Symptom presentation and evolution in the first 48 hours after injury are associated with return to play after concussion in elite Rugby Union

Background:Return to play(RTP)in elite rugby is managed using a 6-stage graduated RTP protocol,which can result in clearance to play within 1 week of injury.We aimed to explore how symptom,cognitive,and balance presentation and evolution during concussion screens 2 h(head injury assessment(HIA2)and 48 h(HIA3)after injury were associated with time to RTP)to identify whether a more conservative graduated RTP may be appropriate.Methods:A retrospective cohort study was conducted in 380 concussed rugby players from elite men’s rugby over 3 consecutive seasons.Players were classified as shorter or longer returns,depending on whether RTP occurred within 7 days(allowing them to be considered to play the match 1 week after injury)or longer than 8 days,respectively.Symptom,cognitive,and balance performance during screens was assessed relative to baseline(normal or abnormal)and to the preceding screen(improving or worsening).Associations between sub-test abnormalities and RTP time were explored using odds ratios(OR,longer vs.shorter).Median day absence was compared between players with abnormal or worsening results and those whose results were normal or improving.Results:Abnormal symptom results during screens 2 h and 48 h after concussion were associated with longer return time(HIA2:OR=2.21,95%confidence interval(95%CI):1.39-3.50;HIA3:OR=3.30,95%CI:1.89-5.75).Worsening symptom number or severity from the time of injury to 2 h and 48 h post-injury was associated with longer return(HIA2:OR=2.49,95%CI:1.36-4.58;HIA3:OR=3.34,95%CI:1.10-10.15).Median days absence was greater in players with abnormal symptom results at both HIA2 and HIA3.Cognitive and balance performance were not associated with longer return and did not affect median days absence.Conclusion:Symptom presentation and evolution within 48 h of concussion were associated with longer RTP times.This may guide a more conservative approach to RTP,while still adhering to individualized concussion management principles.

Strengthening the Disciplinary Construction of History of Medicine: A Call for Action by Chinese Academy of Medical Sciences & Peking Union Medical College

Recent years have witnessed a dynamic develop of Peking Union Medical College(PUMC),which was founded in 1921,and Chinese Academy of Medical Sciences(CAMS),which was founded in 1956.In the new era of building a"Healthy China",General Secretary Xi Jinping has emphasized the importance of a profound understanding of the Chinese civilization to let the world better know and understand China,and urged efforts to combine theories and practices to expound how to better uphold the Chinese path,promote the Chinese spirit,and pool together the Chinese strength[1].As an active response,PUMC organized the first Conference of History of Medicine on May 20-21,2023[2],Based on the rich history of PUMC and with an attempt to explore history,inherit the traditional Chinese culture,and promote the spirit of modern medicine,we issued the following call at the conference。

Annual Meeting minutes of the Chinese Geoscience Union,2020

The Seventh Annual Meeting of the Chinese Geoscience Union was held in Chongqing Yuelai International Convention Center,from October 18 to 212020,together with the 36th Annual Meeting of Chinese Geophysical Society which was held.This annual meeting convened one main venue and 31 academic conference venues,hosting 92 sessions with 51 of them focused on geophysics(including one English session).In addition,there were also six union-wide invited talks,5 presentations on the frontiers of geophysics,and 8 award lectures for the 2020 Fu Chengyi Young Scientist Awardees.The annual meeting received about 3200 abstracts,2150 of which were oral presentations and 950 as posters.In total,there were about 4000 participants from the scientific community and more than 80 exhibitors.

Research on the Existing Challenges and Countermeasures in E-business Education among Universities'Upgraded Talents from Colleges:A Case Study of Beijing Union University

At present,there are indeed many problems in the training of upgraded talents among e-business students such as unclear training objectives and characteristics,as well as the lack of classified guidance and its corresponding mechanism.Therefore,there is a need for optimization and upgrading of faculties in which active research should be conducted on these issues.Through various measures to counter the challenges faced in the training of upgraded talents in e-business education based on the student-oriented ideology and advantages of universities,the environment needs to be constantly optimized while improving their levels,designing effective countermeasures,and having finn ideological beliefs.This article strives to educate senior e-business innovative talents in line with the needs of enterprises,continuously promote the integration of industry and education,as well as commit to contributing toward a comprehensive and healthy development of the e-business industry as well as social progress.

Management of Adult Growth Hormone Deficiency at Peking Union Medical College Hospital:A Survey among Physicians

Objective To evaluate physicians' attitude and knowledge about the management of adult growth hormone deficiency(AGHD) at Peking Union Medical College Hospital and impact factors associated with better decision-making.Methods A 21-question anonymous survey was distributed and collected at Peking Union Medical College Hospital,a major teaching hospital in Chinese Academy of Medical Sciences.Data of physicians' educational background,clinical training,patient workload per year and continuing medical education in AGHD were collected.Factors associated with appropriate answers were further analyzed by multivariate regression models.Results One hundred and eighteen internal medicine residents,endocrine fellows,attending physicians and visiting physicians responded to the survey.Among them,44.9% thought that AGHD patients should accept recombinant human growth hormone replacement therapy.Moreover,56.8% selected insulin tolerance test and growth hormone-releasing hormone-arginine test for the diagnosis of AGHD.Logistic regression analysis of physician demographic data,educational background,and work experience found no consistent independent factors associated with better decision-making,other than continued medical education,that were associated with treatment choice.Conclusions The physicians' reported management of AGHD in this major academic healthcare center in Beijing was inconsistent with current evidence.High quality continued medical education is required to improve Chinese physician management of AGHD.

Positive Rate of Different Hepatitis B Virus Serological Markers in Peking Union Medical College Hospital,a General Tertiary Hospital in Beijing

Objectives To investigate the positive rate of different hepatitis B virus(HBV) serological markers,and the demographic factors related to HBV infection.Methods We enrolled all patients tested for HBV serological markers,such as HBV surface antigen(HBsAg),HBV surface antibody(HBsAb),hepatitis B e antigen(HBeAg),hepatitis B e antibody(HBeAb),HBV core antibody(HBcAb),and HBV-DNA from July 2008 to July 2009 in Peking Union Medical College Hospital.The positive rate of each HBV serological marker was calculated according to gender,age,and department,respectively.The positive rates of HBV-DNA among patients with positive HBsAg were also analyzed.Results Among 27 409 samples included,2681(9.8%) were HBsAg positive.When patients were divided into 9 age groups,the age-specific positive rate of HBsAg was 1.2%,9.6%,12.3%,10.9%,10.3%,9.7%,8.0%,S.8%,and 4.3%,respectively.The positive rate of HBsAg in non-surgical department,surgical department,and health examination center was 16.2%,5.8%> and 4.7%,respectively.The positive rate of HBsAg of males(13.3%) was higher than that of females(7.3%,P=0.000).Among the 2681 HBsAg(+)patients,1230(45.9%) had HBV-DNA test,of whom 564(45.9%) were positive.Patients with HBsAg(+),HBeAg(+),and HBcAg(+) result usually had high positive rate of HBV-DNA results(71.8%,P=0.000).Conclusions Among this group of patients in our hospital,the positive rate of HBsAg was relatively high.Age group of 20-29,males,and patients in non-surgical departments were factors associated with high positive rate of HBsAg.

UNION美的艺术:从日本传统建筑文化谈起

日本建设早在公元一世纪便形成了他的基本特点，日本民族对木构架的使用固然与日本岛屿上盛产木材相关，更与日本民族对美孚的认知有关，其都城美学特征的格局，庙宇和宫殿，比较恪守中国的形质，但结构，方法，空间布局，装饰和艺术风格等都形成了独自的风格，尤其是对细节的追求更达到了登峰造极的地步。

Chinese Trade Unions Strive to Protect Workers' Rights and Interests in Dealing with the Global Financial Crisis

Protecting the rights and interests of workers and staff members constitutes an important aspect of China’s human rights protection. At the time when

Pregnancy Outcomes of Repeat Cesarean Section in Peking Union Medical College Hospital

Objective To evaluate the effect of elective repeat cesarean section on the maternal and neonatal outcomes. Methods A retrospective clinicand hospital-based survey was designed for comparing the maternal and neonatal outcomes of elective repeat cesarean section [RCS group (one previous cesarean section) and MRCS group (two or more previous cesarean sections)] and primary cesarean section (FCS group) at Peking Union Medical College Hospital from January 1998 to December 2007. Results The incidence of repeat cesarean section increased from 1.26% to 7.32%. The mean gestational age at delivery in RCS group (38.1±1.8 weeks) and MRCS group (37.3±2.5 weeks) were significantly shorter than that in FCS group (38.9±2.1 weeks, all P<0.01). The incidence of complication was 33.8% and 33.3% in RCS group and MRCS group respectively, and was significantly higher than that in FCS group (7.9%, P<0.05). Dense adhesion (13.5% vs. 0.4%, OR=7.156, 95% CI: 1.7-30.7, P<0.01) and uterine rupture (1.0% vs. 0, P<0.05) were commoner in RCS group compared with FCS group. Neonatal morbidity was similar among three groups (P>0.05). Conclusions Repeat cesarean section is associated with more complicated surgery technique and increased frequency of maternal morbidity. However, the incidence of neonatal morbidity is similar to primary cesarean section.

3D打印结合Union Plate跨弓状缘髋臼解剖钢板在复杂髋臼骨折中的应用

目的探讨术前在3D打印模型上规划后柱螺钉用于髋臼骨折内固定的可行性和安全性,评价这种联合技术对复杂髋臼骨折治疗的早期临床结果。方法回顾性分析华中科技大学同济医学院附属协和医院自2018年6月至2019年8月行复杂髋臼骨折的15例患者资料,根据CT数据行骨盆3D打印,得到1∶1(含髂血管)仿真模型,术前在三维模型上模拟手术固定,并规划后柱拉力螺钉,将螺钉消毒以备术中使用。术中采用高位髂腹股沟入路,并使用Union Plate跨弓状缘髋臼解剖钢板+后柱拉力螺钉进行固定。结果全部患者的手术均按照术前计划顺利进行,平均手术时间172 min(150~290 min),术中平均出血量620 m L(200~1 500 mL);所有后柱螺钉均成功置入,术中透视螺钉位置、长度良好。术后根据Matta标准评价骨折复位情况。其中优9例,良6例,优良率100%。按照Matta改良的Merle d'Aubigne和Postel评分评价髋关节功能,其中优8例,良5例,可2例,优良率为86.7%。围术期出现闭孔神经麻痹1例,随访3个月好转;未观察到切口感染、血栓形成、螺钉松动或断裂等并发症。结论通过术前3D打印模拟手术、规划后柱拉力螺钉,结合跨弓状缘髋臼解剖钢板治疗复杂髋臼骨折置钉成功率高,安全性好,个体化强,效果可靠。

High Contribution of Sea Salt Aerosols on Atmospheric Particles Measured at an Urban Tropical Location in Reunion Island

PM10 was monitored during 2008-2011 period at LUT and BON, two urban tropical stations close to each other at Saint-Pierre city, in Reunion Island (south-western Indian Ocean). During the study period, notable PM10 concentrations are observed at BON close to the coasts. At LUT, a more inland site, the daily PM10 concentration range between 13 and 70 μg/m3. Importantly, the limit value for the protection of the human health is systematically exceeded at BON while it is never exceeded at LUT. Also, the quality objective (QO: 30 μg/m3, on annual average) and the limit value for the human health protection (LV: 40 μg/m3, on annual average) are exceeded at BON each year during 2008-2011, while at LUT no regulatory values are exceeded. Nitrogen dioxide, an atmospheric tracer of anthropogenic activities was also monitored at LUT and BON. The mean diurnal NO2 variation is of the same level and order of magnitude and exhibits a similar pattern at both stations suggesting that distinct sources influence the PM10 at LUT and at BON. Chemical analysis was performed on daily filters sampled in September-November 2011 at the two stations to determine the sea salt contribution on PM10 across Saint-Pierre city. It showed that the sea salt contribution to the PM10 is 55% at BON in September 2011. The sea salt particles are therefore the main cause for the exceedances of the regulatory values of PM10 recorded at BON. The results importantly suggest that the notable PM10 concentrations measured at this urban marine site might have some but minor impact on human health.

Cardiovascular Immunology Research in Wuhan Union Hospital:Over the Past 25 years

Cardiovascular immunology research in Wuhan Union Hospital began in 1991.Anti-heart antibodies in dilated cardiomyopathy and acute viral myocarditis began to be reported from 1993.It was found that a new autoantibody against L-type calcium channel results in ventricular tachycardia and sudden death in patients with dilated cardiomyopathy.Through the Intervention Study of Diltiazem in Dilated Cardiomyopathy,diltiazem was verifi ed to reduce mortality and the chronic heart failure hospitalization rate signifi cantly in patients with dilated cardiomyopathy.The autoantibodies against angiotensin II receptor type 1 andα1-adrenoceptor were associated with the increased recurrence of and death from stroke in hypertensive patients.Through many clinical and experimental studies,the functional imbalance of T-cell subsets was suggested to mediate myocardial injury and chronic heart failure,which provided a new theoretical basis for immunoregulation therapy for heart failure.The first antihypertensive polypeptide vaccine(ATRQβ-001)was invented.In addition to these achievements,there will be more research on cardiovascular immunology in Wuhan Union Hospital in the future.

Potential Use of Essentials Oils to Control Fruitlet Core Rot (FCR) in Pineapple (Queen Victoria Variety) in Reunion Island

Fruitlet Core Rot (FCR) is one of the major postharvest diseases of pineapple (Ananas comosus var. comosus), especially on the prone variety Queen Victoria cultivated in Reunion Island. This aggressive disease is generally due to two pathogens: Fusarium ananatum and Thalaromyces stolii, and needs to be controlled during postharvest. In Reunion Island, F. ananatum is the principal causal agent impacting fruit exportation. Fruit produced for the export market is generally treated with chemicals. This type of postharvest treatment is not in line with consumer expectations, as consumers prefer fruits treated with nonharmful and natural products. The objective of this work was to study alternative postharvest treatments using the fungitoxic properties of essential oils and their ability to elicit the resistance mechanisms of the fruit. Six EAs were tested in vitro on mycelial growth of F. ananatum. Whether by volatilization or included in the culture medium, some essential oils such as thymol, eugenol, geraniol and the carvone/menthol mixture have a strong fungistatic effect. But only thymol has a fungitoxic effect. The thymol, a natural molecule synthesized by thyme (Thymus vulgaris L. thymoliferum) is the more effective in vitro and is the strongest potential to be used in postharvest treatment. Thymol, prepared at 0.025% in a terpene solvent that acts as a penetrating agent, was tested in vivo with inoculated fruits. The treatment was effective only on necrosis development from the upper part of the fruits. Pineapple polyphenol biosynthesis appears to have been suppressed by thymol treatment. Results and opportunities for this treatment are discussed. Additional experiments must be carried out in order to decide on the advisability of this type of treatment.

Clinical nursing care of a nurse diagnosed with COVID-19in Wuhan Union Hospital

The coronavirus disease (COVID‑19) has claimed thousands of lives. The patients have been quarantined and treated in special shelter hospitals,and mild illness accounts for the majority of the total number of patients. This article reports one case of the first batches of infected medicalstaff, who got infected with 2019 novel coronavirus and later discharged 2 weeks after receiving treatment and nursing care in Wuhan UnionHospital. Considering all aspects of the patient’s hospitalization, the patient was performed ward environment management, medical nursing,symptomatic treatment, nutrition management, vital signs monitoring, observation and nursing, psychological assessment and support, andinfection protection and management. As the earliest successful case of cure, the patient’s manifestations are classical and common. Moreover,we hope to share it with colleagues to fight against COVID‑19 for reference. The treatment and nursing guidelines can be applied to treat a largenumber of mild cases, thus improving the discharge rate of patients and reducing the pressure of epidemic situation.

Chinese Trade Unions on the Stage of People-to-people Diplomacy

This year marks the 90thanniversary of All-China Federation of Trade Unions(ACFTU),which was founded on May 1st,1925.A review of the Federation’s international exchanges,from which historical experience can be summarized and drawn,is of pragmatic significance for further development of trade unions’foreign affairs with Chinese characteristics.

Clinical manifestations,diagnosis and long-term prognosis of adult autoimmune enteropathy:Experience from Peking Union Medical College Hospital

BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.

全球心血管疾病学术影响力评价(CAPE)体系的方法探索

目的:构建全球心血管疾病学术影响力评价(Cardiovascular Academic Performance Evaluation,CAPE)体系,并对全球医疗机构心血管疾病学术影响力进行排名。方法:由心血管疾病领域人员和图书情报人员提取医学主题词表(MeSH)、Embase同义词表、国际疾病分类(ICD)中心血管疾病相关术语,建立心血管术语词表(即阜外词表),设定缺血性心脏病、高血压、血管疾病、心律失常、肺血管疾病、心力衰竭、先天性心脏病、心肌病和瓣膜性心脏病等9个亚学科,实现亚学科分类、心血管术语词、入口词的映射。检索Web of Science、PubMed、Scopus数据库2016年1月1日至2022年12月31日的心血管领域论文,并对元数据进行去重融合;应用阜外词表对论文中主题词、题目、关键词、摘要等4个位置的内容进行检索匹配,生成论文“位置-心血管术语词-频次”的信息表,计算每一篇论文心血管学科相关度积分及亚学科积分。对论文的机构名、学者名进行规范化清洗,基于心血管强相关(相关度积分≥4分)原创性论文开展全球心血管疾病领域学术影响力的评价。针对全国医疗机构(心血管)的科技评价,还采集了国家自然科学基金项目、授权发明专利、获奖成果、科研平台、注册试验[国家药品监督管理局药品审评中心(CDE)药物临床试验登记数据]等数据。结果:检索到全球2016~2022年心血管领域论文1545103篇,剔除摘要、书籍、传记、新闻、视频、音频、撤稿、更正声明后为1178019篇,使用阜外词表标引“心血管强相关”论文518058篇。还采集到11143项心血管相关国家自然科学基金项目、19382项心血管相关有效授权发明专利、103项心血管相关国家级获奖成果、24个心血管相关国家科研平台、2084项CDE心血管相关药物临床试验登记等数据。经组织心血管疾病及其亚学科专家团队针对各自亚学科论文进行核对和验证,改进学科分类规则,最终锁定11项指标构建了心血管疾病和9个亚学科领域的综合评价指标体系。2016~2022年,中国发表心血管疾病研究论文数量增幅为123.5%,共发表约7.68万篇,平均每天约30篇,仅次于美国(约11.41万篇),居世界第二位。但中国期刊引证报告(JCR)分区和中国科学院分区论文占比仅居世界第八位。在2020~2022年全球医疗机构心血管原创研究论文影响力综合评估中,仅2家中国医疗机构进入前20名。结论:CAPE项目基于2016~2022年多源数据基础,首次探索建立了心血管领域机构学术影响力综合评价指标体系。

分娩镇痛:舒适与安全并行,教学与质控并举

分娩镇痛是以遵循产妇自愿和临床安全为原则,通过实施有效的分娩镇痛技术,以最大程度减轻产妇产痛的医疗服务。2018年,北京协和医院成为我国分娩镇痛首批试点单位,近年来在分娩镇痛高质量发展的各项工作中取得了满意成果。本文主要介绍北京协和医院分娩镇痛相关经验,具体包括:(1)合理调配人员安排,多学科联动制定标准化诊疗流程,为安全分娩提供舒适度保障;(2)完善危重孕产妇、新生儿救治方案,为安全分娩保驾护航;(3)传递先进的教学理念,将分娩镇痛培训与救治演练落到实处;(4)开展教育与科普讲座,帮助产妇树立科学分娩镇痛观。希望该经验分享可为我国各级诊疗机构提供参考和借鉴。