Volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs) are common organic compounds in indoor and outdoor air, and enter the human body primarily through the respiratory tract and directly damage the respiratory system. Previous studies have suggested that exposure to VOCs/SVOCs may associate with the prevalence, incidence, and progression of asthma, but the extent of the associations is still vague. Furthermore, biomarkers for efficient and simple asthma diagnosis, typing, and attack prediction remain unclear at this stage. From the perspective of the collection and detection methods of VOCs/SVOCs, this paper summarized the epidemiological associations and underlying biological mechanisms between VOCs/SVOCs exposure and the prevalence, incidence, and progression of asthma in children/adults. It also demonstrated the application of VOCs/SVOCs in recent years in assisting asthma diagnosis, such as distinguishing asthma patients from the healthy population, differentiating different asthma phenotypes, and predicting asthma acute exacerbations, aiming to provide a scientific basis for improving current asthma management.

ObjectiveTo analyze stroke mortality data from Yuyao, Zhejiang Province, from 2015 to 2022, and to provide references for the development of effective stroke prevention and control strategies in Yuyao and similar county-level cities or districts. MethodsData on all stroke-related deaths in Yuyao from 2015 to 2022 were collected. Metrics including crude mortality rate (CMR), Chinese-standardized mortality rate, world-standardized mortality rate, truncated mortality rate (35‒64 years), cumulative mortality rate (0‒74 years), premature mortality rate, potential years of life lost (PYLL), average years of life lost (AYLL), PYLL rate (PYLLR), and average annual percentage change (AAPC) were calculated. Differences between groups were compared using the Chi-square test. Linear regression was utilized to calculate AAPC and analyze mortality trends. ResultsFrom 2015 to 2022, a total of 6 533 stroke deaths were recorded among residents in Yuyao, with ischemic stroke accounting for 70.60% and hemorrhagic stroke accounting for 29.40%. The average CMR was 97.67/100 000, China-standardized mortality rate was 45.82/100 000, and world-standardized mortality rate was 32.10/100 000. No statistically significant differences were observed in CMR, China-standardized morality rate, or world-standardized mortality rate over the 8 years (all P>0.05). Stroke deaths primarily occurred in winter (from December to February of next year), accounting for 31.21% of the cases. Male stroke mortality rate (108.15/100 000) was significantly higher than female mortality rate (87.49/100 000, χ²=73.195, P<0.001). Stroke mortality rate increased significantly with age (χ²_trend=17 839.150, P<0.001), peaking at 1 867.82/100 000 in the ≥85-year-old age group. Hemorrhagic stroke mortality rate was higher than ischemic stroke mortality rate in the 10‒64-year-old age group, whereas ischemic stroke mortality rate exceeded hemorrhagic stroke mortality rate in those aged 65 years and above. The PYLL caused by stroke mortality was 11 014.00 person-years, with an AYLL of 10.98 years, and a PYLLR of 1.87‰. ConclusionStroke mortality in Yuyao has remained relatively stable. A community-based comprehensive chronic disease intervention mechanism should be established, with a focus on males and the elderly. This mechanism should integrate community health education, stroke risk assessment, screening and intervention, two-way patient referral systems, and tiered rehabilitation services to reduce mortality rate and mitigate life expectancy loss.

BACKGROUND: Metabolic-associated fatty liver disease (MAFLD) is the predominant form of chronic liver disease worldwide. This study was designed to investigate the proportion and characteristics of MAFLD within the general Chinese population and to identify the contributory risk factors for liver fibrosis among MAFLD individuals. METHODS: The participants were recruited from a cohort undergoing routine health evaluations at the Third Hospital of Hebei Medical University between May 2019 and March 2023. The diagnosis of MAFLD was based on the established clinical practice guidelines. The fibrosis-4 index score (FIB-4) was employed to evaluate hepatic fibrosis, with a FIB-4 score of ≥1.3 indicating significant fibrosis. Binary logistic regression analyses were used to determine risk factors associated with significant hepatic fibrosis in MAFLD. RESULTS: A total of 22,970 participants who underwent comprehensive medical examinations were included in the analysis. The overall proportion of MAFLD was 28.77% (6608/22,970), with 16.87% (1115/6608) of these patients showing significant fibrosis as assessed using FIB-4. Independent risk factors for significant liver fibrosis in MAFLD patients were male (odds ratio [OR] = 0.676, 95% confidence interval [CI]: 0.558-0.821), hepatitis B surface antigen (HBsAg) positivity (OR = 2.611, 95% CI: 1.557-4.379), body mass index ≥23.00 kg/m 2 (OR = 0.632, 95% CI: 0.470-0.851), blood pressure ≥130/85 mmHg (OR = 1.885, 95% CI: 1.564-2.272), and plasma glucose ≥5.6 mmol/L (OR = 1.815, 95% CI: 1.507-2.186) (all P <0.001). CONCLUSIONS The proportion of MAFLD in an urban Chinese population is 28.77%. About 16.87% of MAFLD patients presented with significant liver fibrosis. Independent risk factors for significant liver fibrosis in MAFLD patients should be noticed.
Humans ; Male ; Female ; Liver Cirrhosis/pathology* ; Middle Aged ; Risk Factors ; Adult ; Fatty Liver/pathology* ; Aged ; China/epidemiology* ; Logistic Models ; Urban Population ; East Asian People

Objective:To observe the improving effect of acupuncture and Tuina(Chinese therapeutic massage)combined with Ba Duan Jin(Eight-brocade Exercise)on motor function in patients with Parkinson disease(PD)in the early and middle stages.Methods:Seventy patients with early-or middle-stage PD were randomly divided into a control group and an observation group,with 35 patients in each group.The control group was given conventional treatment such as oral levodopa hydrochloride tablets;the observation group was treated with acupuncture,Tuina,and Ba Duan Jin in addition to the control group's treatment.Acupuncture and Tuina were administered twice a week,and Ba Duan Jin was performed five times a week.Each course of treatment lasted 4 weeks,and a total of 3 courses were completed.The changes in the unified Parkinson disease rating scale Ⅲ(UPDRS Ⅲ)score,Berg balance scale(BBS)score,15-meter walking speed,and 6-minute walk distance were compared between the two groups.Results:The total effective rate in the observation group was 93.6%,which was significantly higher than 45.7%in the control group(P<0.01).After 4,8,and 12 weeks of treatment,the UPDRS Ⅲ score in the observation group was significantly lower than the previous score(P<0.05);the BBS score was significantly higher than the previous score(P<0.05),and the 6-minute walk distance also significantly increased compared to the previous result(P<0.05).After 8 and 12 weeks of treatment,the 15-meter walking speed in the observation group was significantly higher than that before treatment and the previous measurement(P<0.05).In comparison with the control group,the observation group showed significantly lower UPDRS Ⅲ scores after 8 and 12 weeks of treatment(P<0.05).Additionally,after 4,8,and 12 weeks of treatment,the observation group had significantly higher BBS scores,15-meter walking speed,and the 6-minute walk distance than the control group(P<0.05).There were no significant differences in the above indicators before and after treatment in the control group(P>0.05).Conclusion:The addition of acupuncture,Tuina,and Ba Duan Jin to Western medication treatment can effectively improve motor function,balance ability,and walking ability in patients with early-or middle-stage PD.

The multidisciplinary diagnosis and treatment (MDT) mode plays a positive role in diagnosing and treating difficult and complicated diseases, improving service quality, and promoting the construction of an integrated medical system. In March 2023, Zhejiang Provincial People′s Hospital had launched the " 6 New" MDT management practice to further improve the hospital′s inpatient MDT service level, including new concepts, new architectures, new standards, new processes, new models, and new quality control. This practice had improved the quality and efficiency of MDT management and promoted interdisciplinary integration by strengthening top-level design, establishing MDT leadership and quality control teams, developing relevant standards and specifications, enhancing the level of information management throughout the entire process, implementing diversified MDT models, and implementing quality control measures. As of July 2024, the hospital had established 80 MDT teams covering 30 clinical departments, conduct 120 MDT discussions for hospitalized cases per month, and with the continuous promotion of inpatient MDT work, the number of MDT teams and cases continued to increase. This practice had achieved good results and could provide references for other public hospitals in China to improve the level of inpatient MDT services.

Chronic wounds, defined as persistent failure to heal due to specific etiological factors, remain a major clinical challenge. Current standard interventions such as negative pressure wound therapy are limited by complications like hypergranulation and poor patient compliance, while emerging stem cell-based therapies carry potential tumorigenic risks. Consequently, identifying strategies to safely and effectively accelerate wound healing continues to be a critical focus in contemporary clinical research. Platelet-rich plasma derived extracellular vesicles (PRP-EVs) are extracellular vesicles released by platelets after activation. They have the characteristics of autologous origin, higher safety, and more mild and convenient clinical application. Studies have shown that PRP-EVs are rich in bioactive molecules such as lipids, proteins and RNA, which have outstanding performance in regulating wound inflammation, promoting angiogenesis, enhancing cell migration and proliferation, and are expected to become an effective tool for the treatment of chronic wounds. This review discusses the methods, mechanisms of action, and challenges associated with the use of PRP-EVs in chronic wound management, providing a foundation for future research and clinical applications in this field.

Objective:To explore the correlation between inflammatory factor levels in gingival crevicular fluid and pain degree, stress response and masticatory function in patients with combined periodontal and pulpal lesions.Methods:A retrospective selection of 92 patients with combined periodontal and pulpal lesions admitted to Yan ′an People′s Hospital from May 2022 to May 2023 was divided into mild group (60 cases) and moderate-severe group (32 cases) according to the degree of combined periodontal and pulpal lesions. Periodontal clinical indicators were compared between the two groups; enzyme-linked immunosorbent assay (ELISA) was used to detect inflammatory factors in gingival crevicular fluid and serum cortisol (Cor) and adrenocorticotropic hormone (ACTH) levels; Visual Analogue Scale (VAS) was used to evaluate pain degree; and weighing method was used to evaluate masticatory efficiency. Pearson correlation analysis was used to evaluate the correlation between inflammatory factor levels in gingival crevicular fluid and pain degree, stress response and masticatory function.Results:The probing depth (PD), attachment loss (AL), Plaque Index (PLI) and Bleeding Index (BI) in the moderate-severe group [(5.35±0.40)mm, (5.98±0.59)mm, 1.22±0.42, 1.28±0.43] were all higher than those in the mild group [(4.23±0.36)mm, (2.53±0.29)mm, 1.05±0.34, 0.80±0.40] (all P<0.05). The levels of interleukin-1β (IL-1β), interleukin-17 (IL-17) and high-sensitivity C-reactive protein (hs-CRP) in gingival crevicular fluid in the moderate-severe group [(41.87±11.78)μg/L, (606.32±59.33)pg/ml, (58.64±10.63)mg/L] were higher than those in the mild group [(30.35±10.53)μg/L, (478.63±43.18)pg/ml, (43.15±9.85)mg/L], and the level of transforming growth factor-β (TGF-β) [(53.98±6.98)μg/L] was lower than that in the mild group [(121.67±12.87)μg/L] ( P<0.05). The serum Cor and ACTH levels in the moderate-severe group [(165.68±34.64)μg/L, (25.97±6.37)ng/L] were higher than those in the mild group [(148.73±29.65)μg/L, (17.97±5.34)ng/L] (all P<0.05). The VAS score in the moderate-severe group [(5.03±1.20)points] was higher than that in the mild group [(3.57±1.01)points] ( P<0.05). The bite force and masticatory efficiency in the moderate-severe group [(95.32±23.73)lbs, (65.97±13.34)%] were lower than those in the mild group [(113.75±26.46)lbs, (75.89±16.86)%], and the gingival index (1.41±0.50) was higher than that in the mild group (0.85±0.36) (all P<0.05). Correlation analysis showed that IL-1β was positively correlated with disease degree, periodontal indexes, IL-17 and inflammatory factors, and negatively correlated with TGF-β; IL-17 was positively correlated with disease degree and multiple indexes, and negatively correlated with TGF-β, bite force and masticatory efficiency; TGF-β was positively correlated with bite force and masticatory efficiency, and negatively correlated with disease degree and multiple indexes. Conclusions:Inflammatory factors in gingival crevicular fluid of patients with combined periodontal and pulpal lesions are closely related to pain and stress response, and affect masticatory function. In diagnosis and treatment, inflammatory status should be comprehensively considered to provide a basis for personalized treatment.

Objective:To explore the correlation between inflammatory factor levels in gingival crevicular fluid and pain degree, stress response and masticatory function in patients with combined periodontal and pulpal lesions.Methods:A retrospective selection of 92 patients with combined periodontal and pulpal lesions admitted to Yan ′an People′s Hospital from May 2022 to May 2023 was divided into mild group (60 cases) and moderate-severe group (32 cases) according to the degree of combined periodontal and pulpal lesions. Periodontal clinical indicators were compared between the two groups; enzyme-linked immunosorbent assay (ELISA) was used to detect inflammatory factors in gingival crevicular fluid and serum cortisol (Cor) and adrenocorticotropic hormone (ACTH) levels; Visual Analogue Scale (VAS) was used to evaluate pain degree; and weighing method was used to evaluate masticatory efficiency. Pearson correlation analysis was used to evaluate the correlation between inflammatory factor levels in gingival crevicular fluid and pain degree, stress response and masticatory function.Results:The probing depth (PD), attachment loss (AL), Plaque Index (PLI) and Bleeding Index (BI) in the moderate-severe group [(5.35±0.40)mm, (5.98±0.59)mm, 1.22±0.42, 1.28±0.43] were all higher than those in the mild group [(4.23±0.36)mm, (2.53±0.29)mm, 1.05±0.34, 0.80±0.40] (all P<0.05). The levels of interleukin-1β (IL-1β), interleukin-17 (IL-17) and high-sensitivity C-reactive protein (hs-CRP) in gingival crevicular fluid in the moderate-severe group [(41.87±11.78)μg/L, (606.32±59.33)pg/ml, (58.64±10.63)mg/L] were higher than those in the mild group [(30.35±10.53)μg/L, (478.63±43.18)pg/ml, (43.15±9.85)mg/L], and the level of transforming growth factor-β (TGF-β) [(53.98±6.98)μg/L] was lower than that in the mild group [(121.67±12.87)μg/L] ( P<0.05). The serum Cor and ACTH levels in the moderate-severe group [(165.68±34.64)μg/L, (25.97±6.37)ng/L] were higher than those in the mild group [(148.73±29.65)μg/L, (17.97±5.34)ng/L] (all P<0.05). The VAS score in the moderate-severe group [(5.03±1.20)points] was higher than that in the mild group [(3.57±1.01)points] ( P<0.05). The bite force and masticatory efficiency in the moderate-severe group [(95.32±23.73)lbs, (65.97±13.34)%] were lower than those in the mild group [(113.75±26.46)lbs, (75.89±16.86)%], and the gingival index (1.41±0.50) was higher than that in the mild group (0.85±0.36) (all P<0.05). Correlation analysis showed that IL-1β was positively correlated with disease degree, periodontal indexes, IL-17 and inflammatory factors, and negatively correlated with TGF-β; IL-17 was positively correlated with disease degree and multiple indexes, and negatively correlated with TGF-β, bite force and masticatory efficiency; TGF-β was positively correlated with bite force and masticatory efficiency, and negatively correlated with disease degree and multiple indexes. Conclusions:Inflammatory factors in gingival crevicular fluid of patients with combined periodontal and pulpal lesions are closely related to pain and stress response, and affect masticatory function. In diagnosis and treatment, inflammatory status should be comprehensively considered to provide a basis for personalized treatment.

Objective:To observe the improving effect of acupuncture and Tuina(Chinese therapeutic massage)combined with Ba Duan Jin(Eight-brocade Exercise)on motor function in patients with Parkinson disease(PD)in the early and middle stages.Methods:Seventy patients with early-or middle-stage PD were randomly divided into a control group and an observation group,with 35 patients in each group.The control group was given conventional treatment such as oral levodopa hydrochloride tablets;the observation group was treated with acupuncture,Tuina,and Ba Duan Jin in addition to the control group's treatment.Acupuncture and Tuina were administered twice a week,and Ba Duan Jin was performed five times a week.Each course of treatment lasted 4 weeks,and a total of 3 courses were completed.The changes in the unified Parkinson disease rating scale Ⅲ(UPDRS Ⅲ)score,Berg balance scale(BBS)score,15-meter walking speed,and 6-minute walk distance were compared between the two groups.Results:The total effective rate in the observation group was 93.6%,which was significantly higher than 45.7%in the control group(P<0.01).After 4,8,and 12 weeks of treatment,the UPDRS Ⅲ score in the observation group was significantly lower than the previous score(P<0.05);the BBS score was significantly higher than the previous score(P<0.05),and the 6-minute walk distance also significantly increased compared to the previous result(P<0.05).After 8 and 12 weeks of treatment,the 15-meter walking speed in the observation group was significantly higher than that before treatment and the previous measurement(P<0.05).In comparison with the control group,the observation group showed significantly lower UPDRS Ⅲ scores after 8 and 12 weeks of treatment(P<0.05).Additionally,after 4,8,and 12 weeks of treatment,the observation group had significantly higher BBS scores,15-meter walking speed,and the 6-minute walk distance than the control group(P<0.05).There were no significant differences in the above indicators before and after treatment in the control group(P>0.05).Conclusion:The addition of acupuncture,Tuina,and Ba Duan Jin to Western medication treatment can effectively improve motor function,balance ability,and walking ability in patients with early-or middle-stage PD.

The multidisciplinary diagnosis and treatment (MDT) mode plays a positive role in diagnosing and treating difficult and complicated diseases, improving service quality, and promoting the construction of an integrated medical system. In March 2023, Zhejiang Provincial People′s Hospital had launched the " 6 New" MDT management practice to further improve the hospital′s inpatient MDT service level, including new concepts, new architectures, new standards, new processes, new models, and new quality control. This practice had improved the quality and efficiency of MDT management and promoted interdisciplinary integration by strengthening top-level design, establishing MDT leadership and quality control teams, developing relevant standards and specifications, enhancing the level of information management throughout the entire process, implementing diversified MDT models, and implementing quality control measures. As of July 2024, the hospital had established 80 MDT teams covering 30 clinical departments, conduct 120 MDT discussions for hospitalized cases per month, and with the continuous promotion of inpatient MDT work, the number of MDT teams and cases continued to increase. This practice had achieved good results and could provide references for other public hospitals in China to improve the level of inpatient MDT services.