Background Previous studies have focused on the respiratory system and skin damage caused by refractory ceramic fibers (RCFs). However, investigations into cardiovascular health of workers exposed to RCFs are insufficient. There is limited research on the association between occupational RCFs exposure and abnormal blood pressure, as well as the potential underlying mechanisms. Objective To explore the association between occupational exposure to RCFs and abnormal blood pressure, and to analyze the role of serum 8-hydroxy-2’-deoxyguanosine (8-OHdG) in this relationship, providing a reference for comprehensive health protection strategies for RCFs-exposed workers. Methods Using a cluster sampling method, 311 workers engaged in the production and processing of RCFs at a large RCFs enterprise were selected as the study population. A questionnaire survey was conducted to collect demographic information and other relevant data. The workers’ total dust, respirable fiber, and noise exposure levels were measured. Blood pressure was measured during occupational health examinations, and blood samples were collected. Based on blood pressure levels, the participants were divided into three groups: normotension, prehypertension, and hypertension. Serum 8-OHdG concentrations were determined by enzyme-linked immunosorbent assay (ELISA). Ordinal logistic regression and multiple linear regression models were applied to evaluate the associations of exposures to noise and RCFs with abnormal blood pressure and serum 8-OHdG levels. The mediating effect of serum 8-OHdG on the relationship between occupational RCFs exposure and abnormal blood pressure was analyzed using the PROCESS 4.1 macro. Results All 311 RCFs workers had varying levels of occupational exposure to RCFs, among whom 113 were also exposed to noise. The overall prevalences of prehypertension and hypertension among the participants were 49.84% and 11.25%, respectively. In the noise-exposed group, the prevalences of normotension, prehypertension, and hypertension were 44.2%, 43.4%, and 12.4%, respectively, which showed no statistically significant difference compared to the non-noise-exposed group (35.9%, 53.5%, and 10.6%, respectively; P=0.652). Significant differences were observed in the prevalences of normotension, prehypertension, and hypertension among workers with different levels of total dust exposure (P=0.033) and respirable fiber exposure (P=0.034). The differences in serum 8-OHdG concentrations across these groups were also statistically significant (P<0.05). Multiple regression analyses showed that both total dust exposure level (OR=1.83, 95%CI: 1.34, 2.51) and respirable fiber exposure level (OR=1.85, 95%CI: 1.31, 2.62) were positively associated with the detection of abnormal blood pressure. Furthermore, total dust exposure level (β=5.85, 95%CI: 0.53, 11.17) and respirable fiber exposure level (β=6.04, 95%CI: 0.14, 11.94) were positively associated with serum 8-OHdG concentrations. Further analysis indicated that the severity of abnormal blood pressure was positively associated with serum 8-OHdG concentrations (β=10.54, 95%CI: 3.62, 17.46). Mediation analysis demonstrated that serum 8-OHdG mediated the relationship between RCFs total dust exposure levels and the risk of abnormal blood pressure (P<0.05), accounting for 8.63% of the total effect. However, no mediating effect of serum 8-OHdG was observed in the association between RCFs respirable fiber exposure levels and the risk of abnormal blood pressure (P>0.05). Conclusion Occupational exposure to RCFs is closely associated with an increased risk of abnormal blood pressure and elevated serum 8-OHdG levels. Oxidative stress may play a mediating role in the relationship between RCF exposure and abnormal blood pressure.

AIM:To investigate alterations in the expression levels of inflammatory cytokines and subsets of CD8+ T cells in the peripheral blood of patients with diabetic retinopathy(DR).METHODS:Retrospective study. A total of 40 patients with type 2 diabetes admitted to Xi'an People's Hospital(Xi'an Fourth Hospital)from April to July 2022 were recruited for this study and categorized into two groups: 20 cases in the simple type 2 diabetes mellitus(DM)group, and 20 cases in the DR group. Additionally, 20 healthy individuals undergoing routine physical examinations served as the control group. The expression levels of cytokines, including interleukin(IL)-6, IL-8, and IL-10 in peripheral blood were quantified using ELISA. Flow cytometry was employed to analyze the expression of programmed cell death-1(PD-1), T cell immunoglobulin domain and mucin domain protein-3(TIM-3), CD28, and CD57 on CD8+ T cells.RESULTS:The peripheral blood expression of IL-6, IL-8, and IL-10 inflammatory cytokines were significantly elevated in DR patients as detected by ELISA(all P<0.001); flow cytometry analysis showed that the expression of PD-1, TIM-3, and CD57 were elevated in peripheral blood CD8+ T cells of DR patients(all P<0.001), and the expression of CD28 was decreased(all P<0.001).CONCLUSION:In DR patients, CD8+ T cells may undergo depletion and senescence as a result of elevated pro-inflammatory cytokines, including IL-6, IL-8, and IL-10.

Climate change poses a significant threat to public health. Existing studies on the health impacts of climate change focus primarily on chronic and infectious diseases, with limited research on injury. To address this gap, this issue launched a special column titled "Climate change and injuries". Through interdisciplinary integration of atmospheric science and public health, we explored the impact of climate change on injury risk and burden from diverse perspectives. This initiative aims to deepen a comprehensive understanding of the impact of climate change on human health, enhance China's capacity to address climate-related health risks, reduce associated disease burden, and provide scientific evidence for targeted adaptation measures.

Background Previous studies found that high temperature and heatwave increase the risk of traffic injuries. The complex road conditions in Yunnan Province result in frequent traffic accidents. However, there is limited evidence on the correlation between heatwave and traffic injuries in Yunnan Province. Objective To assess the association between heatwave events and traffic injuries, to estimate its disease burden, and to identify relevant sensitive groups. Methods We collected data on traffic injury cases and concurrent meteorological information from four surveillance sites in Yunnan Province, China: Dali, Lufeng, Zhaoyang, and Qilin from May to September each year from 2015 to 2023. Traffic injury cases refer to patients who visited the outpatient or emergency departments of local surveillance hospitals for the first time due to traffic injuries. Meteorological data were derived from the fifth generation atmosphericreanalysis dataset of the global climate provided by the European Centre for Medium-Range Weather Forecasts. A time-stratified case-crossover design combined with distributed lag non-linear model was used to analyze the association between short-term exposure to heatwave and traffic injuries. We also conducted subgroup analyses by sex, age, occupation, injury cause, activity at the time of injury occurrence, and severity of injury. Results A total of 34764 traffic injury surveillance cases were included in the analysis. The risk of traffic injuries occurred during heatwave was 1.13 times (95%CI: 1.07, 1.20) greater than those occurred during non-heatwave, and 2.64% (95%CI: 1.49%, 3.73%) of traffic injuries were attributed to heatwave exposure throughout the study period. The results of stratified analysis showed greater impacts of heatwave on the risk of traffic injuries in female [odds ratio (OR)=1.17, attributable fraction (AF)=3.23%], people aged 15-64 years (OR=1.13, AF=2.68%), farmers/workers (OR=1.22, AF=4.07%), people with non-motor vehicle traffic injuries (OR=1.17, AF=3.24%), people who were driving or riding when injuries occurred (OR=1.12, AF=2.43%), and people with minor injuries (OR=1.18, AF=3.49%) ( P<0.05). Longer duration [excess risk (ER)=0.99%] and greater intensity (ER=4.12%) of heatwave had greater impacts on the risk of traffic injuries (P<0.05). Conclusion Heatwave events are associated with an increased risk of traffic injuries. Female, people aged 15-64, farmers/workers, people with non-motor vehicle traffic injuries, those injured while driving/riding a vehicle, and people with minor injuries are particularly vulnerable. The findings suggest that targeted mitigation and adaptation measures should be taken to address the risk of traffic injuries associated with extreme climate events.

Background Injury poses a serious threat to human health. As global warming continues to intensify, there is an urgent need to explore the impact of temperature changes on injury deaths. However limited research has focused on this issue. Objective To investigate the relationship between daily mean temperature change (Tm) and injury death, as well as to estimate the associated future death burden in Hunan Province. Methods We employed an individual-level, time-stratified case-crossing design to establish a conditional logistic regression model to analyze the exposure-response relationship between daily mean temperature change and injury death in Hunan Province from 2013 to 2018. Consequently, we conducted subgroup analysis of gender, age group, and injury type. Finally, we estimated the excess burden of injury death attributable to temperature changes under a sustainable development path [low emission scenario (SSP1-2.6)], regional competition path [high emission scenario (SSP3-7.0)], or fossil fuel development path [very high emission scenario (SSP5-8.5)]. Results The study collected 155577 injury deaths in Hunan Province. The results indicated that for each 1 ℃ increment in daily mean temperature, the cumulative excess risk (CER) of injury mortality among Hunan residents increased by 0.71% (95%CI: 0.53%, 0.90%). Notably, the CER for intentional injuries (1.06%, 95%CI: 0.51%, 1.61%) was higher than that for unintentional injuries (0.66%, 95%CI: 0.46%, 0.87%). Warmer temperatures were positively associated with CER of mortality due to drowning, falls, transport injuries, assaults, and suicides, while they were negatively associated with mortality due to poisoning. Compared with 2010–2019, for 2090–2099, the excess mortality rate (EMR) due to ambient temperature increase in Hunan Province under the SSP5-8.5 scenario (14.62/100000, 95%CI: 10.81/100000, 18.40/100000) would be higher than that of the SSP3-7.0 scenario (10.28/100000, 95%CI: 7.58/100000, 12.97/100000) and the SSP1-2.6 scenario (3.35/100000, 95%CI: 2.46/100000, 4.23/100000); the EMR would be around 2.5 times among men (20.64/100000, 95%CI: 14.44/100000, 26.8/100000) than that among women (8.33/100000, 95%CI: 3.98/100000, 12.6/100000). Among unintentional injuries, the leading contributors to EMR would be drowning (4.46/100000), falls (3.96/100000), and transport injuries (2.96/100000). And among intentional injuries, the EMR for suicide (2.08/100000) would be higher than that for assault (0.47/100000). Conclusion Climate warming will increase the total burden of injury-related deaths among residents in Hunan Province, especially in the absence of effective mitigation strategies and measures. It is necessary to strengthen the prevention and control of severe injuries closely related to temperature changes, such as drowning, falls, traffic, and suicides injuries, in order to reduce injury deaths associated with climate change.

Background Under the background of global warming, research on association between ambient temperature and risk of injury is needed. Objective To examine the effect of temperature on injury in Bao'an district, Shenzhen and identify the sensitive population, thereby providing a scientific basis for formulating prevention and control strategies and measures of injury. Methods The injury reports from the Injury Surveillance System and the meteorological data of Bao'an District between 2018 to 2022 were collected. The meteorological data were sourced from the fifth generation of the European Centre for Medium-Range Weather Forecasts (ECMWF) land reanalysis data. Based on time-stratified case-crossover design, conditional logistic regression combined with distributed lag nonlinear model was used to evaluate the exposure-response association between ambient temperature and injury. The stratified analyses were further conducted by gender, age, and causes of injury. Results A total of 156205 injury cases were collected from the injury surveillance sentinel hospitals in Bao'an District of Shenzhen from 2018 to 2022, and the median of daily average temperature during the same period was 20.0 ℃. The exposure-response curve showed that the risk of injury was positively correlated with temperature. The linearized analysis revealed that each 1°C increase in temperature was associated with a 1.05% (95%CI: 0.68%, 1.42%) rise in injury risk (ER). Notably, the effect was greater in females (ER=1.31%, 95%CI: 0.67%, 1.94%) than males (ER=0.92%, 95%CI: 0.47%, 1.37%). Among age groups, adults ＞60 years faced the highest risk (ER=1.91%, 95%CI: −0.36%, 4.24%). The top three temperature-associated injury risks were sharp instrument injuries (ER=2.19%, 95%CI: 1.16%, 3.22%), animal injuries (ER=1.71%, 95%CI: 0.86%, 2.56%), and blunt injuries (ER=071%, 95%CI: −0.08%, 1.51%). The impact of temperature on unintentional injuries (ER=1.11%, 95%CI: 0.72%, 1.49%) was higher than that on intentional injuries (ER=0.43%, 95%CI: −0.85%, 1.72%). Severe injuries (ER=2.20%, 95%CI: −3.09%, 7.77%) were more affected by temperature than mild injuries (ER=1.00%, 95%CI: 0.58%, 1.43%) and moderate injuries (ER=1.15%, 95%CI: 0.42%, 1.89%). Conclusion The increase in ambient temperature associates with injury occurrence, and the impact of temperature exhibits obvious heterogeneity among different populations, indicating that targeted intervention measures should be taken for different populations and types of injuries.

Climate change is a significant environmental concern in the 21^st century. It can directly and indirectly affect public health, making it a major public health problem. This review focused on the relationship between meteorological factors and health-related behaviors such as physical activity, sleep, dietary behavior, and social contact behavior. The results indicated that meteorological factors such as temperature, relative humidity, wind speed, atmospheric pressure, and rainfall are associated with the four health behaviors. Physical activity levels are negatively associated with temperature, relative humidity, and rainfall. Sleep quality tends to decrease under extreme temperatures and extreme weather events. Dietary behavior is influenced by high and low temperatures, low pressure, and daylight duration, which in turn affects appetite and food intake. Social contact frequency decreases in response to extreme temperatures, increased rainfall, and extreme weather events. However, there are differences in the strength and direction of the associations between meteorological factors and health-related behaviors in various studies. Research on the combined effects of multiple meteorological factors exposure on health-related behaviors is rare, and the mechanisms underlying the associations are unclear. Therefore, there is a need for more multi-center, large-scale studies to explore the biological and behavioral mechanisms behind these associations, which will help clarify the complex effects of meteorological factors on human health behaviors and provide scientific evidence for policy-making, thereby mitigating the negative impact of climate change on public health.

Falls are one of the most common injuries, with a high prevalence and risk of disability, which poses the greatest threat to the health of the elderly. Falls are influenced by a variety of factors, including environmental factors such as slippery pavements, poor meteorological conditions, and inadequate lighting. The Sixth Assessment Report of the United Nations Intergovernmental Panel on Climate Change (IPCC) stated that climate change has become more frequent and stronger in recent years, which may threat people's health and lives. This review summarized the progress of epidemiological studies on the association between meteorological factors (e.g. temperature, precipitation, frost, and snowfall) and falls, and found that most of the studies focused on the association between temperature and falls, and the results of different studies varied greatly. While the studies on the association between other meteorological factors and falls were relatively few. Moreover, the mechanisms behind the associations were unclear. Therefore, we point out that it is necessary to further conduct large-sample and multi-centre studies to evaluate the effects of exposure to multiple meteorological factors, and further to explore the mechanisms of the associations, which may provide scientific evidence for better response to climate change.

Objective:To systematically analyze the incidence and influencing factors of frailty in elderly patients with hematologic malignancies.Methods:Research on frailty in elderly patients with hematologic malignancies was retrieved from Chinese and English databases such as China National Knowledge Infrastructure, Wanfang Data, PubMed, and Web of Science. The search period was from database establishment to August 23, 2024. Two researchers screened the included studies, conducted quality assessment, and extracted data. Meta-analysis was conducted using Stata 18 and RevMan 5.4.Results:A total of seven studies were included, encompassing 19 076 elderly hematologic malignancy patients, with a frailty incidence of 59% [95% CI (0.48, 0.69) ]. Meta-analysis revealed that age [ MD=4.31, 95% CI (3.67, 4.96) ], gender [ OR=0.88, 95% CI (0.83, 0.93) ], alcohol consumption [ OR=1.67, 95% CI (1.15, 2.44) ], self-care ability [ MD=-1.79, 95% CI (-3.17, -0.41) ], anemia [ OR=6.67, 95% CI (2.94, 15.14) ], infection [ OR=1.81, 95% CI (1.16, 2.84) ], and neuropathy [ OR=2.52, 95% CI (1.38, 4.61) ] were the influencing factors of frailty in elderly patients with hematologic malignancies. Conclusions:The incidence of frailty is high in elderly patients with hematologic malignancies. Elderly patients with hematologic malignancies who are older, female, consume alcohol, have low self-care ability, anemia, infections, and neuropathy are prone to frailty. Healthcare providers can conduct early screening and intervention for high-risk populations of frailty based on risk factors to improve the quality of life for elderly hematologic malignancy patients.

Objective:To establish an early warning model of oral infection risk in patients with acute leukemia undergoing chemotherapy and to verify its predictive efficacy, so as to provide reference for formulating strategies to prevent oral infections.Methods:A retrospective study was conducted to select 288 patients with acute leukemia undergoing chemotherapy from January 2021 to January 2023 in Hematology Hospital of Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences) as the training set. According to whether they developed oral infection after chemotherapy, they were divided into the infected group and the non-infected group. The risk factors of oral infection in patients with acute leukemia undergoing chemotherapy were investigated, and a risk warning model was established. A total of 246 acute leukemia undergoing chemotherapy patients admitted to the same hospital from February 2023 to February 2024 were selected as the validation set to conduct external verification of the model.Results:The oral infection rate was 19.44% (56/288) in the training set. There were 21 males and 35 females in the infected group (56 cases), with 49 cases<60 years old and 7 cases ≥60 years old. There were 102 males and 130 females in the non infected group (232 cases), with 196 cases<60 years old and 36 cases ≥60 years old. Multivariate analysis showed that neutrophil count <1.5×10 9/L, nutritional risk screening 2002≥3 points, high-dose of methotrexate, antibiotic types ≥3, poor oral self-cleaning habits, oral pH ≤6.5 were the risk factors for oral infection in patients with acute leukemia undergoing chemotherapy ( OR values were 2.716-10.074, all P<0.05). Based on this, the risk early warning model was as follows: Logit ( P)=-5.849+2.310× neutrophil count <1.5×10 9/L+1.363× nutritional risk screening 2002≥3 points +1.150× high-dose methotrexate +1.132× antibiotic types ≥3 + 1.044× oral pH ≤6.5 + 0.999× poor oral self-cleaning habits. The area under receiver operator characteristics curves (ROC) curve of this model Logit ( P) was 0.892, the maximum approximate entry index was 0.653, the sensitivity was 0.804, and the specificity was 0.849. Hosmer-Lemeshow test results indicated that χ2=4.91, P=0.768. For external validation, the goodness of fit test results were χ2=6.47, P=0.595. The area under ROC curve was 0.884, the sensitivity was 0.832, and the specificity was 0.825. Conclusions:The established early warning model of oral infection risk in patients with acute leukemia undergoing chemotherapy has good predictive value, which is helpful for medical staff to conduct early risk assessment of oral infection in such patients, and formulate countermeasures to reduce the incidence and improve the treatment effect of the disease.