Objective To investigate the effect of angiotensinogen (AGT), angiotensin-converting enzyme (ACE) and AngII receptor (ATR) gene polymorphisms combined with climatic factors on the incidence of essential hypertension (EH) in Tibetan population in Gannan area. Methods A follow-up study was conducted to select 671 Tibetan people in Gannan area who were physically examined in April 2019 at the Health Management Center of the Second Hospital of Lanzhou University and agreed to be enrolled as a fixed cohort, and the blood pressure values of the enrolled subjects were measured after 3.5 years of follow-up, and a total of 501 cases were obtained. At the same time, the peripheral blood of all subjects was collected and the polymorphisms of AGT, ACE and ATR genes were detected by gene chip technology, and the possible interactions were analyzed by logistic regression model, fork generation method and multifactor-dimensionality reduction (MDR). Results Sunshine time was a protective factor for the incidence of hypertension in the Tibetan population of Gannan (OR=0.781), while relative humidity (OR=1.182), air pressure (OR=1.338) and temperature (OR=1.449) were the risk factors for the incidence of hypertension. According to the results of partial correlation analysis, temperature had no effect on the incidence of hypertension after controlling air pressure. There was an additive interaction between high air pressure and the polymorphisms of rs699 (OR=1.650, 95%CI: 1.293-2.399, P<0.001) and rs5049 (OR=1.711, 95%CI: 1.337-4.920, P<0.001) genes of AGT gene; there was a multiplicative interaction between relative humidity and rs699 (OR=0.472, 95%CI: 0.120-0.783, P<0.05);there was a multiplicative interactions between the altitude ≥ 3000m and rs699 (OR=1.503, 95%CI: 1.220-3.174, P<0.01), rs5049 (OR=1.673, 95%CI: 1.380-3.961, P<0.001) or rs2148582 (OR=0.519, 95%CI: 0.284-0.716, P<0.05).However, there was no interaction between climatic factors and ACE or ATR gene polymorphisms on the incidence of hypertension. Conclusion Climatic factors and altitude ≥3 000 m are closely related to the incidence of hypertension in the Tibetan population of Gannan area, and the interaction between AGT gene polymorphisms and climatic factors affects the incidence of hypertension in the population of this area.

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.

Talents are the main force for the development of traditional Chinese medicine（TCM）， and the construction of TCM talents and the reformation of talent evaluation system are essential to promote the inheritance and innovation of TCM. At present， we are still exploring and developing in the fields of the formulation， implementation and evaluation indicators of TCM talent evaluation system. However， there are shortcomings and difficulties. For instance， insufficient stratification in the evaluation， excessive emphasis on the quantity of achievements， neglecting the quality of the achievements and the actual contribution， imperfect assessment indicators， and the weak characteristics of TCM. Therefore， national ministries and commissions have jointly issued a document requesting to break the four only and set a new standard， in order to promote the construction of a scientific and technological talent evaluation system oriented by innovation value， ability and contribution. For the evaluation of TCM clinical talents， China Association for Science and Technology commissioned China Association of Chinese Medicine to build the China Clinical Cases Library of TCM（CCCL-TCM）， which aims at collecting the most authoritative and representative TCM clinical cases and exploring the advantages of applying clinical cases as masterpiece of achievement in TCM clinical talents evaluation. CCCL-TCM can promote the construction of a talent evaluation system that is more in line with the development characteristics of TCM industry， and to carry out relevant pilot in TCM colleges and institutions across the country in order to promote the reformation of TCM talent evaluation system.

Aural vertigo frequently encountered in the otolaryngology department of traditional Chinese medicine （TCM） mainly involves peripheral vestibular diseases of Western medicine， such as Meniere's disease， benign paroxysmal positional vertigo， vestibular neuritis， and vestibular migraine， being a hot research topic in both TCM and Western medicine. Western medical therapies alone have unsatisfactory effects on recurrent aural vertigo， aural vertigo affecting the quality of life， aural vertigo not relieved after surgery， aural vertigo with complex causes， and children's aural vertigo. The literature records and clinical practice have proven that TCM demonstrates unique advantages in the treatment of aural vertigo. The China Association of Chinese medicine sponsored the "17th youth salon on the diseases responding specifically to TCM： Aural vertigo" and invited vertigo experts of TCM and Western medicine to discuss the difficulties and advantages of TCM diagnosis and treatment of aural vertigo. The experts deeply discussed the achievements and contributions of TCM and Western medicine in the diagnosis and treatment of aural vertigo， the control and mitigation of the symptoms， and the solutions to disease recurrence. The discussion clarified the positioning and advantages of TCM treatment and provided guidance for clinical and basic research on aural vertigo.

Objective:To evaluate the effect of tumor volume on the radiation dose and efficacy of locally advanced cervical cancer patients undergoing radical radiotherapy and chemotherapy.Methods:Clinical data of 126 patients who were diagnosed with cervical cancer (stage ⅡB-ⅣA) and underwent radical concurrent chemoradiotherapy in Guangxi Medical University Cancer Hospital from November 2019 to November 2022 were retrospectively analyzed. The cut-off values of tumor volume before (pre-TV) and after (post-TV) external radiotherapy and tumor volume reduction rate (TVRR) were calculated by Jamovi software. The effects of pre-TV, post-TV and TVRR on short-term efficacy, progression-free survival (PFS), brachytherapy (BT) mode , high-risk clinical target volume (HR-CTV) and organs at risk (OAR) dose were investigated by univariate and multivariate analyses.Results:Pre-TV≥67.03 cm 3 and post-TV≥14.88 cm 3 were poor prognostic factors for 6-month PFS and objective response rate (ORR) (both P<0.05), and post-TV was an independent prognostic factor. In the TVRR≥73.0% and <73.0% groups, no statistical differences were observed in the 6-month PFS and ORR. In the pre-TV≥67.03 cm 3 group, the cases number of intracavitary brachytherapy (ICBT) and intracavitary / interstitial brachytherapy (IC/IS-BT) was 36 (50.0%), while in the pre-TV<67.03 cm 3 group, the cases number of ICBT and IC/IS-BT was 41 (76%) and 13 (24%), respectively ( P=0.003). In the post-TV≥14.88 cm3 group, the cases number of ICBT and IC/IS-BT was 28 (47%) and 32 (53%), while 49 (72%) and 17 (26%) in the post-TV<14.88 cm3 group, respectively ( P=0.002). The dose of HR-CTV D 90% in the TVRR≥73.0% group was significantly higher than that in the TVRR<73.0% group ( P=0.014), but there was no significant difference in the dose of bladder D 2 cm3, rectal D 2 cm3 and small intestine D 2 cm3 (all P>0.05). The dose of HR-CTV D 90% in the post-TV<14.88 cm 3 group was significantly higher than that in post-TV≥14.88 cm 3 group ( P<0.001), and the dose of bladder D 2 cm3 in the post-TV≥14.88 cm 3 group was higher than that in the post-TV<14.88 cm 3 group ( P<0.05). There was no significant difference in the dose of rectal D 2 cm3 and small intestinal D 2 cm3 between two groups (both P>0.05). The number of concurrent chemotherapy (≥4 times vs.<4 times) had no statistical difference for 6-month PFS and TVRR. Conclusions:Pre-TV and post-TV are the influencing factors of short-term efficacy and BT mode selection for locally advanced cervical cancer. Post-TV is an independent prognostic factor and also indirectly affects the dose of HR-CTV D 90% and bladder D 2 cm3 Increasing the number of concurrent chemotherapy (≥4 times) does not improve TVRR and short-term efficacy.

With social development and technology progress, there is an increasing use of daily electronic products and radioactive medical devices, which increases the risk of exposure to radiation in medical practices, daily life activities, and work. Notably, the effects of radiation exposure on pregnant women and their offspring have attracted increasing attention. Comprehensive and accurate assessment and intervention of the effects of radiation exposure on pregnant women and their offspring are of great significance to reduce birth defects and achieve eugenics. This article reviews the effects of radiation exposure during pregnancy on offspring health based on animal experiments and clinical studies, and describes the possible mechanisms, so as to provide the basis for further studies.

Objective:To analyze the expression of cell division cycle associated protein 5 (CDCA5) in pancreatic cancer tissues and its correlation with prognosis based on the bioinformatics.Methods:The RNA sequencing data (HTSeq-FPKM) and corresponding clinical information of 168 pancreatic cancer samples from January to December 2021 were downloaded from the Cancer Genome Atlas (TCGA) database, and the data of 179 pancreatic patients from January to December 2021 were downloaded from the GEPIA2 database, and 171 normal pancreatic tissues from TCGA and GTEx databases were simultaneously integrated. The relative expression level of CDCA5 mRNA in pancreatic cancer patients in GEPIA2 database and its relationship with overall survival (OS) and disease-free survival (DFS) were explored. Combined with the clinical data of the patients, univariate and multivariate Cox regression model analysis was used to analyze the factors influencing the OS of pancreatic cancer patients. Gene set enrichment analysis (GSEA) was performed to investigate the possibly involved signal pathways of CDCA5 in pancreatic cancer.Results:In the GEPIA2 database, the relative expression level of CDCA5 mRNA in pancreatic cancer tissues was higher than that in normal pancreatic tissues, and the difference was statistically significant ( P < 0.05). The pancreatic cancer patients were divided into the high CDCA5 mRNA expression group (89 cases) and the low CDCA5 mRNA expression group (89 cases) according to the median of relative expression level of CDCA5 mRNA (the case equal to the median value was not subgrouped). Survival analysis showed that patients with high CDCA5 mRNA expression had shorter OS ( P = 0.024) and DFS ( P = 0.025) compared with those with low CDCA5 mRNA expression. Multivariate Cox analysis showed that in TCGA database, N staging ( HR = 2.15, 95% CI 1.24-3.72, P = 0.006) and CDCA5 expression ( HR = 1.71, 95% CI 1.23-2.38, P = 0.001) were independent influencing factors of OS for pancreatic cancer patients. The results of GSEA enrichment analysis indicated that high CDCA5 mRNA expression was enriched in 13 biological pathways [all P < 0.05, false discovery rate (FDR) < 0.005] including cell cycle, DNA replication, homologous recombination, pyrimidine metabolism, mismatch repair, pentose phosphate pathway, glycolysis gluconeogenesis and p53. The expression of CDCA5 mRNA was positively correlated with the expressions of HK2, PKM, PGK1, ALDOA, EN01 and LDHA (all P < 0.05). Conclusions:CDCA5 is highly expressed in pancreatic cancer tissues and is associated with poor prognosis of patients, and it can be used as a prognostic marker for pancreatic cancer.

Objective:To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer.Methods:This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m 2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results:Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7–83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively ( P=0.455); disease free survival was 90.0% and 83.3%, respectively ( P=0.455); overall recurrence rate 6.6% and 10.0%, respectively ( P=0.625); and local recurrence rate both were 3.3% ( P=0.990), respectively. None of these differences was statistically significant. Conclusions:NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.

Objective:To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer.Methods:This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m 2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results:Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7–83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively ( P=0.455); disease free survival was 90.0% and 83.3%, respectively ( P=0.455); overall recurrence rate 6.6% and 10.0%, respectively ( P=0.625); and local recurrence rate both were 3.3% ( P=0.990), respectively. None of these differences was statistically significant. Conclusions:NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.

Objective:To investigate the current situation of perioperative nursing quality and nursing human resource allocation in 82 hospitals in Shanghai and analyze the correlation between them.Methods:The convenient sampling method was used to select surgical wards in 82 secondary and tertiary hospitals in Shanghai that underwent nursing quality supervision in September 2022 as the research objects. Perioperative nursing quality data (patients' condition, perioperative nursing routine and operation process, etc.) and nursing human resource allocation data (bed-to-nurse ratio, nurse-to-patient ratio, etc.) of inpatients in 82 hospitals were collected from the platform of Shanghai Nursing Quality Control Center. Pearson correlation analysis was used to investigate the correlation between perioperative nursing quality and nursing human resource allocation in inpatients.Results:The standard-reaching rate of perioperative nursing quality in 82 hospitals in Shanghai is 56.1% (46/82). The overall standard-reaching rate of perioperative nursing quality in secondary hospitals is 30.4% (7/23), which was lower than 66.1% (39/59) of tertiary hospitals, and the difference was statistically significant ( P<0.05). The total score of perioperative nursing quality in 82 hospitals was (79.67±1.89), among which the item with the lowest score was "perioperative complication predictive nursing", followed by "perioperative nursing routine and operation process" and "patient safety risk assessment". The bed-to-nurse ratio of surgical wards in 82 hospitals was 1∶ (0.47±0.21) and the nurse-to-patient ratio was 1∶ (12.20±6.44). The proportion of nurses with bachelor degree or above was (68±11) %, the proportion of nurses with intermediate title or above was (38±7) %, and the proportion of nurses with 5 years of work experience or above was (52±8) %. The total level of perioperative nursing quality was negatively correlated with the nurse-patient ratio ( r=-0.367, P<0.01), and positively correlated with the bed-to-nurse ratio, the proportion of nurses with bachelor's degree or above, the proportion of nurses with intermediate professional title or above, and the proportion of nurses with 5 years of work experience or above ( r=0.506, 0.631, 0.552, 0.636; P<0.01) . Conclusions:The overall level of perioperative nursing quality in 82 hospitals in Shanghai is average, and it is positively correlated with bed-to-nurse ratio and negatively correlated with nurse-to-patient ratio. Hospital managers should improve the scientific and refined level of perioperative nursing management, improve the perioperative nursing risk control mechanism, refine the perioperative nursing operation process, construct the risk forecasting, early-warning and pre-control mode of surgical complications and optimize the nursing human resource structure, so as to promote the high-quality development of perioperative nursing.