Objective To analyze the disease burden and trends of bladder cancer in China and globally from 1992 to 2021.  Methods Using the GBD 2021 database, the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rates of bladder cancer in China and globally from 1992–2021 were analyzed. Average annual percentage change (AAPC) was calculated using Joinpoint regression. Subgroup analyses by sex and age were conducted, and a Bayesian age-period-cohort (BAPC) model was used to predict trends in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for the next 15 years.  Results In 2021, China reported 106 000 new cases (ASIR: 5.14/100 000), 571 000 prevalent cases (age-standardized prevalence rate, ASPR: 26.61/100 000), 43 000 deaths (ASMR: 2.34/100 000), and a DALY rate of 45.31/100 000. From 1992–2021, China showed upward trends in ASIR and ASPR but declines in ASMR and DALYs, while global ASIR, ASMR, and DALYs decreased overall with slow ASPR growth. The peak cases in China and globally were both concentrated in the 65-79 age group, with a significantly higher burden on males than females. In China, smoking-related ASMR and ASDR exceeded global averages and rose, whereas high glucose-related indexes were lower and declined. Projections for 2021–2036 indicated that the global incidence and mortality rates would be rising, but ASIR/ASPR would be declining, while in China, the incidence rate would continue to rise, and the mortality rate will stabilize, with a significant increase in ASIR and a gradual decrease in ASPR.  Conclusion From 1992 to 2021, the incidence of bladder cancer in China has shown a continuous upward trend and is projected to persist in the future, with significant gender and age differences. Particular attention should be given to elderly males aged 85-89. The disease burden of bladder cancer attributable to smoking continues to rise, highlighting the urgent need to strengthen tobacco control policies.

ObjectiveTo investigate the differences in pregnancy outcomes between dichorionic diamniotic （DCDA） twin pregnancies conceived via assisted reproductive technology （ART） and those from spontaneous conception， in order to provide evidence for the perinatal management of ART-conceived DCDA twins. MethodsA retrospective analysis was conducted on the clinical data of 549 DCDA twin parturients. Based on the mode of conception， they were divided into ART group （423 cases） and spontaneous conception group （126 cases）. The baseline characteristics， pregnancy complications and neonatal outcomes were compared between the two groups. ResultsRegarding baseline characteristics， the ART group had higher maternal age， number of previous abortions， proportions of primiparas， proportions of advanced maternal age and greater 24-hour postpartum blood loss， but lower parity and proportion of scarred uterus compared to the spontaneous conception group （P<0.05）. For pregnancy complications， the ART group exhibited higher incidences of hypertensive disorders of pregnancy， placental adhesion， postpartum hemorrhage and a higher application rate of uterine artery ascending branch ligation （P<0.05）. There were no statistically significant differences in neonatal-related indicators between the two groups. After adjusting for confounding factors such as age， number of abortions and parities， ART remained an independent risk factor for hypertensive disorders of pregnancy， placental adhesion and postpartum hemorrhage （P<0.05）， while it did not increase the risk of adverse neonatal outcomes. Further subgroup analysis by gestational age showed that in the late preterm subgroup， the risk of ART-related pregnancy complications remained elevated （P<0.05）. Additionally， neonatal outcomes showed no significant difference between the two groups in both the late preterm and term subgroups. ConclusionART increases the risk of hypertensive disorders of pregnancy， placental adhesion and postpartum hemorrhage in DCDA twin parturients. Clinically， enhanced monitoring of blood pressure during pregnancy and blood loss during delivery and postpartum， along with targeted prevention and management of these complications， are crucial for improving pregnancy outcomes.

Objective To investigate the current status of work readiness and its influencing factors among patients returning to work after lung cancer surgery. Methods A retrospective study was conducted on young and middle-aged postoperative lung cancer patients who were treated at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to September 2023 and returned to their jobs. Data were collected through a general information questionnaire, readiness for return-to-work scale (RRTW), general self-efficacy scale (GSES), and simplified coping style questionnaire (SCSQ). Univariate and multivariate logistic regression analyses were used to explore the factors affecting the work readiness of patients returning to work. Results A total of 219 patients were included, with 59 males and 160 females aged 18-60 years. Among the postoperative lung cancer patients returning to work, 73.1% were in the active maintenance stage of return-to-work readiness with a RRTW score of (17.59±1.48) points, and 26.9% were in the uncertain maintenance stage with a RRTW score of (16.22±1.50) points. Multivariate logistic regression analysis showed that patients aged≤30 years (OR=52.381), employees of enterprises and institutions (OR=7.682), agricultural, pastoral, fishery, forestry laborers (OR=15.665), positive coping (OR=5.043), those with higher self-efficacy (OR=1.157) and engaged in physically demanding work (OR=2.449) had higher return-to-work readiness, while patients with≥2 children (OR=0.055), self-payment (OR=0.044), and those working more than 40 hours per week (OR=0.122) had lower return-to-work readiness. Conclusion The return-to-work readiness of young and middle-aged postoperative lung cancer patients needs to be improved, and occupation, job nature, main coping styles, general self-efficacy and other factors are associated with return-to-work readiness.

ObjectiveTo investigate the correlation between different female body mass index （BMI） values and key indicators of in vitro fertilization/intracytoplasmic sperm injection （IVF/ICSI） treatment cycles， as well as their impact on obstetric outcomes. MethodsA retrospective analysis was conducted on data from patients who underwent IVF/ICSI treatment， with 19 834 cycles included after propensity score matching to balance group differences. Based on the Chinese BMI classification standards with extended categories， patients were stratified into five groups： severely underweight （BMI<16）， underweight （16.0≤BMI<18.5）， normal weight （18.5≤BMI<24.0）， overweight （24.0≤BMI<28.0）， and obese （BMI≥28.0）. Baseline characteristics， ovarian stimulation protocols， treatment processes， and assisted reproductive outcomes were compared among the groups. Additionally， 75 delivered patients with complications were followed up to analyze the association between BMI and pregnancy-related complications. ResultsNo statistically significant differences were observed among the five groups in baseline parameters such as age， duration of infertility， or antral follicle count. Regarding ovarian stimulation protocols and processes， a statistically significant difference was found in the number of IVF oocytes retrieved （P<0.001）， with the normal-weight group showing a significantly higher number than both the overweight and obese groups. In terms of assisted reproductive outcomes， no significant differences were observed in biochemical pregnancy rates or birth defect rates. However， cumulative live birth rates differed significantly among the groups （P<0.05）， which was significantly higher in the overweight group than in the normal-weight group. Among the 75 followed-up patients， 25 were diagnosed with gestational hypertension， and 22 with gestational diabetes mellitus， of whom overweight and obese individuals accounted for 60.00% and 45.40% of the respective complications. ConclusionFemale BMI is significantly associated with IVF/ICSI outcomes. Pre-pregnancy body mass evaluation should be emphasized in patients with extremely low body weight. Although the live birth rate of overweight and obese patients was comparable to that of the normal-weight group， weight reduction prior to treatment is strongly recommended to minimize risks of miscarriage， preterm birth， and pregnancy complications.

Radiation enteritis(RE)is an inflammatory reaction caused by radiation exposure,commonly observed following radiotherapy for malignancies in the abdominal,pelvic and retroperitoneal regions.The authors believe that the pathogenesis of RE is complex,involving factors such as deficiency and excess,cold and heat,as well as qi and blood.The general pathogenesis can be summarized as"instability of the Zhongzhou,depletion of essence and blood,dysregulation of ascending and descending,and accumulation of heat-toxins".And"the instability of the Zhongzhou and subsequent malnutrition of the intestines"are the key drivers of disease progression.Based on theoretical exploration and clinical observations,this article proposed a comprehensive diagnostic and therapeutic approach centered on"stabilizing the Zhongzhou,replenishing essence and blood,regulating ascending and descending functions,and clearing heat-toxins".These four methods are often applied simultaneously,with"stabilizing the Zhongzhou and regulating the intestines"serving as the core of treatment.The approach is tailored according to the individual patient's condition of blood,qi and body fluids.A medical case was attached as evidence for verification.

Objective To investigate the current status of productive engagement of elderly patients undergoing unilateral total hip arthroplasty in postoperative rehabilitation period.Methods From May to Novermber 2024,242 elderly patients undergoing the first total hip arthroplasty from the joint surgery department of Nanjing Medical University Kangda College First Affiliated Hospital were selected as investigation subjects.They were investigated in postoperative rehabilitation period after receiving rehabilitation training for a week at getting out of bed for the first time after surgery by the Basic Information Questionnaire,Productive Engagement Scale,Improved Barthel Index Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,Fall Risk Perception Scale for Community-dwelling Older Adults,Tampa Rating Scale(17 Item Version),Perceived Social Support Scale and Social Isolation Scale for the Elderly.Results In the 230 valid questionnaires,the score of productive engagement of elderly patients undergoing unilateral total hip arthroplasty was(31.13±3.69)points in postoperative rehabilitation period.The Linear regression analysis showed that age,education level,place of residence,normal BMI,number of coexisting chronic diseases,time after surgery,ability of self-care,fall risk perception,Tampa,perceived social support and social isolation were all significant influencing factors for productive engagement of elderly patients undergoing unilateral total hip arthroplasty in postoperative rehabilitation period(P＜0.05).Conclusion The level of productive engagement of elderly patients undergoing unilateral total hip arthroplasty in postoperative rehabilitation period is relatively low.Their productive engagement were influenced by many factors.Clinical medical staff should develop intervention plans based on such influence factors to improve their level of productive participation.

Childhood primary renal tubular diseases are chronic kidney diseases characterized by impaired renal tubular reabsorption. Primary renal tubular disease has diverse clinical manifestations and lacks of specificity. Laboratory tests are limited，making it prone to missed diagnosis and misdiagnosis. Based on the current knowledge of renal tubular diseases，authors propose early warning signals of renal tubular diseases such as family history of primary tubular diseases，unexplained polyhydramnios during pregnancy，polydipsia，polyuria，delayed growth and development or rickets，decreased muscle strength and tone，unexplained electrolyte disturbance，hyperuricemia，acid-base disturbance，positive urine sugar test，renal tubular proteinuria，urinary imaging examination suggesting kidney stones，calcium deposition，renal cysts and early onset of eye，ear，joint and neuron injury.Meanwhile，some universal management strategies for primary renal tubular disease are proposed，emphasizing the importance of multidisciplinary collaboration，genetic testing and individualized intervention to improve the long-term prognosis of childhood primary renal tubular diseases.

Objective:To observe the effect of traditional Chinese medicine (TCM) hot ironing on limb function and balance ability in stroke patients with hemiplegia during the recovery period, and to provide more reference schemes for clinical rehabilitation of stroke patients with hemiplegia.Methods:A randomized controlled study was conducted. Stratified random sampling was used to select stroke patients with hemiplegia during the recovery period admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2023 to January 2024. The patients were divided into a control group and an observation group using the random envelope method. The control group received limb positioning techniques combined with conventional acupuncture intervention, while the observation group received additional TCM hot ironing intervention. Before and after the intervention, the Brunnstrom motor function grading, three-level assessment method, and Activities of Daily Living (ADL) scale were used to evaluate the patients′ limb function, balance function, and daily living ability.Results:Among the 66 patients included, with 33 patients in the control group, includinng 19 males and 14 females, aged (51.02 ± 8.34) years old, and 33 patients in the observation group, including 21 males and 12 females, aged (49.65 ± 8.21) years old. Before the intervention, there were no statistically significant differences in Brunnstrom upper limb motor function, Brunnstrom lower limb motor function, sitting balance, standing balance, and ADL scores between the two groups (all P>0.05). After the intervention, the observation group showed significant improvements in Brunnstrom upper limb motor function (0 cases at levelⅠ, 33 cases at levelⅡor above), Brunnstrom lower limb motor function (1 case at levelsⅠ-Ⅲ, 32 cases at level Ⅳ or above), sitting balance (0 cases at levelsⅠ-Ⅱ, 33 cases at level Ⅲ), and standing balance (1 case at levelsⅠ-Ⅱ, 32 cases at level Ⅲ). The control group showed less improvement in Brunnstrom upper limb motor function (10 cases at levelⅠ, 23 cases at level Ⅱor above), Brunnstrom lower limb motor function (14 cases at levelsⅠ-Ⅲ, 19 cases at level Ⅳ or above), sitting balance (9 cases at levelsⅠ-Ⅱ, 24 cases at level Ⅲ), and standing balance (11 cases at levelsⅠ-Ⅱ, 22 cases at level Ⅲ). The differences between the two groups were statistically significant ( Z values were 9.39-15.51, all P<0.05). The ADL score in the observation group was (80.25 ± 8.89) points, higher than the control group′s score of (69.97 ± 8.17) points, the difference was statistically significant ( t=4.89, P<0.05). Conclusions:TCM hot ironing can effectively improve limb dysfunction, motor function, balance ability, and walking mobility in stroke patients with hemiplegia during the recovery period, thereby enhancing their daily living ability.

Objective To explore the correlation between tongue features of type 2 diabetes patients with coronary heart disease and glycosylated hemoglobin,liver function,blood lipids,C-reactive protein,so as to provide reference for related research.Methods Using the TFDA-1 tongue imaging device to collect patients'tongue images,experts will interpret the tongue images and extract objective parameters of the tongue images through the intelligent auxiliary diagnosis system of traditional Chinese medicine tongue diagnosis;Record patient laboratory indicators and use SPSS statistical software to analyze the correlation between tongue image distribution characteristics,tongue image parameter characteristics,and laboratory indicators using Spearman method.Results 702 patients with type 2 diabetes and coronary heart disease were included.In terms of glycated hemoglobin indicators,bruising parameters are positively correlated with HbA1c,while tongue tip RGB values are negatively correlated with HbA1c.In terms of liver function indicators,tongue edge redness,tongue tip and tongue texture R value are positively correlated with ALT and AST;Red tongue tip,tooth marks on the tongue,etc.are positively correlated with ALT;Fat tongue is positively correlated with AST.In terms of blood lipid indicators,parameters such as tooth mark tongue and tooth mark are positively correlated with TG;The parameters of white coating and tongue coating area are positively correlated with LDL-C;Thin coating is positively correlated with HDL-C,while thick coating is negatively correlated with HDL-C;Red tongue is negatively correlated with TCHO.In terms of C-reactive protein,red tongue,tip red,and edge red are positively correlated with CRP;The GB value of tongue root and tongue substance is negatively correlated with CRP.Conclusion Type 2 diabetes patients with coronary heart disease have tongue picture distribution,tongue shape parameters,tongue color parameters,coating color parameters and HbA1c,ALT,AST,TCHO,TG,HDL-C,LDL-C,CRP indicators in varying degrees of correlation.The combination of patients'tongue picture and laboratory indicators is helpful to clarify the diagnosis and prognosis of type 2 diabetes with coronary heart disease.

Objective To analyze the current promotion status of professional titles of healthcare-associated infec-tion(HAI)management full-time professionals in medical institutions in Anhui Province.Methods A cross-sec-tional survey was designed.An electronic questionnaire survey was conducted among HAI management full-time professionals from all levels of medical institutions in 16 cities in Anhui Province by Anhui Province HAI Manage-ment Quality Control Center,and the data were analyzed.Results A total of 815 HAI management full-time pro-fessionals participated in the survey.78.16％of the professionals were with nursing background;25.89％had mas-ter's degree and higher;55.95％held an intermediate-level professional titles;49.45％engaged in HAI manage-ment for less than 5 years;most professionals with advanced title were from tertiary medical institutions.There were significant differences in the pursuing route of professional title promotion among HAI management full-time professionals with different professional backgrounds:91.94％of clinical medical professionals chose the medical promotion route;96.55％of nursing professionals chose the nursing promotion route;75.41％of public health pro-fessionals chose the medical promotion route;84.61％of laboratory professionals and 50.00％of pharmacy profe-ssionals chose the medical technician promotion route.43.31％of HAI management full-time professionals were generally satisfied with the current status of professional title promotion,only 5.65％being very satisfied.The main cause why HAI management full-time professionals were dissatisfied with professional title promotion was"current professional title promotion evaluation standards",accounting for 45.60％.There was a statistically signi-ficant difference in the evaluation on the difficulty in promoting to the next level of professional title among full-time professionals with different professional titles(P＜0.001).The higher the professional title,the more difficult it was to be promoted to the next level.48.22％of HAI management full-time professionals thought the difficulties in pro-moting their professional titles was due to"the lack of professional and technical titles in HAI management",fo-llowed by"low promotion rates"(10.43％)and"weak competitiveness in promotion based on their original posi-tions"(9.69％).Conclusion Professional title promotion route for HAI management full-time professionals in An-hui Province depends on their original professional fields,and promotion is generally difficult,especially to senior professional titles.It is urgent to establish an independent technical professional title series for HAI management as well as a matched evaluation and appointment mechanism to stabilize the talent team.