Objective Emergency response to public health emergencies constitutes a vital component of the modernization of national governance systems and capacities, directly impacting national security, social stability, and public health. This study aims to analyze the key issues and research hotspots in the field of emergency response to public health emergencies, providing theoretical foundations and practical guidance for formulating scientific and effective emergency strategies and policies. Ultimately, it seeks to enhance the nation’s capability to respond to public health emergencies and safeguard public health. Methods Using core journals indexed in the China National Knowledge Infrastructure (CNKI) database as the data source, 1094 journal articles in the field of emergency response to public health emergencies in China from 2003 to September 2024 were selected as the research sample. Citespace visualization software was employed to organize and analyze the research process in the field of emergency response to public health emergencies. Results The current research in this field predominantly involves small-scale cooperation, and the research process can be divided into four stages. The research in the emerging stage mainly focuses on the themes of emergency mechanism and emergency management, the development stage mainly centers on the themes of emergency capacity improvement and system exploration, the outbreak stage emphasizes the themes of COVID-19 and epidemic prevention and control, and the sustainable development stage highlights collaborative governance and informatization. Conclusion The COVID-19 pandemic has accelerated the development of research in this field. Currently, the field shows a continuous growth, with an increasing volume of publications. The focus of current research has shifted towards collaborative governance and the study of assessment tools, aiming to enhance the efficiency and effectiveness in responding to public health emergencies. Moreover, the field is advancing toward more systematic and comprehensive research. However, there is still a need to strengthen scientific communication and collaboration.

Objective To investigate the current level of public awareness regarding nuclear emergency evacuation around a nuclear power plant, analyze the influencing factors, and propose suggestions and countermeasures based on the results. Methods In July 2024, according to the survey protocol and questionnaire developed by the National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, a field-based centralized online questionnaire was administered. A total of 854 residents living near the nuclear power plant were included as survey participants. An analysis of variance was used to compare the impact of different factors on the public knowledge of nuclear radiation and awareness of nuclear emergency evacuation, while the chi-square test was employed to compare differences between groups. Results A total of 854 questionnaires were collected in this study. The survey revealed that the levels of public knowledge about nuclear radiation and awareness of nuclear emergency evacuation around the power plant were relatively low, with average objective awareness rates of 51% and 47%, respectively. In terms of age, the 30-45 years old group had the highest average score, while the group aged 60 and above had the lowest. Regarding education level, the group with primary school education or below had the lowest average score, whereas those with junior college or undergraduate education scored the highest. The internet (73.7%) was the primary source of emergency information for the public, followed by television (61.7%). The majority of the public (85.0%) expressed trust in the government during evacuation and were willing to follow governmental evacuation arrangements. The main reason for this willingness was the belief that the government could provide sufficient emergency supplies. Conclusion The surveyed population exhibited low levels of knowledge regarding nuclear radiation and awareness of nuclear emergency evacuation, with generally low awareness rates. Awareness levels were influenced by factors such as sex, age, educational background, and distance from the nuclear power plant. To enhance public awareness, it is necessary to strengthen science communication related to nuclear radiation and public protective actions in nuclear emergencies. Targeted dissemination strategies with high communication effectiveness, accessibility, and public acceptance should be adopted to gradually enhance public awareness of nuclear radiation and nuclear emergency protective actions.

In the past 20 years,the development of artificial intelligence has made rapid progress,and it is increasingly applied in the medical field,including medical image-assisted diagnosis and treatment,health management,disease risk prediction and so on.In this paper,the application status of artificial intelligence-assisted detection and diagnosis system based on deep learning in anorectal diseases is summarized,and the new methods related to the diagnosis and treatment of anorectal diseases at home and abroad are summarized.It mainly reviews the research progress of artificial intelligence technology in the diagnosis and treatment of anal fistula,perianal abscess,hemorrhoids and other anorectal diseases.

Objective To analyze and explore the health response capability construction in the long-term recovery phase of nuclear or radiological emergencies. Methods By evaluating China’s participation in an international nuclear emergency exercise organized by Organization for Economic Co-operation and Development’s Nuclear Energy Agency, and considering the relevant guidelines published by international organizations such as the International Atomic Energy Agency, the sections that need to be strengthened in the health response during the long-term recovery phase of nuclear or radiological emergencies were analyzed. The related issues such as health monitoring and medical follow-up were explored. Results The tasks in the long-term recovery phase mainly include monitoring the affected population and information management, medical follow-up, and psychological assistance. In response to potential nuclear or radiological emergencies, 22 nuclear emergency medical rescue bases have been established in China, with a geographical distribution that includes key regions. Relevant institutions have basic capabilities of health response to nuclear or radiological emergencies. However, the exercise shows that strategy and capacity construction in long-term recovery phase are weak points in health response to nuclear or radiological emergencies. China should further strengthen strategies in major public protection actions and information management of affected populations in nuclear or radiological emergencies. Conclusion It is recommended to develop standard operating procedures for major public protection actions, long-term health monitoring and evaluation of affected populations, medical follow-up, and psychological assistance in the future. A unified health registration system for affected populations in nuclear or radiological emergencies should be established to further enhance China’s health response capabilities during the long-term recovery phase of nuclear or radiological emergencies.

OBJECTIVE: To compare the effectiveness of O-arm navigation and C-arm navigation for guiding percutaneous long sacroiliac screws in treatment of Denis type Ⅱ sacral fractures. METHODS: A retrospective study was conducted on clinical data of the 46 patients with Denis type Ⅱ sacral fractures between April 2021 and October 2022. Among them, 19 patients underwent O-arm navigation assisted percutaneous long sacroiliac screw fixation (O-arm navigation group), and 27 patients underwent C-arm navigation assisted percutaneous long sacroiliac screw fixation (C-arm navigation group). There was no significant difference in gender, age, causes of injuries, Tile classification of pelvic fractures, combined injury, the interval from injury to operation between the two groups ( P>0.05). The intraoperative preparation time, the placement time of each screw, the fluoroscopy time of each screw during placement, screw position accuracy, the quality of fracture reduction, and fracture healing time were recorded and compared, postoperative complications were observed. Pelvic function was evaluated by Majeed score at last follow-up. RESULTS: All operations were completed successfully, and all incisions healed by first intention. Compared to the C-arm navigation group, the O-arm navigation group had shorter intraoperative preparation time, placement time of each screw, and fluoroscopy time, with significant differences ( P<0.05). There was no significant difference in screw position accuracy and the quality of fracture reduction ( P>0.05). There was no nerve or vascular injury during screw placed in the two groups. All patients in both groups were followed up, with the follow-up time of 6-21 months (mean, 12.0 months). Imaging re-examination showed that both groups achieved bony healing, and there was no significant difference in fracture healing time between the two groups ( P>0.05). During follow-up, there was no postoperative complications, such as screw loosening and breaking or loss of fracture reduction. At last follow-up, there was no significant difference in pelvic function between the two groups ( P>0.05). CONCLUSION Compared with the C-arm navigation, the O-arm navigation assisted percutaneous long sacroiliac screws for the treatment of Denis typeⅡsacral fractures can significantly shorten the intraoperative preparation time, screw placement time, and fluoroscopy time, improve the accuracy of screw placement, and obtain clearer navigation images.
Humans ; Fracture Fixation, Internal/methods* ; Retrospective Studies ; Imaging, Three-Dimensional ; Bone Screws ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed ; Spinal Fractures/surgery* ; Fractures, Bone/surgery* ; Pelvic Bones/injuries* ; Postoperative Complications ; Neck Injuries

Objective To analyze and explore the health response capability construction in the long-term recovery phase of nuclear or radiological emergencies. Methods By evaluating China’s participation in an international nuclear emergency exercise organized by Organization for Economic Co-operation and Development’s Nuclear Energy Agency, and considering the relevant guidelines published by international organizations such as the International Atomic Energy Agency, the sections that need to be strengthened in the health response during the long-term recovery phase of nuclear or radiological emergencies were analyzed. The related issues such as health monitoring and medical follow-up were explored. Results The tasks in the long-term recovery phase mainly include monitoring the affected population and information management, medical follow-up, and psychological assistance. In response to potential nuclear or radiological emergencies, 22 nuclear emergency medical rescue bases have been established in China, with a geographical distribution that includes key regions. Relevant institutions have basic capabilities of health response to nuclear or radiological emergencies. However, the exercise shows that strategy and capacity construction in long-term recovery phase are weak points in health response to nuclear or radiological emergencies. China should further strengthen strategies in major public protection actions and information management of affected populations in nuclear or radiological emergencies. Conclusion It is recommended to develop standard operating procedures for major public protection actions, long-term health monitoring and evaluation of affected populations, medical follow-up, and psychological assistance in the future. A unified health registration system for affected populations in nuclear or radiological emergencies should be established to further enhance China’s health response capabilities during the long-term recovery phase of nuclear or radiological emergencies.

After the Three Mile Island, Chernobyl, and Fukushima nuclear accidents, numerous issues were exposed during the emergency evacuation process, such as insufficiently detailed emergency plans, lack of specific evacuation route schemes, inadequate preparation of emergency protective materials, and delays in emergency response decision-making. Additionally, these accidents revealed serious issues with the emergency evacuation of vulnerable populations. In particular, during the Fukushima nuclear accident, the lack of resource support led to deteriorating health and fatalities among hospital patients and elderly residents in nursing homes near the nuclear power plant during emergency evacuation. To learn from the experiences and lessons of public protection actions in emergency evacuations during major nuclear accidents, the government should enhance the guidance of nuclear emergency evacuation plans, increase the quality of emergency training and exercises, and improve their specificity and continuity, as well as establish an efficient nuclear emergency rescue response and decision-making mechanism. For vulnerable populations in nuclear emergency evacuations, the government should consider updating the nuclear emergency plans and disaster preparedness material reserves of medical facilities (such as designated treatment hospitals) and elderly facilities (such as nursing homes) within the emergency protection action areas of nuclear power plants in a timely manner. This will ensure that these institutions have the capacity to provide initial evacuation and necessary support for vulnerable populations in disaster situations.

This study was designed to investigate the effects of TNFSF14 on mitochondrial function in ischemia/reperfusion-induced acute kidney injury(I/R-AKI)and its mechanism.TNFSF14-/-and TNFSF14+/+mice underwent renal ischemia-reperfusion operation to establish I/R-AKI models,and their histopathology changes were compared by using Periodic Acid-Schiff stain,transmission electron microscopy.Immunohistochemistry(IHC)was used to detect levels of TNFSF14,HVEM,LT[3R,mitochondrial activity related proteins(Dpr1 and Mfn2)and inflammatory cells infiltration in kidney tissues of mice and relevant patients.In vitro cell experiments,immunofluorescence and immunoblotting were used to observe the effects of exogenous recombinant TNFSF14 factor on the damage and mitochondrial activity of renal tubular epithelial cell line HK-2 cells.Data showed that the expression of TNFSF14 and its receptors were significantly increased in kidney tissues of I/R-AKI mice and clinical human renal tissues of acute tubular injury.Compared with the sham group,I/R mice showed significantly higher levels of renal tubular injury score,inflammatory cells infiltration,cell apoptosis,mitochondrial damage,and Drp1 expression,while knocking out the TNFSF14 gene,the above indicators were significantly reduced.In vitro,exogenous TNFSF14 stimulation could aggravate the hypoxia-induced apoptosis and the decrease of mitochondrial membrane potential in HK-2 cells,while increasing phosphorylation of Drp1 at Se616 to promote its transfer from cytoplasm to mitochondria,leading to an abnormal increase in mitochondrial fission.In conclusions,TNFSF14 may mediate the pathological process of I/R-AKI by promoting mitochondrial damage.

Objective:To investigate the prognostic value of baseline peripheral blood inflammatory biomarkers for prognosis in patients with advanced hepatocellular carcinoma (HCC) receiving immunotherapy combined with targeted therapy.Methods:The clinical data of a total of 120 patients with advanced HCC who received immunotherapy combined with targeted therapy at Cancer Center of Renmin Hospital of Wuhan University from December 2019 to March 2022 were analyzed retrospectively. Receiver operating characteristic (ROC) curve was used to calculate the optimal cut-off values of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune inflammation index (SII) and prognostic nutritional index (PNI). According to the optimal cut-off values, the study objects were divided into high value group and low value group. The Kaplan-Meier method was used for survival analysis. Cox proportional hazard regression model was applied to analyze the factors associated with prognosis.Results:By the end of follow-up, 74 patients died and 46 survived. The median follow-up time was 23.0 months, the median overall survival (mOS) was 15.6 months, and the median progression-free survival (mPFS) was 13.1 months. ROC curve analysis showed that the optimal cut-off values of NLR, PLR, SII, LMR and PNI were 3.45, 131.87, 626.21, 2.12 and 43.30, respectively. The mPFS (18.3 months vs. 8.7 months) and mOS (26.6 months vs. 10.9 months) of patients in the low-NLR group ( n=75) were longer than those of the high-NLR group ( n=45), and there were statistically significant differences ( χ2=55.64, P<0.001; χ2=64.14, P<0.001). The mPFS (17.9 months vs. 10.9 months) and mOS (24.5 months vs. 13.5 months) of patients in the low-PLR group ( n=55) were longer than those of the high-PLR group ( n=65), and there were statistically significant differences ( χ2=5.27, P=0.023; χ2=11.84, P<0.001). The mPFS (18.0 months vs. 10.7 months) and mOS (25.7 months vs. 12.8 months) of patients in the low-SII group ( n=75) were longer than those of the high-SII group ( n=45), and there were statistically significant differences ( χ2=24.46, P<0.001; χ2=25.42, P<0.001). The mPFS (18.2 months vs. 10.9 months) and mOS (26.6 months vs. 13.2 months) of patients in the high-LMR group ( n=56) were longer than those of the low-LMR group ( n=64), and there were statistically significant differences ( χ2=19.25, P<0.001; χ2=19.92, P<0.001). The mPFS (17.9 months vs. 10.9 months) and mOS (25.4 months vs. 13.4 months) of patients in the high-PNI group ( n=62) were longer than those of the low-PNI group ( n=58), and there were statistically significant differences ( χ2=13.69, P<0.001; χ2=19.07, P<0.001). Univariate analysis showed that Barcelona clinic liver cancer (BCLC) stage ( HR=1.83, 95% CI: 1.17-2.87, P=0.008), Child-Pugh grade ( HR=2.21, 95% CI: 1.47-3.34, P<0.001), modified albumin-bilirubin (mALBI) grade ( HR=1.35, 95% CI: 1.01-1.81, P=0.045), extrahepatic metastases ( HR=2.18, 95% CI: 1.47-3.25, P<0.001), NLR ( HR=1.40, 95% CI: 1.28-1.54, P<0.001), PLR ( HR=1.00, 95% CI: 1.00-1.01, P=0.001), SII ( HR=1.00, 95% CI: 1.00-1.00, P<0.001), LMR ( HR=0.64, 95% CI: 0.51-0.79, P<0.001) and PNI ( HR=0.95, 95% CI: 0.93-0.98, P=0.001) were correlated with PFS; BCLC stage ( HR=2.18, 95% CI: 1.21-3.91, P=0.009), Child-Pugh grade ( HR=2.57, 95% CI: 1.61-4.09, P<0.001), Eastern Cooperative Oncology Group performance status score ( HR=1.59, 95% CI: 1.01-2.51, P=0.044), mALBI grade ( HR=1.60, 95% CI: 1.17-2.17, P=0.003), extrahepatic metastasis ( HR=2.51, 95% CI: 1.59-3.96, P<0.001), NLR ( HR=1.45, 95% CI: 1.32-1.60, P<0.001), PLR ( HR=1.01, 95% CI: 1.01-1.01, P<0.001), SII ( HR=1.01, 95% CI: 1.01-1.01, P<0.001), LMR ( HR=0.57, 95% CI: 0.40-0.72, P<0.001) and PNI ( HR=0.92, 95% CI: 0.89-0.96, P<0.001) were correlated with OS. Multivariate analysis showed that extrahepatic metastasis ( HR=1.78, 95% CI: 1.10-2.87, P=0.018) and NLR ( HR=1.46, 95% CI: 1.24-1.73, P<0.001) were independent influencing factors for PFS; extrahepatic metastasis ( HR=2.09, 95% CI: 1.21-3.61, P=0.009), NLR ( HR=1.56, 95% CI: 1.29-1.88, P<0.001), SII ( HR=1.00, 95% CI: 1.00-1.00, P=0.025), LMR ( HR=0.59, 95% CI: 0.45-0.78, P=0.008) and PNI ( HR=0.93, 95% CI: 0.88-0.99, P=0.013) were independent influencing factors for OS. Conclusion:NLR and extrahepatic metastasis can be regarded as important indicators to predict PFS in patients with advanced HCC receiving immunotherapy combined with targeted therapy, and NLR, SII, LMR, PNI and extrahepatic metastasis can be regarded as important indicators to predict OS in patients with advanced HCC receiving immunotherapy combined with targeted therapy. High NLR, high SII, low LMR, low PNI and extrahepatic metastasis indicate poor prognosis of HCC patients.

Objective:To systematically evaluate the impact of the three major nuclear accidents at Three Mile Island, Chernobyl and Fukushima on the mental health status of emergency responders.Methods:MeSH and Entry Terms were searched. Relevant literature on the mental health consequences of the emergency responders to the Three Mile Island, Chernobyl, and Fukushima nuclear accidents were retrieved from PubMed, Web of Science, and APA PsycINFO databases, and screened and reviewed.Results:Totally 37 studies were included. General psychological distress, depression, anxiety, post-traumatic stress disorder and other abnormal psychological problems are prevalent among emergency responders following nuclear accidents. The psychological impact of the Chernobyl nuclear accident was most profound, causing serious mental disorders such as organic mental disorder and personality disorder among the clean-up workers. The mental health condition of emergency responders was associated with disaster-related emergency response tasks and the social factors brought in nuclear accidents.Conclusions:General psychological distress, anxiety, depression, post-traumatic stress reaction/disorder, severe mental disorder and other long-term abnormal psychological problems are common among first responders after nuclear accidents, and baseline mental health and psychological interventions require further study.