Objective To quantitatively assess the exposure-response association between exposure to heatwave and sudden death, estimate the attributable excess deaths, and identify potential vulnerable subgroups. Methods A time-stratified case-crossover study was conducted among residents who died from sudden death in Jiangsu Province, China between 2015 and 2021. Heatwave events in Jiangsu Province, defined using varying relative temperature thresholds and durations, were identified using temperature data from the China Meteorological Administration Land Data Assimilation System (CLDAS V2.0). Individual heatwave exposure was assessed based on each subject's residential address. The exposure-response association between heatwave and sudden death was evaluated using conditional logistic regression model combined with a Distributed Lag Nonlinear Model(DLNM). Heatwave-attributable excess deaths were estimated. Stratified analyses by sex and age were performed to assess potential effect modifications. Results Under all definitions, exposure to heatwave was significantly associated with an increased risk of sudden death, and the risk increased with the intensity of heatwave. Using the P95_3d definition (temperature exceeding the 95th percentile for ≥3 consecutive days), heatwave was significantlyassociated with a 56% increased risk of sudden death (95% CI: 31%, 86%). The population-attributable fraction of sudden death due to heatwave exposure was 1.45% (95% CI: 0.97%, 1.90%). Stratified analyses indicated no statistically significant differences in the association between heatwave exposure and sudden death across age or sex subgroups. Conclusion Heatwave exposure was associated with an increased risk of sudden death. Reducing heatwave exposure during summer may help lower the occurrence of sudden death.

Objective: To analyze and compare the levels of various coagulation factors in cryoprecipitate and corresponding fresh frozen plasma, thereby providing a basis for the precise clinical administration of cryoprecipitate. Methods: Fibrinogen, coagulation factors Ⅱ, Ⅴ, Ⅶ, Ⅷ, Ⅸ, Ⅹ, Ⅺ, Ⅻ, and ⅩⅢ, von Willebrand factor antigen (VWF∶Ag), and von Willebrand factor activity (VWF∶Act) were measured in cryoprecipitate and corresponding fresh frozen plasma prepared from 400 mL of whole blood. The levels of each coagulation factor were quantified and subjected to paired comparisons; the total coagulation factor content was also calculated for each bag of cryoprecipitate and fresh frozen plasma. Results: The fibrinogen level in the precipitate was (4.48±0.83) g/L, coagulation factor Ⅷ activity was (330.11±172.00) IU/dL, VWF∶Ag was (510.7±229.34) IU/dL, VWF∶Act was (341.35±116.21) IU/dL; the activities of other coagulation factors did not differ significantly from those in fresh frozen plasma. In each bag of cryoprecipitate (47.7±1.68) mL, the fibrinogen content was (211.94±39.6) mg, the coagulation factor Ⅷ content was (156.67±79.82) IU, the VWF∶Ag content was (245.18±103.25) IU, VWF∶Act was (164.21±54.30) IU. Paired comparisons between cryoprecipitate and fresh frozen plasma revealed that the concentrations of Fib, FⅧ, FⅨ, FⅪ, FⅫ, FⅩⅢ, VWF∶Ag, and VWF∶Act in cryoprecipitate were all higher than those in fresh frozen plasma, with statistically significant differences (P<0.05). Conclusion: Fresh frozen plasma and cryoprecipitate can serve as treatment options for patients with coagulation factor deficiencies. The results provide data to guide the precise selection of blood products and the rational use of blood in clinical practice.

The coagulation factors in cryoprecipitate are mainly coagulation factor Ⅷ, fibrinogen, von Willebrand factor (VWF), and coagulation factor ⅩⅢ. This article provides different treatment dosages and plans for different patients with rare coagulation disorders based on their actual conditions referring to international and domestic guidelines and consensus. In order to achieve precise infusion for cryoprecipitate, it is necessary to avoid poor treatment effects caused by insufficient doses, as well as waste of blood components and the risk of thrombosis caused by excessive infusion.

By analyzing the epidemic characteristics of influenza during the COVID-19 epidemic in Jiangsu Province from 2020 to 2022, it found that 90 721 influenza-like case samples were collected in Jiangsu Province from 2020 to 2022, of which 6 732 were nucleic acid-positive samples, with an average positive detection rate of 7.4% in three years. The annual positive detection rate presented a U-shaped distribution, with positive detection rates of 4.4%, 3.2% and 14.7%, respectively, with statistically significant differences ( χ2=12 126.00, P<0.001). During the seasonal peak period of influenza from 2020 to 2022, there was a significant decrease in the intensity of the two influenza activity peaks that occurred before the virus became fully prevalent in the population. The first peak occurred from January to February 2020, and the positive detection rate of influenza nucleic acid decreased from 54.4% (317/583) in the third week to 2.1% (12/584) in the eighth week, with a statistically significant difference ( χ2=394.49 , P<0.001) . The second occurred in December 2022, and the positive detection rate of influenza nucleic acid decreased from 14.9% (90/605) at the 49th week to 1.9% (11/572) at the 52nd week, with a statistically significant difference ( χ2=62.88, P<0.001). The influenza epidemic in Jiangsu Province from 2020 to 2022 had obvious seasonal characteristics, and the distribution differences of influenza virus-positive cases in each month were statistically significant ( χ2=858.00, P<0.001), with two epidemic peaks each year: winter, spring (December to March of the following year), and summer, and autumn (July to November). The epidemic strains were the B-V strain and seasonal H3 strain, respectively. There was a statistically significant difference in the positive detection rate of influenza cases detected in different age groups ( χ2=60.00, P<0.001). The age group between 5 and 14 years old had the highest influenza-positive detection rate (10.4%), while the age group≥60 years old had a relatively low influenza-positive detection rate (5.1%). The positive detection rate decreased with the increase in the age group ( Z trend=12.82, P<0.001).

By analyzing the epidemic characteristics of influenza during the COVID-19 epidemic in Jiangsu Province from 2020 to 2022, it found that 90 721 influenza-like case samples were collected in Jiangsu Province from 2020 to 2022, of which 6 732 were nucleic acid-positive samples, with an average positive detection rate of 7.4% in three years. The annual positive detection rate presented a U-shaped distribution, with positive detection rates of 4.4%, 3.2% and 14.7%, respectively, with statistically significant differences ( χ2=12 126.00, P<0.001). During the seasonal peak period of influenza from 2020 to 2022, there was a significant decrease in the intensity of the two influenza activity peaks that occurred before the virus became fully prevalent in the population. The first peak occurred from January to February 2020, and the positive detection rate of influenza nucleic acid decreased from 54.4% (317/583) in the third week to 2.1% (12/584) in the eighth week, with a statistically significant difference ( χ2=394.49 , P<0.001) . The second occurred in December 2022, and the positive detection rate of influenza nucleic acid decreased from 14.9% (90/605) at the 49th week to 1.9% (11/572) at the 52nd week, with a statistically significant difference ( χ2=62.88, P<0.001). The influenza epidemic in Jiangsu Province from 2020 to 2022 had obvious seasonal characteristics, and the distribution differences of influenza virus-positive cases in each month were statistically significant ( χ2=858.00, P<0.001), with two epidemic peaks each year: winter, spring (December to March of the following year), and summer, and autumn (July to November). The epidemic strains were the B-V strain and seasonal H3 strain, respectively. There was a statistically significant difference in the positive detection rate of influenza cases detected in different age groups ( χ2=60.00, P<0.001). The age group between 5 and 14 years old had the highest influenza-positive detection rate (10.4%), while the age group≥60 years old had a relatively low influenza-positive detection rate (5.1%). The positive detection rate decreased with the increase in the age group ( Z trend=12.82, P<0.001).

Objective To study the effect of xuebijing on the expression of Caspase-3 in lung tissues and inflammatory factors in serum in acute respiratory distress syndrome rat model with paraquat poisoning. Methods Selecting 50 healthy rats and dividing into 5 groups randomly, Control group, Paraquat group, Low-dose xuebijing group(LD), Middle-dose xuebijing group(MD), High-dose xuebijing group(HD). Using 25 mg/kg paraquat solution to establish the animal model. 14 μmol/kg, 28 μmol/kg, 56μmol/kg xuebijing solution were injected into the abdominal cavity in LD, MD and HD group respectively, and the same dose of normal saline was injected into Control and Paraquat group. The expression levels of TNF-α and IL-6 in plasma were detected by ELISA after 24 hours, Immunohistochemistry was used to detect the expression levels of caspase-3 in the right lung tissue, and TUNEL method was used to detect apoptosis in the right lung tissue. Results The expression levels of TNF-α and IL-6 in plasma were significantly increased after paraquat poisoning, and expression of Caspase-3 protein was also significantly increased in lung tissue(P<0.01). After different dose of xuebijing treatment, the levels of TNF-α and IL-6 in plasma and the protein expression of Caspase-3 in lung tissue were much lower than those in Paraquat group, but still higher than those in Control group(P<0.05), the apoptosis levels in MD and HD groupwere much lower than those in Paraquat group(P<0.05). Conclusions Xuebijing can significantly reduce the level of inflammatory factors in plasma, suppress the Caspase-3 protein expression and apoptosis in lung tissue in acute respiratory distress syndrome rat model with paraquat poisoning.