Objective To systematically analyze the spatiotemporal distribution characteristics and epidemiological trends of tracheal, bronchus, and lung cancer (TBL) disease burden attributed to air pollution globally and in China and the United States from 1990 to 2021, and to assess the patterns of disease burden changes from 2022 to 2031 based on predictive models, providing a scientific basis for formulating targeted TBL prevention and control strategies. Methods Based on the Global Burden of Disease (GBD) 2021 database, we analyzed the disease burden data of TBL attributed to air pollution globally and in China and the United States from 1990 to 2021. R Studio 4.3.2 software was used to analyze the corresponding trends and the Bayesian age-period-cohort (BAPC) prediction model was used to predict the status of the disease burden of TBL attributed to air pollution in the world and in China and the United States from 2022 to 2031. Results In 2021, China had the highest number of deaths and disability-adjusted life years attributed to air pollution (211 400 patients and 4.8947 million person-years), followed by the United States (6 000 patients and 124 300 person-years). The age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) of TBL due to air pollution in the world and in China and the United States showed a decreasing trend. From 1990 to 2021, the ASMR and ASDR of TBL in China due to air pollution were much higher than those in the United States and the global average. In terms of gender, from 1990 to 2021, the disease burden of male patients with TBL attributed to air pollution was much higher than that of female patients. The BAPC prediction model showed that from 2022 to 2031, the ASMR and ASDR of TBL attributed to air pollution showed an upward trend globally, while they showed a downward trend in China and the United States. Conclusion Over the past 30 years, the air pollution-related TBL disease burden in the world and in China and the United States has continued to decline, but China's disease burden is still significantly higher than the global average. The disease burden in men far exceeds that in women, with men and the population aged ≥50 years being high-risk groups. In the future, the global disease trend may reverse and rise, while China and the United States are expected to continuously decline. However, precise prevention and control for high-risk groups remains a key challenge.

Objective To investigate the screening results and factors affecting abnormal detection rates among high-risk groups of esophageal cancer and to explore effective intervention measures. Methods We investigated and collected the information on gender, education level, age, marital status, symptoms of reflux esophagitis (heartburn, acid reflux, belching, hiccup, foreign body sensation in the pharynx, and difficulty swallowing), consumption of pickled vegetables, salt use, and esophageal cancer incidence of villagers in a natural village in Wenfeng District, Anyang City, Henan Province. Changes in reflux esophagitis symptoms in the high-incidence area of esophageal cancer before and after 16 years were observed, and the relationship of such changes with esophageal cancer was analyzed. Results In 2008, 711 cases were epidemiologically investigated, including 213 cases with one of the symptoms of reflux esophagitis such as heartburn, acid reflux, belching, hiccups, foreign body sensation in the pharynx, and difficulty swallowing (sorted in accordance with the abovementioned symptoms; if there are multiple symptoms, then the former is taken); 55 cases with at least two related symptoms, among which the most symptom was heartburn in 108 cases (15.1%); followed by acid reflux, belching, etc. In 2024, the same group of people was investigated, and eight people were missing because of relocation. A total of 703 people were successfully investigated, of which 189 cases (26.8%) had one of the symptoms of reflux esophagitis, such as heartburn (sorted in accordance with relevant symptoms, if there are multiple symptoms, then the former will be selected); 167 cases (23.7%) had at least two related symptoms, among which the most symptom was heartburn in 139 cases (19.7%); followed by acid reflux. Over 16 years, among the 703 people investigated, 45 cases had esophageal cancer and they had one or more of the abovementioned symptoms. No significant differences in the reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.26); no significant differences in the composition of reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.299). Conclusion The detection rate of reflux esophagitis-related symptoms in the population in a high-risk area of esophageal cancer has not decreased in the past 16 years, and the high-risk factors still exist. Esophageal cancer is closely related to reflux esophagitis, and clinical practice can provide early diagnosis and treatment for high-risk population.

Objective To investigate the relationship between tooth loss and the occurrence of esophageal cancer in a natural village in Wenfeng District, Anyang City, Henan Province. Methods A prospective cohort study was conducted to observe the occurrence of tooth loss and esophageal cancer among the asymptomatic residents of the natural village for 16 years from January 2008 to July 2024. Data were analyzed by chi-square test, binary logistic regression, and restricted cubic spline. Results Among the total population of 711 cases, 136 cases were lost to follow-up and 575 cases were included in the final statistics, including 45 cases with esophageal cancer. Significant statistical difference was found between esophageal cancer patients with and without tooth loss (P<0.05). Logistic regression analysis showed that tooth loss was associated with the occurrence of esophageal cancer (OR=3.977, 95%CI: 1.543-10.255). After the adjustment for confounders, tooth loss remained significantly associated with the occurrence of esophageal cancer (OR=3.038, 95%CI: 1.035-8.914). A nonlinear dose-response relationship was observed between the number of teeth lost and the incidence of esophageal cancer. When the number of teeth lost was less than 12, the risk of esophageal cancer increased with the number of teeth lost. When more than 12 teeth were lost, the risk of esophageal cancer decreased as the number of teeth lost increased. Conclusion Tooth loss is a risk factor for the occurrence of esophageal cancer in this natural village. When the number of teeth lost is less than 12, the risk of esophageal cancer increases with the number of teeth lost.

Objective:To analyze the nonlinear correlation and inflection points between age and short-term mortality in patients with negative systemic inflammatory response syndrome (SIRS)sepsis score.Methods:A retrospective cohort study was conducted using the medical information mart for intensive care Ⅳ(MIMIC-Ⅳ)database, which included adult patients with sepsis who were admitted to the intensive care unit(ICU)within 24 hours and did not receive mechanical ventilation or vasoactive drug, with a SIRS score ≤1.Patients were divided into survivors and non-survivors based on 28-day survival.Baseline variables such as age, gender, Charlson Comorbidity Index(CCI), body mass index(BMI), Sequential Organ Failure Assessment(SOFA)score, and initial lactate levels were compared between the two groups.With case fatality rate as the dependent variable, variables with differences in univariate analysis were incorporated into the binary logistic regression model, and baseline variables with statistically significant differences except age were matched according to the 1∶3 propensity score.Restricted cubic spline (RCS) regression was used to analyze the nonlinear relationship between patient age and mortality after matching and to determine the inflection point.Results:A total of 53 150 hospital records in the MIMIC-Ⅳ database were retrospectively screened, and 1 691 adult patients[aged(69.82±14.87)years]diagnosed with sepsis and negative SIRS score within 24 hours of ICU admission were included, with 101(5.97%)deaths within 28 days.Patients in the non-survivor group were older [(73.63±14.55)years vs.(69.58±14.86)years, t=-2.663, P=0.008], had higher CCI(4.38±2.64 vs.2.99±2.34, t=-5.732, P<0.001), and higher SOFA score (8.18±3.58 vs.5.04±2.67, t=-8.664, P<0.001)compared to the survivor group.There were no significant differences in gender, BMI, initial lactate levels, and the suspected infection sites (all P>0.05).Multivariable logistic regression analysis showed that increased age ( OR=1.03, 95% CI: 1.02-1.05, P<0.001), increased CCI ( OR=1.16, 95% CI: 1.06-1.26, P<0.001), and increased SOFA score ( OR=1.34, 95% CI: 1.26-1.43, P<0.001)were significantly associated with increased mortality in patients with negative SIRS score.After including SOFA score and CCI in the propensity score matching, there were 271 survivors and 93 non-survivors.RCS results showed a non-linear association between age and mortality( Poverall=0.001, Pnon-linear=0.001), with a significant increase in the OR for mortality when age exceeded 73 years. Conclusions:In sepsis patients with comparable organ function, the short-term mortality rate of patients with negative SIRS score increases non-linearly with age.These patients have mild symptoms but poor clinical outcomes, necessitating early and enhanced monitoring when age exceeds 73 years.

Objective:To investigate the hepatoprotective effect of N-acetylcysteine(NAC)on rats with liver injury induced by cisplatin and its effect on intestinal flora and the expression of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and nuclear factor-kappa B(NF-κB).Methods:Male Sprague-Dawley rats were randomly divided into control group(CG),cisplatin group(CP),and NAC group.The rats in the NAC group were given NAC 15 mg/kg by gavage for 8 consecutive days.At half an hour after intragastric administration on the fifth day,all rats except those in the NC group were given intraperitoneal injection of 8 mg/kg cisplatin to induce acute liver injury.An automatic biochemical analyzer was used to measure the content of aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),and total bilirubin(TBIL);liver index was calculated for the rats;Western blot was used to measure the relative expression levels of NF-κB,IL-6,and TNF-α in liver tissue;the 16S rDNA technique was used to measure and analyze the amplification information of the V3-V4 regions of each sample.Results:Compared with the NC group,the CP group had significant increases in the content of AST,ALT,ALP,and TBIL,while NAC reversed the abnormal liver function caused by cisplatin.Compared with the NC group,the CP group had a sig-nificant increase in liver index(P=0.000),while the NAC group had a significant reduction in liver index compared with the CP group(P=0.007).Compared with the NC group,the CP group had signifi-cant increases in the expression levels of IL-6,TNF-α,and NF-κB,while the NAC group showed reductions in the expression of these genes,with significant differences in the expression of IL-6 and TNF-α(P=0.006 and 0.000).Compared with the NC group,the CP group had a significant increase in the α-diversity index of intesti-nal flora,while compared with the CP group,the NAC group tended to have a reduction in the α-diversity index of intestinal flora.Com-pared with the CP group at the phylum level,the NAC group had an increase in the abundance of Actinobacteria and a reduction in the abundance of Firmicutes.Compared with the CP group at the genus level,the NAC group had a reduction in the abundance of Rumino-coccaceae and increases in the abundance of Bifidobacterium and Allobaculum.Conclusion:NAC can alleviate acute liver injury caused by cisplatin,possibly by downregulating the expression of IL-6,TNF-α,and NF-κB and regulating the abundance and diver-sity of intestinal flora.

BACKGROUND:Previous studies by the research team have shown that the neuroprotective effect of ginsenoside Rb1 on improving cerebral ischemia-reperfusion injury may be related to the Wnt/β-catenin signaling pathway,but the specific mechanism of action remains unclear.OBJECTIVE:To explore the molecular mechanism of ginsenoside Rb1 in alleviating cerebral ischemia-reperfusion injury in mice.METHODS:100 C57BL/6 mice were randomly divided into four groups.The sham operation group(n=25)did not undergo model establishment.In the cerebral ischemia-reperfusion injury group(n=25),the middle cerebral artery occlusion model was established by thread embolism.In the ginsenoside Rb1 group(n=25),the middle cerebral artery occlusion model was established by thread embolism and ginsenoside Rb1 was intraperitoneally injected every day for 3 days before the establishment.In ginsenoside Rb1+inhibitor group(n=25),the middle cerebral artery occlusion model was established by thread embolism and ginsenoside Rb1 and Wnt/β-catenin signaling pathway inhibitor XAV939 were intraperitoneally injected every day for 3 days before the establishment.Three days after modeling,Zea Longa score and balance beam test were used to evaluate the neurological deficits of mice.TTC staining was used to observe the volume of cerebral infarction.The dry-wet mass method was used to detect the degree of brain edema in mice.The activities of superoxide dismutase and glutathione peroxidase and the concentration of malondialdehyde in the parietal lobe of the ischemic side were detected by colorimetry.The co-expression of microglial marker Iba1 and inducible nitric oxide synthase(or arginase 1)was detected by immunofluorescence.The levels of aquaporin AQP4,inflammatory-related factors,and phosphorylation of Wnt/β-catenin pathway proteins glycogen synthase kinase 3β and β-catenin were detected by western blot assay.The mRNA expression of inflammatory factors was detected by q-PCR.RESULTS AND CONCLUSION:(1)Compared with cerebral ischemia-reperfusion injury group,the neurological deficit symptoms,cerebral infarction foci and brain tissue edema,oxidative stress and inflammatory response of the mice were alleviated;the number of M1 microglia(Iba1 and inducible nitric oxide synthase co-expressed)decreased;the number of M2 microglia(Iba1 and arginase 1 co-expressed)increased;the expression of phosphorylated glycogen synthase kinase 3β and phosphorylated β-catenin protein decreased in ginsenoside Rb1 group.Compared with ginsenoside Rb1 group,the neurological deficit symptoms,cerebral infarction foci and brain tissue edema,oxidative stress and inflammatory response of the mice were aggravated;the number of M1 microglia increased;the number of M2 microglia decreased;the expression of phosphorylated glycogen synthase kinase 3β and phosphorylated β-catenin protein increased in ginsenoside Rb1+inhibitor group.(2)The results indicate that ginsenoside Rb1 can regulate the polarization of microglia to M2 type and alleviate oxidative stress damage and inflammatory response after cerebral ischemia-reperfusion injury.Its mechanism may be related to the nuclear translocation of β-catenin mediated by the Wnt/β-catenin signaling pathway.

Objective To explore the application effect of constructing a data sharing-based multidrug-resistant or-ganism(MDRO)information reminder system combined with multidisciplinary standardized measures on the whole-process closed-loop management of MDRO.Methods Hospitalized patients from whom MDRO were detected from January 1 to July 31,2024 were taken as the control group,those from August 1,2024,to May 31,2025 were as the intervention group.The control group adopted the traditional manual reporting mode for MDRO,while the in-tervention group adopted the combination of MDRO reminder system and multidisciplinary management mode.Differences in isolation order issuing rate for MDRO and process-and outcome-indicators for multidisciplinary spe-cialty before and after system implementation were compared.Results After implementing information reminder system combined with multidisciplinary measures,issuing rates of ≤24 hour and＜4 hour MDRO isolation orders in the intervention group were both higher than in the control group([90.20％vs 65.23％,P＜0.05],[80.64％vs 55.08％,P＜0.001],respectively).Antimicrobial use rate in the intervention group was lower than in the con-trol group(36.27％vs 43.41％),with a statistically significant difference(P＜0.05).The implementation rates of MDRO prevention and control measures,pathogen detection rates,and fluorescence labeling clearance rates in the intervention group were all higher than those in the control group,all with statistically significant differences(all P＜0.05).The detection rate of MDRO decreased compared with the control group(10.83％vs 16.49％),and the in-cidence of MDRO healthcare-associated infection in the intervention group was lower than that in the control group(0.09％vs 0.19％),both with statistically significant differences(both P＜0.001).The treatment expense in the intervention group reduced by 27 422 Yuan compared with the control group.Conclusion This study constructed an MDRO reminder system,realized full-chain monitoring system for the multidisciplinary MDRO information interac-tion platform,strengthened multidisciplinary in-depth integration,and improved the prevention and control effect for MDRO.

BACKGROUND:Previous studies by the research team have shown that the neuroprotective effect of ginsenoside Rb1 on improving cerebral ischemia-reperfusion injury may be related to the Wnt/β-catenin signaling pathway,but the specific mechanism of action remains unclear.OBJECTIVE:To explore the molecular mechanism of ginsenoside Rb1 in alleviating cerebral ischemia-reperfusion injury in mice.METHODS:100 C57BL/6 mice were randomly divided into four groups.The sham operation group(n=25)did not undergo model establishment.In the cerebral ischemia-reperfusion injury group(n=25),the middle cerebral artery occlusion model was established by thread embolism.In the ginsenoside Rb1 group(n=25),the middle cerebral artery occlusion model was established by thread embolism and ginsenoside Rb1 was intraperitoneally injected every day for 3 days before the establishment.In ginsenoside Rb1+inhibitor group(n=25),the middle cerebral artery occlusion model was established by thread embolism and ginsenoside Rb1 and Wnt/β-catenin signaling pathway inhibitor XAV939 were intraperitoneally injected every day for 3 days before the establishment.Three days after modeling,Zea Longa score and balance beam test were used to evaluate the neurological deficits of mice.TTC staining was used to observe the volume of cerebral infarction.The dry-wet mass method was used to detect the degree of brain edema in mice.The activities of superoxide dismutase and glutathione peroxidase and the concentration of malondialdehyde in the parietal lobe of the ischemic side were detected by colorimetry.The co-expression of microglial marker Iba1 and inducible nitric oxide synthase(or arginase 1)was detected by immunofluorescence.The levels of aquaporin AQP4,inflammatory-related factors,and phosphorylation of Wnt/β-catenin pathway proteins glycogen synthase kinase 3β and β-catenin were detected by western blot assay.The mRNA expression of inflammatory factors was detected by q-PCR.RESULTS AND CONCLUSION:(1)Compared with cerebral ischemia-reperfusion injury group,the neurological deficit symptoms,cerebral infarction foci and brain tissue edema,oxidative stress and inflammatory response of the mice were alleviated;the number of M1 microglia(Iba1 and inducible nitric oxide synthase co-expressed)decreased;the number of M2 microglia(Iba1 and arginase 1 co-expressed)increased;the expression of phosphorylated glycogen synthase kinase 3β and phosphorylated β-catenin protein decreased in ginsenoside Rb1 group.Compared with ginsenoside Rb1 group,the neurological deficit symptoms,cerebral infarction foci and brain tissue edema,oxidative stress and inflammatory response of the mice were aggravated;the number of M1 microglia increased;the number of M2 microglia decreased;the expression of phosphorylated glycogen synthase kinase 3β and phosphorylated β-catenin protein increased in ginsenoside Rb1+inhibitor group.(2)The results indicate that ginsenoside Rb1 can regulate the polarization of microglia to M2 type and alleviate oxidative stress damage and inflammatory response after cerebral ischemia-reperfusion injury.Its mechanism may be related to the nuclear translocation of β-catenin mediated by the Wnt/β-catenin signaling pathway.

Objective To explore the application effect of constructing a data sharing-based multidrug-resistant or-ganism(MDRO)information reminder system combined with multidisciplinary standardized measures on the whole-process closed-loop management of MDRO.Methods Hospitalized patients from whom MDRO were detected from January 1 to July 31,2024 were taken as the control group,those from August 1,2024,to May 31,2025 were as the intervention group.The control group adopted the traditional manual reporting mode for MDRO,while the in-tervention group adopted the combination of MDRO reminder system and multidisciplinary management mode.Differences in isolation order issuing rate for MDRO and process-and outcome-indicators for multidisciplinary spe-cialty before and after system implementation were compared.Results After implementing information reminder system combined with multidisciplinary measures,issuing rates of ≤24 hour and＜4 hour MDRO isolation orders in the intervention group were both higher than in the control group([90.20％vs 65.23％,P＜0.05],[80.64％vs 55.08％,P＜0.001],respectively).Antimicrobial use rate in the intervention group was lower than in the con-trol group(36.27％vs 43.41％),with a statistically significant difference(P＜0.05).The implementation rates of MDRO prevention and control measures,pathogen detection rates,and fluorescence labeling clearance rates in the intervention group were all higher than those in the control group,all with statistically significant differences(all P＜0.05).The detection rate of MDRO decreased compared with the control group(10.83％vs 16.49％),and the in-cidence of MDRO healthcare-associated infection in the intervention group was lower than that in the control group(0.09％vs 0.19％),both with statistically significant differences(both P＜0.001).The treatment expense in the intervention group reduced by 27 422 Yuan compared with the control group.Conclusion This study constructed an MDRO reminder system,realized full-chain monitoring system for the multidisciplinary MDRO information interac-tion platform,strengthened multidisciplinary in-depth integration,and improved the prevention and control effect for MDRO.

Objective:To analyze the nonlinear correlation and inflection points between age and short-term mortality in patients with negative systemic inflammatory response syndrome (SIRS)sepsis score.Methods:A retrospective cohort study was conducted using the medical information mart for intensive care Ⅳ(MIMIC-Ⅳ)database, which included adult patients with sepsis who were admitted to the intensive care unit(ICU)within 24 hours and did not receive mechanical ventilation or vasoactive drug, with a SIRS score ≤1.Patients were divided into survivors and non-survivors based on 28-day survival.Baseline variables such as age, gender, Charlson Comorbidity Index(CCI), body mass index(BMI), Sequential Organ Failure Assessment(SOFA)score, and initial lactate levels were compared between the two groups.With case fatality rate as the dependent variable, variables with differences in univariate analysis were incorporated into the binary logistic regression model, and baseline variables with statistically significant differences except age were matched according to the 1∶3 propensity score.Restricted cubic spline (RCS) regression was used to analyze the nonlinear relationship between patient age and mortality after matching and to determine the inflection point.Results:A total of 53 150 hospital records in the MIMIC-Ⅳ database were retrospectively screened, and 1 691 adult patients[aged(69.82±14.87)years]diagnosed with sepsis and negative SIRS score within 24 hours of ICU admission were included, with 101(5.97%)deaths within 28 days.Patients in the non-survivor group were older [(73.63±14.55)years vs.(69.58±14.86)years, t=-2.663, P=0.008], had higher CCI(4.38±2.64 vs.2.99±2.34, t=-5.732, P<0.001), and higher SOFA score (8.18±3.58 vs.5.04±2.67, t=-8.664, P<0.001)compared to the survivor group.There were no significant differences in gender, BMI, initial lactate levels, and the suspected infection sites (all P>0.05).Multivariable logistic regression analysis showed that increased age ( OR=1.03, 95% CI: 1.02-1.05, P<0.001), increased CCI ( OR=1.16, 95% CI: 1.06-1.26, P<0.001), and increased SOFA score ( OR=1.34, 95% CI: 1.26-1.43, P<0.001)were significantly associated with increased mortality in patients with negative SIRS score.After including SOFA score and CCI in the propensity score matching, there were 271 survivors and 93 non-survivors.RCS results showed a non-linear association between age and mortality( Poverall=0.001, Pnon-linear=0.001), with a significant increase in the OR for mortality when age exceeded 73 years. Conclusions:In sepsis patients with comparable organ function, the short-term mortality rate of patients with negative SIRS score increases non-linearly with age.These patients have mild symptoms but poor clinical outcomes, necessitating early and enhanced monitoring when age exceeds 73 years.