Background Previous studies found that high temperature and heatwave increase the risk of traffic injuries. The complex road conditions in Yunnan Province result in frequent traffic accidents. However, there is limited evidence on the correlation between heatwave and traffic injuries in Yunnan Province. Objective To assess the association between heatwave events and traffic injuries, to estimate its disease burden, and to identify relevant sensitive groups. Methods We collected data on traffic injury cases and concurrent meteorological information from four surveillance sites in Yunnan Province, China: Dali, Lufeng, Zhaoyang, and Qilin from May to September each year from 2015 to 2023. Traffic injury cases refer to patients who visited the outpatient or emergency departments of local surveillance hospitals for the first time due to traffic injuries. Meteorological data were derived from the fifth generation atmosphericreanalysis dataset of the global climate provided by the European Centre for Medium-Range Weather Forecasts. A time-stratified case-crossover design combined with distributed lag non-linear model was used to analyze the association between short-term exposure to heatwave and traffic injuries. We also conducted subgroup analyses by sex, age, occupation, injury cause, activity at the time of injury occurrence, and severity of injury. Results A total of 34764 traffic injury surveillance cases were included in the analysis. The risk of traffic injuries occurred during heatwave was 1.13 times (95%CI: 1.07, 1.20) greater than those occurred during non-heatwave, and 2.64% (95%CI: 1.49%, 3.73%) of traffic injuries were attributed to heatwave exposure throughout the study period. The results of stratified analysis showed greater impacts of heatwave on the risk of traffic injuries in female [odds ratio (OR)=1.17, attributable fraction (AF)=3.23%], people aged 15-64 years (OR=1.13, AF=2.68%), farmers/workers (OR=1.22, AF=4.07%), people with non-motor vehicle traffic injuries (OR=1.17, AF=3.24%), people who were driving or riding when injuries occurred (OR=1.12, AF=2.43%), and people with minor injuries (OR=1.18, AF=3.49%) ( P<0.05). Longer duration [excess risk (ER)=0.99%] and greater intensity (ER=4.12%) of heatwave had greater impacts on the risk of traffic injuries (P<0.05). Conclusion Heatwave events are associated with an increased risk of traffic injuries. Female, people aged 15-64, farmers/workers, people with non-motor vehicle traffic injuries, those injured while driving/riding a vehicle, and people with minor injuries are particularly vulnerable. The findings suggest that targeted mitigation and adaptation measures should be taken to address the risk of traffic injuries associated with extreme climate events.

Objective To investigate the clinical efficacy of platelet-rich plasma (PRP) therapy for interstitial cystitis/bladder pain syndrome (IC/BPS). Methods This single-center prospective study involved 97 IC/BPS patients treated in our hospital during Sep.2023 and Apr.2025, who underwent transurethral bladder injection of PRP. The injections were administered once a month for four sessions. The global response assessment (GRA) score,24-hour urinary frequency, maximum single voiding volume, visual analogue scale (VAS) score, O'Leary score, pelvic pain, urgency and frequency (PUF) score, and Zung self-rating anxiety scale (SAS) score were analyzed. Results All 97 patients completed four injections. The GRA score,24-hour urinary frequency, VAS score, O'Leary score and PUF score were improved significantly after treatment (P<0.007). Intraoperative bladder capacity with significant improvement were observed after the first injection (P<0.01), and the maximum urine output were observed after the fourth injection (P<0.007). The SAS score was not significantly improved. Conclusion Repeated PRP injections can effectively alleviate bladder pain, improve frequent and urgent urination symptoms, and increase the bladder capacity.

Objective To study the clinical efficacy of Xiaoqinglong decoction combined with the conventional protocol of western medicine in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)presenting with exterior cold and interior fluid retention syndrome,and to evaluate its effect on the short-term prognosis of patients.Methods A total of 124 AECOPD patients presenting exterior cold and interior fluid retention syndrome were divided into an observation group(62 cases)and a control group(62 cases)using a random number table.Patients in the control and observation groups were managed with conventional western medicine treatment protocols consisting of bronchodilators,glucocorticoids,and antibacterial drugs.In addition,patients in the observation group were also given Xiaoqinglong decoction at one dose per day for 10 days in succession.The primary outcome indicators included the total effective treatment rate and the main traditional Chinese medicine(TCM)syndrome scores before treatment and after 10 days of Xiaoqinglong decoction treatment.The secondary outcome indicators included infection and inflammatory indicators,including white blood cell count(WBC),procalcitonin(PCT),interleukin(IL)-6,C-reactive protein(CRP),and arterial blood gas indicators,including arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),and arterial oxygen saturation(SaO2),measured before treatment and after 10 days of treatment,adverse drug reactions during treatment,and the severity of dyspnea assessed by the modified Medical Research Council(mMRC)dyspnea scale at the 1-month follow-up after discharge.Results Compared with baseline findings for the same group before treatment,the main TCM syndrome scores and the total score were reduced in both groups after treatment(P<0.05).After treatment,compared with those of the control group,the syndrome scores for cough,aversion to cold,nasal congestion,and runny nose,and the total score in the observation group were lower(P<0.05).The total effective treatment rate in the observation group(94.91%)was significantly higher than that in the control group(82.76%)(P<0.05).After 10 days of treatment,the levels of PaCO2,WBC,PCT,IL-6,and CRP in both groups were significantly reduced compared with those before treatment(P<0.05).After treatment,the levels of PaCO2,WBC,PCT,IL-6,and CRP in the observation group were lower than those in the control group(P<0.05).Compared with those before treatment,PaO2 and SaO2 levels in both groups increased significantly after 10 days of treatment(P<0.05).During the course of treatment,no severe adverse reactions,such as liver or kidney dysfunction,occurred in either group.No adverse reactions associated with Xiaoqinglong decoction were observed.No patients in either group reached mMRC grade 4 at the 1-month follow-up after discharge.The mMRC grades in both groups declined at the 1-month follow-up after discharge compared to those before treatment(P<0.05).At the 1-month follow-up after discharge,the mMRC grades of patients in the observation group were lower than those of the control group(P<0.05).Conclusion Xiaoqinglong decoction combined with the conventional protocol of western medicine deminstrates good clinical efficacy in treating patients with AECOPD of exterior cold and interior fluid retention syndrome,and can effectively improve the TCM syndromes,relieve the symptoms of dyspnea,reduce the inflammatory response,promote the resolution of infection,delay disease progression,improve short-term prognosis,and shows better safety.

Objective:To explore the clinical and molecular basis for a Chinese pedigree affected with Complete androgen insensitivity syndrome (CAIS).Methods:A CAIS pedigree presented at Tianjin Medical University General Hospital between 2019 and 2021 was selected as the study subject. Clinical data of the proband was collected, along with peripheral blood samples from the proband and her family members. Chromosomal karyotyping, sex-determining region of the Y chromosome ( SRY) testing, and next-generation sequencing (NGS) were carried out for the proband, and candidate variant was verified by Sanger sequencing of her family members. Prenatal diagnosis was provided for the sister of the proband. This study was approved by Medical Ethics Committee of the Tianjin Medical University General Hospital (Ethics No. IRB2023-WZ-070). Results:The 18-year-old proband, who has a social gender of female, underwent laparoscopic examination, which showed no presence of uterus and ovaries. The karyotype of peripheral blood sample was 46, XY, with SRY gene detected. NGS indicated that the proband has harbored a heterozygous c. 1988C>G (p.Ser663Ter) variant of the AR gene. Sanger sequencing confirmed that her mother and sister had both harbored the same variant, whilst her father and younger sister were of the wild-type. Prenatal diagnosis revealed that her sister′s first fetus had harbored carried the same variant, which had led to termination of pregnancy. Her second fetus did not carry the variant, and a healthy boy was born. Based on guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as likely pathogenic (PM2_Supporting+ PM4+ PP3_Moderate+ PP4). Conclusion:The c. 1988C>G (p.Ser663Ter) variant of the AR gene probably underlay the CAIS in the proband. The accurate diagnosis of sex development disorders will rely on the physicians′ thorough understanding of the clinical symptoms and pathogenic genes. Genetic testing and counseling can enable precise diagnosis, prenatal diagnosis, and guidance for reproduction

Objective To investigate the protective effects and underlying mechanisms of sodium butyrate on rats exposed to hypoxia and cold conditions.Methods Fifty-eight male SD rats (aged 7～8 weeks,weighing 240～260 g ) were randomly divided into normoxia normothermia saline control (NNC ) group (n=10),normoxia normothermia sodium butyrate(NNB)group(n=10),hypoxia cold saline control (HCC) group (n=19),and hypoxia cold sodium butyrate (HCB)group (n=19).The intragastric dose of sodium butyrate was 200 mg/kg for the NNB and HCB groups,while the NNC and HCC groups were given normal saline of 5 mL/kg.①After continuous intragastric administration for 7 d,the rats in the HCC and HCB groups were placed in a low-pressure hypoxic chamber to simulate an altitude of 5000 m and exposed to a temperature of 8 ℃ for 7 d.Subsequently,blood samples were collected from the abdominal aorta for blood gas analysis,blood routine test,and detection for serum biochemical indicators.ELISA was used to determine serum inflammatory cytokines and endocrine hormones.The rats in the NNC and NNB groups(n=10)were fed outside the chamber and underwent the same tests in 7 d later to evaluate the protective effects of sodium butyrate on the body.②Core body temperature monitoring was conducted to assess the impact of sodium butyrate on the rmoregulation in rats exposed to hypoxia and cold(n=3).③Hypoxia exercise tolerance of the HCC group and HCB group in a hypoxic chamber (11％O2 )was evaluated for their hypoxia resistance (n=6).Results Compared to the NNC group,the rats in the HCC group exhibited significant decreases in arterial oxygen saturation (SaO2 )and arterial oxygen partial pressure (PaO2 ),serum levels of IL-4,estradiol (E2)and cortisol (F),core temperature,and exercise duration (P<0.05),and had notably increased levels of red blood cell (RBC)count,hemoglobin (HGB),hematocrit (HCT),cardiac troponin (CRDAC-T),uric acid (UA),alanine aminotransferase (ALT),total cholesterol (TC),low-density lipoprotein (LDL),IL-6 and granulocyte-macrophage colony-stimulating factor (GM-CSF)(P<0.05).Compared to the HCC group,the rats in the HCB group exhibited significant increases in SaO2,PaO2,IL-4,E2,F,corticotropin releasing hormone (CRH)and adrenocorticotropic hormone (ACTH)(P<0.05),remarkably longer exercise duration under hypoxic exposure (P<0.05 ),but decreases in RBC count,serum levels of HGB,HCT,CRDAC-T,UA,ALT,TC,LDL,IL-6,GM-CSF and free thyroxine (FT4 ),and core temperature (P<0.05).Conclusion Sodium butyrate exhibits protective effects on rats exposed to hypoxia and cold conditions,and it is helpful in their adaptation to these hypoxia and cold environments.

Objective:To explore the behavioral intentions of pediatric nurses towards using vascular visualization devices in light of the theory of planned behavior.Methods:This was a qualitative study. From March to November 2023, 20 pediatric nurses from Peking University First Hospital were selected using purposive sampling for semi-structured interviews. The interview data were analyzed and themes were extracted using Colaizzi 7-step analysis method.Results:The behavioral intentions of pediatric nurses towards the use of vascular visualization devices could be summarized into nine themes based on the theory of planned behavior. Attitudes towards behavior included positive evaluations, negative evaluations, and unclear information. Subjective norms involved peers' attitudes as well as expectations and pressures from patients. Perceived behavioral control encompassed workload, level of knowledge, more limited equipment performance, and external resource support.Conclusions:The behavioral intentions of pediatric nurses towards the use of vascular visualization devices are influenced by their attitudes towards the behavior, subjective norms, and perceived behavioral control. Nursing managers should conduct standardized training on vascular visualization devices to enhance nurses' knowledge and skills, while also valuing the sources of various supports to create a supportive environment for the use of vascular visualization devices. This will improve the usage experience of pediatric nurses and promote the use of vascular visualization devices in pediatric nursing practice.

Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO₂, NO₂, CO, PM_2.5, PM₁₀, and maximum 8 h O₃ concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM_2.5, NO₂, SO₂, and O₃ were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM_2.5, NO₂, SO₂ and O₃ were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.

Objective:To explore the establishment and application of ovarian cancer organoids.Methods:Fresh ovarian tumor tissues, obtaining from patients underwent surgery in the First Affiliated Hospital of Nanjing Medical University between October 2021 and March 2022, were collected, enzymatic degraded, digested, and embedded into matrigel to establish organoids. A total of 32 ovarian cancer samples were collected. Hematoxylin eosin (HE) staining and immunofluorescence (IF) procedure were used to verify the morphological structure of organoids and their expression of molecular markers. 3D cyto-live or dead assay was used to detecte the live or dead cells in organoids. Carboplatin with a concentration ranging from 5 to 80 μmol/L (5, 10, 20, 40, 80 μmol/L) was added to organoids to calculate the 50% inhibitory concentration (IC 50) in different organoids. Results:(1) Organoids from a total of 32 patients were established, of which 18 cases could be passaged stably in the long term in vitro, while 14 could be passaged in the short time. The average amplification time of long-term passage in vitro was over 3 months, and the longest reached 9 months. (2) In HE staining, significant nuclei atypia and local micropapillary structures were observed in organoids. IF staining revealed that ovarian cancer organoids expressed molecular markers similar to primary tumor tissues, such as Pan cytokeratin (Pan-CK), p53, paired box gene 8 (PAX8), and Wilms tumor gene 1 (WT1). (3) In 3D cyto-live or dead assay, a large number of apoptotic cells were observed inside and around the organoids after added carboplatin. The sensitivity to carboplatin varied in 18 organoids could amplify in the long term, with an average IC 50 of (29.5±15.8) μmol/L. Moreover, IC 50 values of 4 organoids derived from patients received neoadjuvant chemotherapy were much higher than the 14 organoids which did not received neoadjuvant chemotherapy [(48.7±11.3) μmol/L vs (24.0±12.1) μmol/L; t=3.429, P=0.022]. Conclusions:Organoids recapitulate ovarian cancers in vitro and could be stably passaged. Organoids derived from patients received neoadjuvant chemotherapy have higher resistance to carboplatin.

Objective:To investigate the clinical characteristics and correlation of sleep disturbances(SD)with cognitive impairment-associated cerebral small vascular disease(CSVD-CI)in elderly patients.Methods:In this cross-sectional study, 261 elderly CSVD-CI patients admitted to the Department of Neurology, Second Hospital of Tianjin Medical University between December 2019 and December 2021 were continuously enrolled.The Pittsburgh Sleep Index Scale(PSQI)was used to evaluate the overall sleep quality.Those with a PSQI score ≥7 was assigned to the CSVD-CI with sleep disturbances(CSVD-CI-SD)group, while those with a PSQI score <7 was assigned to the CSVD-CI without SD(CSVD-CI-NSD)group.The Montreal Cognitive Assessment(MoCA)was used to evaluate the cognitive function of patients with CSVD-CI, and scores on the overall cognitive function and various cognitive domains were compared between the CSVD-CI-SD group and the CSVD-CI-NSD group.Results:There were no significant differences between the CSVD-CI-SD group and the CSVD-CI-NSD group in sex ratio, age, education level and comorbidities( P>0.05). Compared with the CSVD-CI-NSD group, patients in the CSVD-CI-SD group took longer to fall asleep, had worse sleep efficiency, a shorter sleep duration, more obvious SD at night, worse sleep quality, more use of sleeping drugs, and more obvious daytime dysfunction(all P<0.05). Compared with the CSVD-CI-NSD group, the total MoCA score, attention score and orientation score in the CSVD-CI-SD group were significantly decreased( P<0.01). Correlation analysis results showed that the total MoCA score and attention in the CSVD-CI-SD group were negatively correlated with SD at night( r=-0.198, r=-0.115, P<0.05 for both), and orientation was negatively correlated with sleep quality( r=-0.170, P<0.05). Conclusions:The prevalence of SD is high in CSVD-CI patients, with CSVD-CI-SD patients showing more obvious overall cognitive, attention and orientation impairment in MoCA.Additionally, the total MoCA score and attention are negatively correlated with nighttime SD, and orientation is negatively correlated with sleep quality in CSVD-CI-SD patients.

Objective:To investigate the clinical application and surgical effect of minimal invasive liposuction system (MILS) in lumbar abdominal liposuction.Methods:From July 2019 to March 2021, 985 patients were selected for lumbar and abdominal liposuction. Local anesthesia and intravenous anesthesia were used in all operations. The preoperative design and intraoperative procedures were carried out according to the requirements of MILS method. An average of 2 425 ml fat was aspirated, and the average operation time was 142.4 min.Results:After 3-18 (average 3.85 months) months of follow-up, 857 patients (87% of the patients) were discharged on the day of operation. The waist line curve of the patients was clear and the bulge of the upper and lower abdomen was significantly reduced. The satisfactory rate was 93.5%, and the incidence of complications was 2.8%. No severe complication occurred.Conclusions:MILS is a safe and effective method to perform the waist and abdominal liposuction scientifically and finely. The MILS method makes the lumbar abdominal liposuction standardized, reduces unnecessary procedure, shortens the liposuction learning curve, reduces the occurrence of complications, and achieves the best aesthetic effect.