The increasing frequency of radiographic diagnostic imaging and the cumulative dose to the public from radiation has raised widespread concerns. However, accurate measurement of the radiation dose received by the human body is difficult to achieve. Monte Carlo simulation, as a numerical computational method guided by probability statistics theory, has been applied to various dose assessments, imaging optimizations, and radiation protection in radiographic diagnostic imaging. We provide a comprehensive review of the principles of the Monte Carlo method, the modelling process of Monte Carlo simulation and the progress of its application to diagnostic radiological dose estimation.

Objective:To analyze the spatial-temporal epidemiological characteristics of pertussis from 2013 to 2022 in Hebei Province and to provide a reference for improving prevention and control measures.Methods:Based on the data of pertussis reported in Hebei Province during 2013-2022 to analyze the popular characteristic, the ArcGIS 10.8 software was used to construct a ring map and to perform spatial autocorrelation analysis; the SaTScan 10.1 software was used for spatial-temporal scan statistics.Results:There were 6 715 cases of the cumulative report in Hebei Province from 2013 to 2022 without death. The annual report incidence was 0.90/100 000. The overall incidence rate showed an upward trend from 2013 to 2019, and during 2020-2021, it showed a sharp decline, but in 2022, it showed a sharp increase. Summer and autumn are the peak seasons of the epidemic. The incidence was highest in age group <1 year (48.67%), and the lowest age group in age group ≥15 years (0.45%) and mainly scattered children (78.03%); the incidence about men is higher than women. Spatial autocorrelation analysis showed that the onset of pertussis has spatial clustering, and high-high clusters were found in Langfang, Baoding, and Cangzhou, the top three countries with reported incidence. The area covered by a low-low cluster was consistent with the distribution of the corresponding low-incidence areas in this study. Space-time scan detects five statistically significant areas, and three zones were concentrated in 2022.Conclusions:The incidence of pertussis in Hebei had obvious season, population, and area-specific differences. There was obvious spatiotemporal and clustering, so the control of key areas should target the characteristics of time and space.

Myopia is a significant global health issue,and its exact causes are still not fully understood,leaving a lack of effective and propaqable treatment options.The prevalence of myopia among children and adolescents in China remains high,posing challenges for prevention and control efforts.According to the"theory of imbalance of essence and tendon",an imbalance in the essential elements and tendons can impede the passage of eye essence and blood,resulting in delayed expansion and contraction of the eye meridians and tendons,leading to blurred vision.Modern research indicates that during the development of myopia,there are notable changes in the microstructure,activation range,and signaling of various brain regions,providing a biological basis for the"brain-eye"mechanism.Moreover,abnormal activity in the brain nucleus contributes to alterations in choroid blood flow and the impairment of eye muscle regulation,thereby accelerating the progression of myopia,this phenomenon represents the manifestation of the brain-eye imbalance.Consequently,strategies for myopia prevention and control should prioritize nourishing kidney essence,replenishing brain marrow,promoting liver and blood health,and softening the meridians.These measures aim to optimize the functioning of the brain and eyes,maintain the flexibility of eye tendons,enhance eye regulation,sustain the strength of eye tendons,and delay the advancement of eye axis growth and myopia.By enriching the scientific understanding of the appropriate application of traditional Chinese medicine techniques to prevent and control myopia through the brain,this research provides valuable insights for future explorations in this field.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Parkinson's disease (PD) is a kind of neurodegenerative disease based on damage of striatal nigrostriatal dopaminergic neurons, with motor dysfunction as typical clinical feature. However, PD is often accompanied by a series of non-motor symptoms (NMS) represented by depression and anxiety, which not only interferes with clinical management of PD patients, but also seriously affects quality of life of patients. Pathophysiological mechanism of PD comorbid depression and anxiety is still unclear, but is closely related to the disease process, severity of motor dysfunction, and metabolic disorders of neurotransmitter cytokines. This article reviews the epidemiological characteristics, diagnostic criteria, pathophysiological mechanism and treatment strategies of PD comorbid depression and anxiety, in order to improve the NMS clinical management and quality of life of PD patients.

Objective:To investigate the carriage status of Neisseria meningitidis ( Nm) among the healthy population in Hebei Province for the prevention and control of meningitis. Methods:From 2015 to 2022, throat swabs were collected from health people, which were selected by cluster random sampling in 11 cities of Hebei.The positive rate of Nm was detected by bacterial culture. The serogroups of isolated strains were identified.The laboratory detection results of Nm strains, combined with epidemiological survey data, were synthetically analyzed. Results:A total of 20 245 people were investigated; 249 strains of Nm were isolated; the overall Nm carriage rate was 1.23%. The carriage rate was significantly higher in men than in women(χ 2=28.831, P<0.05). The positive rates of Nm in different age groups were significantly different(χ 2=428.018, P<0.05), with the highest rates in the 15-19 year-old group(4.90%, 149/3 042). The positive rates of Nm were significantly different in different regions(χ 2=177.512, P<0.05), with the highest positive rate of Nm in Xingtai, Shijiazhuang, Chengde and Baoding city in sequence. Among the isolated Nm strains, ungroupable serogroups, serogroup B, serogroup C, and serogroup W accounted for 71.49%(178/249), 13.65%(34/249), 6.83%(17/249) and 4.42%(11/249), respectively. Conclusions:The carriage rate of Nm among healthy population is generally low in Hebei Province. It is recommended to continue to strengthen monitoring, pay attention to the changes and distribution characteristics of Nm, and formulate scientific and targeted prevention and control measures of meningococcal disease.

Abstract: Objective To evaluate the impact of meningococcal vaccine immunization on the incidence of meningococcal meningitis, aiming to refine the local immunization strategies and programs. Methods Data on the reported incidence of meningococcal meningitis in Hebei province for 1970-2023 were collected, and interrupted time-series( ITS) analysis was used to quantitatively analyze the levels and slope change of the incidence of meningococcal meningitis before and after vaccine immunization and before and after inclusion in the Expanded Program on Immunization (EPI). Results The annual average reported incidences of meningococcal meningitis in Hebei province before vaccination (1970-1979), before (1980-2007) and after (2008-2023) the inclusion of the vaccine in the EPI were respectively 20.79 per 100 000, 1.66 per 100 000, and 0.018 per 100 000. The interrupted time-series analysis from 1970 to 2023 showed an initial meningitis incidence rate of 24.12 per 100 000 (t=9.86, P<0.05), with an average annual decrease of 1.07 per 100 000 (t=-2.42, P<0.05). After the introduction of the meningococcal vaccine in 1980, the incidence of meningococcal meningitis decreased quickly with an annual average decline of 18.39 per 100 000, showing a significant short-term intervention effect (t=-2.70, P<0.05); however, the rate of decrease slowed over the long term to 0.13 per 100 000, with the long-term intervention effect not being significant (P>0.05). And the incidence was significantly increased due to the outbreak (t=7.80, P<0.05). From 1980 to 2023, the initial level of incidence was 5.13 per 100 000 (t=8.70, P<0.05), and decreased by 0.23/100 000 per year on average (t=-6.42, P<0.05). After the inclusion of the vaccine in the EPI in 2008, the rate of decrease further slowed down to an average of 0.008 per 100,000 per year, with the long-term intervention effect being significant (t=2.50, P<0.05); the impact of epidemic outbreaks on incidence during this period was not statistically significant (P>0.05). Conclusions Meningococcal meningitis vaccination has led to a general downward trend in the incidence of meningitis in Hebei Province, and has flattened the trend of increased incidence caused by outbreaks. Therefore, long-term maintenance in immunization programs on the meningococcal meningitis is necessary. In addition, it is important to strengthen the monitoring of the distribution of epidemic serogroups in patients and healthy carriers, and to adjust immunization strategies timely based on changes in bacterial populations, selecting and promoting vaccines accordingly for the prevalent strains.

Objective To explore the effect and mechanism of miR-92a regulating sonic hedgehog(SHH)pathway on promoting vascular regeneration after myocardial ischemia-reperfusion(I/R)injury.Methods Primary cardiomyocytes were isolated from newborn SD rats(1 to 3 days old),and then cultured to establish a cellular model of hypoxia/reoxygenation injury.The cardiomyo-cytes were divided into cardiomyocyte normoxia group and cardiomyocyte I/R group.After miR-92a mimic and inhibitor were respectively transfected into primary cardiomyocytes to overex-press or lower its expression,the cells were then grouped into control,I/R,miR-92a mimic and in-hibitor groups.CCK-8 assay was used to determine cell viability,flow cytometry was employed to detect cell apoptosis,ELISA and QT-PCR were applied to detect the expression of VEGF,b-FGF and Ang-1,and Western blotting was performed to measure the expression of SHH signaling pathway related proteins.Results The expression level of miR-92a was significantly higher in the cardiomyocytes from the ischemia/reperfusion(I/R)group than the normoxia group(3.89±0.29 vs 1.53±0.19,P＜0.01).Statistical differences were observed among the control group,miR-92a inhibitor group,I/R group,and miR-92a mimic group in the protein levels of SHH(0.57±0.13 vs 0.51±0.11 vs 0.24±0.03 vs 0.14±0.02,P＜0.01),of Smoothened(SMO,0.53±0.12 vs 0.49± 0.10 vs 0.14±0.04 vs 0.09±0.01,P＜0.01),of glioma-associated oncogene homolog 1(Gli-1,0.56±0.14 vs 0.50±0.13 vs 0.15±0.03 vs 0.08±0.01,P＜0.01),and of glioma-associated onco-gene homolog 2(Gli-2,0.58±0.11 vs 0.49±0.12 vs 0.18±0.02 vs 0.11±0.03,P＜0.01).Conclu-sion MiR-92a is abnormally highly expressed in cardiomyocytes after I/R injury,and inhibition of miR-92a can activate SHH signaling pathway to promote the expression of angiogenesis factors effectively.

Objective:To explore the influence of different size related parameters of common CT scanned body parts on body-specific dose estimate (SSDE) , in order to establish rapid conversion factors for SSDE.Methods:A total of 189 clinical cases were collected from 6 common CT scanned body parts, including head, nasal bone, sinus, neck, chest, abdomen and pelvis, at Beijing Tongren Hospital, Capital Medical University from March 8 to May 10, 2021. Batch-processing of image was carried out by using Matlabcode. The axial images′area, anteroposterior (AP) dimension, lateral (LAT) dimension and average CT values were calculated. The conversion factors for estimating body-specific dose values were obtained from the real effective diameter ( De) and water equivalent diameter ( Dw) of the clinical cases, and the differences in values were compared between SSDE ED and SSDE WED. Based on the information on AP, LAT, AP + LAT, estimated De, the real De and Dw obtained in clinical practices, the SSDE rapid correction factors for adult body parts were established. The convenient conversion relation between Dw and De was obtained. Based on the correction factors for Dw, the relative errors of the correction factors for various sizes related parameters were compared. Results:The SSDE fast conversion factors for the real De of the 6 body parts were 1.01, 1.01, 1.01, 0.97, 1.28, 1.32, and those for Dw were 0.87, 0.97, 0.98, 0.99, 1.42, 1.36, respectively. The relative errors of different conversion factors ranged from 0.68% to 18.05%. The conversion factors for abdomen and pelvis had the smallest difference, and those for AP and LAT of the chest had the smallest error. The differences between CTDI vol, SSDE ED and SSDE WED in sinus, chest and abdomen were statistically significant ( tsinus=2.44, 4.23, tchest=17.67, 17.00, tabdomen and pelvis =17.93, 18.75, P<0.05) . The differences between CTDI vol and SSDE WED in head, nasal bone, were statistically significant ( t=-22.27, 2.80, P<0.05) , but not with SSDE ED ( P>0.05) . The difference between CTDI vol and SSDE ED in neck was statistically significant ( t=-3.06, P<0.05) but without statistical insignificance in camparison with SSDE WED ( P>0.05) . Conclusions:SSDE WED can be used to accurately evaluate the body-specific dose estimatates, and different size related parameters can be selected for correction in different scanned body parts. The rapid conversion factor can be easily used in clinical practice to improve the accuracy of estimated radiation dose.

Objective:To explore the clinical application effect of handover record sheet between hospitals based on situation-background-assessment-recommendation (SBAR) model.Methods:Using the convenient sampling method, patients who underwent inter-hospital transfer in the general surgery ward of Peking University Third Hospital from August 2020 to August 2021 were selected. The quality of patient transfer, adverse events of patient transfer and nurses' satisfaction with use were analyzed.Results:A total of 90 patients were included, and there were no adverse events such as falls, pipeline slippage and accidental injuries during the transfer process. The score of handover quality was (6.47±0.68) and the handover quality was good. The score of nurses' satisfaction with the use of handover record sheet was (88.12+12.62) and the overall score was high.Conclusions:The inter-hospital handover record sheet based on the SBAR model conforms to the clinical scenario, which has good clinical application effect. It can improve the quality of patient transfer and ensure the safety of patient transfer.