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.

Osteosarcoma is a highly aggressive bone tumor that primarily affects children and adolescents. It is characterized by high rates of recurrence and metastasis, with the tumor microenvironment playing a pivotal role in disease progression. Exosomes, small extracellular vesicles secreted by various cell types, exert dual roles in osteosarcoma. On one hand, exosomes derived from osteosarcoma cells remodel the microenvironment to facilitate tumor progression. For instance, they carry miR-501-3p to activate the PTEN/PI3K/Akt signaling pathway, promoting osteoclastogenesis and bone destruction; TGF-β1/3 stimulates bone marrow-derived mesenchymal stem cells (BMSCs) to secrete IL-6 and IL-8, enhancing the inflammatory microenvironment; and miR-25-3p suppresses DKK3, thereby promoting angiogenesis and invasion. Moreover, exosomes contribute to the formation of a pre-metastatic niche by transporting miR-21 and miR-675, which promote lung metastasis, activate cancer-associated fibroblasts, and enhance invasiveness via the linc00881/miR-29c-3p/MMP2 axis. Conversely, exosomes derived from mesenchymal stem cells deliver tumor-suppressive miRNAs such as miR-1913, miR-150, and miR-206, which target NRSN2, IGF2BP1, and TRA2B, thereby inhibiting tumor growth. In the context of drug resistance, osteosarcoma-derived exosomes transport MDR-1 mRNA and circRNA_103801, contributing to chemotherapy resistance. Additionally, TGF-β-induced IL-6 activates the STAT3 pathway, further enhancing resistance. In terms of immune modulation, these exosomes suppress T cell and NK cell activity and upregulate PDL1 expression, promoting immune evasion. Exosomes also hold therapeutic potential. They can serve as drug delivery vehicles, for example, carrying doxorubicin or kanamycin, to achieve targeted cytotoxicity via ferroptosis or apoptosis. Engineered exosomes enriched with miR-101 or MEG3 have been shown to inhibit metastasis, while plant-derived exosome-like nanoparticles activate the P38/JNK pathway to induce apoptosis. These approaches aim to improve therapeutic efficacy while minimizing adverse effects. In summary, exosomes play multifaceted roles in the pathogenesis of osteosarcoma and offer promising avenues for early diagnosis, prognostic assessment, and precision therapy, including pathway-targeted strategies. However, challenges remain in optimizing exosome isolation, standardizing large-scale production, and validating clinical applications. Addressing these issues is essential for translating laboratory findings into effective clinical treatments.

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.

Osteosarcoma is a highly aggressive bone tumor that primarily affects children and adolescents. It is characterized by high rates of recurrence and metastasis, with the tumor microenvironment playing a pivotal role in disease progression. Exosomes, small extracellular vesicles secreted by various cell types, exert dual roles in osteosarcoma. On one hand, exosomes derived from osteosarcoma cells remodel the microenvironment to facilitate tumor progression. For instance, they carry miR-501-3p to activate the PTEN/PI3K/Akt signaling pathway, promoting osteoclastogenesis and bone destruction; TGF-β1/3 stimulates bone marrow-derived mesenchymal stem cells (BMSCs) to secrete IL-6 and IL-8, enhancing the inflammatory microenvironment; and miR-25-3p suppresses DKK3, thereby promoting angiogenesis and invasion. Moreover, exosomes contribute to the formation of a pre-metastatic niche by transporting miR-21 and miR-675, which promote lung metastasis, activate cancer-associated fibroblasts, and enhance invasiveness via the linc00881/miR-29c-3p/MMP2 axis. Conversely, exosomes derived from mesenchymal stem cells deliver tumor-suppressive miRNAs such as miR-1913, miR-150, and miR-206, which target NRSN2, IGF2BP1, and TRA2B, thereby inhibiting tumor growth. In the context of drug resistance, osteosarcoma-derived exosomes transport MDR-1 mRNA and circRNA_103801, contributing to chemotherapy resistance. Additionally, TGF-β-induced IL-6 activates the STAT3 pathway, further enhancing resistance. In terms of immune modulation, these exosomes suppress T cell and NK cell activity and upregulate PDL1 expression, promoting immune evasion. Exosomes also hold therapeutic potential. They can serve as drug delivery vehicles, for example, carrying doxorubicin or kanamycin, to achieve targeted cytotoxicity via ferroptosis or apoptosis. Engineered exosomes enriched with miR-101 or MEG3 have been shown to inhibit metastasis, while plant-derived exosome-like nanoparticles activate the P38/JNK pathway to induce apoptosis. These approaches aim to improve therapeutic efficacy while minimizing adverse effects. In summary, exosomes play multifaceted roles in the pathogenesis of osteosarcoma and offer promising avenues for early diagnosis, prognostic assessment, and precision therapy, including pathway-targeted strategies. However, challenges remain in optimizing exosome isolation, standardizing large-scale production, and validating clinical applications. Addressing these issues is essential for translating laboratory findings into effective clinical treatments.

Objective To evaluate the characteristics of dose distribution of neuronal networks in vitro on microelectrode arrays(MEAs)under 2.6 GHz radiofrequency(RF)exposure.Methods The MEAs were coupled with a real-time RF exposure setup,and electromagnetic simulation software was used to calculate the RF dose absorbed in cultured neuronal networks.A fiber-optic temperature probe was used for experimental validation and monitoring of the cell temperature during RF exposure.The MEAs were used to record the electrical activity of neurons.Results For an input power of 1 W,a specific absorption rate(SAR)level of(15.51±2.48)W/kg was calculated,and the variability of the SAR distribution was 16%.In our experimental system,the temperature elevation of neurons was up to 0.15℃for an SAR of 4 W/kg RF exposure.Conclusion The exposure device can provide high SAR efficiency and uniformity in the 2.6 GHz band,which is suitable for studying the real-time effects of RF fields on the electrical activity of neuronal networks in the 5G network band.

OBJECTIVETo investigate the impact of depression and anxiety assessment performed in gastrointestinal cancer patients on postoperative depression and anxiety symptom and mental health service visit.

METHODSA total of 254 gastrointestinal cancer patients who underwent surgical procedure were assigned into assessment group (n=121) and control group (n=133). Depression and anxiety assessment were performed with PHQ-9 and GAD-7 in assessment group on admission, discharge and at 3-month follow-up while in control group only at 3-month follow-up. The point prevalence of depression and anxiety were evaluated in assessment group with established cut-off reported by ASCO defining depression as a PHQ-9 score no less than 8 and anxiety as a GAD-7 score no less than 5. PHQ-9 and GAD-7 scores at 3-month follow-up were compared using Mann-Whitney U test.

RESULTSAccording to the PHQ-9 and GAD-7 score, the prevalence of depression was 28.9%(35/121) and anxiety was 37.2%(45/121) in assessment group, and depression was found in 9.9%(12/121) with comorbid anxiety. During the 3-month follow-up, the PHQ-9 and GAD-7 score in assessment group (6.02±4.67 and 4.19±3.95) were both lower than those in control group (8.83±6.63 and 6.41±5.80) with statistically significant differences (all P<0.05). Patients in assessment group were more likely to seek for help in mental health service than those in control group [10.7%(13/121) vs. 3.0%(4/133), χ(2)=9.726, P=0.014] in 3-month follow-up after surgery.

CONCLUSIONSThe prevalence of depression and anxiety is high in gastrointestinal cancer patients. Depression and anxiety assessment routinely performed for gastrointestinal cancer patients can enhance utilization of mental health service and reduce postoperative depression and anxiety symptom thus potentially improve quality of life.

Anxiety ; diagnosis ; Depression ; diagnosis ; Gastrointestinal Neoplasms ; psychology ; surgery ; Humans ; Mental Health Services ; Postoperative Period ; Quality of Life ; Surveys and Questionnaires

OBJECTIVETo compare the efficacy difference between acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages.

METHODSThe randomized controlled prospective study method was adopted. Sixty cases of avascular necrosis of femoral head at Ficat-ArletⅠto Ⅱ stages were randomized into an acupotomy group (32 cases) and an acupuncture group (28 cases) by the third part. In the acupotomy group, the acupotomy was adopted for the loose solution at the treatment sites of hip joint, once every two weeks, totally for 3 times. In the acupuncture group,points around the hip joint were selected and stimulated with warm acupuncture therapy, once every day, for 6 weeks. Harris hip score was observed before and after treatment. The efficacy was evaluated in the two groups.

RESULTSHarris hip score was improved significantly after treatment in the two groups (both<0.05). The result in acupotomy group was better than that in the acupuncture group (<0.05). The effective rate was 90.6% (29/32) in the acupotomy group, better than 75.0% (21/28) in the acupuncture group after treatment (<0.05).

CONCLUSIONSHarris hip score and the effective rate in the acupotomy group are better than those in the treatment with routine acupuncture for avascular necrosis of femoral head at the early and middle stages.

Objective To determine the viability of Schistosoma japonicum cercariae by staining. Methods Schistosoma japonicum cercariae were stained by 0.4%trypan blue 0.5%methylene blue?eosin?borax M.E.B 0.5%eosin 0.5%methy?lene blue and 0.05% neutral red respectively for 5 min then they were observed under a stereoscopic microscope. Results The dead cercariae were stained in the trypan blue M.E.B eosin and neutral red but unstained in the methylene blue. The vi?tal cercariae were unstained in all the five kinds of dyes. Conclusion The staining methods by using 0.4% trypan blue 0.5%M.E.B 0.5%eosin and 0.05%neutral red can be used to determine the viability of S. japonicum cercariae.

Objective To investigate the role of phosphatidylinositol 3-kinase (PI3K)/protein-serine-threonine kinases(Akt) signal transduction pathway in EphB receptor-mediated neuropathic pain in rats.Methods Forty-eight pathogen-free male SD rats aged 2-3 months weighing 150-180 g were randomly divided into 6 groups (n =8 each):groups sham operation (groups S1 and S2 ); groups chronic constrictive injury (CCI) (groups C1and C2 ) and groups EphBI-Fc (EphB receptor antagonist) + CCI (groups E1 and E2 ).Neuropathic pain was induced by placing 4 ligatures on left sciatic nerve at 1 mm intervals with 5-0 silk thread in groups C1,C2,E1 and E2.EphBI-Fc 0.5 μg in 5 μl normal saline was injected intrathecally 1 h before operation and at 1 and 2 d after operation (group E1 ) or on 5th day after operation (group E2).Normal saline 5 μl was injected intrathecally instead of EphBI-Fc 1 h before operation and at 1 and 2 days after operation (groups S1 and C1 ) or on 5th day after operation (groups S2 and C2 ).Pain withdrawal latency to noxious thermal stimulation (PWL) and pain withdrawal threshold to noxious mechanical stimulation (PWT) were measured before operation and at 1,3 and 5 d after operation.The animals were sacrificed at 5 d after operation after measurement of pain threshold.The lumbar segment of spinal cord (L4-6) was removed for determination of c-Fos,PI3K and phosphorylated Akt(p-Akt) expression.Results CCI significantly reduced PWL and PWT and up-regulated spinal c-Fos,PI3K and p-Akt expression in groups C1 and C2 as compared with groups S1 and S2.EphB1-Fc significantly decreased hyperalgesia and the upregulated spinal Fos,PI3K and p-Akt protein expression induced by CCI in groups E1 and E2 as compared with groups C1 and C2.Conclusion Spinal EphB receptor is involved in the development and maintenance of neuropathic pain through PI3K/Akt signal transduction pathway.

Objective To investigate the expression of nuclear factor-κB (NF-κB) and p53 up-regulated modulator of apoptosis (PUMA) in acute lung injury (ALI) induced by severe acute pancreatitis (SAP), and the therapeutic role of proline dithiocarbamate (PDTC). Method SD rats weighed 200～ 250 g were randomly(random number) divided into sham operation group (A group, n = 18), ALI group (B group, n = 18) and PDTC treatment group (C group, n = 18). The model of SAP was eastablished by injecting 1 mL/kg of sodium tauarocholate into the pancreatic capsule of the rats in B group and C group. The model rats in C group were treated with PDTC one hour after modeling. Six rats of each group were sacrificed 6 h,12 h, and 24 hours after modeling. The histopathological changes in lung and pancreas were observed. The levels of NF-κB p65 and PUMA in lung were detected by using Western blotting, and the expressions of bcl-2, bax and caspase-3 mRNA in the lung were detected by using RT-PCR. The lung tissue was taken for examination under transmission electron microscope. TUNEL was used for detection of apoptotic alveolar epithelial cells. Results Six to 24 hours after modeling, the pathological scores in lung of ALI group were significantly higher than those of control group and PDTC group after sodium taurocholate injection ( P ＜ 0.05). The levels of NF-κB p65 and PUMA, and the expressions of bax and caspase3 mRNA in ALI group at different intervals were higher than those in control group and PDTC group ( P ＜ 0.05),whereas the expression of bcl-2 mRNA in ALI group was lower than that in control group and PDTC group ( P ＜0.05). The NF-κB p65 was correlated closely and positively with PUMA ( r= 0.987, P ＜ 0.01). Higher activity of caspase-3 acrtive units was seen in ALI group than that in control group and PDTC group ( P ＜ 0.05). The microvilli disappeared in ALI group 24 hours later. The apoptosis index in ALI group was higher than that in control group and PDTC group ( P ＜ 0.05). Conclusions The apoptosis of alveolar epithelial cells of rats in ALI group is caused by PUMA activated by NF-κB. PDTC treatment can inhibit apoptosis of alveolar epithelial cells of rats in ALI group by inhibiting the activation of NF-κB.