Objective To investigate the expansion margins of the planning target volume (PTV) and the planning organ at risk volume (PRV) in nasopharyngeal carcinoma patients immobilized with Styrofoam and head-neck-shoulder mask. Methods A convenient sample of 33 nasopharyngeal carcinoma patients who received radiotherapy at Huanggang Central Hospital from January to October 2024 were selected as the research subjects. All patients underwent cone beam CT scans during the first three treatments and weekly thereafter. After registration and calibration, the setup errors in the X (LAT), Y (LNG), and Z (VRT) directions were recorded. Statistical analysis was performed on the setup errors in each direction to determine differences, and the expansion margins for PTV and PRV were calculated using empirical formulas. Results A total of 229 cone beam CT images were collected. Statistical analysis found that the setup errors (systematic error ± random error) of the patients in the X, Y, and Z directions were 1.05 ± 0.72, 1.30 ± 0.80, and 1.29 ± 0.82 mm, respectively. The expansion margins for PTV in the left-right, superior-inferior, and anterior-posterior directions were 1.40, 1.76, and 1.8 mm, respectively. The expansion margins for PRV in these directions were 0.83, 1.02, and 1.05 mm, respectively. Conclusion For patients immobilized using Styrofoam and head-neck-shoulder mask, it is recommended that the expansion margins for PTV and PRV be set at 2 mm and 1 mm, respectively, in the left-right, superior-inferior, and anterior-posterior directions, and the PRV margin for the spinal cord be set at 3 mm in all directions.

OBJECTIVE: To analyze the disease burden of pelvic fractures at the global, regional, and national levels from 1990 to 2023 using data from the 2023 Global Burden of Disease Study (GBD), and to predict the disease burden through 2050. METHODS: Leveraging data from the GBD 2023, this study investigated the disease burden of pelvic fractures across 204 countries and regions. Assessment indicators included incidence rate, prevalence rate, and years lived with disability (YLDs). The Joinpoint regression model was employed to analyze trends in pelvic fracture burden from 1990 to 2023, while the average annual percentage change (AAPC) was used to quantify this temporal trend. The relationship between the socio-demographic index and pelvic fracture burden was evaluated. Furthermore, the long short-term memory (LSTM) model was applied to predict trends in pelvic fracture burden through 2050. RESULTS: In 2023, the estimated number of new pelvic fracture cases globally was 7 479 884 [95% uncertainty interval ( UI): 5 293 401-10 611 876], representing a 42.74% increase from 1990. In the same year, the number of prevalent pelvic fracture cases and YLDs were 23 007 508 (95% UI: 21 021 518-25 327 165) and 3 909 228 person-years (95% UI: 2 725 498-5 194 385), respectively. Additionally, age-standardized rates exhibited an opposing downward trend. Significant disparities in the disease burden of pelvic fractures were identified across different age groups, genders, and social contexts. According to predictions from the LSTM model, the global age-standardized incidence rate (ASIR) of pelvic fractures will be approximately 88.44 per 100 000 persons by 2050, while the total number of incident cases will rise to 8 547 095. CONCLUSION Although the overall incidence rate, prevalence rate, and YLDs of pelvic fractures have exhibited an upward trend over the past three decades, the ASIR, age-standardized prevalence rate (ASPR), and age-standardized years of life lost rate (ASYR) have shown a downward trend. It is predicted that over the upcoming 26-year period, the age-standardized rate of disease burden due to pelvic fractures will further decrease, while the number of incident cases and prevalent cases will continue to exhibit an upward trend. Formulating more targeted disease prevention strategies is critical to addressing disparities across genders, regions, and other dimensions, and to mitigating the burden of pelvic fractures.
Humans ; Fractures, Bone/epidemiology* ; Pelvic Bones/injuries* ; Male ; Female ; Middle Aged ; Adult ; Incidence ; Prevalence ; Aged ; Global Burden of Disease/trends* ; Global Health ; Adolescent ; Cost of Illness ; Young Adult ; Forecasting ; Disability-Adjusted Life Years ; Memory, Short-Term

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

In the context of facing the dual challenges of aging population and declining birth rates, the absolute number of working-age population in China is decreasing, while the proportion of middle-aged and elderly workers is significantly increasing. However, China possesses a vast labor force, and the advantages of talent dividend are gradually emerging, both of which can offset the negative impact of the shrinking demographic dividend on social productivity. Labor is the most active factor among various production factors and is an important component for developing new quality productive forces. With the development of new quality productive forces, occupational health and occupational medicine are presented with new development opportunities. In the process of aging of the labor force, occupational health and occupational medicine can investigate how to utilize next-generation information technology, artificial intelligence, biotechnology, and other growth engines to safeguard the occupational health of workers, extend their working lives, actively unleash their creativity and initiative, and compensate for the labor shortage caused by an aging population and the potential decrease in labor productivity. This transformation in occupational health and occupational medicine is not only crucial for the health and career development of workers in an aging society, but will also have a positive impact on the creation of an age-friendly society and the sustainable development of productivity.

Although there are continuous progresses in economy and society, the accelerated aging process has brought widespread impacts on various aspects of society and economy in China, especially on the supply of the working-age population. Effectively addressing labor force aging has become an urgent challenge for China's economic and social development. North American countries, particularly the United States and Canada, are also facing severe aging population issues, and have entered an aging society earlier than China. These countries have alleviated labor supply shortages through proactive immigration policies, while implementing flexible retirement, reemployment of elderly individuals, and vocational training policies to effectively encourage elderly workers to remain in their jobs. Additionally, the occupational health programs of large enterprises in North America have yielded positive returns on their health investments. Building upon an overview of the current situation and corresponding measures in response to the aging working-age population in North America, this paper presented constructive recommendations to address the aging population issue in China.

ObjectiveMetabolomics was utilized to investigate the preventive effect of notoginseng total saponins（NTS） on aspirin（acetyl salicylic acid， ASA）-induced small bowel injury in rats. MethodFifty male SD rats were randomly divided into normal and model groups， NTS high-dose and low-dose groups（62.5， 31.25 mg·kg^-1）， and positive drug group（omeprazole 2.08 mg·kg^-1+rebamipide 31.25 mg·kg^-1）， with 10 rats in each group. Except for the normal group， rats in other groups were given ASA enteric-coated pellets 10.41 mg·kg^-1 daily to establish a small intestine injury model. On this basis， each medication group was gavaged daily with the corresponding dose of drug， and the normal group and the model group were gavaged with an equal amount of drinking water. Changes in body mass and fecal characteristics of rats were recorded and scored during the period. After 14 weeks of administration， small intestinal tissues of each group were taken for hematoxylin-eosin（HE） staining， scanning electron microscopy to observe the damage， and the apparent damage of small intestine was scored. Serum from rats in the normal group， the model group， and the NTS high-dose group was taken and analyzed for metabolomics by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS）， and the data were processed by multivariate statistical analysis， the potential biomarkers were screened by variable importance in the projection（VIP） value≥1.0， fold change（FC）≥1.5 or ≤0.6 and t-test P<0.05， and pathway enrichment analysis of differential metabolites was performed in conjunction with Human Metabolome Database（HMDB） and Kyoto Encyclopedia of Genes and Genomes（KEGG）. ResultAfter 14 weeks of administration， the average body mass gain of the model group was lower than that of the normal group， and the NTS high-dose group was close to that of the normal group. Compared with the normal group， the fecal character score of rats in the model group was significantly increased（P<0.05）， and compared with the model group， the scores of the positive drug group and the NTS high-dose group were reduced， but the difference was not statistically significant. HE staining and scanning electron microscopy results showed that NTS could significantly improve ASA-induced small intestinal injury， compared with the normal group， the small bowel injury score of the model group was significantly increased（P<0.01）， compared with the model group， the small bowel injury scores of the NTS low and high dose groups were significantly reduced（P<0.05， P<0.01）. Serum metabolomics screened a total of 75 differential metabolites between the normal group and the model group， of which 55 were up-regulated and 20 were down-regulated， 76 differential metabolites between the model group and the NTS groups， of which 14 were up-regulated and 62 were down-regulated. NTS could modulate three differential metabolites（salicylic acid， 3-hydroxybenzoic acid and 4-hydroxybenzoic acid）， which were involved in 3 metabolic pathways， namely， the bile secretion， the biosynthesis of folic acid， and the biosynthesis of phenylalanine， tyrosine and tryptophan. ConclusionNTS can prevent ASA-induced small bowel injury， and the underlying mechanism may be related to the regulation of bile secretion and amino acid metabolic pathways in rats.

Objective Genotypes(G)1,3,and 5 of the Japanese encephalitis virus(JEV)have been isolated in China,but the dominant genotype circulating in Chinese coastal areas remains unknown.We searched for G5 JEV-infected cases and attempted to elucidate which JEV genotype was most closely related to human Japanese encephalitis(JE)in the coastal provinces of China. Methods In this study,we collected serum specimens from patients with JE in three coastal provinces of China(Guangdong,Zhejiang,and Shandong)from 2018 to 2020 and conducted JEV cross-neutralization tests against G1,G3,and G5. Results Acute serum specimens from clinically reported JE cases were obtained for laboratory confirmation from hospitals in Shandong(92 patients),Zhejiang(192 patients),and Guangdong(77 patients),China,from 2018 to 2020.Seventy of the 361 serum specimens were laboratory-confirmed to be infected with JEV.Two cases were confirmed to be infected with G1 JEV,32 with G3 JEV,and two with G5 JEV. Conclusion G3 was the primary infection genotype among JE cases with a definite infection genotype,and the infection caused by G5 JEV was confirmed serologically in China.

Objective To explore the relationship between the intraoperative plasma transfusion volume,the changes of blood coagulation test values and the clinical prognosis of surgical patients,so as to provide a theoretical basis for guiding the rational use of blood during the operation.Methods The clinical data of 556 surgical patients who received plasma in-fusion from January 2017 to December 2020 in Sun Yat-sen Memorial Hospital were collected.Patients were divided into low plasma dose group(＜15 mL/kg)and high plasma dose group(≥15 mL/kg).The univariate regression analysis,logistic multivariate regression analysis and linear regression analysis were used to explore the relationship of plasma dose,the chan-ges of coagulation indicators and the clinical prognosis.Results A total of 556 surgical patients were included in the study and the median(interquartile range)of plasma transfusion volume for all patients during the operation was 10.5(8.5～14.0)mL/kg.In multivariate regression analysis,an increase of 1 mL/kg of intraoperative plasma dose resulted in an in-creased risk of red blood cell infusion within 24 hours after surgery[OR(95%CI)1.16(1.01,1.33),P＜0.05],an in-crease in the ICU stays[Mean(95%CI)0.19(0.03,0.35),P＜0.05]and an increase in the hospitalization days[Mean(95%CI)0.55(0.27,0.81),P＜0.05].The preoperative INR value increased the risk of red blood cell infusion within 24 hours after surgery[OR(95%CI)1.82(1.33,2.50),P＜0.05],and increased the hospital mortality of postoperative pa-tients[OR(95%CI)2.15(1.09,4.24),P＜0.05];the decrease in INR reduced the risk of red blood cell infusion in pa-tients 24 hours after surgery[OR(95%CI)0.47(0.27,0.84),P＜0.05]and reduced hospital mortality[OR(95%CI)0.23(0.13,0.50),P＜0.05].Conclusion In surgical patients undergoing intraoperative plasma infusion,abnormal preopera-tive INR value and high intraoperative plasma infusion are related to poor clinical prognosis,while INR decrease(preopera-tive-postoperative)was related to better clinical results.

[Objective]To assess the impact of intraoperative plasma infusion dose and coagulation test value INR on the clinical prognosis of patients undergoing cardiac surgery,providing a basis for guiding rational blood use during cardi-ac surgery.[Methods]The clinical data of 305 surgical patients who received fresh frozen plasma transfusion during cardiac surgery were collected in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2014 to December 2022.The patients were divided into low-dose group(plasma infusion dose<15 mL/kg,n=214)and high-dose group(plasma infusion dose≥15 mL/kg,n=91)based on the intraoperative plasma dose.Univariate analysis,correlation analysis and logistic multivariate regression analysis were used to analyze the relationship between plasma infusion dose,changes in INR before and after plasma transfusion,and the clinical prognosis of patients undergoing cardiac surgery.[Results]The median plasma infusion dose for all patients was 11.11(8.17-19.05)mL/kg,while the median plasma infusion dose in the high-dose group and the low-dose group was 17.78(15.69-20.91)mL/kg and 9.52(7.77-11.43)mL/kg,respectively,with a statistically significant difference(P<0.001).The median INR decrease in the high-dose and low-dose groups was 0.98(0.60-1.26)and 0.50(0.35-0.76),respectively,with a statistically significant difference(P<0.001).Logistic multi-variate regression analysis revealed that abnormally elevated preoperative INR values increased the risk of postoperative red blood cell transfusion within 24 hours in cardiac surgery patients(P<0.001),with an OR 95%CI of 6.757(3.068,14.822).Additionally,it also increased the risk of postoperative in-hospital mortality(P<0.001),with an OR 95%CI of 5.441(2.193,13.499).INR decrease reduced the risk of postoperative red blood cell transfusion within 24 hours in cardi-ac surgery patients(P=0.001),with an OR 95%CI of 0.244(0.107,0.558).Correlation analysis showed positive correla-tion between plasma infusion dose and postoperative ICU days(rs=0.569,P<0.001)and hospital days(rs=0.302,P<0.001)in cardiac surgery patients.[Conclusion]Among patients undergoing cardiac surgery who receive intraoperative plasma transfusion,high plasma infusion dose and abnormally elevated preoperative INR values are associated with poorer clinical outcomes,while patients who show a greater degree of INR correction after plasma transfusion exhibit better clini-cal results.