ObjectiveTo explore the spatial distribution patterns of flavonoid glycosides in Epimedium sagittatum and the influences of environmental factors on the accumulation of these components. MethodsThe spatial statistical analysis and GeoDetector model were used to analyze the distribution patterns of epimedin A，epimedin B，epimedin C，icariin，and total flavonoid glycosides in E. sagittatum samples from 92 different production areas in 36 cities of 13 provinces/municipalities/autonomous regions of China，as well as the effects of 28 environmental factors on the accumulation of each component. ResultsThe average content of flavonoid glycosides 64 （69.56%） producing areas and 30 （83.33%） cities met the quality standard of no less than 1.50% of total flavonoid glycosides in the 2020 edition of Chinese Pharmacopoeia.Epimedin A，epimedin B，epimedin C，icariin，and their sum showed significantly high accumulation.The hot spots regions of epimedin A and epimedin B were similar with each other，mainly located in western Hunan，eastern Hubei，eastern Guizhou，and northern Guangxi.The common hot spot areas of epimedin C and total flavonoid glycosides were in western and southwestern Hunan，southern Henan，northern Anhui，eastern Guizhou，and southern Chongqing.The hot spots areas of icariin were in southern Chongqing，western Hunan，and eastern and northeastern Guizhou.The interactions between environmental factors had stronger explanatory power for the accumulation of components than single factors.The strongest single factor and interactive factor affecting the accumulation of epimedin C were precipitation of wettest quarter （q=0.16） and its interaction with temperature seasonality （q=0.35），respectively.The strongest single factor influencing both the accumulation of icariin and total flavonoid glycosides was the precipitation of coldest quarter （q equals 0.15 and 0.22，respectively）.The strongest interactions were observed between precipitation of coldest quarter and gravel content （q=0.34），as well as between precipitation of coldest quarter and aspect （q=0.35）. ConclusionThirteen cities，including Zhumadian and Nanyang in Henan，Huaihua，Shaoyang，and Zhangjiajie in Hunan，and Zunyi，Qiandongnan，and Tongren in Guizhou，were hot spots of total flavonoid glycosides in E.sagittatum.Precipitation，gravel content，temperature seasonality，and aspect significantly influence the accumulation of flavonoid glycosides in E.sagittatum.This study provides reference for the utilization and production zoning of E.sagittatum.

Objective To systematically analyze the medical radiation exposure levels in a district of Ningbo City and to provide a scientific basis for the reasonable and effective control of medical radiation exposure. Methods Based on the radiological diagnosis frequency and dose information system, basic medical radiation exposure data were collected, such as radiation doses received by patients in various X-ray diagnostic examinations, from all 13 public medical institutions in a district of Ningbo City from January 1 to December 31, 2020. The data were analyzed for the percentage and collective effective dose of various diagnostic examinations, the distribution of examinations by sex and age, and the number of patients undergoing two or more examinations and their cumulative doses within multiple time intervals. Results Among medical X-ray diagnostic examinations in the district, the percentages of CT examination and routine photography examination were 50.88% and 47.93%, respectively, and the collective effective dose of CT examination accounted for 97.75%. By age and sex, the frequency of examination was the highest in the age group of 45-54 years, and the frequency of examination in the male was higher than that in the female before age 55. The annual effective dose for two patients exceeded 100 mSv. Conclusion In this study, CT examination accounted for up to 50.88% of all medical X-ray diagnostic examinations, and contributed 97.75% of the collective effective dose, highlighting the need for particular attention to the justification of medical radiation exposure from CT.

Objective To understand the individual radiation dose levels and changes of occupational external exposure among radiation workers in a steel group from 2020 to 2023, and to provide a basis for strengthening radiation protection in the group. Methods According to the Specifications for individual monitoring of occupational external exposure (GBZ 128-2019), individual monitoring was conducted using a thermoluminescent dosimeter, with each monitoring cycle lasting 90 days, totaling four cycles per year. Individual monitoring data of occupational external exposure among radiation workers in the steel group from 2020 to 2023 were collected for statistical analysis. Results A total of 5889 monitoring records were collected from radiation workers across 37 affiliated units of the steel group during the period of 2020-2023. The average annual effective dose was 0.150 mSv, the maximum annual effective dose was 3.84 mSv, and 0.3% monitored workers showed annual effective doses exceeding 1 mSv. The average annual effective dose in 2023 was 0.146 mSv, which was lower than in 2020 but higher than in 2021 and 2022 (Z = −6.657 to 14.129, P < 0.001). The number of monitored workers in industrial and medical sectors accounted for 86.9% and 13.1%, respectively. Their average annual effective doses were 0.152 mSv and 0.140 mSv, respectively, and the difference was statistically significant (Z = −7.969, P < 0.001). In the industrial sector, the average annual effective dose for the monitored workers in industrial radiography was significantly higher than other occupations (Z = −8.094, P < 0.001). There was a significant difference in average annual effective dose among workers of different occupational categories in the medical sector (H = 67.040, P < 0.001). The average annual effective doses were relatively high for diagnostic radiology and nuclear medicine. Additionally, the average annual effective doses for male and female radiation workers were 0.150 mSv and 0.152 mSv, respectively (P > 0.05). Conclusion The average annual effective dose of radiation workers in the steel group was at low levels for four consecutive years, which meet the requirements of the national standard. However, to maintain the individual radiation dose levels of radiation workers as low as reasonably achievable, it remains necessary to strengthen radiation protection management in the steel group.

Objective To investigate the levels and influencing factors for eye lens dose of interventional radiology workers, and to provide a basis for reasonable and scientific radiation protection. Methods Thermoluminescent eye lens dosimeters were used to monitor the left and right eye lens doses of interventional radiology workers in real time during different surgical positions and varying eye protection conditions. The annual eye lens doses for the operators were estimated based on their yearly workload. The differences in eye lens doses under different conditions were analyzed and the influencing factors were identified. Results For individual interventional operations, the range of personal dose equivalent H_p(3) of the left eye of interventional radiology workers was ( < MDL ~ 418.33) μSv, the median (Q₁, Q₃) was 9.29 ( < MDL, 40.79) μSv, and the mean was 40.79 ± 70.36 μSv. The estimated annual eye lens doses were 4.05 mSv and 17.80 mSv based on the median and mean values of the eye lens dose of a single operation multiplied by average annual frequency of operations per person, respectively. The left eye lens dose was higher than the right eye lens dose of the same operator (Z = −4.24, P < 0.05), and the dose of the right eye lens was strongly positively correlated with that of the left eye lens. The left eye lens dose of the first surgeon was higher than that of the second surgeon in the same operation (Z = −3.10, P < 0.05). The eye lens dose was influenced by operator position (χ² = 9.149, P = 0.002, OR = 8.343), eye protection (χ² = 4.619, P = 0.032, OR = 4.352), and air kerma area product (χ² = 8.032, P = 0.005, OR = 5.488). Conclusion According to the results of this study, a significant portion of interventional operators have eye lens doses that approach or exceed international occupational dose limits. It is recommended to pay attention to the operation frequency of the first operator and the air kerma area product of interventional operation, and strengthen radiation protection and dose monitoring for the eye lens of interventional radiology workers.

Objective: To explore the longitudinal associations between dietary macronutrients and lung function in schoolaged children, so as to provide the nutritional research evidence for promoting children s lung health. Methods: In November 2021, two primary schools located in Chengdu, Sichuan Province were selected from the Southwest China Childhood Nutrition and Growth (SCCNG) cohort by a stratified cluster random sampling method, enrolling a total of 1 112 school aged children aged 8 to 13 years. At baseline, the dietary and sociodemographic characteristics of the children were assessed. One year later, the forced vital capacity (FVC) of the children was measured and converted into Z scores (FVC- Z ), while the vital capacity index (VCI) was also calculated. Generalized linear regression analysis was employed to examine the associations between dietary macronutrients and lung function, considering interactions with gender and age, followed by stratified analysis. Results: After adjusting for confounding factors, the analysis results of the generalized linear regression model showed that the carbohydrate energy ratio was negatively correlated with FVC- Z ( β =-0.02) and VCI ( β =-0.16), while the fat energy ratio showed a positive correlation with FVC- Z ( β =0.03) and VCI ( β =0.23) ( P <0.05). The protein energy ratio was positively correlated with FVC- Z ( β =0.09) and VCI ( β =0.60) specifically in girls ( P <0.05). Additionally, there was an interaction effect of age on the associations between macronutrients and lung function ( P <0.01); in children aged 8-9 and 10-11, the carbohydrate energy supply ratio was negatively correlated with FVC- Z ( β =-0.04, -0.03) and VCI ( β =-0.29, -0.21), and fat energy supply ratio was positively correlated with FVC- Z ( β =0.07, 0.05) and VCI ( β =0.46, 0.32) ( P <0.05). Conclusions There are age and sex differences in the association of dietary macronutrients with lung function, with a low carbohydrate, high fat diet promoting lung function in children. Additionally, protein intake appears to have a positive influence on the lung function of girls. The early school age period may represent a critical window for dietary interventions aimed at promoting lung health.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease with high global prevalence and long course, which affects more than 30% of the population and seriously endangers human health. Lipid metabolism plays an important role in the occurrence and development of MASLD. An increasing number of studies have shown that active ingredients in traditional Chinese medicine can regulate lipid metabolism to improve MASLD. Due to the obvious advantages of multi-target regulation and fewer side effects, the active ingredients have shown great potential and value for application. However, the pathological mechanism of MASLD is intricate and the active ingredients of traditional Chinese medicine can improve MASLD from multiple aspects, there is currently a lack of systematic discussion on lipid metabolism. Therefore, this review focuses on lipid metabolism and reviews the latest research progress of active ingredients from traditional Chinese medicine in ameliorating MASLD from the aspects of lipid uptake, lipid synthesis, lipid oxidation, lipid secretion, etc., in order to provide more theoretical references for active ingredients of traditional Chinese medicine in regulating lipid metabolism to improve MASLD.

Objective To investigate the impact of the artificial intelligence iterative reconstruction (AIIR) algorithm on image quality in chest computed tomography (CT) at different radiation doses, and assess its value in reducing radiation dose during chest CT examinations. Methods A simulated chest phantom was scanned with 12 groups of tube voltages and milliampere-seconds, and the radiation dose was recorded for each group. The images of each group were reconstructed using seven methods: AIIR with noise levels 1-5, KARL iterative reconstruction, and filtered back projection (FBP). The CT values and standard deviations of soft tissue, thoracic vertebrae, pulmonary nodules, and the mediastinum were measured, with standard deviation representing image noise. Subjective evaluation of image quality was performed. The Friedman test was used to compare CT values among the seven reconstruction groups, a linear mixed model was employed for statistical analysis of image noise, and the Friedman test was also used for comparing subjective evaluation scores. Results The reconstruction algorithm, tube voltage, milliampere-seconds, and their interactions all showed statistically significant effects on image noise for the four tissues (F = 2.041-391.283, P < 0.05). Among the reconstruction algorithms, noise reduction capability decreased in the following order: AIIR levels 1-5, KARL, and FBP. The interaction between the reconstruction algorithm and tube voltage or milliampere-seconds indicated that AIIR exhibited improved noise reduction efficacy under low tube voltage and low milliampere-second conditions (|t| = 1.892-8.245, P < 0.05). In terms of subjective evaluation of image quality, there was no statistically significant difference among AIIR levels 3-5 (|Z| ≤ 0.567, P > 0.05), and the score of AIIR level 3 was significantly higher than those of AIIR level 1, AIIR level 2, FBP, and KARL level 2 (|Z| = 3.449-5.906, P < 0.05). Conclusion The AIIR reconstruction algorithm significantly reduced image noise in chest CT examinations. For improving image quality while maintaining image realism, AIIR level 3 is recommended, which can reduce the radiation dose by more than 75%. Furthermore, AIIR showed superior performance in noise reduction under low tube voltage and low milliampere-second conditions, demonstrating significant potential for reducing radiation dose.

In recent years, the high temperature and heatwaves have seriously affected the health of Chinese residents, and there is an important need for public health protection guidelines for high temperature and heatwaves in China. The National Bureau of Disease Control and Prevention has organized experts to fully investigate the evidence from epidemiological research on the health of populations in high temperature and heatwaves globally and in China, analyze the health hazards and protection needs of different populations, and put forward practical and effective individual protection measures and health recommendations. For this reason, the "Guideline for Public Health Protection against High Temperature and Heatwaves" (referred to as the "Guideline") was officially issued in June 2023. This article interprets the background and significance of the Guideline, the principles of compilation, the main considerations, the main contents, the implementations and promotions and other aspects, to improve the understanding of the content of the Guideline and strengthen the publicity and implementations.

Objective·To explore the influencing factors of oral nutritional supplement compliance in postoperative patients with digestive tract cancer based on COM-B model,and to analyze the mediating role of medication belief and self-efficacy in oral nutritional supplement.Methods·A total of 300 postoperative gastrointestinal cancer patients were selected by convenience sampling method.The General Information Questionnaire,Morisky Medication Adherence Scale,Digestive Cancer Patients Nutrition Knowledge,Attitude and Practice Questionnaire,Multidimensional Scale of Perceived Social Support,Beliefs about Medicines Questionnaire and General Self-Efficacy Scale were used.A mediating effect model was used to analyze the influencing factors of compliance with oral nutritional supplements.Results·The score of Morisky Medication Adherence scale was 1.61±1.38,which was at a low level.Oral nutritional supplement compliance was significantly positively correlated with nutrition knowledge,social support,medication belief and self-efficacy(r=0.391,0.401,0.438,0.410,all P＜0.01).Medication belief had a partial mediating effect between nutrition knowledge and adherence to oral nutritional supplements(effect size=0.097,accounting for 18.00%of the total effect).Self-efficacy had a partial mediating effect between nutrition knowledge and oral nutritional supplement compliance(effect size=0.044,accounting for 8.16%of the total effect).Self-efficacy had a partial mediating effect between social support and oral nutritional supplement compliance(effect size=0.044,accounting for 16.67%of the total effect).Conclusion·The compliance of oral nutritional supplements in postoperative patients with gastrointestinal cancer is at a low level.The individualized nursing intervention can increase the nutritional knowledge of patients,improve the social support,reduce the concerns of patients about oral nutrition,and improve the self-efficacy of patients,so as to promote the compliance of patients with oral nutritional supplements.

Objective To investigate the correlation between pericarotid fat density(PFD)and carotid plaque CT vulnerability characteristics.Methods The clinical and imaging data of 78 patients were analyzed retrospectively.PFD and subcutaneous neck fat density(SNFD),as well as plaque density,degree of lumen stenosis,and maximum plaque thickness were measured on picture archiving and communication system(PACS),and PFD/SNFD ratio was calculated.The plaques were divided into 4 subgroups according to their composition,namely fatty plaque group,fibrous plaque group,calcified plaque group and mixed plaque group.The groups were divided into no/mild-to-moderate stenosis group and severe stenosis/complete occlusion group according to the degree of stenosis,and the differences between groups were compared for clinical indices,PFD,SNFD and PFD/SNFD ratio,respectively.Results The PFD/SNFD ratio[0.54(0.32,0.72)]in the fatty plaque group was lower than that in the calcified plaque group[0.74(0.56,0.96)],with a statistically significant difference(P=0.005).The PFD/SNFD ratio in the severe stenosis/complete occlusion group(0.51±0.29)was lower than that in the no/mild-to-moderate stenosis group(0.67±0.27)(P=0.001),and the PFD in the severe stenosis/complete occlusion group[-39.75(-61.13,-24.00)]was higher than that in the no/mild-to-moderate stenosis group[-61.75(-72.00,-45.38)](P＜0.001).Conclusion PFD,PFD/SNFD ratio are correlated with carotid plaque vulnerability.