With the rapid development of mobile internet technology, mobile health application (mHealth APP) are increasingly widely used in the field of health management and have been proven to play an important role in the management of chronic diseases. Solid organ transplant recipients face complex health management needs after surgery, including postoperative follow-up, medication management, prevention and treatment of complications and comorbidities, and lifestyle adjustment. mHealth APP can provide solid organ transplant recipients with convenient self-management tools. Although some progress has been made in this field, there are still many challenges, such as insufficient user experience, technological dependence, and data security risks. Therefore, this article discusses the development process, main functions and current application status of mHealth APP, and analyzes its advantages in improving the self-management ability of solid organ transplant recipients, promoting doctor-patient communication and reducing the incidence of complications. At the same time, based on the practical experience of author’s team in developing the “TransMate” mHealth APP, we propose the directions that mHealth APPs should focus on in the future, in order to provide more effective support and services for the health management of solid organ transplant recipients.

BACKGROUND: Premature menopause, defined as natural menopause before age 40, is associated with diminished ovarian reserve. Despite growing concerns regarding environmental pollutants, no large-scale population-based studies have systematically examined the association between urinary polycyclic aromatic hydrocarbon metabolites (UPAHMs) and premature menopause. METHODS: This cross-sectional study analyzed 2001-2020 NHANES data, including urinary levels of six PAH metabolites: 1-naphthol (1-NAP), 2-naphthol (2-NAP), 3-fluorene (3-FLU), 2-fluorene (2-FLU), 1-phenanthrene (1-PHE), and 1-pyrene (1-PYR). Premature menopause was self-reported as natural menopause occurring before age 40. Multivariable logistic regression assessed UPAHMs' association with premature menopause, with restricted cubic splines (RCS) evaluating nonlinear trends. Subgroup analyses examined demographic interactions. RESULTS: Among 2,565 participants, 662 reported premature menopause. Multivariable logistic regression showed significant associations between elevated urinary levels of 1-NAP (OR: 1.01, 95% CI: 1.00-1.02, P = 0.02), 2-NAP (OR: 1.01, 95% CI: 1.00-1.02, P = 0.02), and 3-FLU (OR: 1.03, 95% CI: 1.01-1.05, P = 0.01) and increased risk of premature menopause. RCS analysis revealed significant nonlinear relationships for 2-NAP, 3-FLU, 2-FLU, 1-PHE, and 1-PYR with premature menopause risk. White participants showed greater susceptibility to UPAHMs. CONCLUSION Elevated UPAHMs, particularly 1-NAP, 2-NAP, and 3-FLU, were linked to higher premature menopause risk, with nonlinear trends observed. White individuals demonstrated greater vulnerability, emphasizing the need for targeted interventions to reduce PAH exposure.
Humans ; Female ; Cross-Sectional Studies ; United States/epidemiology* ; Polycyclic Aromatic Hydrocarbons/urine* ; Adult ; Middle Aged ; Environmental Pollutants/urine* ; Nutrition Surveys ; Menopause, Premature/urine* ; Young Adult ; Environmental Exposure

Climate change has led to an increasing frequency and intensity of extreme climate events such as heat and drought extremes with considerable global public health burden. This systematic review collected 87 domestic and international studies from 2000 to 2023, considering the impacts of heat extremes, drought extremes, and compound hot-dry events on infectious diseases attributable to various transmission pathways such as waterborne, foodborne, insect-borne, airborne, and contact-transmitted diseases. Our results showed that high temperature was associated with increased transmission risks of waterborne and foodborne diseases including infectious diarrheal diseases (cholera, dysentery, typhoid, and paratyphoid) and infectious gastroenteritis; vector-borne diseases including dengue fever, Zika virus (ZIKV) disease, chikungunya fever, malaria, West Nile fever, and Rift Valley fever; airborne diseases including influenza-like diseases, influenza A, measles, and mumps; and contact-transmitted diseases including HIV/AIDS, schistosomiasis, and leptospirosis. Additionally, drought conditions also amplified the transmission risks of waterborne and foodborne diseases including cholera, Escherichia coli infection, rotavirus infection, and hepatitis E; vector-borne diseases such as scrub typhus, schistosomiasis, hemorrhagic fever with renal syndrome, and West Nile fever; airborne diseases including meningococcal meningitis, pertussis, measles, and upper respiratory infections; and contact-transmitted diseases such as HIV/AIDS. Along with global warming, the frequency of compound high temperature and drought events shows a considerably increasing trend, causing more adverse health effects than heat or drought alone. However, there is limited research quantifying their effects on infectious diseases. These associations may be mediated through temperature and precipitation on infectious disease pathogens, transmission vectors, population susceptibility, public health services, and behaviors. In the context of climate change, the increasing occurrence of compound events of high temperatures and droughts raises health concerns, and further studies are needed to enhance our understanding of the impacts of climate change on infectious diseases and improve human adaption to climate change.

OBJECTIVE To excavate the adverse drug event （ADE） signals of three third-generation tetracycline antibiotics （tigecycline， omadacycline， eravacycline） based on FDA adverse event reporting system （FAERS）， and to provide reference for the safe use of them. METHODS The ADE reports of tigecycline， omadacycline and eravacycline from the first quarter of 2005 to the second quarter of 2023 were retrieved from FAERS database. The ADE signals of 3 kinds of drugs were mined by the method of reporting odds ratio method and the proportional reporting ratio method. RESULTS Totally 2 538 ADE reports with tigecycline， omadacycline and eravacycline as the primary suspected drugs were obtained， including 2 135 tigecycline ADE reports， 349 omadacycline ADE reports and 54 eravacycline ADE reports. A total of 131 ADE positive signals of tigecycline were mined， involving 19 system organ classes （SOCs）， mainly concentrated in investigations， hepatobiliary system， blood and lymphatic system， and gastrointestinal system， etc； the preferred terminologies （PT） with intense signal were hypofibrinogenaemia and blood fibrinogen decreased. Fourteen ADE signals were not mentioned in the drug instruction， such as renal failure， acute kidney injury and hemorrhage. Totally 24 ADE positive signals of omadacycline were mined， involving 6 SOCs， mainly concentrated in the gastrointestinal system and various examinations； the PTs with intense signals were tooth discoloration， jet-like vomiting and loose feces， etc. ADE signals were not mentioned in the drug instructions， included lip swelling， gastroesophageal reflux disease， eosinophilia， skin discoloration， feces softening， and night sweats. Five ADE positive signals of eravacycline were mined， involving 4 SOCs， mainly concentrated in various examinations， gastrointestinal system， etc. The most intense ADE signals were blood fibrinogen decreased and hypofibrinogenaemia. CONCLUSIONS ADE of the gastrointestinal system are mostly identified in the three third-generation tetracycline antibiotics， especially pancreatitis caused by tigecycline and gastroesophageal reflux disease caused by oral administration of omadacycline. The liver function， renal function （for tigecycline） and coagulation function （for tigecycline， eravacycline） should be monitored biyiliang@hotmail.com regularly during medication， so as to prevent the occurrence of serious ADE.

Objective To investigate the correlation between amide proton transfer-weighted(APTw)value derived from APTw imaging and Ki-67 expression in hepatocellular carcinoma.Methods Sixty patients with hepatic occupations underwent preoperative upper abdominal MRI scanning,including APTw and diffusion weighted imaging(DWI)sequences.Thirty-two patients with hepatocellular carcinoma proved by pathological results were enrolled in the prospective study.The APTw and apparent diffusion coefficient(ADC)values of the lesions were measured from the corresponding APTw and ADC images,respectively.Mann-Whitney U test or independent sample t test was used to analyze the differences in APTw and ADC values between the high and low Ki-67 expression groups.Pearson correlation analysis was used to evaluate the correlation between APTw value,ADC value and Ki-67 expression level of hepatocellular carcinoma.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of amide proton transfer(APT)parameter in differentiating high and low Ki-67 expression groups.Results The APTw values of high Ki-67 expression group(n=24)was higher than that of low Ki-67 expression group(n=8)[(1.33±0.77)％vs(0.64±0.58)％,P=0.026].There was no significant difference in ADC values between the two groups(0.82×10-3 mm2/s vs 0.86×10-3 mm2/s,P=0.679).The APTw values were positively correlated with Ki-67 expression(r=0.377,P=0.035),and the area under the curve(AUC)of APTw value＞1.24％for the diagnosis of high Ki-67 expression was 0.794,with a sensitivity of 67％and a specificity of 88％.Conclusion The APTw value of hepatocellular carcinoma is positively correlated with Ki-67 expression,which has certain diagnostic value for predicting the expression status of Ki-67.

Objective To investigate the feasibility,safety and efficacy of transcatheter drug-loaded microsphere embolization(DLME)in treating patients with advanced bladder cancer with bleeding(ABCB).Methods A total of 26 ABCB patients who underwent DLME for tumor supply arteries were retrospectively selected.The postoperative efficacy and related complications were observed.The recurrence of hematuria and survival situation were followed up.Results All 26 surgeries achieved success with a technical success rate of 100.0％.There were 21 cases(80.8％)of bilateral bladder artery embolism and 5 cases(19.2％)of unilateral bladder artery embolism.Three days after the operation,24 patients(92.3％)had hematuria remission.And the other two patients(7.7％)had no hematuria remission,they were relieved after interventional embolization again.Compared with that before operation,the blood transfusion rate,blood transfusion volume,hematocrit and hemoglobin at one week after operation were significantly improved(P＜0.05).One month after the last intervention,there were 2 cases of complete response,19 cases of partial response,3 cases of stable disease,and 2 cases of progressive disease.The objective remission rate was 80.8％,and the disease control rate was 92.3％.Compared with that before operation,the T stage was significantly improved at one month after operation(P＜0.05).No patients had severe complications such as ectopic embolism.After follow-up for 3-36 months,5 cases(19.2％)had a recurrence of hematuria.Conclusion Transcatheter DLME is feasible,safe,and effective in the treatment of patients with ABCB.It is an optional,minimally invasive palliative measure.

Objective:To test the practical effect of the research projects outpatient strategy for application of the National Natural Science Foundation (NSFC) in a hospital of Chinese medicine.Methods:We compared the number and success rate of the National Natural Science Foundation of China grant awards before and after the implementation of the research projects outpatient strategy, and further analyzed the promotional effect of the research projects outpatient strategy on general programs and youth scientists funds through univariate analysis and multivariate Logistic regression.Results:Since the implementation of the research projects outpatient strategy, both the number of NSFC grant awards and the success rate continuously increased, indicating that the strategy played a positive role in improving the overall success rate of the hospital. However, this effect was primarily reflected in the assistance provided to applications for youth scientists funds. The main favorable factor for winning general programs was the applicant′s preliminary foundation. Applicants who have previously received NSFC funding had a higher success rate.Conclusions:The strategy of research projects outpatient can promote the winning of NSFC youth scientists funds.

Objective To analyze the epidemiological characteristics of population-based cohort of patients with the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes in Lingnan area,and to study the related influencing factors in the onset and progression of the disease. Methods A retrospective cohort study was used to collect data from people who underwent physical examination in the Eleventh People's Hospital of Guangzhou from May 2022 to December 2023. Data mainly included questionnaire surveys,physical examinations,and laboratory testing indicators. The 2022 was defined as the baseline to statistically analyze the occurrence and development of the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes in this population,and to analyze the related influencing factors of comorbidity and distribution of traditional Chinese medicine constitution in comorbidity population. Results Finally,a total of 26498 subjects were included,from which there were 359 patients with the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes (comorbidity group),accounting for 1.4％ of the total. Among them,290 were male,accounting for 80.8％,which is much higher than female. The mean age was(61.6±9.5)years old,which was significantly higher than that of the non-comorbidity group. The cases of comorbidity group were mainly concentrated in the age group of 45-75 years old,and no cases were found in people under 35 years old. There were 293 patients with the comorbidity of ischemic cardiovascular disease and type 2 diabetes,whose proportion (81.6％) is much higher than that of other types. Significant differences between comorbidity group and non-comorbidity group were found in terms of gender,age,age distribution,height,body mass,body mass index (BMI),smoking,alcohol consumption,marital status,exercise,and dampness syndrome (P<0.05). About 1.0％ of population at the baselined converted from non-comorbidities or single disease to comorbidities. The proportion of newly diagnosed patients with the comorbidity of ischemic cardiovascular disease and type 2 diabetes is the highest,up to 68.9％. BMI overweight or obesity,large waist circumference,smoking,dampness syndrome and exercise were the risk factors affecting the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes. A total of 264 cases of comorbidity group had finished evaluation of traditional Chinese medicine body constitutions. The proportion of balanced constitution was the highest (31.1％),followed by dampness-heat constitution (18.2％),yang-deficiency constitution (13.3％) and phlegm-dampness constitution (11.7％). Conclusion The incidence of the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes is high in Lingnan area,which may be related to dampness constitution,BMI overweight or obesity,large waist circumference,smoking,dampness syndrome and lack of exercise.

Objective:To investigate the long-term clinical value of composite biomaterial mesh in inguinal hernia repair.Methods:The prospective randomized controlled non-inferiority study was conducted. The clinical data of 172 adult patients with inguinal hernia who were admitted to 3 medical centers, including Huadong Hospital Affiliated to Fudan University et al, from July 2014 to February 2015 were selected. Based on random number table, patients were divided into two groups. Patients underwent technique of abdominal wall reinforcement with biological mesh. Patients using the electrospun composite biomaterial mesh were allocated into experimental group, and patients using the small intestinal submucosa mesh were allocated into control group. Observation indicators: (1) grouping situations of the enrolled patients; (2) endpoint of the study. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the non-parameter rank sum test. Taking the recurrence rate of hernia at 6 years after surgery as the basis of efficacy evaluation, the Cochran-Mantel-Haenszel test was used for comparison between groups. The confidence interval method was used to conduct non-inferiority statistical analysis. If the lower limit of 95% confidence interval of the difference of recurrence rate of hernia between the experiment group and the control group was more than -10%, the experiment group was considered to be non-inferior to the control group. If the lower limit of 95% confidence interval is more than 0, the experiment group was considered to be superior to the control group. Results:(1) Grouping situations of the enrolled patients. A total of 172 adult patients with inguinal hernia were selected for eligibility. They were males, aged (61±2)years. All 172 patients were randomly divided into to the experimental group and the control group with 86 cases in each group. At 6 years after surgery, 20 patients in the experi-mental group and 19 patients in the control group was lost to follow-up. (2) Endpoint of the study. ① The primary endpoint of study. At 6 years after surgery, no patient had recurrence in the 66 patients of experimental group and 4 patients had recurrence in the 67 patients of control group. Results of non-inferiority statistical analysis showed that the 95% confidence interval of the difference of recurrence rate of hernia between the two groups was 0.27% to 14.41%, with the lower limit as 0.27%, which was more than -10% and simultaneously more than 0. ② The secondary endpoint of study. There was no significant difference in the simple verbal scale between the two groups after 6 months and 6 years at rest or cough status ( P>0.05). At a follow-up of 6 months after surgery, 2 cases of the experimental group and 5 patients of the control group had complications, showing no significant difference between the two groups( χ2=1.38, P>0.05). At a follow-up of 6 years after surgery, no complication occurred in either group. Conclusion:Composite biological mesh in inguinal repair is safe and feasible, which can have low long-term recurrence and achieve good long-term efficacy.

Objective To explore the effect of hematoma aspiration device combined with low posterior osteotomy and small bone window craniotomy on neurological function and prognosis in patients with hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 132 patients with HICH in the Department of Neurosurgery,Gansu Provincial people's Hospital from February 2020 to February 2022 were collected and divided into small bone window group(n=52)and aspiration group(n=80).The levels of serum neuron specific enolase(NSE)and interleukin-6(IL-6)were detected by enzyme linked immunosorbent assay(ELISA).The intraoperative condition(duration of operation and intraoperative blood loss),intracranial pressure,complete clearance rate of intracranial hematoma and the incidence of postoperative complications were compared.The prognosis of the patients was evaluated by activity of daily living scale(ADL).Results There was no significant difference in the levels of serum NSE and IL-6 between the two groups before operation(P>0.05).The levels of NSE and IL-6 in serum after operation were significantly lower than those before operation,and the intracranial pressure was improved after treatment,the difference has statistic significance(P<0.05).The postoperative serum NSE and IL-6 levels,operation duration,postoperative intracranial pressure and the total incidence of complications in aspiration group were lower than those in small bone window group(P<0.05),but there was no significant difference in intraoperative blood loss and the total incidence of long-term complications between the two groups(P>0.05).During the 6-month follow-up after surgery,the good prognosis rate of aspiration group was higher than that of small bone window group,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the complete clearance rate of intracranial hematoma between the two groups of patients(P>0.05).Conclusion Low posterior osteotomy combined with hematoma aspiration can effectively treat HICH,promote the recovery of neurological function in patients.