As a major category of occupational hazards in China, physical factors are widely distributed in various industries and affect a large number of workers. The list and diagnostic criteria of occupational diseases caused by physical factors are important basis for occupational disease diagnosis and protection of occupational health rights and interests for occupational populations. This article compares the differences in the list of occupational diseases caused by physical factors at home and abroad, analyzes the problems in the current list of occupational diseases caused by physical factors and related diagnostic standards in China, and puts forward relevant suggestions for further adjusting the list of occupational diseases caused by physical factors, formulating and revising relevant diagnostic standards for occupational diseases, providing reference for improving the classification and catalogue of occupational diseases in China in the future.

The patient was admitted to the hospital with a diagnosis of diffuse large B-cell lymphoma for one month,accompanied by limb numbness for one week.Upon admission,the patient was initially prescribed vitamin B,and mecobalamin for symptomatic relief,which led to an improvement in the symptoms of limb numbness.Subsequently,the patient was administered chemotherapy consisting of rituximab,lenalidomide,and prednisone.However,following the initiation of chemotherapy,the symptoms of limb numbness became more severe.After review of the patient's medication history and analysis of relevant data,the clinical pharmacist suggested that the patient's limb numbness was caused by lenalidomide-induced peripheral neuropathy.

Objective To study the expression of PLA2G2A and its significance in vaginal wall tissue of patients with pelvic organ pro-lapse(POP).Methods Twenty-three patients without POP(control group)and 26 patients with POP(POP group)admitted to the Third Affiliated Hospital of Zhengzhou University,between June 2023 and September 2024,were selected.Histological features were observed using hematoxylin and eosin and Masson's trichrome staining.Localization of PLA2G2A was detected using immunofluorescence.The PLA2G2A expression level was assessed using immunohistochemistry,real-time PCR,and Western blotting.After transfecting fibroblasts with silenced PLA2G2A,changes in collagen Ⅰ and collagen Ⅲ were measured.Results The histological structure of the vaginal wall in the POP group was significantly different from that in the control group.PLA2G2A was expressed in fibroblasts,with protein and mRNA expression levels higher than those in the control group(P＜0.05).After silencing PLA2G2A,collagen Ⅰ and collagen Ⅲ expression were upregulated.Conclusion High expression of PLA2G2A in vaginal wall tissue of patients with POP.Increased PLA2G2A expression may be closely related to the development and presence of POP.

Objective To investigate the associations between physical health status,refraction and ocular biometrics in school-age children,and further clarify the relation of eyes'refractive status to physical growth and development,so as to provide scientific evidences for myopia prevention and con-trol.Methods A total of 1718 children(977 boys and 741 girls)aged 8-12 years were enrolled in this study.They were collected uncorrected visual acuity,refraction and ocular biometrics,including spherical equivalent,cylindrical equivalent,axial length(AL),corneal refraction(K1,K2)and anteri-or chamber depth(ACD),as well as the AL/CR ratio and spherical equivalent refraction(SER).Moreover,their height,weight and physical fitness level were measured,including speed,strength,flexibility,agility and aerobic endurance.Then all data were analyzed using the Pearson correlation,One-way ANOVA and multiple linear regression model.Results The overall prevalence of myopia was 43.83%,which was higher in girls than in boys(46.96%vs.41.45%).Moreover,the height and weight of school-age children were negatively correlated with SER(P<0.01),but positively correlated with AL,ACD and AL/CR(P<0.01).After controlling the age and gender variables in the multiple linear regression model,it was found that for 10-cm increase in height,SER decreased by 0.013 D(P<0.01),AL extended by 0.022 mm(P<0.01),and ACD increased by 0.002 mm(P<0.05).In addi-tion,for 10-kg increase in the body weight,the AL would be 0.009 mm longer(P<0.05)and ACD 0.002 mm deeper(P<0.05).Moreover,the speed,strength and agility were negatively correlated with SER(P<0.01,P<0.05),but positively correlated with AL,ACD and AL/CR(P<0.01,P<0.05).The maximal oxygen uptake level was positively correlated with SER(P<0.01),and negatively correlated with AL,ACD and AL/CR(P<0.01,P<0.05).After controlling the age and gender variables in the multiple linear regression model,it was found that the children with worse speed quality had shorter AL(-0.043 D,P<0.05).Meanwhile,the better agility was accompanied by the lower SER(-0.003 D,P<0.01),longer AL(+0.002 mm,P<0.05),lighter ACD(+4.812e-4 mm,P<0.05),and higher AL/CR(+2.446e-4,P<0.05).Conclusion With variables of age and gender controlled,the height,weight,and the speed and agility quality are highly associated with eyes'refractive status among chil-dren aged 8-12 years old.It is suggested that the human body may have a coordination mechanism to regulate the development of the body stature,physical fitness and ocular biometrics in the early child-hood,which should be considered in their myopia prevention and control.

Objective To investigate the associations between physical health status,refraction and ocular biometrics in school-age children,and further clarify the relation of eyes'refractive status to physical growth and development,so as to provide scientific evidences for myopia prevention and con-trol.Methods A total of 1718 children(977 boys and 741 girls)aged 8-12 years were enrolled in this study.They were collected uncorrected visual acuity,refraction and ocular biometrics,including spherical equivalent,cylindrical equivalent,axial length(AL),corneal refraction(K1,K2)and anteri-or chamber depth(ACD),as well as the AL/CR ratio and spherical equivalent refraction(SER).Moreover,their height,weight and physical fitness level were measured,including speed,strength,flexibility,agility and aerobic endurance.Then all data were analyzed using the Pearson correlation,One-way ANOVA and multiple linear regression model.Results The overall prevalence of myopia was 43.83%,which was higher in girls than in boys(46.96%vs.41.45%).Moreover,the height and weight of school-age children were negatively correlated with SER(P<0.01),but positively correlated with AL,ACD and AL/CR(P<0.01).After controlling the age and gender variables in the multiple linear regression model,it was found that for 10-cm increase in height,SER decreased by 0.013 D(P<0.01),AL extended by 0.022 mm(P<0.01),and ACD increased by 0.002 mm(P<0.05).In addi-tion,for 10-kg increase in the body weight,the AL would be 0.009 mm longer(P<0.05)and ACD 0.002 mm deeper(P<0.05).Moreover,the speed,strength and agility were negatively correlated with SER(P<0.01,P<0.05),but positively correlated with AL,ACD and AL/CR(P<0.01,P<0.05).The maximal oxygen uptake level was positively correlated with SER(P<0.01),and negatively correlated with AL,ACD and AL/CR(P<0.01,P<0.05).After controlling the age and gender variables in the multiple linear regression model,it was found that the children with worse speed quality had shorter AL(-0.043 D,P<0.05).Meanwhile,the better agility was accompanied by the lower SER(-0.003 D,P<0.01),longer AL(+0.002 mm,P<0.05),lighter ACD(+4.812e-4 mm,P<0.05),and higher AL/CR(+2.446e-4,P<0.05).Conclusion With variables of age and gender controlled,the height,weight,and the speed and agility quality are highly associated with eyes'refractive status among chil-dren aged 8-12 years old.It is suggested that the human body may have a coordination mechanism to regulate the development of the body stature,physical fitness and ocular biometrics in the early child-hood,which should be considered in their myopia prevention and control.

Objective To investigate the incidence and adverse prognosis of late onset sepsis(LOS)in neonates in neonatal intensive care unit(NICU).Methods A retrospective study was conducted to collect and analyze the peri-natal condition,underlying diseases,invasive procedures,and adverse prognosis of neonates in NICU of a regional maternal and child healthcare hospital from 2019 to 2023.According to whether LOS occurred during hospitaliza-tion,neonates were divided into LOS group and non-LOS group.The LOS group was divided into 5 subgroups based on whether invasive procedures were performed:LOS plus umbilical vein catheter(UVC)group,LOS plus peripherally inserted central catheter(PICC)group,LOS plus sequential catheter group,LOS plus tracheal intuba-tion group,and LOS plus lumbar puncture group,the relationship between LOS and adverse prognosis was ana-lyzed.Results Among 2 945 neonates in NICU,354(12.02％)developed LOS.Comparison between LOS groups and non-LOS group were as follows:in term of perinatal condition of neonates,there were statistically significant difference in weight,gestational age,and whether they were twins between the two groups(all P＜0.001);in term of underlying diseases,there were statistically significant differences in the number of cases of maternal gestational hypertension,neonatal asphyxia,neonatal congenital heart disease,neonatal ventricular dilation,neonatal pneumo-nia,neonatal hyperthyrotropinemia,and neonatal anemia,as well as five invasive procedures between the two groups(all P＜0.05).Compared with the non-LOS group,the incidences of retinopathy of prematurity(ROP),neonatal necrotizing enterocolitis(NNEC),bronchopulmonary dysplasia(BPD),and neonatal respiratory distress syndrome(NRDS)in LOS group were all higher(all P＜0.001).Regression analysis showed that compared with the non-LOS groups,the risk of ROP increased in the LOS group and its subgroups,with the LOS plus sequential catheter group having a 2.27-fold higher risk of ROP than non-LOS group;the risk of NNEC increased in the LOS group and its subgroups,with the LOS plus UVC group having an 8.29-fold higher risk of NNEC than the non-LOS group.Except for the LOS plus UVC group,the risk of BPD increased in the LOS group and other subgroups,with the LOS plus PICC group and LOS plus sequential catheter group having 4.68-and 4.64-fold higher risk of BPD than the non-LOS group,respectively;the risk of NRDS in the LOS plus PICC group was 6.84-fold higher than the non-LOS group(all P＜0.05).The top three pathogens causing LOS were coagulase negative Staphylococcus,Klebsiella pneumoniae,and Escherichia coli.Conclusion LOS can significantly increase the risks of ROP,NNEC,BPD,and NRDS.LOS plus invasive procedures can further increase the risk of adverse prognosis.

Objective To provide relevant suggestions for ethical considerations in clinical research by searching literature related to ethics in clinical research using the visualization analysis software CiteSpace,and to analyze and compare the current research status of clinical research ethics at home and abroad.Methods The papers on the application of medical ethics in clinical trials from the core collection of CNKI and Web of Science databases were collected and the bibliometric software CiteSpace was used to draw a knowledge map of domestic and foreign literature.The research hotspots and development trends of medical ethics in clinical trials were analyzed.Results In terms of the process of informed consent,risk minimization,fair selection,and protection on the rights and interests of vulnerable groups,the focus of medical ethics research in China were basically consistent with foreign literature.The difference was that foreign research focused more on ethical education,the quality of life of research participants,and ethical counseling.Otherwise,domestic research focused more on the quality management of clinical trials and the specificity of traditional Chinese medicine research,with research on vulnerable groups mostly focused on children.Conclusion Chinese researchers should strengthen multi-dimensional research on medical ethics in China,and gradually expand their view from ethical review points and management research to applied research solved clinical problems and the specificity of research participants,and increasing the number and dimensions of research.

Objective:To systematically evaluate the unmet needs and challenges of caregivers of cancer patients at home and clarify their unmet needs.Methods:A computerized search was conducted in PubMed, Web of Science, Embase, Cochrane Library, ProQuest, Scopus, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative studies on the unmet needs and challenges of caregivers of cancer patients in the home environment. The search time limit was from the establishment of the databases to April 30, 2024. The Joanna Briggs Institute Centre for Evidence-Based Healthcare's quality assessment criteria for qualitative research were used to evaluate the quality of the literatures, and the aggregative integration method was used to summarize and integrate the research results.Results:A total of 17 articles were finally included, which were summarized into eight new categories. Further synthesis yielded three integrated results: caregivers in the home environment face multi-dimensional unmet needs and challenges related to patients; caregivers in the home environment face challenges and unmet needs in self-care; caregivers in the home environment are hesitant to obtain external support, and continuity and sustainability are hindered.Conclusions:Medical staff should accurately assess the unmet needs of caregivers of cancer patients at home, pay attention to their negative experiences, promote positive coping, optimize the patient-and family-centered cancer care model, and strengthen social support.

Objective:To explore the surgical efficacy of cervical cerclage with cervical length (CL) <10 mm and emergency cerclage.Methods:From January 2013 to June 2022, a total of 98 singleton pregnant women who underwent ultrasound-indicated cervical cerclage because of CL<10 mm in the second trimester and underwent emergency cervical cerclage because of cervical dilation found by physical examination in Peking University First Hospital were enrolled. The differences in clinical data between the <34 weeks delivery group (25 cases) and the ≥34 weeks delivery group (73 cases) were compared. Meanwhile, according to different cervical status, they were divided into CL<10 mm group (43 cases) and cervical dilatation group (55 cases), and the cervical dilatation group was further divided into cervical dilatation <4 cm group and cervical dilatation ≥4 cm group. The clinical data and pregnancy outcomes of pregnant women with different cervical status were compared.Results:(1) There were significant differences in the proportion of preoperative CL<10 mm and the degree of preoperative cervical dilation between the <34 weeks delivery group and the ≥34 weeks delivery group (all P<0.05). (2) After cervical cerclage, compared with women in the cervical dilatation group, the prolonged gestational age in the CL<10 mm group was longer [(10.5±4.6) vs (14.3±3.4) weeks], the gestational age at delivery was later (median: 35.7 vs 38.0 weeks), the preterm birth rates before 37 and 34 weeks were lower, the late abortion rate was lower [9% (5/55) vs 0 (0/43)], and the newborn birth weight was higher, the differences were statistically significant (all P<0.05). (3) Compared with the cervical dilation ≥4 cm group, the prolonged gestational age of the cervical dilatation <4 cm group was longer [(7.5±5.3) vs (11.1±4.2) weeks], the gestational age at delivery was later (median: 29.2 vs 36.0 weeks), and the birth weight of the newborn was higher (all P<0.05). The late abortion rate of cervical dilatation <4 cm group was lower than that of cervical dilatation ≥4 cm group [7% (3/45) vs 2/10; P=0.220]. Conclusions:Timely cervical cerclage in individuals with CL<10 mm could reduce preterm birth rate before 34 weeks gestation, and the pregnancy outcome is better than that of individuals with cervical dilation. Moreover, the pregnancy outcome of cervical cerclage in women with cervical dilation <4 cm is significantly better than that in women with cervical dilatation ≥4 cm.

Objectives:To analyze the correlation between the the body shape index(ABSI)and all-cause mortality(ACM)as well as cardiovascular mortality(CVM)in patients with acute heart failure.Methods:This study analyzed data from the National Registration Study of Major Chronic Diseases,a prospective cohort on heart failure.A total of 4 907 patients with acute heart failure were enrolled from multiple centers nationwide,of which 4 375 were eligible for this study.The relationships of between body mass index(BMI),waist circumference,and ABSI with ACM and CVM were assessed using multivariable cox proportional hazards models.Results:The mean age of the patients was(65.0±13.4)years,62.3%was male.The median follow-up time was 4.6(4.59,4.65)years,there were 1 972(45.1%)ACM and 1 400(32.0%)CVM.Multivariable cox regression analysis showed that higher ABSI was associated with an increased risk of mortality.Compared to the second quartile of ABSI,the hazard ratio(HR)for the highest(fourth)quartile were 1.29(95%CI:1.14-1.46,P<0.05)for ACM and 1.23(95%CI:1.06-1.43,P<0.05)for CVM.In contrast,BMI and waist circumference were inversely associated with risks of both ACM and CVM.Conclusions:ABSI can more intuitively reflect the correlation between obesity and death in patients with heart failure than BMI and waist circumference,which has important clinical significance.