Background The job content of aircraft maintenance workers is complex, with high intensity and high requirements, and they are prone to work-related musculoskeletal disorders (WMSDs), but related research is relatively rare. Objective To investigate the positive rate of WMSDs among aircraft maintenance workers, evaluate ergonomic load, and analyze the risk factors of WMSDs. Methods We used a self-compiled questionnaire for WMSDs and the Quick Exposure Checklist (QEC) to investigate the basic situation, positive rate of WMSDs, and the ergonomic load of 2271 male maintenance workers in 6 departments of an aircraft maintenance company, including airline maintenance, overall overhaul, accessory/landing gear overhaul, engine overhaul, product customization, and power assist. We used a logistic regression model to analyze the risk factors of WMSDs in the neck, shoulder, hand/wrist, and lower back. Results The positive rate of WMSDs in the past 12 months was 70.4% (1598/2271) and the positive rate of WMSDs in different body parts ranged from 6.6% to 49.5%, with the top three parts of lower back, neck, and knee, respectively. There were statistically significant differences in the positive rate among different departments (P<0.05). The average QEC scores for neck, hand/wrist, and back (static) were moderate, while those for shoulder and back (dynamic) were high, and the body part specific positive rate of WMSDs increased with the increase of ergonomic load level. Working years (5-<10 years, ≥20 years), working with back flexed or twisted or side bent (moderately, excessively), high maximum force level exerted by one hand, and feeling difficult (sometimes, often) and stressful (moderately, very) while working were associated with higher risks of lower back pain (OR=1.486, 1.505; 2.151, 3.769; 1.637; 2.110, 2.407; 1.637, 1.794; P<0.05). Working years (15-<20 years, ≥20 years), working with head/neck bent or twisted (occasionally, continuously), feeling difficult (sometimes) and stressful (very) while working were associated with higher risks of neck pain (OR=1.731, 1.586; 3.732, 8.341; 1.633; 1.696; P<0.05). Working years (15-<20 years, ≥20 years), working with hands in a high position (at shoulder or above), very frequent shoulder/arm movements, feeling difficult (sometimes, often) and stressful (moderately, very) while working were associated with higher risks of shoulder pain (OR=1.587, 1.709; 1.299; 1.521; 1.643, 2.239; 1.659, 1.977; P<0.05). Working with wrist at deviated or bent angle, high repetition of similar movements, feeling difficult (sometimes, often) and stressful (moderately, very) while working were associated with higher risks of hand/wrist pain (OR=1.692; 1.670; 1.827, 2.884; 2.190, 2.625; P <0.05) . Physical exercise after work (≥3 times·week⁻¹) was associated with a lower risk of neck pain (OR=0.582, P<0.05). Shift workers were at a lower risk of shoulder pain and hand/wrist pain (OR=0.737 and 0.554, P<0.05). Conclusion The high positive rate of WMSDs symptoms among aircraft maintenance workers is related to individual, occupational ergonomic, and psychological factors, and active prevention and intervention should be taken.

Objective To analyze the evaluation results of health enterprises in Beijing City and their influencing factors. Methods A total of 40 enterprises that passed the health enterprise evaluation in Beijing from 2021 to 2022 were selected as the study subjects using the judgment sampling method. The total evaluation scores and influencing factors were analyzed based on the size, nature, industry classification, and establishment time of the enterprises. Results The total evaluation score of the 40 health enterprises was (553.1±18.4) points. Scores for the primary evaluation indicators, including management organization and system, occupational disease prevention measures, health environment, health promotion measures, prevention measures for occupational stress caused damage, and musculoskeletal injury prevention measures, were (94.0±4.8), (94.0±4.3), (94.5±3.8), (89.7±4.8), (89.6±4.6), and (91.4±5.9) points, respectively. The result of multiple linear regression analysis showed that, large enterprises had higher total evaluation scores than medium enterprises and micro and small enterprises after controlling for confounding factors such as industry classification and establishment time (all P<0.10). The total evaluation scores of private enterprises and foreign-funded enterprises were lower than that of state-owned or state-participated enterprises (all P<0.10). Conclusion Enterprise size and nature are influencing factors for the total evaluation score of health enterprises. It is necessary to enhance resource and policy support for medium-sized, micro and small enterprises and private enterprises to improve the development of the health enterprises.

Background Bus drivers are a high-risk group for work-related musculoskeletal disorders (WMSDs). There are a large number of bus drivers in mega-cities. High volumes of passenger traffic and complexity of road conditions may elevate their risk of WMSDs, but there are few studies related to this group. Objective To investigate the prevalence of WMSDs among bus drivers in a mega-city and to analyze potential influencing factors. Methods Based on cross-sectional study design and self-administered questionnaire, the prevalence of WMSDs in past 12 months were estimated by stratified cluster sampling among bus drivers in a mega-city. Pearson χ² and logistic regression models were used to analyze the influencing factors for the body regions with a high prevalence. Results The overall prevalence of WMSDs in past 12 months among bus drivers in a mega-city was 49.5% (551/1113). The prevalence of WMSDs by body regions ranged from 4.0% to 38.5%, and led by neck pain (38.5%), lower back pain (25.5%), and shoulder pain (20.8%). The results of logistic regression showed that the risk factors for neck pain were age (>50 years), smoking, tiredness after work (moderate, severe), long sitting (frequently), awkward postures (sometimes, often, frequently), overtime(occasionally, often), workplace temperature (uncomfortable), and noise (severe) (OR=2.014、1.577、2.793、3.025、2.708、2.032、3.406、2.746、1.442、2.998、1.456、3.506；P<0.05); the lower back pain risk factors were current work experience (6-10 years, 11-15 years, and 16-20 years), smoking, tiredness after work (moderate, severe), and awkward postures(sometimes, often, frequently)(OR=1.777、2.130、2.400、1.503、2.951、3.364、1.836、4.569、2.786，P<0.05); and the shoulder pain risk factors were age (46-50 years, and >50 years), smoking, tiredness after work (moderate, severe), vehicle type (hybrid power, diesel oil), awkward postures (often, frequently), overtime (often), and workplace temperature (uncomfortable) (OR=1.737、2.357、1.553、2.259、2.489、1.659、3.295、2.777、3.320、2.266、1.426，P<0.05). Identified protective factors for neck and lower back pain were off-duty physical activity (1-2 times per week, and ≥3 times per week) (OR=0.553、0.470、0.586、0.485，P<0.05). Conclusion Nearly half of the bus drivers in the mega-city report symptoms of WMSDs, mainly in the neck, lower back, and shoulders. The prevalence is related to individual and occupational factors, and prevention and intervention measures should be actively taken.

Background The current increasing trend of new cases of occupational noise-induced deafness indicates that the hearing loss of occupational population has not been effectively controlled in China. It is of great significance to study the characteristics of hearing loss among noise-exposed workers and its related factors. Objective To investigate characteristics and influencing factors of hearing loss among occupational noise-exposed workers in a large machinery maintenance enterprise, and to provide a scientific basis to prevent and control noise-induced hearing loss. Methods A cross-sectional survey was conducted to investigate male Han occupational noise-exposed workers in a large mechanical maintenance enterprise. We acquired demographic characteristics, occupational exposure history, and individual life behavior characteristics of the workers through questionnaires, collected occupational exposure level data from annual occupational disease hazard factor surveillance reports, obtained pure tone hearing threshold test data through occupational health examinations, and estimated individual noise exposure levels using cumulative noise exposure (CNE). According to the results of pure tone air conduction hearing threshold test, the workers were divided into a hearing loss group and a normal hearing group. The chi-square test was employed to compare the occupational exposure characteristics and individual life behavior characteristics between the two groups. Additionally, the trend chi-square test was utilized to analyze the changing trends of age, length of service, CNE, and hearing loss rate within the two groups. The relationship between high-frequency hearing loss in both ears and its related influencing factors was assessed by a multiple logistic regression model. Results The M (P₂₅, P₇₅) of CNE for the 2531 occupational noise-exposed workers was 97.51 (95.39, 99.96) dB(A)·year. The incidence of hearing anomaly, binaural high-frequency hearing anomaly, random ear high-frequency hearing anomaly, binaural low-frequency hearing anomaly, and random ear low-frequency hearing anomaly were 22.48%, 16.59%, 22.13%, 2.77%, and 3.52%, respectively. High-frequency hearing threshold increase was the main reason for hearing anomaly (98.42%). In comparison to the CNE ≤ 97 dB(A)·year group, the 97 dB(A)·year100 dB(A)·year group experienced a 36.4% and 52.3% increase in the risk of bilateral high-frequency hearing loss, respectively. The smoking group exhibited a 43.5% elevated risk of bilateral high-frequency hearing loss when compared to the non-smoking group. Conversely, the group frequently wearing hearing protection equipment demonstrated a 23.6% lower risk of bilateral high-frequency hearing loss in comparison to the group occasionally wearing protective equipment. The data suggested that CNE＞97 dB(A)·year and smoking might be independent risk factors for bilateral high-frequency hearing loss, and frequently wearing hearing protection equipment might be an important protective factor. Conclusion Increased CNE and smoking can elevate the risk of high-frequency hearing loss, while personal hearing protection can effectively reduce the risk of hearing loss.

Objective:To observe the clinical efficacy of exercise-based acupuncture in treating ischemic stroke and its effects in improving the patient's motor function and daily living ability. Methods:A total of 106 patients with motor dysfunction due to cerebral infarction were randomized into a trial group and a control group,each consisting of 53 cases.Both groups received conventional rehabilitation;in addition,the control group was given point-toward-point acupuncture at scalp points,and the trial group was offered exercise-based acupuncture,3 times weekly for 4 consecutive weeks.Before treatment,after 2 and 4 weeks of treatment,and at the 2-month follow-up,the Fugl-Meyer assessment(FMA)scale,Lovett scale for muscle strength,modified Ashworth scale(MAS),and activities of daily living(ADL)scale were used to assess the patient's motor function,muscle strength,muscle tension,and daily living ability. Results:After treatment,both groups gained improvements in motor function and daily living ability;after 4-week treatment and at the 2-month follow-up,the trial group had higher FMA and ADL scores than the control group(P<0.05).The MAS score decreased after treatment in both groups;after 2 and 4 weeks of treatment and at the 2-month follow-up,the MAS score was lower in the trial group than in the control group(P<0.05).After the intervention,the Lovett score increased in both groups;after 4 weeks of treatment,the Lovett score was higher in the trial group than in the control group(P<0.05). Conclusion:Based on routine rehabilitation,exercise-based acupuncture and scalp point-toward-point acupuncture both can improve the motor function and daily living ability in ischemic stroke patients;exercise-based acupuncture performs better than scalp point-toward-point acupuncture.

Objective:To observe the effect of Ba Duan Jin(Eight-brocade Exercise)plus Tuina(Chinese therapeutic massage)in treating primary dysmenorrhea due to cold-induced blood stasis in female college students and on the score of fatigue scale-14(FS-14). Methods:Seventy-two female college students with primary dysmenorrhea due to cold-induced blood stasis were randomized into a Tuina group and a joint group,with 36 cases in each group.The Tuina group only received Tuina manipulations.In the joint group,besides the same Tuina manipulations,patients practiced Ba Duan Jin.For both groups,the once-daily intervention was conducted from 6 d before the menstrual period until menstrual day 1 for 3 menstrual cycles.Changes in the scores of COX menstrual symptom scale(CMSS),visual analog scale(VAS),and FS-14 after the intervention were observed.Clinical efficacy was also estimated. Results:During the process,1 case dropped out in the Tuina group,and 35 cases completed the intervention;2 cases dropped out in the joint group,and 34 cases completed the intervention.The total effective rate was 94.1%in the joint group,higher than 88.6%in the Tuina group(P<0.05).After treatment,the symptom duration and intensity scores in the scores of CMSS,VAS,and FS-14 declined in both groups(P<0.05 or P<0.01);the CMSS symptom duration score and FS-14 score were lower in the joint group than in the Tuina group(P<0.05). Conclusion:Tuina manipulations alone or combined with Ba Duan Jin practice can effectively treat primary dysmenorrhea due to cold-induced blood stasis in female college students;when combined with Ba Duan Jin practice,Tuina manipulations can more significantly improve pain duration and fatigue,suggesting the advantages of combining Tuina Gongfa and manipulations.

{L-End}Objective To study and develop a suitable scale to identify and assess risks of occupational stress in workplaces of enterprises, and to explore the establishment of a workplace occupational stress risk assessment method aimed at guiding enterprises to improve working conditions based on the electronics industry in Beijing City. {L-End}Methods The initial version of the Workplace Occupational Stress Risk Assessment Scale (WOSRAS) was constructed based on literature review and expert evaluation. A total of 1 284 employees from four electronics enterprises in Beijing City were selected as the research subjects using a convenient sampling method. Item analysis and exploratory factor analysis were used to determine the final items of the scale and test its reliability and validity. The method of percentile norms was used to establish risk assessment method for the electronics industry workplace and its stress sources, and the cut-off values of low, medium, high risk was graded by the 50th and 80th percentiles of the total score and the score of each dimension of the risk assessment scale. {L-End}Results i) Based on item analysis and exploratory factor analysis, a WOSRAS consisting of six dimensions and 23 items was constructed, which could explain 63.2% of the total variation of occupational stress. The results of confirmatory factor analysis showed that the root mean square error of approximation and standardized root mean square residual were both <0.080, and the comparative fit index and Tucker-Lewis index were both >0.900. The total criterion validity of the scale was 0.816. The total Cronbach's α coefficient of the scale was 0.835, and the Spearman-Brown coefficient was 0.802. ii) The cut-off values of WOSRAS scores for high, medium and low risk in electronics industry were <53.0, 53.0-60.0 and >60.0,respectively. According to the result, the workplace stress risk levels of the production, research and development, and logistics departments of the electronics industry in Beijing were medium risk, while the management department was low risk. {L-End}Conclusion The WOSRAS constructed in this study has good reliability and validity. The proposed risk assessment method can reflect the actual risk status of enterprises in the electronic industry and is convenient for widespread application.

{L-End}Objective To explore the suitable methods for individual occupational stress examination and evaluation for workers in China based on the electronics industry. {L-End}Methods A total of 1 164 workers from four electronics enterprises in Beijing City were selected as the research subjects using a convenient sampling method. The Occupational Stress Measurement Scale, which was developed based on the Japanese Brief Job Stress Questionnaire, was used to assess the occupational stress of the research subjects, and test the reliability and validity of the scale. Percentile norms and T-score norms were established, and the T-scores of the three dimensions of stress reaction (psychological reaction and physical symptoms), stress factors, and social support were divided into five stages using the normal distribution method with x¯±0.5 s and x¯±1.5 s, which was used to explore a proposed standard for assessing individual stress levels. {L-End}Results The revised scale consisted of 57 items, which could explain 64.0% of the total variation of occupational stress based on the result of item analysis and exploratory factor analysis. The results of confirmatory factor analysis showed that the model fitted well, with root mean square error of approximation of 0.052, standardized root mean square residual of 0.070, comparative fit index of 0.960, and Tucker-Lewis index of 0.958. The Cronbach's α coefficient of the scale was 0.951, and the Spearman-Brown coefficient was 0.837. Cronbach's α coefficients of the three dimensions ranged from 0.794 to 0.952, and the Spearman-Brown coefficients ranged from 0.737 to 0.850. The scores of the three dimensions of stress reaction, stress factors, and social support were (49.1±13.0), (44.9±7.7), and (18.1±3.6), respectively. Workers in the electronics industry met one of the following items were identified as the high level of occupational stress individuals: i) a score of stress reaction dimension ≥72.0 points; ii) a sum of stress factor and social support dimension scores ≥81.0 points, and a stress reaction dimension score ≥58.0 points. {L-End}Conclusion The Occupational Stress Measurement Scale and the criteria for determining high level of occupational stress can be used to assess the individual occupational stress levels of workers in the electronics industry in China. This method can provide a theoretical basis for the formulation of occupational stress examination and assessment for Chinese workers.

{L-End}Objective To analyze the current status of occupational stress and its influencing factors among workers in pharmaceutical enterprises in Beijing City. {L-End}Methods A total of 860 employees from six pharmaceutical enterprises in Beijing City were selected as the research subjects using convenience sampling method. The Chinese version of the New Brief Job Stress Questionnaire was used to evaluate the occupational stress, and multiple linear regression analysis was used to analyze the influencing factors of occupational stress. {L-End}Results The detection rate of high occupational stress was 1.40% (12/860). The results of multiple linear regression analysis showed that the workers with higher education level and longer length of service had a higher risk of high occupational stress (all P<0.01). Workers who were satisfied with their jobs had a lower risk of high occupational stress than those who were unsatisfied with their jobs (P<0.01). Workers who were satisfied with life had a significantly lower risk of high occupational stress than those who were unsatisfied with life (P<0.01). {L-End}Conclusion The detection rate of high occupational stress in workers of pharmaceutical enterprises is relatively low. Occupational stress is mainly affected by individual factors such as education level and length of service, and work and life satisfaction. Improving job and life satisfaction is helpful to reduce occupational stress level.

Nucleic acid drugs are highly applicable for cancer immunotherapy with promising therapeutic effects, while targeting delivery of these drugs to disease lesions remains challenging. Cationic polymeric nanoparticles have paved the way for efficient delivery of nucleic acid drugs, and achieved stimuli-responsive disassembly in tumor microenvironment (TME). However, TME is highly heterogeneous between individuals, and most nanocarriers lack active-control over the release of loaded nucleic acid drugs, which will definitely reduce the therapeutic efficacy. Herein, we have developed a light-controllable charge-reversal nanoparticle (LCCN) with controlled release of polyinosinic-polycytidylic acid [Poly(I:C)] to treat triple negative breast cancer (TNBC) by enhanced photodynamic immunotherapy. The nanoparticles keep suitably positive charge for stable loading of Poly(I:C), while rapidly reverse to negative charge after near-infrared light irradiation to release Poly(I:C). LCCN-Poly(I:C) nanoparticles trigger effective phototoxicity and immunogenic cell death on 4T1 tumor cells, elevate antitumor immune responses and inhibit the growth of primary and abscopal 4T1 tumors in mice. The approach provides a promising strategy for controlled release of various nucleic acid-based immune modulators, which may enhance the efficacy of photodynamic immunotherapy against TNBC.