Background Air pollution has widespread adverse health effects on human health, but research on its impact on reproductive health and related physiological mechanisms remains insufficient. Objective To investigate the associations between short-term exposure to particulate matter and nitrogen dioxide (NO₂) and serum levels of anti-Müllerian hormone (AMH) and testosterone in healthy adults. Methods A total of 152 healthy adults were recruited for a panel study, undergoing four follow-up visits from September 2019 to January 2020. Basic demographic information and serum samples were collected. Reproductive hormone levels were measured by enzyme-linked immunosorbent assay kits. Concurrently, environmental data in the study area were monitored, including fine particulate matter (PM_2.5), black carbon (BC), NO₂, particle number concentrations in the 5-560 nm size fraction (PNC_{5_560}), and meteorological variables. Linear mixed-effects models were constructed to estimate the effects of short-term exposure to these particulate matter on serum reproductive hormone levels. Results The participants had an average age of (23.9±2.4) years, with 102 women. For each interquartile range (IQR) increment in pollutant moving average concentrations, PM_2.5, PNC_{5_25}, PNC_{100_560}, BC, and NO₂ were associated with relative decreases in female serum AMH levels by 10.2%-16.9%, 46.2%-58.0%, 16.9%-21.2%, 14.8%-26.5%, and 11.3%-17.6%, respectively. These negative associations were stronger in females with waist-to-hip ratio > 0.76 and physical activity levels ≤ 1217 metabolic equivalents (MET) min per week. Similarly, in males, an IQR increase in the same pollutants was associated with relative decreases in serum free testosterone by 11.1%-17.2%, 35.2%, 10.5%-18.9%, 18.7%-24.2%, and 10.3%-26.0%, respectively. These effects were more pronounce in male with a waist-to-hip ratios > 0.81 and physical activity levels ≤ 1498 MET-min per week. Conclusion Short-term exposure to particulate matter and NO₂ may reduce serum levels of AMH and testosterone in healthy adults. Furthermore, these adverse effects appears to be stronger in adults with higher waist-to-hip ratios.

Background Microparticles (MPs) are one of the main medium of inflammatory reaction with an important role in atherosclerotic progression. Studies on association of air pollution exposure and levels of peripheral blood MPs are limited among human. Objective To evaluate the effects of short-term exposure to air pollution on levels of peripheral blood MPs. Method A panel of 73 healthy adults was followed with 4 repeated follow-ups in Beijing, China, from November 2014 to January 2016. During each visit, we collected questionnaire information, fasting venous blood, urine, and exposures to fine particulate matter (PM_2.5), black carbon, nitric oxide, nitrogen dioxide, nitrogen oxide, sulfur dioxide, carbon monoxide, and ozone. We used linear mixed-effect models to analyze associations of air pollution exposure with levels of total MPs (TMPs) and MPs derived from various cells. Stratified analysis was conducted by levels of C-reactive protein (CRP) and malondialdehyde (MDA). Results The results showed significant associations between air pollution exposure and peripheral blood TMPs at 2 h-6 d prior to the follow-ups (P<0.05), while no statistical associations were found for MPs derived from different cell types. Significant increases in TMPs of 7.8% (95%CI: 0.7%, 15.3%) and 14.3% (95%CI: 2.8%, 27.2%) were observed with each interquartile range (IQR) increase in PM_2.5 (IQR=64.9 μg·m⁻³) at prior 18 h and NO (IQR=40.5 μg·m⁻³) at prior 48 h. Among participants with low levels of CRP and MDA, significantly positive associations were observed between air pollution exposure and levels of TMPs (P<0.05). Conclusion Short-term exposure to air pollution is significantly associated with increased levels of circulating MPs in healthy adults, and in people with lower systemic inflammation, peripheral blood MPs levels are more easily affected after exposure to air pollutants.

Objective To explore current status and potential subtypes of elderly stroke patients' medication literacy among,and to analyze related influencing factors of different subtypes.Methods A total of 285 elderly stroke patients admitted in the First Affiliated Hospital of Zhengzhou University from November 2023 to June 2024 were selected as subjects.General Information questionnaire,medication literacy scale for elderly patients with chronic diseases,and perceived social support scale were conducted.Latent profile analysis(LPA)of elderly stroke patients' medication literacy was conducted,and Logistic regression analysis was used to explore influencing factors of different profiles.Results Score of medication literacy scale for elderly stroke patients was(48.26±12.51)points.Medication literacy among elderly stroke patients can be divided into 3 profiles,namely proactive-high literacy type(51.9％),balanced-medium literacy type(34.0％),and dependent-low literacy type(14.1％).Logistic regression analysis showed that recent medication types,current place of residence,educational level,diabetes,and social support were the influencing factors of elderly stroke patients' medication literacy(P＜0.05).Conclusion The level of medication literacy among elderly stroke patients is medium,which is characterized by 3 categories.Medical staffs targeted intervention should be adopted according to different category characteristics,so as to accurately meet their nursing needs,finally improve the level of elderly stroke patients' medication literacy.

The air-ground transfer device for patients with serious injury is one kind of medical equipment and system that can realize the safe and efficient transfer for patients with serious injury between the air and the ground under scenarios of emergency medical rescue,which plays an important role in the process of aviation rescue.At present,a variety of air-to-ground transport devices for patients with serious injury have been developed abroad,such as the trauma life support and transportation system of United States,the medical transport aircraft of Israel and so on.In China,it has also been developed,such as general-purpose airborne stretcher supports,life support system for patients with serious injury in moving,cross-platform and etc..However,there are still many challenges in current research and development of air-to-ground transfer devices,including technical stability,intelligent level,the application of new materials and so on.Based on this,this paper systematically reviewed the domestic and international development status of air-to-ground transport devices for patients with serious injury,and analyzed the facing problems and technical challenges of these devices,and discussed their development trends in future.Through the research and analysis for existing devices,this study aimed to provide references for the research and development of air-to-ground transport devices for patients with serious injury,so as to improve the efficiency and quality of emergency medical rescue.

Objective:To construct a deep learning model based on YOLOV8-Seg algorithm to conduct automatic segmentation for the central gland(CG)and peripheral zone(PZ)of prostate,so as to provide a reliable basis for clinical diagnosis and treatment.Methods:The sequence data of T2-weighted imaging(T2WI)of horizontal relaxation time of 158 patients were selected from a public data set of magnetic resonance imaging(MRI)for prostate MRI,which was provided by the Charité University Hospital in Berlin,were selected.The all data were divided into a training set(109 cases),a validation set(16 cases),and a test set(33 cases)as the ratio of 7 to1 to 2.A lightweight asymmetric decoupled head(LADH)structure and the large kernel UniRepLKNetBlock module were integrated into the YOLOV8-Seg algorithm to enhance the capabilities of model's extraction feature,and the new model was named as YOLOV8-URLK.The assessment model with mean Average Precision(mAP),Dice Similarity Coefficient(DSC),95%Hausdorff Distance(HD95),and Average Surface Distance(ASD)was adopted to segment performance of the detection at prostate CG and PZ.Comparative experiments were conducted among that and YOLOV8-Seg,TransU-Net,and U-Net network,so as to validate the effectiveness of YOLOV8-URLK for detection and segmentation at prostate zone.Results:On the test set,the mAP@0.5(box)of YOLOV8-URLK model was 0.878,and the mean Dice coefficients,the mean HD95 values and the ASD values of that at CG and PZ were respectively(0.867,17.123 and 1.461)and(14.902,0.898 and 1.112).On the test set,the mAP@0.5(box)of YOLOV8-Seg model was 0.860,and the mean Dice coefficients of that at CG and PZ were 0.851 and 0.884,the mean HD95 values of that at them were 19.174 and 15.298,and ASD values of that at them were 1.781 and 1.219,respectively.On test set,the mean Dice coefficients of TransU-Net model at CG and PZ were 0.864 and 0.824,and the mean HD95 values of that at them were 18.134 and 19.402,and ASD values of that at them were 1.698 and 1.717,respectively.On the test set,the mean Dice coefficients of the U-Net model at CG and PZ were 0.857 and 0.690,and the mean HD95 values of that at them were 18.976 and 26.934,and ASD values of that at them were 1.753 and 2.135.The YOLOV8-URLK model can better reappear the segmentation trend of manual annotations.Conclusion:The YOLOV8-URLK model demonstrates higher precision in the detection and segmentation of MRI images of prostate,which were superior to YOLOV8-Seg,TransU-Net and U-Net.It can enhance the efficiency of the detection and segmentation.

Objective:To develop an air transfer stretcher for severely injured patients,so as to meet the requirements of severely injured patients for rapid transport of aviation medical treatment.Methods:The guide rails of hatch of mainstream civil airliner models were analyzed through investigation.Based on the principles of modularization,integration and intelligence,a highly universal and portable aviation stretcher with the functions of rapid transport and life support was designed and developed.The design of the stretcher was verified through simulation analysis and calculation,as well as tests in laboratory,which should meet the requirements of the standards from China Civil Aviation Regulations(CCAR)-25.Results:The results of simulation analysis and tests of laboratory showed that the aviation transport stretcher,and the strength and stiffness of its structure reached to requirement of CCAR-25 standard,which was suit to the portable aviation evacuation of severely injured patients on civil airliners,and the rapid transfer between air and ground.It has the function of supporting life,and the aviation transport stretcher with high universality and convenience can enhance the safety and rescue capability of aviation evacuation system of medical treatment of aviation.Conclusion:The portable aviation stretcher with high-versatility that was researched and developed by this study can effectively solve the problems of life support,injury monitoring,and emergently rescue and treatment during the transport for severely injured patients,which improve the support ability of air-ground transportation for severely injured patients.

Objective To understand the current status and influencing factors of microbial contamination of dental unit waterlines(DUWLs)of secondary and lower medical institutions in Wuhan,and provide scientific basis for for-mulating prevention and control measures.Methods A stratified convenience sampling method was adopted to con-duct questionnaire survey on 248 dental medical institutions in 15 districts of Wuhan City,DUWLs from 44 medical institutions were sampled and detected according to hospital levels.Results Among disinfection and maintenance management measures for source water and waterlines,the highest implementation rate was the installation rate of anti-suction dental handpiece(73.39％,182/248),but only 16.48％(30/182)of institutions regularly conducted the detection on anti-suction function;The lowest was the daily disinfection rate of water storage tanks(17.53％,17/97).A total of 132 water specimens were collected from 44 medical institutions,with a qualified rate of microbi-al detection of 56.06％.The qualified rates for secondary,primary,and unclassified medical institutions were 77.78％,50.00％,and 50.72％,respectively,with statistically significant differences(P＜0.05).The qualified rates of microbial detection for source water,handpiece water,and three-way syringe water were 59.09％,50.00％,and 59.09％,respectively,with no statistically significant difference(P＞0.05).Univariate analysis re-sults showed that medical institutions that regularly conducted chemical disinfection on DUWLs,understood DU-WLs waterline cleaning and disinfection standards,regularly performed microbial monitoring on diagnosis and treat-ment water,qualified source water,and flushed waterlines for 3 minutes before and after daily consultations had a higher qualified rate of microbial detection in DUWLs diagnosis and treatment water,and the differences were all statistically significant(all P＜0.05).Conclusion The contamination status of DUWLs in secondary and lower medical institutions in Wuhan is relatively serious.It is recommended to focus on strengthening the training of rele-vant regulations,installing inlet filters,regularly detecting the anti-suction function of dental handpieces,imple-menting chemical disinfection and microbial monitoring on waterlines,standardizing the implementation of flushing before and after diagnosis and treatment,and strengthening the disinfection and use management of independent wa-ter storage tanks to control contamination.

Objective:To analyze the epidemiological characteristics, spatial clustering, and correlation between dental fluorosis detection rates and meteorological factors in children aged 8 - 12 years old in 37 counties (cities, districts, hereinafter referred to as counties) affected by coal-burning-borne endemic fluorosis in Guizhou Province, and to provide a scientific basis for prevention and control of the disease.Methods:Monitoring data on dental fluorosis in children aged 8 - 12 years old from 2019 to 2022 were collected from the National Health Security Information System for Endemic Diseases. Meteorological data, including annual average temperature, annual average precipitation, annual sunshine hours, and annual average relative humidity, were obtained from the Guizhou Provincial Bureau of Statistics. Descriptive epidemiology, analytical epidemiology, and spatial correlation analysis methods were used to analyze the data. Visual maps were created based on the clustering levels of annual dental fluorosis detection rates (high-high, low-low, high-low, low-high). Spatial autocorrelation and meteorological factors were used to analyze the epidemiological characteristics, spatial clustering, and the impact of meteorological factors on dental fluorosis.Results:From 2019 to 2022, a total of 3 649 161 children aged 8 - 12 in the counties affected by coal-burning-borne endemic fluorosis were monitored, and 115 793 children were diagnosed with dental fluorosis, with a detection rate of 3.17%. The detection rates were 4.73% (45 093/954 338) in 2019, 3.35% (31 424/938 445) in 2020, 2.86% (21 727/760 195) in 2021, and 1.76% (17 549/996 183) in 2022, respectively. The dental fluorosis indices were 0.09, 0.07, 0.06, and 0.03, respectively. The number of counties with detection rates > 6% was 7, 5, 5, and 0 in 2019 - 2022, respectively. Dafang County consistently had the highest detection rates, with rates of 10.06% (6 783/67 408), 10.07% (1 955/19 421), 13.54% (4 017/29 667), and 4.83% (3 284/76 206) in 2019 - 2022, respectively. The Moran's I indices for dental fluorosis detection rates were 0.45, 0.53, 0.53, and 0.53 in 2019 - 2022, with Z = 4.29, 5.07, 5.31, and 5.10, respectively ( P < 0.05), indicating global spatial autocorrelation (positive) and spatial clustering of dental fluorosis detection rates. The number of counties with "high-high" clustering of detection rates was 7, 7, 6, and 7 in 2019 - 2022, mainly concentrated in the northwestern region, including Qixingguan District, Nayong County, Dafang County, Zhijin County, and Jinsha County of Bijie City. "Low-high" clustering areas were distributed in Zhongshan District of Liupanshui City in 2019, 2020, and 2022. The detection rate of dental fluorosis was associated with local annual average temperature (°C) and annual precipitation (mm) ( r = - 0.393, - 0.337, P = 0.016, 0.041). Conclusions:From 2019 to 2022, the detection rate of dental fluorosis in children aged 8 - 12 in coal-burning-borne endemic fluorosis areas in Guizhou Province has been decreasing year by year, and it shows spatial clustering. The high clustering area is in the northwest of Guizhou Province, which should be regarded as a key prevention and control area for coal-burning-borne fluorosis in the future. At the same time, areas with lower temperatures and precipitation should also strengthen prevention and control efforts.

Macrophage polarization is involved in the entire process of the occurrence and development of knee osteoarthritis(KO A).By polarizing into distinct functional phenotypes,macrophages play key regulatory roles in the initiation of inflammation,matrix degradation,suppression of cartilage formation,and progression of the disease.The M1-type macrophages secrete numerous pro-inflammatory cytokines to exacerbate the inflammatory responses and promote the destruction of articular cartilage.Conversely,the M2-type macrophages help maintain the extracellular matrix homeostasis and facilitate cartilage formation by releasing anti-inflammatory factors while suppressing the secretion of inflammatory factors,thereby exerting anti-inflammatory effects and promoting tissue repair.Recent studies have shown that an imbalanced ratio of M1/M2 macrophages(M1/M2 ratio)is closely linked with both the pathogenesis and progression of KO A.Restoration of the dynamic balance between these two subtypes could be an essential strategy for treating and preventing KO A.This article reviewed the current literatures retrieved from PubMed and CNKI databases using the keywords"knee osteoarthritis"and"macrophages"over the past decade.The review introduced the process of macrophage polarization and the mechanisms of different macrophage phenotypes in KOA,and further discussed the recent advances in modulating the M1/M2 ratio for KOA management through chemical drugs,bioactive molecules,and traditional Chinese medicine and so on,aiming to provide the theoretical insights for future research and clinical interventions.

Objective To explore the clinical safety of plasma exchange(PE)combined with early continuous renal replacement therapy(CRRT)and its effects on coagulation and immune functions in patients with polytrauma and hypermyoglobinemia.Methods A non-randomized controlled study was conducted on 60 patients with severe polytrauma and myoglobinemia hospitalized in our department from January 2021 to December 2024.Based on different blood purification,the patients were divided a control group(CRRT)combined with conventional basic treatment,n=30)and an observation group(PE+CRRT and conventional basic treatment,n=30).Biochemical indicators(myoglobin,Mb),inflammation-related indicators,peripheral blood lymphocyte subsets,coagulation indicators,clinical-related indicators,and scores were observed and compared between the 2 groups before and after treatment.Results After 1,2 and 3 d of treatment,the levels of Mb,creatine kinase(CK),creatine kinase-MB isoenzyme(CK-MB),lactate dehydrogenase(LDH),serum creatinine(SCr),blood urea nitrogen(BUN),K+,C-reactive protein(CRP),procalcitonin(PCT),IL-6 and D-dimer(D-D),and white blood cell(WBC)count were significantly decreased in both groups(P<0.05).Among them,the observation group obtained obviously lower levels of all above indicators than the control group at the 3 time points(P<0.05).Additionally,notably shorter average length of total hospital stay,shorter average length of trauma intensive care unit stay,and lower score of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)was observed in the observation group than the control group(P<0.05).There were no statistical differences in coagulation function indicators or T lymphocyte subsets between the 2 groups.No complications occurred.Conclusion For patients with polytrauma and hypermyoglobinemia,early application of PE+CRRT can effectively reduce serum myoglobin level,improve serum biochemical inicators,renal function and inflammatory status,and maintain homeostasis,but shows no effect on immune or coagulation functions.This approach is worthy of promoting in clinical practice.