Objective:To evaluate the association between heatwaves and fall-related mortality.Methods:A total of 61 421 fall-related mortality from 2013 to 2022 in 7 provinces of China were included in a time-stratified case-crossover design, with daily meteorological data derived from the fifth generation European Reanalysis dataset produced by the European Centre for Medium-Range Weather Forecasts. Conditional logistic regression chimeric distributed lag nonlinear model was used to analyze the association between heatwaves and fall-related mortality and stratified analysis was conducted according to gender and age.Results:Heatwaves were associated with an increased risk of fall-related morality. The risk of fall-related mortality during heatwaves was higher than during non-heatwave periods ( OR=1.11, 95% CI: 1.05-1.18). The attributable fraction of fall-related motality due to heatwaves was 10.25% (95% CI: 4.49%-15.36%). For each 1 ℃ increase above the heatwave threshold, the risk of fall-related mortality increased by 34% ( OR=1.34, 95% CI: 1.02-1.76). The effect of heatwave duration on fall-related mortality was not statistically significant. Stratified analyses indicated that women experienced a higher risk of fall-related mortality during heatwaves ( OR=1.13, 95% CI: 1.04-1.22) compared to man ( OR=1.10, 95% CI: 1.04-1.17). Conclusions:Heatwave increases the risk of fall-related mortality, and the intensity of heatwaves modify this risk. Women are vulnerable populations.

Objective:To analyze the current status, hotspots, and future research trends of Ganmai Dazao Decoction.Methods:Literature about Ganmai Dazao Decoction was retrieved from the CNKI, Wanfang Data, Chongqing VIP, and CBM from January 1, 1994, to June 30, 2024. CiteSpace 6.3.R1 software was used for co-occurrence analysis of authors and institutions, as well as co-occurrence, clustering, timeline, and burst analysis of keywords.Results:A total of 696 articles were included, with an overall fluctuating upward trend in annual publications in this field, peaking in 2018 (51 articles). The institution with the most publications was Nanjing University of Chinese Medicine (12 articles); the journal with the most publications was Inner Mongolia Journal of Traditional Chinese Medicine (28 articles); among the authors, five published the most, with only 3 articles each. Research mainly focused on clinical applications of TCM, theory exploration, animal experiments, and other areas. Conclusions:The publication volume of Ganmai Dazao Decoction research shows an overall upward trend, with high attention on the treatment of diseases such as depression, organ dysregulation, and perimenopausal syndrome. The research hotspots include the mechanism of Ganmai Dazao Decoction in anti-depression and endocrine regulation and so on.

Objective:To evaluate the association between heatwaves and fall-related mortality.Methods:A total of 61 421 fall-related mortality from 2013 to 2022 in 7 provinces of China were included in a time-stratified case-crossover design, with daily meteorological data derived from the fifth generation European Reanalysis dataset produced by the European Centre for Medium-Range Weather Forecasts. Conditional logistic regression chimeric distributed lag nonlinear model was used to analyze the association between heatwaves and fall-related mortality and stratified analysis was conducted according to gender and age.Results:Heatwaves were associated with an increased risk of fall-related morality. The risk of fall-related mortality during heatwaves was higher than during non-heatwave periods ( OR=1.11, 95% CI: 1.05-1.18). The attributable fraction of fall-related motality due to heatwaves was 10.25% (95% CI: 4.49%-15.36%). For each 1 ℃ increase above the heatwave threshold, the risk of fall-related mortality increased by 34% ( OR=1.34, 95% CI: 1.02-1.76). The effect of heatwave duration on fall-related mortality was not statistically significant. Stratified analyses indicated that women experienced a higher risk of fall-related mortality during heatwaves ( OR=1.13, 95% CI: 1.04-1.22) compared to man ( OR=1.10, 95% CI: 1.04-1.17). Conclusions:Heatwave increases the risk of fall-related mortality, and the intensity of heatwaves modify this risk. Women are vulnerable populations.

Objective:To investigate the dynamic brain function changes in adolescent depression patients with or without suicidal ideation, and to explore the characteristics and the hypothalamus-pituitary-adrenal axis of adrenocorticotropic hormone (ACTH) and the potential correlation between levels of the hormone cortisol.Methods:From March 2018 to January 2021, the First Affiliated Hospital of Jinan University conducted a study involving 48 adolescent patients with major depressive disorder (MDD) who have suicidal ideation(MDD+SI), 38 MDD patients without suicidal ideation(MDD-SI), and 41 healthy control participants(HC). The study utilized resting state functional magnetic resonance imaging (fMRI) to analyze the brain activity of these individuals. The dynamic local consistency (dReHo) and dynamic functional connection (dFC) values for the three groups were computed utilizing a sliding time window analysis technique. Blood samples were obtained within 24 hours following the completion of the MRI scan to quantify ACTH and cortisol levels via direct chemiluminescence. A one-way analysis of covariance was employed to compare the dReHo and dFC values among the three groups, while a one-way analysis of variance was utilized to compare the hormone levels across the three groups. Significant differences in dReHo values among the three groups were identified in specific regions, as well as in dFC values, using the least significant differences method correction following inspection ( P<0.05). Additionally, a partial correlation analysis was conducted to investigate the relationship between these dynamic indexes and hormone levels. Results:The difference of dReHo values among the three groups was found in the right posterior cerebellum (mainly Crus Ⅱ and Crus I) ( F=9.44, P<0.001), and the left precuneus ( F=10.93, P<0.05). There were significant differences in dFC values between the three groups in the left precuneus and left middle temporal gyrus ( F=9.60, P<0.001), and the left precuneus with bilateral precuneus ( F=9.66, P<0.001). The correlation analysis revealed a positive relationship between the decreased dReHo ( r=0.350, P=0.018) variability in the left precuneus, the decreased dFC( r=0.362, P=0.015) variability between the left precuneus and the left middle temporal gyrus (MTG), and the decreased cortisol level( P=0.013, 0.039) in the group of MDD+SI. Conclusion:Adolescents diagnosed with MDD, both with and without suicidal ideation, exhibit dynamic functional alterations in the precuneus and middle temporal gyrus. The cerebellar function changes appear to be unique to those with suicidal ideation. Furthermore, the aberrant dynamic brain function observed in the precuneus and middle temporal gyrus is associated with abnormal cortisol levels in individuals with suicidal ideation.

Objective: To analyze the status of health risk behaviors among middle school students in Beijing City from 2018 to 2022, in order to provide reference for scientific and effective intervention. Methods: Using multi stage stratified cluster random sampling method,data of student health and associated factors monitoring among 84 712 middle school students from 16 districts of Beijing during 2018 to 2022 were compared regarding the differences of health risk behaviors among students in different groups by Chi quare test. And their change trends were evaluated by annual percentage change (APC). Results: In the five surveys during 2018 to 2022,reporting rates of unhealthy diet, unintentional injury, intentional injury, substance abuse and Internet addiction (only in 2018 and 2020) behaviors were higher in boys than in girls ( χ 2=4.91-297.52, P ＜0.05).Reporting rate of physical inactivity behavior in girls was higher than that in boys ( χ 2=56.49-160.88, P ＜0.05). Reporting rates of unhealthy diet, physical inactivity, unintentional injury (except 2021), substance abuse and Internet addiction (only in 2018 and 2019) behaviors were the highest in vocational high school, followed by general high school, and the lowest in junior middle school ( χ 2=23.30-1 285.98, P ＜0.01). Intentional injury behavior was highest in junior high school, followed by vocational high school, and lowest in general high school ( χ 2=96.18-378.32, P ＜0.01).Reporting rate of Internet addiction (2020-2022) behavior was highest in general high school, followed by vocational high school, and lowest in junior high school ( χ 2=16.93-60.11, P＜0.01). Reporting rates of unhealthy diet, intentional injury (2020 and 2022) and substance abuse (except 2018) behaviors were higher in suburban areas than in urban areas (χ 2=6.70-117.56, P＜0.05). Reporting rates of physical inactivity, unintentional injury, intentional injury (2018 and 2019) and Internet addiction behaviors were higher in urban areas than in suburban areas (χ2=3.90-130.80, P＜0.05). Standardized rates of unintentional injury, intentional injury, substance abuse and Internet addiction behaviors showed a statistically significant downward trend from 2018 to 2022 (APC=-14.16, -13.43, -16.03, -8.48, t =-6.94, -4.46, -11.98, -4.36, P ＜0.05). Conclusions During 2018-2022, unintentional injury, intentional injury, substance abuse and Internet addiction behaviors of middle school students in Beijing City have improved, and the reporting rates of unhealthy diet and physical inactivity behaviors are high and don t show a downward trend. Efforts should be made to strengthen intervention in unhealthy diet and physical inactivity behaviors among middle school students, in order to reduce the occurrence of health risk behaviors.

BACKGROUND:Tissue engineering is considered an ideal treatment for growth plate regeneration.However,most of the current research on regenerative tissue engineering is the traditional scaffold-based strategy.As the limitations of traditional scaffolds are gradually revealed,the research direction is gradually diversifying. OBJECTIVE:To summarize the application of scaffold-based and scaffold-free strategies in the treatment of growth plate cartilage regeneration and their respective advantages and disadvantages. METHODS:The relevant articles were searched from PubMed,Wiley,and Elsevier.The search terms were"growth plate injury,regeneration,tissue engineering,scaffold,scaffold-free,biomimetic,cartilage"in English.The time was limited from 1990 to 2023.Finally,104 articles were included for review. RESULTS AND CONCLUSION:The biomimetic strategy is to reduce the cell composition,biological signals and unique mechanical properties of each region to the greatest extent by simulating the unique organizational structure of the growth plate,so as to build a biomimetic microenvironment that can promote tissue regeneration.Therefore,the design of a biomimetic scaffold is to simulate the original growth plate as far as possible in terms of composition,structure and mechanical properties.Although some results have been achieved,there is still the problem of the unstable regeneration effect.The scaffold-free strategy believes that the limitations of scaffolds will have adverse effects on regenerative therapy.Therefore,the design of scaffold-free constructs relies as much as possible on the ability of cells to generate and maintain extracellular matrix without interfering with cell-cell signals or introducing exogenous substances.However,there are some problems,such as poor stability,low mechanical strength and greater difficulty in operation.Biomimetic strategy and scaffold-free strategy have different emphases,advantages and disadvantages,but they both have positive effects on growth plate cartilage regeneration.Therefore,subsequent studies,whether adopting a biomimetic strategy or a scaffold-free strategy,will focus on the continuous optimization of existing technologies in order to achieve effective growth plate cartilage regeneration therapy.

Objective: To analyze the current status and related factors of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing, so as to provide a basis for comprehensive public health interventions for common diseases. Methods: Through stratified cluster random sampling in October 2022, a total of 11 262 junior high school, senior high school, and vocational high school students in 16 districts of Beijing were surveyed with self administered questionnaires, physical examinations and visual acuity examinations. The χ 2 test and binary Logistic regression model were used to analyze group differences in the comorbidity of myopia, obesity and depression symptoms and factors influencing the comorbidity. Stratified analysis was applied to analyze the associations between health risk behaviors and the comorbidity. Results: The detection rate of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing was 3.35%, the comorbidity rate among vocational high school students (4.61%) was higher than that in junior high school students (2.80%) and senior high school students (3.41%). The comorbidity rate was higher among students in suburban areas (3.66%) than that in urban areas (2.92%), and the differences was statistically significant ( χ 2=15.02, 4.63, P <0.05). Binary Logistic regression analyses indicated that middle school students with poor dietary behaviors ( OR =1.59) and excessive screen time ( OR =1.70) were associated with elevated risk of comorbidity of myopia, obesity, and depression symptoms. Both boys and girls with poor dietary behaviors ( OR =1.63, 1.69) and excessive screen time ( OR =1.45, 2.23) had elevated likelihood of comorbidity of myopia, obesity and depression symptoms. Students in junior high school and senior high school with poor dietary behaviors ( OR =2.16, 1.47) and excessive screen time ( OR =2.20, 1.63 ) had elevated likelihood of comorbidity of myopia, obesity, and depression symptoms ( P <0.05). Conclusions The current status of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing is concerning. Schools and parents should work together to guide students to develop healthy behaviors such as balanced diet and moderate video, in order to achieve the goal of controlling myopia, obesity and depression symptoms.

Objective:To investigate the dynamic brain function changes in adolescent depression patients with or without suicidal ideation, and to explore the characteristics and the hypothalamus-pituitary-adrenal axis of adrenocorticotropic hormone (ACTH) and the potential correlation between levels of the hormone cortisol.Methods:From March 2018 to January 2021, the First Affiliated Hospital of Jinan University conducted a study involving 48 adolescent patients with major depressive disorder (MDD) who have suicidal ideation(MDD+SI), 38 MDD patients without suicidal ideation(MDD-SI), and 41 healthy control participants(HC). The study utilized resting state functional magnetic resonance imaging (fMRI) to analyze the brain activity of these individuals. The dynamic local consistency (dReHo) and dynamic functional connection (dFC) values for the three groups were computed utilizing a sliding time window analysis technique. Blood samples were obtained within 24 hours following the completion of the MRI scan to quantify ACTH and cortisol levels via direct chemiluminescence. A one-way analysis of covariance was employed to compare the dReHo and dFC values among the three groups, while a one-way analysis of variance was utilized to compare the hormone levels across the three groups. Significant differences in dReHo values among the three groups were identified in specific regions, as well as in dFC values, using the least significant differences method correction following inspection ( P<0.05). Additionally, a partial correlation analysis was conducted to investigate the relationship between these dynamic indexes and hormone levels. Results:The difference of dReHo values among the three groups was found in the right posterior cerebellum (mainly Crus Ⅱ and Crus I) ( F=9.44, P<0.001), and the left precuneus ( F=10.93, P<0.05). There were significant differences in dFC values between the three groups in the left precuneus and left middle temporal gyrus ( F=9.60, P<0.001), and the left precuneus with bilateral precuneus ( F=9.66, P<0.001). The correlation analysis revealed a positive relationship between the decreased dReHo ( r=0.350, P=0.018) variability in the left precuneus, the decreased dFC( r=0.362, P=0.015) variability between the left precuneus and the left middle temporal gyrus (MTG), and the decreased cortisol level( P=0.013, 0.039) in the group of MDD+SI. Conclusion:Adolescents diagnosed with MDD, both with and without suicidal ideation, exhibit dynamic functional alterations in the precuneus and middle temporal gyrus. The cerebellar function changes appear to be unique to those with suicidal ideation. Furthermore, the aberrant dynamic brain function observed in the precuneus and middle temporal gyrus is associated with abnormal cortisol levels in individuals with suicidal ideation.

Objective:To explore the teaching experience of clinical teaching teachers in master of integrated traditional Chinese and western medicine nursing, so as to provide a reference for improving the training quality of master of integrated Chinese and western medicine nursing.Methods:From March to May 2022, a total of 14 clinical teaching teachers of integrated traditional Chinese and western medicine nursing in the First Affiliated Hospital of Hunan University of were enrolled using the objective sampling method and investigated by the semi-structured face-to-face interview. Content analysis was used to analyze the interview results.Results:Five themes were extracted, namely, the practice ability of nursing graduate students needs to be improved, the evaluation methods of clinical practice ability of graduate students need to be more diversified, teaching benefits teachers as well as students; difficulties of teaching (conflicts between teachers' clinical work and teaching, unclear orientation of postgraduate clinical practice learning) , hope to get support (improve scientific research ability, improve theoretical knowledge of traditional Chinese medicine, guarantee the clinical practice and study time of graduate students) .Conclusions:A variety of practice approaches should be provided for the training in master of integrated traditional Chinese and western medicine nursing graduate students, to improve students' clinical practice ability and professional identity, strengthen clinical teacher training, improve teachers' ability, and continuously improve the clinical practice training model and the quality of talent training for nursing graduate students.

Objective:To investigate the clinical features of neonatal testicular torsion and to evaluate the effect and necessity of early intervention.Methods:A retrospective analysis was performed on 11 neonates admitted to the Second Hospital of Shandong University with neonatal testicular torsion from June 2017 to June 2022. Clinical data of these cases including clinical manifestations, ultrasonography findings, surgical management and outcomes were reviewed and analyzed with descriptive statistical methods.Results:The median age of the 11 patients on admission was 2.6 d (1-5 d). The median time from finding abnormal scrotum to admission was 12 h (1-120 h). Various degrees of scrotal swelling or scleroma were found in the patients. Among them, seven patients presented with acute inflammatory signs of cyano sis or skin redness, and testis-like tissue induration could be touched. Ultrasound scan showed abnormal blood flow in the affected testicle in all cases. Emergency scrotal exploration under general anesthesia was performed successfully in all cases and ten of them underwent orchiectomy of the affected testicle plus contralateral orchiopexy. The rest one who was admitted within 1 h after birth only underwent orchiopexy of the affected testicle as the parents refused contralateral testicular exploration. During the operation, 12 twisted testis were observed, including seven with extravaginal torsion, three with intravaginal torsion and two adhering to the surrounding tissue without normal testicular tissue or distinguishable torsion direction or degree. In this study, ten patients had unilateral testicular torsion, which affected the left side in seven cases and the right side in three cases, and one had bilateral testicular torsion, which was diagnosed as left testicle torsion before surgery. During scrotal exploration, the left testicle of this bilateral case was resected due to necrosis, while the right testicle twisted about 180 degrees with good blood flow and was subjected to orchidopexy after reduction. In one case, the unaffected testicle was unfixed and dysplastic during contralateral exploration, which was also subjected to orchidopexy. In the 12 testis with torsion, one testicle of the patient admitted within 1 h after birth and the right testicle of the bilateral case were preserved with a salvage rate of 2/12. Pathological examination showed necrosis in the ten excised testis, and fibrosis and calcification foci in two of them. None of the patients had any perioperative complications and the scrotal incision healed well in all neonates. The patients were followed up for 6-12 months with regular ultrasound. The two preserved testis and the contralateral testis subjected to orchidopexy were located in the scrotum with good blood supply, and no torsion, atrophy or other abnormalities occurred.Conclusions:Neonatal testicular torsion is rarely seen in clinical practice and has no specific manifestations. It has a high excision rate due to testicular necrosis. Early diagnosis and bilateral scrotal exploration are crucial to the prognosis and the keys to save the affected testis and avoid anorchidism.