To analyze the disease burden of acute lymphoid leukemia(ALL) and its changing trends in China and globally from 1990 to 2021, aiming to provide a theoretical basis for disease prevention, treatment, and policy formulation.

Objective To investigate the effects of dapagliflozin on inflammatory factors and prognosis in patients with type 2 diabetes mellitus (T2DM) and acute myocardial infarction (AMI). Methods In a randomized, double-blind trial, 146 patients with T2DM and AMI (within 7 days of onset) were divided into dapagliflozin (dapagliflozin 10 mg/d combining AMI standard therapy) and control (AMI standard therapy) groups, and were followed up for 12 months. Serum levels of interleukin-1β (IL-1β), IL-6, high-sensitivity C reactive protein (hs-CRP) at baseline, 1, 3, 6, and 12 months, and left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP), and major adverse cardiovascular events (MACE) rate at 12 months were compared between the two groups. Kaplan-Meier curves were used to analyze the cumulative incidences of MACE in the two groups. Results Three patients were withdrawn or dropped out. At 12 months, IL-1β, IL-6, and hs-CRP levels were significantly lower in dapagliflozin group (n＝71) than those in control group (n＝72, P＜0.01), approaching normal levels. Compared with the control group, LVEF was higher (P＜0.01), BNP was lower (P＜0.01), MACE incidence was lower (P＝0.047) in dapagliflozin group at 12 months. Generalized linear mixed models showed significant group-time interactions in IL-1β, IL-6, and hs-CRP (P＜0.001), and these factors declined faster in the dapagliflozin group. Kaplan-Meier curve showed the cumulative incidences of MACE and heart failure were lower in dapagliflozin group than those in non-dapagliflozin group (P＜0.05). Conclusions For patients with T2DM patients and AMI, dapagliflozin has good anti-inflammatory and cardioprotective effects.

In the context of global warming, protecting outdoor workers from occupational heat exposure has become an important public health concern. This review summarized the principle, applicability, and limitation of three categories of wet bulb globe temperature (WBGT) prediction models: empirical regression models, heat-balance models, and machine-learning models. Drawing on international experience from the United States, Europe, and Japan, this review further examined the technical challenges of applying WBGT-based prediction models to large-scale occupational heat stress early warning systems. In response to gaps in occupational heat stress management in China, WBGT should be considered a core assessment indicator to support a transition from passive response to proactive intervention. A localized implementation pathway is proposed, incorporating mechanism-based model calibration, regional parameter adaptation, and multi-source data fusion. Strengthening collaboration between public health and meteorological departments and developing platform-based flexible intervention strategies for workers in new forms of employment may improve the targeting of occupational heat stress early warning and health protection. Future research should focus on physics-constrained machine learning, refined microenvironmental prediction, and individualized risk assessment to support the development of a digitally enabled occupational heat-health protection framework.

Addressing the current clinical problems of conventional antidepressants， such as delayed onset of action and prominent adverse reactions， this paper explores the theoretical basis， mechanism of action， and application prospects of nasal administration as a novel rapid antidepressant strategy. By clarifying the conceptual connotation of rapid antidepressants， elucidating their clinical demands and application advantages， and explaining the physiological basis of nasal-to-brain delivery， it is proposed that the olfactory and trigeminal nerve pathways can bypass the blood-brain barrier to achieve rapid targeted delivery of drugs to brain tissue. On this basis， combined with the theory of opening orifices with aromatic medicinals in traditional Chinese medicine （TCM） as well as related research in modern aromatherapy， the ancient and modern clinical evidence of nasal administration in regulating emotions was systematically reviewed. Furthermore， this article discusses the application advantages of nasal administration in special populations such as the elderly， children， and pregnant women， and analyzes the practical bottlenecks such as mucosal clearance， limited formulation volume， and safety evaluation. Nasal administration is expected to become an important supplementary means for rapid antidepressants， and the integrated model of "TCM aromatic medicinals plus nanopreparations plus nasal administration" can provide new ideas for research on the integration of TCM and western medicine in treating depression.

Objectives: Hip fracture is a global public concern exhibiting high mortality rates but often underrecognized. We compared the mortality rates, risk, and secular trend of hip fractures with common cancers in females and males, aiming to call attention to hip fractures. Methods: In 2010–2020, 193,767 patients with the first diagnosed hip fractures and the top 5 prevalent cancers in each sex and aged 50 years and above were included. Age-standardized mortality rates were adjusted to the WHO Standard Population and the sex-specific relative risk of mortality was computed using Cox proportional hazards models, adjusted for potential confounders. The trend analyses used joinpoint regression to compute annual percent changes in age-standardized mortality rates. Results The 1-year and 5-year age-standardized mortality rates and sex-specific mortality risk of hip fracture are greater than those of breast cancer (hazard ratio [HR]: 0.93, 95% confidence interval [CI]: 0.90 to 0.97) and thyroid cancer (HR: 0.55, 95% CI: 0.47 to 0.64) in females and prostate cancer (HR: 0.56, 95% CI: 0.53 to 0.58) in males. Moreover, mortality rates in lung cancer, male liver cancer, female breast cancer, and male prostate cancer have decreased in the past decade. For hip fracture, the mortality rates have significantly decreased in females, while in males, we observed only a decreasing trend in 1-year hip fracture mortality, not in 5-year Conclusions: Hip fractures exhibit higher mortality compared to female breast and thyroid cancers and male prostate cancer. More attention is needed to enhance the management and prevention of hip fractures.

Objective:To identify independent risk factors for chronic critical illness (CCI) secondary to severe pneumonia and to develop and validate a clinical prediction model.Methods:A retrospective cohort study was conducted using electronic medical records from 415 patients with severe pneumonia admitted between January 2023 and March 2024. Patients were randomly divided into a training set ( n = 290) and a validation set ( n = 125) at a 7:3 ratio. Univariate and multivariate logistic regression analyses were used to identify independent risk factors, and a nomogram was constructed. The model’s discriminative ability, calibration, and clinical utility were assessed using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Results:The overall incidence of CCI was 23.13% (96/415). Multivariate analysis identified five independent predictors: virus infection ( OR = 13.00, 95% CI: 5.07–33.35, P < 0.001), mechanical ventilation ≥72 hours ( OR = 8.06, 95% CI: 3.68–20.09, P < 0.001), neutrophil-to-albumin ratio (NAR) ( OR = 27848, 95% CI: 193.93–5542274.11, P < 0.001), oxygenation index ( OR =1.09, 95% CI: 1.01–1.09, P < 0.001), and age ( OR = 0.94, 95% CI: 0.91–0.97, P < 0.001). The model demonstrated excellent performance in both sets: training set AUC = 0.96 (95% CI: 0.94–0.98), sensitivity 0.93, specificity 0.89, Brier score 0.09; validation set AUC = 0.93 (95% CI: 0.88–0.98), sensitivity 0.89, specificity 0.64, Brier score 0.13. Calibration curves showed high consistency between predicted and observed risks (mean absolute error < 3%), and DCA indicated significant net clinical benefit within the threshold probability range of 15–60%. Conclusions:The developed prediction model integrates etiological, inflammatory, metabolic, and respiratory support parameters and demonstrates outstanding predictive performance (AUC > 0.90). It may serve as a quantitative tool for early risk stratification and intervention in patients with severe pneumonia. Further multicenter external validation and exploration of integrating dynamic biomarker monitoring are recommended.

To analyze the disease burden and trends of motor neuron disease(MND) in China and globally from 1990 to 2021, providing evidence for the formulation of relevant health strategies inChina.

Cerebral blood flow directly affects the metabolism of substances and neural activity in the brain, and is closely associated with the occurrence and development of cerebral small vessel disease (CSVD). Multiple studies have revealed that various imaging biomarkers in patients with CSVD, such as lacunar infarction, enlarged perivascular spaces, cerebral microbleeds, cerebral atrophy, and white matter hyperintensities, are closely associated with cerebral autoregulation (CA) function. Therefore, understanding the regulatory mechanism of CA in patients with CSVD is of great significance for delaying the further development of CSVD, improving cerebral ischemia and cognitive impairment. This article reviews the correlation and mechanism between CA and CSVD.

BACKGROUND:Acupoint embedding and floating needle therapy are two methods for the treatment of knee osteoarthritis,but there are few reports on the combined treatment of the two methods. OBJECTIVE:To investigate the therapeutic effect of acupoint embedding combined with floating needle therapy on different stages of knee osteoarthritis using generalized estimating equations. METHODS:A total of 436 patients with knee osteoarthritis admitted to Dongguan Hospital of Traditional Chinese Medicine from February 2019 to February 2023 were selected as the research subjects.All patients were randomly divided into a control group with floating needle therapy(n=218)and an observation group with acupoint embedding method combined with floating needle therapy(n=218).Staging was performed according to the K-L staging method.In the control group,there were 57 cases in stage Ⅰ,62 in stage Ⅱ,49 in phase Ⅲ,and 50 in stage Ⅳ,while in the observation group,there were 48 cases in stage Ⅰ,66 in stage Ⅱ,63 in phase Ⅲ,and 41 in stage Ⅳ.The levels of indexes and clinical efficacy were compared between groups before and after treatment.Generalized estimating equation model was used to analyze the influencing factors of clinical efficacy and the interaction effect of different time points,different methods and different stages on therapeutic efficacy. RESULTS AND CONCLUSION:There was no significant difference in baseline data between the observation group and the control group,as well as between the patients of different stages(P>0.05).After treatment,the cure rate of stage Ⅰ patients was the highest after treatment,and the total improvement rate in the observation group was significantly higher than that in the control group.There were significant differences in the cure rate among different stages in each group(P<0.05).After treatment,all indicators in the two groups were significantly decreased.In the control group,there were significant differences in various indicators of patients at different stages after 4 weeks of treatment(P<0.05).In the observation group,after 2 weeks of treatment,there were significant differences in various indicators of patients at different stages(P<0.05),and all the indexes in the observation were lower than those in the control group after 4 weeks of treatment(P<0.05)and the therapeutic effect in the observation group was better than that in the control group.Generalized estimating equation model analysis showed that trauma history,interleukin-6 level,treatment method,treatment time and K-L stage all significantly affected the clinical efficacy in patients.In the interaction effect analysis,after 2 weeks of treatment,there was a significant difference in the visual analogue scale score between the two groups in stages Ⅲ and Ⅳ(P<0.05).After 4 weeks of treatment,there was a significant difference in the visual analogue scale score between the two groups in stages Ⅱ,Ⅲ,and Ⅳ(P<0.05).To conclude,acupoint embedding combined with floating needle therapy is superior to floating needle therapy alone in the treatment of different stages of knee osteoarthritis.Trauma history,interleukin-6 level,treatment method,treatment time and K-L stage significantly influence the therapeutic effect.

Objective To investigate the relationship between primary pulmonary mucinous adenocarcinoma (PPMA) mass type and pneumonia type and their difference in malignant degree, and to analyze the role of clinical manifestations and CT features in the diagnosis of this disease. Methods The clinical data of PPMA patients admitted in the First Affiliated Hospital of Xiamen University from May 2011 to March 2022 were retrospectively analyzed. According to CT features, they were divided into a mass type group and a pneumonia type group. The clinical manifestations, CT features and the degree of malignancy between the two groups were analyzed and compared. Results A total of 57 PPMA patients were enrolled. There were 17 males and 40 females, with an average age of (53.82±10.65) years, and 28 (49%) patients had reversed hato-like sign. There were 42 patients in the mass type group and 15 patients in the pneumonia type group. PPMA often occurs in both lower lungs, with clinical manifestations mainly of coughing and expectorating white mucoid sputum. There were statistical differences between the two groups in the maximum diameter of tumor (P<0.001), boundary condition (P<0.001) and pleural indentation sign (P=0.019). There was no statistical difference between the two groups in Ki-67 index (P>0.05). Conclusion There is no statistical difference in the degree of malignancy between the two types of PPMA. Considering their clinical manifestations and differences in imaging features, it is supported that the pneumonia type is just a progression of the mass type. CT can present various manifestations, among which the reversed hato-like sign is expected to become an important imaging feature. Combined with a high proportion of solid components, pleural indentation sign, and vacuole sign, reversed hato-like sign can play a significant role in the diagnosis of PPMA.