Objective To analyze and compare the disease burden of high BMI in Kunshan City in different periods, and to provide a scientific basis for the prevention and control of overweight and obesity in Kunshan City. Methods Using the global burden of disease research method, the number of deaths attributable to high BMI and attributable YLL in Kunshan City were calculated using the survey data of chronic diseases and their risk factors and the data of the death registration system in Kunshan City. Results In 2023, R5.46% of deaths in Kunshan City were attributed to high BMI, with 345 attributable deaths, and attributable mortality rate and standardized attributable mortality rate were 39.16/100 000 and 33.82/100 000, Rrespectively. Attributable YLL rate and standardized attributable YLL rate were 692.35/100 000 and 604.46/100 000, respectively. High BMI caused a loss of 0.52 years of life expectancy per capita. Compared with 2012, PAF, standardized attributable mortality rate, standardized attributable YLL rate and life expectancy loss per capita of high BMI in 2023 increased by 121.95%, 100.71%, 57.05%, and 100%, respectively. Among different genders, PAF increased by 91.05% for males and 161.97% for females from 2012 to 2023. Among different diseases, cardiovascular and cerebrovascular diseases and cancers had the highest attributable disease burden, while diabetes, chronic kidney disease and Alzheimer's disease all had a significant increase. Conclusion The burden of disease attributable to high BMI has risen dramatically in Kunshan City, and the adverse health effects of overweight and obesity need to be reduced through scientific weight loss and comprehensive practical measures.

INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, contact tracers were under immense pressure to deliver effective and timely contact tracing, raising concerns of higher susceptibility to burnout. Our study aimed to determine burnout prevalence among hospital-based contact tracers and associated risk factors, so that interventions to reduce burnout risk could be formulated. METHODS: One hundred and ninety-six active contact tracers across three hospitals within a healthcare cluster were invited to complete an anonymous online survey. To identify burntout, data such as demographics, work-related variables and contact tracing-related variables were collected using the Copenhagen Burnout Inventory. Associated factors were identified using multivariate statistics. Open-ended questions were included to understand the challenges and potential improvements through qualitative analysis. RESULTS: A total of 126 participants completed the survey, giving a completion rate of 64%, and almost half of these participants (42.9%) reported burnout. Protective factors included being on work-from-home arrangements (adjusted odds ratio [OR] 0.22, 95% confidence interval [CI] 0.08-0.56), perception of being well supported by their institution (adjusted OR 0.25, 95% CI 0.08-0.80) and being married (adjusted OR 0.28, 95% CI 0.12-0.64). Risk factors included having an administrative role pre-COVID-19 (adjusted OR 3.62, 95% CI 1.33-9.83). Work-related burnout was related to being activated for more than 1 day in the preceding week (unadjusted OR 3.25, 95% CI 1.33-7.94) and multiple activations in a day (unadjusted OR 3.54, 95% CI 1.44-4.41). Biggest challenges identified by participants were language barrier (62.7%), followed by workflow-related issues (42.1%). CONCLUSION Our study demonstrated burnout and other challenges faced by a team of mostly hospital-based administrative staff redeployed on a part-time basis to ensure timely contact tracing. To mitigate burnout, we recommend choosing staff on work-from-home arrangements and ensuring adequate manpower and rostering arrangements.
Humans ; COVID-19/epidemiology* ; Burnout, Professional/epidemiology* ; Singapore/epidemiology* ; Female ; Male ; Cross-Sectional Studies ; Adult ; Middle Aged ; Risk Factors ; Surveys and Questionnaires ; Contact Tracing/methods* ; SARS-CoV-2 ; Prevalence ; Pandemics

AIM To investigate the effects of volatile oil from Acorus tatarinowii Schott(A.tatarinowii)on neuroinflammation in a rat model of tic disorders.METHODS The SD rats were randomly divided into the blank group(8 rats)and the model group(40 rats).The rat models of tic disorders established successfully by intraperitoneal injection of iminodiapropionitrile(IDPN)were further divided into the model group,the tiapride group and the high-dose,moderate-dose and low-dose A.tatarinowii volatile oil groups,with 8 rats in each group.The 4-week intragastric treatment of respective drug was initiated the next day after the completion of modeling,and normal saline was dosed upon the blank group and the model group,during which the rats' behavioral changes were assessed by stereotyped behavior and motor behavior score every week.After the administration,the rats had their morphological changes of striatal neurons observed by Nissl staining;their levels of TGF-β,IL-10,TNF-αand IL-1β in serum and striatum detected by ELISA;their striatal protein expressions of CX3CL1 and CX3CR1 detected by Western blot and immunohistochemistry;and their striatal expressions of M1,M2 microglia marker proteins CD86,CD206,SYN and PSD-95 detected by immunofluorescence co-staining.RESULTS Compared with the model group,the A.tatarinowii volatile oil groups demonstrated improved twitch-like behavior;decreased scores of motor behavior and rigid behavior(P＜0.01);alleviated damage of Nissl bodies in neurons;increased serum and striatum levels of TGF-β and IL-10(P＜0.05,P＜0.01);decreased levels of TNF-α and IL-1β(P＜0.01);decreased striatal protein expressions of CX3CL1 and CX3CR1(P＜0.01);increased protein expressions of PSD95 and SYN(P＜0.05,P＜0.01);and decreased CD86/Iba1(P＜0.01)and increased CD206/Iba1(P＜0.01)in terms of the fluorescence intensity.CONCLUSION A.tatarinowii volatile oil contributes an anti-tic effect and improves the neuroinflammation in the brain of the rat model of tic disorders by promoting the transformation of microglia into M2 type via CX3CL1/CX3CR1 signal axis.

Hypercholesterolemia is pathologically characterized by abnormal accumulation of low-density lipoprotein cholesterol,which is closely associated with metabolic dysfunction-associated fatty liver disease and increased cardiovascular risks.Hepatocytes maintain cholesterol homeostasis through LDL receptor-mediated uptake and esterification storage mechanisms.However,chronic cholesterol overload induces mitochondrial dysfunction,reactive oxygen species accumulation,and endoplasmic reticulum stress,leading to hepatocyte injury.Moreover,systemic hypercholesterolemia disrupts gut microbiota balance and impairs short-chain fatty acid and ketone metabolism,exacerbating metabolic disturbances and aggravating hepatic injury through enhanced metabolic stress.In this article,we review the advance of studies on hypercholesterolemia in recent years and summary its association with hepatic injury,which can provide theoretical support for further research.

Constipation is a common functional gastrointestinal disorder with a global prevalence of approximately 10％to 20％.Its causes include functional disorders,organic diseases,and drug factors,with the majority being functional constipation.In recent years,driven by advancements in biomedicine,artificial intelligence(AI),and microbiome research,significant progress has been made in the diagnosis and treatment of constipation.This review systematically explores the latest developments in constipation treatment,including the role of the gut microbiota in constipation,the metabolic regulatory effects of short-chain fatty acids(SCFAs),the impact of mental factors on intestinal motility.Additionally,it discusses future development directions such as AI-assisted diagnosis,AI-based consultation systems,personalized microbiota transplantation,and minimally invasive neuromodulation,providing new insights for precision medicine in constipation.

Objective:To evaluate the cost-effectiveness of interventional bronchoscopy with rigid bronchoscopy(scleroscope),laryngeal mask airway and endotracheal intubation access for the treatment of central airway stenosis.Methods:The data of patients with central airway stenosis who underwent interventional bronchoscopy under general anesthesia were collected,and divided into rigid bronchoscopy group,laryngeal mask group and tracheal intubation group.The average Cost-Effectiveness Ratio(CER)was calculated using total hospitalization cost and total surgery cost as the cost indices,and improvement of shortness of breath symptoms as the effect index.The stability of the evaluation result was analyzed by one-factor sensitivity analysis and probabilistic sensitivity analysis.Results:A total of 205 patients were included:rigid bronchoscopy group(66 patients),laryngeal mask group(64 patients)and tracheal intubation group(75 patients).The CERs were 8 851.29 for the rigid bronchoscopy group,10 942.62 for the laryngeal mask group,and 8 902.98 for the tracheal intubation group when using total hospitalization cost as the cost index.For total surgery cost,the CERs were 2 617.80,3 389.73,and 2 741.38,respectively.The order was rigid bronchoscopy＜tracheal intubation＜laryngeal mask.The main factors affecting the model results were the discount rate,non-surgical costs,and improvement of shortness of breath symptoms.Probabilistic sensitivity analysis shows that the results of the basic analysis are stable.Conclusion:Interventional bronchoscopy via rigid bronchoscope is the most economical method for treating central airway stenosis.

Objective:To explore the effects of real-time feedback intervention based on ecological momentary assessment on health behaviors and quality of life in stroke patients, to provide new insights and evidence for secondary prevention of stroke and post-discharge rehabilitation management.Methods:This was a non synchronous controlled study. A total of 160 stroke patients admitted to the First Affiliated Hospital of Soochow University from January 2022 to June 2023 were selected by convenience sampling method and sequentially assigned to a control group (80 cases) and an intervention group (80 cases) according to the admission time. The control group received routine discharge follow-ups. The intervention group wore smart wristbands and received ecological momentary assessment -based real-time feedback intervention. Health behaviors and quality of life were compared between the two groups before discharge, 3 months and 6 months after discharge.Results:Both groups of patients completed the study. In the intervention group, there were 43 cases aged ≤ 65 years and 37 cases aged>65 years, with 55 males and 25 females. In the control group, there were 42 cases aged ≤ 65 years and 38 cases aged>65 years, with 53 males and 27 females. There were no significant differences in the level of health behaviors and quality of life before discharge between the two groups (both P>0.05). At both 3 and 6 months after discharge, the total scores of the health behaviors were (92.59 ± 7.12), (92.58 ± 5.77) points in the intervention group, and (86.15 ± 14.64), (83.40 ± 8.19) points in the control group, there were significant differences between the two groups ( t=-3.54, -7.72; both P<0.01). The quality of life in the intervention group at 3 months after discharge was 0.904 ± 0.123, which was higher than the control group's 0.845 ± 0.232, and the difference was statistically significant ( t=-2.01, P<0.05). However, there was no statistically significant difference in the quality of life between the two groups at 6 months after discharge ( P>0.05). The overall compliance rate with smart wristband usage in the intervention group was 100%(80/80). Conclusions:Ecological momentary assessment-based real-time feedback intervention effectively improves health behaviors in stroke patients and enhances their quality of life in the short term, demonstrating good feasibility and acceptability.

Objective:To evaluate the cost-effectiveness of interventional bronchoscopy with rigid bronchoscopy(scleroscope),laryngeal mask airway and endotracheal intubation access for the treatment of central airway stenosis.Methods:The data of patients with central airway stenosis who underwent interventional bronchoscopy under general anesthesia were collected,and divided into rigid bronchoscopy group,laryngeal mask group and tracheal intubation group.The average Cost-Effectiveness Ratio(CER)was calculated using total hospitalization cost and total surgery cost as the cost indices,and improvement of shortness of breath symptoms as the effect index.The stability of the evaluation result was analyzed by one-factor sensitivity analysis and probabilistic sensitivity analysis.Results:A total of 205 patients were included:rigid bronchoscopy group(66 patients),laryngeal mask group(64 patients)and tracheal intubation group(75 patients).The CERs were 8 851.29 for the rigid bronchoscopy group,10 942.62 for the laryngeal mask group,and 8 902.98 for the tracheal intubation group when using total hospitalization cost as the cost index.For total surgery cost,the CERs were 2 617.80,3 389.73,and 2 741.38,respectively.The order was rigid bronchoscopy＜tracheal intubation＜laryngeal mask.The main factors affecting the model results were the discount rate,non-surgical costs,and improvement of shortness of breath symptoms.Probabilistic sensitivity analysis shows that the results of the basic analysis are stable.Conclusion:Interventional bronchoscopy via rigid bronchoscope is the most economical method for treating central airway stenosis.

Objective:To establish a complete system for the isolation, purification, identification, and culture of Kaposiform hemangioendothelioma-derived endothelial cells (KHE-ECs), to analyze the phenotype of KHE-ECs, and to explore the possibility of establishing a KHE-EC bank.Methods:A novel digestion solution for KHE tumors (patent number: CN202410500224.2) was formulated using collection fluid, Liberase TM and dispase stock solutions, and was used to process tumor tissues to obtain cells. High-purity KHE-ECs were purified using CD31 + immunomagnetic beads. The EGM-2 complete medium containing 10% fetal bovine serum and 2% penicillin-streptomycin solution was employed for cell culture. To verify the characteristics of KHE-ECs, immunofluorescence assay was conducted to determine the expression of endothelial cell-specific markers CD31 and CD34, KHE disease markers podoplanin (D2-40), prospero-related homeobox 1 (Prox-1), and lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1), as well as an infantile hemangioma-specific diagnostic marker glucose transporter 1 (GLUT-1). Human umbilical vein endothelial cells (HUVECs) served as controls for the phenotype analysis of KHE-ECs, including cell viability, cytoskeleton, proliferation, migration, invasion, tube formation, and sprouting ability. Results:Primary cells were successfully isolated from KHE tumor tissues, and high-purity KHE-ECs were obtained by using CD31 + immunomagnetic beads. The cells exhibited typical spindle-shaped morphology and an adherent growth pattern. Immunofluorescence assay showed that KHE-ECs expressed CD31, CD34, D2-40, Prox-1, and LYVE1, but did not express GLUT-1. There were significant differences in cell morphology, cell viability, and cytoskeletal structures between KHE-ECs and HUVECs. Additionally, the KHE-EC group showed significantly increased percentages of proliferative cells (29.1% ± 2.5%), numbers of migratory cells (114.3 ± 9.4) and invasive cells (110.0 ± 6.1), tube length (32 121.0 ± 892.0 μm), and number of sprouting cells (25.0 ± 3.6) compared with the HUVEC group (13.0% ± 2.2%, 38.0 ± 3.6, 35.3 ± 2.3, 25 345.0 ± 448.1 μm, 5.0 ± 1.0, respectively, all P ≤ 0.001) . Conclusion:An innovative digestion solution specifically for KHE tumors was formulated for the first time, and high-purity and well-growing KHE-EC strains were successfully isolated and purified by using the novel digestion solution in combination with CD31 + immunomagnetic beads, providing a stable and reliable cell source for subsequent experimental studies on KHE and laying the foundation for establishing a KHE-EC bank.

Hypercholesterolemia is pathologically characterized by abnormal accumulation of low-density lipoprotein cholesterol,which is closely associated with metabolic dysfunction-associated fatty liver disease and increased cardiovascular risks.Hepatocytes maintain cholesterol homeostasis through LDL receptor-mediated uptake and esterification storage mechanisms.However,chronic cholesterol overload induces mitochondrial dysfunction,reactive oxygen species accumulation,and endoplasmic reticulum stress,leading to hepatocyte injury.Moreover,systemic hypercholesterolemia disrupts gut microbiota balance and impairs short-chain fatty acid and ketone metabolism,exacerbating metabolic disturbances and aggravating hepatic injury through enhanced metabolic stress.In this article,we review the advance of studies on hypercholesterolemia in recent years and summary its association with hepatic injury,which can provide theoretical support for further research.