Background Meteorological factors are among the key extrinsic triggers for the onset and exacerbation of cardiovascular and cerebrovascular diseases (CVD). Against the backdrop of sustained global warming, elucidating the impact of ambient temperature and atmospheric pressure on CVD, especially on pre-hospital CVD emergent events, has become imperative for evidence-based prevention and emergency preparedness. Objective To quantify the temporal trends of daily mean temperature and atmospheric pressure and their associations with pre-hospital CVD emergent events in Yantai, and to explore effect modification by demographic subgroups and geographic areas, thereby providing an empirical basis for the rational allocation of emergency medical resources. Methods Pre-hospital CVD emergency data from January 1, 2016 to December 31, 2022 were selected from the Yantai 120 Emergency Medical Command System. Synchronous meteorological factors and environmental pollutant data were obtained from the websites of the National Oceanic and Atmospheric Administration and the National Centers for Environmental Information of the United States. Time-series analysis combined with distributed lag non-linear model was used to analyze the association between daily temperature, atmospheric pressure, and pre-hospital CVD emergencies. Average annual percentage changes (AAPC) were calculated using Joinpoint (version 5.2.0.0) to reflect temporal trends. Spearman correlation analysis was employed to screen variables with low collinearity for inclusion in the multi-pollutant adjusted models. Results From 2016 to 2022, a total of 268275 pre-hospital CVD emergency cases were recorded in Yantai City, showing an increasing annual trend (AAPC=7.16%, P=0.002). Emergency volume, daily temperature, atmospheric pressure, and PM₁₀ displayed marked seasonal patterns, with summer bottoms and winter peaks for emergencies, daily temperature higher in summer and lower in winter, and the inverse for atmospheric pressure. Correlation analysis showed that both daily temperature and atmospheric pressure were positively correlated with O₃, with correlation coefficients of 0.745 and 0.723, respectively; negatively correlated with PM_2.5, with correlation coefficients of −0.246 and −0.235, respectively; and negatively correlated with PM₁₀, with correlation coefficients of −0.241 and −0.229, respectively (P < 0.05). A U-shaped correlation was revealed between daily temperature and pre-hospital CVD emergency risk. Using 24 °C as the reference, risk was elevated at both low and high daily temperatures, with the strongest cold effect at –11 ℃ (RR=1.53, 95%CI: 1.35, 1.73) and strongest heat effect at 30 ℃ (RR=1.06, 95%CI: 1.01, 1.11); cold effects were prolonged (lag0–14d) compared to heat effects. Atmospheric pressure exhibited a positive association with emergencies; using a median of 1012.2 hPa as the reference, the maximum risk occurred at 1037 hPa (RR=1.25, 95%CI: 1.03, 1.52), with a 0–5 d lag. In the subgroup analysis, the impact of low temperature was more pronounced among females (RR_{−9 ℃}=1.66), people over 60 years (RR_{−9 ℃}=1.91), and rural residents (RR_{−9 ℃}=1.76). High atmospheric pressure significantly increased the risk of pre-hospital CVD emergency among females (RR_{1035 hPa}=1.54), people under 18 years (RR_{1035 hPa}=3.62), and rural residents (RR_{1035 hPa}=1.46). The sensitivity analysis results indicated that, after excluding the impact of pandemic and the degrees of freedom for time variations, the effects of daily average temperature and atmospheric pressure on pre-hospital CVD emergency volume were consistent with the primary analysis findings. Conclusion Both non-optimal temperature and atmospheric pressure significantly increase the pre-hospital CVD emergency volume; therefore, emergency medical services should develop targeted response protocols, optimize resource allocation, and intensify public health education to mitigate the pre-hospital burden attributable to temperature and pressure fluctuations.

Objective:To investigate the clinical efficacy and safety of different combination therapies with aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of facial basal cell carcinoma in the elderly.Methods:A retrospective analysis was conducted on 131 elderly patients with facial basal cell carcinoma who visited Shanghai Skin Disease Hospital from August 2020 to October 2023. According to the depth of the lesions, the patients were divided into 3 groups to receive intensive pretreatment with curettage (41 cases), CO 2 laser therapy (35 cases), and narrow-margin excision surgery without sutures (55 cases) respectively, all followed by ALA-PDT. During the follow-up period of 17.7 ± 9.0 months, the efficacy was evaluated and adverse reactions were recorded in each group. Results:The total remission rates were 100%, 100%, and 96.4% in the curettage + ALA-PDT group, CO 2 laser + ALA-PDT group, and narrow-margin excision surgery without sutures + ALA-PDT group, respectively. The patients experienced mild pain and local erythematous swelling during ALA-PDT treatment, which were temporary and fully tolerable, and no wound infections or difficulties in healing were observed. After treatment, scar formation was observed in 3 cases of basal cell carcinoma on the nose and nasolabial folds in the narrow-margin excision surgery without sutures + ALA-PDT group, but the rest of the patients retained a good facial appearance. Conclusions:In this preliminary exploration study on PDT for basal cell carcinoma of different depths, ALA-PDT combined with curettage, CO 2 laser or narrow-margin excision surgery without sutures all exhibited definite efficacy and minimal damage, providing effective treatment options for facial basal cell carcinoma in the elderly.

Objective:To investigate the clinical efficacy and safety of different combination therapies with aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of facial basal cell carcinoma in the elderly.Methods:A retrospective analysis was conducted on 131 elderly patients with facial basal cell carcinoma who visited Shanghai Skin Disease Hospital from August 2020 to October 2023. According to the depth of the lesions, the patients were divided into 3 groups to receive intensive pretreatment with curettage (41 cases), CO 2 laser therapy (35 cases), and narrow-margin excision surgery without sutures (55 cases) respectively, all followed by ALA-PDT. During the follow-up period of 17.7 ± 9.0 months, the efficacy was evaluated and adverse reactions were recorded in each group. Results:The total remission rates were 100%, 100%, and 96.4% in the curettage + ALA-PDT group, CO 2 laser + ALA-PDT group, and narrow-margin excision surgery without sutures + ALA-PDT group, respectively. The patients experienced mild pain and local erythematous swelling during ALA-PDT treatment, which were temporary and fully tolerable, and no wound infections or difficulties in healing were observed. After treatment, scar formation was observed in 3 cases of basal cell carcinoma on the nose and nasolabial folds in the narrow-margin excision surgery without sutures + ALA-PDT group, but the rest of the patients retained a good facial appearance. Conclusions:In this preliminary exploration study on PDT for basal cell carcinoma of different depths, ALA-PDT combined with curettage, CO 2 laser or narrow-margin excision surgery without sutures all exhibited definite efficacy and minimal damage, providing effective treatment options for facial basal cell carcinoma in the elderly.

Bladder cancer （BCa） is the most common malignant tumor of the urinary system， and its incidence is increasing year by year. At present， for all patients with resectable non-metastatic muscle-invasive BCa， radical cystectomy + bilateral pelvic lymph node dissection is strongly recommended， but they still face the risk of recurrence， metastasis and death. In recent years， the proportion of patients with advanced and metastatic BCa is increasing among patients with newly diagnosed BCa. Although current treatment models are diverse， they often struggle to achieve significant efficacy due to their low effectiveness and adverse effects， resulting in low survival rates for patients with advanced and metastatic BCa. Therefore， the treatment of BCa still faces great challenges， and there is an urgent need to discover an effective new antitumor drug. With the improvement of medical standards， traditional Chinese medicine has shown great advantages in the treatment of BCa. Traditional Chinese medicine is mild and easy to accept， and can inhibit tumor progression through a multi-pathway， multi-way and multi-target manner， so as to exert its anticancer effect. Taraxaci Herba is a medicinal and food homologous plant， which has many biological activities， such as antibacterial， anti-inflammatory， anti-oxidation， anti-tumor， protecting liver and gallbladder， reducing blood sugar and enhancing immunity， and it has shown a clear anticancer effect in breast cancer， liver cancer， gastric cancer， tongue cancer and lung cancer. By reviewing previous studies worldwide， this article summarizes the mechanism of Taraxaci Herba extract in inducing autophagy and apoptosis， inhibiting cell migration and invasion， regulating cell cycle and proliferation， regulating cell metabolism， inhibiting tumor angiogenesis， combining the effects of chemotherapeutic drugs， and regulating the transduction of related signal pathways. On this basis， this study systematically elaborates on the potential mechanism of Taraxaci Herba against BCa， in order to provide a theoretical basis for the research and treatment of BCa.

BACKGROUND: Recent evidence suggests that IL-33, a novel member of the IL-1b family, is involved in organ fibrosis. However, the roles of IL-33 and its receptor ST2 in epidural fibrosis post spine operation remain elusive. METHODS: A mouse model of epidural fibrosis was established after laminectomy. IL-33 in the wound tissues post laminectomy was measured with Western blotting, ELISA and imaging. The fibroblast cell line NIH-3T3 and primary fibroblasts were treated with IL-33 and the mechanisms of maturation of fibroblasts into myofibroblasts were analyzed. To explore roles of IL-33 and its receptor ST2 In vivo, IL-33 knockout (KO) and ST2 KO mice were employed to construct the model of laminectomy. The epidural fibrosis was evaluated using H&E and Masson staining, western-blotting, ELISA and immunohistochemistry. RESULTS: As demonstrated in western blotting and ELISA, IL-33 was increased in epidural wound tissues post laminectomy. The immunoflurosence imaging revealed that endothelial cells (CD31 + ) and fibroblasts (a-SAM +) were major producers of IL-33 in the epidural wound tissues. In vitro, IL-33 promoted fibroblast maturation, which was blocked by ST2 neutralization antibody, suggesting that IL-33-promoted-fibroblasts maturation was ST2 dependent. Further, IL-33/ ST2 activated MAPK p38 and TGF-β pathways. Either p38 inhibitor or TGF-β inhibitor decreased fibronectin and a-SAM production from IL-33-treated fibroblasts, suggesting that p38 and TGF-β were involved with IL-33/ST2 signal pathways in the fibroblasts maturation. In vivo, IL-33 KO or ST2 KO decreased fibronectin, a-SMA and collagen deposition in the wound tissues of mice that underwent spine surgery. In addition, TGF-β 1 was decreased in IL-33 KO or ST2 KO epidural wound tissues. CONCLUSION In summary, IL-33/ST2 promoted fibroblast differentiation into myofibroblasts via MAPK p38 and TGF-β in a mouse model of epidural fibrosis after laminectomy.

Objective To investigate the effects of butylphthalide injection on cerebral blood flow (CBF) perfusion and cognitive function in patients with acute cerebral infarction accompanied by cognitive disorder.Methods From September 2016 to September 2017,80 patients with acute cerebral infarction and cognitive impairment were admitted to the Department of Neurology,Yan'an Hospital of Kunming Medical University.They were assigned to an observation group (n=40) and a control group (n=40).The control group received conventional treatment while the observation group received butylphthalide injection in addition to conventional treatment.The treatment lasted for 14 days for both groups.Before and after treatment,dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) was used to measure the CBF parameters in the cerebral ischemic region,and Montreal Cognitive Assessment (MoCA) was used to evaluate the changes in cognitive function.Results After treatment,rCBF and rCBV increased significantly and rMTT and rTTP decreased significantly in the observation group (P＜0.05).After treatment,there were significant improvements in MoCA subscores and total score in the observation group (P＜0.05).In the observation group,the post-treatment increases in rCBV and rCBF were positively correlated with increased MoCA total score (r=0.474,P=0.013;r=0.282,P=0.027),and the post-treatment decreases in rMTT and rTTP were negatively correlated with increased MoCA total score (r=-0.294,P=0.021;r=0.382,P=0.019).Conclusion Butylphthalide injection can safely improve CBF perfusion in the focal region and cognitive function in patients with acute cerebral infarction,with no obvious adverse reactions.