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 integrate and analyze the trend of the disease burden of tracheal,bronchus,and lung cancer(TBL)attributable to secondhand smoke in China from 1990 to 2021 and to analyze future projections,aiming to provide data support for the prevention and treatment of TBL in China.Methods:Based on the global burden of disease(GBD)2021 database,TBL with ICD-10 disease classification C33,C34-C34.92 was studied.Using secondhand smoke as a risk factor,the data on TBL mortality and disability-adjusted life year(DALY)due to secondhand smoke in China from 1990 to 2021 were further age-standardized.Using Joinpoint 4.7.1 regression analysis model to calculate annual percentage change(APC)and average annual percentage change(AAPC),Hiplot software was used to plot disease burden data for different ages and genders,and R 4.3.1 software was used to construct a grey model GM(1,1)to predict the predicted value and trend of TBL disease burden attributed to secondhand smoke in China from 2022 to 2031.Results:From 1990 to 2021,the TBL mortality rate,age-standardized mortality rate,and DALY rate attributed to secondhand smoke in China increased from 1.76/100 000,2.63/100 000,and 49.43/100 000 to 4.08/100 000,2.80/100 000,and 95.57/100 000,respectively;the growth was 131.18%,6.45%,and 93.34%;the age-standardized DALY rate decreased from 65.04/100 000 to 63.32/100 000 with the reduction of 2.65%.The results of the Joinpoint regres-sion showed that the AAPC(95%CI)of mortality,age-standardized mortality rate,and DALY rate for TBL were 2.75(2.58-2.93)%,0.16(0.11-0.21)%,and 2.15(2.11-2.18)%,respectively,with an overall increasing trend;the AAPC(95%CI)of age-standardized DALY rate was-0.14(-0.40-0.12)%,with an overall fluctuating and unchanged trend and it was higher in males than in females.In both 1990 and 2021,the TBL mortality rate attributable to secondhand smoke in China gradually increased with age,and the DALY rate first increased and then slowed down with age.The main groups of the burden of disease were the elderly and males.The grey prediction model GM(1,1)showed that the age-standardized mortality rate of TBL attributable to secondhand smoke from 2022 to 2031 showed a slow increasing trend,and the predicted value in 2031 would increase to 2.95/100 000.The age-standardized DALY showed a slow decreasing trend,and the predicted value in 2031 would decrease to 63.83/100 000.Conclusions:From 1990 to 2021,the TBL mortality,age-standardized mortality,and DALY rates attributable to secondhand smoke in China increased,and the age-standardized DALY rate decreased.Men and the elderly are the main groups affected by TBL.Appropriate measures should be formulated to reduce exposure to and contact with secondhand smoke,tak-ing into account gender and age differences.Additionally,efforts should be made to strengthen secondhand smoke prevention and public health education.

Objective:To explore the impact of air pollution on hospital visits for mental and behavioral disorders among residents in an industrial area in Henan Province from 2016 to 2021.Methods:Daily outpatient visits data for mental and behavioral disorders were collected from Angang General Hospital in Angang Industrial Area at Anyang City between January 2016 and December 2021. And air pollutants and meteorological data during the same period were also collected. A generalized additive model was used for time-series analysis to examine the relationship between daily average concentrations of nitrogen dioxide (NO 2), sulfur dioxide (SO 2), fine particulate matter (PM 2.5), inhalable particulate matter (PM 10), carbon monoxide (CO), and ozone (O 3) with a lag of 0 to 7 days on the number of visits for mental and behavioral disorders among residents. The single-day lag effect (lag0-lag7 d) and cumulative lag effect (lag01-lag07 d) were analyzed. The smooth cubic spline function was used to fit the exposure-response relationship, and subgroup analysis was performed according to different genders, seasons and ages. Results:A total of 26 268 hospital visits for mental and behavioral disorders were collected from the industrial area between 2016 and 2021. The daily average concentrations of SO 2, NO 2, PM 2.5, PM 10, and CO were (27.50±27.33), (43.11±18.33), (73.87±60.30), (134.01±83.81) μg/m 3, and (1.72±1.03) mg/m 3, respectively. The daily maximum 8-hour average concentration of O 3 was (82.18±53.70) μg/m 3. After controlling for long-term trends, temperature, relative humidity, day of the week effects, and holiday effects, the generalized additive model analysis showed that NO 2 had a statistically significant impact on the hospital visits for mental and behavioral disorders at lag0 d, lag2 d and lag01-lag05 d and CO had a statistically significant impact at lag0-lag3 d and lag01-lag06 d (all P<0.05). NO 2 at lag02-lag04 d and CO at lag0-lag2 d and lag01-lag04 d had statistically significant effects on the visits for neurasthenia (both P<0.05). The impacts of NO 2 at lag03-lag04 d, PM 2.5 at lag3 d and lag03-lag04 d, PM 10 at lag3 d and lag03 d, and CO at lag3 d and lag01-lag05 d on visits for generalized anxiety disorder were also statistically significant (all P<0.05). After false discovery rate (FDR) correction, it was shown that for every 10 μg/m 3 increase in NO 2 and every 0.1 mg/m 3 increase in CO, the percentage increase in visits for mental and behavioral disorders and its 95% confidence interval (95% CI) were 3.38% (0.95%-5.87%) and 0.78% (0.38%-1.17%), respectively. For every 0.1 mg/m 3 increase in CO, the visits for neurasthenia increased by 0.78% (0.27%-1.29%). For every 10 μg/m 3 increase in PM 2.5 and every 0.1 mg/m 3 increase in CO, the visits for generalized anxiety disorder increased by 1.07% (0.46%-1.68%) and 1.17% (0.37%-1.97%), respectively (adjusted P<0.05). There was a linear exposure-response relationship between NO 2 and CO and the hospital visits for mental and behavioral disorders, CO and the hospital visits for neurasthenia, and CO and PM 2.5 and the hospital visits for generalized anxiety disorder ( P<0.05 for the overall association test and P>0.05 for the non-linearity test). Stratified analysis showed that air pollutants had an impact on male patients with neurasthenia, female patients with generalized anxiety disorder, individuals aged <45 years with mental and behavioral disorders, and individuals aged ≥65 years with generalized anxiety disorder. The impact of air pollutants was greater during the cold season or winter. Conclusion:Exposure to air pollution can increase hospital visits for mental and behavioral disorders among residents in industrial areas, with a higher risk among those aged<45 years old and during the cold season.

Objective:To investigate the dosimetric impact of dwell position spacing in the design of three-dimensional (3D) interstitial brachytherapy plans for cervical cancer, and to provide a reference for selecting dwell spacing in clinical planning.Methods:A total of 15 patients with cervical cancer who underwent 3D interstitial brachytherapy at Tianjin Medical University Cancer Institute & Hospital between March 2022 and March 2024 were selected using simple random sampling. For each patient, 10 brachytherapy plans were generated with different dwell position spacings set at 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 mm, respectively. Key parameters among different dwell spacings compared included D 90%, V 100%, V 200%, and V 300% for the high-risk clinical target volume (HRCTV); D 90% for the intermediate-risk clinical target volume (IRCTV); D 2 cm3 for organs at risk (OARs) (bladder, small intestine, colon, and rectum); and the total dwell time. Statistical analyses were performed using repeated measurement ANOVA or the Friedman test. Results:Among different dwell spacings, there were no statistically significant differences in HRCTV D 90%, HRCTV V 100%, bladder D 2 cm3, and rectum D 2 cm3 among different dwell spacings ( P=0.075, 0.061, 0.480, 0.639). All plans with dwell spacings ≤ 3 mm met clinical dose requirements. When the dwell spacing was set to 1 mm, HRCTV V 200% and V 300% had the smallest mean values, while IRCTV D 90% and total dwell time had the largest mean values; all differences were statistically significant ( P<0.05). When the dwell spacing was ≥6 mm, an increase in spacing led to a decrease in mean small intestine D 2 cm3, and total dwell time, but an increase in HRCTV V 200% and a decrease in IRCTV D 90%, with statistically significant differences compared to spacings of 1-4 mm ( P<0.05). When the dwell spacing was ≥8 mm, the median colon D 2 cm3 decreased, with statistically significant differences compared to spacings of 1-3 mm ( P<0.05). Conclusions:For 3D interstitial brachytherapy planning in cervical cancer, dwell position spacings ≤ 3 mm can meet clinical dose requirements, with 1 mm providing optimal target coverage. Spacings ≥6 mm / ≥8 mm can reduce radiation dose to the small intestine and colon, respectively, while also shortening dwell time.

Objective To investigate the effects of PPARδ agonist pretreatment on mice myocardial is-chemia-reperfusion injury(MI/RI).Methods The mice were divided into the control group(sham operation group),model group(ischemia for 30 min,reperfusion for 24 h),experiment group 1(GW501516,3 mg·kg-1·d-1)and experiment group 2(GW501516,10 mg·kg-1·d-1).LVEF,LVFS,serum CK-MB,LDH and cTnI levels in the mice of each group were measured;the wet-dry myocardial tissue weight ratio was de-tected,the myocardial histomorphology was observed by microscope,the myocardial cellular apoptosis rate was detected by in situ end labeling(TUNEL);Bax and Bcl-2 were detected by Western blot;the mRNA ex-pressions of PGC-1,NFR-1 and NFR-2 were detected by PCR.Results Compared with the control group,the wet-dry weight ratio,myocardial cellular apoptosis rate,CK-MB,LDH,cTnI and Bax protein expressions in the model group were increased,and the Bcl-2 protein expression,LVEF,LVFS,PGC-1 mRNA,NFR-1 mR-NA and NFR-2 mRNA were decreased(P＜0.05).Compared with the model group,the wet-dry weight ratio,myocardial cellular apoptosis rate,CK-MB,LDH,cTnI levels and Bax protein expression in the experimental group 1 and 2 were decreased,while the levels of Bcl-2 protein expression,LVEF,LVFS,PGC-1 mRNA,NFR-1 mRNA and NFR-2 mRNA were significantly increased(P＜0.05).There was no statistically significant difference in the above indicators between the experimental group 1 and 2(P＞0.05).Conclusion PPARδ ag-onist reduces the mitochondrial damage possibly through PGC-1/NFRs signaling pathway,thereby reduces the myocardial cellular apoptosis in mice and ameliorates MI/RI.

Objective:To explore the impact of air pollution on hospital visits for mental and behavioral disorders among residents in an industrial area in Henan Province from 2016 to 2021.Methods:Daily outpatient visits data for mental and behavioral disorders were collected from Angang General Hospital in Angang Industrial Area at Anyang City between January 2016 and December 2021. And air pollutants and meteorological data during the same period were also collected. A generalized additive model was used for time-series analysis to examine the relationship between daily average concentrations of nitrogen dioxide (NO 2), sulfur dioxide (SO 2), fine particulate matter (PM 2.5), inhalable particulate matter (PM 10), carbon monoxide (CO), and ozone (O 3) with a lag of 0 to 7 days on the number of visits for mental and behavioral disorders among residents. The single-day lag effect (lag0-lag7 d) and cumulative lag effect (lag01-lag07 d) were analyzed. The smooth cubic spline function was used to fit the exposure-response relationship, and subgroup analysis was performed according to different genders, seasons and ages. Results:A total of 26 268 hospital visits for mental and behavioral disorders were collected from the industrial area between 2016 and 2021. The daily average concentrations of SO 2, NO 2, PM 2.5, PM 10, and CO were (27.50±27.33), (43.11±18.33), (73.87±60.30), (134.01±83.81) μg/m 3, and (1.72±1.03) mg/m 3, respectively. The daily maximum 8-hour average concentration of O 3 was (82.18±53.70) μg/m 3. After controlling for long-term trends, temperature, relative humidity, day of the week effects, and holiday effects, the generalized additive model analysis showed that NO 2 had a statistically significant impact on the hospital visits for mental and behavioral disorders at lag0 d, lag2 d and lag01-lag05 d and CO had a statistically significant impact at lag0-lag3 d and lag01-lag06 d (all P<0.05). NO 2 at lag02-lag04 d and CO at lag0-lag2 d and lag01-lag04 d had statistically significant effects on the visits for neurasthenia (both P<0.05). The impacts of NO 2 at lag03-lag04 d, PM 2.5 at lag3 d and lag03-lag04 d, PM 10 at lag3 d and lag03 d, and CO at lag3 d and lag01-lag05 d on visits for generalized anxiety disorder were also statistically significant (all P<0.05). After false discovery rate (FDR) correction, it was shown that for every 10 μg/m 3 increase in NO 2 and every 0.1 mg/m 3 increase in CO, the percentage increase in visits for mental and behavioral disorders and its 95% confidence interval (95% CI) were 3.38% (0.95%-5.87%) and 0.78% (0.38%-1.17%), respectively. For every 0.1 mg/m 3 increase in CO, the visits for neurasthenia increased by 0.78% (0.27%-1.29%). For every 10 μg/m 3 increase in PM 2.5 and every 0.1 mg/m 3 increase in CO, the visits for generalized anxiety disorder increased by 1.07% (0.46%-1.68%) and 1.17% (0.37%-1.97%), respectively (adjusted P<0.05). There was a linear exposure-response relationship between NO 2 and CO and the hospital visits for mental and behavioral disorders, CO and the hospital visits for neurasthenia, and CO and PM 2.5 and the hospital visits for generalized anxiety disorder ( P<0.05 for the overall association test and P>0.05 for the non-linearity test). Stratified analysis showed that air pollutants had an impact on male patients with neurasthenia, female patients with generalized anxiety disorder, individuals aged <45 years with mental and behavioral disorders, and individuals aged ≥65 years with generalized anxiety disorder. The impact of air pollutants was greater during the cold season or winter. Conclusion:Exposure to air pollution can increase hospital visits for mental and behavioral disorders among residents in industrial areas, with a higher risk among those aged<45 years old and during the cold season.

Objective:To integrate and analyze the trend of the disease burden of tracheal,bronchus,and lung cancer(TBL)attributable to secondhand smoke in China from 1990 to 2021 and to analyze future projections,aiming to provide data support for the prevention and treatment of TBL in China.Methods:Based on the global burden of disease(GBD)2021 database,TBL with ICD-10 disease classification C33,C34-C34.92 was studied.Using secondhand smoke as a risk factor,the data on TBL mortality and disability-adjusted life year(DALY)due to secondhand smoke in China from 1990 to 2021 were further age-standardized.Using Joinpoint 4.7.1 regression analysis model to calculate annual percentage change(APC)and average annual percentage change(AAPC),Hiplot software was used to plot disease burden data for different ages and genders,and R 4.3.1 software was used to construct a grey model GM(1,1)to predict the predicted value and trend of TBL disease burden attributed to secondhand smoke in China from 2022 to 2031.Results:From 1990 to 2021,the TBL mortality rate,age-standardized mortality rate,and DALY rate attributed to secondhand smoke in China increased from 1.76/100 000,2.63/100 000,and 49.43/100 000 to 4.08/100 000,2.80/100 000,and 95.57/100 000,respectively;the growth was 131.18%,6.45%,and 93.34%;the age-standardized DALY rate decreased from 65.04/100 000 to 63.32/100 000 with the reduction of 2.65%.The results of the Joinpoint regres-sion showed that the AAPC(95%CI)of mortality,age-standardized mortality rate,and DALY rate for TBL were 2.75(2.58-2.93)%,0.16(0.11-0.21)%,and 2.15(2.11-2.18)%,respectively,with an overall increasing trend;the AAPC(95%CI)of age-standardized DALY rate was-0.14(-0.40-0.12)%,with an overall fluctuating and unchanged trend and it was higher in males than in females.In both 1990 and 2021,the TBL mortality rate attributable to secondhand smoke in China gradually increased with age,and the DALY rate first increased and then slowed down with age.The main groups of the burden of disease were the elderly and males.The grey prediction model GM(1,1)showed that the age-standardized mortality rate of TBL attributable to secondhand smoke from 2022 to 2031 showed a slow increasing trend,and the predicted value in 2031 would increase to 2.95/100 000.The age-standardized DALY showed a slow decreasing trend,and the predicted value in 2031 would decrease to 63.83/100 000.Conclusions:From 1990 to 2021,the TBL mortality,age-standardized mortality,and DALY rates attributable to secondhand smoke in China increased,and the age-standardized DALY rate decreased.Men and the elderly are the main groups affected by TBL.Appropriate measures should be formulated to reduce exposure to and contact with secondhand smoke,tak-ing into account gender and age differences.Additionally,efforts should be made to strengthen secondhand smoke prevention and public health education.

Objective To explore the role of regulatory T cells and exosome programmed death-ligand 1(PD-L1)in the immunotherapy of advanced non-small cell lung carcinoma(NSCLC).Methods Sixty patients with advanced NSCLC who visited China Coast Guard Hospital of the People's Armed Police Force from March 2022 to June 2024 were selected and included in lung carcinoma group.Among them,there were 30 patients squamous cell carcinoma and 30 patients with non-squamous cell carcinoma.Sixty healthy individuals undergoing physical examinations during the same period were selected as control group.Patients in squamous cell carcinoma group were treated with sintilimab+paclitaxel+cisplatin,while patients in non-squamous cell carcinoma group were treated with sintilimab+pemetrexed+carboplatin.Therapeutic effects and blood index results of two groups of patients were evaluated.Results The red blood cell count,hemoglobin,white blood cell count,platelets,CD3+,CD4+,CD4/CD8 and PD-L1 of patients in lung carcinoma group were significantly lower than those in control group(P＜0.05).The remission rate of patients in squamous cell carcinoma group was significantly higher than that in non-squamous cell carcinoma group(P＜0.05).After treatment,white blood cell count,CD8+,and exosome PD-L1 of patients in squamous cell carcinoma group were significantly lower than those in non-squamous cell carcinoma group,while red blood cell count,hemoglobin,platelets,CD3+,CD4+,and CD4/CD8 were significantly higher than those in non-squamous cell carcinoma group(P＜0.05).Conclusion There are differences in immune responses among different subtypes of lung carcinoma,and targeted treatment plans should be formulated based on pathological types.

Objective To explore the role of regulatory T cells and exosome programmed death-ligand 1(PD-L1)in the immunotherapy of advanced non-small cell lung carcinoma(NSCLC).Methods Sixty patients with advanced NSCLC who visited China Coast Guard Hospital of the People's Armed Police Force from March 2022 to June 2024 were selected and included in lung carcinoma group.Among them,there were 30 patients squamous cell carcinoma and 30 patients with non-squamous cell carcinoma.Sixty healthy individuals undergoing physical examinations during the same period were selected as control group.Patients in squamous cell carcinoma group were treated with sintilimab+paclitaxel+cisplatin,while patients in non-squamous cell carcinoma group were treated with sintilimab+pemetrexed+carboplatin.Therapeutic effects and blood index results of two groups of patients were evaluated.Results The red blood cell count,hemoglobin,white blood cell count,platelets,CD3+,CD4+,CD4/CD8 and PD-L1 of patients in lung carcinoma group were significantly lower than those in control group(P＜0.05).The remission rate of patients in squamous cell carcinoma group was significantly higher than that in non-squamous cell carcinoma group(P＜0.05).After treatment,white blood cell count,CD8+,and exosome PD-L1 of patients in squamous cell carcinoma group were significantly lower than those in non-squamous cell carcinoma group,while red blood cell count,hemoglobin,platelets,CD3+,CD4+,and CD4/CD8 were significantly higher than those in non-squamous cell carcinoma group(P＜0.05).Conclusion There are differences in immune responses among different subtypes of lung carcinoma,and targeted treatment plans should be formulated based on pathological types.

Objective:To investigate the dosimetric impact of dwell position spacing in the design of three-dimensional (3D) interstitial brachytherapy plans for cervical cancer, and to provide a reference for selecting dwell spacing in clinical planning.Methods:A total of 15 patients with cervical cancer who underwent 3D interstitial brachytherapy at Tianjin Medical University Cancer Institute & Hospital between March 2022 and March 2024 were selected using simple random sampling. For each patient, 10 brachytherapy plans were generated with different dwell position spacings set at 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 mm, respectively. Key parameters among different dwell spacings compared included D 90%, V 100%, V 200%, and V 300% for the high-risk clinical target volume (HRCTV); D 90% for the intermediate-risk clinical target volume (IRCTV); D 2 cm3 for organs at risk (OARs) (bladder, small intestine, colon, and rectum); and the total dwell time. Statistical analyses were performed using repeated measurement ANOVA or the Friedman test. Results:Among different dwell spacings, there were no statistically significant differences in HRCTV D 90%, HRCTV V 100%, bladder D 2 cm3, and rectum D 2 cm3 among different dwell spacings ( P=0.075, 0.061, 0.480, 0.639). All plans with dwell spacings ≤ 3 mm met clinical dose requirements. When the dwell spacing was set to 1 mm, HRCTV V 200% and V 300% had the smallest mean values, while IRCTV D 90% and total dwell time had the largest mean values; all differences were statistically significant ( P<0.05). When the dwell spacing was ≥6 mm, an increase in spacing led to a decrease in mean small intestine D 2 cm3, and total dwell time, but an increase in HRCTV V 200% and a decrease in IRCTV D 90%, with statistically significant differences compared to spacings of 1-4 mm ( P<0.05). When the dwell spacing was ≥8 mm, the median colon D 2 cm3 decreased, with statistically significant differences compared to spacings of 1-3 mm ( P<0.05). Conclusions:For 3D interstitial brachytherapy planning in cervical cancer, dwell position spacings ≤ 3 mm can meet clinical dose requirements, with 1 mm providing optimal target coverage. Spacings ≥6 mm / ≥8 mm can reduce radiation dose to the small intestine and colon, respectively, while also shortening dwell time.