Background Microparticles (MPs) are one of the main medium of inflammatory reaction with an important role in atherosclerotic progression. Studies on association of air pollution exposure and levels of peripheral blood MPs are limited among human. Objective To evaluate the effects of short-term exposure to air pollution on levels of peripheral blood MPs. Method A panel of 73 healthy adults was followed with 4 repeated follow-ups in Beijing, China, from November 2014 to January 2016. During each visit, we collected questionnaire information, fasting venous blood, urine, and exposures to fine particulate matter (PM_2.5), black carbon, nitric oxide, nitrogen dioxide, nitrogen oxide, sulfur dioxide, carbon monoxide, and ozone. We used linear mixed-effect models to analyze associations of air pollution exposure with levels of total MPs (TMPs) and MPs derived from various cells. Stratified analysis was conducted by levels of C-reactive protein (CRP) and malondialdehyde (MDA). Results The results showed significant associations between air pollution exposure and peripheral blood TMPs at 2 h-6 d prior to the follow-ups (P<0.05), while no statistical associations were found for MPs derived from different cell types. Significant increases in TMPs of 7.8% (95%CI: 0.7%, 15.3%) and 14.3% (95%CI: 2.8%, 27.2%) were observed with each interquartile range (IQR) increase in PM_2.5 (IQR=64.9 μg·m⁻³) at prior 18 h and NO (IQR=40.5 μg·m⁻³) at prior 48 h. Among participants with low levels of CRP and MDA, significantly positive associations were observed between air pollution exposure and levels of TMPs (P<0.05). Conclusion Short-term exposure to air pollution is significantly associated with increased levels of circulating MPs in healthy adults, and in people with lower systemic inflammation, peripheral blood MPs levels are more easily affected after exposure to air pollutants.

Background Air pollution has widespread adverse health effects on human health, but research on its impact on reproductive health and related physiological mechanisms remains insufficient. Objective To investigate the associations between short-term exposure to particulate matter and nitrogen dioxide (NO₂) and serum levels of anti-Müllerian hormone (AMH) and testosterone in healthy adults. Methods A total of 152 healthy adults were recruited for a panel study, undergoing four follow-up visits from September 2019 to January 2020. Basic demographic information and serum samples were collected. Reproductive hormone levels were measured by enzyme-linked immunosorbent assay kits. Concurrently, environmental data in the study area were monitored, including fine particulate matter (PM_2.5), black carbon (BC), NO₂, particle number concentrations in the 5-560 nm size fraction (PNC_{5_560}), and meteorological variables. Linear mixed-effects models were constructed to estimate the effects of short-term exposure to these particulate matter on serum reproductive hormone levels. Results The participants had an average age of (23.9±2.4) years, with 102 women. For each interquartile range (IQR) increment in pollutant moving average concentrations, PM_2.5, PNC_{5_25}, PNC_{100_560}, BC, and NO₂ were associated with relative decreases in female serum AMH levels by 10.2%-16.9%, 46.2%-58.0%, 16.9%-21.2%, 14.8%-26.5%, and 11.3%-17.6%, respectively. These negative associations were stronger in females with waist-to-hip ratio > 0.76 and physical activity levels ≤ 1217 metabolic equivalents (MET) min per week. Similarly, in males, an IQR increase in the same pollutants was associated with relative decreases in serum free testosterone by 11.1%-17.2%, 35.2%, 10.5%-18.9%, 18.7%-24.2%, and 10.3%-26.0%, respectively. These effects were more pronounce in male with a waist-to-hip ratios > 0.81 and physical activity levels ≤ 1498 MET-min per week. Conclusion Short-term exposure to particulate matter and NO₂ may reduce serum levels of AMH and testosterone in healthy adults. Furthermore, these adverse effects appears to be stronger in adults with higher waist-to-hip ratios.

Objective To analyze the level of occupational health literacy (OHL) and mental health status in key populations in Jiangsu Province, and explore the impact of OHL on occupational stress, depressive symptoms, anxiety symptoms and insomnia symptoms. Methods A total of 11 181 workers from Jiangsu Province from April to December 2023 were selected as the research subjects using a combination of stratified cluster random sampling and probability proportional sampling method. The OHL levels of the workers, as well as their occupational stress, depression symptoms, anxiety symptoms and insomnia symptoms, were investigated using the Occupational Health Literacy Questionnaire of National Key Populations (including Occupational Health Literacy Scale, Core Occupational Stress Scale, Patient Health Questionaire-9, Generalized Anxiety Disorder 7-item Scale, and Self-Sleep Management Questionnaire). Results The OHL level of the research subjects was 41.7%, and the literacy levels of the four dimensions of occupational health legal knowledge, basic knowledge of occupational health protection, basic skills of occupational health protection, and healthy working style and behavior were 40.6%, 76.4%, 28.0% and 54.4%, respectively. The detection rates of occupational stress, depression symptoms, anxiety symptoms and insomnia symptoms were 21.8%, 17.7%, 26.4% and 29.6%, respectively. The result of multivariable logistic analysis showed that participants with adequate OHL had a lower risk of occupational stress, depressive symptoms, anxiety symptoms, and insomnia symptoms than those without adequate OHL (all P<0.01) after controlling individual and occupational confounding factors. The odds ratios and their 95% confidence intervals were 0.448(0.402-0.499), 0.664(0.593-0.742), 0.705(0.639-0.777) and 0.885(0.809-0.969), respectively. Conclusion OHL is an independent influencing factor for occupational stress, depressive symptoms, anxiety symptoms and insomnia symptoms in key populations from Jiangsu Province. Effective measures should be taken to improve the OHL level of workers, to reduce the risks of occupational stress, depressive symptoms, anxiety symptoms and insomnia symptoms.

Macrophage polarization is involved in the entire process of the occurrence and development of knee osteoarthritis(KO A).By polarizing into distinct functional phenotypes,macrophages play key regulatory roles in the initiation of inflammation,matrix degradation,suppression of cartilage formation,and progression of the disease.The M1-type macrophages secrete numerous pro-inflammatory cytokines to exacerbate the inflammatory responses and promote the destruction of articular cartilage.Conversely,the M2-type macrophages help maintain the extracellular matrix homeostasis and facilitate cartilage formation by releasing anti-inflammatory factors while suppressing the secretion of inflammatory factors,thereby exerting anti-inflammatory effects and promoting tissue repair.Recent studies have shown that an imbalanced ratio of M1/M2 macrophages(M1/M2 ratio)is closely linked with both the pathogenesis and progression of KO A.Restoration of the dynamic balance between these two subtypes could be an essential strategy for treating and preventing KO A.This article reviewed the current literatures retrieved from PubMed and CNKI databases using the keywords"knee osteoarthritis"and"macrophages"over the past decade.The review introduced the process of macrophage polarization and the mechanisms of different macrophage phenotypes in KOA,and further discussed the recent advances in modulating the M1/M2 ratio for KOA management through chemical drugs,bioactive molecules,and traditional Chinese medicine and so on,aiming to provide the theoretical insights for future research and clinical interventions.

Objective To explore the clinical safety of plasma exchange(PE)combined with early continuous renal replacement therapy(CRRT)and its effects on coagulation and immune functions in patients with polytrauma and hypermyoglobinemia.Methods A non-randomized controlled study was conducted on 60 patients with severe polytrauma and myoglobinemia hospitalized in our department from January 2021 to December 2024.Based on different blood purification,the patients were divided a control group(CRRT)combined with conventional basic treatment,n=30)and an observation group(PE+CRRT and conventional basic treatment,n=30).Biochemical indicators(myoglobin,Mb),inflammation-related indicators,peripheral blood lymphocyte subsets,coagulation indicators,clinical-related indicators,and scores were observed and compared between the 2 groups before and after treatment.Results After 1,2 and 3 d of treatment,the levels of Mb,creatine kinase(CK),creatine kinase-MB isoenzyme(CK-MB),lactate dehydrogenase(LDH),serum creatinine(SCr),blood urea nitrogen(BUN),K+,C-reactive protein(CRP),procalcitonin(PCT),IL-6 and D-dimer(D-D),and white blood cell(WBC)count were significantly decreased in both groups(P<0.05).Among them,the observation group obtained obviously lower levels of all above indicators than the control group at the 3 time points(P<0.05).Additionally,notably shorter average length of total hospital stay,shorter average length of trauma intensive care unit stay,and lower score of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)was observed in the observation group than the control group(P<0.05).There were no statistical differences in coagulation function indicators or T lymphocyte subsets between the 2 groups.No complications occurred.Conclusion For patients with polytrauma and hypermyoglobinemia,early application of PE+CRRT can effectively reduce serum myoglobin level,improve serum biochemical inicators,renal function and inflammatory status,and maintain homeostasis,but shows no effect on immune or coagulation functions.This approach is worthy of promoting in clinical practice.

Objective To investigate the application effect of high flow humidified oxygen therapy combined with tracheotomy in elderly patients with cerebral hemorrhage and analyze the risk factors of pulmonary infection.Methods A total of 140 elderly patients with cerebral hemorrhage who underwent tracheotomy in our hospital from 2019 to 2023 were selected as the study objects,of which 93 patients receiving high-flow humidified oxygen therapy were selected as the observation group,and 47 patients receiving conventional low-flow oxygen therapy were selected as the control group during the same period.The changes of PaO2,SpO2,heart rate and mean arterial pressure were compared,and patients in the observation group were divided into infected group(n=26)and non-infected group(n=67)according to whether pulmonary infection occurred during hospitalization.The risk factors affecting pulmonary infection during hospitalization in elderly patients with cerebral hemorrhage were analyzed,and a nematographic prediction model was built to predict the risk of pulmonary infection.Results The PaO2 and SpO2 levels in observation group were higher than those in control group at 24 h and 72 h,but the respiratory rate was lower than that in control group(P＜0.05).The improvement of sputum viscosity in the observation group(68 cases of grade Ⅰ sputum and 25 cases of grade Ⅱ sputum)was better than that in the control group(16 cases of grade Ⅰ sputum,17 cases of grade Ⅱ sputum and 14 cases of gradeⅢ sputum).The rate of phlegm scab formation(0)and the number of sputum aspiration(5.15±1.08)times were lower than those in the control group[14.87％,(8.17±1.82)times](P＜0.05).There were significant differences in tracheotomy time,smoking history,bed rest time,mechanical ventilation time and nasal feeding tube retention time between infected and non-infected groups(P＜0.05).Logistic regression analysis showed that tracheotomy time＞5 d,smoking history,bed time＞10 d,mechanical ventilation time ≥24 h,nasal feeding tube retention time≥10 d were the risk factors for pulmonary infection in elderly patients with cerebral hemorrhage during treatment(P＜0.05).The AUC,sensitivity and specificity were 0.696,0.565 and 0.889 in elderly patients with cerebral hemorrhage complicated by pulmonary infection during treatment.Conclusion High-flow humidification oxygen therapy combined with tracheotomy can improve the oxygenation status in elderly patients with cerebral hemorrhage,but the time of tracheotomy,smoking history,bed rest time,mechanical ventilation time,and nasal feeding tube retention time will affect the pulmonary infection during treatment.The construction of a nomogram model based on these risk factors has higher predictive efficacy in evaluating the pulmonary infection.

Objective:To develop an air transfer stretcher for severely injured patients,so as to meet the requirements of severely injured patients for rapid transport of aviation medical treatment.Methods:The guide rails of hatch of mainstream civil airliner models were analyzed through investigation.Based on the principles of modularization,integration and intelligence,a highly universal and portable aviation stretcher with the functions of rapid transport and life support was designed and developed.The design of the stretcher was verified through simulation analysis and calculation,as well as tests in laboratory,which should meet the requirements of the standards from China Civil Aviation Regulations(CCAR)-25.Results:The results of simulation analysis and tests of laboratory showed that the aviation transport stretcher,and the strength and stiffness of its structure reached to requirement of CCAR-25 standard,which was suit to the portable aviation evacuation of severely injured patients on civil airliners,and the rapid transfer between air and ground.It has the function of supporting life,and the aviation transport stretcher with high universality and convenience can enhance the safety and rescue capability of aviation evacuation system of medical treatment of aviation.Conclusion:The portable aviation stretcher with high-versatility that was researched and developed by this study can effectively solve the problems of life support,injury monitoring,and emergently rescue and treatment during the transport for severely injured patients,which improve the support ability of air-ground transportation for severely injured patients.

Objective:To analyze the risk factors of prognosis in patients with intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC).Methods:The clinical data of 74 intracranial SFT/HPC patients underwent surgical treatment from January 2017 to January 2024 in Luhe Hospital, Capital Medical University and Sanbo Brain Hospital, Capital Medical University were retrospectively analyzed. The patients were followed up the prognosis (including recurrence, death and extracranial metastasis). Kaplan-Meier and log-rank tests were used to analyze the risk factors of prognosis in patients with intracranial SFT/HPC, and multivariate Cox analysis was used to analyze the independent risk factors of prognosis in patients with intracranial SFT/HPC.Results:Seventy-four patients with intracranial SFT/HPC were followed up for 3 to 80 months, averaging 52.5 months. Among them, there were 17 cases of recurrence, 6 cases of extracranial metastasis, and 12 cases of death. In patients with intracranial SFT/HPC, the results of the log-rank univariate analysis showed that the tumor location, resection extent, WHO pathological grade, and adjuvant radiotherapy were risk factors of recurrence ( P<0.01); the tumor location, WHO pathological grade and extracranial metastasis were risk factors of death ( P<0.05 or <0.01); and the age, WHO pathological grade and Ki67 were risk factors of extracranial metastasis ( P<0.05 or <0.01). In patients with intracranial SFT/HPC, multivariate Cox regression analysis result showed that the subtotal resection and non-postoperative radiation therapy were independent risk factors of recurrence ( HR = 0.377 and 0.315, 95% CI 0.148 to 0.932 and 0.164 to 2.221, P<0.01 and <0.05); the WHO pathological grade Ⅲ and extracranial metastasis were independent risk factors of death ( HR = 3.657 and 1.657, 95% CI 0.964 to 7.147 and 0.964 to 2.848, P<0.01); the WHO pathological grade Ⅲ was an independent risk factor of extracranial metastasis ( HR = 1.657, 95% CI 0.964 to 2.848, P<0.01). Conclusions:Patients with intracranial SFT/HPC who undergo subtotal resection and non-postoperative radiation therapy are more prone to recurrence, WHO pathological grade Ⅲ patients are more likely to develop extracranial metastases, and extracranial metastases patients have shorter survival. For intracranial SFT/HPC patients with pathologically high-grade, SFT/HPC, it is necessary to increase the frequency of follow-ups and be alert for extracranial metastasis.

Objective:To analyze the prognostic influencing factors in patients with isocitrate dehydrogenase (IDH) wild-type glioma, and further evaluate the value of surgical resection in prognosis.Methods:The clinical data and molecular pathological information of 647 patients with IDH wild-type glioma were retrieved from the Chinese Glioma Genome Atlas (CGGA) database (from 2006 to 2019). The clinical characteristics were recorded, including gender, age, initial symptoms, preoperative Karnofsky performance status (KPS) score, tumor location, tumor laterality, extent of resection, O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status and postoperative treatment. Kaplan-Meier survival curve was plotted to calculate overall survival (OS) and progression-free survival (PFS), and comparisons were performed using the log-rank test. Multivariate Cox regression analysis was used to identify the independent influencing factors of prognosis in patients with IDH wild-type glioma.Results:Among the 647 patients with IDH wild-type glioma, there were 120 cases of WHO grade Ⅱ, 115 cases of grade Ⅲ, and 412 cases of grade Ⅳ; the median OS was 20.3 months. There were statistical differences in age, initial symptoms, tumor location, preoperative KPS score, extent of resection, MGMT promoter methylation status and postoperative treatment among patients with different WHO grades (P<0.01), but there were no statistical difference in gender and tumor laterality (P>0.05). The median OS and PFS in patients with WHO grade Ⅱ were significantly longer than those in patients with WHO grade Ⅲ and WHO grade Ⅳ (169.9 months vs. 24.7 and 14.4 months, 138.8 months vs. 17.7 and 11.4 months), the indexes in patients with WHO grade Ⅲ were significantly longer than patients with WHO grade Ⅳ, and there were statistical differences (P<0.05). The median OS and PFS in patients with total resection were significantly longer than those in patients with subtotal resection and partial resection (37.2 months vs. 20.3 and 8.5 months, 29.5 months vs. 17.6 and 6.0 months), the indexes in patients with subtotal resection were significantly longer than patients with partial resection, and there were statistical differences (P<0.05). Among 153 patients with MGMT promoter methylation who received postoperative chemoradiotherapy, the median OS and PFS in patients with total resection (67 cases) were significantly longer than those in patients with subtotal resection (64 cases) and partial resection (22 cases): 28.8 months vs. 18.4 and 9.0 months, 25.6 months vs. 16.6 and 6.5 months), the indexes in patients with subtotal resection were significantly longer than patients with partial resection, and there were statistical differences (P<0.05). Among 202 patients with MGMT promoter non-methylation who received postoperative chemoradiotherapy, the median OS and PFS in patients with total resection (81 cases) were significantly longer than those in subtotal resection (81 cases) and partial resection (40 cases): 31.3 months vs. 21.9 and 14.0 months, 22.7 months vs. 16.8 and 9.7 months, and there were statistical differences (P<0.05), but there were no statistical difference in the indexes between patients with subtotal and patients with partial resection (P>0.05). Multivariate Cox regression analysis result showed that age, extent of resection, WHO grade (grade Ⅲ/grade Ⅳ) and postoperative treatment were independent OS and PFS influencing factors in patients with IDH wild-type glioma (OS: HR = 1.327, 3.295, 3.406/7.964 and 1.597; 95% CI 1.079 to 1.633, 2.627 to 4.132, 2.225 to 5.216/5.339 to 11.880 and 1.288 to 1.981; P<0.01. PFS: HR = 1.282, 2.655, 3.143/6.511 and 1.477; 95% CI 1.039 to 1.583, 2.123 to 3.322, 2.049 to 4.819/4.376 to 9.690 and 1.181 to 1.849; P<0.05 or <0.01).Conclusions:The age, extent of resection, WHO grade and postoperative treatment are independent prognosis influencing factors in patients with IDH wild-type glioma. Treatment strategies should fully consider the clinical and molecular pathological characteristics to achieve maximal safe tumor resection and optimal survival benefit.

Objective:To analyze the epidemiological characteristics, spatial clustering, and correlation between dental fluorosis detection rates and meteorological factors in children aged 8 - 12 years old in 37 counties (cities, districts, hereinafter referred to as counties) affected by coal-burning-borne endemic fluorosis in Guizhou Province, and to provide a scientific basis for prevention and control of the disease.Methods:Monitoring data on dental fluorosis in children aged 8 - 12 years old from 2019 to 2022 were collected from the National Health Security Information System for Endemic Diseases. Meteorological data, including annual average temperature, annual average precipitation, annual sunshine hours, and annual average relative humidity, were obtained from the Guizhou Provincial Bureau of Statistics. Descriptive epidemiology, analytical epidemiology, and spatial correlation analysis methods were used to analyze the data. Visual maps were created based on the clustering levels of annual dental fluorosis detection rates (high-high, low-low, high-low, low-high). Spatial autocorrelation and meteorological factors were used to analyze the epidemiological characteristics, spatial clustering, and the impact of meteorological factors on dental fluorosis.Results:From 2019 to 2022, a total of 3 649 161 children aged 8 - 12 in the counties affected by coal-burning-borne endemic fluorosis were monitored, and 115 793 children were diagnosed with dental fluorosis, with a detection rate of 3.17%. The detection rates were 4.73% (45 093/954 338) in 2019, 3.35% (31 424/938 445) in 2020, 2.86% (21 727/760 195) in 2021, and 1.76% (17 549/996 183) in 2022, respectively. The dental fluorosis indices were 0.09, 0.07, 0.06, and 0.03, respectively. The number of counties with detection rates > 6% was 7, 5, 5, and 0 in 2019 - 2022, respectively. Dafang County consistently had the highest detection rates, with rates of 10.06% (6 783/67 408), 10.07% (1 955/19 421), 13.54% (4 017/29 667), and 4.83% (3 284/76 206) in 2019 - 2022, respectively. The Moran's I indices for dental fluorosis detection rates were 0.45, 0.53, 0.53, and 0.53 in 2019 - 2022, with Z = 4.29, 5.07, 5.31, and 5.10, respectively ( P < 0.05), indicating global spatial autocorrelation (positive) and spatial clustering of dental fluorosis detection rates. The number of counties with "high-high" clustering of detection rates was 7, 7, 6, and 7 in 2019 - 2022, mainly concentrated in the northwestern region, including Qixingguan District, Nayong County, Dafang County, Zhijin County, and Jinsha County of Bijie City. "Low-high" clustering areas were distributed in Zhongshan District of Liupanshui City in 2019, 2020, and 2022. The detection rate of dental fluorosis was associated with local annual average temperature (°C) and annual precipitation (mm) ( r = - 0.393, - 0.337, P = 0.016, 0.041). Conclusions:From 2019 to 2022, the detection rate of dental fluorosis in children aged 8 - 12 in coal-burning-borne endemic fluorosis areas in Guizhou Province has been decreasing year by year, and it shows spatial clustering. The high clustering area is in the northwest of Guizhou Province, which should be regarded as a key prevention and control area for coal-burning-borne fluorosis in the future. At the same time, areas with lower temperatures and precipitation should also strengthen prevention and control efforts.