OBJECTIVE To investigate the role and mechanism of paeonol in inhibiting the migration of bladder cancer T24 cells by regulating nuclear factor κB （NF-κB）/hypoxia-inducible factor-1α （HIF-1α）-mediated aerobic glycolysis. METHODS T24 cells were divided into control group， cisplatin group （positive control， 3.001 μg/mL）， and paeonol low-， medium- and high-dose groups （100， 200， 400 μg/mL）， respectively. After 24 h of administration intervention， the effect of paeonol on the migration ability of T24 cells was detected （expressed by the cell scratch wound healing rate）. The effect of paeonol on the mitochondrial membrane potential of T24 cells was detected （expressed by the ratio of red/green fluorescence intensity）. Cellular adenosine triphosphate （ATP） levels and lactate content in T24 cells were measured. The levels of NF-κB/HIF-1α signaling pathway， the expression of migration-related proteins， and key enzymes involved in aerobic glycolysis in the cells were all determined. RESULTS Compared with the control group， the cell scratch wound healing rates in the paeonol medium- and high-dose groups and the cisplatin group were decreased significantly （P＜0.01）； in the paeonol groups， the expression levels of NF-κB/HIF-1α signaling pathway-related proteins such as NF- κB and HIF-1α， migration-related proteins such as matrix metalloproteinase 2 （MMP2）， MMP9， and vascular endothelial growth factor， as well as key enzymes involved in aerobic glycolysis such as glucose transporter 1， hexokinase 2 and pyruvate kinase isozyme type M2， were all reduced to varying degrees in the cells， most of these reductions showed statistically significant differences （P＜0.05 or P＜0.01）； the ratio of red/green fluorescence intensity in mitochondria of cells in the medium- and high-dose paeonol groups were significantly decreased （P＜0.01）； the ATP concentration in cells of the paeonol high-dose group， and the lactate content in cells across all paeonol groups were significantly decreased （P＜0.05 or P＜0.01）. CONCLUSIONS Paeonol significantly inhibits the migration of bladder cancer T24 cells， and its mechanism of action may be related to the inhibition of the NF-κB/HIF-1α signaling pathway， and the down-regulation of key enzyme activities involved in aerobic glycolysis.

As an important non-drug treatment for chronic obstructive pulmonary disease(COPD),pulmonary rehabilitation helps to improve dyspnea and negative emotions.This article mainly elaborates on pulmonary rehabilitation contents such as smoking cessation,breathing training,exercise training,traditional Chinese medicine rehabilitation,and psychological rehabilitation,and discusses the application of telemedicine and virtual reality technology in COPD pulmonary rehabilitation.The COVID-19 has a certain impact on the traditional pulmonary rehabilitation model.This article explores the relationship between COVID-19 and COPD and the implementation methods of pulmonary rehabilitation for COPD patients with COVID-19,so as to provide evidence-based basis for the implementation of pulmonary rehabilitation in the context of COVID-19,and provide new ideas and methods for improving the clinical treatment effect of COPD.

ObjectiveTo investigate the trends and significant determinants of delayed HIV diagnosis （DHD） among newly reported HIV/AIDS cases in Xuhui District， Shanghai between 2018 and 2022. MethodsIn the newly reported HIV/AIDS cases， patients died within one year without accident， HIV/AIDS cases with CD₄ cell count <200 cells·μL^-1， and AIDS cases with a CD₄ cell count between 200 to 499 cells·μL^-1 were defined as delayed diagnosis. Univariate and multivariate logistic analysis were employed to explore the influencing factors of DHD. ResultsAmong the 862 newly reported HIV/AIDS cases， The DHD rate was 39.79% without statistically significant difference by year（χ²=4.508， P=0.342）. Patients with CD₄ cell count <200 cells·μL^-1 contributed the largest proportion of DHD. During 2018‒2022， the DHD rate declined among HIV/AIDS patients who were younger than 35 years old or 45‒65 years old， never married， original diagnosis from tertiary specialized hospitals. Patients who were 65 years or older， married or divorced， with heterosexual transmitted HIV/AIDS， and original diagnosis from other types of testing and tertiary metropolitan hospital， had sustainably higher DHD rates. The number of HIV screening and diagnosed from voluntary counseling and testing （VCT） decreased during the COVID-19 epidemic， while the DHD rate increased sharply. Multivariate logistic regression analysis suggested the DHD rates were higher among older age， other types of testing（OR=3.805， 95%CI： 2.260‒6.406）and pre-operative testing（OR=2.411， 95%CI： 1.424‒4.081）. Patients who received CD₄ test in 15 days had a higher DHD rate compared to the cases received CD₄ test exceeding 90 days （OR=0.336， 95%CI： 0.216‒0.522）. ConclusionThere is no significant decrease of delayed HIV diagnosis rate in Xuhui District in recent years， and the number of HIV tests has decreased in 2022. Monitoring of newly reported HIV/AIDS should be conducted continuously. Expansion of HIV antibody screening should be conducted in non-infectious departments and inpatient departments in healthcare institutions， particularly metropolitan hospitals. Assistance should be provided to clinicians and elderly patients for improving their ability to recognize and perceive the risk of HIV/AIDS， in order to enhance early diagnosis and subsequent treatment.

Objective To assess the sweat secretion of Yin-deficient ovariectomized rats and investigate the changes in biochemical indexes.Methods Eighteen SD female rats were randomly divided into a sham operation group,model group,and positive control group of six rats each.The rats in the sham operation group underwent a sham operation,and those in the model group and positive control group underwent bilateral ovariectomy.L-Thyroxine(92 mg/kg)was given once a day for 7 consecutive days starting on the 7th postoperative day to establish a Yin-deficient ovariectomized model.The rats in the positive control group were orally administered Qinggu San Tang(7.3 g/kg)once a day,while those in the sham operation group and model group were orally administered an equal amount of distilled water once a day for a total of 14 days.Sweat secretion from the plantar region of the foot was measured using the Wada-Takagaki reagent coloring method.At the end of the experiment,blood was taken from the abdominal aorta and the tissue of the paw pads was separated.The serum levels cyclic adenosine monophosphate(cAMP),cyclic guanosine monophosphate(cGMP),luteinizing hormone(LH),gonadotropin-releasing hormone(GnRH),and estradiol(E2)were measured by enzyme-linked immunosorbent assay.Western Blot was used to determine the expression levels of M3 R,β2 AR,and aquaporin-5(AQP5)in the paw pad.Results The three main findings of this study were as follows.(1)Compared with the rats in the sham operation group,those in the model group were more irritable and aggressive,and their body weights decreased while their average temperature and sweat secretion significantly increased.(2)Serum cAMP level and cAMP/cGMP ratio increased,the LH and GnRH levels significantly increased,and the E2 level decreased.(3)M3 R expression was down-regulated and β2 AR and AQP5 expression was up-regulated in the paw pads of the rats.After 2 weeks of positive control treatment,the serum cAMP level and cAMP/cGMP ratio significantly decreased and the LH and GnRH levels decreased;however,no statistically significant difference was observed in the serum E2 level.The expression levels of M3 R were increased-regulated in paw pads of the rats,and reduced expression of β2 AR and AQP5.Conclusions Sweat secretion significantly increased in this"combined disease and evidence"model of perimenopausal syndrome kidney yin deficiency established by desiccation combined with thyroxine.The underlying mechanism may be related to the changes in cGMP,cAMP,and key proteins M3 R,β2 AR,and AQP5 in sweat glands that regulate sweat secretion.

Passing the hospital grading evaluation, establishing a tertiary-A specialized hospital for occupational diseases, enhancing hospital's internal quality and sustainable development, and continuously improving medical service quality are important measures to promote the high-quality development of hospitals. The evaluation standards for occupational disease specialized tertiary-A hospital require standardized, scientific, and sustainable management of medical equipment. Guangdong Province Hospital for Occupational Disease Prevention and Treatment is the first tertiary-A hospital for occupational diseases specialized in Guangdong Province. Relative regulation on medical equipment management was systematically reviewed based on the requirement of tertiary-A specialized hospital for occupational diseases during hospital grading evaluation process. Building and completing the medical equipment management system, standardizing and strengthening government procurement management, completing the configuration management and safety management of large-scale medical equipment, strengthening the effectiveness analysis and evaluation of large equipment, enhancing training on medical equipment usage, establishing emergency allocation systems for first-aid and life support medical equipment, and forming a medical equipment quality and safety management team is the measure to systematically improve and implement each item in various regulation for the full lifecycle management of medical equipment. It provides vital support in passing the tertiary-A hospital evaluation for hospitals. During the hospital grading evaluation process, each issue identified in medical equipment management was addressed and improved. This process continuously enhanced the hospital's medical equipment management level, ensured the safe and effective use of medical equipment, and improved the quality of medical services, laying a solid foundation for the hospital to become a high level specialized medical institution for occupational diseases.

{L-End}Objective To establish the construction of intelligent management system for equipment and supplies of medical rescue teams for provincial nuclear and radiation accidents, based on modern Internet+ Internet of Things. {L-End}Methods The current status and requirements of emergency equipment and supplies allocation and management of medical emergency teams for provincial nuclear and radiation accidents were analyzed. Utilizing technologies such as Internet of Things, low-power Bluetooth, and radio frequency identification, an intelligent management system for medical rescue teams, its equipment and supplies for provincial nuclear and radiation accidents was designed. {L-End}Results The intelligent management system for medical rescue teams, its equipment and supplies for nuclear and radiation accidents was able to perform the inventory warning, expiration date warning, maintenance alert, and warning for emergency personnel health status, based on dynamic management of rescue personnel, equipment and supplies. It provided an effective support for on-site commanders in making emergency decisions. {L-End}Conclusion The use of Internet+Internet of Things technology can achieve intelligent management for medical rescue teams and its equipment and supplies can effectively improve the level of personnel and equipment support for the rescue of nuclear and radiation accidents at the provincial level.

OBJECTIVE To optimize the processing technology of honey bran-fried Atractylodis Rhizoma， and to compare the anti-gastric ulcer effect before and after processing. METHODS Combing with entropy-weight and technique for order preference by similarity to ideal solution model， L（9 34） orthogonal experiment design was adopted to optimize the processing technology of honey bran-fried Atractylodis Rhizoma using the comprehensive score of the contents of atractylone， β-cineole， atractylenolide Ⅲ and atractylodine as evaluation index， using the ratio of excipients to medicine， frying temperature and frying time as factors. The validation tests were conducted. The gastric ulcer model of mice was induced by intragastrical administration of anhydrous ethanol； using Compound aluminum hydroxide tablet as positive control， anti-gastric ulcer effect of Atractylodis Rhizoma was compared with that of honey bran-fried Atractylodis Rhizoma using the contents of serum inflammatory factors [interleukin-2 （IL-2）， IL-6， tumor necrosis factor-α （TNF-α）]， ulcer index and inhibitory rate of gastric ulcer as evaluation indexes. RESULTS The optimal processing technology of honey bran-fried Atractylodis Rhizoma was as follows：ratio of adjuvant and medicinal materials of 3∶10 （g/g）， frying temperature at 140 ℃ and frying time of 4 min. Results of 3 validation tests showed that the contents of 4 components （including atractylone）， in honey bran-fried Atractylodis Rhizoma processed by the optimal technology kept stable （RSDs were 3.47%-5.80%， n＝3）； the comprehensive scores were 95.53%-95.89% （RSD＝0.21%， n＝3）. Atractylodis Rhizoma and honey bran-fried Atractylodis Rhizoma could increase the serum content of IL-2 in mice， but reduce serum contents of IL-6 and TNF-α to varying degrees； honey bran-fried Atractylodis Rhizoma could significantly decrease its ulcer indexes （P＜0.05 or P＜ 0.01）； the improvement effect of honey bran-fried Atractylodis Rhizoma on the above indicators was generally better than that of the same dosage of Atractylodis Rhizoma （P＜0.05 or P＜ 0.01）. The inhibitory rates of low-dose， medium-dose and high-dose Atractylodis Rhizoma and honey bran-fried Atractylodis Rhizoma to gastric ulcer in mice were 9.18%， 19.30%， 30.70%， and 50.32%， 61.39%， 53.16%， respectively. CONCLUSIONS The optimal processing technology of honey bran-fried Atractylodis Rhizoma is stable and feasible， and the anti-gastric ulcer effect of Atractylodis Rhizoma has been enhanced after being fried with honey bran.

Ethical review is an important protective measure for research participants when conducting life sciences and medical research involving humans. "Exemption from ethical review" was proposed in The Measures for Ethical Review of Human Life Sciences and Medical Research Involving Humans issued in February 2023. To implement the exemption from ethical review within the permitted scope of laws and regulations, and to protect the privacy and rights of research participants when utilizing their data information and biological samples, multiple factors need to be considered, including the person responsible for exemption from ethical review, the conditions for exemption from ethical review, and the specific process for exemption from ethical review. As with other review procedures, exemption from ethical review also required the development of corresponding systems, implementation of responsibilities, and reliance on the construction of subject protection systems. It is hoped that this discussion can provide considerations for the implementation of exemption from ethical review.

Objective To understand phthalic acid esters pollution of daily consumed food in Guangzhou City，and evaluate the hazard of phthalic acid esters exposure in residents dietary. Methods Detected the content of phthalic acid esters in 10 types of food by gas chromatography-mass spectroscopy（GC-MS）methods .It combined with a survey on dietary nutrients intake of Guangzhou residents was conducted．Hazard index on the dietary exposure assessment of chemicals in food was applied. Results It showed that the highest levels of DBP，DEHP and DIBP，from the mixed diet samples in Guangzhou were 1.256，1.418，0.576 mg/kg respectively；and the exposure level of DBP，DEHP and DIBP were 2.431、5.981、2.408μg/kg.d ;HQ was respectively 0.243、0.125、0.025. HI was 0.393. Conclusion The dietary contamination of phthalic acid esters for Guangzhou was kept at a low level.But the pollution of 3 kinds of mixed samples such as meats，eggs，aquatic and products may be a certain risk of health that should attract more attention.

Objective:To investigate the relationship between previous bleeding history and poor prognosis of patients with acute upper gastrointestinal bleeding.Methods:This study was a prospective multicentre real-world study (Acute Upper Gastrointestinal Real-word study, AUGUR study). The data of patients with UGIB who were admitted to the emergency department of 20 tertiary hospitals in China from June 30, 2020 to February 10, 2021 were collected. According to the number of previous bleeding history, the patients were divided into three groups (0 time, 1-3 times, and≥4 times). Based on the patient’s demographic data, clinical characteristics, laboratory data, treatment, and outcomes, univariate and logistic regression analysis were performed to investigate the correlation between the number of previous bleeding and the 90-day mortality and rebleeding of patients with gastrointestinal bleeding.Results:A total of 1 072 patients with acute UGIB were included in this study. The all-cause mortality and rebleeding rate of all patients were 10.9% (117/1 072) and 11.8% (129/1 072), respectively. Among them, 712 patients (66.42%) had no previous bleeding, 297 patients (27.71%) had previous bleeding 1-3 times, and 63 patients (5.88%) had previous bleeding≥4 times. In univariate analysis, age, vital signs and consciousness on admission, history of liver cirrhosis, onset with hematemesis, admission hemoglobin, varicose veins bleeding, peptic ulcer bleeding, red blood cell infusion, tracheal intubation and the use of vasopressors after admission were risk factors for the 90-day mortality and rebleeding rate. Multivariate logistic regression analysis showed that patients with previous bleeding≥4 times had a higher risk of the 90-day mortality ( OR=2.17, 95% CI: 1.04-4.57, P=0.040) and rebleeding ( OR=2.32, 95% CI: 1.19-4.53, P=0.013). Conclusions:The history of previous bleeding≥ 4 times can be used as an independent risk factor for the 90-day mortality and rebleeding in patients with acute UGIB.