ObjectiveTo investigate the association of particulate matter and ozone with the prevalence of non-alcoholic fatty liver disease (NAFLD) in a district of Shanghai, and to provide epidemiological evidence for the further identification of early health hazards of air pollution and for the prevention and control of NAFLD. MethodsBased on Songjiang Sub-cohort of Shanghai Natural Population Cohort, a cross-sectional survey design was used to recruit participants from 2016 to 2017. Annual average exposure levels to air pollution from 2009 to 2017 were matched to the participant’s residential address using a high-resolution and high-quality ambient air pollutants dataset in China. NAFLD was diagnosed according to the “Guidelines for the prevention and treatment of metabolism⁃associated (non⁃alcoholic) fatty liver disease” by the Chinese Medical Association. Multivariate logistic regression models were employed to analyze the association between air pollution and the prevalence of NAFLD, and stratified analyses were used to compare differences by age, gender, obesity, and lifestyle habits within subgroups. ResultsA total of 32 791 individuals were included in the study. The prevalence of NAFLD among community residents in suburban Shanghai was 38.88%. For every 1 μg·m^-3 increase in PM₁, PM_2.5, PM₁₀, or O₃, the risk of NAFLD increased correspongdinglt, with the odds ratios (95%CI) of 1.071 (1.043‒1.099), 1.065 (1.042‒1.089), 1.041 (1.027‒1.055), or 1.061 (1.032‒1.091), respectively. There were differences in effects across different gender, age, and obesity status subgroups. ConclusionPM₁, PM_2.5, PM₁₀, and O₃ are positively associated with an increased risk of NAFLD. Stratified analyses reveal that individuals aged 65 years old or above exhibited greater susceptibility to PM₁, PM_2.5, and O₃, whereas those aged less than 65 years old are more vulnerable to PM₁₀. Males are more sensitive to PM₁ and O₃, and females are more susceptible to PM_2.5 and PM₁₀. The association between air pollutant exposure and NAFLD risk is more pronounced among obese participants compared to that in non-obese counterparts.

This article reviews the benifits and challenges of nano-microspheres (NPs) in the treatment of osteoarthritis (OA). OA is a degenerative disease associated with aging, trauma, and excessive loading, with treatment strategies including basic therapy, drug therapy, reparative therapy, and reconstructive surgery. As emerging nanomaterials, NPs offer unique advantages in promoting cartilage repair due to their high surface area, excellent drug-loading capacity, and good biocompatibility. These advantages include facilitating chondrocyte generation through magnetic-mechanical control of mesenchymal stem cell microspheres and enhancing antioxidant levels using biomimetic liposomal NPs combined with glucosamine. Additionally, NPs can effectively modulate inflammatory responses, such as by inhibiting the formation of M1 macrophages and promoting their polarization to the M2 type to alleviate inflammation. Some NPs also enhance joint lubrication and relieve pain, such as hyaluronic acid-based NPs modified with choline phosphate groups. However, the application of NPs faces challenges such as high production costs, poor biocompatibility for certain types, and unknown long-term safety. Despite these challenges, with advancements in nanotechnology and a deeper understanding of the pathological mechanisms of OA, NPs are expected to provide new therapeutic approaches and more comprehensive and effective treatment options for OA patients in the future.

ObjectiveTo explore the establishment of performance assessment indicators for the classification and grading of public health staff in district-level Centers for Disease Control and Prevention (CDCs), and to provide a basis for such evaluations. MethodsThrough literature review and group interviews, performance evaluation indicators were developed based on competency evaluation. Experts were invited to evaluate the weight of performance evaluation indicators for public health staff from different categories, with the average value used to represent the weight of each indicator. ResultsTwenty-nine experts from universities in Shanghai, municipal CDCs, and district CDCs participated, yielding an expert authority coefficient of 0.86. The performance evaluation indicators for department managers were categorized into three levels, with 4 indicators at the primary level, 16 indicators at the secondary level, and 42 indicators at the tertiary level, while those for general staff included 4 primary indicators, 15 secondary indicators, and 36 tertiary indicators. Significant differences were observed in the weight coefficients of the primary indicators (internal operations, professional work, and learning and growth) between department managers and general staff. The top three secondary indicators for department managers were department management, monitoring and prevention, and level of expertise. For mid-level and senior staff, the top three secondary indicators were monitoring and prevention, level of expertise, and research work. The top three secondary indicators for junior staff were monitoring and prevention, professional expertise, and professional attitude. No significant statistical differences were found among tertiary indicators. ConclusionThe developed performance evaluation indicators are reliable. Staff at different levels and classifications should be evaluated using different performance evaluation standards to accurately reflect individual performance and contributions.

Lower extremity arteriosclerosis obliterans(LEASO) is a disease in which systemic atherosclerosis affects the blood-supplying arteries of the lower extremities, resulting in chronic ischemia of the lower extremities. Angiopoietin-like protein 2(Angptl2) is a newly discovered pro-inflammatory protein that promotes the development of atherosclerosis by inducing vascular inflammatory responses. It is closely associated with certain risk factors for LEASO, such as advanced age, obesity, and type 2 diabetes. In addition, the high expression of Angptl2 in LEASO correlates with the continued progression of LEASO and may reflect the severity of the disease, suggesting that Angptl2 may be an important serologic biomarker for LEASO. In this article, we review the progress of research on the correlation between Angptl2 and LEASO, and analyze the value of Angptl2 as a biomarker for LEASO.

This article reviews the benifits and challenges of nano-microspheres (NPs) in the treatment of osteoarthritis (OA). OA is a degenerative disease associated with aging, trauma, and excessive loading, with treatment strategies including basic therapy, drug therapy, reparative therapy, and reconstructive surgery. As emerging nanomaterials, NPs offer unique advantages in promoting cartilage repair due to their high surface area, excellent drug-loading capacity, and good biocompatibility. These advantages include facilitating chondrocyte generation through magnetic-mechanical control of mesenchymal stem cell microspheres and enhancing antioxidant levels using biomimetic liposomal NPs combined with glucosamine. Additionally, NPs can effectively modulate inflammatory responses, such as by inhibiting the formation of M1 macrophages and promoting their polarization to the M2 type to alleviate inflammation. Some NPs also enhance joint lubrication and relieve pain, such as hyaluronic acid-based NPs modified with choline phosphate groups. However, the application of NPs faces challenges such as high production costs, poor biocompatibility for certain types, and unknown long-term safety. Despite these challenges, with advancements in nanotechnology and a deeper understanding of the pathological mechanisms of OA, NPs are expected to provide new therapeutic approaches and more comprehensive and effective treatment options for OA patients in the future.

OBJECTIVE To investigate the variations in taste， aroma and volatile organic compounds of Rhei Radix et Rhizoma decoction pieces derived from different sources， and to identify their origins. METHODS The flavor， odor and volatile organic compounds of Rhei Radix et Rhizoma decoction pieces from different sources were compared and analyzed by using electronic tongue， electronic nose， and gas chromatography-ion mobility spectrometry （GC-IMS）. Principal component analysis （PCA）， partial least squares-discriminant analysis （PLS-DA）， orthogonal partial least squares discriminant analysis （OPLS-DA） and Fisher discriminant analysis were employed to identify the origins of Rhei Radix et Rhizoma decoction pieces and establish the basis discrimination criteria. RESULTS The differences in taste of Rhei Radix et Rhizoma decoction pieces from 3 origins were primarily characterized by bitterness， astringency， and bitter-astringent aftertaste. In terms of smell， variations were mainly observed in inorganic sulfides， organic sulfides containing aromatic components， methane and other short-chain alkanes， alcohols， ethers， aldehydes and ketones， as well as nitrogen oxides. Differentially volatile organic compounds mainly consisted of alcohols， aldehydes and ketones. Furthermore， the samples from 8 batches could be effectively classified into 3 categories.Three types of Rhei Radix et Rhizoma decoction pieces can be effectivily identified based on the peak intensity ratio between volatile substances. For example， when the peak intensity of 2-acetylfuran was 3-19 times that of isobutyric acid [dimer]， it was considered as Rheum officinale Baill. CONCLUSIONS The discriminant models established in this study， along with the criteria for determining the origins based on the peak intensity ofcharacteristic volatile compounds， can be utilized for the identification of Rhei Radix et Rhizoma decoction pieces.

Objective:To analyze the bubble dynamic characteristics of shock wave enhanced emission photoacoustic streaming(SWEEPS)technique in free water region under different temporay delays.Methods:The Er∶YAG laser tip was activated in free water model with SWEEPS mode at 150-600 μs pulse delay.The bubble dynamic process during irrigation was recorded by a high-speed camera(200 000 Hz).Matlab was used to analyze the interaction between bubble made by the dual pulses frame by frame.The distance between bubble remnants and laser tip was measured before the bubble disappeared.The experimental data were statisti-cally analyzed by SPSS 19.0.Results:In free water region,different temporal delays caused different interaction between the bub-bles activated by the SWEEPS technique with a dual pulse modality.The interactions include bubble fusion,bubble collision and bubble separation.When the temporal delay between 360-440 μs,bubble collision was the most violent,and the farthest distance between bubble remnants and laser tip was reached.Conclusion:In free water region,the dual pulse of SWEEPS technique can lead to bubble interaction which may enhance the cavitation effect of Er∶YAG laser irrigation,and improve the debridement in clinic ap-plication.

Objective:To explore the distribution characteristics and antibiotic resistance of pathogen in children with hematological disorders and cancers complicated with sepsis in pediatric intensive care unit (PICU).Methods:The clinical data of children with hematological disorders and cancers complicated with sepsis hospitalized at Shenzhen Children′s Hospital affiliated to China Medical University from January 2016 to August 2023 were retrospectively analyzed. Patients were divided into survival group and death group based on the outcome of sepsis on 28 days after diagnosis.Results:A total of 202 sepsis episodes occurred in 176 children were enrolled in this study. Among all, 144 (71.3%) cases of bloodstream infection, 59 (29.2%) cases of pulmonary infection, 21 (10.4%) cases of abdominal infection, 9 (4.5%) cases of soft tissue infection, 9 (4.5%) cases of nervous system infection, and 3 (1.5%) cases of urinary tract infection. A total of 244 pathogenic strains were identified, in which 74 (30.3%) cases were gram-positive bacteria. The top 3 pathogens isolated were Coagulase negative Staphylococcus (21 strains), Staphylococcus aureus (19 strains) and Streptococcus pneumoniae (13 strains). Gram-negative bacteria accounted for 122 (50.0%) strains, in which top 3 were Klebsiella pneumonia (33 strains), Escherichia coli (25 strains), and Pseudomonas aeruginosa (23 strains). Fungi comprised 48 (19.7%) strains:the top 3 were Candida tropicalis (14 strains), Candida albicans (10 strains), Aspergillus and Pneumocystis jirovecii (7 strains each). The incidence of Acinetobacter baumannii, Stenotrophomonas maltophilia, and Pseudomonas aeruginosa were significantly higher in death group compared to survival group[9.0%（6/67）vs. 2.3%（4/177）, χ2＝3.971 ，P＝0.046; 9.0%（6/67）vs. 1.1%（2/177）, χ2＝7.080 ，P＝0.008;16.4%（11/67）vs. 6.8%（12/177）, χ2＝5.288 ，P＝0.021]. The samples of 57 cases were simultaneously detected by both culture and metagenomic next-generation sequencing (mNGS). Pathogens were detected in 25 cases by both culture and mNGS. In 30 cases, pathogen detection were mNGS positive but culture negative. Two cases showed positive results only with culture. A total of 79 (46.8%) strains were multi-drug resistant bacteria, including 27 (34.2%) strains of gram-positive bacteria and 52 (65.8%) strains of gram-negative bacteria. A total of 174 (86.1%) children with sepsis received empirical anti-infective drugs within 24 hours of fever onset. A total of 124 (61.4%) cases were appropriately covered by the initial empirical antibiotics, while 40 (19.8%) cases were not adequately covered and 10 (5.0%) cases had incomplete coverage. Despite the inclusion of pathogenic in the coverage, resistance to initial antibiotics was observed in 22 (10.9%) cases. Fifty-one patients died. Conclusion:The predominant pathogens responsible for sepsis in PICU with hematological disorders and cancers is gram-negative bacteria, followed by gram-positive bacteria and fungi. In comparison to healthy children with sepsis, there is a higher incidence of fungal infections among hematological disorders and cancers. The proportion of multi-drug resistant bacteria infection is high. Early identification and combination of local etiological distribution and drug resistance, along with the empirical selection of appropriate anti-infection treatment strategies, can greatly enhance survival rate.

Objective:To investigate the efficacy and safety of the "frame and buttress" fixation in the treatment of acetabular quadrilateral fractures.Methods:A total of 26 patients with acetabular quadrilateral fractures treated with the "Frame and buttress" fixation strategy (reconstructing frame and providing buttress for quadrilateral surface) from January 2017 to January 2021 were retrospectively analyzed in the Department of Orthopaedics, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, including 17 males and 9 females, aged 47.7±16.5 years, (range, 25-71 years). There were 13 cases from car accidents, 8 cases from falls, and 5 cases from heavy objects. Quadrilateral fractures were classified according to whether the anterior column (A) and posterior column (P) of the acetabulum were fractured and whether the quadrilateral plate (Q) was partially (1) or completely (2) separated from the two columns. Among these cases, there were 5 cases of type AQ1, 1 case of type AQ2, 1 case of type PQ2, 14 cases of type APQ1 and 5 cases of type APQ2. The "frame and buttress" fixation strategy was used to perform open reduction and internal fixation. The Matta scale was used to assess the quality of resurfacing based on pelvic radiographs, and the Matta modified Merle d'Aubigne and Postel scores were referenced to evaluate hip function.Results:All the 26 patients successfully completed the operation, the operation time was 88.1±57.8 min (range, 90-320 min), the intraoperative bleeding was 753.8±309.5 ml (range, 400-1 400 ml). There were 14 cases of anatomical reduction, 8 cases of satisfactory reduction and 4 cases of unsatisfactory reduction with an excellent rate of 85% (22/26), the excellence rate was 85% (22/26). All patients were followed up for 16.3±4.3 months (range, 12-24 months). The hip function score after operation was higher than that before operation, and the difference was statistically significant ( F=19.80, P<0.001). The hip function score was 13.1±2.2 at 3 months postoperatively, increased to 15.9±2.3 at 6 months postoperatively, and increased to 16.6±1.9 at the last follow-up, with a statistically significant difference ( P<0.001). After operation, 5 patients showed symptoms of lateral femoral cutaneous nerve injury such as hypoesthesia and numbness in the anterolateral thigh. During the follow-up, there was no ectopic ossification, traumatic arthritis, necrosis of the femoral head and central dislocation of the femoral head. Conclusion:The "frame and buttress" fixation strategy based on quadrilateral fracture typing for acetabular quadrilateral fracture open reduction internal fixation provides strong fixation, satisfactory reduction quality, and facilitates joint function recovery after operation.

Objective:To investigate the clinical efficacy of modified Guipi Decoction combined with omeprazole in the treatment of acute non-variceal upper gastrointestinal bleeding (ANVUGIB) with failure of the spleen to control blood vessels syndrome.Methods:Prospective cohort study. A total of 120 patients from January 2018 to December 2021 Taihe County Hospital of Traditional Chinese Medicine with ANVUGIB of failure of the spleen to control blood vessels syndrome were selected, and the patients were divided into observation group and control group according to the random number table method, with 60 cases in each group. The control group was treated with a large dosage of proton pump inhibitor (omeprazole injection was injected intravenously first, and then omeprazole enteric coated tablets were taken); the observation group took Guipi Decoction on the basis of the control group, and both groups were treated for 7 days. TCM syndrome score, Hemoglobin (Hb) and hematocrit (HCT) levels were measured by colorimetry before and after the treatment. BUN was detected by urease glutamate dehydrogenase method. Prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) levels were detected by immunoturbidimetry. The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results:Two patients in the observation group and two patients in the control group dropped out of the study. After treatment, the scores of main symptoms, secondary symptoms and total scores in the observation group were lower than those in the control group ( t values were respectively 10.73, 4.45, 7.98, P<0.05). After treatment, the levels of HCT [(41.25 ± 5.03)% vs. (38.19 ± 5.26)%, t=2.95], Hb [(81.09 ± 5.23) g/L vs. (78.39 ± 5.37) g/L, t=2.74] in the observation group were higher than those in the control group ( P<0.01), and BUN [(4.38±0.96) mmol/L vs. (5.39 ± 1.13) mmol/L, t=5.19] was lower than that in the control group ( P<0.01); PT [(12.48 ± 0.67) s vs. (13.22 ± 0.73) s, t=5.69], APTT [(24.66 ± 2.29) s vs. (27.78 ± 2.04) s, t=7.75] were lower than those in the control group ( P<0.01), and FIB [(3.68 ± 0.62) g/L vs. (3.41 ± 0.74) g/L, t=2.13] level was higher than that in the control group ( P<0.05). The total effective rate of the observation group was 93.1% (54/58), and that of the control group was 79.3% (46/58), with statistical significance ( χ2=4.64, P=0.031). During the treatment, the incidence of adverse reactions in the control group was 3.4% (2/58), while that in the observation group was 1.7% (1/58), without statistical significance ( χ2=0.34, P=0.559). Conclusion:High-dosage omeprazole treatment with the addition of internal administration of Guipi Decoction can significantly improve coagulation function, correct the signs and symptoms associated with insufficient blood volume in the body circulation, improve hemostatic efficiency, and reduce the risk of bleeding in patients with ANVUGIB, without increasing the risk of patient safety with the drug.