Objective: To investigate the characteristics of public health emergencies in Jinhua City, Zhejiang Province from 2014 to 2023, so as to provide the reference for prevention and control of public health emergencies. Methods: Data of public health emergencies and related information in Jinhua City from 2014 to 2023 were collected through Emergency Public Reporting System of Chinese Disease Prevention and Control Information System. Attack rates, and distribution of time, areas and places were descriptively analyzed. Results: A total of 276 public health emergencies were reported in Jinhua City from 2014 to 2023. There were 10 324 reported cases and 7 deaths, with an attack rate of 0.32%. There were 53 Ⅳ-level (19.20%) and 223 unclassified public health emergencies (80.80%). Infectious disease emergencies were predominant types, accounting for 97.83% (270 events). The three most common infectious disease emergencies were other infectious diarrhea (42.03%), influenza (21.01%) and COVID-19 (16.30%). The reported public health emergencies peaked in November and December, with 66 and 45 events reported, respectively. The three most counties (cities, districts) included Yiwu City, Wucheng District and Lanxi City, accounting for 24.28% (67 events), 18.48% (51 events) and 11.96% (33 events), respectively. School and preschool institutions were predominant places where public health emergencies occurred (198 events, 71.74%). Conclusions The public health emergencies in Jinhua City from 2014 to 2023 were Ⅳ-level and unclassified emergencies, and infectious disease emergencies were predominant. November and December were the peak reporting periods, and schools and preschool institutions were the main places where these events occurred.

The European Society of Cardiology (ESC) released the "2024 ESC guidelines for the management of elevated blood pressure and hypertension" on August 30, 2024. This guideline updates the 2018 "Guidelines for the management of arterial hypertension." One notable update is the introduction of the concept of "elevated blood pressure" (120-139/70-89 mm Hg). Additionally, a new systolic blood pressure target range of 120-129 mm Hg has been proposed for most patients receiving antihypertensive treatment. The guideline also includes numerous additions or revisions in areas such as non-pharmacological interventions and device-based treatments for hypertension. This article interprets the guideline's recommendations on definition and classification of elevated blood pressure and hypertension, and cardiovascular disease risk assessment, diagnosing hypertension and investigating underlying causes, preventing and treating elevated blood pressure and hypertension. We provide a comparison interpretation with the 2018 "Guidelines for the management of arterial hypertension" and the "2017 ACC/AHA guideline on the prevention, detection, evaluation, and management of high blood pressure in adults."

Objective By combining biological detection and imaging evaluation, a clinical prediction model is constructed based on a large cohort to improve the accuracy of distinguishing between benign and malignant pulmonary nodules. Methods A retrospective analysis was conducted on the clinical data of the 32 627 patients with pulmonary nodules who underwent chest CT and testing for 7 types of lung cancer-related serum autoantibodies (7-AABs) at our hospital from January 2020 to April 2024. The univariate and multivariate logistic regression models were performed to screen independent risk factors for benign and malignant pulmonary nodules, based on which a nomogram model was established. The performance of the model was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Results A total of 1 017 patients with pulmonary nodules were included in the study. The training set consisted of 712 patients, including 291 males and 421 females, with a mean age of (58±12) years. The validation set included 305 patients, comprising 129 males and 176 females, with a mean age of (58±13) years. Univariate ROC curve analysis indicated that the combination of CT and 7-AABs testing achieved the highest area under the curve (AUC) value (0.794), surpassing the diagnostic efficacy of CT alone (AUC=0.667) or 7-AABs alone (AUC=0.514). Multivariate logistic regression analysis showed that radiological nodule diameter, nodule nature, and CT combined with 7-AABs detection were independent predictors, which were used to construct a nomogram prediction model. The AUC values for this model were 0.826 and 0.862 in the training and validation sets, respectively, demonstrating excellent performance in DCA. Conclusion The combination of 7-AABs with CT significantly enhances the accuracy of distinguishing between benign and malignant pulmonary nodules. The developed predictive model provides strong support for clinical decision-making and contributes to achieving precise diagnosis and treatment of pulmonary nodules.

Objective: To understand the growth and development levels of four physical measurements in children aged 3-6 years in China, so as to provide a reference for child nutrition improvement and health promotion. Methods: A stratified random sampling method was used to collect physical measurement data from 120 kindergartens 25 842 children aged 3-6 years across 24 provinces and cities in seven natural geographical regions of North China, Northeast China, East China, Central China, South China, Southwest China and Northwest China from 2020 to 2023. The development levels of head circumference, chest circumference, waist circumference, and hip circumference were evaluated using a grading method. The analysis of gender and age differences was conducted using Mann-Whitney U- test and Kruskal-Wallis test, and the comparison of abnormal detection rates for different genders was conducted using Chi square test. Results: The distribution range of children aged 3-6 was 51.74(50.08, 53.33) cm in terms of head circumference, 55.73(52.09, 59.04) cm in terms of chest circumference, 53.04(48.92, 56.40) cm in terms of waist circumference, and 59.36(56.30, 62.32) cm in terms of hip circumference. The detection rate of abnormal head circumference in boys and girls aged 3-6 years old was relatively high (19.71%-42.02%), and the detection rate of abnormal physical circumference development levels in boys was higher than that in girls of all ages ( χ 2=5.63-83.35, P <0.05). The detection rate of abnormal hip circumference (4.89%-6.53%) and chest circumference (4.51%-6.38%) in boys and girls aged 3-6 was relatively low, and there was no statistically significant difference in the abnormal rate between different ages and genders ( χ 2=0.00-1.61, 0.00-3.71, P >0.05). The detection rate of abnormal waist circumference in boys and girls aged 3-6 was relatively high (13.70%-42.45%), and the detection rate of abnormal waist circumference in girls was higher than that in boys aged 4-6 groups ( χ 2=10.49-58.18, P < 0.05). Conclusions The overall physical development of children aged 3-6 years in China is improving, but the abnormal detection rates for head circumference and waist circumference are relatively high. Child healthcare should focus on preventing and treating abdominal obesity, with differentiated health intervention strategies based on different age groups and genders.

Objective: Mortality surveillance was established in the state of Victoria just before the COVID-19 pandemic. Here, we describe the establishment of this surveillance system, justify the modelling approach selected, and provide examples of how the interpretation of changes in mortality rates during the pandemic was influenced by the model chosen. Methods: Registered deaths occurring in Victoria from 1 January 2015 to 31 December 2020 were sourced from the Victoria Death Index. Observed mortality rates were compared to a raw historical 5-year mean and to predicted means estimated from a seasonal robust regression. Differences between the observed mortality rate and the historical mean (delta-MR) and excess mortality rate from the observed and predicted rates were assessed. Results: There were 20 375 COVID-19 cases notified in Victoria as of 31 December 2020, of whom 748 (3.7%) died. Victorians aged >=85 years experienced the highest case fatality ratio (34%). Mean observed mortality rates in 2020 (MR: 11.6; 95% confidence interval [CI]: 11.4, 11.9) were slightly reduced when compared with the annual rate expected using the historical mean method (mean MR: 12.2; 95% CI: 12.1, 12.3; delta-MR: -0.57; 95% CI: -0.77, -0.38), but not from the rate expected using the robust regression (estimated MR: 11.7; 95% prediction interval [PI]: 11.5, 11.9; EMR: -0.05; 95% CI: -0.26, 0.16). The two methods yielded opposing interpretations for some causes, including cardiovascular and cancer mortality. Discussion: Interpretation of how pandemic restrictions impacted mortality in Victoria in 2020 is influenced by the method of estimation. Time-series approaches are preferential because they account for population trends in mortality over time.

Background: Currently, colorectal cancer (CRC) ranks as the third most common cancer and the second leading cause of cancer-related mortality worldwide. CRC frequently metastasizes to the liver (50%), lungs (10–15%), peritoneum (4%), bones (10.7%–23.7%), brain (0.3%–6%), and spinal cord. Approximately 35% of CRC cases are diagnosed before distant metastasis, 36% upon lymph node involvement, and 23% after distant organ metastasis. Although several studies have established primary tumor models in mice in our country, there are limited studies on experimental lung metastasis models, prompting the need for this research. Aim: To establish and evaluate a lung metastasis model of colorectal cancer in C57BL/6J mice using the MC38 cell line. Materials and Methods: This study was conducted at the Institute of Biomedical Sciences, Mongolian National University of Medical Sciences. Approval was obtained from the Ethics Review Board of the Mongolian National University of Medical Sciences (2023/3-09) and all laboratory safety regulations and protocols were strictly followed. Male C57BL/6J mice bred at the Experimental Animal Center of Mongolian National University of Medical Sciences were used. MC38 murine colorectal carcinoma cells were cultured and injected intravenously (via the tail vein) at a concentration of 0.25×10⁶ cells per mouse (n=12) to induce lung metastasis. Histological analysis was subsequently performed. Results: Histological examination revealed significant alterations in lung tissue architecture, characterized by areas of dense infiltration by pleomorphic, hyperchromatic cells, disrupting the normal alveolar structure. No histological abnormalities were observed in other organs. Conclusion Intravenous injection of MC38 colorectal adenocarcinoma cells into the tail vein of C57BL/6J mice successfully induced lung metastases, characterized by hyperchromatic, pleomorphic cell infiltrates forming glandular structures within the lung parenchyma.

Background: The corneal endothelium, the innermost layer of the cornea, is composed of hexagonal cells that maintain corneal transparency and provide essential nutrients to the stroma. These cells play a critical role in preserving visual acuity. Previous studies have demonstrated that endothelial cells do not regenerate, and their density progressively declines with age, accompanied by morphological alterations. Given the individual variability in corneal thickness and endothelial morphology, establishing normative reference values is crucial for diagnosing corneal diseases, planning corneal transplantation, and optimizing surgical strategies for cataract surgery. However, there is a scarcity of data regarding central corneal thickness, endothelial cell density, and cell morphology among Mongolian adults. This knowledge gap provided the rationale for the present study. Aim: To study the central corneal thickness and endothelial cell morphology in Mongolian adults. Materials and Methods: This study was conducted using an analytical cross-sectional design. A total of 198 individuals aged 20 to 79 years were randomly selected, and comprehensive ophthalmic examinations were performed. Corneal parameters—including central corneal thickness, endothelial cell density, mean cell area, coefficient of variation of cell size, and the percentage of hexagonal cells—were quantitatively assessed using a non-contact specular microscope. Ethical approval was obtained from the Research Ethics Committee of the Mongolian National University of Medical Sciences (Approval No. 2024/3-06), and written informed consent was obtained from all participants prior to enrollment. Results: The mean age of the study participants was 48.4±14.5 years, with 48.9% (n=97) being male and 51.1% (n=101) female. In the central cornea, the mean endothelial cell density (ECD) was 2857.14±291.49 cells/mm², the mean central corneal thickness (CCT) was 526.25±33.67 µm, the mean cell area was 335.11±37.82 µm², the percentage of hexagonal cells was 64.81±3.94%, and the coefficient of variation (CV) in cell size was 0.31±0.04. With increasing age, both ECD and the percentage of hexagonal cells showed a statistically significant decline, while the mean cell area and CV demon strated a significant inverse correlation (P=0.0001). No statistically significant differences were observed in corneal thickness or endothelial morphometric parameters between the right and left eyes or between sexes. Among the Mongolian adults, the endothelial cell density decreases by approximately 0.3% annually (r=0.2107, p<0.0001). Conclusion 1. The mean central corneal thickness (CCT) in adult Mongolian individuals was 526.25±33.67 μm, which is comparable to reported averages from other populations. However, the mean endothelial cell density (ECD) was relatively higher, measured at 2857.14±291.49 cells/mm². 2. With advancing age, a progressive decline in central endothelial cell density and the proportion of hexagonal cells was observed, whereas the coefficient of variation (CV) in cell size and the mean cell area showed a corresponding increase

Background: Globally, approximately 684,000 deaths occur annually due to falls. In Mongolia, 47 individual aged between 45 and 85 have died as a result of falls. Therefore, there is a pressing need to assess fall risks among the general population in Mongolia and identify risk factors to prevent accidents and injuries. Aim: To assess the risk of falls among individuals aged 45 years and older who are receiving care at tertiary-level referral hospitals in Ulaanbaatar, Mongolia. Materials and Methods: A cross-sectional study was conducted involving 408 participants aged 45 years and above who were attending tertiary-level hospitals in Ulaanbaatar. Fall risk was assessed using the internationally recognized Falls Risk Assessment Tool (FRAT) questionnaire. Data were analyzed using SPSS version 26.0. Results: The mean age of the participants was 59.24±6.54 years; 40% were male and 60% were female. Among the participants, 45.3% (n=185) were categorized as low risk, 33.6% (n=137) as moderate risk, and 21.1% (n=86) as high risk for falls. Logistic regression analysis was performed to identify significant risk factors associated with falls. Key factors included: slippery shoe soles (OR=0.226, 95% CI: 0.119–0.428, p=0.001), performing unexpected hazardous movements while changing positions (OR=0.262, 95% CI: 0.143–0.480, p=0.001), use of assistive walking devices (OR=0.209, 95% CI: 0.110–0.397, p=0.001), anxiety or unstable mental status (OR=0.276, 95% CI: 0.148–0.514, p=0.001), tendency to resist instructions or behave stubbornly (OR=0.330, 95% CI: 0.183–0.596, p=0.001), difficulty in recognizing the surrounding environment (OR=0.354, 95% CI: 0.187–0.671, p=0.001), and a history of previous falls (OR=4.737, 95% CI: 2.151–10.429). Conclusion 1. Based on the FRAT assesment, 45.3% of participants had low fall risk, 33.6% moderate risk, and 21.1% high risk. 2. Risk factors such as sudden movements, the use of assistive devices, and emotional instability significantly influence fall risk assessment, and individuals with a history of previous falls are 4.7 times more likely to experience another fall.

Background: According to the World Health Organization (WHO), 99 percent of the world’s population is exposed to air that exceeds WHO recommendations, with low- and middle-income countries being the most affected. The main causes of indoor air pollution include human activities such as fuel burning, cooking, cleaning, and smoking; housing characteristics such as walls, floors, ceilings, and furniture; ventilation; and outdoor air pollution. Aim : To assess PM1 and PM10 concentrations in 120 selected households in Ulaanbaatar. Materials and Methods : Indoor PM1 and PM10 concentrations were measured using Purple Air real-time sensors in randomly selected Ulaanbaatar households between October 2023 and January 2024. Supplementary data on factors affecting the PM2.5 concentration were collected via questionnaires. Each measurement was taken in 10-minute intervals, yielding 51,309 data for analysis. Results : PM1 concentrations were measured at 55.5±53.2 μg/m³ in gers, 54.9 ± 46.7 μg/m³ in houses, and 31.6±40.1 μg//m³ in apartments (p<0.001) and measuring PM10 concentrations were 110.6±108.6 μg/m³ in gers, 110.6±96.7 μg/m³ in houses, and 62.2±83.0 μg/m³ in apartments (p<0.001) When considering the concentration of PM1, PM10 by heating type, PM1 was 55.3±50.1 μg/m³ and PM10 was 110.6±103.0 μg/m³ in households with stoves and furnaces, and PM1 was 31.6±40.1 μg/m³ and PM10 was 62.2±83.0 μg/m³ in households connected to the central heating system (p<0.001). Regarding the months of measurement, the highest concentration was observed in December 2023, at 77.1±94.1 μg/m³. The highest concentrations for both PM₁ and PM₁₀ were recorded in January 2024, at PM₁: 64.8±55.1 μg/m³, PM₁₀: 131.4±116.0 μg/m³. Conclusion 1. Indoor PM10 concentrations in residential environments in Ulaanbaatar city were within the MNS4585:2016 Air Quality Standard, however, it was exceeded the WHO air quality guidelines, indicating an excessive risk of increasing morbidity and mortality among the population. 2. Indoor PM1 and PM10 concentrations in residential environments in Ulaanbaatar varies depending on location, type of housing, type of heating, and month of measurement.

Background: The most common clinical manifestation of HCV infection, which includes both hepatic and extrahepatic manifestations, is mixed cryoglobulinemia, which is characterized by the precipitation of certain proteins in the blood at temperatures below 37°C (in vitro), aggregation, and deposition in the walls of small and medium-sized vessels, causing vasculitis, which is clinically manifested by a triad of joint pain, fatigue, and rash on the soles of the feet. Cryoglobulinemia is commonly diagnosed in people with HCV infection, with a prevalence ranging from 10% to 70%. Vasculitis that occurs when cryoglobulinemia is detected mainly affects the small vessels of the skin, kidneys, and peripheral nerves, causing complications in other organ systems. Aim : To determine the prevalence of cryoglobulinemia in people with HCV infection, study it in relation to the stage of liver fibrosis, and determine its clinical relevance. Materials and Methods : 200 chronic HCV infected individuals were included in the study according to the inclusion and exclusion criteria. After obtaining informed consent from each participant, a questionnaire was used to collect information, perform physical measurements, and collect peripheral blood samples. Complete blood count and biochemical tests (liver and kidney function) were performed. The degree of liver fibrosis was assessed non-invasively (APRI, FIB4). The glomerular filtration rate was calculated electronically using the MDRD GFR Equation. Skin examination was performed to assess the presence of rash, ulcers, and scarring on the shins and ankles of cryoglobulinemia. To determine cryoglobulinemia, 8 ml of blood was collected in a tube without anticoagulant, and the sample was kept motionless for 1 hour at room temperature until clotting was complete. After centrifugation, the samples were separated and stored in a refrigerator at +4°C for 7 days, and then at room temperature for 30 minutes, the precipitate was detected. Results : A total of 200 people participated in the study, of which 71 were men (35.5%), the average age was 53.39±13.0. Cryoglobulinemia protein precipitates were determined in a total of 148 people, of which 50 were men (33.8%), the average age was 52.95±13.0. Cryoglobulinemia protein precipitates were detected in 89 people, or 60.1% of the study participants. Of the total study participants, 176 (88.0%) had chronic hepatitis C (CHC). Of these, 57 people had CHC with cryoglobulinemia. Comparing laboratory parameters, the mean GGT level in the cryoglobulinemia group was statistically significantly higher than in the non-cryoglobulinemia group (p=0.039). However, when laboratory parameters were grouped by increasing or decreasing, AST and ALT levels were significantly higher in the cryoglobulinemia group, indicating more hepatocellular damage (p<0.000). Increased creatinine levels may be associated with the risk of renal dysfunction. The FIB-4 index and APRI index showed a more severe degree of fibrosis in the cryoglobulinemia group (p<0.005; p<0.000). Univariate logistic regression analysis showed that age was associated with the occurrence of cryoglobulinemia (OR=2.48; 95% CI:1.31–4.70; p=0.005). Platelet count had a statistically significant positive effect in multivariate analysis (OR=14.38; 95% CI:1.26–163.89; p=0.032). Conclusion The prevalence of cryoglobulinemia among HCV-infected patients was 60.1%, and older age and decreased platelet count among infected individuals were associated with the occurrence of cryoglobulinemia.