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 To investigate the current level of public awareness regarding nuclear emergency evacuation around a nuclear power plant, analyze the influencing factors, and propose suggestions and countermeasures based on the results. Methods In July 2024, according to the survey protocol and questionnaire developed by the National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, a field-based centralized online questionnaire was administered. A total of 854 residents living near the nuclear power plant were included as survey participants. An analysis of variance was used to compare the impact of different factors on the public knowledge of nuclear radiation and awareness of nuclear emergency evacuation, while the chi-square test was employed to compare differences between groups. Results A total of 854 questionnaires were collected in this study. The survey revealed that the levels of public knowledge about nuclear radiation and awareness of nuclear emergency evacuation around the power plant were relatively low, with average objective awareness rates of 51% and 47%, respectively. In terms of age, the 30-45 years old group had the highest average score, while the group aged 60 and above had the lowest. Regarding education level, the group with primary school education or below had the lowest average score, whereas those with junior college or undergraduate education scored the highest. The internet (73.7%) was the primary source of emergency information for the public, followed by television (61.7%). The majority of the public (85.0%) expressed trust in the government during evacuation and were willing to follow governmental evacuation arrangements. The main reason for this willingness was the belief that the government could provide sufficient emergency supplies. Conclusion The surveyed population exhibited low levels of knowledge regarding nuclear radiation and awareness of nuclear emergency evacuation, with generally low awareness rates. Awareness levels were influenced by factors such as sex, age, educational background, and distance from the nuclear power plant. To enhance public awareness, it is necessary to strengthen science communication related to nuclear radiation and public protective actions in nuclear emergencies. Targeted dissemination strategies with high communication effectiveness, accessibility, and public acceptance should be adopted to gradually enhance public awareness of nuclear radiation and nuclear emergency protective actions.

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 investigate the transfusion and infusion warmer manufacturers, combine the use failures to analyze adverse events, and provide support for enterprise risk management and clinical safe use. METHODS: The sentinels from 7 manufacturing enterprises and 11 medical institutions that participated in Shandong Province's key monitoring program during the "14th Five-Year Plan" period were targeted. This was done by understanding the equipment's principles, structures, and quality control. Additionally, real-world data from January 2019 to December 2023 were collected to count adverse events. RESULTS: During production, there are risks in switching power supply stability and solder joint firmness. Fifteen kinds of faults occurred during use, and common faults such as inability to heat, unable to turn on the machine, and bubbles in the infusion tube accounted for more than 80%. CONCLUSION There are many risk points and failures for transfusion and infusion warmers, so enterprises should improve processes and quality control to address risks, and medical institutions should formulate specifications and maintenance plans to provide targeted theoretical basis for supervision.
Blood Transfusion/instrumentation* ; Risk Factors ; Quality Control ; Humans ; Risk Management ; Equipment Failure

Objective: To investigate the aberrant alterations of microRNAs ( miRNAs) in exosomes derived from bone marrow stromal cells ( BMSCs) in the bone marrow supernatants of patients with acute myeloid leukemia (AML) and their impact on the prognosis of AML patients . Methods: Bone marrow supernatant samples were col- lected from three AML patients and three healthy donors . Exosomes were isolated using a commercial kit , identif- ying the morphology and marker expression , and subjected to miRNA sequencing to determine differentially ex- pressed miRNAs (DE-miRNAs) . The DE-miRNAs were then intersected with the exosomal miRNA expression pro- files of primary AML cells (GSE64029) to exclude AML cell - derived signals and to identify BMSC-derived DE - miRNAs . Subsequently , candidate miRNAs were identified through Cox regression and Lasso regression analyses based on data from The Cancer Genome Atlas (TCGA) . A prognostic risk model for AML was constructed , and pa- tients were stratified into high-risk and low-risk groups according to the median risk score . The prognostic value and clinical relevance of the model were further validated . Finally , the target genes of the candidate miRNAs were pre- dicted , followed by pathway enrichment analysis , construction of key regulatory networks , and correlation analysis between the expression levels of key miRNAs and their corresponding target genes . Results: Isolated exosomes ex- hibited a typical cup-shaped morphology with intact structures with particle size of 30 - 150 nm , and expressed exo- somal markers CD63 , ALIX , and TSG101 . miRNA sequencing identified 103 DE-miRNAs in AML patients com- pared with healthy donors; after intersection with the GSE64029 dataset , 83 BMSC-derived DE-miRNAs were re- tained . Among these , five candidate miRNAs ( miR-25-3p , miR-532-5p , miR-194-5p , miR-10a-5p , and miR- 20a-5p) were used to construct the prognostic model . Kaplan-Meier survival analysis demonstrated significantly lon- ger overall survival in the low-risk group compared with the high-risk group (P < 0. 05) . The areas under the ROC curve for the training/validation cohorts were 0. 80/0. 74 , 0. 80/0. 78 , and 0. 79/0. 64 at 1 , 2 , and 3 years , re- spectively . The prognostic model was significantly associated with risk stratification , patient age , and FAB classifi- cation (P < 0. 05) . KEGG pathway enrichment revealed that target genes of the candidate miRNAs were closely linked to cancer-related signaling pathways , including hepatocellular carcinoma , breast cancer , and non-small cell lung cancer. Correlation analysis indicated that the candidate miRNAs were significantly associated with key genes such as HIF1A , CREB1 , PIK3CA , IGF1R , PIK3R1 , TIAM1 , CRK , and PTEN (P < 0. 05) . Conclusion AML patients exhibit distinct miRNA expression profiles in BMSC-derived exosomes . A five-miRNA signature ( miR-25 - 3p , miR-532-5p , miR-194-5p , miR-10a-5p , and miR-20a-5p) demonstrates robust prognostic performance , sup- porting its potential clinical utility in risk stratification and outcome prediction for AML.

OBJECTIVE To observe the effects of liraglutide on cardiovascular metabolism， left ventricular structure and function of non-alcoholic fatty liver disease （NAFLD） patients with type 2 diabetes mellitus （T2DM）. METHODS Totally 351 NAFLD patients with T2DM were enrolled retrospectively， who visited the Department of Endocrinology in our hospital from January 2019 to December 2022. They were divided into control group （196 cases） and observation group （155 cases） according to different treatment regimens. The control group received conventional standard treatment， and the observation group was additionally given Liraglutide injection 0.6 mg/d subcutaneously once a day based on the control group， adjusted to 1.2 mg/d after 7 days. Both groups received regular treatment for more than 12 months. The propensity matching method was used to match the two groups of patients at a ratio of 1∶1. The cardiovascular metabolism indexes and cardiac ultrasound parameters were compared， and the correlation between left ventricular structure， function parameters and cardiovascular metabolism indexes was analyzed. RESULTS After propensity score matching， there was no significant difference in baseline clinical data between the two groups （each 155 cases） before treatment （P＞0.05）. After 12 months of treatment， the waist circumference， weight， body mass index （BMI）， systolic blood pressure （SBP）， fasting blood glucose （FBG）， glycosylated hemoglobin （HbA1c） and triglyceride （TG） of both groups， as well as the diastolic blood pressure （DBP）， total cholesterol （TC）， uric acid （UA） and left ventricular mass （LVM） of the observation group， exhibited a significant decrease compared to pre-treatment levels （P＜0.05）. The high-density lipoprotein cholesterol （HDL-C）， estimated glomerular filtration rate （eGFR）， and E/A ratio in both groups， as well as the aspartate aminotransferase （AST） in the control group and the left ventricular ejection fraction （LVEF） in the observation group， were all significantly increased compared with before treatment in the same group （P＜0.05）. Moreover， the improvement of the above indicators （except for TG and SBP） in the observation group was generally more significant than those in the control group （P＜0.05）. The left ventricular structure and functional parameters （LVM， LVEF， E/A ratio） of the two groups before and after treatment had varying degrees of correlation with the patients’ waist circumference， body weight， BMI， SBP， FBG and HbA1c. Moreover， BMI （observation group： β＝ 0.229， P＝0.004） and SBP （control group： β＝0.240， P＝0.004； observation group： β＝0.226， P＝0.007） were independent influential factors for LVM of the patients. CONCLUSIONS Liraglutide combined with conventional standard treatment can effectively control blood glucose in NAFLD patients with T2DM， reduce waist circumference， body weight and blood pressure， improve blood lipid disorders， and protect their cardiac structure and function.

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 explore high-risk sexual behaviors of HIV/AIDS and related factors in young students in Guangzhou.Methods:A cross-sectional survey was conducted in 5 different types of Guangzhou colleges by convenience sampling with minimum number of classes per grade and 600 samples per school from September to November 2021. The R 4.2.2 software was used to consolidate databases. Simultaneously, a logistic regression model and a decision tree algorithm model, stratifying by whether sexual behaviors had occurred before, were constructed. In each layer, the prediction performance of the two models was evaluated through area under receiver operating characteristic and the confusion matrix, and then the model with high prediction performance was retained.Results:A total of 7 346 students were surveyed. The proportion of the respondents reporting sexual experience were 9.08% (667/7 346), in whom 26.24% (175/667) had risky sexual activity in the past year. The decision tree algorithm model performs well in predicting whether high-risk sexual behaviors have occurred in the past year. When the complexity parameter value is 0.018, and nsplit reaches 4, which means there are 5 leaf nodes in the model, the cross error of the tree will be the smallest. The first best grouping variable in the decision tree was whether to use condoms throughout the first sexual behavior. If condoms were used at their sexual debut, but homosexual practices have occurred in the past year, the probability of risky sexual behavior will increase. If homosexual practices have not occurred in the past year, but the age of sexual debut was below 18 years old while the period of HIV education was after high school, the probability of risk sexual behavior will also increase.Conclusions:AIDS-related risky behaviors of young students still deserved attention. The experience of sexual debut and whether AIDS-related health education has been received before the sexual debut were significant predictors for the occurrence of high-risk sexual behavior. The decision tree algorithm model has particular applicability for predicting and screening potential risk populations.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.