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.

Objective: To examine the application of multi-disciplinary treatment (MDT) in the diagnosis and management of recurrence and metastasis of adenoid cystic carcinoma (ACC) of the palate, as well as the treatment of concurrent massive palatal bleeding. This article aimed to provide references for the diagnosis and treatment of patients with advanced oral cancer, along with strategies for managing massive hemorrhage. Methods: This article reported on the MDT process for a patient diagnosed with ACC of the left upper palate, who experienced skull base recurrence and lung metastasis following surgery and radiotherapy. The case was further complicated by massive palatal hemorrhage. Additionally, the article analyzed patients with ACC recurrence and significant hemorrhage in the context of relevant literature. The patient was a 36-year-old female with ACC located in the left palate, initially diagnosed at clinical stage T3N0M0 in 2013. She underwent an extensive resection of the palatal lesion, followed by radioactive 125I seed implantation, which was guided by a radiotherapy planning system (TPS) and a digital guide. The patient was monitored for four years post-surgery, during which no signs of tumor recurrence were observed. However, at the fifth year of follow-up, the patient developed recurrence with lung metastasis, classified as T4N0M1. Following a multidisciplinary consultation involving the oral and maxillofacial surgery, radiotherapy, medical oncology, and thoracic surgery, the patient underwent a procedure comprising left subtotal maxillary resection, autologous free flap transplantation, and thoracoscopic resection of pulmonary metastases. After surgery, the patient received 60 Gy of radiotherapy and was orally administered Anlotinib hydrochloride capsules to suppress tumor growth. After 31 months of follow-up, the patient reported experiencing slight bleeding in the mouth. A craniomaxillofacial CT scan revealed that the tumor had grown aggressively, resulting in destruction of the skull base. Consequently, the patient was admitted to the hospital. On the second day of admission, she experienced a sudden episode of oral bleeding. Despite the application of pressure, the bleeding continued unabated. An emergency tracheotomy was performed to relieve the obstruction of the patient’s respiratory tract, and a red blood cell suspension was transfused to address the hemorrhagic shock. Following an urgent consultation with the vascular interventional surgery department, super-selective embolization was promptly employed to effectively halt the bleeding and achieve rapid vascular occlusion. An individualized treatment plan was developed under MDT, incorporating postoperative radiotherapy, targeted therapies, and immunotherapy to manage the tumor. Results: Through the MDT model, the patient successfully achieved emergency hemostasis, and normal vital signs were restored. With the addition of radiotherapy and immune-targeted drug treatment, tumor progression was effectively controlled, leading to an improved quality of life for the patient, who successfully survived for 129 months with the tumor by July 2024. A review of the relevant literature indicated that MDT offered significant advantages in the management of adenoid cystic carcinoma. In selecting surgical methods, the team administering MDT could comprehensively evaluate factors such as the patient’s age, physical condition, tumor location, size, and extent of invasion to develop a personalized treatment plan. Radical surgical resection was a common treatment option for ACC. Postoperative tissue defects could be restored to their corresponding functions and aesthetic appearance through autologous tissue reconstruction, utilizing techniques such as peroneal myocutaneous flaps or iliac myocutaneous flaps, or by the implantation of artificial materials. In complex cases involving positive margins, recurrence, and metastasis, the MDT model employed interdisciplinary collaboration to devise a comprehensive treatment plan that may have included re-operation, radiotherapy, and chemotherapy, with the aim of minimizing the risk of ACC recurrence and controlling distant metastasis. Massive bleeding resulting from advanced oral cancer presented a complex medical challenge, influenced by various risk factors such as tumor type, metastasis, treatment options, and the patient’s overall condition. Early identification of bleeding risks, along with strategies to mitigate the adverse effects of bleeding on disease progression—through supportive care, medical treatment, surgical intervention, and interventional therapy—could significantly enhance patients’ quality of life. Conclusion The MDT model can provide comprehensive, precise, and personalized treatment plans for patients with advanced oral cancer and massive hemorrhage and improve the effectiveness of treatment strategies.

Yttrium-90 selective internal radiation therapy (⁹⁰Y-SIRT) is a treatment technique that delivers radioactive microspheres precisely to the arterial vascular bed of neoplasms, utilizing beta radiation to administer a high local dose of radiation to the neoplasm tissues. This technology has demonstrated significant efficacy in patients with unresectable pirmary liver cancers and liver metastases. This article systematically reviews the development history and clinical application status of ⁹⁰Y-SIRT in the treatment of liver cancer, and looks forward to future development directions.

With the rapid development of mobile internet technology, mobile health application (mHealth APP) are increasingly widely used in the field of health management and have been proven to play an important role in the management of chronic diseases. Solid organ transplant recipients face complex health management needs after surgery, including postoperative follow-up, medication management, prevention and treatment of complications and comorbidities, and lifestyle adjustment. mHealth APP can provide solid organ transplant recipients with convenient self-management tools. Although some progress has been made in this field, there are still many challenges, such as insufficient user experience, technological dependence, and data security risks. Therefore, this article discusses the development process, main functions and current application status of mHealth APP, and analyzes its advantages in improving the self-management ability of solid organ transplant recipients, promoting doctor-patient communication and reducing the incidence of complications. At the same time, based on the practical experience of author’s team in developing the “TransMate” mHealth APP, we propose the directions that mHealth APPs should focus on in the future, in order to provide more effective support and services for the health management of solid organ transplant recipients.

Objective: To investigate the influencing factors for vaccination willingness of herpes zoster vaccine (HZV) among the elderly, so as to provide the basis for improving the HZV vaccination strategy for the elderly. Methods: From July 2023 to June 2024, permanent residents aged ≥60 years in Yangzhou City, Jiangsu Province were selected using the multistage random sampling method and probability proportionate to size sampling method. Basic information, disease history, awareness of herpes zoster (HZ) and HZV, vaccination history, and vaccination willingness of HZV were collected through questionnaire surveys. Multivariable logistic regression model was used to analyze the influencing factors for vaccination willingness of HZV among the elderly. Results: Totally 1 209 valid questionnaires were recovered, with an effective recovery rate of 95.95%. The respondents included 657 males (54.34%) and 552 females (45.66%). Among them, 626 (51.78%) individuals were aged 60 -<70 years. There were 113 individuals had vaccination willingness of HZV, with a vaccination willingness rate of 9.35%. The multivariable logistic regression analysis showed that female (OR=2.872, 95%CI: 1.624-5.080), urban (OR=4.909, 95%CI: 2.732-8.818), individual monthly income of 1 000-<2 000 yuan (OR=3.085, 95%CI: 1.602-5.940), accessibility of vaccination clinics (OR=5.717, 95%CI: 1.109-29.462), presence of chronic diseases (OR=2.423, 95%CI: 1.325-4.431), history of varicella infection (OR=2.114, 95%CI: 1.213-3.684), awareness of HZ (OR=2.194, 95%CI: 1.096-4.394), awareness of HZV (OR=3.562, 95%CI: 2.005-6.330), history of influenza vaccine vaccination (OR=7.833, 95%CI: 4.189-14.645), and history of 23-valent pneumococcal vaccine vaccination (OR=2.955, 95%CI: 1.603-5.449) were promoting factors for vaccination willingness of HZV. Conclusion The vaccination willingness rate of HZV among the elderly is relatively low, which is mainly affected by factors such as gender, residence, individual monthly income, accessibility of vaccination clinics, presence of chronic diseases, history of varicella infection, awareness of HZ and HZV, and history of influenza vaccine and 23-valent pneumococcal vaccine vaccination.

Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO₂/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO₂), maximum metabolic equivalent (METs), and maximum work (W_max). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO₂/kg, AT, EqCO₂, METs, or W_max between the two groups (P>0.05). At the end of the trail, the indicators like pVO₂/kg [(19.81±2.38) mL·(min·kg)⁻¹], AT [(14.48±2.33) mL·(min·kg)⁻¹], METs (5.64±0.69), and W_max [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)⁻¹, (11.70±1.94) mL·(min kg)⁻¹, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO₂ between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.

Objective To investigate the separation efficiency of three physical separation methods for gaseous ¹⁴C, namely membrane separation, adsorption separation, and low-temperature separation, to screen for the optimal separation method, and to provide a reference for the separation and enrichment of ¹⁴CO₂ in online monitoring of ¹⁴C. Methods The experimental plan was designed, and three devices were constructed for separation and purification experiments. The purity, recovery rate, and separation time of CO₂ separated by the three methods were analyzed. Results All the three methods achieved the separation of CO₂. Under certain conditions, 20 mL of sample gas was obtained. The separation time of membrane separation method was 0.5 hour, CO₂ gas with a sample purity of 0.0486%-0.0488%VOL was obtained, and the recovery rate was only 2.5%−12.7%. The separation time of MOF material adsorption separation method was 24−30 hours, CO₂ gas with a sample purity of 20.2%−47.5%VOL was obtained, and the recovery rate was 57.3%−63.2%. The separation time of low-temperature separation method was 3 hours, CO₂ gas with a sample purity of 96.0%−99.8%VOL was obtained, and the recovery rate was 81.5%−92.5%. Conclusion The purity and recovery rate of CO₂ with low-temperature separation method were higher compared to membrane separation method and MOF material adsorption separation method. The separation time of low-temperature separation method was moderate. The low-temperature separation method can provide a reference for the enrichment technology of ¹⁴C in the rapid measurement of gaseous ¹⁴C effluent.

[摘 要] 目的：探讨异莲心碱（Iso）通过PI3K/Akt/mTOR信号通路对结肠癌SW480细胞增殖、凋亡和自噬的影响。方法：用10、20和40 μmol/L的Iso处理结肠癌SW480细胞，CCK-8法、流式细胞术和WB法分别检测Iso对细胞增殖活力、凋亡和自噬相关蛋白LC3Ⅰ、LC3Ⅱ、p62表达的影响。然后，用20 μmol/L的Iso和25 μmol/L的PI3K激活剂740 Y-P分别处理SW480细胞，将细胞分为对照组、740 Y-P组、Iso组和Iso+740 Y-P组，流式细胞术、WB法检测Iso和740 Y-P对各组细胞凋亡及细胞中LC3Ⅰ、LC3Ⅱ、p62、PI3K、p-PI3K、 mTOR和p-mTOR蛋白表达的影响。结果：10、20和40 μmol/L的Iso处理后，SW480细胞增殖活力均显著下降（均P<0.05），细胞凋亡率均显著升高（均P<0.05），LC3Ⅱ/LC3Ⅰ表达均显著上调（均P<0.05），p26蛋白表达显著下调（P<0.05）。Iso和740 Y-P处理后，与对照组相比，740 Y-P组细胞凋亡率、LC3Ⅱ/LC3Ⅰ表达均显著下降（均P<0.05），p26、p-PI3K/PI3K和p-mTOR/mTOR表达均显著升高（均P<0.05）；Iso组细胞凋亡率、LC3Ⅱ/LC3Ⅰ表达升高（均P<0.05），p26、p-PI3K/PI3K和p-mTOR/mTOR表达均显著下降（均P<0.05）；与740 Y-P组相比，Iso+740 Y-P组细胞凋亡率、LC3Ⅱ/LC3Ⅰ表达升高（P<0.05），p26、p-PI3K/PI3K和p-mTOR/mTOR表达均显著下降（均P<0.05）；与Iso组相比，Iso+740 Y-P组细胞凋亡率、LC3Ⅱ/LC3Ⅰ表达下降（均P<0.05），p26、p-PI3K/PI3K和p-mTOR/mTOR表达均显著升高（均P<0.05）。结论：Iso通过抑制PI3K/Akt/mTOR信号通路抑制结肠癌SW480细胞增殖并诱导细胞凋亡和自噬。

Background Photovoltaic (PV) cells can convert solar energy into electricity and alleviate the dilemma of energy supply shortage. Shanghai's PV module industry is booming, but there are few reports on the health status of the workers and there is an urgent need for health risk assessment. Objective To evaluate the health status of PV module production workers and the association between work and health status, in order to provide a direction for the health management of the workers. Methods Among the PV module production workers who completed prescriptive occupational health examination by a designated medical institution in 2021, 2453 workers with more than one year of working age were selected as the exposure group and 538 newly hired workers as the control group. On the basis of the Technical specifications for occupational health surveillance (GBZ 188−2014), the health examination included physical examination and laboratory examination and information such as sociodemographics, living habits, and disease history. We compared the indicators of pure-tone hearing test, blood routine examination, electrocardiogram (ECG), liver function, and kidney function between the two groups. The blood routine results included erythrocyte-related indicators, leukocyte-related indicators, and platelet-related indicators, and the results of liver function included hepatocyte injury indicators, hepatic secretory function indicators, and hepatic synthesis function indicators. The workers were divided into four groups by quartiles of working age. Trend chi-square test was used to analyze differences in health status between the four working age groups. Multiple logistic regression models were used to evaluate the association between working age and health indicators. Results Among the exposure group workers, 2035 (83.0%) were male and 418 (17.0%) were female. The median (P₂₅, P₇₅) age was 34.0 (30.0, 39.0) years and the median (P₂₅, P₇₅) working age was 6.0 (3.0, 10.0) years. The abnormality rate of blood routine was 61.7%. Among them, the abnormality rates of platelet-related indicators and liver secretory function indicators were 39.8% and 48.1% respectively. The risks of abnormal hepatocyte injury-related indicators, fatty liver, and platelet-related indicator abnormalities among the exposure group were 1.471 (95%CI: 1.060, 2.054), 1.691 (95%CI: 1.208, 2.385), and 7.576 (95%CI: 4.967, 11.994) times higher than those in the control group respectively. The single-factor analysis demonstrated a positively linear trend between working age and hypertension prevalence, electrical audiometry abnormality rate, or liver secretory function indicator abnormality rate. Corrected for gender, age, smoking status, hypertension, etc., the results of logistic analysis showed that quartile working age was positively related to abnormal liver secretion function and abnormal platelet-related indicators respectively (OR=1.047, P=0.005; OR=1.037, P=0.014), and inversely associated with the abnormal rate of renal function (OR=0.953, P=0.044). Conclusion Negative associations between health status and working age are identified in PV module production workers. The target PV module production employees are in younger age, and with the increase of working age, the abnormalities of liver function and platelets may increase. Therefore, the enterprises should extend occupational health work from workplace to workers.

Bioactive compounds derived from herbal medicinal plants modulate various therapeutic targets and signaling pathways associated with cardiovascular diseases (CVDs), the world's primary cause of death. Ginkgo biloba, a well-known traditional Chinese medicine with notable cardiovascular actions, has been used as a cardio- and cerebrovascular therapeutic drug and nutraceutical in Asian countries for centuries. Preclinical studies have shown that ginkgolide B, a bioactive component in Ginkgo biloba, can ameliorate atherosclerosis in cultured vascular cells and disease models. Of clinical relevance, several clinical trials are ongoing or being completed to examine the efficacy and safety of ginkgolide B-related drug preparations in the prevention of cerebrovascular diseases, such as ischemia stroke. Here, we present a comprehensive review of the pharmacological activities, pharmacokinetic characteristics, and mechanisms of action of ginkgolide B in atherosclerosis prevention and therapy. We highlight new molecular targets of ginkgolide B, including nicotinamide adenine dinucleotide phosphate oxidases (NADPH oxidase), lectin-like oxidized LDL receptor-1 (LOX-1), sirtuin 1 (SIRT1), platelet-activating factor (PAF), proprotein convertase subtilisin/kexin type 9 (PCSK9) and others. Finally, we provide an overview and discussion of the therapeutic potential of ginkgolide B and highlight the future perspective of developing ginkgolide B as an effective therapeutic agent for treating atherosclerosis.