Background Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are the standard first-line treatment for EGFR-mutant lung adenocarcinoma. However, the efficacy and prognosis vary significantly among individuals. This study aimed to investigate the correlation between baseline 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) metabolic parameters and the efficacy of targeted therapy as well as long-term prognosis in patients with EGFR-mutant lung adenocarcinoma, with a specific subgroup analysis for exon 19 deletion (19del) and exon 21 L858R mutation. Methods A total of 175 patients with pathologically confirmed EGFR-mutant lung adenocarcinoma who underwent baseline 18F-FDG PET/CT before EGFR-TKI treatment were retrospectively enrolled. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. The primary endpoints were progression-free survival (PFS) and overall survival (OS). The secondary endpoint was objective response rate (ORR). Kaplan-Meier curves, log-rank tests, and Cox proportional hazards regression models were used for survival analysis. Subgroup analysis was performed according to EGFR mutation subtypes (19del vs. L858R). Results During a median follow-up of 48 months, high SUVmax, MTV, and TLG were significantly associated with shorter PFS and OS (all P < 0.05). Multivariate analysis confirmed that MTV (HR = 1.862, 95% CI: 1.324–2.619, P < 0.001) and TLG (HR = 1.745, 95% CI: 1.248–2.439, P = 0.001) were independent prognostic factors for PFS. In subgroup analysis, the prognostic value of MTV and TLG was more pronounced in the L858R subgroup compared with the 19del subgroup. Conclusions Baseline 18F-FDG PET/CT metabolic parameters, especially MTV and TLG, are valuable independent prognostic biomarkers for EGFR-mutant lung adenocarcinoma patients treated with EGFR-TKIs. The predictive performance differs between 19del and L858R subtypes, which may help guide individualized treatment strategies.

Allergic rhinitis is an inflammatory disease of the nasal mucosa caused by an immunoglobulin E (IgE) mediated response to inhaled allergens. The global prevalence of allergic rhinitis ranges from 5% to 50%, and it has been on the rise in recent years. Allergic rhinitis is often comorbid with allergic conjunctivitis and asthma, causing a burden on personal life and socio-economic well-being. Except for genetics, environment, and lifestyle, increasing evidence showed that air pollution is an important factor that increases the risk of allergic rhinitis and exacerbates its symptoms. Due to the complexity of air pollution, current research focuses more on mixed air pollutants, and other environmental factors have also become research objects. However, the types of air pollutants studied are still limited, and the mechanisms of many pollutants' effects are not yet clear. Moreover, research on the synergistic effects with other factors is not complete. Therefore, summaries of existing research results and deeper studies on the impact of air pollution on allergic rhinitis are crucial for the prevention and control of the disease. This study analyzes the effects, mechanisms, and related synergistic factors of air pollution on allergic rhinitis. Multiple keyword combinations such as "allergic rhinitis" and "air pollution", "allergens", "meteorology", "genetics" or "intervention" were used to screen relevant literature in four domestic and foreign databases. We excluded studies lacking explicit pollutant types or potential synergistic factors, focusing on summarizing and analyzing the latest research developments over the past five years. A qualitative review method was used to identify current research deficiencies and propose potential future research directions based on the findings. Our conclusions are as follows: air pollution may affect different stages of the disease process, impacting allergic rhinitis by acting as allergens or allergen enhancers during sensitization, and influencing the sensitization or effector stages through oxidative stress, inflammatory responses, or immune system regulation. These effects may involve the interaction of multiple mechanisms, but most of them ultimately lead to inflammatory response. Epidemiological studies have found associations between particulate matter (PM2.5, PM10, and their chemical components) and outdoor gaseous pollutants (SO2, NO2, O-3, CO) with allergic rhinitis across different regions and populations. And some volatile organic compounds are associated with allergic rhinitis in indoor environments. These pollutants can affect allergic rhinitis through different mechanisms mentioned above, which have been corroborated by animal studies. Moreover, air pollution also interacts synergistically with other environmental factors. Environmental allergens are the direct cause of allergic rhinitis, and air pollution can synergize with allergens through multiple pathways to promote sensitization. Air pollution can also interact with meteorological factors such as temperature and humidity and epigenetics factors to influence allergic rhinitis, while interventions such as wearing masks and using air purifiers can reduce the adverse effects of air pollution on allergic rhinitis. Finally, although there have been studies that have shown a correlation between air pollution and allergic rhinitis, the types of pollutants studied remains limited. Furthermore, there are considerable differences in research methodologies, and high-quality research is relatively lacking. The impact of air pollution on allergic rhinitis still remains uncertain. Therefore, we suggest that future research should identify more potential pollutants that may impact allergic rhinitis and investigate the distinct effects of individual and mixed pollutants. Methods such as omics or machine learning should be used to explore the effect mechanism and biomarkers of air pollution on allergic rhinitis in the human body. Given the incurable of allergic rhinitis, it is imperative to develop more effective personalized intervention measures.

OBJECTIVES:To explore the clinical characteristics of noise-induced hearing loss (NIHL) caused by long-term exposure to steady-state noise and find a possible inflection point time leading to hearing deterioration. MATERIAL AND METHODS:Subjects exposed to steady-state noise were selected as the noise-exposed group and matched with a control group of individuals not exposed to noise. Both groups underwent pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE), and their hearing conditions were analyzed. The time inflection point with the most significant disparities in NIHL between early and late exposure was evaluated. The noise-exposed subjects were divided into 2 groups based on cumulative exposure time: the early exposure group (group A) and the late exposure group (group B). Retrospective analyses of clinical characteristics of hearing loss were conducted. RESULTS:The noise-exposed group exhibited significantly higher hearing thresholds and reduced otoacoustic emissions compared to the control group, with high-frequency hearing loss being the most prominent. The most significant disparity in high-frequency hearing loss in PTA was observed before and after 5 years of cumulative steady-state noise exposure. Among the 78 noise-exposed subjects, 37 were in group A (≤5 years) and 41 in group B (>5 years). In DPOAE, the most significant disparity occurred before and after 4 years of acexposure, with 33 subjects in group A (≤4 years) and 45 in group B (>4 years). Distortion product otoacoustic emissions identified the time inflection point of significant hearing deterioration 1 year earlier than PTA. CONCLUSIONS:Hearing loss caused by long-term exposure to steady-state noise showed evident deterioration after 4-5 years. The DPOAE can illustrate the inflection point of hearing deterioration 1 year earlier than PTA. Int J Occup Med Environ Health. 2025;38(1):57-69.

Objective: To evaluate the relationship between air pollution, meteorological factors, and eosinophils in the peripheral blood of allergic rhinitis (AR) patients. Methods: We conducted a retrospective study of medical records from the Ninth Medical Center of PLA General Hospital in Beijing. A review of medical records (1st January 2014-31th August 2022) of 1080 AR patients who underwent peripheral blood eosinophil count tests. Patients were stratified into elevated and normal eosinophil count groups. Daily meteorological data (mean temperature and relative humidity) and ambient pollutant levels (PM2.5, PM10, NO2, SO2, CO, and ozone [O3]) were collected. The mean pollutant levels and meteorological factors on the day of eosinophil count measurement were calculated separately for each group. Linear regression was performed to analyze the association between eosinophil counts and both meteorological factors and pollutant levels among AR patients. Results: In 1080 AR patients, 11.85% had elevated eosinophil counts. Higher temperature (16.88 ± 9.09°C), humidity (57.75 ± 17.22%), and O3 levels (116.54 ± 54.92 μg/m3) correlated significantly (p < 0.05) with elevated eosinophil counts. Linear regression confirmed positive associations between eosinophil count and temperature (β = 0.003), humidity (β = 0.001), and O3 (β = 0.0004) (p < 0.05). Other pollutants showed no significant differences. Conclusion: Elevated eosinophil counts in AR patients correlated significantly with higher temperature, humidity, and O3 levels. Linear regression confirmed positive associations between eosinophil count and these meteorological factors.

Inhaled dose is crucial for accurately assessing exposure to air pollution, determined by pollutant concentration and minute ventilation (VE). However, the VE predictive models and its application to assess the health effects of air pollution are still lacking. In this study, we developed VE predictive models using machine learning techniques, utilizing data obtained from eighty participants who underwent a laboratory cardiopulmonary exercise test (CPET). VE predictive models were developed using generalized additive model (GAM), random forest model (RF) and extreme gradient boosting (XGBoost) and analyzed for explanation of input variables. The Random Forest model, cross-validated, exhibited outstanding performance with an R2 of 0.986 and a MAE of 1.816 L/min. The median difference between the measured VE and the predicted VE was 0.18 L/min, and the median difference between the black carbon (BC) inhaled dose based on predicted VE and measured VE was 0.02 ng. Employing explainable machine learning, the results showed that metabolic equivalent (METs), heart rate, and body weight are the three top important variables, emphasizing the significance of incorporating METs variables when constructing VE models. Through multiple linear regression models and an adjusted stratified analysis model, the significant adverse association between BC concentration and inhaled dose on diastolic blood pressure (DBP) was only observed in female. The disparity in the effect of BC inhaled dose compared to BC concentration on DBP reached up to 115 %. This study is the first to explore the ability of different machine learning algorithms to construct VE prediction models and directly apply the models to assess health effects of an example pollutant. This study contributes to the accurate assessment of air pollution exposure leveraging wearable devices, an approach useful for environmental epidemiology studies.

Gastroesophageal airway reflux disease (GARD) refers to a class of diseases in which the contents of the digestive system reflux into esophagus, the upper and lower airways, mouth, ear and nose et al, causing uncomfortable symptoms. It covers gastroesophageal reflux disease and extra-esophageal reflux disease. GARD is one of the most common diseases in clinical practice. The main cause of GARD-related clinical symptoms and signs of GARD is the structural damage and functional disability, which were caused by repeated contact between the mucous epithelium of the reflux tract and the acidic and non-acidic components of the reflux. Over the years, major progress has been made in the understanding of the molecular pathogenesis of reflux associated mucosal inflammation, suggesting a complex and multifactorial pathogenesis and immune-mediated effects. Thus, we reviewed the clinical and pathophysiological characteristics of GARD and probe the complexity of the pathogenesis of GARD-related mucosal inflammation from the aspects of microscopic changes and specific molecular mediators. New drug therapies for the mucosal injuries in the reflux tract were also reviewed. From bench to bedside, these novel molecular findings might provide new perspectives and therapeutic approaches for GARD.

Background: Occupational hearing loss of workers exposed to impulse noise and workers exposed to steady noise for a long time may have different clinical characteristics. Methods: As of May 2019, all 92 servicemen working in a weapon experimental field exposed to impulse noise for over 1 year were collected as the impulse noise group. As of Dec 2019, all 78 servicemen working in an engine working experimental field exposed to steady noise for over 1 year were collected as the steady noise group. The propensity score matching (PSM) model was used to eliminate the imbalance of age and working time between the two groups of subjects. After propensity score matching, 51 subjects in each group were finally included in the study. The machine learning model is constructed according to pure tone auditory threshold, and the performance of the machine learning model is evaluated by accuracy, sensitivity, specificity, and AUC. Results: Subjects in the impulse noise group and the steady noise group had significant hearing loss at high frequencies. The hearing of the steady noise group was worse than that of the impulse noise group at speech frequency especially at the frequency of 1 kHz. Among machine learning models, XGBoost has the best prediction and classification performance. Conclusion: The pure tone auditory threshold of subjects in both groups decreased and at high frequency. The hearing of the steady noise group at 1 kHz was significantly worse than that of the impulse noise group. XGBoost is the best model to predict the classification of our two groups. Our research can guide the prevention of damage caused by different types of noises.

Objective. The purpose of this study was to compare the diagnostic utility of pH monitoring using 24-hour esophageal pH-Impedance (HEMII-pH) testing versus pharyngeal pH (Restech) testing (Respiratory Technology Corporation, Houston, Texas) for diagnosing laryngopharyngeal reflux (LPR).Methods. Retrospectively, patients were reviewed who had completed a Reflux Symptom Index (RSI) survey and stroboscopy within 60 days before or after undergoing simultaneous esophageal pH-Impedance monitoring and Restech testing. Reflux Finding Score (RFS) was determined by 4 blinded observers. 80.45% of patients were on anti-reflux medications at the time of study and had incomplete response to treatment for reflux. Improvement on reflux treatment was determined by evaluating presenting pre-pH monitoring RFS, post treatment RFS, and improvement of symptoms. Pearson correlation coefficients were calculated to assess relationships among RSI, RFS, and test results from HEMII-pH and Restech tests.Results. Eighty-seven patients were included in the analysis. The inter-rater reliability of the RFS determination was 74.57%, and the intra-rater reliability was 67.00%. Subjects who had a positive RYAN Score had a significant correlation with RFS (r of 0.222 and p-value of 0.0492). There was no correlation between RFS and number or per-cent time of reflux events, longest event, total number of events, or percent of time at alkaline pH for either HEMII-PH or Restech test. RSI correlated better with HEMII-pH test than with Restech for percent time spent in both upright (r of 0.226 and p-value of 0.029) and supine position (r of 0.261 and a p-value of 0.032). Restech correlated better with total patient symptom Scores including cough, heartburn, burping, and throat clearing, with a r of 0.242 and a p-value of 0.048. Restech detected more percent time in reflux for total reflux, supine reflux, and upright reflux (p-value less than 0.0001). Restech also detected longer event times than Impedance (p-value of less than 0.0001). When diagnosis of LPR is based on the definition of CRC, the Sataloff Score test had 70.45% sensitivity and 80.95% specificity. The RYAN Score had a sensitivity of 72%, and a specificity of 56.45%, and the Wu Score had a sensitivity of 62.16%, and specificity of 54.05%. When the Sataloff and Wu Score were used together, the sen-sitivity was 71.45%, specificity 100%, positive predictive value of 100%, and a negative predictive value of 59.46%.Conclusion. The amount of time of reflux events correlates with symptoms better than the number of events. The HEMII-pH test was able to detect more events of pH<4 than Restech, possibly because there might have been more acid events below than above the upper esophageal sphincter, while Restech detected more total events. Restech recorded longer event times than HEMII-pH test. Since length of time correlates with RFS (probably reflecting laryn-geal inflammation), and since laryngeal clearance of acid is more similar to pharyngeal than esophageal clearance, this finding might prove valuable clinically. The Sataloff Score has a sensitivity of 70.45%, and a specificity of 80.95% and appears useful clinically to detect mild to moderate that is missed by the RYAN Score. A combination of Sataloff Score and Wu Score may be clinically valuable to identify LPR with an increased sensitivity of 71.45% and increased specificity of 100%. The Wu Score is not yet available for the general clinical use, but the Sataloff Score is.

Pancreatic ductal adenocarcinoma (PDAC), as one of the malignant cancers with the worst prognosis, is becoming the most urgent clinical problem. Due to the lack of early diagnosis and curable therapeutic methods, it is critical to exploit proper models that can capture the overall attributes of the primary tumor. Recently, organoid technology has emerged and flourished as a powerful tool to enable long-term culture of pancreatic tissues, including PDAC. As accumulating studies suggest, organoids can retain morphological, genetic, and behavioral traits, and have tremendous value in predicting the therapeutic response to conventional chemotherapy drugs or newfangled agents. Herein, this review comprehensively summarizes the tissue source including human fetal and adult pancreatic tissue to generate a pancreatic organoid as well as current organoids cultivate system. As PDAC organoids can be established from a small number of samples derived from endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB), we also review the literature to date on EUS-FNA/FNB-based organoid constitution and its implementation in inquiring tumor behavior and evaluating therapeutic responses. By enabling the alignment of basic and clinical research platforms, the application of organoids would open up new avenues for drug discovery and maximally benefit translational medicine in the near future.

Background and Aims: Studies on the effect of antireflux mucosectomy (ARMS) on laryngopharyngeal reflux disease (LPRD) are lacking. We conducted a multicenter retrospective study to explore the clinical efficacy of ARMS on LPRD. Methods: We retrospectively analyzed the data of patients diagnosed with LPRD by oropharyngeal 24-hour Dx-pH monitoring who underwent ARMS. The effects of ARMS on LPRD were evaluated by comparing the 36-Item Short-Form Survey (SF-36), reflux symptom index (RSI), and 24-hour Dx-pH monitoring scores before and 1 year after surgery. Patients were divided into groups according to gastroesophageal flap valve (GEFV) grade to explore the effect of GEFV on prognosis. Results: One hundred eighty-three patients were included in the study. The oropharyngeal pH monitoring results showed that the effective rate of ARMS was 72.1% (132/183). After surgery, the SF-36 score was higher (P = .000), RSI score was lower (P = .000), and the symptoms of constant throat clearing; difficulty swallowing food, liquids, and pills; coughing after eating or after lying down; troublesome or annoying cough; and breathing difficulties or choking episodes were significantly improved (P < .05). Upright reflux was dominant in GEFV grade I to III patients, and the SF-36, RSI, and upright Ryan index scores were significantly improved after surgery (P < .05). In GEFV grade IV patients, regurgitation was dominant in the supine position, and the above evaluation indexes were worse after surgery (P < .05). Conclusions: ARMS is effective for LPRD. The GEFV grade can predict the prognosis of surgery. ARMS is effective in GEFV grade Ito III patients, but the effect is not exact in GEFV grade IV patients and may even be aggravated.

The aim of this study was to explore the changes in pH and pepsin concentrations in oral lavage fluid of rabbit reflux model. A total of 18 New Zealand rabbits were randomly divided into two groups. The lower esophageal sphincters (LESs) of the rabbits in the experimental group (EG) were dilated by balloon after the LESs were localized by manometry. The pH levels of the throat and the lower esophagus were monitored 1 week before and 2 weeks after inflation. Oral lavage fluid was collected 1 week before, and 2 and 8 weeks after inflation. The pH monitoring showed that the percentage of reflux time, the number of reflux events, and the longest time of reflux after the dilation (AE) in the EG were significantly higher than before the dilation (P < 0.01). The pepsin concentrations at 2 and 8 weeks AE in the EG were significantly higher than that before and that in the control group (P < 0.05). Based on receiver operating characteristic curve analysis, the best diagnostic threshold value was 30.3 ng/ml. The reflux model constructed by balloon inflation of the LES in rabbits is characterized by a decrease in throat pH and an increase in salivary pepsin concentration.

OBJECTIVE:To assess the diagnostic value of the W score in differentiating laryngopharyngeal reflux disease (LPRD) patients from the normal population by pharyngeal pH (Dx-pH) monitoring, compared with the RYAN score. METHODS:One hundred and eight patients with suspected LPRD and complete follow-up results after more than 8 weeks of anti-reflux therapy were enrolled from the Department of Otolaryngology-Head and Neck Surgery, Gastroenterology and Respiratory Medicine of seven hospitals. Their Dx-pH monitoring data before treatment were reanalyzed to obtain the W score in addition to the RYAN score and then the diagnostic sensitivity and specificity were compared and evaluated with reference to the result of anti-reflux therapy. RESULTS:In eighty-seven (80.6%) cases, anti-reflux therapy was effective, and in 21 patients (19.4%), therapy was ineffective. Twenty-seven patients (25.0%) had a positive RYAN score. The W score was positive in 79 (73.1%) patients. There were 52 patients who had a negative RYAN score, but a positive W score. The diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of the RYAN score were 28.7%, 90.5%, 92.6%, and 23.5%, respectively (kappa = 0.092, P = 0.068), whereas those of the W score for LPRD was 83.9%, 71.4%, 92.4%, and 51.7%, respectively (kappa = 0.484, P < 0.001). CONCLUSIONS:W score is much more sensitive for the diagnosis of LPRD. Prospective studies with larger patient populations are necessary to validate and improve diagnostic efficacy. TRIAL REGISTRATION:Chinese Clinical Trial Registry: ChiCTR1800014931.

Ambient fine particulate matter (FPM) promotes airway inflammation and aggravates respiratory and cardiovascular diseases. Macrophage polarization plays an essential role in FPM-induced inflammation and tissue repair. The balance of pro-inflammatory M1-type and anti-inflammatory M2-type macrophages determines the fate of tissues and is involved in the pathogenesis of various FPM-induced diseases. The mechanism of macrophage polarization induced by FPM is still not fully understood. Here, we explored the effect of ambient FPM exposure duration on the polarization of peritoneal macrophages. Mice were exposed to concentrated ambient FPM for different duration. Markers of M1-type macrophage and M2-type macrophage in peritoneal macrophages were detected. We found that macrophage polarization was affected by FPM both in vitro and in vivo. Acute FPM stimulation in vitro and short-term concentrated ambient FPM exposure in vivo promoted the expression of NLRP3 and NOS2 and inhibited the expression of ARG1 and CD206. With the extension of concentrated ambient FPM exposure time, ARG1 was gradually up-regulated, and NLRP3 was gradually down-regulated. These results indicate that FPM exposure duration interferes with macrophage polarization. This may provide new insight into the treatment of patients exposed to FPM.

BACKGROUND:The susceptibility of allergic rhinoconjunctivitis (ARC) patients to air pollution has yet to be clarified. OBJECTIVES:Based on a repeated measurement panel study, we explored the association of short-term PM exposure with lung function in ARC patients and to further identify the susceptible populations. METHODS:Personal PM exposure, including PM1, PM2.5 and PM10, was monitored consecutively for three days before outcomes measurements. Lung function indices including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and forced expiratory flow at 25-75 % of the vital capacity (FEF25-75) were measured. Serum total immunoglobulin E (IgE), specific-allergen IgE, blood eosinophil and basophils, and the symptoms severe scores were tested in each visit. Linear mixed effect models were applied to estimate the association between PM exposure and lung function. Furthermore, stratified and overlapping grouped populations based on IgE levels were implemented to characterize the modification role and the modulating threshold of IgE at which the association turned significantly negative. RESULTS:Short-term PM personal exposure was associated with a significant decrease in lung function in ARC patients, especially for small airway respiratory indexes. The highest estimates occurred in PM1, specifically a 10 μg/m3 increase reduced FEV1/FVC, PEF and FEF25-75 by 1.36 % (95 %CI: -2.29 to -0.43), 0.23 L/s (95 %CI: -0.42 to -0.03) and 0.18 L/s (95 %CI: -0.30 to -0.06), respectively. Notably, PM-induced decreases in lung function were stronger in patients with higher IgE levels (IgE ≥ 100 IU/mL), which were related to higher inflammatory cytokines and symptoms scores. Further, PM-associated lung function declines enhanced robustly and monotonically with increasing IgE concentration. Potential modulating thresholds of IgE occurred at 46.8-59.6 IU/mL for significant PM-lung function associations. CONCLUSION:These novel findings estimated the short-term effects of PM on lung function in ARC patients, and the threshold values of IgE for the significant and robust associations.

Background:Currently, antireflux mucosectomy (ARMS) and Stretta radiofrequency (SRF) are the most commonly used minimally invasive antireflux therapies. To date, there have not been any reports comparing ARMS and SRF. Our aim was to compare the clinical efficacies of these two therapeutic methods.Methods:We analyzed data from gastroesophageal reflux disease (GERD) patients, including 39 who received ARMS treatment and 30 who received SRF treatment between January 2020 and May 2021. Symptom control, gastroesophageal reflux disease questionnaire (GERDQ) score, gastroesophageal reflux disease health-related quality of life (GERD-HRQL) score, proton pump inhibitor (PPI) withdrawal, and PPI reduction were analyzed and compared.Results:After 6 months of follow-up, the results showed that both therapies were effective in improving symptoms and quality of life. No difference was found between the ARMS group and SRF group in GERDQ score, GERD-HRQL score, PPI withdrawal rate, or PPI reduction rate (P>0.05). There was no significant difference in the PPI withdrawal rate between the two therapies among patients with gastroesophageal flap valve (GEFV) grade II and grade III (P>0.05), but the PPI withdrawal rate in the ARMS group was significantly higher than that in the SRF group among patients with GEFV grade IV (P<0.05).Conclusions:The clinical efficacies of ARMS and SRF 6 months postoperation were equivalent. The results showed that both ARMS and SRF treatment were acceptable for patients with GEFV grades II and III, while ARMS should be selected for patients with GEFV grade IV.

Mounting evidence indicated the associations between air pollution and outpatient visits for allergic rhinitis (AR), while few studies assessed the effect modification of these associations by ambient temperature and relative humidity (RH). In this study, dataset of AR outpatients was obtained from Chinese People's Liberation Army Strategic Support Force Characteristic Medical Center in Beijing during 2014 to 2019, and the average concentrations of air pollutants including particulate matter ≤2.5 μm in diameter (PM2.5) and ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and meteorological factors (temperature and RH) at the same period were collected from one nearby air monitoring station. We performed a time-series study with Poisson regression model to examine the effects of air pollutants on AR outpatients after adjustment for potential confounders. And the effects modification analysis was further conducted by stratifying temperature and RH by tertiles into three groups of low, middle and high. In total of 33,599 outpatient visits for AR were recorded during the study period. Results found that a 10 μg/m3 increase in PM2.5, PM10, NO2 and SO2 was associated with significant increases in AR outpatients of 1.24% (95% confidence interval (CI): 0.69%, 1.78%), 0.79% (95% CI: 0.43%, 1.15%), 3.05% (95% CI: 1.72%, 4.40%) and 5.01% (95% CI: 1.18%, 8.96%), respectively. Stronger associations were observed in males than those in females, as well as in young adults (18-44 years) than those in other age groups. Air pollution effects on AR outpatients increased markedly at low temperature (<33.3th percentile) and high RH (>66.7th percentile). Findings in this study indicate that air pollution is associated with increased risk of AR outpatients, and the effects of air pollution on AR could be enhanced at low temperature and high RH.

Trauma is one of the most important public health challenges. In recent years, the applications of artificial intelligence and machine learning for the prediction and diagnosis of trauma-related diseases are gradually rising and show the bright prospect. The research and application of artificial intelligence in traumatic brain injury mainly focus on the prediction of traumatic brain injury, intracranial haemorrhage, chest, abdominal injury and fracture. Venous thromboembolism and infection, need for critical care and the outcomes after trauma injuries were also predicted by the model created by artificial intelligence and machine learning. In this review, we summarized the application and development of artificial intelligence in the prediction and diagnosis of trauma medicine over the recent years.

A number of studies have found associations between the short-term exposure to ambient air pollution and hospital admissions. However, little is known about the temporal variations in ambient air pollution associated with health exposure, especially in China. We evaluated whether the risks of allergic rhinitis (AR) outpatient visits from short-term exposure to air pollution varied over time (2014–2020) in Beijing, China. A quasi-Poisson generalized additive model was used to evaluate the relative risks (RRs) and 95% confidence intervals (CIs) associated with the pollutant concentrations during the entire study period and three specific periods. We also analyzed the temporal variations of the period-specific associations and tested the trend of change using the Mann–Kendall test. The concentration-response relationships for the specific periods were further investigated. The RRs (95%CI) for an interquartile range (IQR) increased in PM10 (70 μg/m3) and CO (0.5 mg/m3) decreased from period 1 to period 3. However, The RRs (95%CI) of PM2.5 (55 μg/m3), SO2 (7 μg/m3) and NO2 (27 μg/m3) increased from 1.015 (0.978, 1.054), 1.027 (1.009, 1.044) and 1.086 (1.037, 1.137) in period 1 to 1.069 (1.005, 1.135), 1.074 (1.003, 1.149) and 1.214 (1.149, 1.282) in period 3, respectively. A statistically significant temporal change and the stable effects were observed between the NO2 exposure and AR visits over time. Despite a substantial reduction in ambient air pollution, the short-term effects on AR outpatient visits remained significant. Our findings provide a rationale for continued air pollution control efforts in the future to minimize air pollution and to protect the public.