Objective To investigate the impact of 15 days of complete fasting on individuals'risk decision-making abilities and the role of physical exercise in this process.Methods Twenty-four healthy participants completed a 28-day experiment divided into baseline,complete fasting,calorie restriction,and full recovery phases.Participants were randomly assigned to a light exercise group(EL),moderate exercise group(EM),or control group(CN).Risk decision-making capacity was assessed using the Balloon Analogue Risk Task(BART),with data analyzed via Kruskal-Wallis and Friedman tests.Results Fifteen days of complete fasting did not significantly affect the participants'risk decision-making abilities.Additionally,after fasting,the moderate exercise group was more likely to make risky decisions compared to the light exercise group.Conclusion Long-term fasting has no significant impact on risk decision-making ability,but engaging in physical exercise makes people more likely to make high-risk decisions.

Objective:To evaluate the impact of short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves on the risk of road traffic mortality and calculate the attributable mortality burden.Methods:This study collected road traffic mortality data from the Disease Surveillance System in Guangdong, Hunan, Zhejiang, Yunnan, and Jilin Provinces from 2013 to 2018. A time-stratified case-crossover design was used in this study, with the death date for each case serving as the case day. Control days were selected from the same year, month, and day of the week as the case day. A conditional logistic regression model was employed to estimate the cumulative associations of short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves on the risk of road traffic mortality (lag 0-1 day) and to calculate the attributable fractions (AF).Results:Compared to non-heatwave days, the excess risk ( ER) of road traffic mortality on daytime heatwave days, nighttime heatwave days, and compound heatwave days was 5.3% (95% CI: 0.5%-10.2%), 4.9% (95% CI: 0.5%-9.4%) and 7.5% (95% CI: 2.3%- 12.9%), with corresponding AF of 5.0% (95% CI: 0.5%-9.3%), 4.7% (95% CI: 0.5%-8.6%), and 6.9% (95% CI: 2.3%-11.4%), respectively. Stratified analysis showed that the risk of traffic mortalities caused by daytime heatwaves was higher in females ( ER=15.7%, 95% CI: 5.8%-26.5%) than in males ( ER=1.8%, 95% CI: -3.6%-7.4%). Elderly individuals over 64 years old ( ER=10.9%, 95% CI: 0.3%- 22.6%) had a higher risk of road traffic mortalities from compound heatwaves than those under 45 years old ( ER=2.6%, 95% CI: -5.4%-11.2%). The risk of road traffic injury mortality from motor vehicle accidents caused by compound heatwaves ( ER=16.6%, 95% CI:2.4%-32.7%) was higher than that from non-motor vehicle accidents ( ER=5.7%, 95% CI:0.1%-11.5%). Conclusions:Short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves was associated with an increased risk of road traffic mortality, with the strongest association observed for compound heatwaves. The mortality burden attributable to compound heatwaves was higher than that for daytime and nighttime heatwaves. Heatwaves were more significantly associated with road traffic mortality risk among females, elderly individuals over 64 years old, and motor vehicle accidents.

Objective:To evaluate the impact of short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves on the risk of road traffic mortality and calculate the attributable mortality burden.Methods:This study collected road traffic mortality data from the Disease Surveillance System in Guangdong, Hunan, Zhejiang, Yunnan, and Jilin Provinces from 2013 to 2018. A time-stratified case-crossover design was used in this study, with the death date for each case serving as the case day. Control days were selected from the same year, month, and day of the week as the case day. A conditional logistic regression model was employed to estimate the cumulative associations of short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves on the risk of road traffic mortality (lag 0-1 day) and to calculate the attributable fractions (AF).Results:Compared to non-heatwave days, the excess risk ( ER) of road traffic mortality on daytime heatwave days, nighttime heatwave days, and compound heatwave days was 5.3% (95% CI: 0.5%-10.2%), 4.9% (95% CI: 0.5%-9.4%) and 7.5% (95% CI: 2.3%- 12.9%), with corresponding AF of 5.0% (95% CI: 0.5%-9.3%), 4.7% (95% CI: 0.5%-8.6%), and 6.9% (95% CI: 2.3%-11.4%), respectively. Stratified analysis showed that the risk of traffic mortalities caused by daytime heatwaves was higher in females ( ER=15.7%, 95% CI: 5.8%-26.5%) than in males ( ER=1.8%, 95% CI: -3.6%-7.4%). Elderly individuals over 64 years old ( ER=10.9%, 95% CI: 0.3%- 22.6%) had a higher risk of road traffic mortalities from compound heatwaves than those under 45 years old ( ER=2.6%, 95% CI: -5.4%-11.2%). The risk of road traffic injury mortality from motor vehicle accidents caused by compound heatwaves ( ER=16.6%, 95% CI:2.4%-32.7%) was higher than that from non-motor vehicle accidents ( ER=5.7%, 95% CI:0.1%-11.5%). Conclusions:Short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves was associated with an increased risk of road traffic mortality, with the strongest association observed for compound heatwaves. The mortality burden attributable to compound heatwaves was higher than that for daytime and nighttime heatwaves. Heatwaves were more significantly associated with road traffic mortality risk among females, elderly individuals over 64 years old, and motor vehicle accidents.

Using clinical physicians as an example,this article describes the current status of evaluation models for sen-ior health technical personnel in China.It explores the professional title assessment mechanism-an important system reflecting the evaluation of clinical technical capabilities-as well as practical experiences and advanced practices adopted in various re-gions.The existing problems are summarized,including insufficient refinement in the classification of assessment systems,diffi-culties in quantifying clinical practice,lack of standardization in evaluation informatization,and disconnection between evaluation results and their application.Recommendations are proposed:optimizing the hierarchical and categorized evaluation mechanism,improving the evaluation system and standards,exploring quantitative assessment of clinical capabilities,innovating evaluation tools,and establishing a virtuous cycle between talent evaluation and talent utilization to promote the sustainable development of the healthcare sector.

Objective:To explore the effect of contezolid on platelet count in patients with severe pneumonia and analyze the risk factors.Methods:The study was designed as a retrospective case-control study. The research subjects were selected from patients with severe pneumonia who were admitted to the Department of Respiratory and Critical Care Medicine of Shaanxi Provincial People′s Hospital from July 1, 2022 to November 30, 2024 and were treated with contezolid or linezolid. The clinical data of patients were collected and the incidence of thrombocytopenia [platelet count (PLT)<100×10 9/L after medication], the PLT before and at 1 week of treatments, and the lowest PLT value during treatments were compared in patients treated with contezolid and linezolid. The patients were divided into 2 groups based on whether contezolid- related thrombocytopenia occurred. The clinical characteristics of the patients were compared, and the independent risk factors of contezolid-related thrombocytopenia were analyzed by binary logistic regression method. Results:A total of 175 patients were included, among whom 73 received contezolid and 102 received linezolid. There was no statistically significant difference in PLT between the 2 groups before medication ( P=0.364). Compared with patients treated with linezolid, the incidence of thrombocytopenia in patients treated with contezolid was lower [19.2% (14/73) vs. 40.2% (41/102)], and the PLT at 1 week of treatments and the lowest value of PLT during treatments were higher. The differences were all statistically significant (all P<0.05). Compared with patients without contezolid-related thrombocytopenia(59 patients), patients who developed thrombocytopenia after using contezolid had a longer duration of contezolid medication, lower PLT and creatinine clearance rate before medication, and higher procalcitonin and serum creatinine levels before medication. All these differences were statistically significant (all P<0.05). The results of binary logistic regression analysis showed that lower PLT [odds ratio ( OR)=0.971, 95% confidence interval ( CI): 0.950-0.992, P=0.008] and higher procalcitonin level ( OR=7.292, 95% CI: 1.067-49.814, P=0.043) before medication and longer duration of contezolid medication ( OR=1.165, 95% CI: 1.002-1.355, P=0.046) were the independent risk factors of contezolid-related thrombocytopenia. Conclusions:Compared with linezolid, contezolid has a relatively safer profile in the treatment of patients with severe pneumonia and the risk of thrombocytopenia after medication is lower. Patients with lower PLT and higher procalcitonin levels before medication, and those with a longer duration of contezolid medication have a higher risk of contezolid-related thrombocytopenia and should be closely monitored.

Using clinical physicians as an example,this article describes the current status of evaluation models for sen-ior health technical personnel in China.It explores the professional title assessment mechanism-an important system reflecting the evaluation of clinical technical capabilities-as well as practical experiences and advanced practices adopted in various re-gions.The existing problems are summarized,including insufficient refinement in the classification of assessment systems,diffi-culties in quantifying clinical practice,lack of standardization in evaluation informatization,and disconnection between evaluation results and their application.Recommendations are proposed:optimizing the hierarchical and categorized evaluation mechanism,improving the evaluation system and standards,exploring quantitative assessment of clinical capabilities,innovating evaluation tools,and establishing a virtuous cycle between talent evaluation and talent utilization to promote the sustainable development of the healthcare sector.

Objective:To explore the effect of contezolid on platelet count in patients with severe pneumonia and analyze the risk factors.Methods:The study was designed as a retrospective case-control study. The research subjects were selected from patients with severe pneumonia who were admitted to the Department of Respiratory and Critical Care Medicine of Shaanxi Provincial People′s Hospital from July 1, 2022 to November 30, 2024 and were treated with contezolid or linezolid. The clinical data of patients were collected and the incidence of thrombocytopenia [platelet count (PLT)<100×10 9/L after medication], the PLT before and at 1 week of treatments, and the lowest PLT value during treatments were compared in patients treated with contezolid and linezolid. The patients were divided into 2 groups based on whether contezolid- related thrombocytopenia occurred. The clinical characteristics of the patients were compared, and the independent risk factors of contezolid-related thrombocytopenia were analyzed by binary logistic regression method. Results:A total of 175 patients were included, among whom 73 received contezolid and 102 received linezolid. There was no statistically significant difference in PLT between the 2 groups before medication ( P=0.364). Compared with patients treated with linezolid, the incidence of thrombocytopenia in patients treated with contezolid was lower [19.2% (14/73) vs. 40.2% (41/102)], and the PLT at 1 week of treatments and the lowest value of PLT during treatments were higher. The differences were all statistically significant (all P<0.05). Compared with patients without contezolid-related thrombocytopenia(59 patients), patients who developed thrombocytopenia after using contezolid had a longer duration of contezolid medication, lower PLT and creatinine clearance rate before medication, and higher procalcitonin and serum creatinine levels before medication. All these differences were statistically significant (all P<0.05). The results of binary logistic regression analysis showed that lower PLT [odds ratio ( OR)=0.971, 95% confidence interval ( CI): 0.950-0.992, P=0.008] and higher procalcitonin level ( OR=7.292, 95% CI: 1.067-49.814, P=0.043) before medication and longer duration of contezolid medication ( OR=1.165, 95% CI: 1.002-1.355, P=0.046) were the independent risk factors of contezolid-related thrombocytopenia. Conclusions:Compared with linezolid, contezolid has a relatively safer profile in the treatment of patients with severe pneumonia and the risk of thrombocytopenia after medication is lower. Patients with lower PLT and higher procalcitonin levels before medication, and those with a longer duration of contezolid medication have a higher risk of contezolid-related thrombocytopenia and should be closely monitored.

Objective To observe the expression and trends of tight junction proteins Occludin and zonula occlu-den-1(ZO-1)in blood-brain barrier(BBB)of rats with traumatic brain injury(TBI),and to explore the interven-tion effect of cannabidiol(CBD)on the BBB.Methods The TBI model of rat was prepared by modified"Feeney free fall method"and randomly divided into three groups:the sham-operated group(Sham group),the model group(TBI+vehicle group)and the CBD intervention group(TBI+CBD group),with 24 rats in each group.Each group was subdivided into six time points:8 h,1,2,3,5 and 7 d after injury.The expression of Occludin and ZO-1,which are closely related to the permeability of BBB,was detected by immunohistochemistry,immuno-fluorescence staining and Western blot at different points.The permeability of BBB was detected by sodium fluores-cein assay.Results The results of immunohistochemistry showed that compared with Sham group,the positive ex-pression of Occludin and ZO-1 decreased with time after brain trauma(P<0.05),and both reached the lowest level at 2 d.The expression levels of Occludin and ZO-1 were up-regulated after 1 d of CBD intervention(P<0.05).Immunofluorescence staining showed a similar trend to Western blot results,with Occludin and ZO-1 fluo-rescence expression intensity and protein expression reduced after TBI compared with Sham group(P<0.05).And the expression levels of Occludin and ZO-1 were up-regulated after 2 d of CBD intervention(P<0.05).The results of fluorescein sodium experiment showed that the BBB integrity of brain tissue was destroyed after TBI,and the permeability increased after TBI(P<0.01).The permeability of BBB decreased after CBD intervention(P<0.05).Conclusion The expression of tight junction proteins Occludin and ZO-1 decreases after TBI,and the permeability of BBB is disrupted,and CBD intervention reverses the disruption of the BBB by TBI.

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Objective:To analyze the correlation between the grouping and weighting of two sets of disease combination systems, namely diagnosis-related groups(DRG) and diagnosis-intervention packet(DIP), and to establish a multidimensional analysis and evaluation mode by applying DRG, DIP, and clinical pathway to guide the standardized diagnosis and treatment and management of disease types.Methods:DRG grouping and DIP simulation full enrollment were applied to patients discharged from a tertiary Grade A general hospital in 2019. The correlation analysis between DRG, DIP, and clinical pathway inclusion(entry), correlation analysis between relative weight of DRG group and DIP standard score, and correlation analysis between clinical pathway entry and cost structure of the two disease groups were conducted by using chi-square test, Pearson correlation analysis, t-test, structural change value, degree of structural change, and incremental contribution rate. Results:Among the 130 395 patients, 41 460 cases entered the clinical pathway, 127 535 cases were enrolled in DRG, and 104 227 cases were enrolled in DIP. There was a correlation between the enrollment of DRG, DIP, and clinical pathway( P<0.05), and there was also a correlation between the relative weight of DRG groups and the enrollment of clinical pathway. The relative weight of the DRG disease group was positively correlated with the DIP standard score( r2=0.761 7, P<0.001). There was a significant difference in hospitalization costs between patients with and without clinical pathway access for some diseases( P<0.05), and different cost categories had different impacts on the total costs. Conclusions:The weight assignment and value orientation of DRG and DIP disease types are consistent, and the multi-dimensional fusion evaluation mode for DRG-DIP-clinical pathway is feasible. The correlation analysis of DRG, DIP, and clinical pathways can serve as the basis for disease classification and cost structure evaluation, which could help to carry out hospital′s refined management and optimize disease structure.