Objective To address the safety challenges arising from the rapid development of nuclear energy and technology, assess the current status of health emergency response capabilities in nuclear radiation emergencies, and promote capacity enhancement. Methods A preliminary evaluation system for health emergency response capability in nuclear radiation emergencies was developed based on a literature review. Two rounds of Delphi expert consultation (n = 20) were conducted, and the analytic hierarchy process was employed to establish judgment matrices for assigning indicator weights. Results The finalized system included six primary indicators (radiation protection capability, triage capability, decontamination and evacuation capability, medical treatment capability, radiation detection capability, and radiation dose estimation capability), along with 29 secondary indicators, such as capability for setting up emergency zones, capability for protecting personnel from internal and external contamination, on-site first aid capability, and personal dose monitoring capability. The expert response rate was 0.95, and the expert authority coefficient reached 0.80. The Kendall’s coefficient of concordance was W = 0.288 (P<0.01) for the first round of expert consultation and W = 0.308 (P<0.01) for the second round. Both rounds demonstrated high agreement among experts, and the consultation questionnaires passed reliability and validity tests. Conclusion By integrating qualitative analysis and quantitative calculation, this study developed a scientifically sound and operationally feasible evaluation system. This system will help identify gaps in health emergency response capabilities and provide scientific guidance and a decision-making basis for optimizing emergency plans and improving the level of health emergency response in nuclear radiation emergencies.

Objective Emergency response to public health emergencies constitutes a vital component of the modernization of national governance systems and capacities, directly impacting national security, social stability, and public health. This study aims to analyze the key issues and research hotspots in the field of emergency response to public health emergencies, providing theoretical foundations and practical guidance for formulating scientific and effective emergency strategies and policies. Ultimately, it seeks to enhance the nation’s capability to respond to public health emergencies and safeguard public health. Methods Using core journals indexed in the China National Knowledge Infrastructure (CNKI) database as the data source, 1094 journal articles in the field of emergency response to public health emergencies in China from 2003 to September 2024 were selected as the research sample. Citespace visualization software was employed to organize and analyze the research process in the field of emergency response to public health emergencies. Results The current research in this field predominantly involves small-scale cooperation, and the research process can be divided into four stages. The research in the emerging stage mainly focuses on the themes of emergency mechanism and emergency management, the development stage mainly centers on the themes of emergency capacity improvement and system exploration, the outbreak stage emphasizes the themes of COVID-19 and epidemic prevention and control, and the sustainable development stage highlights collaborative governance and informatization. Conclusion The COVID-19 pandemic has accelerated the development of research in this field. Currently, the field shows a continuous growth, with an increasing volume of publications. The focus of current research has shifted towards collaborative governance and the study of assessment tools, aiming to enhance the efficiency and effectiveness in responding to public health emergencies. Moreover, the field is advancing toward more systematic and comprehensive research. However, there is still a need to strengthen scientific communication and collaboration.

Objective To analyze and explore the health response capability construction in the long-term recovery phase of nuclear or radiological emergencies. Methods By evaluating China’s participation in an international nuclear emergency exercise organized by Organization for Economic Co-operation and Development’s Nuclear Energy Agency, and considering the relevant guidelines published by international organizations such as the International Atomic Energy Agency, the sections that need to be strengthened in the health response during the long-term recovery phase of nuclear or radiological emergencies were analyzed. The related issues such as health monitoring and medical follow-up were explored. Results The tasks in the long-term recovery phase mainly include monitoring the affected population and information management, medical follow-up, and psychological assistance. In response to potential nuclear or radiological emergencies, 22 nuclear emergency medical rescue bases have been established in China, with a geographical distribution that includes key regions. Relevant institutions have basic capabilities of health response to nuclear or radiological emergencies. However, the exercise shows that strategy and capacity construction in long-term recovery phase are weak points in health response to nuclear or radiological emergencies. China should further strengthen strategies in major public protection actions and information management of affected populations in nuclear or radiological emergencies. Conclusion It is recommended to develop standard operating procedures for major public protection actions, long-term health monitoring and evaluation of affected populations, medical follow-up, and psychological assistance in the future. A unified health registration system for affected populations in nuclear or radiological emergencies should be established to further enhance China’s health response capabilities during the long-term recovery phase of nuclear or radiological emergencies.

Objective To analyze and explore the health response capability construction in the long-term recovery phase of nuclear or radiological emergencies. Methods By evaluating China’s participation in an international nuclear emergency exercise organized by Organization for Economic Co-operation and Development’s Nuclear Energy Agency, and considering the relevant guidelines published by international organizations such as the International Atomic Energy Agency, the sections that need to be strengthened in the health response during the long-term recovery phase of nuclear or radiological emergencies were analyzed. The related issues such as health monitoring and medical follow-up were explored. Results The tasks in the long-term recovery phase mainly include monitoring the affected population and information management, medical follow-up, and psychological assistance. In response to potential nuclear or radiological emergencies, 22 nuclear emergency medical rescue bases have been established in China, with a geographical distribution that includes key regions. Relevant institutions have basic capabilities of health response to nuclear or radiological emergencies. However, the exercise shows that strategy and capacity construction in long-term recovery phase are weak points in health response to nuclear or radiological emergencies. China should further strengthen strategies in major public protection actions and information management of affected populations in nuclear or radiological emergencies. Conclusion It is recommended to develop standard operating procedures for major public protection actions, long-term health monitoring and evaluation of affected populations, medical follow-up, and psychological assistance in the future. A unified health registration system for affected populations in nuclear or radiological emergencies should be established to further enhance China’s health response capabilities during the long-term recovery phase of nuclear or radiological emergencies.

Objective:To observe the expression of interleukin-35(IL-35) in Hashimoto's thyroiditis(HT) patients, and evaluate its regulatory effect on the balance between regulatory T cells(Treg) and T helper 22(Th22) cells.Methods:Forty-two HT patients and eighteen controls were consecutively enrolled. Plasma and peripheral blood mononuclear cells(PBMC) were isolated. Treg were purified. Plasma IL-35 and IL-22 were detected with enzyme-linked immunosorbent assay. Treg and Th22 percentages were measured using flow cytometry. Real-time quantitative PCR was used to assess mRNA levels of forhead box protein 3(FoxP3) and aryl hydrocarbon receptor(AhR). Treg were stimulated with exogenous IL-35, and were co-cultured with autologous PBMC to induce Treg-to-Th22 phenotypic differentiation, evaluating the effect of IL-35 on Treg function and differentiation.Results:There was imbalance between Treg and Th22 cells in HT group. HT group had reduced Treg percentage, plasma IL-35 and FoxP3 mRNA( P<0.001), while had elevated Th22 percentage and AhR mRNA( P<0.001). There was no significant difference in plasma IL-22 level between two groups( P=0.775). The suppressive capacity of Tregs in the HT group was diminished( P=0.013), and secretion levels of IL-35 and IL-10 were lower than those in the control group( P<0.001). The ability of Tregs in the HT group to differentiate into Th22 cells was increased, with higher levels of CCR4, CCR6, CCR10, AhR mRNA, and IL-22 secretion compared to the control group( P<0.01). IL-35 stimulation induced elevation of Treg percentage, FoxP3 mRNA, and IL-35/IL-10 secretion( P<0.05), but did not affect Th22 percentage, AhR mRNA, or IL-22 secretion( P>0.05). IL-35 stimulation enhanced Treg function in HT group, increasing proliferation inhibition and secretion of IL-35 and IL-10( P<0.05). IL-35 stimulation reduced the differentiation of Treg to Th22 phenotype in HT group, with decreased levels of CCR4, CCR6 CCR10, AhR mRNA, and IL-22 secretion( P<0.05). Conclusion:IL-35 enhances the immunosuppression of Tregs in HT patients and inhibits its differentiation into Th22 cells, thus regulating the balance between Tregs and Th22 cells.

To investigate the clinical features of one case of imported dengue fever, and to clarify the key points of its diagnosis and prevention. One case of dengue fever confirmed in the First Affiliated Hospital of Bengbu Medical University on September 1, 2023 was selected, and the clinical manifestations and epidemiological data were retrospectively analyzed, along with testing for the dengue virus nucleic acid in the patient. The patient had a history of travel and residence in the Maldives, and developed symptoms such as fever, chills, accompanied by muscle aches, and scattered rashes on both lower limbsfollowing exposure to cold, with a positive dengue virus nucleic acid test. After symptomatic treatment with nutritional support, antipyretic, rehydration, hemostasis, and elevated granulocytes, the patient was discharged from the hospital with improvement. The clinical manifestations of dengue fever are complex and diverse, and the collection of medical history should consider the patient's travel history abroad. Currently, there is no specific anti-dengue virus drug, and symptomatic and supportive treatment is mainly adopted.

Objective:To explore clinical value of nucleic acid detection for hepatitis B virus (HBV) screening in hospitalized patients.Methods:This cross-sectional study collected and analyzed plasma samples from patients admitted to 10 domestic medical institutions from July 2021 to December 2021. Serological immunoassay and nucleic acid screening were used to simultaneously detect hepatitis B markers such as hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B e Antigen (HBeAg), hepatitis B e antibody (HBeAb), hepatitis B core antibody (HBcAb),and HBV DNA. Statistical analysis was performed on the serology, nucleic acid test results and clinical information of the patients.Results:Of the 8 655 collected samples, HBsAg was positive in 216 (2.50%) samples,HBV DNA was positive in 238 (2.75%) samples ( P>0.05); 210 (2.43%) samples were positive for both HBsAg and HBV DNA, 28 (0.32%) were HBsAg negative and HBV DNA positive, 6 cases (0.07%) were HBsAg positive and HBV DNA negative. Conclusion:These results indicate that the HBV DNA testing is equally effective as hepatitis B virus serological detection for hepatitis B virus screening in hospitalized patients.

Objective:This multi-centre study was conducted to assess the efficacy of various preoperative/pre-transfusion screening methods for blood transmitted disease.Methods:From July 2021 to December 2021, plasma samples of patients admitted to 10 hospitals were collected for screening preoperative/pre-transfusion blood transmitted disease. Nucleic acid detection technology was used to detect hepatitis B virus (HBV) DNA, hepatitis C virus (HCV) RNA and human immunodeficiency virus (HIV)(1+2) RNA, and the results were compared with the immuno-serological methods. χ 2 test and Kappa test were used to analyze the efficacy of these two methods. Results:A total of 8 655 valid specimens were collected from 10 hospitals. There was a statistically significant difference in the positive detection rate of HCV between the two methods ( P<0.001). There was no significant difference in the positive detection rate of HBV and HIV assessed by the two methods ( P>0.05), but the number of positive cases detected by HBV DNA and HIV RNA (218 and 4 cases) was significantly higher than the corresponding serological results (216 and 2 cases). At the same time, there were HBV, HCV and HIV immuno-serological omissions by the immuno-serological methods, among which 28 cases were HBsAg negative and HBV DNA positive, 2 cases were HCV antibody negative and HCV RNA positive, and 2 cases were HIV antigen/antibody negative and HIV RNA positive. In addition, in the 66 samples with inconsistent results from the two detection methods, 83.3% (55/66), 68.2% (45/66), 63.6% (42/66) and 62.1% (41/66) of patients aged was>45 years, tumor, surgery and male, respectively. Conclusions:Compared with immuno-serological tests, nucleic acid tests have the advantage in terms of sensitivity on detecting HBV, HCV and HIV infection and could reduce missed detection. The risk of transmission can be reduced by adding HBV, HCV, and HIV nucleic acid tests to preoperative/pre-transfusion immuno-serological tests screening for patients over 45 years of age and tumor patients.

Objective:To compare the cost-effectiveness of hospitalized Chinese patients undergoing nucleic acid screening strategies for hepatitis B and hepatitis C, immunological screening strategy, and no screening strategy under different willingness to pay (WTP). The results might aid to decision-making for the optimal strategy.Methods:In this study, nucleic acid screening, immunological screening and no screening were used as screening strategies, and China′s GDP in 2021 (80 976 yuan) was used as the threshold of WTP to construct a Markov model. After introducing parameters related to the diagnosis and treatment of hepatitis B and C in inpatients, a cohort population of 100 000 inpatients was simulated by TreeAge Pro 2021 software, the total cost, total health effects, incremental cost-effectiveness ratio and average cost-effectiveness ratio of different screening strategies were calculated, and cost-effectiveness analysis was conducted. Univariate and probabilistic sensitivity analysis were used to assess the impact of parameter uncertainty on the final results.Results:Compared with the non-screening strategy, the incremental total cost of the hepatitis B immunological screening strategy for cohort patients was 11 049 536 yuan, and the incremental cost-effectiveness ratio was 24 762 yuan/quality-adjusted life years (QALY), while the total incremental cost of nucleic acid screening was 19 208 059 yuan, and the incremental cost-effectiveness ratio was 29 873 yuan/QALY; the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 834 yuan/QALY. Compared with the non-screening strategy, the incremental cost-effectiveness ratio of hepatitis C immunological screening strategy was 5 731 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening strategy was 8 722 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 591 yuan/QALY. The results of probabilistic sensitivity analysis showed that when the cost of nucleic acid testing exceeded 214.53 yuan, it was not cost-effective to perform hepatitis B nucleic acid screening under the WTP as 1 fold GDP. When the cost of nucleic acid testing exceeded 132.18 yuan, it was not cost-effective to conduct hepatitis C screening under the WTP as 1 fold GDP.Conclusions:Nucleic acid screening strategy can achieve more cost-effectiveness and is worthy of vigorous promotion. Compared with no screening, both the nucleic acid and immunological screening strategies are cost-effective, and hepatitis nucleic acid screening is the optimal strategy for hospitalized patients.

Objective:To investigate the clinical manifestations and pathogenic gene mutation sites of familial cavernous hemangioma by a pedigree study of this disease.Methods:A family of cerebral cavernous hemangioma who was admitted to the Department of Neurology of the First Affiliated Hospital of Henan University of Science and Technology in April 2019 was diagnosed as cerebral cavernous hemangioma type 1 based on clinical manifestations and head magnetic resonance imaging (MRI), diffusion weighted imaging and susceptibility weighted imaging screening. According to Zabramski classification criteria, the family′s clinical data were collected and genes were sequenced.Results:A 58-year-old female proband had dizziness and headache as the main symptoms, her daughter and son had no clinical symptoms, and her granddaughter had clinical manifestations of cerebral hemorrhage and seizures. The proband and her family members showed multiple cavernous hemangioma on cranial MRI,and the p.L436fs mutation in the KRIT1 gene of familial cerebral cavernous malformation type 1 was confirmed through genetic examination, which was consistent with the Zabramski typing results based on head MRI. The mutation site of the familial spongiform malformation type 1 pathogenic gene was found to be p.L436fs in KRIT1 gene, which has not been reported in familial cerebral cavernous hemangioma type 1 until now.Conclusion:A new p.L436fs mutation of KRIT1 gene was found in familial cerebral cavernous malformation type 1, which expands understanding of the clinical manifestations and pathogenic gene mutation sites of familial cavernous hemangioma.