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.

Objective:To investigate the postoperative prosthesis position and early clinical efficacy of 3D printing patient-specific instrumentation (PSI)-assisted unicompartmental knee arthroplasty (UKA).Methods:The clinical data of 15 patients (17 knees, PSI group) with medial compartment knee osteoarthritis who underwent PSI-assisted UKA in the Second Affiliated Hospital, the Air Force Medical University from May to August 2023 were retrospectively analyzed, matched with fifteen patients (17 knees, non-PSI group) with medial compartment knee osteoarthritis undergoing conventional UKA. The differences in the prosthesis placement positions in the postoperative X-ray films between the two groups were compared, including the coronal varus-valgus angles of the tibial and femoral prostheses, the sagittal posterior inclination angle of the tibial prosthesis, the flexion-extension angle of the femoral prosthesis, and the height of the reconstructed joint line. The indicators related to the lower limb alignment (including the femoral valgus angle, the lateral femoral angle, the hip-knee-ankle angle, and the femur-tibia angle) and the range of motion of the knee joint before and after the operation were compared. The Oxford knee score (OKS), American Knee Society (AKS) knee score and function score, and the visual analogue scale (VAS) were used to evaluate the clinical effects of the two groups.Results:In the PSI group, the coronal varus-valgus angle of the tibial prosthesis was 1.6°±0.3° after the operation, and the sagittal posterior inclination angle was 5.7°±0.8°. The coronal varus-valgus angle of the femoral prosthesis was -0.5°±1.5°, and the sagittal flexion-extension angle was 4.0°±1.9°. In the non-PSI group, the corresponding angles were 2.3°±0.6°, 4.5°±1.0°, 1.4°±1.5°, and 7.3°±2.2° respectively with significant differences between the two groups ( P<0.05). The OKS of the PSI group before and after the operation were 26.5±1.8 and 38.6±4.1 points respectively. The AKS knee score were 56.9±8.6 and 89.2±7.2 points. The AKS function score were 70.1±4.2 and 77.5±9.4 points. The VAS were 4.5±3.7 and 2.3±0.3 points, and the range of motion of the knee joint were 115.2°±4.8° and 125.9°±4.6° with significant differences ( P<0.05). The OKS of the non-PSI group before and after the operation were 25.3±6.2 and 38.2±3.5 points respectively. The AKS knee score were 50.6±9.3 and 84.5±6.6 points. The AKS function score were 73.4±3.9 and 77.2±4.8 points. The VAS were 5.8±2.4 and 2.5±1.6 points, and the range of motion of the knee joint were 113.6°±6.7° and 122.3°±5.0° with significant differences ( P<0.05). There were inter-group differences in the AKS knee score and the range of motion of the knee joint after the operation between the two groups with significant differences ( P<0.05). Conclusion:PSI guides-assisted UKA can effectively correct the lower limb alignment of patients and improve knee joint function with good short-term efficacy. Compared with conventional UKA, PSI guides-assisted UKA is less time-consuming with higher precision in prosthesis installation position and fewer post-operative complications.

Objective:To investigate the relationship between lymph node metastases and the prognosis of uterine cervical cancer patients diagnosed at Ⅲ C1p after abdominal surgery. Methods:The clinical data of 350 uterine cervical cancer patients preoperatively confirmed as 2018 International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ B-Ⅱ A who underwent abdominal hysterectomy followed by postoperative concurrent chemoradiotherapy between January 2012 and December 2019 at Subei People's Hospital of Jiangsu Province were retrospectively analyzed, and there were 81 patients postoperatively diagnosed at stage Ⅲ C1p. Kaplan-Meier method was used to analyze the survival of patients stratified by different factors, and multivariate Cox proportional risk model was used to analyze the factors affecting the prognosis of patients. Results:Among 81 uterine cervical cancer patients diagnosed at stage Ⅲ C1p after abdominal surgery, 79 cases were successfully followed up. Kaplan-Meier analysis showed that patients with parametrial infiltration, the number of metastatic lymph nodes > 2, metastatic lymph node rate > 20 and common iliac lymph node metastasis had worse disease-free survival (DFS) and the overall survival (OS) (all P < 0.05). Multivariate Cox proportional analysis showed that the number of metastatic lymph nodes > 2 ( HR = 5.38,95% CI 1.30-22.20, P = 0.020) was an independent risk factor for OS; the number of metastatic lymph nodes >2 ( HR = 5.99, 95% CI 1.45-24.77, P = 0.013), common iliac lymph node metastasis ( HR = 4.91, 95% CI 1.17-20.55, P = 0.029) were independent risk factors for DFS. Conclusion:Lymph node metastasis may be associated with the prognosis of uterine cervical cancer patients diagnosed at stage Ⅲ C1p after abdominal surgery. The number of metastatic lymph nodes > 2 is a adverse influencing factor for OS and DFS.

Objective:To evaluate the influence of telomerase reverse transcriptase (TERT) promoter mutation on radioiodine uptake status of radioactive iodine refractory papillary thyroid cancer (RAIR-PTC) and radioiodine therapy response by analyzing the mutation frequency of TERT promoter in RAIR-PTC.Methods:A total of 37 patients with RAIR-PTC (15 males, 22 females, age (49.8±16.1) years) and 40 PTC patients with effective radioiodine therapy (13 males, 27 females, age (39.8±10.9) years) between January 2005 and June 2020 in JiangYuan Hospital Affiliated to Jiangsu Institute of Nuclear Medicine were retrospectively analyzed. TERT promoter mutation and B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation of patients were observed. The differences across genotype patterns on radioiodine uptake status and therapy response were compared. The Fisher′s exact test and independent-sample t test were used for data analysis. Results:The incidence rate of TERT promoter mutation in the RAIR-PTC group was 40.54% (15/37, all C228T), which was significantly higher than that in the effective radioiodine therapy group (0, 0/40; P<0.001). No statistically significant difference was found for the mutation rate of BRAF V600E between the RAIR group (64.86%, 24/37) and the effective radioiodine therapy group (72.50%, 29/40; P=0.858). Patients with TERT promoter mutation were older ( t=3.76, P=0.001) and the non-intake rate of radioiodine in distant metastases of those patients was higher ( P=0.037). Furthermore, 2/3 of patients who received targeted therapies and 3/4 deaths had TERT promoter mutation. Among 35 patients with negative thyroglobulin antibody (TgAb), 11/14 of patients with TERT mutation had a rising stimulated thyroglobulin (sTg), while the percentage of the non-TERT mutation group was 57.1% (12/21; P=0.357). Conclusion:The TERT promoter mutation rate is significantly increased in RAIR-PTC patients and can serve as a prognostic predictor in RAIR.

Objective:To evaluate delayed laparoscopic cholecystectomy (DLC) after percutaneous transhepatic gallbladder drainage (PTGBD) in acute cholecystitis.Methods:Clinical data of 64 patients who were diagnosed moderate (grade Ⅱ) acute cholecystitis by the 2018 Tokyo Guidelines in acute phase and underwent delayed LC at our hospital from Jan 2018 to Jan 2021 were compared between two groups ie PTGBD treatment (21 cases)in acute stage before DLC and DLC without PTGBD group (43 cases). The difficulty score of TG18 was used to evaluated every surgical procedure of the cases by reviewing the operation videos.Results:Patients in DLC after PTGBD group had a longer hospital stay and operation time, more blood lose and higher difficulty score than the DLC without PTGBD group(all P<0.05). There was no statistically significant difference in the conversion rate and morbidity rate between the two groups( P>0.05). Conclusion:This study fails to show there is any if ever benefit of PTGBD before DLC over DLC without PTGBD in the management of Grade Ⅱ acute cholecystitis.

Objective: To analyze the possible responses of parents of young children to Child sexual assault (CSA) and the potential influencing factors, so as to provide evidence for prevention programs of CSA. Methods: Part of the data from "2016-2020 Child Injury Prevention Project" was used to analyze responses to CSA among parents of children younger than 3rd grade in primary school by chi square test and Logistic regression analysis. Results: A total of 4 072 parents were included in the analysis. Among them, 86.8% of parents chose "to solve problems together", 51.0% of parents taking children to a "psychologist", 4.9% of parents "scolding children for being too careless", 2.9% of parents "letting child not disclose abuse" and 6.5% of parents chose "other" coping methods. Parents with foreign nationality [OR(95%CI)=2.58(1.25-5.15)] and lower education level (OR=0.26-0.64) tend to "blame" their children. Mothers [(OR(95%CI)=0.54(0.33-0.90)], higher parental education level (OR=0.27-0.72) were more reluctant to encourage their children to keep quiet. Mothers [OR(95%CI)=1.73(1.32-2.27)], older children (OR=1.33-1.78) and parents with higher education level (OR=1.65-2.99) tend to "accompany". Parents aged 30 or more, and from high school/technical school/technical secondary school tend to take their children to see a "psychologist" [OR(95%CI)=1.39(1.14-1.71), 1.79(1.26-2.53)]. Conclusion Parents universally pay attention to the physical and mental health of children after CSA, but some parents still take negative coping methods, e.g. "blame" and "not disclose". Parenting educational level, duration of parent-child communication and age of children are primary factors associated with parental responses to child sexual assault. This study suggests that prevention secondary injury following child sexual assault should be farther strengthened, while fully considering the characteristics of the educated objects.

BACKGROUND: The 2019 novel coronavirus disease (COVID-19) has had a massive impact on public health, resulting in sudden dietary and behavioral habit changes. Frontline epidemic prevention workers play a pivotal role against COVID-19. They must face high-risk infection conditions, insufficient anti-epidemic material supplies, mental pressure, and so on. COVID-19 seriously affects their dietary and behavioral habits, and poor habits make them more susceptible to COVID-19. However, their baseline dietary and behavioral habits before COVID-19 and their willingness to change these habits after the outbreak of COVID-19 remain unclear for these workers in China. This study aimed to explore the baseline dietary and behavioral habits of frontline workers and their willingness to change these habits after the outbreak of the epidemic; in addition, susceptible subgroups were identified by stratified analyses as targets of protective measures to keep them from being infected with COVID-19. METHODS: A cross-sectional study was conducted through an online questionnaire using a sample of 22,459 valid individuals living in China, including 9402 frontline epidemic prevention workers. RESULTS: Before COVID-19, 23.9% of the frontline epidemic prevention workers reported a high-salt diet, 46.9% of them reported a high frequency of fried foods intake, and 50.9% of them smoked cigarettes. After the outbreak of COVID-19, 34.6% of them expressed a willingness to reduce salt intake, and 43.7% of them wanted to reduce the frequency of pickled vegetables intake. A total of 37.9% of them expressed a willingness to decrease or quit smoking, and 44.5% of them wanted to increase sleep duration. Significant differences in the baseline dietary and behavioral habits and the willingness to change their habits were observed between frontline epidemic prevention workers and other participants. Among the frontline epidemic prevention workers with poor dietary and behavioral habits before COVID-19, frontline epidemic prevention experience was a promoting factor for adopting worse dietary and behavioral habits, including those in the high-salt intake subgroup (OR, 2.824; 95% CI, 2.341-3.405) and the 11-20 cigarettes/day subgroup (OR, 2.067; 95% CI, 1.359-3.143). CONCLUSIONS The dietary and behavioral habits of frontline epidemic prevention workers were worse than that those of other participants before COVID-19. They had a greater willingness to adopt healthy dietary and behavioral habits after experiencing the outbreak of COVID-19. However, frontline epidemic prevention workers with poor dietary and behavioral habits before COVID-19 continued in engage in these poor habits. Dietary and behavioral intervention policies should be drafted to protect their health, especially frontline epidemic prevention workers with poor habits at baseline.
Adult ; COVID-19/psychology* ; China/epidemiology* ; Cross-Sectional Studies ; Diet/standards* ; Female ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Health Personnel/psychology* ; Humans ; Male ; Risk Reduction Behavior ; SARS-CoV-2 ; Surveys and Questionnaires

Objective:To investigate the current status of knowledge, attitude and behavior of primary caregivers about aspiration prevention in high-risk aspiration patients and to analyze its influencing factors so as to provide a basis for formulating the health education and continuous nursing intervention in high-risk aspiration patients.Methods:From July 2018 to December 2018, we selected 232 primary caregivers of high-risk aspiration patients at a ClassⅢ Grade A hospital in Ningbo City, Zhejiang Province, by convenience sampling. All care givers were investigated with the Aspiration Prevention Knowledge, Attitude and Practice Questionnaire for the Inpatient Caregiver. We also analyzed the influencing factors of aspiration prevention knowledge, attitude and behavior.Results:Finally, a total of 220 valid questionnaires were collected with 94.83% for the valid recovery rate. Among 220 primary caregivers, scores of aspiration prevention knowledge, attitude and behavior were (31.41±9.99) , (45.83±5.19) and (40.57±8.92) respectively. Correlation analysis showed that the aspiration prevention knowledge of caregivers had positive correlations with the attitude ( r=0.425, P<0.01) and the behavior ( r=0.554, P<0.01) , the attitude also had a positive correlation with the behavior ( r=0.472, P<0.01) . Single factor analysis showed that there were statistical differences in the scores of aspiration prevention knowledge and behavior among caregivers with different ages, genders, relationships with patients, care experience, care years and whether caregivers had been trained ( P<0.05) ; there were also statistical differences in the score of aspiration prevention attitude among caregivers with different ages, relationships with patients, care years and whether caregivers had been trained ( P<0.05) . Multiple linear regression analysis indicated that the influencing factors of aspiration prevention knowledge of caregivers included the ages, care experience and whether caregivers had been trained with statistical differences (Standardized regression coefficients were -0.173, -0.181, -0.337; P<0.05) ; the influencing factor of aspiration prevention attitude of caregivers was the ages with a statistical difference (The standardized regression coefficient was -0.179, P<0.01) . Conclusions:Primary caregivers of high-risk aspiration patients have a good aspiration prevention attitude, a medium level of behavior their knowledge needs to be improves. Nurses should pay more attention to the aspiration prevention care of caregivers with no care experience, untrained and non-middle age.

Objective To observe the objective response rate, survival and safety of radiotherapy combined with Iressa for patients with locally advanced non-small cell lung cancer ( NSCLC) unsuitable for surgery or concurrent chemoradiotherapy. Methods The patients with locally advanced NSCLC unsuitable for surgery or concurrent chemoradiotherapy were recruited and received thoracic intensity-modulated radiotherapy ( IMRT) combined with Iressa 250 mg daily. Results A total of 30 patients were enrolled between July 2014 and March 2017. Twenty-nine patients were analyzed. At 1 month after radiotherapy,the complete response (CR) was 0,partial response (PR) was 21(72％),stable disease (SD) was 6(21％), progressive disease (PD) was 2(7％),the disease control rate (CR+PR+SD) was 93％,and the objective response rate was 72％. The median follow-up time was 25 months. Fourteen ( 48％) patients died,and 15 (52％) survived. Twenty-three (79％) patients obtained PD including local progression in 18(62％) and distant metastasis in 14(48％). The median survival time (MST) was 26 months and the median PFS was 11 months. The 1-year OS and PFS were 79％ and 44％,and the 2-year OS and PFS were 55％ and 18％. Univariate analysis demonstrated that smoking history and disease stage were influencing factors for OS ( P=0. 035,0. 031) . Moreover, disease stage, the primary tumor diameter, the volume of GTV and PTV were influencing factors for PFS (P=0. 000,0. 016,0. 039,0. 030). Multivariable analysis revealed that disease stage and the volume of PTV were independent prognostic factors for PFS (P=0. 000,0. 012).Two patients ( 7％) developed grade 3 acute adverse events and 7 ( 24％) experienced grade 2 acute irradiation pneumonitis. Conclusions For patients with locally advanced NSCLC unsuitable for surgery or concurrent chemoradiotherapy,IMRT combined with Iressa yields high objective response rate and well tolerance. The long-term clinical efficacy remains to be validated.

Objective To formulate a prevention and control guideline for deep venous thrombosis (DVT) in lower extremities in bedridden elderly patients and to explore its effects. Methods The problems existing in prevention and control of DVT in bedridden elderly patients were analyzed by search for literature, interviewing medical and nursing staff in the ward and reviewing DVT cases in bedridden elderly patients. The prevention and control guideline was formulated based on the evidence-based practice guideline. Relevant health videos were made and quality control measures were formulated by building DVT prevention and control teams and processes for bedridden elderly patients and adopting Caprini's and Padua's risk assessment tools. The prevention and control guideline was put into clinical use since February 2017. The incidence of DVT and blood stasis in bedridden elderly patients before (from May 2016 to January 2017, n=112) and after (between February and November 2017, n=99) the implementation of the guideline. Results After the prevention and control guideline was implemented, the positive rate of blood stasis in the bedridden elderly patients rose from 6.3% (7/112) to 15.2%(15/99), while the incidence rate of DVT dropped from 8.9% (10/112)to 2.0%(2/99) (χ2=4.458, 4.676;P＜ 0.05). Conclusions The prevention and control guideline based on the DVT prevention and management guideline can reduce the risks of DVT in bedridden elderly inpatients.