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.

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel endoscopic thyroid surgery method. TOETVA can completely dissect the lymph nodes in the central area and Ⅳ area. TOETVA has both advantages of beauty and curative effect. Based on the clinical experience of this technique, the author reviewed the development, indications, complications and surgical skills of TOETVA in recent years, and looked forward to the development trend of this technique.

Objective To explore the relationship between haptoglobin gene polymorphism and disease se-verity and susceptibility in senile vascular dementia patients.Methods A total of 80 patients with senile vas-cular dementia admitted to the hospital from February 2018 to February 2023 were selected as the vascular de-mentia group,and 80 stroke patients with non-vascular dementia admitted to the hospital during the same pe-riod were selected as the control group.The genotype distribution and allele frequency of haptoglobin gene were measured using polymerase chain reaction with sequence-specific primers,and their relationship with the severity and susceptibility of vascular dementia patients was analyzed.Results The proportion of history of hyperlipidemia and diabetes mellitus and the levels of total cholesterol and triglyceride in vascular dementia group were higher than those in control group,the differences were statistically significant(P＜0.05).The distribution of genotypes was in Hardy-Weinberg equilibrium(P＞0.05).The frequency of haptoglobin 2-2 genotype and haptoglobin 2 allele in vascular dementia group were higher than those in control group,and the differences were statistically significant(P＜0.05).There were significant differences in the scores of mini-mental state examination and hachinski ischaemic score among patients with vascular dementia with different haptoglobin genotypes(P＜0.05).Multivariate Logistic regression analysis showed that the carrier of hapto-globin 2-2 genotype and the carrier of haptoglobin 2 allele were independent risk factors for vascular dementia(P＜0.05).Conclusion Haptoglobin 2-2 genotype and haptoglobin 2 allele distribution frequency are associ-ated with the occurrence of vascular dementia after stroke,and those with high frequency of haptoglobin 2-2 genotype and haptoglobin 2 allele distribution suffer a severe disease,which can provide reference for early i-dentification and assessment of vascular dementia.

Objective To understand the prevalence and risk factors of hyperuricemia in electronics factory workers in Wuhan, and to provide evidence for the health protection of electronics factory workers. Methods A total of 1 415 employees in an electronics factory in Wuhan were selected as the research subjects, and the physical examination and determination of various biochemical indicators, as well as questionnaire survey were carried out. Results The detection rate of hyperuricemia among workers in the electronics factory in Wuhan was 32.43%, with 36.33% for men and 14.11% for women, and the difference was statistically significant ( χ²＝46.077，P＜0.001). The detection rate of hyperuricemia was the highest (33.77%) among those with university or college education, followed by graduate students and above (31.50%). Compared with subjects with good lifestyle habits, people with drinking habits had higher hyperuricemia detection rate (49.38%), and the difference was statistically significant (P =0.001). The detection rates of hyperuricemia in those with central obesity and elevated alanine aminotransferase were 48.23% and 61.29%, respectively, which were significantly higher than those in the subjects without the above diseases (26.91% and 27.21%, respectively), and the differences were statistically significant (P <0.001). Obese people had the highest detection rate of hyperuricemia (66.95%), followed by overweight people (43.75%), and the difference was statistically significant (P <0.001). Multivariate logistic analysis showed that alcohol drinking (OR=1.836, 95% CI=1.139-2.961, P =0.013) and body mass index ≥ 24 kg/m² (OR=2.175, 95% CI=1.686 -2.806, P <0.001) were risk factors for hyperuricemia in electronic factory workers. Elevated alanine aminotransferase (ALT) was significantly correlated with hyperuricemia (OR=2.964, 95%CI=2.146-4.095 , P <0.001). Female gender was a protective factor for hyperuricemia in workers in the electronics factory (OR=0.441, 95%CI=0.297-0.653 , P <0.001). Conclusion The detection rate of hyperuricemia among workers in an electronics factory in Wuhan is high, and the detection rate of hyperuricemia in men is higher than that in women. Alcohol consumption, overweight and obesity will increase the risk of hyperuricemia. Elevated ALT is associated with hyperuricemia. Maintaining an ideal body mass index and establishing a good lifestyle play an important role in preventing hyperuricemia.

Objective To investigate the efficacy of antibacterial photodynamic therapy(aPDT)as an adjunct to subgingival scaling and root planning in the treatment of chronic periodontitis.Methods This study followed medical ethics guidelines,and informed consent was obtained from all patients.Sixteen patients were recruited for this random-ized split-mouth controlled trial.The control group underwent subgingival scaling and root planning(SRP),while the ex-perimental group received subgingival scaling and root planing plus aPDT treatment using Perowave? with a toluidine blue O solution photosensitizer.The probing pocket depth(PD),recession,plaque index(PLI),bleeding index(BI)and proportion of positive sites of bleeding on probing(BOP)(BOP%)at all sites were examined at baseline(before treat-ment)and at 1,3 and 6 months after treatment.Results Follow-up was completed for 13 patients.On the control side,356 teeth were tested at 2 136 sites.A total of 360 teeth on the test side and 2 160 sites were included in the study.Before treatment,there was no significant difference in the baseline indicators between the two groups.After treatment,both groups showed significant improvement in clinical parameters,including PD,PLI,BI,and BOP%,compared with baseline.At 3 months,the BOP%and PLI in the experimental group were significantly lower than those in the control group(P＜0.05).The improvement in BOP%and PLI in the experimental group was significantly greater than that in the control group 3 months after treatment(P＜0.05).Conclusion aPDT,as an adjuvant treatment to SRP for chronic periodontitis,can improve gingival bleeding and control periodontal inflammation in the early stage.

In recent years, mRNA drugs have shown a great potential for the treatment of genetic diseases and attracted the attention of many researchers. This article has reviewed the advance in the research of mRNA drugs for the treatment of genetic diseases over the past 30 years, including their mechanisms of action and structure design, with a focus on their advantages as alternative therapies such as high specificity, low dosage, and sustained expression. Meanwhile, challenges for the effective delivery and storage methods for the mRNA drugs are discussed, with an aim to provide guidance for subsequent researches.

Objective:To explore the clinical and molecular basis for a Chinese pedigree affected with Complete androgen insensitivity syndrome (CAIS).Methods:A CAIS pedigree presented at Tianjin Medical University General Hospital between 2019 and 2021 was selected as the study subject. Clinical data of the proband was collected, along with peripheral blood samples from the proband and her family members. Chromosomal karyotyping, sex-determining region of the Y chromosome ( SRY) testing, and next-generation sequencing (NGS) were carried out for the proband, and candidate variant was verified by Sanger sequencing of her family members. Prenatal diagnosis was provided for the sister of the proband. This study was approved by Medical Ethics Committee of the Tianjin Medical University General Hospital (Ethics No. IRB2023-WZ-070). Results:The 18-year-old proband, who has a social gender of female, underwent laparoscopic examination, which showed no presence of uterus and ovaries. The karyotype of peripheral blood sample was 46, XY, with SRY gene detected. NGS indicated that the proband has harbored a heterozygous c. 1988C>G (p.Ser663Ter) variant of the AR gene. Sanger sequencing confirmed that her mother and sister had both harbored the same variant, whilst her father and younger sister were of the wild-type. Prenatal diagnosis revealed that her sister′s first fetus had harbored carried the same variant, which had led to termination of pregnancy. Her second fetus did not carry the variant, and a healthy boy was born. Based on guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as likely pathogenic (PM2_Supporting+ PM4+ PP3_Moderate+ PP4). Conclusion:The c. 1988C>G (p.Ser663Ter) variant of the AR gene probably underlay the CAIS in the proband. The accurate diagnosis of sex development disorders will rely on the physicians′ thorough understanding of the clinical symptoms and pathogenic genes. Genetic testing and counseling can enable precise diagnosis, prenatal diagnosis, and guidance for reproduction

In order to improve the level of refined management of medical consumables, a hospital used radio frequency identification (RFID) technology to map the unique device identification barcode of medical devices to the supply-processing-distribution (SPD) code, generating a medical consumables RFID tag code with dual code carrier function and a unique serial number. The " three streams in one" mutual integration management mode of hospital information flow, material flow and financial flow was constructed, which realized the whole lifecycle traceability of medical consumables, effectively improved the intelligence and accuracy of inventory control, further optimized the integration function of medical consumables industry and finance, and provided strong data support for the decision-making analysis of hospital operation and management.

Purpose To explore the application value of machine learning models based on cortical morphological features in the diagnosis of early Parkinson's disease(PD).Materials and Methods MRI and clinical data of 170 subjects from January 2014 to December 2017,including 100 early PD patients and 70 healthy controls,were selected from the Parkinson's Progression Markers Initiative database.Firstly,computational anatomy toolbox was used to preprocess the images to extract the fractal dimension(FD)and gyrification index(GI)of the cerebral cortex,and the differences of two indexes between early PD and healthy controls were compared.Then,all subjects were randomly divided into the train set and the test set with a 7∶3 ratio,and the optimal features were selected by t-test and recursive feature elimination.The classification model was constructed by random forest and evaluated by the receiver operating characteristic curve,and the decision curve analysis was used to evaluate the clinical value of the model.Results Compared to healthy controls,early PD patients had reduced GI in the bilaterally precentral gyrus,bilaterally rostral middle frontal cortex,bilaterally caudal middle frontal cortex,bilaterally triangular part of inferior frontal gyrus,bilaterally opercular part of inferior frontal gyrus,bilaterally orbital part of inferior frontal gyrus,the right superior frontal gyrus,the right lateral orbitofrontal cortex and the right insula(all P<0.05),but there was no significant difference in the FD(all P>0.05).The results of model evaluation showed that the area under curve values of the FD,the GI and the combined model in the train set were 0.860,0.895 and 0.939,respectively,and those in the test set were 0.762,0.821 and 0.868,respectively.The Hosmer-Lemeshow test showed that there was no statistically significant difference in the goodness of fit between the train and test set(all P>0.05).The decision curve analysis curve showed that clinical net benefit of the combined model was optimal when the probability threshold was in the range of 0.10 to 0.88.Conclusion In the early stages of the disease,cortical morphology of PD patients have changed.Machine learning model based on cortical morphology features has good diagnostic performance,and may be of important value in assisting clinical early diagnosis of PD.

Objective:To investigate the effect of serine/arginine-rich splicing factor 2 (SRSF2) on ferroptosis and its possible mechanism in glioblastoma cells.Methods:The online database of gene expression profiling interactive analysis 2 (GEPIA 2) and Chinese Glioma Genome Atlas were used to analyze the expression of SRSF2 in glioblastoma tissue and its association with patients prognosis. To validate the findings of the online databases, the pathological sections of glioblastoma and non-tumor brain tissues from Tianjin Medical University General Hospital, Tianjin, China were collected and analyzed by using immunohistochemistry. Silencing SRSF2 gene expression in glioblastoma cells by siRNA was analyzed with Western blot. The proliferation index was detected by using CCK8 assay. The rescued experiment was conducted by using expression plasmid of pcDNA3.1(+)-SRSF2. The activity of ferroptosis was assessed by using the levels of iron ions and malondialdehyde in glioblastoma cells and the changes in the ratio of glutathione to oxidized glutathione. The changes of gene expression and differential pre-mRNA alternative splicing (PMAS) induced by SRSF2 were monitored by using the third-generation sequencing technology analysis, namely Oxford nanopore technologies (ONT) sequencing analysis.Results:SRSF2 expression was higher in glioblastoma tissues than non-tumor brain tissues. Immunohistochemistry also showed a positive rate of 88.48%±4.60% in glioblastoma tissue which was much higher than the 9.97%±4.57% in non-tumor brain tissue. The expression of SRSF2 was inversely correlated with overall and disease-free disease survivals ( P<0.01). The proliferation index of glioblastoma cells was significantly reduced by silencing with SRSF2 siRNA ( P<0.01) and could be reversed with transfection of exogenous SRSF2. The levels of intracellulariron ions and malondialdehyde increased ( P<0.05), but the glutathione/oxidized glutathione ratio and the expression of key proteins in the glutathione pathway remained unchanged ( P>0.05). ONT sequencing results showed that silencing SRSF2 in glioblastoma cells could induce a significant alternative 3' splice site change on ferroptosis suppressor protein 1 (FSP1). Conclusion:SRSF2 inhibits the ferroptosis in glioblastoma cells and promotes their proliferation, which may be achieved by regulating FSP1 PMAS.