ObjectiveTo investigate the changing trend of the disease burden of hepatitis B and its related liver cirrhosis in China， to identify related influencing factors， and to provide a basis for optimizing prevention and treatment strategies. MethodsBased on the data from Global Burden of Disease Study in 2021， the Joinpoint regression model was used to calculate the average annual percentage change of the age-standardized incidence rate， prevalence rate， mortality rate， and disability-adjusted life year （DALY） rate of chronic hepatitis B and its related liver cirrhosis from 1992 to 2021. An age-period-cohort model was established to assess the risk of disease onset， and the ARIMA model was used to predict the trend of disease burden from 2022 to 2031. ResultsFrom 1992 to 2021， there was a tendency of reduction in the overall age-standardized incidence rate， prevalence rate， mortality rate， and DALY rate of hepatitis B and its related liver cirrhosis in China， with an average annual decline of 4.52% （95% confidence interval ［CI］： -4.63% to -4.44%， P<0.05）， 2.73% （95%CI： -2.80% to -2.66%， P<0.05）， 3.41% （95%CI： -3.50% to -3.33%， P<0.05）， and 3.55% （95%CI： -3.65% to -3.48%， P<0.05）， respectively. Compared with female individuals， male individuals had significantly higher age-standardized incidence rate， prevalence rate， mortality rate， and DALY rate. From 1992 to 2021， the risk of hepatitis B and its related liver cirrhosis in China first decreased， then increased， and decreased again with age， and it showed an tendency of reduction with time， while it first increased and then decreased with birth cohort. The predictive model showed that there would be a tendency of reduction in the age-standardized incidence rate， prevalence rate， mortality rate， and DALY rate of hepatitis B and its related liver cirrhosis in China from 2022 to 2031. ConclusionFrom 1992 to 2021， there was a tendency of reduction in the disease burden of hepatitis B and its related liver cirrhosis in China， and it would maintain a downward trend in the next decade. There are sex and age differences in the risk of hepatitis B and its related liver cirrhosis.

BACKGROUND:Osteoarthritis is a common degenerative joint disease,and the etiology and development of its pathogenesis are still unclear.Timely diagnosis and treatment of early osteoarthritis are crucial,and there is currently no definite and effective method.Extracellular vesicles come from a wide range of sources,including non-coding RNAs such as small RNAs,circular RNAs,and long chain non-coding RNAs.Extracellular vesicles non-coding RNAs can be directly delivered from primitive cells to neighboring or remote cells,regulating cell activity through intercellular communication and playing an important regulatory role in reshaping the bone and joint microenvironment.OBJECTIVE:To summarize the intervention effects of exosome-derived non-coding RNAs on the joint microenvironment of osteoarthritis and the progress made in clinical application,and to clarify the potential of exosome-derived non-coding RNAs in the diagnosis and treatment of osteoarthritis.METHODS:Search terms "exosomes,non-coding RNA,osteoarthritis,application,signal pathway,synovial fluid,cartilage cells,cartilage matrix,subchondral,mechanism" were used for the search on PubMed database.Finally,66 related articles were included for review analysis.RESULTS AND CONCLUSION:(1) Exosome-derived non-coding RNAs play an important regulatory role in the joint microenvironment during the pathogenesis of osteoarthritis,mainly reflected in:exosome non-coding RNAs regulating the inflammatory response in the joint,degeneration of chondrocytes and cartilage matrix,subchondral bone remodeling,and intercellular communication.(2) The non-coding RNAs in exosomes can serve as biomarkers for osteoarthritis,aiding in the early diagnosis and monitoring of disease progression and prognosis.(3) Exosome non-coding RNAs serve as therapeutic targets for osteoarthritis.Exosomes carry miRNAs to the articular chondrocytes and cartilage matrix to play a regulatory role.(4) Exosomes non-coding RNAs can improve the effect of cartilage tissue engineering by regulating gene expression and promoting intercellular communication to repair or regenerate damaged cartilage.(5) In future research,researchers should continue to explore the intervention mechanism of non-coding RNAs derived from exosomes on osteoarthritis,and apply them to clinical practice in combination with the latest research outcomes in cartilage tissue engineering,which will effectively help solve the pain of osteoarthritis patients.

Objective:Based on the functional classification structure of the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS), the data available in the open database of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed longitudinally to construct the development trajectories of different functional dimensions among China′s elderly population.Methods:The CHARLS data for 2013, 2015 and 2018 describing persons aged 60 and older were distributed using the ICF-RS′s classification structure. Group-based multi-trajectory modeling (GBMTM) was then applied to analyze the characteristics of the development trajectories of physical functioning, daily activities and social participation.Results:Different development trajectory subtypes emerged from the data. A gradual decline in physical functioning was evident throughout the study period, while daily activities first improved and then declined. Social participation was in decline throughout the period. There were, however, significant differences in the initial functional level, the degree of decline and the degree of decline reversal among the different subtype groups.Conclusions:The overall functional performance of the elderly in China shows a downward trend, but some functional dimensions can still improve with time, at least during the specific period covered in this open database. It is recommended that the ICF-RS be integrated into the CHARLS to comprehensively assess the classification of function and developmental changes among China′s elderly.

Objective To assess the incidence of contrast-induced nephropathy(CIN)in patients with chronic thromboembolic pulmonary hypertension(CTEPH)after receiving balloon pulmonary angioplasty(BPA),and to evaluate the effect of the contrast agents on renal function.Methods A total of 143 CTEPH patients,who received BPA at the China-Japan Friendship Hospital of China from December 2018 to May 2022,were enrolled in this study.The clinical data,hemodynamic indicators,and serum creatinine(SC)concentrations within one week before and 48-72 h after BPA were collected.The estimated glomerular filtration rate(eGFR)was calculated according to the Modification of Diet in Renal Disease(MDRD)formula.The SC concentration and eGFR changes before and after each BPA procedure were compared.The incidence of CIN and its risk factors were evaluated,and the changes in hemodynamics,SC and eGFR after the initial and last time of BPA treatment were analyzed.Results A total of 192 BPA procedures were performed in 115 CTEPH patients,including 88 BPA procedures in males and 103 BPA procedures in females.The mean amount of contrast agent used for each BPA was(145.58±47.26)mL.After BPA,12 patients developed 13 times of CIN,with an incidence of 6.8％.There was no significant differences(P＞0.05)in the baseline characteristics and SC concentration before BPA between CIN patients and non-CIN patients.In terms of the hemodynamic indexes,the mixed venous oxygen saturation(SvO2)in CIN patients was significantly lower than that in non-CIN patients(58.58％±10.38％vs.66.15％±8.02％,P=0.002),and no statistically significant differences(P＞0.05)in the other hemodynamic indexes existed between CIN group and non-CIN group.No statistically significant differences in SC concentration and eGFR existed before and after each BPA procedure.In patients who had received several BPA procedures,significant improvements in the SC[(78.09±18.760)μmol/L vs.(82.26±21.37)μmol/L,P＜0.001]and eGFR[(86.08±21.22)mL/(min·1.73 m2)vs.(82.07±22.05)mL/(min·1.73 m2),P=0.007]was achieved when compared with their baseline values.Conclusion CTEPH patients may develop CIN after receiving BPA treatment.After receiving several BPA treatments the patient's clinical symptoms and hemodynamics can be improved,and the patient's renal function is also significantly improved.

The long service life and high reliability of SiC sliding bearings are crucial for the long-term normal operation of aerospace power equipment.In response to the fracture phenomenon observed in the sliding bearing assembly of a certain delivery pump during operation,this paper analyzes the issue from the perspectives of stress characteristics and thermal expansion effects,proposing a structural optimization design method based on temperature coefficient compensation.The research indicates that the primary cause of bearing fracture is the difference in thermal expansion coefficients between the bearing and the metal rotor under elevated temperatures,leading to axial loosening of the bearing.Additionally,the gap between the bearing and the pin,combined with unstable lubrication of the friction pair,exacerbates bearing stalling and pin impact,ultimately causing cracks and localized chipping.By optimizing the bearing structure and employing a rubber pad for torque transmission,this issue has been successfully resolved.The improved structure demonstrated high reliability and stability in bench tests,providing important theoretical and technical references for the design of bearings under similar extreme operating conditions.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To evaluate the impact of COVID-19 prevention and control measures on the disease burden of upper respiratory infections(URIs)in China.Methods Age-standardized incidence rate,mortality rate,and di-sability-adjusted life-year rate in Global Burden of Disease(GBD)2021 database were used to describe the disease burden and compared before and after the outbreak of COVID-19.The disease burden in 2022-2024 was predicted by the autoregressive integrated moving average model in R 4.4.0 software.Results The disease burden of URIs in China showed a fluctuating downward trend from 1990 to 2021.Age-standardized incidence rate,mortality rate,and disability-adjusted life-year rate showed a downward trend from 2018 to 2019.The age-standardized incidence rate decreased from 137 869.97/100 000(95％UI:121 058.04/100 000-158 137.76/100 000)in 2019 to 137 060.04/100 000(95％UI:120 167.04/100 000-156 888.93/100 000)in 2020.The age-standardized mortality rate were 0.15/100 000(95％UI:0.09/100 000-0.40/100 000)and 0.15/100 000(95％UI:0.09/100 000-0.38/100 000,respectively.The age-standardized disability-adjusted life-year rate decreased from 51.76/100 000(95％UI:32.16/100 000-77.43/100 000)to 51.44/100 000(95％UI:32.19/100 000-76.90/100 000.In 2021,the above-mentioned indicators were higher than those in 2020,but still lower than those in 2019.The au-toregressive integrated moving average model predicted that over the next three years,the age-standardized incidence rate and disability-adjusted life-year rate might show an upward trend,and the age-standardized mortality rate was likely to decline.Conclusion The disease burden of URIs in China shows a downward trend,and declines signifi-cantly after the outbreak of COVID-19.After COVID-19 being categorized as a class B infectious disease managed with class B measures,the age-standardized incidence rate increases,which reflects the effectiveness of the COVID-19 prevention and control measures on reducing the disease burden of URIs.

Severe intra-abdominal infections are life-threatening conditions and a significant challenge for surgeons. This article presents a case of an elderly patient with a severe intra-abdominal infection complicated by an anastomotic leak. This patient had experienced prolonged sepsis and multiple surgical traumas. Upon admission to our department, exploratory surgery revealed extensive bowel edema and adhesions, an anastomotic leak, and abdominal contamination with infection. In accordance with the principles of damage control surgery, the anastomotic leak was exteriorized, the abdomen was left open, and continuous intra-abdominal lavage with dual-lumen catheters was implemented to effectively control the infection. Negative pressure wound therapy was used to manage the open abdomen, and a negative pressure-assisted drainage device was used to manage the enteroatmospheric fistula. After granulation of the abdominal wound, split-thickness skin grafting was performed. The enteroatmospheric fistula was converted into an enterocutaneous fistula. A 3D-printed stoma baseplate was used to manage the digestive fistula. Concurrently, enhanced parenteral and enteral nutritional support was provided. Six months later, the patient successfully underwent definitive fistula resection and abdominal wall defect repair.