Objective To predict the radiation impact of discharging wastewater containing uranium within the specified limit generated during the normal operation of a new production line at a nuclear fuel plant on the receiving water body and its downstream, and to provide a reference for the management of radioactive liquid effluent discharge from nuclear facilities. Methods Based on the technical guidelines for environmental impact assessment, literature on radiation environmental impact assessment, and data collected from on-site investigations, appropriate hydrological parameters and prediction models were selected to analyze and predict the variation pattern of radioactive nuclide uranium along the receiving water body and the radiation exposure of nearby residents. Results The maximum increase in uranium concentration in the receiving water body and its downstream caused by the discharge of uranium-containing wastewater was 1.14 μg/L. The maximum predicted concentration was 2.75 μg/L after adding the background data of the water body. The resulting maximum individual annual effective dose for the public was 1.49 × 10⁻⁴ mSv/a. Conclusion The maximum predicted uranium concentration in the receiving water body and its downstream is lower than the uranium concentration limit of 30 μg/L specified in the Standards for Drinking Water Quality (GB 5749-2022). The maximum individual annual effective dose for the public is much lower than the control value of 0.2 mSv/a specified in the Radiation Protection Regulations for Uranium Processing and Fuel and Fuel Manufacturing Facilities (EJ 1056-2018). The radiation impact is acceptable.

Objective:To analyze the clinicopathological characteristics and prognostic factors of patients with Castleman disease (CD).Methods:A retrospective case-series study was conducted. A total of 85 patients newly diagnosed with CD in the First Affiliated Hospital of Air Force Medical University between July 2007 and August 2024 were collected. Their clinical characteristics and prognostic factors were analyzed.Results:Among the 85 patients, 45 had unicentric Castleman disease (UCD) and 40 had multicentric Castleman disease (MCD). In the UCD group, females were more commonly affected (64.4%, 29/45), with a median age of onset of 39 years. The primary lesions were mainly located in the retroperitoneum, neck, abdomen, and axilla; and the hyaline vascular subtype was the predominant pathological type (69.4%, 25/36). In the MCD group, males were more frequently affected (62.5%, 25/40), with a median age of onset of 50 years; and the plasmacytic subtype was the main pathological type (68.2%, 15/22). Compared with UCD patients, MCD patients presented more systemic symptoms and signs [85.0% (34/40) vs. 13.3% (6/45), χ2 = 43.66, P < 0.001], splenomegaly [42.5% (17/40) vs. 2.2% (1/45), χ2 = 20.58, P < 0.001], hepatomegaly [25.0% (10/40) vs. 0 (0/45), χ2 = 10.46, P = 0.001], edema or effusion in serous cavity [67.5% (27/40) vs. 8.9%(4/45), χ2 = 31.40, P < 0.001], hematological system involvement [32.5% (13/40) vs. 0 (0/44), χ2 = 16.92, P < 0.001], and renal involvement [22.5% (9/40) vs. 2.3%(1/44), χ2 = 6.36, P = 0.012]. Laboratory findings showed that the levels of hemoglobin and albumin in MCD patients were lower than those in UCD patients, while white blood cell count in MCD patients was higher than that in UCD patients. Additionally, MCD patients exhibited elevated levels of C-reactive protein, interleukin-6, vascular endothelial growth factor, erythrocyte sedimentation rate, and ferritin compared to UCD patients (all P < 0.05). Among UCD patients, 40 cases underwent simple surgical resection, with no deaths during follow-up and the 5-year overall survival (OS) rate of 100.0%; among MCD patients, 34 cases received chemotherapy, 4 received siltuximab, 3 died during follow-up with a 5-year OS rate of 87.5%; and there was no statistically significant difference in OS between the MCD and UCD groups ( χ2 = 3.67, P = 0.055). Among MCD patients, the OS of those with renal involvement (9 cases) was worse than that of those without renal involvement (31 cases) ( χ2 = 8.39, P = 0.004). Conclusions:CD is a highly heterogeneous disorder. Surgical resection is the primary treatment for UCD, with a favorable prognosis. Chemotherapy is the main treatment for MCD, with a relatively poor prognosis.

Objective:To investigate the relationship between empathy and meaning in life among medical students,and explore the mediating role of altruistic behavior.Methods:A total of 581 medical students were recrui-ted.They were assessed with the Interpersonal Reactivity Index-C(IRI-C),Altruistic Behavior Questionnaire of College Students(ABQ-CS),and Quadripartite Existential Meaning Scale(QEMS).The bootstrap method was used to test the hypothesized mediating effect.Results:The scores of IRI-C were positively correlated with the scores of ABQ-CS and QEMS(r=0.45,0.21,Ps＜0.001).The scores of ABQ-CS were positively correlated with the QEMS scores(r=0.46,P＜0.001).Altruism was a complete mediator between empathy and meaning in life,the indirect effect was 0.20(95％CI:0.15-0.26).Conclusion:This study reveals the underlying connections a-mong altruistic behavior,empathy,and meaning in life among medical students,suggesting that interventions targe-ting empathy and altruistic behavior may enhance their meaning in life.

Objective:To explore the efferent projections of glutamatergic neurons in the basal forebrain(BF)and the function of its projections to lateral habenula(LHb)under isoflurane anesthesia.Methods:Channelrhodopsin-as-sisted circuit mapping(CRACM)was used to explore the efferent projections of BF glutamatergic neurons in cre driver mice lines.On this basis,we optogenetically activated the BF glutamatergic projections to LHb to explore its function in wake-anesthesia regulation of isoflurane anesthesia.Results:The glutamatergic projections of BF mainly project to LHb,optogenetic activation of BF glutamatergic projections to LHb could significantly prolonged the time of loss of righ-ting reflex(LORR)and shortened the time of recovery of righting reflex(RORR).Optical stimulation of this projection reduced the burst suppression ratio(BSR)under 1.0%isoflurane anesthesia.When the mice were anesthetized by 0.8%isoflurane,a significant decrease of δ power percentage was observed,while the power percentage of β bands and γ bands increased.Conclusion:The glutamatergic neurons of BF mainly project to LHb,activation of this projection can not only prolong the induction time but also shorten the emergence time.Furthermore,this projection also exerts a pro-arousal effect under the maintenance phase of isoflurane anesthesia.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To evaluate the safety and efficacy of laparoscopes adhesiolysis in the treatment of adhesive intestinal obstruction.Methods:A retrospective analysis was conducted on the clinical data of 30 patients with adhesive intestinal obstruction who underwent laparoscopes adhesiolysis at the First Affiliated Hospital, Zhejiang University School of Medicine between January 2021 and December 2024. The demographics, surgical parameters and postoperative complications were recorded.Results:Among the 30 patients, 16 were male and 14 were female, with age of (55.93 ± 13.83) years. A history of abdominal surgery was present in 25 patients (83.3%). Of the surgeries, 4 cases (13.3%) were performed as emergency procedures and 26 cases (86.7%) were elective. The operative time was (125.57 ± 48.25) min, and intraoperative blood loss was (26.17 ± 16.90) ml. The time to first flatus was (3.30 ± 1.95) d, the time to first oral intake was 4.00 (3.00, 5.00) d, the hospital stay was (24.23 ± 17.97) d, and the postoperative hospital stay was 11.50 (6.75, 18.75) d. The incision pain score 0 score was in 8 cases (26.7%), 1 score in 5 cases (16.7%), 2 scores in 10 cases (33.3%), 3 scores in 3 cases (10.0%), 4 scores in 3 cases (10.0%), and 5 scores in 1 case (3.3%). One case developed a postoperative wound infection. The patients were followed up for 1 year, 1 patient experienced recurrent incomplete intestinal obstruction due to widespread peritoneal metastasis from gastric cancer.Conclusions:Laparoscopes adhesiolysis is a safe and effective treatment for adhesive intestinal obstruction, offering advantages in terms of postoperative recovery and low complication rates. The continued use of minimally invasive techniques is recommended in the management of this condition.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To evaluate the safety and efficacy of laparoscopes adhesiolysis in the treatment of adhesive intestinal obstruction.Methods:A retrospective analysis was conducted on the clinical data of 30 patients with adhesive intestinal obstruction who underwent laparoscopes adhesiolysis at the First Affiliated Hospital, Zhejiang University School of Medicine between January 2021 and December 2024. The demographics, surgical parameters and postoperative complications were recorded.Results:Among the 30 patients, 16 were male and 14 were female, with age of (55.93 ± 13.83) years. A history of abdominal surgery was present in 25 patients (83.3%). Of the surgeries, 4 cases (13.3%) were performed as emergency procedures and 26 cases (86.7%) were elective. The operative time was (125.57 ± 48.25) min, and intraoperative blood loss was (26.17 ± 16.90) ml. The time to first flatus was (3.30 ± 1.95) d, the time to first oral intake was 4.00 (3.00, 5.00) d, the hospital stay was (24.23 ± 17.97) d, and the postoperative hospital stay was 11.50 (6.75, 18.75) d. The incision pain score 0 score was in 8 cases (26.7%), 1 score in 5 cases (16.7%), 2 scores in 10 cases (33.3%), 3 scores in 3 cases (10.0%), 4 scores in 3 cases (10.0%), and 5 scores in 1 case (3.3%). One case developed a postoperative wound infection. The patients were followed up for 1 year, 1 patient experienced recurrent incomplete intestinal obstruction due to widespread peritoneal metastasis from gastric cancer.Conclusions:Laparoscopes adhesiolysis is a safe and effective treatment for adhesive intestinal obstruction, offering advantages in terms of postoperative recovery and low complication rates. The continued use of minimally invasive techniques is recommended in the management of this condition.

Objective To evaluate the therapeutic effects of different intracranial pressure lower-ing regimens in patients with acute large-area cerebral infarction based on electrical impedance tomo-graphy(EIT)technology.Methods A total of 75 patients with acute large-area cerebral infarction were selected as the study subjects and randomly divided into study group(n=40,using mannitol combined with albumin to decrease intracranial pressure)and control group(n=35,using mannitol alone to decrease intracranial pressure).EIT technology was used to continuously monitor the changes in intracranial pressure within 48 hours in the patients.Clinical data of the two groups were collected,and the 24-hour intracranial pressure change rate,48-hour intracranial pressure change rate,ICU stay duration,hospitalization duration,antibiotic use duration,and National Institutes of Health Stroke Scale(NIHSS)score at discharge were observed and compared between the two groups.A 90-day sur-vival follow-up was also conducted.Results There was no statistically significant difference in the 24-hour intracranial pressure change rate between the two groups(P＞0.05).The 48-hour intracrani-al pressure change rate in the study group was higher than that in the control group,and the difference was statistically significant(P＜0.05).The ICU stay duration,hospitalization duration,and antibiotic use duration in the study group were all shorter than those in the control group,and the NIHSS score at discharge in the study group was lower than that in the control group,with statistically significant differences(P＜0.05).The follow-up results showed that the survival duration in the study group was longer than that in the control group,and the 90-day cumulative survival rate in the study group was higher than that in the control group,but the differences were not statistically significant(P＞0.05).The modified Rankin Scale score in the study group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion Compared with the use of mannitol alone,early use of mannitol combined with albumin can effectively decrease the in-tracranial pressure within 48 hours,shorten the hospitalization duration,and improve neurological function in patients with acute large-area cerebral infarction.

Objective:To explore the efferent projections of glutamatergic neurons in the basal forebrain(BF)and the function of its projections to lateral habenula(LHb)under isoflurane anesthesia.Methods:Channelrhodopsin-as-sisted circuit mapping(CRACM)was used to explore the efferent projections of BF glutamatergic neurons in cre driver mice lines.On this basis,we optogenetically activated the BF glutamatergic projections to LHb to explore its function in wake-anesthesia regulation of isoflurane anesthesia.Results:The glutamatergic projections of BF mainly project to LHb,optogenetic activation of BF glutamatergic projections to LHb could significantly prolonged the time of loss of righ-ting reflex(LORR)and shortened the time of recovery of righting reflex(RORR).Optical stimulation of this projection reduced the burst suppression ratio(BSR)under 1.0%isoflurane anesthesia.When the mice were anesthetized by 0.8%isoflurane,a significant decrease of δ power percentage was observed,while the power percentage of β bands and γ bands increased.Conclusion:The glutamatergic neurons of BF mainly project to LHb,activation of this projection can not only prolong the induction time but also shorten the emergence time.Furthermore,this projection also exerts a pro-arousal effect under the maintenance phase of isoflurane anesthesia.