Objective: To analyze the epidemiological characteristics and influencing factors of severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang Province from 2019 to 2023, so as to provide the reference for strengthening SFTS prevention and control. Methods: Data on laboratory-confirmed SFTS cases in Zhejiang Province from 2019 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Meteorological data, geographic environment and socioeconomic factors during the same period were collected from the fifth-generation European Centre for Medium-Range Weather Forecasts, Geospatial Data Cloud, and Zhejiang Statistical Yearbook, respectively. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of SFTS from 2019 to 2023, and a Bayesian spatio-temporal model was constructed to analyze the influencing factors of SFTS incidence. Results: A total of 578 SFTS cases were reported in Zhejiang Province from 2019 to 2023, with an annual average incidence of 0.23/105. The peak period was from May to July, accounting for 52.60%. There were 309 males and 269 females, with a male-to-female ratio of 1.15∶1. The cases were mainly aged 50-<80 years, farmers, and in rural areas, accounting for 82.53%, 77.34%, and 75.43%, respectively. Taizhou City and Shaoxing City reported more SFTS cases, while Shaoxing City and Zhoushan City had higher annual average incidences of SFTS. The Bayesian spatio-temporal interaction model showed good goodness of fit. The results showed that mean temperature (RR=1.626, 95%CI: 1.111-2.378) and mean wind speed (RR=1.814, 95%CI: 1.321-2.492) were positively correlated with SFTS risk, while altitude (RR=0.432, 95%CI: 0.230-0.829) and population density (RR=0.443, 95%CI: 0.207-0.964) were negatively correlated with SFTS risk. Conclusions SFTS in Zhejiang Province peaks from May to July. Middle-aged and elderly people and farmers are high-risk populations. Taizhou City, Shaoxing City, and Zhoushan City are high-incidence areas. Mean temperature, mean wind speed, altitude, and population density can all affect the risk of SFTS incidence.

Background Occupational health risk assessment is the foundation of safeguarding workers' occupational health. However, traditional assessment methods often fail to adequately account for health effects and enterprise-specific characteristics, limiting their comprehensive evaluation capabilities. Additionally, these methods suffer from inconsistent standards, narrow application scopes, insufficient hazard sub-categorization, and indicator systems that poorly support informatization and digital transformation. To address these gaps, this study proposes methodological innovations focusing on the assessment indicator system. Objective To construct a systematic, generalizable, and practical occupational health comprehensive risk assessment indicator system by leveraging occupational health practices and surveillance big data from Shanghai. Methods Initial system indicators were extrated through literature review. Subsequently, expert interviews and group discussions, combined with occupational health surveillance big data, were used to refine these indicators, forming a candidate pool covering two major dimensions: risk factor characteristics and enterprise characteristics. The Delphi method was applied to evaluate and screen the indicators, while the analytic hierarchy process (AHP) was used to construct a hierarchical model and determine indicator weights. Results A total of 76 articles were reviewed, identifying 25 candidate indicators. After two rounds of Delphi expert consultation, 8 primary indicators (e.g. hazard characteristics, exposure characteristics, health effects, industry characteristics, management characteristics, protective features, adverse events, and uncertainty) and 17 secondary indicators (hazard factor characteristics, exposure levels, number of people exposed, number of factor exposure, special physical exam indicators, suspected occupational diseases, occupational diseases, industry categories, organizational management, hazard reporting, occupational health training, hazard factor testing, occupational health exams, protective facilities, personal protective equipment, administrative penalties, and data quality) were finalized. The expert response rate was 100%, and the expert authority coefficient was 0.86. The Kendall's W coefficients for importance and accessibility scores across the two consultation rounds were 0.41, 0.40 and 0.41, 0.50. A hierarchical model targeting the comprehensive occupational health risk index was constructed, comprising two major elements and three levels of indicators. AHP was applied to calculate the weights, with all judgment matrices demonstrating satisfactory consistency (consistency ratio < 0.1). Conclusion By integrating risk factor profiles with enterprise-specific characteristics via the Delphi-AHP approach, a robust occupational health comprehensive risk assessment indicator system is established. This system provides a practical framework for digitized occupational health management, though further empirical validation in real-world settings is warranted.

OBJECTIVE To investigate the current status of informatization tools applied to antimicrobial stewardship in county hospitals in China， and to provide a reference for promoting the informatization development of antimicrobial stewardship in county hospitals.METHODS From August to September 2025， an online questionnaire survey was conducted among 1 007 county hospitals across 31 provinces（autonomous regions， and municipalities） in China. The survey focused on the application of four types of informatization tools：the real-time monitoring system for antimicrobial use， the pre-prescription review system， the irrational use warning system， and the electronic prescription evaluation system（hereinafter referred to as the “monitoring system”“review system”“warning system”“evaluation system”，respectively）. Correlation analysis and binary Logistic regression analysis were employed to explore the influencing factors.RESULTS Of the county hospitals， 80.83% were equipped with at least one type of informatization tool for antimicrobial stewardship， while 19.17% had no relevant tool. Only 18.87% of the hospitals were equipped with all four types of tools. The monitoring system exhibited the highest equipped rate （70.80%）， whereas the warning system was equipped in only 33.96% of the hospitals. Four types of tools are evenly and adequately deployed in the eastern region， the central and western regions have far lower deployment rates of intervention tools including review system and warning system， accompanied by prominent intra-provincial gaps. The total number of the health technicians， hospital grade， and prescription review rate of outpatient antibacterial drug were significantly and positively correlated with the deployment rates of the four informatization tools （ P ＜0.05）. The results of the Logistic regression model fitting indicated that the model of the review system was rated “excellent” [area under the receiver operating characteristic curve （AUC）＝0.81]， and the model of the warning system was rated “further improvement” （AUC＝0.67）. The total number of health technicians was significantly positively correlated with the deployment rates of all four types of informatization tools （all P ＜0.05）.CONCLUSIONS The informatization of antimicrobial stewardship in county hospitals in China remains in the initial stage of transitioning from “passive statistics” to “active prevention and control”， with challenges such as structural imbalance and regional disparities. In the future， differentiated support strategies should be implemented， the allocation of resources should be optimized， to enhance the level of refined antimicrobial stewardship.

ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndrome patterns among postmenopausal women with dyslipidemia， and to examine the correlations of lipid parameters with bone mineral density （BMD） and bone metabolism markers across common TCM syndrome patterns， thereby providing a clinical reference for individualized integrative traditional Chinese and western medicine interventions stratified according to TCM syndrome patterns. MethodsA multi-center cross-sectional study was conducted among postmenopausal women aged 45-64 years with dyslipidemia. TCM syndromes were determined using a scale-based scoring method. BMD measurements were collected， and fasting venous blood samples were assayed for lipid parameters including total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C）， and bone metabolism biomarkers including osteocalcin （OST）， total procollagen type Ⅰ N-terminal propeptide （P1NP）， alkaline phosphatase （ALP）， bone-specific alkaline phosphatase （BALP）， β-isomerized C-terminal telopeptide of type Ⅰ collagen （β-CTX）， 25-hydroxyvitamin D ［25（OH）D］， and thyroid-stimulating hormone （TSH）. Chi-square tests were used to compare the distribution of dyslipidemia across different TCM syndromes. Spearman's rank correlation analysis was performed to evaluate the correlations between TCM syndrome patterns and dyslipidemia， as well as the correlations of lipid parameters with BMD and bone metabolism markers within each syndrome pattern. ResultsA total of 506 postmenopausal women with dyslipidemia were included， comprising 172 cases of spleen-kidney yang deficiency syndrome （33.99%）， 163 cases of phlegm-turbidity obstruction syndrome （32.21%）， 118 cases of liver-kidney yin deficiency syndrome （23.32%）， 33 cases of qi stagnation and blood stasis syndrome （6.52%）， and 20 cases of yin deficiency and yang hyperactivity syndrome （3.95%）. Phlegm-turbidity obstruction syndrome was negatively correlated with TC abnormality （r=-0.120， P=0.007） and positively correlated with TG abnormality （r=0.246， P＜0.001）. Spleen-kidney yang deficiency syndrome and liver-kidney yin deficiency syndrome were both negatively correlated with TG abnormality （r=-0.101， P=0.023； r=-0.116， P=0.009， respectively）. Further correlation analysis confirmed that phlegm-turbidity obstruction syndrome was negatively correlated with TC abnormality （r=-0.120） and significantly positively correlated with TG abnormality （r=0.246）. Both the spleen-kidney yang deficiency syndrome and liver-kidney yin deficiency syndrome were negatively correlated with TG abnormality （r=-0.101 and r=-0.116， respectively）. In patients with phlegm-turbidity obstruction syndrome， HDL-C was negatively correlated with BMD at the left femoral neck （r=-0.178， P=0.023） and at left total hip （r=-0.190， P=0.015）. In patients with liver-kidney yin deficiency syndrome， TG was positively correlated with BMD at the lumbar spine （L1-L4） and left total hip （r=0.214， P=0.020； r=0.221， P=0.016， respectively）. More significant correlations were observed in patients with spleen-kidney yang deficiency syndrome， TG was positively correlated with ALP （r=0.210， P=0.006）； TC was positively correlated with TSH and 25（OH）D （r=0.153， P=0.045； r= 0.231， P=0.002， respectively）； HDL-C was positively correlated with OST and 25（OH）D （r=0.156， P=0.040； r=0.228， P=0.003， respectively）； and LDL-C was positively correlated with TSH and 25（OH）D （r=0.156， P= 0.041； r=0.182， P=0.017， respectively）. In patients with liver-kidney yin deficiency syndrome， HDL-C was negatively correlated with TSH （r=-0.204， P=0.027）. ConclusionThe association between dyslipidemia and skeletal health in postmenopausal women varies across TCM syndromes. Lipid abnormalities in women with phlegm-turbidity obstruction syndrome or liver-kidney yin deficiency syndrome are accompanied primarily by site-specific alterations in BMD， whereas those in women with spleen-kidney yang deficiency syndrome are reflected mainly in changes in bone metabolism markers. These findings suggest that targeted intervention strategies should be developed according to TCM syndrome characteristics for postmenopausal women with dyslipidemia.

ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndrome patterns among postmenopausal women with dyslipidemia， and to examine the correlations of lipid parameters with bone mineral density （BMD） and bone metabolism markers across common TCM syndrome patterns， thereby providing a clinical reference for individualized integrative traditional Chinese and western medicine interventions stratified according to TCM syndrome patterns. MethodsA multi-center cross-sectional study was conducted among postmenopausal women aged 45-64 years with dyslipidemia. TCM syndromes were determined using a scale-based scoring method. BMD measurements were collected， and fasting venous blood samples were assayed for lipid parameters including total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C）， and bone metabolism biomarkers including osteocalcin （OST）， total procollagen type Ⅰ N-terminal propeptide （P1NP）， alkaline phosphatase （ALP）， bone-specific alkaline phosphatase （BALP）， β-isomerized C-terminal telopeptide of type Ⅰ collagen （β-CTX）， 25-hydroxyvitamin D ［25（OH）D］， and thyroid-stimulating hormone （TSH）. Chi-square tests were used to compare the distribution of dyslipidemia across different TCM syndromes. Spearman's rank correlation analysis was performed to evaluate the correlations between TCM syndrome patterns and dyslipidemia， as well as the correlations of lipid parameters with BMD and bone metabolism markers within each syndrome pattern. ResultsA total of 506 postmenopausal women with dyslipidemia were included， comprising 172 cases of spleen-kidney yang deficiency syndrome （33.99%）， 163 cases of phlegm-turbidity obstruction syndrome （32.21%）， 118 cases of liver-kidney yin deficiency syndrome （23.32%）， 33 cases of qi stagnation and blood stasis syndrome （6.52%）， and 20 cases of yin deficiency and yang hyperactivity syndrome （3.95%）. Phlegm-turbidity obstruction syndrome was negatively correlated with TC abnormality （r=-0.120， P=0.007） and positively correlated with TG abnormality （r=0.246， P＜0.001）. Spleen-kidney yang deficiency syndrome and liver-kidney yin deficiency syndrome were both negatively correlated with TG abnormality （r=-0.101， P=0.023； r=-0.116， P=0.009， respectively）. Further correlation analysis confirmed that phlegm-turbidity obstruction syndrome was negatively correlated with TC abnormality （r=-0.120） and significantly positively correlated with TG abnormality （r=0.246）. Both the spleen-kidney yang deficiency syndrome and liver-kidney yin deficiency syndrome were negatively correlated with TG abnormality （r=-0.101 and r=-0.116， respectively）. In patients with phlegm-turbidity obstruction syndrome， HDL-C was negatively correlated with BMD at the left femoral neck （r=-0.178， P=0.023） and at left total hip （r=-0.190， P=0.015）. In patients with liver-kidney yin deficiency syndrome， TG was positively correlated with BMD at the lumbar spine （L1-L4） and left total hip （r=0.214， P=0.020； r=0.221， P=0.016， respectively）. More significant correlations were observed in patients with spleen-kidney yang deficiency syndrome， TG was positively correlated with ALP （r=0.210， P=0.006）； TC was positively correlated with TSH and 25（OH）D （r=0.153， P=0.045； r= 0.231， P=0.002， respectively）； HDL-C was positively correlated with OST and 25（OH）D （r=0.156， P=0.040； r=0.228， P=0.003， respectively）； and LDL-C was positively correlated with TSH and 25（OH）D （r=0.156， P= 0.041； r=0.182， P=0.017， respectively）. In patients with liver-kidney yin deficiency syndrome， HDL-C was negatively correlated with TSH （r=-0.204， P=0.027）. ConclusionThe association between dyslipidemia and skeletal health in postmenopausal women varies across TCM syndromes. Lipid abnormalities in women with phlegm-turbidity obstruction syndrome or liver-kidney yin deficiency syndrome are accompanied primarily by site-specific alterations in BMD， whereas those in women with spleen-kidney yang deficiency syndrome are reflected mainly in changes in bone metabolism markers. These findings suggest that targeted intervention strategies should be developed according to TCM syndrome characteristics for postmenopausal women with dyslipidemia.

Objective To investigate whether the PI3K/AKT/Cdkn1a/GPX4 signaling axis participates in the pathogenesis of radiation-induced heart disease (RIHD) through the ferroptosis pathway. Methods An RIHD mouse model was established by irradiating C57BL/6J mice with 20 Gy X-rays. Transcriptomic sequencing, the FerrDb ferroptosis-related gene set, and weighted gene co-expression network analysis were used to identify hub genes associated with ferroptosis in RIHD. KEGG enrichment analysis was employed to determine key signaling pathways. An AC16 cardiomyocyte model of RIHD was constructed, and the optimal modeling conditions were determined using CCK-8 assays and flow cytometry. Reverse transcription-quantitative PCR and Western blotting were applied to validate the expression changes of key genes and pathways in cardiomyocytes. Results Compared with the control group, myocardial tissues from irradiated mice exhibited typical RIHD pathological alterations, including structural disorganization and degeneration. Bioinformatics analysis identified Cdkn1a and Ddit4 as potential hub genes, with the PI3K/AKT pathway as the key signaling pathway. The optimal conditions for establishing the RIHD cell model were determined to be 10 Gy irradiation and 48 hours of incubation. Cellular experiments confirmed that, compared with the control group (0 Gy), irradiated cardiomyocytes (10 Gy) showed significantly elevated CDKN1A expression (P < 0.01), inhibited phosphorylation of the PI3K/AKT signaling pathway (P < 0.05), downregulated GPX4 expression (P < 0.05), and induction of ferroptosis. Conclusion This study preliminarily clarifies the potential role of the PI3K/AKT/Cdkn1a/GPX4 signaling axis in regulating ferroptosis in RIHD cardiomyocytes, providing new therapeutic targets and strategies for the prevention and treatment of RIHD.

Objective:To analyze the electroencephalogram features of visual working memory in the delay stage based on microstate analysis.Methods:In this cross-sectional study, ten healthy male subjects aged 19-29 years old from Tianjin Medical University were selected from January to July 2015. The 32-channel electroencephalogram experimental data were recorded from these subjects during the visual working memory eye-open state for 10 min (resting-state) and the delayed matching-to-sample (DMS) task (task-state) conditions, respectively. After data pre-processing, a short-time Fourier transform was applied for time-frequency analysis to extract the characteristic time periods and frequency bands, and electroencephalogram microstates of the resting and task states of visual working memory were computed separately, using an improved k-means clustering algorithm. The Mann-Whitney U test was used to analyze the statistical differences between resting-state and task-state microstate parameters, including global field power (GFP), global explained variance (GEV), time proportion, mean spatial correlation, frequency of occurrence and duration. Results:The time-frequency distribution of the Fz channel in the responsible brain region in DMS task visual working memory showed that the energy was mainly concentrated in the theta band (4-8 Hz) during the delay stage (4.039-7.039 s). The bipolar locations of microstates A, B, C, and D were prefrontal and occipital, central frontal and occipital, right occipital and left frontal, and left occipital and right frontal, respectively. In microstates A and C, the mean spatial correlation of the task-state was both higher than that of the resting state. The comparison results for microstate A were (0.632 5±0.105 8 vs 0.624 5±0.461 4, P<0.05), and the results for microstate C were (0.589 4±0.233 4 vs 0.561 3±0.066 8, P<0.01). The parameters of the task-state microstate D were lower than those of the resting-state, including GFP (1.125±0.061 vs 1.277±0.741, P<0.05), GEV (0.077±0.061 vs 0.101±0.057, P<0.05), and time proportion (0.191±0.165 vs 0.224±0.094, P<0.05) and mean spatial correlation (0.561 2±0.211 6 vs 0.612 1±0.315 2, P<0.01). Conclusions:The critical period of visual working memory is the delay stage and the critical frequency band is the theta band. Microstate D is the characteristic feature of visual working memory in the delay stage of the theta band, and microstates A and C can also serve as its potential features.

Acute lung injury （ALI） is one of the most common and critical diseases in clinical practice， with extremely high morbidity and mortality， seriously threatening human life and health. The pathogenesis of ALI is complex， in which the inflammatory response is a key factor. Studies have shown that NOD-like receptor protein 3 （NLRP3） inflammasomes are involved in ALI through mechanisms such as inflammation induction， increased microvascular permeability， recruitment of neutrophils， oxidative stress， and pyroptosis， playing a key role in the occurrence and progression of ALI. Therefore， regulating NLRP3 inflammasomes and inhibiting the release of inflammatory factors can alleviate the damage in ALI. At present， ALI is mainly treated by mechanical ventilation and oxygen therapy， which have problems such as high costs and poor prognosis. In recent years， studies have shown that traditional Chinese medicine （TCM） can reduce the inflammatory response and the occurrence of oxidative stress and pyroptosis by regulating the NLRP3 inflammasome， thus alleviating the damage and decreasing the mortality of ALI. Based on the relevant literature in recent years， this article reviews the research progress in TCM treatment of ALI by regulating NLRP3 inflammasomes， discusses how NLRP3 inflammasomes participate in ALI， and summarizes the active ingredients， extracts， and compound prescriptions of TCM that regulate NLRP3 inflammasomes， aiming to provide new ideas for the clinical treatment of ALI and the development of relevant drugs.

Robot-assisted surgery with its advantages such as three-dimensional high-definition vision, dexterous robotic arms, and tremor filtration, is increasingly being applied to complex radical gastrectomy. However, the role of the surgical assistant remains crucial during the procedure. The assistant is responsible for tasks outside the console, including adjusting robotic arms, changing instruments, exposing the surgical field, and addressing unexpected situations. The technical proficiency of the assistant and their collaboration efficiency with the primary surgeon directly impact the smoothness of surgery and patients' outcomes. With the expansion of robot-assisted surgical indications, the establishment of a standardized training system and the optimization of team collaboration models have become urgent challenges to address. This article draws on the author's practical experience as an assistant in robot-assisted gastric cancer surgeries, conducting an in-depth analysis of the responsibilities and operational skills of surgical assistants in robot-assisted procedures. The aim is to develop a relatively comprehensive set of operational guidelines for surgical assistants in robot-assisted radical gastrectomy, providing valuable references for enhancing the overall efficiency of surgical teams and improving surgical outcomes.

OBJECTIVE To explore optimization pathways for the drug traceability code management model in outpatient pharmacy workflows， providing practical evidence for enhancing the efficiency of pharmaceutical service. METHODS Taking the outpatient pharmacy of the First Affiliated Hospital of Sun Yat-sen University as the research subject， a comprehensive drug traceability system was established through three key interventions： upgrading the information system architecture [including integration of the hospital information system （HIS） with the traceability platform]， workflow optimization （reorganizing the inventory-dispensing-verification tripartite process）， and designing a dual-mode traceability data collection mechanism （primary data capture at dispensing stations and supplementary capture at verification stations）. Operational efficiency differences before and after implementation were analyzed using the medical insurance data and service timeliness metrics in September 2024. RESULTS After the implementation of drug traceability code management， in terms of data collection: Mode Ⅰ （verification-stage capture） uploaded 26 144 records， while Mode Ⅲ （inventory-as-sales capture） uploaded 443 061 records， totaling 469 205 entries； in terms of time efficiency： average drug dispensing time increased from 28.74 s to 43.37 s （enhanced by 51%）. Through dynamic staffing adjustments， patient wait time only extended from 8.04 min to 8.67 min （enhanced by 8%）. CONCLUSIONS Drug traceability code management can be effectively implemented via a “system reconstruction-process reengineering-human-machine collaboration” trinity strategy， leveraging informatization （e.g.， dual-mode data capture） to offset manual operation delays， which validates the feasibility of balancing national traceability demands with service efficiency in outpatient pharmacies.