Background The impact of cold spells on population health can be categorized into an independent main effect of extreme low temperatures and an added effect of prolonged low temperatures. However, studies on the added effects of cold spells on hospitalizations remain limited. Objective To investigate the added effects of cold spells on hospitalizations of residents in Hengyang City, Hunan Province, and to provide a scientific basis for establishing a cold spell early warning system. Methods Daily meteorological data, air pollutant data, and hospitalization data from six tertiary hospitals of four districts in Hengyang City from 2017 to 2023 were collected. A generalized linear model (GLM) combined with a distributed lag nonlinear model (DLNM) was used to assess the added effects of cold spells on non-accidental hospitalizations, as well as hospitalizations for circulatory system diseases and respiratory system diseases, after controlling the main effect of temperature. The modifying effects of cold spell characteristics (intensity and duration) and individual characteristics (gender and age) were also analyzed. Results Compared with non-cold spell periods, the relative risks (RRs) of total non-accidental hospitalizations and hospitalizations across disease categories, genders, and age groups were elevated during cold spells of varying intensities and durations. However, the total effects of cold spells exhibited a "U-shape" nonlinear relationship with intensity and decreased with prolonged duration. During high-intensity cold spells (daily average temperature < P₅ and lasting ≥ 2 d), the RR (95%CI) for non-accidental hospitalizations was 1.71 (1.21, 2.42); the RRs (95%CIs) for males and females were 1.99 (1.38, 2.84) and 1.47 (1.00, 2.16), respectively; for individuals < 65 years and ≥ 65 years, the RRs (95%CIs) were 1.59 (1.12, 2.26) and 1.93 (1.27, 2.92), respectively; and for circulatory and respiratory system diseases, the RRs (95%CIs) were 1.84 (1.22, 2.79) and 1.07 (0.71, 1.60), respectively. No statistically significant differences were observed between the above subgroups. The single-day lagged effects of cold spells displayed a two-peaked pattern. The single-day lag RR for total non-accidental hospitalizations peaked at lag 1 d after cold spell exposure, declined thereafter, and began to rise again after lag 5 d, reaching a second peak at lag 12–13 d before gradually decreasing. The lagged effects remained statistically significant during lag 8–18 d. The lag patterns of cold spell associations across disease categories, genders, and age groups were largely consistent with those of total hospitalizations. Conclusion Cold spells have a significant impact on non-accidental hospitalizations of residents in Hengyang City, with notable lagged effects. The findings provide important theoretical support for establishing a more targeted cold spell early warning system.

OBJECTIVE To estimate the quality markers of antioxidant activity for standard decoction of Schisandrae Chinensis Fructus.METHODS 15 batches of Schisandrae Chinensis Fructus standard decoctions were subjected to quality evaluation by ultra high-performance liquid chromatography(UPLC)based on single-marker(QAMS)method,before being summarized by chemometrics analysis.The antioxidant abilities of 15 batches of samples were determined by DPPH and ABTS methods,while gray correlation analy-sis(GRA)and the partial least squares regression(PLSR)methods were subsequently applied to investigating the relationship between the contents of 8 components and the antioxidant activity.Ultimately,molecule docking was utilized to explore the binding properties between candidate quality markers and the core targets of anti-oxidation,with the experimental verification being executed on the indi-vidual compound by in vitro anti-oxidation.RESULTS There was no remarkable difference between the results of QAMS and external standard method(ESM),with P valued greater than 0.05.And it was speculated that protocatechuic acid,gomisin A,schizantherin B and schisandrin B were the constituents of quality difference.Moreover,the 4 quality variation components were reckoned to be the al-ternative markers on antioxidant according to the results of GRA and PLSR.The molecule docking result also showed that 4 candidate quality markers presented good binding affinity with the antioxidant core targets.The antioxidant capacity was presumably originated from the collaborated effects by multi-components in the standard decoction of Schisandrae Chinensis Fructus.In the interim,protocate-chuic acid exhibited noteworthy antioxidant efficacy with dosage-depended manner in the results of single-compound verification,which was best conformed to the characteristics of quality markers and supposed to be the antioxidant quality marker for Schisandrae Chinensis Fructus standard decoction.CONCLUSION This research predicts the potential antioxidant substances on the basis of content deter-mination by UPLC and in vitro antioxidant assay,but also provides rational foundation for quality assessment on other preparations of Schisandrae Chinensis Fructus.

Purpose: This study was aimed to investigate long-term survivals and toxicities of early-stage nasopharyngeal carcinoma (NPC) in endemic area, evaluating the role of chemotherapy in stage II patients. Materials and Methods: Totally 187 patients with newly diagnosed NPC and restaged American Joint Committee on Cancer/ International Union Against Cancer 8th T1-2N0-1M0 were retrospectively recruited. All received intensity-modulated radiotherapy (IMRT)±chemotherapy (CT) from 2001 to 2010. Results: With 15.7-year median follow-up, 10-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were 93.3%, 93.5%, 92.9% and 88.2%, respectively. Multivariable analyses showed cervical lymph nodes positive and pre-treatment prognostic nutritional index ≥ 52.0 could independently predict DMFS (p=0.036 and p=0.011), DSS (p=0.014 and p=0.026), and OS (p=0.002 and p < 0.001); Charlson comorbidity index < 3 points could predict DSS (p=0.011); age > 45 years (p=0.002) and pre-treatment lactate dehydrogenase ≥ 240 U/L (p < 0.001) predicted OS. No grade 4 late toxicity happened; grade 3 late toxicities included subcutaneous fibrosis (4.3%), deafness or otitis (4.8%), skin dystrophy (2.1%), and xerostomia (1.1%). No differences on survivals were shown between IMRT+CT vs. IMRT alone in stage II patients, even in T2N1M0 (p > 0.05). Unsurprising, patients in IMRT+CT had more acute gastrointestinal reaction, myelosuppression, mucositis, late ear toxicity, and cranial nerve injury (all p < 0.05) than IMRT alone group. Conclusion Superior tumor control and satisfying long-term outcomes could be achieved with IMRT in early-stage NPC with mild late toxicities. As CT would bring more toxicities, it should be carefully performed to stage II patients.

Objective: The aim of this study is to explore the application and advantages of combined intrathecal and extrathecal hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in OSA children. Method: We retrospectively reviewed 726 cases who were diagnosed as OSA. All patients were divided into two groups according to the surgical method: 320 cases by total tonsillectomy and 406 cases by combined extracapsular and intracapsular tonsillectomy. The intro operative bleeding volume, post operative haemorrhage data as time, location and degree in the two groups were compared. Result: There was no statistical difference in the intro operative bleeding volume in the two groups [（9.3±4.6） mL]vs [（7.6±3.5） mL], t=12.687, P=0.235. Two patients who underwent combined extracapsular and intracapsular tonsillectomy presented with post operative haemorrhage, the total post operative haemorrhage rate was significantly decreased that in the total tonsillectomy group（14 cases）（χ²=10.779, P=0.001）. The 2 patients in combined extracapsular and intracapsular tonsillectomy group were secondary haemorrhage, with location in the upper pole and medium, grade A haemorrhage; while in the 14 cases in in the total tonsillectomy group, there were 2 cases presented with primary haemorrhage and 12 cases with secondary haemorrhage; with regard to location of haemorrhage, 1 in the upper pole, 2 in the medium, 11 in the lower pole; 5 cases presented with grade A haemorrhage, 8 with grade B haemorrhage and 1 with grade C haemorrhage. The haemorrhage rate at 7 days after surgery （χ²=5.697, P=0.017）, at the lower pole（χ²=11.961, P=0.001） and grade B（χ²=8.097, P=0.004） were all significantly decreases in the combined extracapsular and intracapsular tonsillectomy group. Conclusion Plasma tonsillectomy combined with intrathecal and extrathecal hypothermic tonsillectomy is a safe and effective method, which has obvious advantages in reducing the postoperative hemorrhage, especially the secondary hemorrhage of Subtonsillar Pole.

The aim of this study is to explore the application and advantages of combined intrathecal and extrathecal hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in OSA children. We retrospectively reviewed 726 cases who were diagnosed as OSA. All patients were divided into two groups according to the surgical method: 320 cases by total tonsillectomy and 406 cases by combined extracapsular and intracapsular tonsillectomy. The intro operative bleeding volume, post operative haemorrhage data as time, location and degree in the two groups were compared. There was no statistical difference in the intro operative bleeding volume in the two groups [（9.3±4.6） mL]vs [（7.6±3.5） mL], =12.687, =0.235. Two patients who underwent combined extracapsular and intracapsular tonsillectomy presented with post operative haemorrhage, the total post operative haemorrhage rate was significantly decreased that in the total tonsillectomy group（14 cases）（χ²=10.779, =0.001）. The 2 patients in combined extracapsular and intracapsular tonsillectomy group were secondary haemorrhage, with location in the upper pole and medium, grade A haemorrhage; while in the 14 cases in in the total tonsillectomy group, there were 2 cases presented with primary haemorrhage and 12 cases with secondary haemorrhage; with regard to location of haemorrhage, 1 in the upper pole, 2 in the medium, 11 in the lower pole; 5 cases presented with grade A haemorrhage, 8 with grade B haemorrhage and 1 with grade C haemorrhage. The haemorrhage rate at 7 days after surgery （χ²=5.697, =0.017）, at the lower pole（χ²=11.961, =0.001） and grade B（χ²=8.097, =0.004） were all significantly decreases in the combined extracapsular and intracapsular tonsillectomy group. Plasma tonsillectomy combined with intrathecal and extrathecal hypothermic tonsillectomy is a safe and effective method, which has obvious advantages in reducing the postoperative hemorrhage, especially the secondary hemorrhage of Subtonsillar Pole.

Objective To explore the common bleeding location, disease features, and the management strategies of intractable aged epistaxis. Methods 134 serious epistaxis patients were examined step by step according to nasal anatomic structure and treated by a stepwise way under endoscopy. Results The bleeding location of the intractable aged epistaxis were found as follows:2 cases (1. 49%) in anterosu-perior area, 44 cases (32. 84%) in anteroinferior area, 18 cases (13. 43%) in posterosuperior area, 22 cases (16. 42%) in posteroinferi-or area, 3 cases (2. 24%) in nasopharynx, and the bleeding site of the other 45 cases (33. 58%) were not found. All the patients were healed. The final treatment way were:46 cases (34. 33%) with pharmacotherapy or cauterization (grade Ⅰ~Ⅲ), 88 cases (65. 67%) with anterior nasal packing (grade Ⅳ), 9 cases (6. 72%) with posterior packing(gradeⅤ),1 case (0. 75%) with selective angiographic embolization (grade Ⅵ). There were 82 cases (61. 19%) succeed with the initial hemostasis methods while 52 cases (38. 81%) succeed with the upgrade therapy. Both hemostasis methods and upgrade therapy had statistical significance in different nasal position groups ( hemo-stasis methods:χ2 =16. 35,P=0. 00; upgrade therapy: χ2 =16. 35,P=0. 00). Conclusion Compartmental examination and classified treatment steps by using endoscope may locate and stop nose bleeding promptly while decrease patients' pain and medical cost.

Objective To observe the levels of serum VEGF in different molecular subtypes of breast cancer and explore its relationship with response to neoadjuvant chemotherapy. Methods Levels of serum VEGF in 110 cases with breast cancer underwent neoadjuvant chemotherapy were detected by ELISA prior to and after 3 cycles of neoadjuvant chemotherapy. Clinical response to neoadjuvant chemotherapy was evaluated by physical examination and ultrasonography. Results Levels of serum VEGF were significantly increased in breast cancer patients with≥4 lymph node metastasis than those with < 4 lymph node[(307.31 ± 101.42) pg/mL vs. (170.16 ± 73.07) pg/mL,P = 0.017]. Patients with positive HER-2 status had significantly higher levels of serum VEGF than those with HER-2 negative status [(235.15 ± 88.42 ) pg/mL vs. (179.82 ± 69.90) pg/mL, P = 0.024]. No significant difference was observed among age , menopausal status and hormone status. In patients with neoadjuvant chemotherapy of cCR and Cpr,the mean levels of serum VEGF were (205.75 ± 78.12) pg/mL and (226.04 ± 89.04) pg/mL, respectively. After 3 cycles of chemotherapy, levels of serum VEGF decreased to (145.15 ± 67.08) pg/mL and (161.27 ± 93.57) pg/mL. There was significant difference between two groups (P=0.009,0.014). In patients with SD or PD response, no significant difference was observed between levels of serum VEGF before and after chemotherapy (P = 0.577). Conclusions Levels of serum VEGF in breast cancer correlate with lymph nodes metastasis and HER-2 status and may decrease after neoadjuvant chemotherapy. However,whether or not the levels of serum VEGF can be used as a biomarker for response to neoadjuvant chemotherapy needs more further studies.

Objective To study the dissociation of EDTA-dependent pseudo platelet aggregation by amikacin and to clarify the potential mechanism.Methods At different time points,two concentrations of amikacin (6.5 mg/ml and 10.0 mg/ml) were respectively added to EDTA-K2 anti-coagulated whole blood samples collected from two subjects with EDTA-dependent pseudothrombocytopenia.The aggregated-platelet dissociation was investigated by platelet count and microscopical examination.CD41,CD61,CD62p,PAC-1,and IgG on the platelets of the two patients and of a normal control were determined by the FCS under various conditions.Results When amikacin (6.5 mg/ml) was added within 1 hour after blood collection,it dissociated the EDTA induced platelet aggregation and the platelet counts returned to the normal level. The expression of CD62p,PAC-1,and PA-IgG on the platelets was decreased,yet the expression of CD41 and CD61 had no change.Conclusion Amikacin supplementation (6.5 mg/ml) within 1 hour after blood sampling may dissociate the aggregated platelets caused by EDTA. The mechanism may be associated that amikacin might inhibit the expression of CD62p,PAC-1,and PA-IgG on platelets. The amikacin supplementation would be an inexpensive,effective,and practical method to solve the platelet aggregation induced by EDTA.

Objective To research the effect of Shengmai capsules on cadiocyte apoptosis with chronic congestive heart failure (CHF) in rats. Methods Seventy five SD female rats were randomly divided into 5 groups:sham-operation group (A), CHF model group (B), CHF model treated by Shengmai capsules group (C), CHF model treated by Captopril group (D), CHF model treated by Shengmai capsule and Captopril group (E). Suprarenal abdominal artery constriction was operated to prepare CHF rat models. After 7 weeks treating respectively, the apoptosis rate of cadiocyte and the content of myocardia Bcl-2 in rats were detected. Results Apoptotic cells ratio of myocardia was higher in group B than in group A (P

Objective:To research the effect of Shengmai capsules on the matrix metalloproteinase(MMPs)& tissue inhibitor of metalloproteinase(TIMPs)in chronic congestive heart failure(CHF)rats.Methods:75 SD female rats weredivided randomly into 5 groups:sham-operation group(A),CHF model group(B),CHF model treated by Shengmai capsules group(Shengmai capsule group,C),CHF model treated by Captopril group(Captopril group,D),CHF model treated by Shengmai capsule and Captopril group(shengmai capsule&captopril group,E),15 rats each group.Suprarenal abdominal artery constriction was operated to prepare CHF rat models.After 7 week treating respectively,the contents of MMP-3&TIMP-1 of cardiac muscle in rats were detected.Results:The content of cardiac MMP-3 was higher in group B than in group A(P