Background The association between occupational physical activity (OPA) and cardiometabolic risk factors remains controversial, potentially due to differences in the associations between OPA and various cardiometabolic indicators, as well as the lack of a clearly defined optimal OPA range for multiple-indicator synergistic benefits. Objective To investigate the relationship between OPA and cardiometabolic risk factors in individuals at high risk of cardiovascular disease (CVD) in Hubei Province, and to explore an optimal OPA range for multi-indicator improvements. Methods Data were derived from the Hubei Province dataset of the China Health Evaluation And Risk Reduction Through Nationwide Teamwork from 2015 to 2023, including 19028 high-risk CVD individuals. OPA (metabolic equivalent·h·d⁻¹, MET·h·d⁻¹) was assessed using the China Kadoorie Biobank physical activity questionnaire, anthropometric measurements (height, weight, waist circumference) and cardiometabolic indicators (blood pressure, fasting blood glucose, lipid profiles) were measured. Multivariate logistic regression was used to analyze the association between logOPA quartiles (Q1-Q4) and abnormal cardiometabolic indicators, while restricted cubic spline (RCS) models were employed to explore their dose-response relationships. Subgroup and interaction analyses were also conducted by gender. Results The median OPA of all participants was 12.86 MET·h·d⁻¹ (male: 14.40 MET·h·d⁻¹, female: 11.14 MET·h·d⁻¹). After adjusting for confounders, compared with the Q1 group, logOPA in the Q4 group was associated with 20% (OR=0.80, 95%CI: 0.72, 0.89), 14% (OR=0.86, 95%CI: 0.78, 0.96), and 13% (OR=0.87, 95%CI: 0.79, 0.95) reduction in the risk of abdominal obesity, low high-density lipoprotein cholesterol (HDL-C), and metabolic syndrome (MS), respectively, and 33% (OR=1.33, 95%CI: 1.18, 1.49), 33% (OR=1.33, 95%CI: 1.18, 1.50), and 38% (OR=1.38, 95%CI: 1.21, 1.57) increase in the risk of high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), and high non-HDL-C, respectively. Similar trends were observed in males and females, with significant positive associations of logOPA with high TC and high non-HDL-C in males (P_interaction<0.05). The risk of low HDL-C decreased rapidly when logOPA was more than 2.213 (OPA>9.14 MET·h·d⁻¹), showing an inverted L-shaped trend. The risk of high TC, high LDL-C, and high non-HDL-C increased beyond logOPA thresholds of 3.244, 2.476, and 3.377 (OPA >25.64, 11.89, and 29.28 MET·h·d⁻¹), respectively, showing a J-shaped trend. However, logOPA exhibited a U-shaped nonlinear dose-response relationship with blood pressure and fasting blood glucose abnormalities (P_non-linear<0.05) , with minimal risks at logOPA 2.969 and 2.372 (OPA of 19.47 and 10.72 MET·h·d⁻¹). Conclusion OPA exhibits heterogeneous dose-response patterns across cardiometabolic indicators. Integrating the inverted L-, J-, and U-shaped association patterns, we suggest an optimal OPA range of 9.14−25.64 MET·h·d⁻¹ for multiple cardiometabolic indicators in total individuals at high-risk of CVD, with ranges of 9.61−31.34 MET·h·d⁻¹ for males and 8.97−22.87 MET·h·d⁻¹ for females. These findings provide critical evidence for developing OPA interventions strategies targeting high-risk population for CVD.

Radiation-induced injury, a body dysfunction caused by irradiation, is associated with the dose, duration, and speed of radiation and is predominantly derived from radiation therapy for patients with malignant tumors. The current clinical treatment mainly includes amelioration of injury, alleviation of symptoms, and improvements in function restoration of the affected sites because of lack of targeted agents specific to radiation-induced injuries. Research and development of preventive and therapeutic agents against radiation-induced injuries are of great significance to reduce the body damages caused by radiotherapy and improve the quality of life of cancer survivors. This review summarizes the radiation-induced injury and its mechanisms, radioprotectants, and therapeutic agents for radiation, and proposes future development directions, so as to provide a reference for alleviation of radiation-induced injury and improvement in prognosis.

BACKGROUND:The high rate of postoperative hypoproteinemia in patients undergoing hip revision is associated with severe trauma,which affects the rapid recovery of patients. OBJECTIVE:To investigate the risk factors of perioperative hypoproteinemia in patients with hip revision,and to provide guidance for early screening of high-risk patients with postoperative hypoproteinemia. METHODS:According to the inclusion and exclusion criteria,161 patients who underwent hip revision were divided into hypoproteinemia group(76 cases)and normal group(85 cases).The rate of hypoproteinemia was 47.2%.Data such as age,gender,body mass index,osteoporosis,operation time,preoperative erythrocytes,preoperative hemoglobin,preoperative leukocytes,preoperative platelets,preoperative fibrinogen,preoperative C-reaction protein,preoperative sedimentation rate,preoperative blood calcium,preoperative albumin,postoperative drainage tube placement,American Society of Anesthesiologists score,and postoperative hypoproteinemia were collected.SPSS software was used to analyze the independent risk factors of hypoproteinemia after hip revision using multivariate binary logistic regression analysis.R software was used to construct the nomogram prediction model.Receiver operating characteristic curve and calibration curve and decision curve were drawn to evaluate the model. RESULTS AND CONCLUSION:(1)Univariate analysis results showed that body mass index,preoperative erythrocytes,preoperative hemoglobin,preoperative platelets,preoperative fibrinogen,preoperative C-reaction protein,and operation time were significantly different between the two groups(P<0.05).(2)Multivariate binary Logistic regression analysis results showed that body mass index(OR=0.859,P=0.021),operation time(OR=1.010,P=0.002),preoperative erythrocytes(OR=0.424,P=0.036),and preoperative C-reaction protein(OR=1.043,P=0.032)levels were independent risk factors for postoperative hypoproteinemia in patients with hip revision.(3)Based on four independent risk factors:body mass index,operation time,preoperative erythrocytes and preoperative C-reaction protein,the nomogram can effectively predict the risk of hypoproteinemia after hip revision.This nomogram prediction model has good differentiation and accuracy,and may lead to better clinical net benefits for patients.

Objective: To investigate the spatio-temporal clustering characteristics of influenza in Yinzhou District, Ningbo City, Zhejiang Province from 2017 to 2021, so as to provide insights into prevention and control of influenza. Methods Data of influenza in Yinzhou District from 2017 to 2021 were collected from the Chinese Disease Prevention and Control Information System. The software ArcGIS 10.8 was employed for spatial autocorrelation analysis, and SaTScan 10.1 was employed for spatio-temporal scanning to analyze the temporal and spatial clustering characteristics of influenza incidence in Yinzhou District. Methods: Data of influenza in Yinzhou District from 2017 to 2021 were collected from the Chinese Disease Prevention and Control Information System. The software ArcGIS 10.8 was employed for spatial autocorrelation analysis, and SaTScan 10.1 was employed for spatio-temporal scanning to analyze the temporal and spatial clustering characteristics of influenza incidence in Yinzhou District. Results: Totally 60 543 influenza cases were reported in Yinzhou District from 2017 to 2021, with an incidence of 0.76%. The incidence of influenza peaked in December 2019 (9.35%) and January 2020 (9.28%) during the period between 2017 and 2021. Spatial autocorrelation analysis showed that there was a positive spatial correlation of influenza incidence in Yinzhou District from 2018 to 2021 (all P<0.05), and a high clustering in 2019 and 2021. Zhonghe Street showed a low-high clustering from 2017 to 2020; Jiangshan Town showed a low-high clustering in 2017 and 2020, and a high-high clustering in 2019 and 2021; Shounan Street showed a high-high clustering from 2018 to 2020; Yunlong Street showed a high-high clustering in 2021. Spatio-temporal scanning analysis showed that the class Ⅰ clusters were located in the central region which centered in Dongqianhu Town, with aggregation time in August 2017, in the northwest region with aggregation time in December and January from 2018 to 2020, and in the west region with aggregation time in August 2021. Conclusion The incidence of influenza in Yinzhou District from 2017 to 2021 showed a spatio-temporal clustering in the northwestern region in winter and summer.

Objective:To explore the module of the construction and application of medical first-aid at the door of the space capsule and the air evacuation.Methods:According to the purpose, principle, and method set by the module, it was divided into two sub-modules: medical first-aid at the door of the space capsule and the air evacuation. During the comprehensive first-aid training, independent training and combined training were carried out respectively according to different mission stages of launch and recovery and different recovery terrain. Meanwhile, research was performed to ensure that medical carrying equipment was lightweight, modular, and portable, and the efficiency of modularization construction was tested in the comprehensive training.Results:The module of medical first-aid at the door of the space capsule and the air evacuation obviously shortened the rescuing time during the comprehensive training, the saving effect was remarkable, and the overall saving efficiency was significantly improved.Conclusions:The module of medical first-aid at the door of the space capsule and the air evacuation meet the requirements that the emergency support system of aerospace medicine should function on an immediate basis, ensuring accurate treatment and air evacuation without any delay, so that to achieve the aim of aerospace medicare.

Objective:To study the application of scenario simulation teaching combined with modular training in nursing education of medical rescue in manned space flight.Methods:Twenty nurses from the medical rescue team of Strategic Support Force Characteristic Medical Center were selected as the research objects. The research objects were randomly divided into the scenario simulation combined with practical training group (practical training group, n=10) and traditional teaching group (control group, n=10). Scenario simulation teaching combined with modular training and traditional teaching were used to carry out nursing training. After the training, theoretical assessment, operation assessment and satisfaction survey were organized. Results:The scenario simulation teaching combined with modular training group was significantly better than the traditional training group in theory assessment, operation assessment and satisfaction survey of nursing staff (all P<0.05). Conclusions:Scenario simulation teaching combined with modular training has obvious teaching effect, which can improve the ability and quality of nursing staff, and help to complete the manned space medical rescue mission efficiently.

Objective:To review the characteristics and coping strategies of the rescue and landing medical support mission of Shenzhou-14 manned spacecraft.Methods:The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft was analyzed, and the coping strategies and experience were discussed.Results:(1) The characteristics of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: long time in space station and high-intensity space missions; high-density space medical support mission in short term; special environmental factors in severe cold night; complex terrain of landing site; and the young medical support team. (2) The main coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft included: strengthened the organization and leadership and improved the training model; reinforcement learning the medical treatment plan and strengthened the medical rescue skills training; optimized the carrying equipment and added the heat preservation and lighting measures; improved the medical rescue process and perfected the emergency plan; emphasized on the scientific research as important as mission; and strengthened the physical exercise and cold resistance exercise.Conclusions:The characteristics and coping strategies of rescue and landing medical support mission of Shenzhou-14 manned spacecraft are summarized to provide the experience for space medical rescue and offer the support for China's manned space industry.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

End-stage liver disease (ESLD) includes decompensated liver cirrhosis and liver failure, which usually have dangerous conditions and a poor prognosis. Liver transplantation is the only effective therapy for ESLD, but its clinical application is limited due to shortage of liver donors, immunological rejection, and expensive costs. Mesenchymal stem cells (MSCs) can differentiate into hepatocyte-like cells and alleviate liver fibrosis by regulating immune function through paracrine, and therefore, MSCs have a wide application prospect in the field of ESLD treatment. A number of clinical studies have shown that MSC infusion is safe and effective in the treatment of ESLD during a short period of time, and there is also certain clinical evidence for its long-term safety and efficacy. MSC-derived exosomes (MSC-Exo) do not have a complete cellular structure and can promote hepatocyte regeneration through a variety of mechanisms, and their clinical value has attracted more and more attention, but there are few studies on this issue. Currently, the core mechanism of MSC therapy for ESLD and the standardized process of MSC preparation are the problems needing to be solved urgently.

Objective:To discuss the application effect of digital classroom based on identifying sectional structure in the experimental teaching of sectional anatomy.Methods:A total of 180 students majoring in imaging diagnosis from six classes of Batch 2018 in Mudanjiang Medical University were randomly selected as the research objects and divided into the experimental group and the control group. Three classes (90 people) in the experimental group implemented the digital classroom teaching of learning platform + virtual digital person, while another three classes (90 people) in the control group adopted traditional teaching. After the course, the effect was evaluated according to the results of the questionnaire and the final exam results. SPSS 18.0 software was used for t-test and Chi-square test. Results:The questionnaire showed that the students in the experimental groups were superior to those in the control group in self-study ability, independent thinking ability, analytical and problem-solving ability, learning efficiency, learning interest and sectional thinking cultivation, and the difference was statistically significant ( P<0.05). The test scores showed that the theoretical scores [(56.08±1.65) vs. (45.19±1.74)], experimental scores [(37.13±3.24) vs. (30.16±2.04)] and total scores [(93.21±3.18) vs. (75.35±1.79)] in the experimental group were higher than those in control group, and the differences were statistically significant ( P<0.05). Conclusion:The digital classroom based on identifying sectional structure is a feasible teaching mode, which improves the students' ability to analyze and solve problems, increases their interest in sectional anatomy, and improves the teaching effect.