Objective To predict the radiation impact of discharging wastewater containing uranium within the specified limit generated during the normal operation of a new production line at a nuclear fuel plant on the receiving water body and its downstream, and to provide a reference for the management of radioactive liquid effluent discharge from nuclear facilities. Methods Based on the technical guidelines for environmental impact assessment, literature on radiation environmental impact assessment, and data collected from on-site investigations, appropriate hydrological parameters and prediction models were selected to analyze and predict the variation pattern of radioactive nuclide uranium along the receiving water body and the radiation exposure of nearby residents. Results The maximum increase in uranium concentration in the receiving water body and its downstream caused by the discharge of uranium-containing wastewater was 1.14 μg/L. The maximum predicted concentration was 2.75 μg/L after adding the background data of the water body. The resulting maximum individual annual effective dose for the public was 1.49 × 10⁻⁴ mSv/a. Conclusion The maximum predicted uranium concentration in the receiving water body and its downstream is lower than the uranium concentration limit of 30 μg/L specified in the Standards for Drinking Water Quality (GB 5749-2022). The maximum individual annual effective dose for the public is much lower than the control value of 0.2 mSv/a specified in the Radiation Protection Regulations for Uranium Processing and Fuel and Fuel Manufacturing Facilities (EJ 1056-2018). The radiation impact is acceptable.

Objective: To summarize the laboratory findings of a case of hemolytic disease of the fetus and newborn (HDFN) caused by Rh system anti-c antibodies and to review the literature, so as to explore the characteristics of anti-c HDFN. Methods: The ABO blood type, Rh blood type, direct antiglobulin test (DAT) results, and the presence of unexpected antibodies and their titers were determined by serological methods. The cases of anti-c HDFN in our laboratory in China and abroad were statistically analyzed, and the incidence of severe HDFN caused by anti-c, anti-D and anti-E was compared. Results: The blood type of the child was B (Rh CcDee) with a positive DAT. Anti-c antibody was detected in both serum and eluate, with a serum antibody titer of 4. The mother’s blood type was AB (Rh CCDee) with a negative DAT, and anti-c antibody was detected in the serum with a titer of 128. Among 20 cases of anti-c HDFN, 17 were DAT positive, and 9 (45%, 9/20) underwent blood transfusion or exchange transfusion. The incidence of severe HDFN was 47.60% (10/21) for anti-c, 47.60% (10/21) for anti-D and 31.30% (5/16) for anti-E. Conclusion: Maternal pregnancy and/or blood transfusion are the main reasons for the production of Rh alloantibodies such as anti-c. The prevention and management of anti-c should be similar to that of anti-D. Rh antigen-matched (five antigens of Rh blood group) transfusion is necessary for women of childbearing age to avoid antibody production, and Rh typing and antibody screening during prenatal examination is recommended to ensure early detection, intervention and treatment.

The discussion on the connotation of children’s subjectivity is not only a response to the lack of children’s subjectivity at the current stage of health management, but also a reference for children’s medical science popularization. Based on the perspective of social critical theory, this study used empirical research methods to review the "Dream Medical College" project of Children’s Hospital of Fudan University. The current situation and influencing factors of health management experience of 1 520 children participating in the "Dream Medical College" project were analyzed. The study showed that 96.35% of 1 316 subjects had diagnosis and treatment experience in specialized hospitals, and the overall negative emotional performance was at a low level (0~12 points). There was significant correlation between diagnosis and treatment, invasive experience and children’s emotional performance (P<0.05). The study revealed that the diagnosis and treatment field is the main practice place of children’s health management, while the subjective of children with different diagnosis and experience perform significantly different. Children over 4 years old have better language anxiety than physical anxiety when receiving diagnosis and treatment. Although medical science popularization is an important practical form of children’s health management, it lacks the science popularization content of invasive diagnosis and treatment and emotional management, and creative popular science form is more suitable for children with long-term and frequent diagnosis and treatment experience.

Objective Data mining technology was used to mine the medication rules of the prescriptions used in the treatment of pediatric atopic dermatitis by Chinese medical master XUAN Guo-Wei.Methods The medical records of effective cases of pediatric atopic dermatitis treated by Professor XUAN Guo-Wei at outpatient clinic were collected,and then the medical data were statistically analyzed using frequency statistics,association rule analysis and cluster analysis.Results A total of 242 prescriptions were included,involving 101 Chinese medicinals.There were 23 commonly-used herbs,and the 16 high-frequency herbs(frequency＞100 times)were Glycyrrhizae Radix et Rhizoma,Saposhnikoviae Radix,Glehniae Radix,Perillae Folium,Ophiopogonis Radix,Cynanchi Paniculati Radix et Rhizoma,Microctis Folium,Dictamni Cortex,Scrophulariae Radix,Coicis Semen,Cicadae Periostracum,Lilii Bulbus,Rehmanniae Radix,Kochiae Fructus,Sclerotium Poriae Pararadicis,and Euryales Semen.The analysis of the medicinal properties showed that most of the herbs were sweet and cold,and mainly had the meridian tropism of the spleen,stomach and liver meridians.The association rule analysis yielded 24 commonly-used drug combinations and 20 association rules.Cluster analysis yielded 2 core drug combinations.Conclusion For the treatment of pediatric atopic dermatitis,Professor XUAN Guo-Wei focuses on the clearing,supplementing and harmonizing therapies,and the medication principle of"supporting the healthy-qi to eliminate the pathogen,and balancing the yin and yang"is applied throughout the treatment.

Objective To explore the correlation between epicardial fat volume(EFV),epicardial fat volume indexed(EFVi)and coronary artery lumen stenosis in young adults.Methods The data of 80 young patients who underwent both coronary computed tomography angiography(CCTA)and coronary angiography(CAG)within 2 weeks were analyzed retrospectively.The correlation between EFV,EFVi and coronary artery lumen stenosis in young adults was evaluated.Results A total of 80 patients were enrolled,taking CAG exomination results as the gold standard,58 cases were enrolled into the lesion group and the other 22 cases were enrolled into the control group.The incidence of coronary artery lumen stenosis was higher in young males than that in young females(t=4.309,P=0.038).EFV and EFVi in the lesion group were higher than those in the control group(t=3.023,P=0.001;t=2.785,P=0.001).The EFV in males was higher than that in females(t=2.558,P=0.012).There was no significant difference in EFVi between male and female groups.The differences between EFV and EFVi of males in lesion group and control group were statistically significant(t=4.083,P<0.01;t=4.429,P<0.01).The differences between EFV and EFVi of females in lesion group and control group showed no sta-tistical significance.EFV and EFVi were moderately positively correlated with coronary artery lumen stenosis(rs=0.437,P<0.01;rs=0.463,P<0.01).Receiver operating characteristic(ROC)curve analysis of EFV and EFVi showed that the area under the curve(AUC)of EFV was 0.784,the cut-off value was 107.24 cm3,the sensitivity was 0.776,and the specificity was 0.682.The AUC,cut-off value,sensitivity and specificity of EFVi was 0.793,53.68 cm3/m2,0.81,0.682,respectively.Conclusion EFV and EFVi are moderately positively correlated with coronary artery lumen stenosis in young adults,which is helpful to the diagnosis of coronary heart disease.However,the differences between EFV and EFVi of young females in lesion group and control group show no statistical significance.

Exosomes are extracellular vesicles commonly detected in numerous body fluids and contain a variety of components such as proteins,nucleic acids,lipids,and metabolites.These components enable exosomes to mediate intercellular communication and impact diverse cellular processes.Recently,research has highlighted that exosomes have a significant regulatory role in numerous aspects of hepatocellular carcinoma(HCC)occur-rence,development,and drug resistance.Non-coding RANs,a crucial component of exosomes,can regulate the HCC tumour microenvironment with a direct impact on biological behaviours such as tumour growth,metastasis,angiogenesis,and immunomodulation.To this end,exosomes present an interesting avenue for further research in the field of HCC therapy.It is anticipated to become a novel diagnostic,prognostic marker,or therapeutic target for hepatocellular carcinoma(HCC).Our review of the role played by exosomal components in HCC progression over the last five years aims to furnish references and innovative perspectives for early diagnosis,prognosis,and treatment of HCC.

Objective To understand the changing trend of Internet outpatient visits in public hospitals,and provide support for the development planning of Internet hospitals.Methods Using the data of Internet outpatient visits in a public hos-pital from January 2021 to June 2023,the ARIMA model and GM(1,1)model were constructed respectively.The mean absolute error(MAE)and root mean square error(RMSE)were used to evaluate the fitting effect,and the Internet outpatient visits from July to December 2023 were predicted based on the dominance model.Results ARIMA(1,2,1)model and GM(1,1)model were used to predict the number of return visits of Internet outpatient service.The average absolute errors were 369.86 and 978.84,and the root-mean-square errors were 479.49 and 1444.83,respectively.The ARIMA(0,1,0)model and GM(1,1)model were used to predict the number of Internet outpatient consultations.The average absolute errors were 297.23 and 369.62,and the root-mean-square errors were 413.61 and 496.30,respectively,indicating that the ARIMA model has a good prediction effect.The forecast results show that the predicted value of Internet outpatient visits in December 2023 is 14,831 cases,and the predicted value of consultation visits is 7461 cases.Conclusion The number of Internet outpatient visits in a public hospital will continue to rise from 2021 to 2023.Therefore,hospitals should fully realize the importance of Internet medical services,take ac-tive measures to continuously optimize the medical service model,and provide patients with high-quality,efficient and convenient Internet medical services.

Objective To investigate the changing trend of the current situation of Internet-based oncology outpatient treatment and provide support for the development and management of Internet hospitals.Methods The ARIMA and GM(1,1)models were constructed based on the Internet-based outpatient data of a cancer hospital from January 2021 to June 2023,and the fitting effect was evaluated by mean absolute error(MAE)and root mean square error(RMSE).Based on the model,the pro-portion of Internet-based outpatient visits and the offline outpatient visits were predicted from July to December 2023.Results ARIMA(1,1,2)and GM(1,1)models were used to predict the proportion of Internet-based outpatient visits.The average abso-lute errors were 2.06%and 2.41%,and the root-mean-square errors were 3.01%and 3.17%,respectively.The ARIMA(0,1,1)and GM(1,1)models were used to predict the proportion of Internet-based outpatient visits to the offline outpatient visits,with the rate of the average absolute errors of 0.58%and 1.08%,respectively,and the rate of the root mean square errors 0.75%and 1.31%,respectively.The figures indicated that the ARIMA model had a better prediction effect.The forecast results showed that the predicted value of Internet outpatient service in December 2023 was 90.35%,and the predicted value of Internet-based outpatient service accounted for 16.46%of the offline outpatient service.Conclusion In 2021-2023,the proportion of Inter-net-based outpatient visits in the cancer hospital showed a steady trend,and the proportion of Internet outpatient visits in the off-line outpatient visits showed a rising trend.Therefore,hospitals need to establish a continuous monitoring mechanism,constantly adjust management strategies and measures to meet the needs of patients and continue to promote the high-quality development of Internet-based medical services.

OBJECTIVE To investigate the multi-target mechanism of action of Poecilobdella manillensis lyophilized powder(SZ) against hyperuricemia(HUA) based on network pharmacology and transcriptomics approaches, combined with animal experiments. METHODS Utilizing Symmap, SwissTargetPrediction, and Pharmmapper databases, the potential active components and corresponding targets of SZ were obtained. Through the Gene Cards and OMIM databases, HUA-related targets were obtained. By taking the intersection mapping, the common targets of SZ and HUA were identified. Cytoscape 3.9.0 software was used to construct a drug component-disease target interaction network, and in combination with the STRING database, a protein interaction network was built and core targets were screened. The DAVID database was used to perform GO biological function annotation and KEGG pathway enrichment analysis on the intersecting targets. A mouse model of HUA was constructed using potassium oxyzate combined with high purine diet, and the effects of SZ on these mice were examined using ELISA and biochemical index detection. qRT-PCR was used to validate the results of RNA-Seq and network pharmacology enrichment analysis. RESULTS Network pharmacological analysis identified 11 major bioactive substances in SZ and 72 potential targets involved in the treatment of hyperuricemia, involving multiple biological processes and different signaling pathways. It was shown that SZ significantly reduced serum uric acid, creatinine and urea nitrogen levels in hyperuricemic mice by inhibiting xanthineoxidase activity. SZ also reduced the levels of URAT1 while increasing the levels of ABCG2. RNA sequencing analysis revealed that there were 112, 536 and 107 differentially expressed genes in the model group vs treated group, control group vs model group and control group vs treated group, respectively. qRT-PCR results indicated that SZ downregulated the expression of genes related to Th17 cell differentiation as well as mRNA of genes on IL-17 and PI3K/Akt signaling pathways. CONCLUSION SZ has therapeutic effects on hyperuricemia. The mechanism of action maybe related to the inhibition of hepatic xanthineoxidase activity, down-regulation of URAT1 levels, up-regulation of ABCG2 levels, affecting the differentiation of Th17 cells and thus the IL-17 signaling pathway, thereby reducing the inflammatory response.

Helicobacter pylori(HP)infection is a Class Ⅰ carcinogen in gastric cancer,closely related to the occurrence of gastric cancer.Many studies have shown that HP eradication has a preventive effect on gastric cancer.However,2.7%-6.1%of patients with early gastric cancer who have been eradicated after endoscopic submucosal dissection(ESD)can still develop metachronous gastric cancer(MGC),and the mechanism of its occurrence is still unclear.In this review,the atrophy of gastric mucosa and intestinal metaplasia cannot be completely reversed after HP eradication,the excessive proliferation of gastric mucosa epithelial cells,the accumulation of genetic abnormalities,the homeostasis imbalance of the epigenetic group,changes in immune microenvironment,the abnormality of stem cells in gastric mucosa,chromatin accessibility,and changes in chromosome remodeling were discussed in the mechanism of carcinogenesis caused by the above molecular changes after ESD and HP eradication in early gastric cancer.