicly published literature data on war trauma-related infections,blast injuries ac-counted for the largest proportion,mainly multi-site injuries,with limb injuries being the most common.Bacteri-al infections were more common than fungal infections,with gram-negative bacteria being predominant and A.baumannii being the most common.Besides early wound management and the use of antibacterial drugs,in-creased attention should be paid to infection prevention and control in austere environments and the development of novel countermeasures.These advancements are critical to address projected changes in combat trauma,inclu-ding increasingly complex injuries and substantially elevated risks of infection and antimicrobial resistance.CONCLUSION This study systematically presents research hotspots,developmental trends,and prospects in com-bat trauma-related infections through evidence evaluation study,providing novel perspectives for researchers and facilitating further development in this field.

Objective:To analyze the risk factors and prognosis of pyogenic liver abscess (PLA) complicated with myocardial injury.Methods:A retrospective selection was made of 108 PLA patients treated in Beijing Friendship Hospital from January 2016 to June 2022 as the research subjects. Patients were divided into the myocardial injury group and non-myocardial injury group according to the occurrence of myocardial injury. Baseline characteristics, laboratory test data, imaging and etiological examination results, echocardiographic indicators, and prognosis were compared between the two groups. A logistic regression model was used to identify the risk factors for PLA complicated with myocardial injury.Results:Among the 108 PLA patients, 24 cases (22.2%) were complicated with myocardial injury. The age of the myocardial injury group was (71±13)years, which was significantly higher than that of the non-myocardial injury group [(59±14)years, P<0.05]. The levels of neutrophil ratio, C-reactive protein (CRP), procalcitonin (PCT), aspartate transaminase (AST), and D-dimer in the myocardial injury group were significantly higher than those in the non-myocardial injury group, while the levels of platelet count (PLT) and albumin (ALB) were significantly lower, with statistically significant differences (all P<0.05). In terms of blood culture, the positive detection rate in the myocardial injury group was as high as 54.2%(13/24), among which the detection rate of Klebsiella pneumoniae was 41.7%(10/24); the positive rate of blood culture in the non-myocardial injury group was only 17.9%(15/84), and the detection rate of Klebsiella pneumoniae was 14.3%(12/84), with statistically significant differences (all P<0.05). The left ventricular ejection fraction in the myocardial injury group was lower than that in the non-myocardial injury group, and the brain natriuretic peptide (BNP) level, the incidence of left ventricular diastolic dysfunction, the proportion of transfer to emergency intensive care unit (EICU), shock, and death were significantly higher than those in the non-myocardial injury group (all P<0.05). Logistic regression analysis showed that age was an independent risk factor for myocardial injury in PLA patients ( P<0.05), and for each 1-year increase in age, the risk of myocardial injury increased by 11.9%. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of age for myocardial injury, with an area under the curve (AUC) of 0.729( P<0.05), and the cut-off value calculated by Youden index was 64.5 years. Conclusions:Age is an independent risk factor for myocardial injury in PLA patients. PLA patients complicated with myocardial injury have poor cardiac function, higher incidence of transfer to EICU, shock, and death, and poor prognosis.

In response to issues in diagnostics experiment teaching for intelligent medical engineering in medical colleges and universities, such as the disconnection between theory and practice, the teaching content emphasizing "medicine" rather than "engineering", the lack of interaction between teachers and students, and the single teaching evaluation method, this study introduced the outcome-based education concept. According to the graduation requirements supported by the course, the experiment teaching reform ideas were adjusted from three aspects: setting curriculum objectives based on learning outcomes, reforming teaching strategies to achieve learning outcomes, and assessing learning outcomes to promote continuous improvement. The results of the reform show that students' satisfaction with the content, methods, and assessment of experiment teaching all exceeded 86.66%. The reform successfully integrated medicine and engineering, virtual and practical training, and teaching and ideological and political education. The reform also significantly improved the teaching effectiveness and talent cultivation level of experimental courses from the three dimensions of knowledge learning, ability improvement, and value shaping.

In response to issues in diagnostics experiment teaching for intelligent medical engineering in medical colleges and universities, such as the disconnection between theory and practice, the teaching content emphasizing "medicine" rather than "engineering", the lack of interaction between teachers and students, and the single teaching evaluation method, this study introduced the outcome-based education concept. According to the graduation requirements supported by the course, the experiment teaching reform ideas were adjusted from three aspects: setting curriculum objectives based on learning outcomes, reforming teaching strategies to achieve learning outcomes, and assessing learning outcomes to promote continuous improvement. The results of the reform show that students' satisfaction with the content, methods, and assessment of experiment teaching all exceeded 86.66%. The reform successfully integrated medicine and engineering, virtual and practical training, and teaching and ideological and political education. The reform also significantly improved the teaching effectiveness and talent cultivation level of experimental courses from the three dimensions of knowledge learning, ability improvement, and value shaping.

OBJECTIVE By conducting evidence evaluation research on literatures,this study aims to reveal the o-verall characteristics and research hotspots in the field of combat trauma-related infections,ultimately providing data support for the prevention and control of such infections.METHODS Relevant research in this field was sys-tematically collected from open-source databases to construct a dataset.The overall characteristics,research hotspots,prevention and control strategies,and future challenges of trauma-related infections were summarized and analyzed.RESULTS From 2004 to 2024,184 papers were published.The United States contributed the most publications,with Uniformed Services University of the Health Sciences being the most productive research insti-tution and Professor Clinton K.Murray as the author with the highest number of publications.The top five key-words with the highest frequency were combat related injury,infection,Acinetobacter baumannii,epidemiology and management.Among the publicly published literature data on war trauma-related infections,blast injuries ac-counted for the largest proportion,mainly multi-site injuries,with limb injuries being the most common.Bacteri-al infections were more common than fungal infections,with gram-negative bacteria being predominant and A.baumannii being the most common.Besides early wound management and the use of antibacterial drugs,in-creased attention should be paid to infection prevention and control in austere environments and the development of novel countermeasures.These advancements are critical to address projected changes in combat trauma,inclu-ding increasingly complex injuries and substantially elevated risks of infection and antimicrobial resistance.CONCLUSION This study systematically presents research hotspots,developmental trends,and prospects in com-bat trauma-related infections through evidence evaluation study,providing novel perspectives for researchers and facilitating further development in this field.

Objective:To analyze the risk factors and prognosis of pyogenic liver abscess (PLA) complicated with myocardial injury.Methods:A retrospective selection was made of 108 PLA patients treated in Beijing Friendship Hospital from January 2016 to June 2022 as the research subjects. Patients were divided into the myocardial injury group and non-myocardial injury group according to the occurrence of myocardial injury. Baseline characteristics, laboratory test data, imaging and etiological examination results, echocardiographic indicators, and prognosis were compared between the two groups. A logistic regression model was used to identify the risk factors for PLA complicated with myocardial injury.Results:Among the 108 PLA patients, 24 cases (22.2%) were complicated with myocardial injury. The age of the myocardial injury group was (71±13)years, which was significantly higher than that of the non-myocardial injury group [(59±14)years, P<0.05]. The levels of neutrophil ratio, C-reactive protein (CRP), procalcitonin (PCT), aspartate transaminase (AST), and D-dimer in the myocardial injury group were significantly higher than those in the non-myocardial injury group, while the levels of platelet count (PLT) and albumin (ALB) were significantly lower, with statistically significant differences (all P<0.05). In terms of blood culture, the positive detection rate in the myocardial injury group was as high as 54.2%(13/24), among which the detection rate of Klebsiella pneumoniae was 41.7%(10/24); the positive rate of blood culture in the non-myocardial injury group was only 17.9%(15/84), and the detection rate of Klebsiella pneumoniae was 14.3%(12/84), with statistically significant differences (all P<0.05). The left ventricular ejection fraction in the myocardial injury group was lower than that in the non-myocardial injury group, and the brain natriuretic peptide (BNP) level, the incidence of left ventricular diastolic dysfunction, the proportion of transfer to emergency intensive care unit (EICU), shock, and death were significantly higher than those in the non-myocardial injury group (all P<0.05). Logistic regression analysis showed that age was an independent risk factor for myocardial injury in PLA patients ( P<0.05), and for each 1-year increase in age, the risk of myocardial injury increased by 11.9%. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of age for myocardial injury, with an area under the curve (AUC) of 0.729( P<0.05), and the cut-off value calculated by Youden index was 64.5 years. Conclusions:Age is an independent risk factor for myocardial injury in PLA patients. PLA patients complicated with myocardial injury have poor cardiac function, higher incidence of transfer to EICU, shock, and death, and poor prognosis.

Objective:To investigate personal exposures to nitrogen oxides(NOX)and nitrogen di-oxide(NO2)and the influence of baseline personal characteristics,living environment and daily activity patterns of the participants on the exposures among adults over 35 in Tianjin and Shanghai.Methods:In this panel study,91 healthy nonsmoking adults aged over 35 from Tianjin and Shanghai participated in our study.The study was conducted in summer and winter.The participants were followed for three times with an interval of at least two weeks.Only participants in Shanghai were followed once in winter because of the COVID-19 pandemic.Twenty-seven participants completed follow-up visits in both seasons.We measured their 24 h personal exposures to NOX and NO2and collected their baseline and time-activity in-formation through questionnaire/diary.The linear mixed model was used to analyze the associations be-tween potential influencing factors and personal NOX and NO2 exposure levels.Results:There were 349 follow-up visits with valid 24 h personal NO2 and NOX exposure measurements in the two cities.The ave-rage 24 h personal exposures to NO2 and NOX(volume fraction)in Tianjin participants were 18.0 x 10-9 and 26.2 × 10-9 in summer,and 31.0 x 10-9 and 54.9 x 10-9in winter,respectively;and the average 24 h personal exposures to NO2 and NOX in Shanghai participants were 38.7 x 10-9and 100.0x10-9in summer,and 45.5 x10-9 and 139.2 x 10-9 in winter,respectively.The results of univariate regression analysis showed that their personal NOX exposure levels were significantly associated with city,season,gender,average daily cooking times,and ambient NO2 concentrations measured at fixed-site monitoring stations.In addition to the above factors,the personal NOX exposure levels were also significantly associ-ated with educational level and the personal NO2 exposure levels were also significantly associated with passive smoking,average daily home time,cooking energy type,residential distance from main traffic road,and use of kitchen ventilators.Multivariate regression analysis showed that the personal exposure levels of NO2 and NOX were significantly lower in Tianjin than that in Shanghai,were significantly lower in summer than that in winter,and were significantly and positively associated with ambient NO2 concen-trations measured at fixed-site monitoring stations.In addition,personal NOX exposure levels were signifi-cantly lower in females than in males,and personal NO2 exposure levels were significantly positively asso-ciated with average daily cooking times and significantly inversely associated with average daily home time.For every interquartile range(IQR)increase(12.7 × 10-9)in ambient NO2,the personal NO2 exposure levels increased by 27.5％(95％CI:17.0％-38.9％),and personal NOX exposure levels in-creased by 16.1％(95％CI:7.1％-25.8％).Conclusion:Season,city and ambient NO2 concentra-tions are significant influencing factors of personal exposure levels of NO2and NOX At the same time,the personal exposures levels of NO2 are also affected by lifestyle factors.Our study provides scientific evi-dence for making precise air pollution control decisions and reducing the exposure levels of NOX in the population.

Objective:To assess the impact of exposure to particulate matter with aerodynamic diameter ≤2.5 μm(PM2.5)on non-accidental mortality under different apparent temperature levels and to further explore the modification effect of apparent temperature.Methods:This study used time-series design.Tianjin and Ningbo from China,Bangkok and Chiang Mai from Thailand were selected as the re-search sites,and the apparent temperature was applied as the exposure index.Through the quantitative estimation of the threshold temperature,the corresponding pollutant concentration was divided into high and low levels,and the generalized Poisson additive model was used to evaluate the association between PM2.5 exposure and non-accidental death of residents at different temperature levels.Results:The ave-rage concentrations of PM2.5 in Tianjin,Ningbo,Bangkok,and Chiang Mai during the study period were(73.6±35.6),(48.0±32.1),(33.5±28.4)and(32.6±28.6)μg/m3,respectively;the average daily non-accidental death counts were 148,57,28,and 8.The analysis of the generalized Poisson addi-tive model showed that the daily non-accidental death counts increased by 0.43％(95％CI:0.33％-0.54％)per 10 μg/m3 increase of PM2.5 in lag 0 day in Tianjin of China;0.27％(95％CI:0.08％-0.46％)per 10 μg/m3 increase of PM2.5 in lag 2 days in Ningbo of China.The effect was magnified in high temperature levels in Tianjin and in low temperatures in Ningbo and Bangkok.The mortality effect of PM2 5 in various temperature levels stayed still in co-pollutant regression models.Conclusion:Exposure to fine particulate matter had an adverse effect on non-accidental mortality,which reminded us to give further attention to the pollution control.The findings also indicated that apparent temperature might modify mortality effects of PM2 .5 and the modification effect varied in different regions.Protective policies due to regional differences should be made and more scientific and social attention on mutual effect of air pollution and climate change needs to be appealed.