Background The global number of type 2 diabetes (T2D) cases has been steadily increasing over the past few decades, becoming a major public health issue. Available toxicological research has indicated that ozone (O₃) can lead to oxidative stress and inflammatory responses, thereby causing metabolic changes and the development of T2D. Existing cohort studies on the impact of long-term O₃ exposure on the risk of developing T2D have reached contradictory conclusions, and the results have shown significant heterogeneity. Objective To summarize cohort studies on long-term O₃ exposure and T2D risk, and investigate heterogeneity sources in the association between O₃ and T2D. Methods Cohort studies on O₃ and T2D were searched through PubMed, Embase, and the Web of Science, with the search deadline set for 25 April, 2025. After two researchers independently screened the literature, extracted data, and evaluated the quality of the included studies, meta-analysis was conducted using Stata 18.0 software. We used a random effects model to calculate the overall relative risk (RR) of the standardized risk estimates and its 95% confidence interval (CI). Additionally, sensitivity analysis, subgroup analysis, meta-regression, and publication bias testing were performed to explore the sources of heterogeneity in the association between O₃ and T2D. Results In the 8 articles meeting predetermined inclusion criteria, a total of 11 cohort studies involving 54887070 participants were finally included. The results of the meta-analysis indicated that long-term exposure to O₃ was associated with a higher incidence of type 2 diabetes [standardized RR=1.04 (95%CI: 1.01, 1.07), P<0.001, I²=97.3%], and significant heterogeneity existed. The subgroup analysis showed that females (standardized RR=1.08, 95%CI: 1.03, 1.13) and the Asian population (standardized RR=1.09, 95%CI: 1.06, 1.11) were are more susceptible to O₃. The meta-regression model that included study region and average O₃ concentration variables explained 60.33% of the heterogeneity between studies. No significant evidence of publication bias was observed after the funnel plot test, Egger's test (P=0.437), Begg's test (P=0.640), and the trim-and-fill method. Conclusion Long-term exposure to O₃ could increase the risk of developing T2D, with females and Asian populations being particularly sensitive. The heterogeneity in the association between O₃ and T2D can be partly explained by factors such as average O₃ concentration and geographic location.

Primary liver cancer is one of the most common causes of cancer-related deaths in China,with hepatocellular carcinoma(HCC)accounting for 75%-85%.Approximately 70%of HCC patients are in the advanced stage at the time of diagnosis and miss the opportunity for radical surgery,leading to a poor prognosis.Yttrium-90 microsphere selective internal radiation therapy(90Y-SIRT),an emerging therapeutic modality,delivers radioactive microspheres via the hepatic artery to target tumors and uses beta radiation for localized tumor ablation.Compared to conventional transarterial chemoembolization and pharmacotherapy,90Y-SIRT shows the advan-tages of significant clinical benefits,good safety profiles,and broad applicability across diverse patient populations.This article re-views the advances in the application of 90Y-SIRT in HCC treatment.

Primary liver cancer is a malignant tumor with high incidence and mortality rates worldwide,and the early diagnosis of pri-mary liver cancer and the optimization of precise treatment strategies have become critical issues in the healthcare field.Due to the in-sufficient capabilities for molecular characterization,it is increasingly difficult for traditional imaging techniques to meet clinical needs in the era of precision medicine.Multimodal molecular imaging technology integrates the advantages of imaging modalities such as ul-trasound imaging,magnetic resonance imaging,and optical imaging,thereby achieving synergistic enhancement between molecular bio-logical information of liver cancer and precise anatomical localization and demonstrating a significant value in the diagnosis and treat-ment of liver cancer.This article reviews the advances in the application of multimodal molecular imaging in the early diagnosis,pre-cise treatment,and therapeutic efficacy monitoring of liver cancer.

Artificial intelligence (AI) integrated with time-lapse (TL) imaging for embryo selection significantly minimizes subjectivity and workload in traditional methods, marking a pivotal advancement in the realm of assisted reproductive technology. This review comprehensively summarizes the representative studies conducted in recent years within these domains and delves into the application of AI combined with TL imaging for embryo selection from three perspectives: data selection, model selection, and model evaluation. While AI research has yet to fully achieve automated embryo selection, it has already commenced assisting embryologists in annotating and selecting embryos to a considerable extent, thereby reducing subjective discrepancies and easing the workload. Existing software for oocyte quality scoring, embryo ploidy prediction, and transfer outcome forecasting has exhibited promising performance in studies. However, there remains an ongoing need for the development of high-quality datasets and the conduct of prospective, multicenter studies with large sample sizes across diverse devices. The evolution of AI combined with TL imaging in the field of embryo selection merits heightened attention from both clinicians and embryologists.

Artificial intelligence (AI) integrated with time-lapse (TL) imaging for embryo selection significantly minimizes subjectivity and workload in traditional methods, marking a pivotal advancement in the realm of assisted reproductive technology. This review comprehensively summarizes the representative studies conducted in recent years within these domains and delves into the application of AI combined with TL imaging for embryo selection from three perspectives: data selection, model selection, and model evaluation. While AI research has yet to fully achieve automated embryo selection, it has already commenced assisting embryologists in annotating and selecting embryos to a considerable extent, thereby reducing subjective discrepancies and easing the workload. Existing software for oocyte quality scoring, embryo ploidy prediction, and transfer outcome forecasting has exhibited promising performance in studies. However, there remains an ongoing need for the development of high-quality datasets and the conduct of prospective, multicenter studies with large sample sizes across diverse devices. The evolution of AI combined with TL imaging in the field of embryo selection merits heightened attention from both clinicians and embryologists.

Objective To evaluate the safety and efficacy of transcatheter arterial chemoembolization(TACE)combined with lenvatinib and camrelizumab in the treatment of advanced hepatocellular carcinoma(HCC).Methods The clinical data of a total of 63 patients with advanced HCC,who received TACE combined with lenvatinib and camrelizumab(triple therapy)or TACE combined with lenvatinib(dual therapy)at the Jingmen Municipal People's Hospital of China between April 2020 and December 2021,were retrospectively analyzed.Triple therapy group had 30 patients,and dual therapy group had 33 patients.The post-treatment tumor response,disease progression-free survival(PFS),overall survival(OS),and the incidence of adverse drug reactions were recorded.Results The median follow-up period of the two groups was 14 months(range of 4-26 months).Compared with the dual therapy group,in the triple therapy group the objective response rate(ORR)was remarkably higher(83.3%vs.57.6%,P=0.026),the disease control rate(DCR)was obviously higher(93.3%vs.69.7%,P=0.039),the median PFS was significantly longer(8.0 months vs.5.0 months,P＜0.01),and the median OS was strikingly longer(24.0 months vs.12.0 months,P=0.004).No statistically significant difference in the incidence of adverse drug reactions existed between the two groups(P＞0.05).Conclusion For the treatment of advanced HCC,TACE combined with lenvatinib and camrelizumab is clinically safe and effective.(J Intervent Radiol,2024,32:57-62)

The clinical efficacy of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) in reducing major cardiovascular adverse events related to atherosclerotic cardiovascular disease (ASCVD) has been well established in recent large randomized outcome trials. Although the cardiovascular and all-cause mortality benefit of PCSK9i remains inconclusive, current cholesterol management guidelines have been modified toward more aggressive goals for lowering low-density lipoprotein cholesterol (LDL-C). Consequently, the emerging concept of "the lower the better" has become the paradigm of ASCVD prevention. However, there is evidence from observational studies of a U-shaped association between baseline LDL-C levels and all-cause mortality in population-based cohorts. Among East Asian populations, low LDL-C was associated with an increased risk for hemorrhagic stroke in patients not on antithrombotic therapy. Accumulating evidence showed that low LDL-C was associated with an enhanced bleeding risk in patients on dual antiplatelet therapy following percutaneous coronary intervention. Additionally, low LDL-C was associated with a higher risk for incident atrial fibrillation and thereby, a possible increase in the risk for intracranial hemorrhage after initiation of anticoagulation therapy. The mechanism of low-LDL-C-related bleeding risk has not been fully elucidated. This review summarizes recent evidence of low-LDL-C-related bleeding risk in patients on antithrombotic therapy and discusses potential measures for reducing this risk, underscoring the importance of carefully weighing the pros and cons of aggressive LDL-C lowering in patients on antithrombotic therapy.

Objective:To integrate the experience of terminal care of nurses in Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU) .Methods:Qualitative and mixed studies related to the terminal care by neonatal and pediatric nurses were systematically searched on the Cochrane Library, the Australia Joanna Briggs Institute Evidence-based Health Care Center Database, PubMed, EBSCO, Web of Science, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP and the China Biomedical Medicine Database. The search time limit was from the establishment of the database to May 2022. The article quality was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center (2016). Meta-synthesis was performed using the aggregation integration method.Results:A total of 9 articles were included. A total of 32 research results were extracted and summarized into 7 categories, forming 3 integrated results, including the ethical dilemmas and complex care experiences of nurses in NICU and PICU during the implementation of palliative care, the attitudes and coping strategies of neonatal and pediatric nurses in responding to death events, the realistic dilemmas and needs of nurses in NICU and PICU during terminal care.Conclusions:Terminal care in NICU and PICU requires multiple efforts. Hospital managers should pay attention to the emotional burden of nurses during terminal care, and enhance their positive coping ability, and focus on improving the terminal care environment and resources in NICU and PICU to provide high-quality terminal care services for children.

Objective: To evaluate the efficacy of articular compression molding techniques in the surgery for acetabular posterior wall fracture. Methods: A retrospective study was conducted of the 28 patients (28 hips) with fracture of acetabular posterior wall plus comminuted compression of articular surface who had been treated using the articular compression molding techniques at Department of Orthopedics, The Hospital of 81 Group Army of PLA from January 2014 to January 2018. They were 25 males and 3 females, aged from 26 to 63 years (average, 49.3 years). The time from injury to surgery ranged from 4 to 12 days (average, 7.8 days). According to the Letournel-Judet classification, all were single element (simple) posterior wall fractures combined with posterior dislocation of the femoral head and articular compression of different degrees; transient sciatic nerve injury was complicated in 12 cases. The posterior hip dislocations were timely and successful reset at emergency treatment. The compression fractures of the posterior wall and hip joint were treated by open reduction and internal fixation via the acetabular posterior (K-L) approach. The articular compression was treated by 4 stabilization techniques: absorbable screwing and blocking technique in 10 cases, indwelling screwing in 12 cases, indwelling Kirschner wiring in 2 cases and die push and squeeze tamping in 4 cases. The operation time, intraoperative bleeding and complications were recorded. The therapeutic efficacy was evaluated by the modified Merle d’Aubigne & Postel scoring criteria at the final follow-up. Results: The operation time lasted from 76 to 118 minutes (average, 94.2 minutes); the intraoperative bleeding ranged from 100 to 320 mL (average,220.8 mL). No incision liquefaction, infection or other complications occurred. The 28 patients were followed up for 10 to 36 months (average, 17.6 months). According to the Matta scoring criteria, 24 cases achieved anatomical reduction but 4 dissatisfactory reduction. By the modified Merle d’Aubigne & Postel scoring criteria at the final follow-up, the efficacy was evaluated as excellent in 26 cases and as good in 2. Heterotopic ossification was observed in 3 cases and microscopic free dense shadow in the joint cavity (about 2 mm in the round ligament) in 3 cases. There were no cases of obvious traumatic arthritis or osteoarthritis, femoral head necrosis, walking pain, lameness or hip abduction weakness. The 12 patients complicated with preoperative transient sciatic nerve injury recovered within 3 months after surgery. Conclusion The articular compression molding techniques can effectively treat severely comminuted articular compression in the acetabular posterior wall fracture and improve reduction of articular surface and hip joint matching, leading to stability and good joint function.

Objective To explore the efficacy of temporary titanium plate screwing for positional maintenance in reduction and internal fixation for displaced acetabular fractures.Methods A retrospective study was conducted of the 28 patients (28 hips) with displaced acetabular fracture who had been treated by open reduction and internal fixation from October 2013 to March 2016.They were 20 males and 8 females,aged from 24 to 68 years (average,42.3 years).The time from injury to surgery ranged from 7 to 21 days(average,14.5 days).According to the Letournel-Judet classification,there were 2 posterior column fractures,4 transverse fractures,5 posterior column plus posterior wall fractures,6 transverse plus posterior wall fractures,2 T-shaped fractures,3 anterior and posterior transverse fractures and 6 double column fractures.The posterior acetabular approach or combined anterior and posterior approach was used.In all the patients temporary titanium plate screwing was conducted to fix one side of the fracture so as to facilitate accomplishment of open reduction and internal fixation without losing the indirect anatomic reduction of the intraarticular fracture.After the open reduction and internal fixation was accomplished,the temporary screw fixation was removed in 26 patients but retained in 2 patients as needed.The reduction quality,complications and outcomes at the final follow-ups were recorded.Results All the 28 patients were followed up for 10 to 36 months (mean,15.6 months).By the Matta criteria,anatomical reduction was achieved in 26 cases,unsatisfactory reduction in one and poor reduction in one,yielding an anatomic reduction rate of 92.9％.By the improved Mere d'Aubigne & Postel criteria,the clinical outcomes at the final follow-up were excellent in 27 cases and good in one,yielding a good to excellent rate of 100％.Postoperatively,heterotopic ossification of different severities occurred in 11 cases but did not affect their joint function;transient paralysis of the sciatic nerve was reported in 6 cases but recovered 3 months after surgery.No complications like avascular necrosis of the femoral head or walking pain were observed during follow-ups.Conclusion Temporary fixation with titanium plate screws during open reduction and internal fixation for displaced acetabular fractures can effectively improve the reduction and fixation of the articular surface,leading to satisfactory short-term clinical outcomes.