Objective To evaluate the environmental radioactive safety level in China, monitor the radioactivity of strontium-90 (⁹⁰Sr) in seafood from selected marine regions of China, and optimize the di-(2-ethylhexyl)phosphoric acid (HDEHP) extraction chromatography method for determining Sr-90 in seafood. Methods In 2023, seafoods of fish, shrimp, shellfish, and seaweed were collected from the Shandong Province (Bohai Sea and Yellow Sea) and Hainan Province (South China Sea). The levels of Sr in the samples were determined by inductively coupled plasma atomic emission spectrometer (ICP-AES). The ⁹⁰Sr separation were performed using HDEHP extraction chromatography, while the recovery of ⁹⁰Sr were determined by the gravitmetry with the assistant of ICP-AES. Results The content of strontium in seafoods varies greatly, and excessive strontium and calcium in seafood may lead to overestimated recovery due to insufficient leaching during chromatographic separation by HDEHP extraction. Therefore, the yttrium content in the eluent should be analyzed by ICP . The radioactivity of ⁹⁰Sr in seafood from the sea areas in Shandong Province was 0.22-1.85 Bq/kg (dry weight), and that of seafood from Hainan Province was 0.19-1.82 Bq/kg (dry weight). Conclusion For the analysis of shirmp and seaweed samples, the recovery rate of ⁹⁰Sr should be analyzed using both gravimetry and ICP-AES. There is no significant linear correlation between total Sr and ⁹⁰Sr in seafood. There is no significant difference in ⁹⁰Sr radioactivity between the seafood samples collected from Shandong and Hainan. The ⁹⁰Sr radioactivity levels of all 28 samples are below the limit specified in the Limited concentrations of radioactive materials in foods (GB 14882—1994) and are within the range of environmental background fluctuations.

Objective To organize a nationwide interlaboratory comparison for measurement of gross α and gross β radioactivity in water, and improve the laboratory analysis of gross α and gross β radioactivity in water. Methods A unified comparison protocol was developed by the organizers. The groundwater with high natural radioactivity was used as water sample and distributed randomly to the participating laboratories. The participating laboratories used routine analytical methods to measure the samples and provided information such as analytical results, original records, and test reports. The results were evaluated using z-score. Results A total of 76 laboratories participated in the comparison, all employing the evaporation concentration-α/β counting method. Among them, 69 laboratories achieved |z| ≤ 2 for both gross α and gross β radioactivity measurements, and 32 laboratories achieved |z| ≤ 0.50 for both gross α and gross β radioactivity measurements. There were 69 laboratories with qualified results and 30 laboratories with excellent results, yielding a qualified rate of 90.8% and an excellent rate of 39.5%. Seven laboratories showed unqualified results and the unqualified rate was 9.2%. Conclusion Most laboratories have the ability to analyze gross α and gross β radioactivity in water. The main reasons for the deviation in comparison results are calibration efficiency, errors in the total residue mass caused by improper water sample processing operations. By analyzing the main technical problems existed in unqualified laboratories, their ability for measurement of gross α and gross β radioactivity in water has been improved.

Objective To investigate the status and influencing factors of overweight and obesity among primary and secondary school students in Pudong New Area of Shanghai, and to provide reference for formulating obesity-related intervention strategies for school-age children. Methods Stratified cluster random sampling method was used to conduct a questionnaire survey among primary and secondary school students in Pudong New Area. The overweight and obesity rate was calculated according to the Chinese health industry standard, and the risk factors of overweight and obesity in children and adolescents of different school age groups were analyzed by logistic regression. Results The overweight and obesity rate (25.3%) of primary and secondary school students in Pudong New Area exceeded the national average level. In primary school group, male, sleep time ≥ 8h per day, water intake ≥ 1200 mL per day, and the presence of mobile food stalls around the school were the risk factors for overweight and obesity. Daily extracurricular exercise time of 30 minutes to 2 hours was a protective factor. In junior high school group, male and electronic product use time of ≥ 2h per day were the risk factors for overweight and obesity. The daily extracurricular exercise time of 1 to 2 hours was a protective factor. In high school group, drinking water ≥1200mL per day was a risk factor for overweight and obesity. Eating breakfast every day for the past week was a protective factor. Conclusion Group intervention targeting overweight and obese school-age children, while changing corresponding unhealthy habits according to different school age groups, is crucial for weight loss in school-age children.

Diabetic cataract, a prevalent ocular complication of diabetes mellitus, arises from a complex interplay of pathological mechanisms, with oxidative stress and glycation stress playing central roles. Autophagy, a critical cellular self-protection mechanism, sustains intracellular homeostasis by selectively degrading damaged organelles and misfolded proteins, thereby counteracting the detrimental effects of oxidative and glycation stress under hyperglycemic conditions. Emerging evidence indicates a synergistic interaction between glycation stress and oxidative stress, which may exacerbate autophagic dysfunction and accelerate the onset and progression of diabetic cataract. However, the precise molecular mechanisms underlying this relationship remain incompletely understood. This review systematically examines the regulatory role of autophagy inthe pathogenesis of diabetic cataract, with a particular focus on how autophagic impairment influences disease progression under the combined effects of glycation and oxidative stress. By elucidating these mechanisms, the paper aims to provide novel insights into molecular diagnostic approaches and targeted therapeutic strategies for diabetic cataract.

Globally, over 300 million surgeries are performed each year, and more than 50% of surgeries involve patients aged 65 and older. Aging poses significant challenges to perioperative brain health, as the deterioration of brain structure and function increases susceptibility to postoperative neurological complications. Protecting perioperative brain health remains a worldwide clinical challenge. With senescence, the brain undergoes a progressive decline in homeostasis across various molecular, cellular, and regional functions. Anesthetics and surgical stimuli may accelerate the disruption of brain homeostasis and exacerbate age-related neurodegeneration. This review provides a framework for understanding how anesthesia and surgery can affect brain health in the aging population and contribute to postoperative neurological complications, with a particular focus on perioperative neurocognitive disorder.

Alopecia areata （AA） is a common hair loss disorder， and the core pathogenesis is the internal gene-ration of turbid toxin caused by qi movement disorder in the liver， spleen， and kidney. Turbid toxin serves as both a pivotal etiological trigger and a pathological driver of disease exacerbation. Clinically， AA can be classified into four principal patterns， including liver constraint with spleen deficiency， internal accumulation of damp-heat， liver-kidney depletion， and qi-blood depletion. Therapeutic strategies prioritize clearing and resolving turbid toxin while regulating the qi movement of the liver， spleen， and kidney. Accordingly， different formulas were applied. Self-formulated Shugan Jianpi Huazhuo Formula （疏肝健脾化浊方） is suggested to drain dampness， resolve turbidity， and unblock qi movement. Self-formulated Sanjiao Fenxiao Jiedu Formula （三焦分消解毒方） can be used to clear heat， drain dampness and resolve toxin. Self-formulated Zishen Yanggan Toudu Decoction （滋肾养肝透毒汤） can clear and vent latent toxins， while Self-formulated Guiqi Shengfa Didu Formula （归芪生发涤毒方） is employed to tonify qi and blood， purge toxins， and regenerate vitality. By differentiating and treating AA based on the functional patterns of the liver， spleen， and kidney， this approach expands the application scope of the turbid toxin theory and provides valuable insights for treatment of AA.

Objective To observe the expression levels of base excision repair(BER)pathway-related proteins in small cell lung cancer(SCLC)tissues,and analyze their relationship with the prognosis and tumor immune microenvironment.Methods A retrospective cohort study was conducted on 74 patients with limited-stage SCLC undergoing surgical treatment in our medical center from December 2018 to June 2023.Immunohistochemical staining was performed to analyze the protein expression of BER pathway components,apurinic/apyrimidinic endonuclease 1(APE1),8-oxoguanine DNA glycosylase 1(OGG1),DNA polymerase β(POLβ),X-ray repair cross-complementing protein 1(XRCC1),ATP-dependent DNA ligase I(LIGⅠ),and immune cell infiltration markers of CD3? T cells,CD8? T cells,CD68? macrophages in SCLC tissues.Chi-square test was applied to analyze the relationship of BER protein expression and clinicopathological features;Kaplan-Meier survival curve was plotted to evaluate the impacts of BER protein expression and immune cells on disease-free survival(DFS)and overall survival(OS),multivariate Cox regression analysis was utilized to identify DFS prognostic factors,and Spearman correlation analysis was performed to analyze the correlation of BER-immune cell infiltration.In in vitro experiments,transient transfection was applied in H196 cells to overexpress APE1/POLβ/LIGⅠ,respectively.Thus,the cells were divided into negative control(NC,empty vector)and overexpression(OE,target plasmids)groups.CCK-8 and TUNEL assays were employed to determine the effects of OEAPE1,OEPOLβ and OELIGⅠon cell sensitivity to cisplatin.In in vivo experiments,nude mice bearing xenograft tumors were grouped into WT,E3330(APE1 inhibitor),cisplatin,and cisplatin+E3330 groups to determine the effects of the combination therapy on tumor growth.Results There were no significant correlations of the expression levels of key BER pathway proteins with clinicopathological characteristics,including gender,age,smoking history,tumor location,Ki67 index,or TNM stage(all P>0.05).The patients with low expression of APE1,POLβ,and LIGⅠ had obviously higher DFS rates than those with high expression(P<0.05),and the patients with larger proportion of CD3+T cells also had higher DFS rates than those with smaller proportion(P=0.043).Multivariate Cox regression analysis indicated that tumor TNM stage(HR=2.465)and APE1 expression(HR=2.730)were independent risk factors for the prognosis of SCLC patients(P<0.05).Spearman correlation analysis demonstrated a positive correlation between APE1 and CD8+T cell proportion in the SCLC patients(r=0.27,P<0.05).In vitro experiments showed that the overexpression(OE)cells(OEAPE1 and OELIGⅠ)exhibited reduced sensitivity to cisplatin than the NC group(P<0.05).Animal experiments indicated that cisplatin+E3330 significant inhibited xenograft tumor growth,indicating enhanced therapeutic efficacy(P<0.01).Conclusion High expression of APE1,POLβ,and LIGⅠ in the BER pathway indicates poor prognosis and low DFS rate in SCLC patients.High expression of APE1 is positively correlated with CD8+T cells,and can be used as an auxiliary marker for SCLC immunotherapy.

Objective To explore the impact of obstructive sleep apnea(OSA)on cognitive impairment in post-stroke patients,to explore its underlying mechanism and to evaluate potential diagnostic value by dynamically moni-toring the level of brain-derived neurotrophic factor(BDNF)and Tau protein in serum.Methods Totally 96 stroke patients admitted to Mianyang third People's Hospital from February 2022 to June 2024 were selected.They were divided into the groups complicated with OSA and control one without OSA following up of neuropsychological scales for 1 week,1 month,3 months,and 6 months after stroke for evaluating cognitive function.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the level of BDNF and Tau protein in serum.The correlation of test results and the degree of cognitive impairment as well as their diagnostic value were analyzed.Results The AHI in the OSA group was significantly higher than that of control group,while LSaO2 and MSaO2 were significantly lower in the OSA group(P＜0.05).One week and 1,3,6 month months after the onset of the disease,the MMSE and MoCA scores in the OSA group were significantly lower than those in the control group,BDNF level was signifi-cantly lower while Tau protein level was significantly higher as compare to those in control group(P＜0.05).Pear-son correlation analysis showed that the serum BDNF level was positively correlated with both MMSE score(r=0.654,P＜0.001)and MoCA score(r=0.689,P＜0.001).However,the serum Tau protein level was nega-tively correlated with both MMSE score(r=-0.623,P＜0.001)and MoCA score(r=-0.667,P＜0.001).The ar-ea under the curve(AUC)of the combined detection of BDNF and Tau protein was greater than that of the individ-ual detection.The diagnostic value of the combined detection of BDNF and Tau protein for cognitive impairment in post-stroke patients was greater than that of the individual detection(P＜0.05).Conclusions OSA significantly exacerbates patients'cognitive impairment after stroke.Elevated serum BDNF level and decreased Tau protein level may be the underlying mechanisms of cognitive impairment.Serum BDNF and Tau protein may function as potential biomarkers for diagnosis of cognitive impairment after stroke.

Objective It aims to construct an evaluation index system for the development level of intelligent health insurance,which can serve as a reference for health insurance management departments in assessing the develop-ment level of intelligent health insurance and the implementation of health insurance informatization.Methods Key events in intelligent health insurance were identified based on event system theory and text analysis.The evaluation index system was determined through a combination of expert interviews and Delphi expert consultations.The entro-py method was used to calculate the weights of each index,followed by the assessment of the current and ideal de-velopment levels.Results A total of 16 experts were consulted.After two rounds of Delphi expert consultation,two first-level indicators and 18 second-level indicators were finally included in the system.The current development level of intelligent health insurance in China is at the intelligent development stage(2.524 points),while the ideal de-velopment level is at the intelligent improvement stage(4.073 points).The positivity coefficient of both rounds of Del-phi expert consultation was 100%,with an authority coefficient of 0.842,and the degree of expert coordination im-proved with each round.Conclusion The constructed evaluation index system exhibits high scientificity,stability,and generalizability.It can provide an effective evaluation tool for the development of intelligent health insurance in various pooled areas.

Taking the reform of DRG payment methods as the background,it discusses how the medical in-surance department uses information technology to achieve refined monitoring and management of medical institu-tions,so as to improve the quality and efficiency of medical services and control the unreasonable growth of medical expenses.The three stages of"precision monitoring-refined supervision-precision governance"of medical insurance DRG based on"refined theory"are proposed;taking Nanjing's"medical insurance high-speed railway"as an example,a DRG refined supervision and governance model framework is constructed,and its analysis is carried out monitoring elements and governance elements,and finally put forward implementation suggestions,including hori-zontal collaboration led by medical insurance,establishing a service and cost evaluation mechanism that combines in-ternal and external services.