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.

Driven by policy initiatives promoting the integration of digital-intelligent technologies with primary healthcare and the digital transformation of traditional Chinese medicine (TCM), Smart TCM has emerged as a pivotal strategy for enhancing primary healthcare services for major chronic diseases. This paper reviews the current status, challenges, and feasible pathways of Smart TCM in community-level management of cardiovascular–cerebrovascular diseases and tumors, which represent major chronic disease burdens. Our findings indicate that Smart TCM demonstrates emerging potential in primary healthcare for chronic diseases across the entire continuum of “prevention-screening-diagnosis-treatment-management.” However, several significant challenges persist, including data silos and security vulnerabilities, limited applicability of existing models to real-world clinical needs, and insufficient digital literacy among primary healthcare physicians and elderly patients. To address these constraints, this paper proposes a multidimensional strategy encompassing the development of secure and interoperable regional data platforms, lightweight intelligent devices and support services aligned with primary care capacity, unified technical and data standards with corresponding quality control systems, adaptive and dynamically updated artificial intelligent models, interdisciplinary workforce training and patient education programs, and enhanced policy and health insurance support. Overall, Smart TCM shows great promise for improving the efficiency of primary healthcare delivery and establishing innovative TCM-based chronic disease management paradigms.

Objective To enhance the gamma spectrometry analysis and detection capabilities of personnel in measuring radionuclides in bio-ash, and ensure the accuracy and precision of gamma spectrometer in our laboratory for the analysis of radionuclides in bio-ash. Methods The laboratory participated in the 2024 national interlaboratory comparison for radionuclide measurement in bio-ash. Radionuclides ²⁴¹Am, ¹³⁷Cs, and ⁴⁰K in four different bio-ash samples were measured. Based on the measurement methods specified in GB/T 16145—2022, sample measurement, result calculation, and uncertainty evaluation were performed using spectrometry analysis software and sourceless efficiency calibration software. The measurement results and performance evaluation of the laboratory in the comparison were analyzed, and factors affecting gamma-spectrometry measurement and result interpretation were discussed. Results The relative deviation (D) of the measurement results for radionuclides ²⁴¹Am and ¹³⁷Cs in the four bio-ash samples ranged from −10.2% to 2.0% and −1.7% to 0.3%, respectively. The P statistic ranged from 7.0% to 12.5% and 5.0% to 10.8%, respectively. These results met the criteria of |D| ≤ 20% (MARB), |D| ≤ 2.58P, and P ≤ 20% (MARB). The ζ-scores for the measurement of ⁴⁰K in the four bio-ash samples ranged from 0.8 to 1.3, satisfying the criterion of |ζ| < 2. All measurement results in this laboratory in the comparison were satisfactory. Conclusion The laboratory uses a high-purity germanium gamma spectrometer to measure radionuclides in bio-ash. The self-absorption correction method, analysis method, and uncertainty evaluation are appropriate, which can ensure the accuracy and precision of the measurement results. The measurement results are accurate and reliable.

Objective To investigate occupational exposure levels of lead, arsenic and cadmium in the lead smelting plant of Hunan Shui Kou Shan Nonferrous Metals Group Co. Ltd., analyze their effects on health of employees, and compare the applicability of different occupational health risk assessment methods, and to provide a basis for prevention and control of occupational exposure risks in enterprises. Methods According to systematic sampling method, 380 employees with lead, arsenic and cadmium exposure (exposure group) and 100 non-exposure employees (non-exposure group) were selected from 2022 to 2024 for on-site investigation of occupational health [concentration time-weighted average (C_TWA)] and physical examination. The risk was evaluated by qualitative assessment method, the U.S. Environmental Protection Agency (EPA) inhalation risk assessment method, and the Singapore Ministry of Manpower (MOM) semi-quantitative method. The consistency was analyzed by the Kappa test. Results C_TWA values of lead, arsenic, and cadmium in all positions were lower than the occupational exposure limit (OEL). The levels of blood lead, urine arsenic, and urine cadmium, as well as the prevalence of multiple systems in the exposure group were significantly higher than those in the non-exposure group (P<0.05). The proportions of chronic lead, arsenic, and cadmium poisoning were increasing year by year in the exposure group (P<0.05). The qualitative assessment method mainly indicated low and medium risk, while the EPA and MOM methods mainly indicated medium and high risk, with good agreement between the two methods (Kappa=0.676, P<0.05). Conclusion Although the enterprise meets the C_TWA standards, there are still occupational health risks of lead, arsenic, and cadmium. The EPA inhalation risk assessment method is more applicable.

ObjectiveTo investigate the protective effect and underlying mechanisms of the Bawei Chenxiang Wan （BCW） against myocardial ischemic injury. MethodsMyocardial ischemia in vivo was induced in rats by subcutaneous injection of isoproterenol （ISO）， and ex vivo ischemia was established by coronary artery ligation in isolated rat hearts. The effects of BCW， alcohol extracts and its polar extracts were evaluated on ST segment on electrocardiogram （ECG）， myocardial damage， hemodynamic parameters， and infarct size. The phosphorylation level of phosphatidylinositol 3-kinase （PI3K）， the expression of cuproptosis-related proteins， and the content of Cu²⁺ in myocardial tissue were detected. The regulatory relationship of the signaling pathway was verified using an oxygen-glucose deprivation （OGD） myocardial cell injury model， combined with PI3K agonists and inhibitors. ResultsBCW ameliorated ST-segment elevation on electrocardiograms（P＜0.01）， reduced serum levels of myocardial injury markers， improved hemodynamic parameters， upregulated PI3K phosphorylation（P＜0.01）， and decreased Cu²⁺ accumulation in rats with myocardial ischemia（P＜0.01）. Moreover， BCW reduced the myocardial infarct size. In the isolated rat heart model of ischemia， both the ethanol extract and various solvent fractions of BCW exerted protective effects and reduced Cu²⁺ content， among which the n-butanol fraction exhibited the most potent activity（P＜0.01）. Specifically， the n-butanol fraction upregulated PI3K phosphorylation（P＜0.01） and downregulated the expression of cuproptosis-related proteins， including ferredoxin reductase 1（FDX1）（P＜0.05）， lipoic acid synthetase（LIAS）， and dihydrolipoamide S-acetyltransferase（DLAT） oligomerization（P＜0.05）. In the OGD-induced cardiomyocyte injury model， treatment with a PI3K agonist inhibited DLAT oligomerization（P＜0.05）， whereas co-administration of a PI3K inhibitor attenuated the inhibitory effect of the n-butanol fraction on DLAT oligomer formation（P＜0.05）. ConclusionThe n-butanol fraction of BCW exerts a significant protective effect against myocardial ischemic injury， and its mechanism may involve activation of the PI3K and inhibition of cuproptosis.

ObjectiveTo investigate the protective effect and underlying mechanisms of the Bawei Chenxiang Wan （BCW） against myocardial ischemic injury. MethodsMyocardial ischemia in vivo was induced in rats by subcutaneous injection of isoproterenol （ISO）， and ex vivo ischemia was established by coronary artery ligation in isolated rat hearts. The effects of BCW， alcohol extracts and its polar extracts were evaluated on ST segment on electrocardiogram （ECG）， myocardial damage， hemodynamic parameters， and infarct size. The phosphorylation level of phosphatidylinositol 3-kinase （PI3K）， the expression of cuproptosis-related proteins， and the content of Cu²⁺ in myocardial tissue were detected. The regulatory relationship of the signaling pathway was verified using an oxygen-glucose deprivation （OGD） myocardial cell injury model， combined with PI3K agonists and inhibitors. ResultsBCW ameliorated ST-segment elevation on electrocardiograms（P＜0.01）， reduced serum levels of myocardial injury markers， improved hemodynamic parameters， upregulated PI3K phosphorylation（P＜0.01）， and decreased Cu²⁺ accumulation in rats with myocardial ischemia（P＜0.01）. Moreover， BCW reduced the myocardial infarct size. In the isolated rat heart model of ischemia， both the ethanol extract and various solvent fractions of BCW exerted protective effects and reduced Cu²⁺ content， among which the n-butanol fraction exhibited the most potent activity（P＜0.01）. Specifically， the n-butanol fraction upregulated PI3K phosphorylation（P＜0.01） and downregulated the expression of cuproptosis-related proteins， including ferredoxin reductase 1（FDX1）（P＜0.05）， lipoic acid synthetase（LIAS）， and dihydrolipoamide S-acetyltransferase（DLAT） oligomerization（P＜0.05）. In the OGD-induced cardiomyocyte injury model， treatment with a PI3K agonist inhibited DLAT oligomerization（P＜0.05）， whereas co-administration of a PI3K inhibitor attenuated the inhibitory effect of the n-butanol fraction on DLAT oligomer formation（P＜0.05）. ConclusionThe n-butanol fraction of BCW exerts a significant protective effect against myocardial ischemic injury， and its mechanism may involve activation of the PI3K and inhibition of cuproptosis.

AIM:To analyze the association between mobile phone addiction and high myopia among college students.METHODS:We conducted a cross-sectional questionnaire survey in December 2022 on all students of a university in Shaanxi Province, and the questionnaire included socio-demographic characteristics, mobile phone addiction, high myopia, and lifestyle. Binary Logistic regression model was used to analyze the association between mobile phone addiction and high myopia among college students.RESULTS:A total of 19 952 college students were included. The prevalence of high myopia was 7.31%. The rate of mobile phone addiction was 25.68%, and the mobile phone addiction score was 37.59±13.38. The incidence of high myopia among college students with mobile phone addiction was higher than non-mobile phone addiction(P<0.001). After adjusting for socio-demographic characteristics and lifestyle, the risk of high myopia among college students with mobile phone addiction was 1.274 times(95%CI:1.131-1.434)higher than non-mobile phone addiction. For each point increase of total mobile phone addiction score, withdrawal symptoms score, salience score, social comfort score, and mood changes score, the risk of high myopia among college students increased by 0.9%(95%CI:1.005-1.013), 2.0%(95%CI:1.010-1.030), 2.6%(95%CI:1.010-1.043), 4.8%(95%CI:1.030-1.066), and 3.3%(95%CI:1.014-1.052), respectively.CONCLUSION:Mobile phone addiction is significantly associated with the increased risk of high myopia among college students, and early intervention of mobile phone use may reduce the risk of high myopia among college students.

ObjectiveTo investigate the effect and mechanism of Yishen Tongluo prescription in protecting mice from oxidative stress injury in diabetic kidney disease （DKD） via the nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1）/NAD（P）H quinone oxidoreductase 1 （NQO1） signaling pathway. MethodsSpecific pathogen-free （SPF） male C57BL/6 mice were assigned into a control group （n=10） and a modeling group （n=50）. The DKD model was established by intraperitoneal injection of streptozotocin. The mice in the modeling group were randomized into a model group， a semaglutide （40 μg·kg^-1） group， and high-， medium-， and low-dose （18.2， 9.1， 4.55 g·kg^-1， respectively） Yishen Tongluo prescription groups， with 10 mice in each group. The treatment lasted for 12 weeks. Blood glucose and 24-h urine protein levels were measured， and the kidney index （KI） was calculated. Serum levels of creatinine （SCr）， blood urea nitrogen （BUN）， alanine aminotransferase （ALT）， and aspartate aminotransferase （AST） were assessed. The pathological changes in the renal tissue were evaluated by hematoxylin-eosin， periodic acid-Schiff， periodic acid-silver methenamine， and Masson’s trichrome staining. Enzyme-linked immunosorbent assay kits were used to measure the levels of β2-microglobulin （β2-MG）， neutrophil gelatinase-associated lipocalin （NGAL）， kidney injury molecule-1 （KIM-1）， liver fatty acid-binding protein （L-FABP）， nitric oxide synthase （NOS）， glutathione （GSH）， total antioxidant capacity （T-AOC）， and 8-hydroxy-2'-deoxyguanosine （8-OHdG）. Immunohistochemical staining was performed to examine the expression of Kelch-like ECH-associated protein 1 （Keap1） and malondialdehyde （MDA）. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR） and Western blot were employed to determine the mRNA and protein levels， respectively， of factors in the Nrf2/HO-1/NQO1 signaling pathway. ResultsCompared with the control group， the DKD model group showed rises in blood glucose， 24-h urine protein， KI， SCr， BUN， and ALT levels， along with glomerular hypertrophy， renal tubular dilation， thickened basement membrane， mesangial expansion， and collagen deposition. Additionally， the model group showed elevated levels of β2-MG， NGAL， KIM-1， L-FABP， NOS， and 8-OHdG， lowered levels of GSH and T-AOC， up-regulated expression of MDA and Keap1， and down-regulated expression of Nrf2， HO-1， NQO1， and glutamate-cysteine ligase catalytic subunit （GCLC） （P<0.05）. Compared with the model group， the semaglutide group and the medium- and high-dose Yishen Tongluo prescription groups showed reductions in blood glucose， 24-h urine protein， KI， SCr， BUN， and ALT levels， along with alleviated pathological injuries in the renal tissue. In addition， the three groups showed lowered levels of β2-MG， NGAL， KIM-1， L-FABP， NOS， and 8-OHdG， elevated levels of GSH and T-AOC， down-regulated expression of MDA and Keap1， and up-regulated expression of Nrf2， HO-1， NQO1， and GCLC （P<0.05）. ConclusionYishen Tongluo prescription exerts renoprotective effects in the mouse model of DKD by modulating the Nrf2/HO-1/NQO1 signaling pathway， mitigating oxidative stress， and reducing renal tubular injuries.

Multimorbidity has emerged as a critical global public health challenge, necessitating effective management strategies. In Heilongjiang Province, a cold north region in China with a high prevalence of multimorbidity, healthcare disparities, uneven resource distribution, and inadequate chronic disease control remain pressing issues. Driven by national policies on family physician contracting and regional demands for chronic disease management, this study established a "hospital-community general practitioner co-management" model utilizing a mobile-based digital platform. This model integrates hospital-based general practitioners into primary care teams to optimize resource allocation and enhance multimorbidity management. The initiative aims to explore pathways for improving healthcare system reform and strengthening the chronic disease prevention framework in the region.

Objective:To develop PixelSIFT-UNet, a novel semantic segmentation model that integrates deep learning with scale-invariant feature transform (SIFT) algorithm to improve the segmentation accuracy of oral mucosal lesions.Methods:This investigation utilized 838 standard clinical white light images of oral mucosal diseases acquired from January 2020 to December 2022 at the Stomatology Hospital Zhejiang University School of Medicine. Randomization was achieved through Python′s random.seed function implementation. The random sample function was subsequently applied for sampling distribution. The dataset was stratified into three subsets with a 6∶2∶2 ratio: training ( n=506), validation ( n=166), and testing ( n=166). Lesion boundaries were annotated using Labelme software, and a PixelSIFT-UNet-based deep learning model was developed with VGG-16 and ResNet-50 backbone networks. Model parameters were optimized using the validation set, and performance metrics [including Dice coefficient, mean intersection over union (mIoU), mean pixel accuracy (mPA), and Precision] were assessed on the test set. The model′s performance was benchmarked against conventional semantic segmentation frameworks (U-Net and PSPNet). Results:The developed PixelSIFT-UNet model could achieve precise segmentation of three common oral mucosal lesions: oral lichen planus, oral leukoplakia, and oral submucous fibrosis. Utilizing VGG-16 as the backbone network, the model achieved Dice coefficient, mIoU, mPA, and Precision values of 0.642, 0.699, 0.836, and 0.792, respectively. Implementation with ResNet-50 backbone network yielded metrics of 0.668, 0.733, 0.872 and 0.817, demonstrating significant improvements across all performance indicators compared to conventional U-Net model (relevant metrics: 0.662, 0.717, 0.861 and 0.809) and PSPNet model (relevant metrics: 0.671, 0.721, 0.858 and 0.813).Conclusions:The proposed PixelSIFT-UNet architecture demonstrates superior performance in oral mucosal lesion segmentation tasks, surpassing conventional semantic segmentation models and providing robust quantitative improvements in segmentation accuracy.