Background Work-related musculoskeletal disorders (WMSDs) are common across industries. Workers in the hairdressing industry are frequently exposed to repetitive upper-limb movements and awkward working postures, which may increase their susceptibility to WMSDs. However, evidence on WMSDs among workers in this industry remains limited. Objective This study aimed to investigate the prevalence of self-reported WMSDs symptoms and associated factors among workers in the hairdressing industry in Hongkou District, Shanghai. Methods A cross-sectional survey was conducted using quota sampling in all eight subdistricts of Hongkou District, Shanghai. Hair salons in each subdistrict were ranked by the number of hairdressers and shampoo workers, and the 6 salons with the largest staff size in each subdistrict were selected, resulting in 48 survey sites. Hairdressers and shampoo workers who met the inclusion and exclusion criteria were surveyed using the Chinese version of the Musculoskeletal Disorders Questionnaire. Information on their individual characteristics, musculoskeletal symptoms, and work-related factors was collected. Chi-square tests and Firth logistic regression were used to estimate the prevalence of self-reported WMSDs symptoms and identify associated factors. Results The overall prevalence of self-reported WMSDs symptoms among workers in the hairdressing industry was 45.72%. Among hairdressers, the most commonly affected body regions were the neck (31.51%), shoulders (25.57%), lower back (15.98%), and feet (14.61%). Among shampoo workers, the most commonly affected regions were the neck (24.17%), lower back (24.17%), shoulders (20.83%), and upper back (10.83%). Firth logistic regression showed that fatigue in the corresponding body region after several hours of continuous work was positively associated with self-reported WMSDs symptoms in both types of workers (OR=6.544-52.838). Regarding individual characteristics, shorter height (female≤160 cm, male≤165 cm) was positively associated with self-reported neck and foot symptoms among hairdressers, and self-reported shoulder symptoms among shampoo workers (OR=16.324, 15.084, 9.680). Female shampoo workers had higher odds of self-reported neck symptoms than male shampoo workers (OR=4.924). Smoking was positively associated with self-reported upper-back and lower-back symptoms among shampoo workers (OR=10.544, 4.381). Among work-related factors, maintaining a fixed neck posture for long periods among hairdressers and prolonged standing among shampoo workers were positively associated with self-reported neck symptoms (OR=6.123, 3.080). Among shampoo workers, frequent overtime and maintaining a twisted posture were positively associated with self-reported upper-back symptoms (OR=11.710, 35.306). Sufficient rest time was negatively associated with self-reported foot symptoms among hairdressers (OR=0.238). Conclusion The prevalence of self-reported WMSDs symptoms was relatively high among workers in the hairdressing industry. Work-related fatigue and awkward working postures were strongly associated with WMSDs symptoms. Measures such as optimizing work-rest schedule, improving ergonomic workplace design, implementing fatigue monitoring and management, promoting work-break exercises, and providing training on appropriate working posture may help reduce the burden of WMSDs symptoms in this occupational group.

ObjectiveWith the development of society and the increasing demand for pregnancy at an advanced age， diminished ovarian reserve （DOR） has attracted wider attention. This disease affects the normal menstruation of women and poses a threat to their mental health. Current research on DOR is still in the initial stage， and advancing research progress in DOR necessitates the construction of effective and clinically relevant animal models. Building on existing literature and integrating the diagnosis criteria of DOR in traditional Chinese medicine （TCM） and Western medicine， this study summarized， analyzed， and evaluated existing models， providing a reference for optimizing DOR animal models. MethodsA retrospective analysis of literature on DOR-related animal models was conducted， and the diagnostic criteria of DOR in TCM and Western medicine were sorted out. By means of evaluation methods of animal models， the clinical relevance of each model to TCM and Western medicine was assessed. ResultsDOR animal models included those based on natural factors， iatrogenic factors， immune factors， metabolic factors， and environmental factors. Among them， the model based on iatrogenic factors， especially models induced by Tripterygium wilfordii preparations， cyclophosphamide， and cisplatin， had a high degree of relevance to both Western medical diseases and TCM syndromes and was confirmed as the optimal modeling method for studying DOR at present. ConclusionThe existing DOR modeling methods mostly have a high degree of clinical relevance to Western medical diseases， while the number of DOR animal models with clear TCM syndromes is very limited. TCM plays an indispensable role in exploring DOR treatment methods. Therefore， the development of DOR animal models related to TCM syndromes should be strengthened， further exploring the potential of TCM and providing strong theoretical support for the application of TCM in DOR treatment.

Objective To achieve the goal of standardized use of surgical consumables and reasonable cost control by the diagnosis-intervention packet(DIP)total control combined with clinical pathways.Methods Four DIP clinical groups implementing clinical pathways were selected as pilot disease groups.Cases from 2019 to 2020 served as control group,develop a diagnosis and treatment plan based on clinical pathways and pathway form combined with the actual situation of the hospital.Cases from 2021 to 2023 formed experimental groups:experimental group 1(added control measures of the inventory of surgical consumables on the basis of the control group),and experimental group 2(added total DIP control measures to the experimental group 1).The average hospitalization costs and average costs of disposable surgical consumables were compared to evaluate the practical outcomes.Results There were significant differences in the average hospitalization costs and average costs of disposable surgical consumables among the three groups(P<0.05).Further pairwise comparisons showed that the average hospitalization costs and average costs of disposable surgical consumables in experimental group 2 were significantly lower than those in experimental group 1 and the control group(P<0.05).The average hospitalization costs in all pilot disease groups except the group undergoing transurethral ureteroscopic laser lithotripsy in the experimental group 1 were significantly lower than those in the control group(P<0.05),and the average costs of disposable surgical consumables in all pilot disease groups in the experimental group 1 were significantly lower than those in the control group(P<0.05).Conclusion The management plan based on DIP combined with clinical pathways can improve the management effect of surgery-related consumables and effectively reduce the costs.

ObjectiveTo construct a rat model of psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type）， and evaluate the macroscopic manifestations and microscopic indicators of the model. MethodsTwenty-two SD rats were divided into normal group （n=3）， common psoriasis group （n=5）， spleen deficiency and dampness obstruction syndrome （external dampness type） group （n=7）， and psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group （n=7）. The spleen deficiency and dampness obstruction syndrome （external dampness type） rat model was established through 32-week exposure to an artificially simulated high-humidity environment， while the common psoriasis model was developed via 7-day topical application of imiquimod cream， and these two approaches were combined to construct a composite model of psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type）. Rats in the normal group were housed under normal humidity conditions. The general state， tongue manifestation of rats were observed to evaluate the macroscopic syndrome manifestations； the microscopic syndrome manifestations of rats were evaluated through adipose tissue and liver tissue changes； the severity of psoriasis in rats was evaluated through skin pathological changes， psoriasis area and severity index （PASI）， proliferating cell nuclear antigen （PCNA） expression and spleen tissue changes； changes in rat CD4⁺ interferon-γ⁺ cells （CD4⁺IFN-γ⁺ cells）， CD4⁺ tumour necrosis factor-α+ cells （CD4⁺ TNF-α⁺ cells）， and forkhead framing protein P3⁺ regulatory T cells （CD3⁺CD4⁺FoxP3⁺ Treg cells） were detected by flow cytometry. ResultsMacroscopically， both the spleen deficiency and dampness obstruction syndrome （external dampness type） group and psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group exhibited manifestations of spleen deficiency and dampness obstruction， including lethargy， huddling behavior， dull and disheveled fur， as well as soft or loose stools and perianal soiling in some individuals； both these two groups displayed enlarged tongue， swollen， and moist tongue texture， accompanied by slippery tongue surface. Microscopically， compared to the common psoriasis group， the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group showed increased epididymal fat index （P＜0.05）； compared to the normal group and spleen deficiency and dampness obstruction syndrome （external dampness type） group， the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group demonstrated significantly elevated spleen mass （P＜0.05）， while hepatic gross morphology and HE staining revealed no significant histopathological changes across all groups. Dorsal skin lesions were markedly exacerbated in the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group when compared to those in common psoriasis group. Both the common psoriasis group and psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group exhibited significantly higher erythema scores， scaling scores， infiltration scores， PASI total scores， and proportions of CD3⁺CD4⁺FoxP3⁺Treg cells compared to the normal group and spleen deficiency and dampness obstruction syndrome （external dampness type） group （P＜0.05）， with pronounced PCNA-positive expression observed in the epidermal basal layer and dermis； the psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） group displayed significantly increased proportions of CD4⁺TNF-α⁺cells compared to the spleen deficiency and dampness obstruction syndrome （external dampness type） group （P＜0.05）； whereas no significant differences were detected in CD4⁺IFN-γ⁺cell proportions among groups （P＞0.05）. ConclusionThe rat model of psoriasis with spleen deficiency and dampness obstruction syndrome （external dampness type） can be successfully constructed by artificially simulating a high-humidity environment combined with imiquimod induction.

Objective To investigate the clinical efficacy of fasting nasogastric administration of sesame oil combined with multi-frequency vibrational abdominal massage in stroke patients with consti-pation undergoing nasogastric feeding.Methods A total of 50 stroke patients with nasogastric feeding were selected as study subjects and randomly divided into control group and study group,with 25 pa-tients in each group.The control group received routine nursing care plus multi-frequency vibrational abdominal massage,while the study group received fasting nasogastric administration of 20 mL of sesa-me oil on the basis of the control group's treatment.After 15 days of intervention,the defecation condi-tions[constipation clinical symptom score(CSS),stool consistency(Bristol stool scale),and stool volume]were compared between the two groups.Results After treatment,the CSS score in the study group was lower than that in the control group[(6.52±2.52)versus(12.64±3.32),P＜0.05].The normal stool consistency(types Ⅳ and Ⅴ on the Bristol stool scale)in the study group was higher than that in the control group(76.0％versus 8.0％,P＜0.05).The stool volume in the study group was higher than that in the control group[(303.00±93.79)g versus(196.40±60.27)g,P＜0.05].The total effective rate of defecation in the study group was 96.0％,which was higher than 32.0％in the control group(P＜0.05).The Patient Assessment of Constipation-Quality of Life(PAC-QOL)score in the study group was lower than that in the control group[(40.07±5.67)versus(63.07±7.46),P＜0.05].Conclusion Fasting nasogastric administration of sesame oil com-bined with multi-frequency vibrational abdominal massage can promote the recovery of intestinal function and improve constipation symptoms in stroke patients with nasogastric feeding.

Objective:To investigate the relationship between oxygen consumption (VO 2), carbon dioxide production (VCO 2), and Oxygen Consumption/lactate (VO 2/Lac) with risk of death in patients with severe ARDS. Methods:A retrospective cohort study method was used, and the study subjects were hospitalized for >5 days adult patients with severe ARDS in the central intensive care unit of Henan Provincial People's Hospital from 1 March 2020 to 30 June 2023. The following patients were excluded: IC test was not completed on the 4th day of ICU admission, IC test results were unreliable, mechanical ventilation duration had exceeded 48 h at the time of ICU transfer or admission, palliative care patients and pregnant and parturient women. Using indirect calorimetry to determine VO 2 and VCO 2 values on the 4th day of admission, reviewing medical records to obtain general condition, disease information, blood gas analysis (including lactate value), diagnostic and therapeutic measures, and following up deaths by telephone and time of death. The primary outcome measure was death at 90 days, and the secondary outcome measure was death at 28 days, length of stay in ICU, total length of stay, and total hospitalization cost. Cox regression analysis and linear regression analysis were used to investigate the relationship between VO 2, VCO 2, VO 2/Lac and primary and secondary outcome indexes. Results:A total of 216 patients were enrolled, 78 patients (36.1%) died and 138 patients (63.9%) survived at 90 days. After correction for confounders, the results of multifactorial Cox regression analysis suggested that compared with the Q4 group, HR (95% CI) for 90-day risk of death in the VO 2 Q1 and Q2 groups was 3.21 (1.38, 7.49) and 3.24 (1.42, 7.38), and HR (95% CI) for 90-day risk of death in the VCO 2 Q1, Q2 and Q3 groups was 5.88 (2.33, 14.84), 4.26 (1. 60, 11.34) and 3.54 (1.34, 9.35), respectively, and the HR (95% CI) for 90-day risk of death in the VO 2/Lac Q1, Q2 and Q3 groups were 8.72 (3.01, 25.25), 8.43 (2.91, 24.47) and 4.04 (1.34, 12.17) respectively. P-trends were all <0.05, indicating that VO 2, VCO 2 and VO 2/Lac were linearly and negatively associated with the risk of 90-day mortality. In addition, VO 2, VCO 2, and VO 2/Lac were negatively associated with 28-day risk of death and higher VO 2/Lac was negatively associated with length of ICU stay. Conclusions:VO 2, VCO 2 and VO 2/Lac were negatively associated with 90-day mortality risk and 28-day mortality risk in patients with severe ARDS and may be independent risk factors predicting mortality risk of such patients.

Objective To analyze the sleep problems and temperament characteristics of children aged 12-35 months so as to understand the relationship between the sleep problems and temperament in early childhood.Methods 129 toddlers with sleep problems and 129 normal controls were selected.The brief infant sleep questionnaire(BISQ)was used to investigate children's sleep problems and the temperament questionnaire was used to investigate their temperament characteristics.The influence of temperament on sleep problems was analyzed by Logistic regression analysis.Results The temperament types of children aged 12 to 35 months with sleep problems were mainly easy to cultivate and moderately easy to cultivate.There was a statistically significant difference(P<0.05)in the comparison of easily cultivating temperament types between the children with the sleep problems and the control group;Compared with the control group,there were statistically significant differences(P<0.05)in the five dimensions of avoidance,adaptability,emotional essence,persistence,and attention dispersion among children with sleep problems.Compared with the temperament type of easy to cultivate,the proportion of sleep problems in children intermediately easy to cultivate and slow to start was higher(both P<0.05)Conclusion There is a certain relationship between the sleep problems and temperament types in children aged 12 to 35 months.Early understanding of sleep problems and temperament characteristics of toddlers can guide parents to adjust their education methods in time,give parents"individualized"sleep guidance and intervention,reduce the occurrence of long-term development problems and promote the healthy physical and mental development of toddlers.

Objective To understand the epidemiological characteristics of road traffic accident injuries in Beijing can provide a theoretical basis for improving the pre-hospital emergency service capabilities and levels,and increasing patient survival rates while reducing disability,mortality rates.Methods A retrospective analysis was conducted on the medical records of 9207 patients who made pre-hospital emergency calls due to road traffic accident injuries at the Beijing Emergency Medical Center in 2023 to understand the patients' age,gender,injury time,injury location,injury degree and other characteristics.Results Traumatic diseases ranked first in the classification of emergency medical conditions in Beijing.Among them,road traffic accidents account for 37％.The ratio of male to female patients was 1.32∶1.The largest number of patients were aged 31-40,accounting for nearly 25％.The proportion of underage patients and those aged 71 and above was 12.16％.The differences in gender and age distribution were statistically significant,while the differences in gender distribution among different age groups were not statistically significant.Road traffic accident injuries occured most frequently in September and least in January.There were more cases in summer and autumn,and fewer in winter and spring.The most common injury sites in road traffic accidents were limbs/skin and head and neck,accounting for 81.06％.The patients with moderate severity of injuries were the most numerous,accounting for 85.29％.Conclusion To avoid road traffic accidents,prevention should be the priority.It is necessary to strengthen the joint governance of multiple departments and minimize the occurrence of road traffic accident from the source.Pre-hospital emergency care must focus on key populations and key seasons,strengthen professional skills training and resource allocation,ensure efficient and smooth connection between pre-hospital and in-hospital care.Popularize and publicize the importance of self-rescue and mutual rescue,promote first aid knowledge and skills training for the public,and create a social atmosphere where"rescue is right beside us".

As a dual hub of energy metabolism and signal transduction,mitochondria maintain metabolic homeostasis of the body by regulating intracellular ATP production,metabolic signal transduction,and inter-tissue communication network,and mitochondrial dysfunction is one of the important risk factors for metabolic diseases.Although previous studies have revealed the relationship between mitochondrial dysfunction and metabolic diseases,the specific mechanism of action remains unclear,especially the mechanism of gen-der differences in mitochondrial function.At present,the global incidence rates of metabolism-related diseases,such as neurodegenera-tive diseases,cardiovascular diseases,and abnormal glucose metabolism,continue to rise and show significant gender differences.Sex hormones establish the molecular basis for gender differences in mitochondrial function by regulating mitochondrial oxidative phos-phorylation efficiency,calcium signaling homeostasis,and antioxidant stress capacity.Such gender differences of mitochondrial activity and function may constitute an important biological basis for gender differences in metabolic diseases.This article systematically re-views the biological functions of mitochondria and their pathological associations with metabolic diseases,focusing on the regulatory mechanism of sex hormone-mitochondrial interaction network in gender differences in metabolic diseases,in order to provide a theo-retical basis for developing gender-specific prevention and treatment strategies.

Objective To develop novel metformin carbon dots(MCDs)with superior performance to enhance the osteogenic differentiation potential of human periodontal ligament stem cells(hPDLSCs)under inflammatory conditions.Methods Three types of MCDs-MCDsCA,MCDsAA,and MCDsCS were synthesized via a one-step hydrothermal method using metformin(Met)in combination with citric acid(CA),ascorbic acid(AA),and carboxymethyl chitosan(CS),respectively.Their physicochemical properties were characterized by transmission electron microscopy(TEM),Fourier-transform infrared spectroscopy(FTIR),and UV-visible spectrophotometry.The biocompatibility and cellular uptake of the MCDs were assessed using CCK-8 assay and confocal laser scanning microscopy.Alkaline phosphatase(ALP)staining and ALP activity assay were conducted to identify the most effective MCDs type in promoting osteogenic differentiation of hPDLSCs under inflammatory conditions.Subsequently,ALP and Alizarin Red S(ARS)staining,qRT-PCR,and Western blotting were performed to assess the effects of the optimal concentration of MCDsCS and its raw material(Met+CS)on osteogenic differentiation under inflammatory conditions.Results All 3 types of nanoscale MCDs exhibited favorable physicochemical characteristics and biocompatibility,and could be effectively internalized by hPDLSCs.Both MCDsCA and MCDsAA significantly promoted hPDLSCs proliferation at lower concentrations(0～0.50 mg/mL),while MCDsCS exhibited excellent cytocompatibility over a broader range(0～2.00 mg/mL).Under inflammatory conditions,MCDsCA and MCDsAA showed no significant effect on ALP expression in hPDLSCs,whereas MCDsCS significantly enhanced ALP expression in a dose-dependent manner,with the optimal effect observed at 0.10 mg/mL(P<0.05).Compared to Met+CS,0.10 mg/mL MCDsCS significantly enhanced ALP expression and calcium nodule formation under inflammatory conditions.It also upregulated the expression of osteogenesis-related genes(ALP,RUNX2,COL-1,OCN)and proteins(ALP,RUNX2,OCN)(P<0.01),while reducing the levels of inflammatory cytokines IL-1β and IL-6(P<0.01).Conclusion A novel MCDsCS with sound biocompatibility is successfully developed,and can effectively promote osteogenic differentiation of hPDLSCs and exerts anti-inflammatory effects under inflammatory conditions,indicating its potential as a nanotherapeutic agent for periodontitis-associated bone regeneration.