Background Previous studies found that high temperature and heatwave increase the risk of traffic injuries. The complex road conditions in Yunnan Province result in frequent traffic accidents. However, there is limited evidence on the correlation between heatwave and traffic injuries in Yunnan Province. Objective To assess the association between heatwave events and traffic injuries, to estimate its disease burden, and to identify relevant sensitive groups. Methods We collected data on traffic injury cases and concurrent meteorological information from four surveillance sites in Yunnan Province, China: Dali, Lufeng, Zhaoyang, and Qilin from May to September each year from 2015 to 2023. Traffic injury cases refer to patients who visited the outpatient or emergency departments of local surveillance hospitals for the first time due to traffic injuries. Meteorological data were derived from the fifth generation atmosphericreanalysis dataset of the global climate provided by the European Centre for Medium-Range Weather Forecasts. A time-stratified case-crossover design combined with distributed lag non-linear model was used to analyze the association between short-term exposure to heatwave and traffic injuries. We also conducted subgroup analyses by sex, age, occupation, injury cause, activity at the time of injury occurrence, and severity of injury. Results A total of 34764 traffic injury surveillance cases were included in the analysis. The risk of traffic injuries occurred during heatwave was 1.13 times (95%CI: 1.07, 1.20) greater than those occurred during non-heatwave, and 2.64% (95%CI: 1.49%, 3.73%) of traffic injuries were attributed to heatwave exposure throughout the study period. The results of stratified analysis showed greater impacts of heatwave on the risk of traffic injuries in female [odds ratio (OR)=1.17, attributable fraction (AF)=3.23%], people aged 15-64 years (OR=1.13, AF=2.68%), farmers/workers (OR=1.22, AF=4.07%), people with non-motor vehicle traffic injuries (OR=1.17, AF=3.24%), people who were driving or riding when injuries occurred (OR=1.12, AF=2.43%), and people with minor injuries (OR=1.18, AF=3.49%) ( P<0.05). Longer duration [excess risk (ER)=0.99%] and greater intensity (ER=4.12%) of heatwave had greater impacts on the risk of traffic injuries (P<0.05). Conclusion Heatwave events are associated with an increased risk of traffic injuries. Female, people aged 15-64, farmers/workers, people with non-motor vehicle traffic injuries, those injured while driving/riding a vehicle, and people with minor injuries are particularly vulnerable. The findings suggest that targeted mitigation and adaptation measures should be taken to address the risk of traffic injuries associated with extreme climate events.

Objective To retrieve relevant literature on risk prediction model for methicillin-resistant Staphylococcus aureus (MRSA) infection among hospitalized patients from databases and evaluate the predictive model. Methods The literature on risk prediction models for MRSA infection among hospitalized patients was retrieved from PubMed, Embase, Scopus, Cochrane library, China National Knowledge Infrastructure (CNKI), WanFang data, and VIP database, with a time range from the inception of the database to January 1, 2024. Two researchers independently screened the literature, extracted data. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was applied to evaluate the risk of bias and applicability of the prediction model in the literature, and descriptive analysis was conducted. Results A total of 12 articles (15 prediction models) were included in this study, with significant differences in the total sample size, the number of MRSA infection events, sample size of modeling, and sample size of validation among the studies. Common predictors in the prediction models were admission to the intensive care unit, antibiotic use, history of residence in nursing facilities, age, chronic kidney disease, and previous hospitalization history. Nine articles conducted internal validation, and three articles conducted both internal and external validation. Nine articles reported the area under the receiver operating characteristic curve, and only three articles reported the calibration of the model based on the Hosmer-Lemeshow test. PROBAST analysis showed that 10 articles were assessed as high risk bias, mainly stemming from statistical analysis. Conclusion Most of the MRSA infection risk prediction models in the current literature have good predictive efficacy for MRSA infection, but they all have higher overall risk of bias, and only a few models have undergone external validation. Researchers should follow PROBAST standards to construct and externally validate models in the future so as to develop models suitable for clinical practice.

Objective: To find out the association between family factors and left-behind children’s dietary behaviors in rural China. Methods: This cross-sectional study was implemented in four counties of medium economic level were selected in Guizhou and Anhui province and four primary schools were chosen in each county and in total 16 schools were involved. Three classes from grades 5 and 6 each were selected randomly from included primary schools; all students in these classes, as well as their caregivers, were invited to participate. Self-designed questionnaire was adopted to collect intake frequencies of vegetable, fruit, meat, egg, milk, drink and fast food. Scores were calculated to evaluate these behaviors frequencies and multi-linear regression was used to explore the association between family factors and behavioral scores. Results: The proportion of fruit, eggs and milk intake more than 4 times once a week in left-behind children were 44.9%, 35.1%, and 28.5%, while they were 57.2%, 38.5%, and 38.1% in non-left-behind children. It was found that statistical significant differences existed between scores of dietary behaviors of leftbehind children’s and non-left-behind children(t=-5.83, P<0.01). The results of multi-linear regression demonstrated that family cohesion (β=0.07, P=0.05) and caregivers’ behaviors (β=0.49, P<0.01) were protective factors for left-behind children’s behaviors, while taking care by single left-behind fathers was a risk factor(β=-1.21, P=0.03). Conclusion Primary caregivers play a critical role in offering guidance to children to help them develop health behaviors.

OBJECTIVE: To assess the clinical value of individualized pharmaceutical services for patients receiving vancomycin for severe infections and establish clinical monitoring procedures during vancomycin treatment. METHODS: Data were collected from patients with severe infections who received vancomycin treatment with individualized pharmacy services (test group, 144 cases) or without such services (control group, 884 cases) between January, 2017 and December, 2018. Using propensity score matching, the patients in the two groups with comparable baseline data were selected for inclusion in the study (62 in each group), and the efficacy, safety and economic indicators were compared between the two groups. RESULTS: The curative effects of the treatment did not differ significantly between the two groups, with the overall response rates of 95.16% in the test group and 91.94% in the control group ( CONCLUSIONS The participation of clinical pharmacists during the treatment can improve the clinical benefits of vancomycin in patients with severe infections.
Anti-Bacterial Agents/therapeutic use* ; Humans ; Infections/drug therapy* ; Pharmaceutical Services ; Retrospective Studies ; Vancomycin/therapeutic use*

Objective To investigate the clinical values of NT-proBNP in left ventricular enlargement(LVE) and left ventricular dysfunction(LVD) of the patients with essential hypertension(EH) to provide a diagnostic basis for their diagnosis .Methods Plas-ma NT-proBNP concentrations in 120 patients with EH and in 29 normal controls were measured ,then the echocardiography exami-nation was performed to determine the left ventricular ejection fraction ( LVEF) ,left ventricular end-diastolic diameter(LVEDD) , left atrium(LA) and left ventricular systolic diameter(LVSDD) .The correlation between plasma NT-proBNP with LVE and LVD was analyzed .The diagnostic accuracy of NT-proBNP was analyzed by using receiver operating characteristic (ROC) curve .Results There were no statistically significant differences in the aspects of age ,sex and serum creatinine between the EH group and con-trol group ,but plasma NT-proBNP level of the former was significantly higher than that of the latter .The NT-proBNP level in the patients with LVE was significantly higher than that in the patients with normal left ventricle (P<0 .05) .The NT-proBNP level in the LVD patients was significantly higher than that in the patients with normal left ventricular function (P<0 .05) .The plasma NT-p roBNP level was positively correlated with LA ,LVEDD and LVSDD(r=0 .518 ,0 .58 ,0 .48 ,P<0 .01) while negatively crrelated with LVEF(r= -0 .61 ,P<0 .01) .The ROC curve showed that when the NT-proBNP was set at 380 pg/mL ,the sensitivity and specificity of NT-proBNP for diagnosing LVE were 80 .6% and 72 .4% ;which for diagnosing LVD were 80 .8% and 77 .4% ,re-spectively .Conclusion NT-proBNP is closely correlated with multiple ultrasonic indicators reflecting the left ventricular function and its level can reliably reflect the left ventricular contraction function ,which can serve as the marker for screening LVE and LVD in the patients with EH .

Objective To investigate the effect of astragalus polysaccharides injection (APS) on autophagy of human nasopharyngeal cancer CNE-2 cells.Methods The inhibitory effect of APS on proliferation of CNE-2 cells was measured by CCK8 assay.Morphological changes of autophagy of APS was detected by acridine orange (AO) staining.Transmission electron microscopy was perform to observe the morphological alterations in the autophagic cells.The expression of Beclin-1 protein was detected by Western blot assay.Results APS markedly inhibited cell growth in a dose-and time-dependent manner.Increases of the number of large vacuoles and double layered membrane structure were observed by transmission electron microscopy.Results of AO staining revealed more bright red cytoplasm or nucleus in the ceradime group,which proved the existence of acidic vesicular organelles.Western blotting showed that Beclin-1 protein level was up-regulated.Conclusion APS may induce autophagy of human nasopharyngeal cancer CNE-2 cells via up-regulating the expression of apoptosis-related gene of beclin1 and inhibit the proliferation of CNE-2 cells.

Objective: To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharmacists for chemotherapy-induced Ⅳ degree myelosuppression.Methods: One advanced lung adenocarcinoma patient suffering from chemotherapy-induced Ⅳ degree myolosuppression was selected as the example, clinical pharmacists provided suggestions on the chemotherapy regimen, assisted physicians in making reasonable treatment plan and implemented comprehensive pharmaceutical care for the patient.Results: Clinical pharmacists played a positive role in the clinical treatment through the comprehensive pharmaceutical care in oncology department.Conclusion: With the professional knowledge of pharmacy, clinical pharmacists can improve the level of clinical rational drug use.

OBJECTIVETo investigate the cystathione beta synthase (CBS) gene T833C, G919A, 844ins68 polymorphisms and plasma homocysteine (Hcy) levels in ethnic Uyghur and Han patients with essential hypertension (EH) in Xinjiang.

METHODSFour hundred twenty nine cases including 211 Uyghur and 218 Han EH patients were recruited, whilst 410 healthy individuals including 210 Uyghurs and 200 Hans were used as the controls. Amplification refractory mutation system (ARMS) was adopted to analyze the CBS gene polymorphisms including T833C, G919A and 844ins68. Enzymoimmunoassay was applied to determine the plasma level of Hcy. Chemiluminescence was applied to determine the plasma folic acid and vitamin B12.

RESULTSCompared with the controls, the plasma Hcy level was significantly higher in the EH group in both ethnic Uyghurs and Hans (P < 0.05). Plasma levels of Hcy in T833C, G919A genotypes (for both heterozygotes and homozygotes) were statistically higher than wild types (P < 0.05). A significant difference was detected in G919A polymorphism between the EH patients and controls in both Uyghur and [CM(144.5mm] Han ethnics (Uyghur: x² = 10.264, P < 0.01; Han: x² = 23.075, P < 0.01), and in T833C between the EH patients and controls in ethnic Uyghurs (x² = 40.254, P < 0.01). Logistic regression analysis indicated that age (OR=1.151, P=0.047, 95% CI = 1.002-1.323), T833C (CC) (OR = 1.078, P = 0.003, 95% CI = 1.043-1.114), obesity (OR = 1.284, P = 0.021, 95% CI = 1.038-1.590), hyperhomocysteine (OR = 3.296, P = 0.016, 95% CI = 1.244-8.733) were independent risk factors for EH among ethnic Uygurs, while age (OR = 1.162, P = 0.007, 95% CI = 1.042-1.297), obesity (OR = 3.501, P = 0.003, 95% CI = 1.521-8.060), hyperhomocysteine (OR = 1.046, P = 0.031, 95% CI = 1.011-1.459) were independent risk factors for EH in ethnic Hans after adjusting for confounding factors.

CONCLUSIONPlasma level of Hcy is associated with ethnic Uyghur and Han patients with EH in Xinjiang. CBS gene T833C CC genotype may be associated with the EH among Uyghur ethnics.

Adult ; Aged ; China ; ethnology ; Cystathionine beta-Synthase ; genetics ; Essential Hypertension ; Female ; Gene-Environment Interaction ; Homocysteine ; blood ; Humans ; Hypertension ; genetics ; Logistic Models ; Male ; Middle Aged ; Polymorphism, Genetic

Objective The renin-angiotensin system ( RAS) is involved in myocardial anoxic injury .This study aimed to in-vestigate the expressions of AT 1-R, AT2-R, and angiotensin-converting enzyme ( ACE ) in bone marrow mesenchymal stem cells (MSCs) under hypoxia. Methods Rat MSCs were isolated, cultured, and identified with CD29 and CD11b/c antibodies.The is-chemic injury model was established by exposing the MSCs to hypoxia and serum deprivation ( Hypoxia/SD) for 24 hours, while the control cells were cultured in L-DMEM with 10%FBS.The vitality and apoptosis of the cells were detected by trypan blue staining , CCK8 assay, and Annexin V-FITC staining.The mRNA and protein expressions of AT 1-R, AT2-R, and ACE were determined by real-time quantitative PCR and Western blot , respectively. Results The positive rate of CD29 was >97%and that of CD11b/c was <1% in the MSCs.Compared with the control group, Hypoxia/SD significantly increased the rate of cell apoptosis ([6.73 ±0.78]%vs [19.93 ±4.92]%, P<0.01), decreased the rate of cell viability ([78.49 ±4.94]%vs [37.33 ±2.91]%, P<0.01), and up-regulated the mRNA and protein expressions of AT 1-R, AT2-R, and ACE. Conclusion Hypoxia/SD activates the RAS in MSCs and improves the protective function of the cells against myocardial anoxic injury .

Objective To evaluate the therapeutic effects of combining acupuncture and physical therapy with drugs on treating Duchenne muscular dystrophy (DMD).Methods Sixty infants with DMD were randomly divided into a treatment group and a control group (n =30 in each).Both groups were injected with Bozhi glycopeptide and given levocamitine and fructose sodium diphosphate orally.Moreover,the treatment group was additionally given acupuncture and physical therapy.Before and after 90 days of treatment,the time to walk 10 metres and to climb stairs of 2 metres high was measured,as were the serum creatine phosphate kinase (CPK),lactate dehydrogenase (LDH) and aspertate aminotransferase (AST) levels of all participants.Results After treatment,the average walking and stair climbing times of both groups were significantly shorter,and those of the treatment group were significantly shorter than those of the control group.Moreover,the average CPK,LDH and AST levels in the treatment group were significantly lower than before treatment and than those of the control group after treatment.There was a significant difference in the overall response rates,with 93％ observed in the treatment group and 73％ in the control group.Conclusion Combining acupuncture and physical therapy with drugs can significantly increase the mobility and improve the serum CPK,LDH and AST levels of children with DMD.