Objective: To analyze the epidemiological characteristics and influencing factors of severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang Province from 2019 to 2023, so as to provide the reference for strengthening SFTS prevention and control. Methods: Data on laboratory-confirmed SFTS cases in Zhejiang Province from 2019 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Meteorological data, geographic environment and socioeconomic factors during the same period were collected from the fifth-generation European Centre for Medium-Range Weather Forecasts, Geospatial Data Cloud, and Zhejiang Statistical Yearbook, respectively. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of SFTS from 2019 to 2023, and a Bayesian spatio-temporal model was constructed to analyze the influencing factors of SFTS incidence. Results: A total of 578 SFTS cases were reported in Zhejiang Province from 2019 to 2023, with an annual average incidence of 0.23/105. The peak period was from May to July, accounting for 52.60%. There were 309 males and 269 females, with a male-to-female ratio of 1.15∶1. The cases were mainly aged 50-<80 years, farmers, and in rural areas, accounting for 82.53%, 77.34%, and 75.43%, respectively. Taizhou City and Shaoxing City reported more SFTS cases, while Shaoxing City and Zhoushan City had higher annual average incidences of SFTS. The Bayesian spatio-temporal interaction model showed good goodness of fit. The results showed that mean temperature (RR=1.626, 95%CI: 1.111-2.378) and mean wind speed (RR=1.814, 95%CI: 1.321-2.492) were positively correlated with SFTS risk, while altitude (RR=0.432, 95%CI: 0.230-0.829) and population density (RR=0.443, 95%CI: 0.207-0.964) were negatively correlated with SFTS risk. Conclusions SFTS in Zhejiang Province peaks from May to July. Middle-aged and elderly people and farmers are high-risk populations. Taizhou City, Shaoxing City, and Zhoushan City are high-incidence areas. Mean temperature, mean wind speed, altitude, and population density can all affect the risk of SFTS incidence.

AIM:To explore the mechanism of Chonghe paste in regulating PTEN-induced kinase 1(PINK1)/parkin pathway-mediated mitophagy on diabetic ulcer wound healing.METHODS:Thirty-six rats were used to construct a diabetic ulcer model by high-sugar and high-fat feed,intraperitoneal injection of streptozotocin and skin defect method,and were randomly divided into model group,Chonghe paste group and growth factor group,with 12 rats in each group.Another 12 rats were taken to construct normal wound model as normal group.The rats in normal group and model group were treated with normal saline for debridement,while those in Chonghe paste group and growth factor group were treated with Chonghe paste and growth factors for wound coating,respectively.The changes in fasting blood glucose and wound healing were observed and recorded,and samples were collected on the 7th and 14th days after treatment.The expression levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),P62 and collagen type Ⅲ(COL3)in granulation tissues were detected by immunohistochemistry.The mitochondrial ultrastructure was observed under an electron microscope,and the number of autophagosomes was recorded.The expression of PINK1,parkin and microtubule-associated protein 1 light chain 3-Ⅱ(LC3-Ⅱ)in wound tissues was detected by immunofluorescence,Western blot and RT-qPCR.RE-SULTS:Compared with normal group,the blood glucose levels of the rats in model group,Chonghe paste group and growth factor group were higher than 16.67 mmol/L on the 7th,14th and 28th days,indicating successful modeling of dia-betes.Compared with normal group,the rats in model group had a lower wound healing rate,the mean absorbance of IL-6,TNF-α and P62 was increased,the mean absorbance of COL3 was decreased,the number of autophagosomes per unit area was increased,the mean absorbance of PINK1,parkin and LC3-Ⅱ was decreased,and the mRNA and protein expres-sion levels of PINK1,parkin and LC3-Ⅱ were decreased.Compared with model group,the wound healing rate of the rats in Chonghe paste group and growth factor group was increased,the mean absorbance of IL-6,TNF-α and P62 was de-creased,the mean absorbance of COL3 was increased,the number of autophagosomes per unit area was decreased,the mean absorbance of PINK1,parkin and LC3-Ⅱ was increased,and the mRNA and protein expression levels of PINK1,parkin and LC3-Ⅱ were elevated.CONCLUSIONS:Chonghe paste can alleviate local inflammatory response in diabetic ulcer wounds,reduce the levels of inflammatory factors IL-6 and TNF-α,promote COL3 expression,activate the PINK1/parkin signaling pathway,and promote mitophagy in wounds,thus accelerating wound healing.

BACKGROUND: Lung cancer is the leading malignancy in China in terms of both incidence and mortality. With increased health awareness and the widespread use of low-dose computed tomography (CT), early diagnosis rates have been steadily improving. Surgical intervention remains the primary treatment option for early-stage lung cancer, and video-assisted thoracoscopic surgery (VATS) has become a common approach due to its minimal invasiveness and rapid recovery. However, post-discharge recovery remains incomplete, underscoring the importance of postoperative care. Traditional follow-up methods, lack standardization, consume significant medical resources, and increase the burden of the patients. Artificial intelligence (AI)-driven disease management platforms offer a novel solution to optimize postoperative follow-up. This study followed 463 lung cancer surgery patients using an AI-based platform, aiming to identify common postoperative issues, propose solutions, improve quality of life, reduce recurrence-related costs, and promote AI integration in healthcare. METHODS: Using the AI disease management platform, this study integrated educational videos, collaboration between healthcare teams and AI assistants, daily health logs, health assessment forms, and personalized interventions to monitor postoperative recovery. The postoperative rehabilitation status of the patients was assessed by the Leicester Cough Questionnaire (LCQ-MC). Two independent t-test and one-way ANOVA were used to analyze the causes of postoperative cough in lung cancer. RESULTS: Most issues occurred within 7 d post-discharge, significantly declined on 14 d post-discharge. Factors such as gender, smoking history, and surgical approaches were found to influence cough recovery. The incidence of cough on 7 d post-discharge in females was higher than that in males (P<0.01), while the incidence of cough on 14 d post-discharge in elderly patients was lower than that in young patients (P=0.03). The AI-based platform effectively addressed cough, pain, and sleep disturbances through phased interventions. CONCLUSIONS The AI-based platform significantly enhanced postoperative management efficiency and the self-care capabilities of the patients, particularly in phased cough management. Future integration with wearable devices could enable more precise and personalized postoperative care, further advancing the application of AI technology across multidisciplinary healthcare domains.
Humans ; Lung Neoplasms/rehabilitation* ; Male ; Female ; Middle Aged ; Aged ; Patient Discharge ; Artificial Intelligence ; Adult ; Postoperative Care ; Postoperative Period ; Disease Management ; Quality of Life

Osteoarthritis (OA) causes chronic pain that significantly impairs quality of life, with current treatments often proving insufficient and accompanied by adverse effects. Recent research has identified the dorsal root ganglion (DRG) and its resident macrophages as crucial mediators of chronic OA pain through neuroinflammation driven by macrophage polarization. We present a novel injectable thermo-sensitive hydrogel system, KAF@PLEL, designed to deliver an anti-inflammatory peptide (KAF) specifically to the DRG. This biodegradable hydrogel enables sustained KAF release, promoting the reprogramming of DRG macrophages from pro-inflammatory to anti-inflammatory phenotypes. Through comprehensive in vitro and in vivo studies, we evaluated the hydrogel's biocompatibility, effects on macrophage polarization, and therapeutic efficacy in chronic OA pain management. The system demonstrated significant capabilities in preserving macrophage mitochondrial function, suppressing neuroinflammation, alleviating chronic OA pain, reducing cartilage degradation, and improving motor function in OA rat models. The sustained-release properties of KAF@PLEL enabled prolonged therapeutic effects while minimizing systemic exposure and side effects. These findings suggest that KAF@PLEL represents a promising therapeutic approach for improving outcomes in OA patients through targeted, sustained treatment.

Hereditary angioedema (HAE) is a rare autosomal dominant genetic disorder characterized by recurrent and unpredictable episodes of edema. Currently, there is no effective cure available, which seriously affects patients′ quality of life. Gene therapy intervenes in the disease at the genetic level, offering new perspectives for the treatment of HAE. This article summarizes the current research progress in gene therapy for HAE, including gene editing, transgenic therapy, and RNA therapy. It aims to draw the attention of researchers in this field, and provide references and insights for clinicians.

AIM:To explore the mechanism of Chonghe paste in regulating PTEN-induced kinase 1(PINK1)/parkin pathway-mediated mitophagy on diabetic ulcer wound healing.METHODS:Thirty-six rats were used to construct a diabetic ulcer model by high-sugar and high-fat feed,intraperitoneal injection of streptozotocin and skin defect method,and were randomly divided into model group,Chonghe paste group and growth factor group,with 12 rats in each group.Another 12 rats were taken to construct normal wound model as normal group.The rats in normal group and model group were treated with normal saline for debridement,while those in Chonghe paste group and growth factor group were treated with Chonghe paste and growth factors for wound coating,respectively.The changes in fasting blood glucose and wound healing were observed and recorded,and samples were collected on the 7th and 14th days after treatment.The expression levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),P62 and collagen type Ⅲ(COL3)in granulation tissues were detected by immunohistochemistry.The mitochondrial ultrastructure was observed under an electron microscope,and the number of autophagosomes was recorded.The expression of PINK1,parkin and microtubule-associated protein 1 light chain 3-Ⅱ(LC3-Ⅱ)in wound tissues was detected by immunofluorescence,Western blot and RT-qPCR.RE-SULTS:Compared with normal group,the blood glucose levels of the rats in model group,Chonghe paste group and growth factor group were higher than 16.67 mmol/L on the 7th,14th and 28th days,indicating successful modeling of dia-betes.Compared with normal group,the rats in model group had a lower wound healing rate,the mean absorbance of IL-6,TNF-α and P62 was increased,the mean absorbance of COL3 was decreased,the number of autophagosomes per unit area was increased,the mean absorbance of PINK1,parkin and LC3-Ⅱ was decreased,and the mRNA and protein expres-sion levels of PINK1,parkin and LC3-Ⅱ were decreased.Compared with model group,the wound healing rate of the rats in Chonghe paste group and growth factor group was increased,the mean absorbance of IL-6,TNF-α and P62 was de-creased,the mean absorbance of COL3 was increased,the number of autophagosomes per unit area was decreased,the mean absorbance of PINK1,parkin and LC3-Ⅱ was increased,and the mRNA and protein expression levels of PINK1,parkin and LC3-Ⅱ were elevated.CONCLUSIONS:Chonghe paste can alleviate local inflammatory response in diabetic ulcer wounds,reduce the levels of inflammatory factors IL-6 and TNF-α,promote COL3 expression,activate the PINK1/parkin signaling pathway,and promote mitophagy in wounds,thus accelerating wound healing.

Objective To explore the relationship between hearing loss and cognitive function in the elderly population through propensity score matching method.Methods We analyzed the data of 7605 participants aged 60 and above who were included in the 2018 China Health and Retirement Longitudinal Study(CHARLS).The non-substitutable 1∶1 nearest neighbor matching method without caliper value was used for propensity score matching and G-computation was used to estimate the average treatment effect(ATE)of hearing loss on all dimensions of cognitive function.Results Before matching,there were 3626(47.68%)women,with 1409(18.53%)of whom suffering from hearing loss and 3031(39.86%)of whom suffering from cognitive impairment.After matching,1409 subjects were included in the hearing loss group and 1409,in the normal hearing group,with both groups sharing similar distribution of basic demographic characteristics.The results for the average treatment effect of the population indicated that the cognitive function scores of the hearing loss group were lower than those of the normal hearing group,with the overall cognitive function being 0.593 points lower(95%confidence intervel[CI]:-0.916--0.257,P<0.001),orientation being 0.183 points lower(95%CI:-0.302--0.055,P=0.004),immediate memory being 0.150 points lower(95%CI:-0.218--0.085,P<0.001),and language skills being 0.178 points lower(95%CI:-0.303--0.058,P=0.006).The prevalence of cognitive impairment of the hearing loss group was 4.2%higher than that of the normal hearing group(95%CI:0.007-0.077,P=0.020).Conclusion Hearing loss adversely affects the orientation,memory,and language skills of the elderly population and forms a potential risk factor for cognitive impairment in the elderly population.

Objective:This study aimed to construct a risk prediction model for obstructive sleep apnea（OSA） related hypertension based on the nomogram, and to explore the independent risk factors for OSA-related hypertension, so as to provide reference for clinical treatment decision-making. Methods:The clinical data of OSA patients diagnosed by polysomnography from October 2019 to December 2021 were collected retrospectively and randomly divided into training sets and validation sets. A total of 1 493 OSA patients with 27 variables were included. The least absolute shrinkage and selection operator（Lasso） logistic regression model was used to select potentially relevant features and establish a nomogram for OSA-related hypertension.The performance and clinical benefits of this nomogram were verified in terms of discrimination, calibration ability and clinical net benefit. Results:Multivariate logistic regression showed that body mass index（BMI）, family history of hypertension, lowest oxygen saturation（LSaO2）, age and cumulative percentage of total sleep time with oxygen saturation below 90% were independent risk factors for OSA-related hypertension. Lasso logistic regression identified BMI, family history of hypertension, LSaO2 and age as predictive factors for inclusion in the nomogram. The nomogram provided a favorable discrimination, with a C-indexes of 0.835（95% confidence interval[CI ]0.806-0.863） 0.865（95%CI 0.829-0.900） for the training and validation cohort, respectively, and well calibrated. The clinical decision curve analysis displayed that the nomogram was clinically useful. Conclusion:Compared with cumulative percentage of total sleep time with blood oxygen saturation below 90%, LSaO2 may have a greater impact on the incidence of OSA-related hypertension, and the effects of different times and degrees of hypoxia on OSA-related hypertension should be further explored in the future. Apnea hypopnea index involvement is weak in predicting OSA-related hypertension, and the blood oxygen index may be a better predictor variable. Furthermore, we established a risk prediction model for OSA-related hypertension patients using nomogram, and demonstrated that this prediction model was helpful to identify high-risk OSA-related hypertension patients. This model can provide early and individualized diagnosis and treatment plans, protect patients from the serious.
Humans ; Sleep Apnea, Obstructive/complications* ; Nomograms ; Hypertension/epidemiology* ; Male ; Female ; Risk Factors ; Middle Aged ; Retrospective Studies ; Polysomnography ; Logistic Models ; Body Mass Index ; Adult

Recommendation formation is a key component of clinical practice guidelines for Chinese patent medicine （CPM）， and should encompass the determination of the strength and direction of the recommendation， the rationale for the recommendation， and the methodology for implementing the recommendation. Recommendations can be formed through formal consensus and informal consensus. The strength and direction of recommendations for CPM guidelines should be determined by considering the quality of evidence for CPMs， the priority of the clinical questions， the pros and cons of efficacy and adverse effects， patient acceptance， the feasibility of the recommendation and the availability of resources， social fairness， economic benefits， and other influencing factors. In order to better guide guideline developers to consider these factors more rationally， this article provideed a detailed explanation of each factor in the context of the characteristics of TCM.

Objective To investigate the characteristics of heart rate variability(HRV)in obese patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods We retrospectively analyzed 78 patients with severe OSAHS diagnosed by polysomnography(PSG)in The Second Affiliated Hospital of Xi'an Jiaotong University from April 2018 to May 2022.According to body mass index(BMI),the patients were divided into obese with severe OSAHS group(43 cases)and non-obese with severe OSAHS group(35 cases).All patients received 24-hour Holter monitoring while on polysomnography monitoring.The differences in HRV indexes between the groups and the correlation between HRV and clinical indicators were analyzed.Results In terms of basic data and PSG indexes,the analysis results showed that compared with those in the non-obese OSAHS group,weight,BMI,neck circumference,waist circumference,and AHI in obese with severe OSAHS group were significantly higher,while the standard deviation of the 24-hour normal R-R interval(SDNN),the standard deviation of the 5-minute mean(SDANN),the triangle index(TI),the heart rate deceleration force(DC),the standard deviation of the normal R-R interval(awake SDNN),and high frequency during sleep in the obese with severe OSAHS group were significantly lower(P＜0.05).The correlation results showed that among obese with severe OSAHS patients,root mean square of the difference of adjacent R-R interval(rMSSD)was negatively correlated with the course of hypertension;TI and DC were negatively correlated with AHI.After adjusting for neck circumference and waist circumference,the linear regression analysis showed that SDNN,SDANN,and rMSSD were correlated with systolic blood pressure(P＜0.05).Conclusion There is significant decrease in HRV index in obese patients with severe OSAHS,suggesting that deterioration of cardiac autonomic nervous regulation function may increase the risk of cardiovascular disease.