BACKGROUND:The causal relationship between modifiable factors such as lifestyle,metabolic characteristics,and nutritional intake and joint sports injuries has been increasingly recognized in clinical studies.However,the exact causal relationship between these modifiable factors and joint sports injuries remains unclear. OBJECTIVE:To investigate the causal relationship between modifiable factors and joint sports injuries using Mendelian randomization to provide a basis for sports injury prevention. METHODS:The GWAS dataset of intervening factors and joint sports injuries was obtained from publicly available data.The causal relationships between lifestyle,metabolic characteristics,nutritional intake,and joint sports injuries were explored using the inverse variance weighting method,the MR-Egger method,and the weighted median method.For sensitivity analyses,Cochran's Q test,MR-Egger regression,leave-one-out method,and MR-PRESSO were used to verify the stability and reliability of the results. RESULTS AND CONCLUSION:(1)In terms of lifestyle,coffee(OR=0.29,95%CI:0.10-0.79,P=0.016),and tea consumption(OR=0.41,95%CI=0.19-0.85,P=0.017)were associated with a decreased risk of ankle and foot joint sports injuries,and coffee consumption(OR=3.31,95%CI=1.02-10.73,P=0.046)was potentially causally associated with an increased risk of shoulder joint sports injuries;and never smoking(OR=0.78,95%CI=0.70-0.87,P=1.49×10-5)was significantly causally associated with a decreased risk of ankle and foot joint sports injuries.(2)In terms of metabolic characteristics,calcium levels(OR=0.88,95%CI=0.79-0.98,P=0.017)were potentially causally associated with a decreased risk of wrist and hand joint sports injuries.(3)In terms of nutritional intake,vitamin A intake(OR=1.08,95%CI:1.02-1.13,P=0.007)was potentially causally associated with increased risk of knee joint sports injury.(4)For the sensitivity analysis,Cochran's Q test showed the existence of heterogeneity(P<0.05),so the random effect model was used for the analysis.MR-Egger regression and MR-PRESSO test did not find evidence of pleiotropy(P>0.05),and the leave-one-out method showed that the results were stable after eliminating single nucleotide polymorphisms one by one.(5)This study preliminarily reveals the effects of modifiable factors,such as lifestyle,metabolic characteristics,and nutritional intake,on the risk of joint sports injuries.It provides valuable research evidence and guidance for the prevention of joint sports injuries.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Medical equipment, as an important indicator of smart hospital evaluation, plays a vital role in hospital operations. To ensure the safe and efficient operation of medical equipment, a reasonable performance evaluation system is indispensable. This study introduces a platform based on Internet of Things (IoT) technology that connects medical devices and collects data, achieving standardized and structured data processing, and supporting online operational supervision. Through the Delphi method, a performance evaluation system for large medical equipment is constructed, including 4 primary indicators and 22 secondary indicators. DICOM data acquisition devices are used to achieve functions such as efficiency analysis, benefit analysis, usage evaluation, and decision-making support for medical equipment. The study is still in its early stages, and in the future, it is expected to integrate more types of equipment, achieve rational resource allocation, and significantly impact decision-making for the development of public hospitals.
Internet of Things ; Delphi Technique

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective:To investigate the efficacy and safety of oral maintenance therapy with tegafur for residual lesions in patients with locally advanced esophageal squamous cell carcinoma (ESCC) after chemoradiotherapy.Methods:A retrospective cohort study was conducted. A total of 38 patients with locally advanced ESCC who had residual lesions after receiving albumin bound paclitaxel combined with platinum chemoradiotherapy from March 2019 to September 2021 in Jiangsu Province Suqian Hospital were selected. All patients were divided into the maintenance treatment group (20 cases) and the non-maintenance treatment group (18 cases) based on whether they received oral maintenance therapy with tegafur after chemoradiotherapy. The progression-free survival (PFS) of both groups was compared and the adverse reactions of the maintenance treatment group were analyzed.Results:There were no statistically significant differences in baseline data between the 2 groups (both P > 0.05). The 1, 2, 3-year PFS rates for the maintenance treatment group were 95.0%, 78.1%, and 58.3%, respectively, with a median PFS time of 33.65 months (95% CI: 29.04-38.26 months); the 1, 2, 3-year PFS rates in the non-maintenance treatment group were 88.9%, 54.5%, and 12.1%, respectively, with a median PFS time of 25.08 months (95% CI: 20.97-29.18 months); there was a statistically significant difference in PFS between the 2 groups ( χ2 = 5.36, P = 0.021). The common adverse reactions in the maintenance treatment group included hematological adverse reactions, hand foot syndrome, decreased appetite, and fatigue. The more common adverse reactions were neutropenia [85.0% (17/20)] and leukopenia [65.0% (13/20)]; 9 cases experienced grade 3-4 adverse reactions, which were relieved by adjusting the dosage or discontinuing the medication. Conclusions:Oral maintenance therapy with tegafur may improve the survival of ESCC patients with residual lesions after chemoradiotherapy and the adverse reactions are controllable.

Dendrobium is the largest genus of the Orchidaceae family.The fresh and dried stems of many species of this genus have been used as Shihu(Dendrobii Caulis)in traditional Chinese medicine,it is known as the foremost of the"Nine Great Herbs of China".Ancient texts highlight its uses for"strengthening yin,enhancing essence,nourishing the five viscera,alleviating fatigue,and dispelling skin heat and prickly heat".Modern research confirms that the polysaccharides and alkaloids it contains have antiviral ef-fects,it can apply in treating immunodeficiency caused by viral infections clinically.While studies are gradually uncovering the antivi-ral mechanisms and material basis of Dendrobium,the lack of systematic analysis and organization has hindered its resource develop-ment.The paper employed CiteSpace software for bibliometric analysis of Chinese and English literature on Dendrobium.It reviewed the herbalism,material basis,and mechanisms of its antiviral properties building upon the systematic review of ancient materia medica and modern literature.Results indicate that Dendrobium can boost vital energy and resist pathogens,showing great potential in antiviral drug development.

Objective:To establish daily quality assurance workflow based on self-developed phantom to ensure MR-linac performance such as beam accuracy, MR image guidance accuracy, and the clinical treatment workflow to enhance the efficiency of daily quality assurance (QA).Methods:The self-developed phantom was made by 3D printer and used in conjunction with Daily QA-MR detector array. After CT-sim scanning, a treatment plan was designed and transmitted to the accelerator, tests were performed such as image guidance accuracy, beam output and beam quality, the differences in daily QA results between the self-developed phantom and standard phantom recommended by the manufacturer were analyzed by using paired t-test. Results:A total of 24 sets results were collected, the image guide accuracy in the X, Y and Z directions between standard and self-made phantom were (0.1±0.4), (-0.14±0.16), (0.07±0.05) mm and (0±0.02), (-0.02±0.02), (0.02±0.01) mm, respectively, and the differences were statistically significant ( P<0.001, =0.001 and <0.001). Daily QA-MR detector array beam measurement results including output, symmetry, beam quality and field size were -0.11%±0.20%, -0.10%±0.19%, -0.01%±0.08%, (0.4±0.1) mm and (0.2±0.1) mm, respectively. The new process saved 25% (approximately 9 min) of the time compared to the standard process. Conclusions:The new daily QA process for MR-linac is performed based on self-developed phantom and Daily QA-MR detector array. The accuracy and sensitivity meet the requirements and can improve the QA efficiency.

Objective:To explore the molecular mechanism of miR-4508 regulating the inflammatory response of human bronchial epithelial cells induced by representative chrysotile asbestos.Methods:The chrysotile asbestos was ground into ultrafine dust using a horizontal planetary instrument, and human bronchial epithelium (16HBE) cells were taken as the object of infection. Cell survival rate was detected by cell counting kit-8 method, cytotoxicity was detected by lactate dehydrogenase (LDH) kit. The released of inflammatory factor IL-6 was detected by electrochemical luminescence. The released inflammatory factor IL-8 was detected by enzyme-linked immunosorbent assay. The expression level of miR-4508 was screened and verified by reverse transcription-quantitative real-time polymerase chain reaction. After 16HBE cells were treated with AKT inhibitor MK2206, the phosphorylation levels of AKT and PTEN were detected by western blot. The expression levels of AKT and PTEN and the contents of IL-6 and IL-8 were detected in miR-4508 overexpression and interference experiments.Results:With the increase of chrysotile asbestos exposure concentration, the cell survival rate decreased in a concentration-dependent manner, and the LDH content gradually increased. The secretion of IL-6 and IL-8 in chrysotile 25, 50 and 75 μg/ml groups were (325.92±8.61) pg/ml, (331.51±4.96) pg/ml, (378.74±13.77) pg/ml, and (94.95±3.11) pg/ml, (357.60±1.80) pg/ml, (537.19±3.11) pg/ml, respectively, while the group with 0 μg/ml chrysotile was (95.85±1.20) pg/ml and (7.81±0.00) pg/ml ( P＜0.05). In addition, chrysotile asbestos exposure to 16HBE could induce the high expression of miR-4508 . After pretreatment with MK2206, the phosphorylation levels of AKT and PTEN were decreased, the contents of IL-6 and IL-8 were significantly decreased, and the expression level of miR-4508 was significantly reduced. Overexpression of miR-4508 significantly increased the expressions of AKT and PTEN, and the contents of IL-6 and IL-8 ( P＜0.01). After interfering with miR-4508, the expressions of AKT and PTEN were significantly decreased, and the contents of IL-6 and IL-8 were significantly decreased ( P＜0.01). Conclusions:Chrysotile asbestos can induce the inflammatory response of 16HBE cells and up-regulate the expression level of miR-4508. The up-regulation of miR-4508 promotes the 16HBE inflammatory response induced by chrysotile asbestos through the PI3K/AKT pathway.

Lacrimal duct obstruction is a common condition in ophthalmology. Chronic dacryocystitis, resulting from a secondary infection, can significantly impact a person's health and quality of life and may easily lead to obstruction due to inflammation or trauma. The most common symptom of a blocked tear duct is excessive tearing. Over time, if the tear duct becomes infected with bacteria, chronic dacryocystitis can develop, leading to inflammation of the conjunctiva, eyelids, and face, which can severely affect a patient's daily life. Therefore, active research into the risk factors associated with lacrimal canal obstruction, as well as an understanding of their prevalence in the population, is essential. This knowledge will aid in further investigations into their pathogenesis and preventive measures, which are crucial for reducing incidence rates and improving treatment outcomes.

Carbon ion radiotherapy(CIRT)is an advanced radiotherapy method with unique physical and biological properties.It increases the dose to the tumor target area while providing better protection to normal tissues.CIRT can be used for hypoxic tumors resistant to photon radiotherapy.It also has the potential superiority of inducing immune responses and can produce the"abscopal effect"when com-bined with different immunotherapies.Radioimmunotherapy can not only ablate tumors at the irradiated site but also partially control dis-tant metastases at the unirradiated site.However,the underlying mechanism has not been fully elucidated.Due to the protection of the tu-mor microenvironment,tumors can sometimes be difficult to completely clear through CIRT-mediated anti-tumor immunity;this can also in-dicate functional limitations of some immune organs after CIRT.Therefore,this study reviewed the impact of CIRT on both innate and adapt-ive immune responses.It also examined the relationship between different radiation doses/fractions and immune protein expression,as well as compared the differences in imaging techniques between carbon ion radiotherapy and traditional radiotherapy.We have also proposed future directions to enhance the superiority of CIRT.This study aimed to provide a strong theoretical basis for improving the efficacy of CIRT and its combination therapy,ultimately benefiting more patients with cancer.