BACKGROUND: There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden. METHODS: Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status. RESULTS: A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status. CONCLUSIONS Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.
Female ; Humans ; China/epidemiology* ; Cities ; Cold Temperature ; Hot Temperature ; Mortality ; Temperature ; Time Factors ; Middle Aged ; Male

Background Injury is a major public health issue, and studying the correlation between temperature and injury in the context of climate change is of great significance for injury prevention and control. Objective To analyze the association between temperature and the volume of emergency medical service response due to injury in Chengdu. Methods Using a retrospective ecological study design, weather data in Chengdu were collected from 1 January 2022 to 31 December 2023 from Chengdu Meteorological Office, including daily average temperature, daily average relative humidity, average wind speed, average pressure, sunshine, and rainfall. Emergency medical service data were collected from an emergency medical service center in Chengdu. A distributional lag non-linear model was conducted to calculate the association between temperature and volume of emergency medical service response due to injury, and gender- and age-stratified analyses were followed to identify susceptible groups. Results Overall 219685 incidents of emergency medical service dispatching due to injury were collected during the study period. The top three injury causes were traffic accident (90765, 41.32%), poisoning (44101, 20.07%), and falling (44046, 20.05%). When daily average temperature exceeded 17.9 ℃, as the temperature rised, the volume of emergency medical service response for injury increased. In terms of the single-day lag effect, the risk of emergency medical service response for injury elevated on lag1 and persisted until lag6, the maximum daily effectwas observed on lag2, lag3 and lag4, and their relative risks associated with every 1℃ higher above 17.9 ℃ were both 1.08 times, 95%CIs were (1.03, 1.14), (1.04, 1.12), and (1.04, 1.16) respectively. Both men and women were susceptible to temperature, but on the same lag day, the men's RR value was higher than the women's. There was no statistical difference in the lag effect of temperature on the 0-17 age group; the lag effect on the 18-44 age group appeared on lag1, and lasted to lag6; that for the 45-64 age group appeared on lag1, and lasted to lag4; that for the 65 age group and over was only on lag 3 (RR: 1.05, 95%CI: 1.00, 1.10). Conclusion As the temperature rises, the volume of emergency medical service response due to injury is increased in Chengdu. In particular, the associated impact is significant on males and people aged 18-44 years old.

Objective To investigate the effect of evodiamine(Evo)on cartilage damage in knee osteoarthritis(KOA)model rats and analyze its mechanism of action.Methods Sixty rats were randomly divided into control,model,low-dose Evo,medium-dose Evo,high-dose Evo,and activator(Shh/Gli1 signaling pathway activator purmorphamine)+high-dose Evo groups,with 10 rats per group.A rat KOA model was constructed,and the corresponding drug interventions were administered to each group.Behavioral observations and Lequesne MG scores were conducted among rats in each group.Hematoxylin&eosin staining and safranine O-fixed green staining were applied to observe the pathological changes and Mankin score of rat cartilage tissue.Enzyme linked immunosorbent assays(ELISA)were applied to detect the levels of interleukin-1β(IL-1β),IL-18,and tumor necrosis factor-α(TNF-α),while dUTP nick end labeling was applied to detect chondrocyte apoptosis.Immunohistochemistry was applied to detect the expression of type Ⅱ collagen(CⅡ)and matrix metalloproteinase 13(MMP13)proteins,and Western blotting was applied to detect the expression of Shh,Smo,Ptc1,and Gli1 proteins.Results The rats in the model group showed movement disorders and severe cartilage tissue damage compared with the control group.The Lequesne MG score,Mankin score,IL-1β,IL-18,and TNF-α levels,chondrocyte apoptosis rate,MMP13 protein expression,and Shh,Smo,Ptc1,and Gli1 protein levels obviously increased,while the CⅡ protein expression decreased(P<0.05)compared with the model group.The activity disorders and cartilage tissue damage in rats in the low,medium,and high dose Evo groups were alleviated,the Lequesne MG score,Mankin score,IL-1β,IL-18,TNF-α levels,chondrocyte apoptosis rate,MMP13 protein expression,and Shh,Smo,Ptc1,and Gli1 protein levels were obviously decreased,the CⅡprotein expression increased(P<0.05);while the Shh/Gli1 signaling pathway activator reversed the improvement effect of high-dose Evo on cartilage damage in KOA rats.Conclusion Evodiamine may reduce the inflamma-tory response and chondrocyte apoptosis in KOA rats by inhibiting the Shh/Gli1 signaling pathway,thereby improving cartilage damage.

Purpose To explore the clinicopathological characteristics of atypical spindle cell lipomatous tumour(ASLT).Methods The clinical pathology,immunopheno-type,and molecular characteristics of 8 ASLTs diagnosed and treated in Fujian Cancer Hospital from 2020 to 2023 were col-lected.The histological morphology,immunophenotype and mo-lecular characteristics of 8 ASLTs were evaluated by HE stai-ning,immunohistochemistry and FISH.Clinicopathological fea-tures of 8 ASLTs were analyzed with literature review.Results Mixed distribution of spindle cells and adipocytes in different proportions was seen in all 8 cases,with no or mild cell atypia and no necrosis.Immunophenotypically,8 ASLTs were CD34 and S-100 positive to varying degrees,RB was negative,MDM2 and CDK4 were negative or focus positive,and Ki67 prolifera-tion index was low.FISH showed MDM2 amplification was nega-tive in 6 cases.Conclusion ASLT is a newly named benign adipose-derived tumor subtype with unique morphology,immu-nophenotype,and molecular characteristics.It has a good prog-nosis.Correct diagnosis can avoid clinical over-treatment.

OBJECTIVE To provide reference for quality control of Gentiana rhodantha. METHODS Taking 52 batches of G. rhodantha as subject， ultra-high performance liquid chromatography （UPLC） fingerprint was adopted. The similarity of 52 batches of medicinal materials samples was evaluated by the Similarity Evaluation System for Chromatographic Fingerprints of Traditional Chinese Medicine （2004A edition）； the content of mangiferin was determined； chemometric analyses [cluster analysis， principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA）] were performed. RESULTS UPLC fingerprints of 52 batches of G. rhodantha were established， 17 common peaks were identified， and 6 of them were identified， which were loganic acid （peak 1）， neomangiferin （peak 3）， swertiamarin （peak 5）， dangyin （peak 6）， mangiferin （peak 7） and isoorientin （peak 9）. The similarities of 52 batches of medicinal materials samples were all greater than 0.9； cluster analysis showed that S1-S46， S48-S52 clustered into one class， and S47 alone； PCA results showed that the cumulative variance contribution rate of the first six principal components was 82.928%； OPLS-DA results showed that the corresponding components of swertiamarin， mangiferin and chemical composition represented by peak 4， 14， 15， 16 were the main iconic components affecting the quality differences of G. rhodantha medicinal materials. The contents of mangiferin in 52 batches of medicinal material samples ranged from 18.2 to 101.0 mg/g， mostly in accordance with 2020 edition of Chinese Pharmacopoeia. CONCLUSIONS The established UPLC fingerprint and chemometric analysis methods combined with content determination method of mangiferin can comprehensively evaluate the quality of G. rhodantha.

Objective:To evaluate the efficacy of daily use of a test emollient combined with topical glucocorticoids applied at the weekend for delaying the recurrence of atopic dermatitis (AD) in children during the maintenance period.Methods:A randomized, blank-controlled, multicenter clinical study was conducted in children with moderate AD from Beijing Children′s Hospital, Capital Medical University, Children′s Hospital of Chongqing Medical University and Shenzhen Children′s Hospital from March 2021 to February 2022. A total of 127 children aged 0 - 12 years with moderate AD were treated with topical glucocorticoids combined with emollients during the run-in period, 112 out of them achieved the investigator′s global assessment (IGA) score ≤ 1 point, and then the 112 patients were randomly divided into a test group (56 cases) and a control group (56 cases) at a ratio of 1∶1. Patients in the test group received treatment with a test emollient twice a day in combination with topical glucocorticoids applied at the weekend, and those in the control group were only treated with topical glucocorticoids at the weekend. Patients in the two groups were followed up at baseline, week 2 (± 3 d), week 4 (± 5 d), and week 12 (±7 d), as well as at the time of AD relapse, and the effect of the test emollient on the remission rate of AD in children during the maintenance period was evaluated, so were its effects on the dosage of topical glucocorticoids, pruritus, sleep, and skin pH. The occurrence of treatment-related adverse events was evaluated and recorded at the same time. Study endpoints were defined as AD relapse during the maintenance period, end of 12-week follow-up, or occurrence of serious adverse events. Comparisons of efficacy indicators between groups were conducted by using chi-square test, Kaplan-Meier survival analysis, Satterthwaite t′ test and Mann-Whitney U test. Results:In the full-analysis set, 45 (80.36%) patients with AD maintained remission in the test group (56 cases) and 30 (53.57%) in the control group (56 cases), and the remission rate difference between the two groups was 26.79% (95% confidence interval [ CI]: 10.09%, 43.49%; χ2 = 9.11, P = 0.003) ; the 12-week follow-up during the maintenance period showed that the time to first relapse was 75.05 ± 25.07 days in the test group, which was significantly longer than that in the control group (49.55 ± 33.92 days, t′ = 4.52, P < 0.001). At the study endpoint, the test group showed significantly decreased AD disease severity score (eczema area and severity index [EASI] score: 0.00 [0.00, 1.20] points vs. 0.60 [0.00, 4.00] points), pruritus visual analog scale (VAS) score (0.00 [0.00, 2.00] points vs. 2. 00 [0.00, 10.00] points), and sleep VAS score (0.00 [0.00, 0.00] points vs. 1.00 [0.00, 4.00] points) compared with the control group ( Z = -2.77, 2.43, 3.48, P = 0.006, = 0.015, < 0.001, respectively), while there was no significant difference in the pH value at the lesional sites between the test group and control group ( t = 0.97, P = 0.335). For the group aged 0 - 2 years, the average daily glucocorticoid dosage at the weekend in AD children during the maintenance period was significantly lower in the test group than in the control group ( Z = -1.97, P = 0.049) ; for the group aged >2 - 12 years, there was no significant difference in the average daily glucocorticoid dosage at the weekend between the two groups ( Z = -0.25, P = 0.802). During the study period, no significant difference was observed in the incidence of treatment-related adverse events between the test group (2/56, 3.57%) and control group (3/56, 5.36%; P = 1.000), and no serious adverse events occurred. Conclusion:Compared with the weekend treatment with topical glucocorticoids alone, the daily use of the test emollient combined with topical glucocorticoids at the weekend could markedly improve the remission rate of AD, prolong the time to relapse, and reduce the disease severity at relapse in children with AD during the maintenance period, which provides a new option for maintenance treatment of children with AD.

Objective:To investigate the clinicopathological features and prognosis of medullary thyroid carcinoma (MTC) co-existent with Hashimoto's thyroiditis (HT).Methods:Seven cases of MTC co-existent with HT were collected from Fujian Cancer Hospital between Jan 2007 and May 2021. Its clinicopathological features were analyzed.Results:All patients were adult female with a median age of 49 years, and 6 of them were unilateral MTC. The tumor diameter ranged from 0.4 to 7.0 cm. The thyroid tissue surrounding the tumor showed HT. The follow-up time was 16 to 152 months, with a median time of 61 months, 5 patients (tumor diameter <1 cm) were biochemically cured, 1 patient (tumor diameter >1 cm) was anatomically cured. The another patient died due to tumor progression 30 months after surgery, the tumor cells in which were highly atypia and more mitoses (5~8/10HPF) necrosis and vascular invasion were also observed.Conclusion:MTC with HT are mostly sporadic cases, and most of them have a fair prognosis.

Here, we took base construction of neurosurgery as example to discuss and analyze according to requirements and evaluation indexes of base construction in Xinqiao Hospital, and put forward the specific objectives, measures and implementations of base construction. Foremost, we summarized experiences and overcame shortcomings through interpreting and implementing scheme of our base construction, which would help to improve the construction of standardized residency training base in China.

OBJECTIVE: To analyze the prevalence and influencing factors of multisite work-related musculoskeletal disorders(WMSDs) of workers in a railway vehicle manufacturing enterprise. METHODS: A total of 366 male workers in the assembly and riveting workshop of a railway vehicle manufacturing enterprise were selected as the research subjects using the cluster sampling method. The Chinese Musculoskeletal Questionnaire was used to investigate the prevalence of multiple sites of WMSDs. Multiple logistic regression analysis was used to analyze the influencing factors. RESULTS: The total prevalence of WMSDs was 56.3%(206/366). The prevalence of WMSDs in all parts from high to low was as follows: lower back(35.5%), hand and wrist(27.6%), neck(23.2%), shoulder(21.0%), knee(19.9%), upper back(18.6%), hip and leg(18.0%), ankle/foot(15.8%) and elbow(12.3%)(P<0.01). The total prevalence of multisite WMSDs was 38.0%(139/366). The prevalence of WMSDs in different numbers of parts from high to low was as follows: 6 or more parts(12.0%), 2 parts(10.7%), 3 parts(6.6%), 5 parts(5.5%) and 4 parts(3.3%)(P<0.01). Multiple logistic regression analysis results showed that the overweight and obese workers had higher risk of multi site WMSDs than those with normal body mass index(P<0.05).Those with long-term low heads, frequent bending, long bending of the elbows, and higher frequency of work requirements, and less frequently communicated with the leader had higher risk of multi site WMSDs(P<0.05). CONCLUSION: The prevalence of multisite WMSDs in railway vehicle manufacturing enterprise is relatively high. The influencing factors include individual factors, adverse ergonomic factors and psychosocial factors.

OBJECTIVE: To explore the influencing factors of neck work-related musculoskeletal disorders( WMSDs) and their effects in airport porters. METHODS: A total of 413 airport porters were chosen as study subjects using judgment sampling method. Chinese version of Musculoskeletal Questionnaire was used to investigate the prevalence of WMSDs.Then structural equation model was constructed and used to analyze the influencing factors of neck WMSDs. RESULTS: The prevalence of neck WMSDs in airport porters was 37. 3%( 154/413). Postural load,mental workload and length of service had a direct effect on neck WMSDs of porters( path coefficients were 0. 405,0. 166,0. 296,P < 0. 05),and mental workload also had an indirect effect on neck WMSDs through postural load( path coefficient was 0. 103,P < 0. 01).CONCLUSION: Posture load,mental workload and length of service are risk factors of neck WMSDs in airport porters.