Background Air pollution exposure has a significant impact on maternal and child health. However, the research on the association between ambient ozone (O₃) exposure during pregnancy and the risk of premature birth in newborns is limited, and the conclusions are inconsistent. Objective To investigate the association of ambient O₃ exposure during pregnancy with the risk of preterm birth in Guangdong Province. Methods Data of pregnant women in Guangzhou from 2013 to 2019 and Foshan from 2018 to 2023 were collected, and O₃ concentrations during different trimesters were assessed according to maternal residential addresses. Bilinear interpolation was used to evaluate the concentrations of air pollution. A cohort study design was adopted in our study. Restricted cubic spline curves were used to evaluate the exposure-response relationship between O₃ exposure and preterm birth risk and explore potential exposure threshold of O₃. Logistic regression models were used to evaluate the association of O₃ exposure with preterm birth. Results A total of 702 924 pregnant women were included in this study, of whom 43 051 (6.12%) were preterm. The average O₃ exposure concentrations of pregnant women during the first, second, third, and whole trimesters were 95.51, 97.51, 100.60, and 97.87 μg·m⁻³, respectively. We observed J-shaped associations between O₃ exposure and preterm birth risk during the second, third, and whole trimesters of pregnancy using restricted cubic spline curves. This study found that there were threshold concentrations between O₃ exposure and preterm birth risk during different gestational periods, and the threshold concentrations in the first, second, third, and whole trimesters were 112.32, 99.83, 111.74, and 112.46 μg·m⁻³, respectively. During the second, third, and whole trimesters of pregnancy, after adjusting for maternal age, baby sex, pre-pregnancy body mass index, mode of delivery, baby birth weight, gestational diabetes, and gestational hypertension, the odds ratios (OR) of preterm birth were 1.02 (95%CI: 1.01, 1.04), 1.02 (95%CI: 1.00, 1.03), and 1.17 (95%CI: 1.13, 1.21) for each 10 μg·m⁻³ increase in O₃ concentration above the O₃ threshold. No significant association was found between O₃ exposure and the risk of preterm birth during the first trimester. Conclusion There is a nonlinear association between the risk of preterm birth and O₃ exposure during pregnancy, and higher concentrations of O₃ exposure during pregnancy are associated with the risk of preterm birth. Above the O₃ threshold concentration during pregnancy, especially during the second, third, and whole trimesters, the risk of preterm birth elevates with the increase of O₃ exposure concentrations.

Objective:To investigate the pathogen distribution, temporal trends in the rates of antimicrobial resistance, and susceptibility of bloodstream isolates and comparatively explore the epidemiological characteristics of bloodstream infections in hematology departments across 56 healthcare facilities in Guangdong Province from 2020 to 2024.Methods:A multicenter analysis was conducted to evaluate the constituent ratio of different pathogens isolated from clinical isolate data from bloodstream specimens in hematology, respiratory, and intensive care unit (ICU) departments across 56 healthcare facilities in Guangdong Province (2020-2024), and antimicrobial resistance trends in pathogens with high-detection rate over 5 years were assessed. Carbapenem-resistant Gram-negative organisms (CRO) were randomly sampled for carbapenemase gene detection and in vitro antimicrobial susceptibility tests with novel antimicrobial agents.Results:From 2020 to 2024, a total of 8 968, 6 440, and 25 511 bloodstream isolates were identified in the hematology, respiratory, and ICU departments, respectively, across 56 participating facilities in Guangdong Province, with significant differences in the pathogen constituent ratio among departments ( P<0.001). Notably, the hematology department demonstrated a predominance of Escherichia coli (24.1%), Klebsiella pneumoniae (17.5%), Pseudomonas aeruginosa (11.7%), coagulase-negative Staphylococci (15.2%), and Staphylococcus aureus (5.1%). In the resistance analysis, the rates of meropenem resistance of Escherichia coli and Klebsiella pneumonia increased from 6.7% and 5.8% (2020) to 14.0% and 15.8% (2024), respectively. Conversely, Pseudomonas aeruginosa exhibited a declining trend in the rate of meropenem resistance (6.2% to 1.9%) and imipenem (10.2% to 6.1%) during the same period. Acinetobacter baumannii demonstrated a biphasic resistance pattern to common antimicrobial agents, characterized by an initial decline, followed by a rebound. In this study, the susceptibility rates to conventional antimicrobial agents were significantly higher in Staphylococcus aureus versus coagulase-negative Staphylococci, with no glycopeptide- or linezolid-resistant strains detected. Notably, the prevalence of vancomycin-resistant Enterococcus faecium increased from 0 in 2020 to 23.1% in 2024. CRO carbapenemase phenotypes through active surveillance revealed that 80% Escherichia coli isolates were carrying blaNDM, 90% Klebsiella pneumoniae isolates were carrying blaKPC, 10% Pseudomonas aeruginosa isolates were carrying blaVIM, and 100% Acinetobacter baumannii were carrying blaOXA-23. The results of the antimicrobial susceptibility test in CRO revealed that carbapenem-resistant Escherichia coli (CRECO) demonstrated a 0 resistance rate to tigecycline, polymyxin B, and aztreonam/avibactam, whereas carbapenem-resistant Klebsiella pneumoniae exhibited a 0 resistance rate to aztreonam/avibactam, ceftazidime/avibactam, and imipenem/relebactam. Carbapenem-resistant Pseudomonas aeruginosa exhibited a 95.0% susceptibility rate to amikacin and polymyxin B, with a 45.0% resistance rate to ceftazidime/avibactam. In contrast, carbapenem-resistant Acinetobacter baumannii demonstrated complete susceptibility (100.0%) to sulbactam/durlobactam (MIC90=2 μg/ml), whereas eravacycline showed MIC50 and MIC90 values of 1 and 2 μg/ml, respectively. Conclusion:The pathogen constituent ratio of bloodstream isolates differed significantly among hematology, respiratory, and ICU departments. Notably, although CRO exhibited an escalating prevalence, it sustained high susceptibility to novel antimicrobial agents.

Objective:To evaluate the sonographic findings of hemiplegic shoulders,to determine the significant predic-tors of hemiplegic shoulder pain(HSP)at the early stage.Method:88 patients with early hemiplegia from hospital during June 2021 to December 2022 were recruited.Age,sex,hemiplegic side,type and duration of stroke,complications,anteflexion strength and tension of the hemiplegic shoulder,visual assessment scale(VAS)were recorded.Sonographic examination was per-formed to assess the long head of the biceps tendon,supraspinatus tendon,infraspinatus tendon,subscapularis tendon,subacromial-subdeltoid bursa,glenohumeral joint and acromioclavicular joint.According to the VAS score,the patients were divided into 3 groups.Patients with VAS≥4 were classified as hemiplegic shoulder pain 1(HSP-1)group,those with VAS＜4 and ≥ 1 were classified as hemiplegic shoulder pain 2(HSP-2)group,and the remaining patients with VAS=0 were classified as hemiplegic non-shoulder pain(HNSP)group.Result:There were abnormal sonographic findings in 71(80.7％)patients'shoulders in hemiplegia side.25(28.4％)patients were slight abnormal results.46(52.3％)patients were obvious abnormal sonographic findings.20(22.7％)patients whose VAS score were ≥ 4 had abnormal sonographic findings.The most common patholo-gies in early hemiplegic shoulders were abnormalities of the long head tendon of the biceps brachii(35.23％),subacromial-subdeltoid bursitis(19.32％)and supraspinatus lesions(15.90％).The significant predictors for HSP in early hemiplegic patients were tendinitis,supraspinatus tendon tear and sum of sonographic abnormalities.Conclusion:Stroke patients may have soft tissue injuries of the hemiplegic shoulders at the early stage.The significant predictors for HSP in early hemiplegic patients were tendinitis,supraspinatus tendon tear and sum of sonographic abnormalities(≥2).Shoulder sonography is recommended as it can accurately identify soft tis-sue injuries associated with HSP,and provide a basis for developing the appropriate rehabilitation programs and preventing further injury.

As the lifestyle of modern people changes,genetic factors continue to become more prominent,and the impact of environmental and water pollution,the incidence of intestinal diseases(colorectal cancer,inflammatory bowel disease,irritable bowel syndrome,chronic constipation,etc.)is increasing.It not only seriously endangers the health of the population,but also consumes a large amount of medical resources.Paeonol,as a class of small molecule phenolic compounds,has a wide range of biological activities,such as anti-inflammatory,anti-viral,anti-tumor,anti-allergic,immune regulation,cardiovascular and cerebrovascular protection,etc.The mechanism and experimental research on the effect of paeonol in preventing and treating intestinal diseases based on the"Brain-Gut-Bacteria axis"are also in-depth.This article aims to systematically review and sort out the latest progress in this field,with a view to providing certain ideas and methods for the precise treatment of intestinal diseases and the development of new drugs.

Objective To explore the effect of progressive intensity muscle training on joint function and inflammatory response after arthroscopic rotator cuff tear surgery.Methods Totally 226 patients with rotator cuff tear injuries and admitted to Shaoxing Traditional Chinese Medicine Hospital between April 2020 and April 2022 were selected,and randomly divided into a study group and a control group,each of 113,using a double-blind random number table.After the arthroscopic surgery,the study group received progressive intensity muscle strength training,while the control group was given routine functional training and rehabilitation.Before and 8 weeks after surgery,both groups were evaluated us-ing the Constant Murley shoulder joint function(CMSJF),Unilaterally Controlled Latin Assets(UCLA),and Fugl Meyer scale(FMA).Moreover,their Activities of Daily Living(ADL)score,se-rum inflammatory factors,and upper limb function score were compared.Results Before surgery,there was no significant difference between the two groups in the average CMSJF score,UCLA score,EMA score,ADL score and the range of motion(ROM)(P>0.05).However,8 weeks after the surgery,all the above values improve significantly,with significantly greater improvement in the study group than the control group(P<0.05).Moreover,before the surgery,there was no significant difference be-tween the two groups in the serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleu-kin-10(IL-10)and transformative growth factor-β(TGF-β)(P>0.05).However,8 weeks after the surgery,a significant increase was observed in the average IL-10 and TGF-β,with a significant de-crease in the average TNF-α and IL-6(P<0.05 for both).Conclusion After arthroscopic surgery for ro-tator cuff tear,progressive muscle strength training has a significant clinical effect on relieving pain,promoting muscle function and strength,and improving the function of the affected limb.

As the lifestyle of modern people changes,genetic factors continue to become more prominent,and the impact of environmental and water pollution,the incidence of intestinal diseases(colorectal cancer,inflammatory bowel disease,irritable bowel syndrome,chronic constipation,etc.)is increasing.It not only seriously endangers the health of the population,but also consumes a large amount of medical resources.Paeonol,as a class of small molecule phenolic compounds,has a wide range of biological activities,such as anti-inflammatory,anti-viral,anti-tumor,anti-allergic,immune regulation,cardiovascular and cerebrovascular protection,etc.The mechanism and experimental research on the effect of paeonol in preventing and treating intestinal diseases based on the"Brain-Gut-Bacteria axis"are also in-depth.This article aims to systematically review and sort out the latest progress in this field,with a view to providing certain ideas and methods for the precise treatment of intestinal diseases and the development of new drugs.

Objective To explore the effect of progressive intensity muscle training on joint function and inflammatory response after arthroscopic rotator cuff tear surgery.Methods Totally 226 patients with rotator cuff tear injuries and admitted to Shaoxing Traditional Chinese Medicine Hospital between April 2020 and April 2022 were selected,and randomly divided into a study group and a control group,each of 113,using a double-blind random number table.After the arthroscopic surgery,the study group received progressive intensity muscle strength training,while the control group was given routine functional training and rehabilitation.Before and 8 weeks after surgery,both groups were evaluated us-ing the Constant Murley shoulder joint function(CMSJF),Unilaterally Controlled Latin Assets(UCLA),and Fugl Meyer scale(FMA).Moreover,their Activities of Daily Living(ADL)score,se-rum inflammatory factors,and upper limb function score were compared.Results Before surgery,there was no significant difference between the two groups in the average CMSJF score,UCLA score,EMA score,ADL score and the range of motion(ROM)(P>0.05).However,8 weeks after the surgery,all the above values improve significantly,with significantly greater improvement in the study group than the control group(P<0.05).Moreover,before the surgery,there was no significant difference be-tween the two groups in the serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleu-kin-10(IL-10)and transformative growth factor-β(TGF-β)(P>0.05).However,8 weeks after the surgery,a significant increase was observed in the average IL-10 and TGF-β,with a significant de-crease in the average TNF-α and IL-6(P<0.05 for both).Conclusion After arthroscopic surgery for ro-tator cuff tear,progressive muscle strength training has a significant clinical effect on relieving pain,promoting muscle function and strength,and improving the function of the affected limb.

Objective:To evaluate the sonographic findings of hemiplegic shoulders,to determine the significant predic-tors of hemiplegic shoulder pain(HSP)at the early stage.Method:88 patients with early hemiplegia from hospital during June 2021 to December 2022 were recruited.Age,sex,hemiplegic side,type and duration of stroke,complications,anteflexion strength and tension of the hemiplegic shoulder,visual assessment scale(VAS)were recorded.Sonographic examination was per-formed to assess the long head of the biceps tendon,supraspinatus tendon,infraspinatus tendon,subscapularis tendon,subacromial-subdeltoid bursa,glenohumeral joint and acromioclavicular joint.According to the VAS score,the patients were divided into 3 groups.Patients with VAS≥4 were classified as hemiplegic shoulder pain 1(HSP-1)group,those with VAS＜4 and ≥ 1 were classified as hemiplegic shoulder pain 2(HSP-2)group,and the remaining patients with VAS=0 were classified as hemiplegic non-shoulder pain(HNSP)group.Result:There were abnormal sonographic findings in 71(80.7％)patients'shoulders in hemiplegia side.25(28.4％)patients were slight abnormal results.46(52.3％)patients were obvious abnormal sonographic findings.20(22.7％)patients whose VAS score were ≥ 4 had abnormal sonographic findings.The most common patholo-gies in early hemiplegic shoulders were abnormalities of the long head tendon of the biceps brachii(35.23％),subacromial-subdeltoid bursitis(19.32％)and supraspinatus lesions(15.90％).The significant predictors for HSP in early hemiplegic patients were tendinitis,supraspinatus tendon tear and sum of sonographic abnormalities.Conclusion:Stroke patients may have soft tissue injuries of the hemiplegic shoulders at the early stage.The significant predictors for HSP in early hemiplegic patients were tendinitis,supraspinatus tendon tear and sum of sonographic abnormalities(≥2).Shoulder sonography is recommended as it can accurately identify soft tis-sue injuries associated with HSP,and provide a basis for developing the appropriate rehabilitation programs and preventing further injury.

Objective:To investigate the pathogen distribution, temporal trends in the rates of antimicrobial resistance, and susceptibility of bloodstream isolates and comparatively explore the epidemiological characteristics of bloodstream infections in hematology departments across 56 healthcare facilities in Guangdong Province from 2020 to 2024.Methods:A multicenter analysis was conducted to evaluate the constituent ratio of different pathogens isolated from clinical isolate data from bloodstream specimens in hematology, respiratory, and intensive care unit (ICU) departments across 56 healthcare facilities in Guangdong Province (2020-2024), and antimicrobial resistance trends in pathogens with high-detection rate over 5 years were assessed. Carbapenem-resistant Gram-negative organisms (CRO) were randomly sampled for carbapenemase gene detection and in vitro antimicrobial susceptibility tests with novel antimicrobial agents.Results:From 2020 to 2024, a total of 8 968, 6 440, and 25 511 bloodstream isolates were identified in the hematology, respiratory, and ICU departments, respectively, across 56 participating facilities in Guangdong Province, with significant differences in the pathogen constituent ratio among departments ( P<0.001). Notably, the hematology department demonstrated a predominance of Escherichia coli (24.1%), Klebsiella pneumoniae (17.5%), Pseudomonas aeruginosa (11.7%), coagulase-negative Staphylococci (15.2%), and Staphylococcus aureus (5.1%). In the resistance analysis, the rates of meropenem resistance of Escherichia coli and Klebsiella pneumonia increased from 6.7% and 5.8% (2020) to 14.0% and 15.8% (2024), respectively. Conversely, Pseudomonas aeruginosa exhibited a declining trend in the rate of meropenem resistance (6.2% to 1.9%) and imipenem (10.2% to 6.1%) during the same period. Acinetobacter baumannii demonstrated a biphasic resistance pattern to common antimicrobial agents, characterized by an initial decline, followed by a rebound. In this study, the susceptibility rates to conventional antimicrobial agents were significantly higher in Staphylococcus aureus versus coagulase-negative Staphylococci, with no glycopeptide- or linezolid-resistant strains detected. Notably, the prevalence of vancomycin-resistant Enterococcus faecium increased from 0 in 2020 to 23.1% in 2024. CRO carbapenemase phenotypes through active surveillance revealed that 80% Escherichia coli isolates were carrying blaNDM, 90% Klebsiella pneumoniae isolates were carrying blaKPC, 10% Pseudomonas aeruginosa isolates were carrying blaVIM, and 100% Acinetobacter baumannii were carrying blaOXA-23. The results of the antimicrobial susceptibility test in CRO revealed that carbapenem-resistant Escherichia coli (CRECO) demonstrated a 0 resistance rate to tigecycline, polymyxin B, and aztreonam/avibactam, whereas carbapenem-resistant Klebsiella pneumoniae exhibited a 0 resistance rate to aztreonam/avibactam, ceftazidime/avibactam, and imipenem/relebactam. Carbapenem-resistant Pseudomonas aeruginosa exhibited a 95.0% susceptibility rate to amikacin and polymyxin B, with a 45.0% resistance rate to ceftazidime/avibactam. In contrast, carbapenem-resistant Acinetobacter baumannii demonstrated complete susceptibility (100.0%) to sulbactam/durlobactam (MIC90=2 μg/ml), whereas eravacycline showed MIC50 and MIC90 values of 1 and 2 μg/ml, respectively. Conclusion:The pathogen constituent ratio of bloodstream isolates differed significantly among hematology, respiratory, and ICU departments. Notably, although CRO exhibited an escalating prevalence, it sustained high susceptibility to novel antimicrobial agents.

Relative Risk ( RR), Hazard Ratio ( HR), and Odds Ratio ( OR) are commonly used statistical measures in the field of public health to assess the magnitude of the effect of exposure factors on outcomes. These indicators have different calculation principles and implications in public health. However, a few researchers misused or misinterpreted RR, HR, and OR values when interpreting study results. Therefore, this article explores the relationships and differences among these measures, as well as the correct selection and application of RR, HR, and OR in both cohort study and case-control study.