Objective: To investigate the impact of extracurricular physical activity on heart rate variability (HRV) among primary and secondary school students in Chengdu City, so ao to provide references for scientific exercise prescription. Methods: Using a convenient sampling method, 1 323 primary and secondary students were enrolled from central Chengdu who underwent physical fitness assessments at Sichuan Provincial Institute of Sports Science from September 2020 to January 2022. According to the standards of the National Physical Fitness Monitoring Center, boys and girls were divided into groups with and without extracurricular physical exercise habits. HRV was monitored using the SA-3000P device. Key HRV parameters were evaluated separately by gender, including standard deviation of normal to normal intervals (SDNN), root mean square of successive differences (rMSSD), total power (TP), low frequency power (LF) and high frequency power (HF). Statistical analyses were employed by t-test, Mann-Whitney U-test and Chi square test. Results: lgSDNN, lgrMSSD, TP, LF and HF in the group without extracurricular physical exercise habit [boys:(1.67±0.13)ms, (1.59±0.20)ms, (7.34±0.73)ms 2, (6.11±0.74)ms 2, (6.05±0.87)ms 2; girls:(1.67± 0.13)ms , (1.59±0.19)ms, (7.35±0.60)ms 2, (6.06±0.69)ms 2, (6.12±0.87)ms 2] were lower than those in the group with extracurricular physical exercise habit [boys:(1.75±0.13)ms, (1.72±0.18)ms, (7.69±0.62)ms 2, (6.41±0.76)ms 2, (6.44±0.79)ms 2；girls:(1.73±0.13)ms, (1.68±0.20)ms, (7.60±0.65)ms 2, (6.26±0.86)ms 2, (6.36±0.90)ms 2] ( t =-8.24, -8.75, -6.54, -5.35 , -6.33；-5.10，-4.90，-4.47，-2.71，-2.93, all P ＜0.01). Only the group of boys without extracurricular physical exercise habits showed a decrease in lgLF/HF [0.04(-0.19,0.27)] compared to the group with extracurricular physical exercise habits [ -0.03 (-0.25,0.20)] ( Z=-2.01, P <0.05). When the score classes of autonomic nerve activity, stress index and fatigue index were compared between boys and girls groups without and with extracurricular physical exercise habits, the proportion of boys normal and above scores increased from 79.3%, 84.1%, 71.8% to 91.4%, 95.7%, 87.3%, respectively, and the differences were statistically significant ( χ 2=47.42, 63.66, 38.28); the proportion of girls normal score and above increased from 79.8%, 85.7%, 75.0% to 85.4%, 92.1%, 79.4%, and the differences were statistically significant ( χ 2=48.31, 22.18, 22.22) (all P <0.01). Conclusion The primary and secondary school students who have the habit of extracurricular physical exercise have enhanced compliance in indicators related to HRV, showing more complex heart rate variability.

Objective To investigate the effects of low-dose ionizing radiation on the thyroid status and hormone levels of radiation workers. Methods Radiation workers who underwent occupational health examinations at a hospital in Guangzhou from 2015 to 2022 were selected as the subjects of this study. The levels of FT3, FT4 and TSH were analyzed, and the thyroid abnormality status of radiation workers in different groups were compared. Results A total of 1152 participants were included in this study, consisting of 885 (76.82%) males and 267 (23.18%) females, with an average age of (35.26 ± 10.16) years. The prevalence of thyroid abnormalities was 9.38%, which was significantly higher in females (13.86%) than in males (8.02%) (P < 0.05). The TSH level of females [(2.15 ± 1.29) mIU/L] was higher than that of males [(1.85 ± 1.20) mIU/L], while the levels of FT3 [(5.10 ± 0.64) pmol/L] and FT4 [(15.84 ± 2.32) pmol/L] in females were lower than those in males [(5.23 ± 0.63) pmol/L and (16.61 ± 2.75) pmol/L, P < 0.05]. The FT3 of industrial workers [(5.25 ± 0.63) pmol/L] was higher than that of medical workers [(5.10 ± 0.63) pmol/L], while the TSH of industrial workers [(1.80 ± 1.12) mIU/L] was lower than that of medical workers [(2.15 ± 1.37) mIU/L]. FT4 levels decreased with increasing age and duration of occupational exposure. Multivariable logistic regression analysis revealed that sex was a significant independent predictor of thyroid abnormalities among radiation workers. Female workers were more likely to experience thyroid abnormalities (β = −0.62, P < 0.05). Conclusion Low-dose ionizing radiation may have a certain impact on the thyroid status of radiation workers, especially for female workers, which requires further attention and research.

Addressing the enduring challenge of evaluating traditional Chinese medicines (TCMs), the integrated evidence chain-based effectiveness evaluation of TCMs (Eff-iEC) has emerged. This paper explored its capacity through a demonstration study that evaluated the effectiveness evidence of six commonly used anti-hepatic fibrosis Chinese patent medicines (CPMs), including Biejiajian Pill (BP), Dahuang Zhechong Pill (DZP), Biejia Ruangan Compound (BRC), Fuzheng Huayu Capsule (FHC), Anluo Huaxian Pill (AHP), and Heluo Shugan Capsule (HSC), using both Eff-iEC and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The recognition of these CPMs within the TCM academic community was also assessed through their inclusion in relevant medical documents. Results showed that the evidence of BRC and FHC received higher assessments in both Eff-iEC and GRADE system, while the assessments for others varied. Analysis of community recognition revealed that Eff-iEC more accurately reflects the clinical value of these CPMs, exhibiting superior evaluative capabilities. By breaking through the conventional pattern of TCMs effectiveness evaluation, Eff-iEC offers a novel epistemology that better aligns with the clinical realities and reasoning of TCMs, providing a coherent methodology for clinical decision-making, new drug evaluations, and health policy formulation.

OBJECTIVES: To detect prfA and hly toxin genes of Listeria monocytogenes using polymerase chain reaction (PCR) and colloidal gold technology. METHODS: L. monocytogenes DNA was extracted by boiling method. With prfA and hly of L. monocytogenes as the target genes, the 5' ends of upstream and downstream primers of prfA gene were labeled with 6-FAM and biotin, and the 5' ends of upstream and downstream primers of hly gene were labeled with digoxin and biotin, respectively, to establish the toxin gene detection method. Using cloning transformation, sequencing analysis, cloning of positive control products, the detection kid was developed and its specificity, sensitivity, reproducibility and stability were tested, followed by verification with sample testing. RESULTS: The concentration of L. monocytogenes DNA extracted by boiling method was 148.81±0.97 ng/μL, and the A₂₆₀/A₂₈₀ ratio ranged from 1.8 to 2.0. The PCR products showed a 100% homology with the gene sequences in GenBank database after cloning, transformation and sequencing. The colloidal gold strip yielded positive results only for L. monocytogenes samples without cross-reactions with Staphylococcus aureus, Escherichia coli or Bacillus cereus, and its minimum detection limit was 10^-2 ng/μL, demonstrating a 10-fold greater sensitivity of the test than agarose gel electrophoresis. The test also showed good reproducibility of the results when performed by different operators with good stability of the test strips after storage for 6 to 12 months. The test results showed that this kit could accurately and quickly detect L.monocytogenes in the test samples. CONCLUSIONS The detection kit developed in this study can simultaneously detect prfA and hly toxin genes of L. monocytogenes with good specificity, sensitivity, reproducibility and stability for use in food safety inspection.
Listeria monocytogenes/isolation & purification* ; Gold Colloid ; Bacterial Toxins/genetics* ; Polymerase Chain Reaction/methods* ; Hemolysin Proteins/genetics* ; Bacterial Proteins/genetics* ; DNA, Bacterial/genetics* ; Food Microbiology ; Heat-Shock Proteins

OBJECTIVE: To investigate the current status of early pain and agitation management in critically ill patients in Guizhou Province. METHODS: A retrospective study was performed using data collected from a quality control activity conducted between April and June 2021 in non-provincial public hospitals with general intensive care unit (ICU) in Guizhou Province. Hospital-level data included hospital name and grade, ICU staffing, and number of ICU beds. Patient-level data included characteristics of patients treated in the general ICU on the day of the survey (e.g., age, sex, primary diagnosis), as well as pain and agitation assessments and the types of analgesic and sedative medications administered within 24 hours of ICU admission. RESULTS: A total of 947 critically ill ICU patients from 145 hospitals were included, among which 104 were secondary-level hospitals and 41 were tertiary-level hospitals. Within 24 hours of ICU admission, 312 (32.9%) critically ill patients received pain assessments, and 277 (29.3%) received agitation assessments. Among the pain assessment tools, the critical care pain observation tool (CPOT) was used in 44.2% (138/312) of critically ill ICU patients, with a significantly higher usage rate in tertiary hospitals compared to secondary hospitals [52.3% (69/132) vs. 38.3% (69/180), P < 0.05]. The Richmond agitation-sedation scale (RASS) was used in 93.8% (260/277) of critically ill ICU patients for agitation assessment, with no significant difference between hospital levels. Among the 947 critically ill patients, 592 (62.5%) received intravenous analgesics within 24 hours, with remifentanil being the most commonly used [42.9% (254/592)]; 510 (53.9%) received intravenous sedatives, with midazolam being the most frequently used [60.8% (310/510)]. Mechanical ventilation data were available for 932 critically ill patients, of whom 579 (62.1%) received mechanical ventilation and 353 (37.9%) did not. Compared with non-ventilated patients, ventilated patients had significantly higher rates of analgesic and sedative use [analgesics: 77.9% (451/579) vs. 38.8% (137/353); sedatives: 71.8% (416/579) vs. 25.8% (91/353); both P < 0.05]. In terms of analgesic selection, ventilated patients were more likely to receive strong opioids than non-ventilated patients [85.8% (95/137) vs. 69.3% (387/451), P < 0.05]. For sedatives, ventilated patients preferred midazolam [66.6% (277/416)], whereas non-ventilated patients more often received dexmedetomidine [45.1 (41/91)]. Blood pressure within 24 hours of ICU admission were available for 822 critically ill patients, of whom 245 (29.8%) had hypotension and 577 (70.2%) did not. Compared with non-hypotensive patients, hypotensive patients had significantly higher rates of analgesic and sedative use [analgesics: 74.7% (183/245) vs. 59.8% (345/577); sedatives: 65.7% (161/245) vs. 51.3% (296/577); both P < 0.05], but there was no significant difference in the choice of analgesic or sedative agents between the two groups. CONCLUSIONS The proportion of critically ill ICU patients in Guizhou Province who received standardized pain and agitation assessments was relatively low. The most commonly used assessment tools were CPOT and RASS, while remifentanil and midazolam were the most frequently used analgesic and sedative agents, respectively. Secondary-level hospitals had a lower rate of using standardized pain assessment tools compared to tertiary-level hospitals. Mechanical ventilation and hypotension were associated with the use of analgesic and sedative medications.
Humans ; Critical Illness ; Intensive Care Units ; Analgesics/therapeutic use* ; Hypnotics and Sedatives/therapeutic use* ; Retrospective Studies ; China ; Pain Measurement ; Pain Management ; Female ; Male ; Critical Care ; Middle Aged

ObjectiveTo understand the current situation of medical damage liability disputes involving breach of the duty to inform in China， analyze the factors influencing the types of medical staff’s breach of the duty to inform， and explore the notification problems of medical staff in clinical practice. On these foundations， suggestions were proposed to improve the performance of the duty to inform and reduce medical disputes. MethodsUsing public cases from the China Judgements Online as the data source， the relationship between risk points and types of breach of duty to inform was analyzed using the Chi-square test. Logistic regression analysis was performed to explore the influencing factors of the types of breach of the duty to inform， and qualitative research summarized the specific contents of breach of the duty to inform. ResultsThere were differences in the effects of factors， including whether the patient was hospitalized， whether surgery was performed， whether Intensive Care Unit （ICU） treatment was required， the level of the medical institution， and whether a consultation occurred， on the types of breach of the duty to inform （P<0.05）. Whether surgery was performed was an influencing factor for the types of breach of the duty to inform. Qualitative research showed that the contents of breach of duty to inform primarily involve risk， treatment plan， and deficiencies in disease notification. ConclusionStrengthening the performance of the medical staff’s duty to inform should mainly focus on the medical side， coordinating with multiple parties and taking measures to improve the performance of the duty to inform， to reduce unnecessary medical disputes.

Objective:To investigate influence of different phantoms on the results of quality control for the images of cone beam computed tomography(CBCT)for breast on the basis of quality control for breast CBCT.Methods:Five different manufacturers'phantoms were selected,and they were placed at the position of testing breast in clinical examination to conduct position for phantom according to the method of the national health industry standard WS 818-2023.The analysis focused on the differences of evaluation results of using different phantoms for image quality on the basis of a series of parameters included uniformity,resolution of high contrast,resolution of low contrast,and CT value of water in scanning images of different phantoms.Data collection and image reconstruction were performed respectively by using commonly clinical procedures.Corresponding module images were selected from the reconstructed images of standard breast phantom.The common layer thickness and projection method of the system were set to record and analyze data.Results:The image uniformity of measured results of the five phantoms were respectively 42.37±2.01,-5.83±0.15,3.76±0.15,2.16±0.06,3.60±0.10.The differences of the image uniformities among the five phantoms were statistically significant(F=1310.02,P<0.001),and the differences of the CT values of the measured water among the five phantoms were statistically significant(F=9 846.46,P<0.001).The differences in the resolution of low contrast among them were also statistically significant(F=27.50,P<0.001).However,the results of the resolution of high contrast were stability,and there was no significant difference in that among the five phantoms.Conclusion:The measured results of quality control of different phantoms are different.

Open reduction and internal fixation are the preferred methods for treating intra-articular fractures of the distal humerus. However, in cases of comminuted fractures, open reduction and internal fixation may result in loss of reduction. Although total elbow arthroplasty can be used as an alternative treatment option, total elbow arthroplasty has several limitations, including excessive bone removal, strict weight-bearing restrictions, polyethylene liner wear, and alterations in biomechanical properties. Elbow hemiarthroplasty is emerging as a novel surgical technique, only the distal end of the humerus is replaced while the proximal end of the ulna and radius is retained. Particularly for patients with high functional demands, elbow hemiarthroplasty may be a viable treatment option. This technique is particularly suitable for young patients with severely comminuted and non-reconstructive intra-articular fractures. Postoperative complications of elbow hemiarthroplasty include elbow stiffness, proximal wear of the ulna and radius, and prosthesis loosening, etc. In some cases, total elbow prosthesis revision is required. Existing research has initially confirmed that elbow hemiarthroplasty has certain advantages in terms of safety and elbow joint function recovery. Additionally, to better accommodate the anatomical characteristics of the Chinese population, customized 3D-printed prostheses based on the contralateral distal humerus and the ipsilateral proximal ulna and radius can be utilized. Further research and development of elbow hemiarthroplasty and novel technologies tailored to the Chinese population should be encouraged to enhance the precise treatment of complex elbow injuries in China.

Elbow Triad refers to an elbow dislocation combined with fractures of the radial head and the coronoid process, representing a complex elbow injury. Management of the elbow triad is challenging and often yields poor outcomes, frequently leading to complications such as elbow instability, ulnar nerve injury, and elbow stiffness. The injury mechanism of the elbow triad typically involves a fall on an outstretched arm, subjecting the forearm to supination, axial loading, and valgus stress. This force sequence results in progressive disruption of the elbow's anatomical structures from lateral to medial. Diagnosis requires particular attention to imaging assessment, and special attention should be paid to differentiating coronoid process fractures from elbow dislocation. Currently, there is no independent classification system, and diagnosis often relies on the modified Mason classification for radial head fractures and the Regan-Morrey and O'Driscoll classifications for coronoid process fractures. Non-surgical indications must be strictly defined and include: congruent joint reduction, absence of bony block to motion, a small or non-displaced coronoid fracture fragment, and inherent elbow stability. For the majority of cases requiring surgical treatment, a lateral approach is recommended, with a combined over-the-top approach when necessary. During surgery, the coronoid process fracture, radial head fracture, and lateral soft tissues should be addressed sequentially, with restoration of stability being crucial. Postoperative care should include early functional exercises and pay attention to preventing complications such as elbow instability, traumatic elbow stiffness, and ulnar nerve injury.

Objective To explore the value of ECG-less technology and deep learning image reconstruction(DLIR)algorithm for coronary CT angiography(CCTA).Methods Seventy-one patients with suspected coronary artery disease(CAD)were prospectively enrolled and randomly divided into group A(n=35,underwent CCTA using ECG-less technology)and B(n=36,underwent CCTA using physical electrocardiographic gating).CCTA images of group A were reconstructed using filtered back projection(FBP),adaptive statistical iterative reconstruction V(ASiR-V)(50％blending)and high-strength DLIR(DLIR-H),respectively,while those of group B were reconstructed using conventional ASiR-V(50％blending).The radiatio n doses and examination durations of CCTA were compared between groups.Then subjective and objective evaluation of imaging quality were compared between groups and within group A among 3 reconstruction algorithms.Results No significant difference of radiation dose of CCTA was found between groups(P＞0.05).The examination duration in group A was reduced by approximately 29.37％compared to group B(P＜0.05).No significant difference of subjective image quality scores nor objective evaluation of ASiR-V reconstructed CCTA was detected between groups(all P＞0.05).In group A,compared to FBP algorithm,subjective image quality scores of DLIR-H and ASiR-V upgraded,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)increased and standard deviation(SD)values decreased(all P＜0.05),but no significant difference of CT values was found(all P＞0.05).Conclusion ECG-less technology could significantly shorten CCTA examination duration,while DLIR could reduce image noise and improve image quality of CCTA.