ObjectiveTo analyze the epidemiological characteristics of long COVID and to investigate its main influencing factors by examining individuals infected with SARS-CoV-2 between March and June 2022 in two communities in Shanghai, to lay the foundation for further research on the mechanism and clinical treatment of long COVID, and to provide the basis for the development of inexpensive, convenient, and feasible prevention and intervention strategies. MethodsA cross-sectional study was conducted, enrolling 6 410 individuals infected with SARS-CoV-2. Data were collected through a questionnaire survey. The incidence and common symptoms of long COVID were analyzed, along with their associations with demographic characteristics, medical history, and behavioral factors. A logistic regression model was used to identify the major factors associated with the development of long COVID symptoms. ResultsThe overall incidence rate of long COVID among the study population was 13.9%. The most commonly reported symptoms included fatigue (65.1%), attention disorders (23.1%), and cough (16.9%). The analysis showed that having underlying chronic diseases (OR=2.580, 95%CI: 2.165‒3.074), a history of allergies (OR=1.418, 95%CI: 1.003‒1.971), current smoking (OR=1.461, 95%CI: 1.013‒2.079), ever smoking (OR=2.462, 95%CI: 1.687‒3.551), a greater number of symptoms during the acute phase [1 symptom (OR=1.778, 95%CI: 1.459‒2.162), 2 symptoms (OR=2.749, 95%CI: 2.209‒3.409), ≥3 symptoms (OR=7.792, 95%CI: 6.333‒9.593)] and aggravated symptoms during the acute phase (OR=1.082, 95%CI: 1.070‒1.094) were factors associated with a higher risk of developing long COVID symptoms. Additionally, individuals who had consumed alcohol in the past year (OR=1.914, 95%CI: 1.344‒2.684) were more prone to objective long COVID symptoms. Among individuals under 50 years of age, females (OR=1.427, 95%CI: 1.052‒1.943) were more likely to develop objective long COVID symptoms. ConclusionThis study has identified the diversity of long COVID symptoms, which involve multiple organs and systems, including fatigue, attention disorders, cough, and joint pain. It has also revealed associations between long COVID and various demographic factors (e.g., age, gender), personal medical history (e.g., underlying chronic diseases, history of allergies), acute-phase characteristics (e.g., number and severity of symptoms), and behavioral factors (e.g., smoking, alcohol consumption). These findings highlight the need for further research and ongoing surveillance of long COVID and may inform the development of more targeted health management strategies for specific populations.

Objective: To investigate the characteristics of malignant tumor incidence and mortality in cancer registration areas of Zhejiang Province in 2021. Methods: Based on the 2021 cancer registration data from 22 national cancer registries in Zhejiang Province, the crude incidence, crude mortality, and cumulative rate for 0 to 74 years were calculated. Age standardized was performed using the age composition of the standard population from the Fifth National Population Census in 2000 and Segi's world standard population. The incidence and mortality characteristics of malignant tumor in different genders, urban/rural areas and ages were described. The order of crude incidence and mortality of malignant tumor were analyzed. Results: In 2021, there were 116 639 new malignant tumor cases in Zhejiang Province. The crude, Chinese population standardized, and world population-standardized incidences were 530.93/100 000, 304.83/100 000, and 288.20/100 000, respectively. The cumulative incidence for 0 to 74 years was 31.92%. There were 40 475 death cases. The crude, Chinese population-standardized, and world population-standardized mortalities were 184.24/100 000, 79.40/100 000, and 78.97/100 000, respectively. The cumulative mortality for 0 to 74 years was 8.37%. The Chinese population-standardized incidence for males and females were 286.34/100 000 and 323.45/100 000, respectively, and the Chinese population-standardized mortality were 106.25/100 000 and 54.17/100 000, respectively. The Chinese population-standardized incidence for urban and rural were 316.85/100 000 and 285.11/100 000, respectively, and the Chinese population-standardized mortality were 75.59/100 000 and 85.48/100 000, respectively. The crude incidence and crude mortality of malignant tumor both increased with age, peaking in the groups aged 80-<80 and ≥85 years at 1 845.06/100 000 and 1 656.88/100 000, respectively. The top ten malignant tumors with the highest crude incidence were, in descending order: lung cancer, thyroid cancer, breast cancer, prostate cancer, colorectal cancer, gastric cancer, liver cancer, cervical cancer, lymphoma, and brain tumors. These accounted for 80.34% of all new malignant tumor cases. The top ten malignant tumors with the highest crude mortality were, in descending order: lung cancer, liver cancer, colorectal cancer, gastric cancer, pancreatic cancer, prostate cancer, breast cancer, esophageal cancer, lymphoma, and gallbladder cancer. These accounted for 82.26% of all malignant tumor deaths. Conclusions In 2021, the cancer registration areas of Zhejiang Province were characterized by a relatively high malignant tumor incidence and a comparatively low mortality compared to national data. Males and the elderly emerged as key populations for targeted prevention and control. It is recommended to enhance screening, early diagnosis, and early treatment for lung cancer, thyroid cancer, prostate cancer, breast cancer, and gastric cancer malignancies.

OBJECTIVE: To evaluate the effect of palliative care on drug use, medical service utilization and medical expenditure of patients with advanced cancer. METHODS: A cohort of patients including pal-liative care and standard care was constructed using the medical records of the patients in Peking University Cancer Hospital from 2018 to 2020, and coarsened exact matching was used to match the two groups of patients. The average monthly opioid consumption, hospitalization rate, intensive care unit (ICU) rate and operation rate, and the average monthly total cost were selected to evaluate drug use, medical service utilization and medical expenditure. Chi-square test and Wilcoxon signed rank test were used to compare the differences between the two groups before and after exposure and the change in the palliative care group. The net impact of palliative care on the patients was calculated using the difference-in-differences analysis. RESULTS: In this study, 180 patients in the palliative care group and 3 101 patients in the stan-dard care group were finally included in the matching, and the matching effect of the two groups was good (L₁ < 0.1). Before and after exposure, the average monthly opioid consumption in the palliative care group was significantly higher than that in the standard care group (Before exposure: 0.3 DDD/person-month vs. 0.1 DDD/person-month, P < 0.01; After exposure: 0.7 DDD/person-month vs. 0.1 DDD/person-month, P < 0.01; DDD refers to defined daily dose), palliative care significantly increased the average monthly opioid consumption in the patients (0.3 DDD/person-month, P < 0.01). The hospitalization rate (48.9% vs. 74.3%, P < 0.01) and operation rate (3.9% vs. 8.8%, P < 0.01) of the patients in palliative care group were significantly lower than those in standard care group, and the ICU rate became similar between the two groups (1.1% vs. 1.6%, P=0.634). Palliative care significantly reduced the patients ' hospitalization rate (-25.6%, P < 0.01), ICU rate (-4.9%, P < 0.01) and operation rate (-14.5%, P < 0.01). Before and after exposure, the average monthly total costs of pal-liative care group were slightly higher than those of standard care group (Before exposure: 20 092.3 yuan vs. 19 132.8 yuan, P=0.725; After exposure: 9 719.8 yuan vs. 8 818.8 yuan, P=0.165). Palliative care increased the average monthly total cost by 2 208.8 yuan, but it was not statistically significant (P=0.316). CONCLUSION Palliative care can increase the opioid consumption in advanced cancer patients, reduce the rates of hospitalization, ICU and surgery, but has no significant effect on medical expenditure.
Humans ; Palliative Care/economics* ; Neoplasms/drug therapy* ; Analgesics, Opioid/economics* ; Male ; Female ; Middle Aged ; Aged ; Hospitalization/economics* ; Intensive Care Units/statistics & numerical data* ; Health Expenditures/statistics & numerical data* ; Adult ; Drug Utilization/statistics & numerical data* ; Patient Acceptance of Health Care/statistics & numerical data*

The pharmaceutical industry faces challenges in quality digitization for complex multi-stage processes, especially in small-sample systems. Here, an intelligent quality prediction and diagnostic (IQPD) framework was developed and applied to Tong Ren Tang's Niuhuang Qingxin Pills, utilizing four years of data collected from four production units, covering the entire process from raw materials to finished products. In this framework, a novel path-enhanced double ensemble quality prediction model (PeDGAT) is proposed, which combines a graph attention network and path information to encode inter-unit long-range and sequential dependencies. Additionally, the double ensemble strategy enhances model stability in small samples. Compared to global traditional models, PeDGAT achieves state-of-the-art results, with an average improvement of 13.18% and 87.67% in prediction accuracy and stability on three indicators. Additionally, a more in-depth diagnostic model leveraging grey correlation analysis and expert knowledge reduces reliance on large samples, offering a panoramic view of attribute relationships across units and improving process transparency. Finally, the IQPD framework integrates into a Human-Cyber-Physical system, enabling faster decision-making and real-time quality adjustments for Tong Ren Tang's Niuhuang Qingxin Pills, a product with annual sales exceeding 100 million CNY. This facilitates the transition from experience-driven to data-driven manufacturing.

ObjectiveTo analyze the epidemiological characteristics and influencing factors of SARS-CoV-2 reinfection by conducting follow-up investigations among community residents who experienced their first SARS-CoV-2 infection between March and June 2022, so as to provide a scientific basis for predicting future epidemic trends and adjusting prevention and control strategies. MethodsA cohort study was conducted in Xuhui District, Shanghai. A total of 1 208 individuals with a documented primary SARS-CoV-2 infection between March and June 2022 were enrolled and followed-up longitudinally. Data were collected using structured questionnaire surveys to assess the reinfection rate, incidence density, and clinical manifestations of SARS-CoV-2 reinfection. A logistic regression model was used to analyze the influencing factors of SARS-CoV-2 reinfection. ResultsA total of 497 SARS-CoV-2 reinfection cases were observed among the 1 208 research subjects, with a reinfection rate of 41.14% and an incidence density of 0.63 cases per 1 000 person-days. The cumulative reinfection rates at 6, 9, 12, 15, and 18 months following the initial infection were 0.08%, 15.31%, 19.04%, 33.53%, and 38.25%, respectively. Compared with the primary infection, reinfection was more likely to be symptomatic, with a greater severity of fever, dry cough, sore throat, and runny nose. Being female, younger age, and symptom duration ≥7 days during the primary infection were identified as influencing factors for SARS-CoV-2 reinfection, while a higher socioeconomic status can reduce the risk of SARS-CoV-2 reinfection. ConclusionSARS-CoV-2 reinfection is relatively common and often symptomatic. Age, gender, income level, and the duration of symptoms during the primary infection are identified as infuencing factors for SARS-CoV-2 reinfection. Continuous monitoring of reinfection in the population is recommended, along with the development of effective strategies to mitigate the impact of reinfection.

Objective To systematically evaluate the efficacy of different traditional Chinese medicine pulmonary rehabilitation interventions on pulmonary function and exercise tolerance in pa-tients with stable phase of.Methods Databases including CNKI,Wanfang,VIP,China Biology Medicine,PubMed,and the Cochrane Library were searched for randomized clinical trials(RCTs)related to chronic obstructive pulmonary disease from their inception to June 30,2023.Two research-ers independently conducted literature screening,data extraction,and bias risk assessment.Statistical analysis was performed using Stata 17.0 and R 4.4.1 software.Results A total of 239 RCTs involving 20,719 patients were included,encompassing 18 types of interventions,such as acupoint application,acupuncture,moxibustion,traditional Chinese medicine exercises,massage,cupping,etc.Network Meta-analysis revealed that compared with conventional treatment,traditional Chinese medicine ex-ercises,moxibustion,acupoint application,acupoint application plus auricular point pressing,acu-point application plus moxibustion,acupoint massage plus traditional Chinese medicine directed drug penetration,Chinese herbal footbath plus moxibustion,comprehensive traditional Chinese medicine rehabilitation,five-element music therapy,pulmonary rehabilitation training,and acupoint applica-tion plus acupoint injection significantly improved forced expiratory volume in the first second(FEV1).Traditional Chinese medicine exercises,moxibustion,acupoint application,acupoint ap-plication plus moxibustion,Chinese herbal medicine,Chinese herbal footbath plus moxibustion,comprehensive traditional Chinese medicine rehabilitation,five-element music therapy,and acu-puncture exhibited significant efficacy in reducing forced vital capacity(FVC).Traditional Chinese medicine exercise therapy,acupoint application therapy,acupoint application plus acupuncture ther-apy,acupoint application plus moxibustion therapy,and acupuncture therapy significantly enhanced exercise tolerance in patients(P＜0.05).The cumulative ranking plot demonstrated that Chinese herbal footbath plus moxibustion and acupoint application plus acupuncture were the most effective interventions for improving pulmonary function and enhancing exercise tolerance in patients with sta-ble phase of chronic obstructive pulmonary disease.Conclusion Traditional Chinese medicine pul-monary rehabilitation interventions are effective in treating patients with chronic obstructive pulmona-ry disease,with each intervention demonstrating distinct advantages.Chinese herbal footbath plus moxibustion and acupoint application plus acupuncture may represent the optimal strategies for im-proving pulmonary function indices and enhancing exercise tolerance in patients with stable phase of chronic obstructive pulmonary disease.

With the rapid acceleration of aging in China, there is a huge need for elderly patients to have improved quality of life in the terminal stage.Palliative sedation is an integral part of palliative care and can alleviate painful refractory symptoms, and its use in patients in various terminal illnesses is being explored across the world.Attention is focused on its indications and implementation.In China, palliative sedation in clinical practice is in an early exploratory stage and relevant criteria and guidelines have yet to be established.A review of the current practice and research progress concerning palliative sedation for patients' end-of-life care in China and the rest of the world will offer insight and strategic considerations in the initial pursuit and accelerated acceptance in the future in China.

Objective:To evaluate the role of O-sialoglycoprotein endopeptidase (OSGEP) in hepatic ischemia-reperfusion injury (HIRI) and the relationship with oxidative stress in mice.Methods:Experiment Ⅰ Twenty-four SPF healthy male C57BL/6 mice, 12 wild-type and 12 OSGEP knockdown, aged 6-8 weeks, weighing 18-22 g, were divided into 4 groups ( n=6 each) by the random number table method: wild-type shamoperation group (Sham group), wild-type HIRI group (HIRI group), OSGEP knockdown+ sham operation group (Sham+ KD group) and OSGEP knockdown+ HIRI group (HIRI+ KD group). Ischemia-reperfusion model was prepared by blocking the hepatic artery and portal vein for 60 min followed by reperfusion in anesthetized animals, the blood vessels were only exposed without occlusion in Sham group and Sham+ KD group, and the blood vessels were clamped for 60 min followed by reperfusion in HIRI group and HIRI+ KD group. The mice were sacrificed after 6-h reperfusion to extract liver tissue samples for microscopic examination of histopathological changes (with an optical microscope after HE staining) which were evaluated using Suzuki score and for determination of the serum concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), level of reactive oxygen species (ROS) (using the DCFH-DA fluorescent probe method), contents of malondialdehyde (MDA) and glutathione(GSH) in liver tissues (using a colorimetric method) and expression of OSGEP (using Western blot). Experiment Ⅱ The well-growing AML12 cells were divided into 4 groups ( n=30 each) using a random number table method: control group (C group), oxygen-glucose deprivation/restoration (OGD/R) group, OGD/R+ OSGEP knockdown group (OGD/R+ KD group), and OGD/R+ OSGEP knockdown negative control group (OGD/R+ NC group). Group C was cultured under normal conditions. Group OGD/R was subjected to O 2-glucose deprivation for 6 h followed by restoration of O 2-glucose supply for 24 h in OGD/R group. In OGD/R+ KD group, stable transfection of AML12 cells with OSGEP knockdown was performed prior to the experiment, and the other procedures were the same as those previously described. The cell survival rate was measured by the CCK-8 assay, the release of lactate dehydrogenase (LDH) was measured, the DCFH-DA method was used to detect the levels of ROS, and the contents of MDA and GSH were determined using a colorimetric method. Results:Experiment Ⅰ Compared with Sham group, the expression of OSGEP was significantly down-regulated, the serum concentrations of AST and ALT, Suzuki score, levels of ROS and content of MDA were increased, and the GSH content was decreased in HIRI group ( P<0.05), and no significant change was found in each parameter in Sham+ KD group ( P>0.05). Compared with HIRI group, the serum concentrations of AST and ALT, Suzuki score, levels of ROS and content of MDA were significantly increased, and the GSH content was decreased in HIRI+ KD group ( P<0.05). Experiment Ⅱ Compared with group C, the expression of OSGEP was significantly down-regulated, the cell survival rate and GSH content were decreased, and the release of LDH, levels of ROS and content of MDA were increased in group OGD/R ( P<0.05). Compared with OGD/R group, the cell survival rate and GSH content were significantly decreased, and the release of LDH, levels of ROS and content of MDA were increased in OGD/R+ KD group ( P<0.05), and no significant change was found in each parameter in OGD/R+ NC group ( P>0.05). Conclusions:OSGEP plays an endogenous protective role in HIRI by inhibiting oxidative stress in mice.

Objective To establish the methods of galvanic vestibular stimulation-vestibular evoked myogenic potentials(GVS-VEMPs)in healthy children and to obtain the normal value of GVS-cVEMP and GVS-oVEMP in these children in China.Methods Twenty(3～14 years)healthy children and 24 healthy adults(18～30 years)were enrolled for conventional examinations of GVS-cVEMP and GVS-oVEMP.Using the galvanic stimulation in-tensity under 3 mA/1 ms for children and 5 mA/1 ms for adults.The characteristics of elicitation and parameter re-sults of GVS-cVEMP and GVS-oVEMP in children and adults,as well as the pain scores and the elicitation of differ-ent stimulus intensities in the two age groups were recorded.Results The elicitation of GVS-cVEMP and GVS-oVEMP were both 100.0％in children and adult groups.The p1 latency,n1 latency and p1-n1 interval latency of GVS-cVEMP were 10.46±1.84 ms,16.98±2.12 ms and 6.52±1.42 ms respectively in children group,the n1 la-tency and p1-n1 interval latency were significantly shorter than the adult group(P＜0.05).The n1 latency,p1 la-tency and p1-n1 interval latency of GVS-oVEMP were 8.87±1.40 ms,12.25±1.80 ms and 3.39±1.07 ms re-spectively in children group with no significant difference between the two groups.The thresholds of GVS-cVEMP and GVS-oVEMP in children group were significantly lower than adult group(P＜0.01),but no differences were found in adult group regarding on the amplitude and interaural amplitude asymmetry ratio.In addition,with the in-crease of the intensity of galvanic stimulation,the correlation between pain scores and the elicitation rates of GVS-cVEMP and GVS-oVEMP also increased.Conclusion Using appropriate stimulus intensity and recording methods,GVS-cVEMP and GVS-oVEMP could be successfully assessed and detected in healthy children over 3 years old and adolescents.The latency of GVS-cVEMP in children is slightly shorter than that in adults,therefore we recommend selecting the matched age group for assessment in the children group.

Objective To systematically evaluate the measurement properties and methodological quality of the palliative quality assessment tools based on the cancer patient experiences,and to provide an evidence-based basis for the selection of a high-quality assessment tool for healthcare professionals.Methods Systematic search of PubMed,Embase,Web of Science,CINAHL,CNKI,Wanfang database,VIP database,and China Biomedical Literature database for studies related to the evaluation of the measurement properties of the self-report palliative care quality assessment tools for cancer patients.The search period from the date of creation to December 10,2023.There are 2 researchers who independently conducted literature screening and data extraction according to the COSMIN selection criteria,and used the COSMIN Risk of Bias Inventory and Quality Criteria Scale to measure the academic characteristics and form the final recommendations.Results A total of 19 studies involving 8 assessment tools for cancer patients were included.The final 6 assessment tools were recommended at level B.2 assessment tools are recommended at level A.Conclusion The SF-QCQ-PC and the Self-Report Palliative Care Quality Assessment Tool for Terminal Cancer Patients can be provisionally recommended.However,further validation of its measurement properties is still needed.