Background As a traditional labor-intensive industry, the manufacturing sector is an important source of occupational exposure to hazards such as dust, toxic chemicals, and noise. Objective To analyze the current status and spatiotemporal patterns of occupational hazards including dust, toxic chemicals, and noise in manufacturing workplaces in Shanghai from 2020 to 2025, and to provided evidence for optimizing targeted prevention and control strategies. Methods Workplace monitoring data for manufacturing enterprises in Shanghai were obtained from the National Occupational Hazard Factor Monitoring System for Workplaces. Descriptive analyses were conducted to evaluate the exceedance rates of occupational hazard factors related to occupational exposure limits. GeoDa software was utilized to perform spatial autocorrelation analysis of hazard-specific exceedance rates to identify spatial clustering patterns. Results From 2020 to 2025, the number of monitored manufacturing enterprises in Shanghai increased from 374 to 504. The monitored enterprises were mainly small and micro enterprises located in suburban areas. Over the six-year period, the exceedance rate for dust-exposed work posts decreased from 21.05% to 10.03%, whereas the exceedance rate for chemical toxicant-exposed work posts remained below 3%. Noise showed the highest and most persistent exceedance rate remaining over 20% throughout the study period. Spatial autocorrelation analysis indicated that high-high clusters of dust hazards were consistently concentrated in suburban districts, including Qingpu, Jinshan, and Songjiang. The spatial pattern of chemical toxicant hazards changed over time, with high-low clusters later concentrated in Baoshan and Minhang. High-high clusters of noise hazards showed an expanding pattern, spreading from Qingpu and Songjiang to several other districts, including Jiading, Minhang, and Fengxian. Conclusion Occupational hazards in the manufacturing sector of Shanghai are mainly characterized by exceedances related to dust and noise, with noise emerging as the most persistent and spatially expanding monitored hazard. These hazards exhibit clear spatial heterogeneity: dust-related risks are concentrated in traditional industrial areas, chemical toxicant risks change dynamically with the spatial distribution of industries, and noise-related risks expand across multiple districts. Future occupational interventions should prioritize noise control and implement targeted prevention strategies based on spatial clustering characteristics.

BACKGROUND:Cannabidiol is effective in ameliorating the body's inflammatory response,but no clear mechanistic studies have been conducted to ameliorate skeletal muscle inflammation induced by exhaustive exercise. OBJECTIVE:To explore the mechanism by which cannabidiol improves skeletal muscle inflammation during exhaustive exercise by using transcriptome sequencing technology. METHODS:Thirty-six Sprague-Dawley rats were randomly divided into six groups:blank control group,exercise coconut oil group,exercise control group,50 mg/kg cannabidiol group,60 mg/kg cannabidiol group,and 70 mg/kg cannabidiol group,with six rats in each group.Except for rats in the blank control group,rats in each group were subjected to swimming exercise for 9 days to produce the exhaustive exercise model.At the end of each swimming exercise,rats in the cannabidiol groups were given 2 mL of fat-soluble cannabidiol at different concentrations(50,60,and 70 mg/kg)by gavage;rats in the exercise coconut oil group were given the same volume of coconut oil by gavage until the end of the exercise on the 9th day;and rats in the blank control group and the exercise control group were not given any special treatment.The levels of inflammatory factors and differentially expressed genes in the skeletal muscle of rats in each group were determined using ELISA and transcriptome sequencing techniques.Differentially expressed genes obtained were subjected to KEGG analysis,and the accuracy of the sequencing data was verified by fluorescence quantitative PCR. RESULTS AND CONCLUSION:The results of ELISA showed that the contents of interleukin-6(P<0.05),tumor necrosis factor-α(P<0.01),interleukin-10 and other inflammatory factors in the exercise group increased significantly compared with the blank control group and the coconut oil group.After cannabidiol intervention,the mass concentrations of interleukin-6 and tumor necrosis factor-α showed a sequential decrease with increasing cannabidiol concentration.By comparing GO and KEGG databases,the functional properties of differentially expressed genes were analyzed,and the results showed that the differentially expressed genes were mainly involved in the tumor necrosis factor signaling pathway and the Toll-like receptor signaling pathway.RT-qPCR results showed that the trends of five randomly selected differentially expressed genes were in agreement with the transcriptome sequencing results.To conclude,cannabidiol can improve skeletal muscle inflammation caused by exhaustive exercise.

Objective To investigate the value of parameters of MR diffusion kurtosis imaging(DKI)for predicting human epidermal growth factor receptor 2(HER2)-positive breast cancer(BC).Methods A total of 122 cases of BC diagnosed by pathology were retrospectively enrolled,including 37 cases of HER2-positive(HER2-positive group)and 85 cases of HER2-negative(HER2-negative group).Parameters obtained based on MR DKI(mean diffusivity[MD]and mean kurtosis[MK]values)and the results of immunohistochemical detection(expression of matrix metalloproteinase-2[MMP-2],vascular endothelial growth factor receptor 2[VEGFR-2])were compared between groups.Then maltivariable logistic regression was used to analyze the independent predictors of HER2-positive BC based on DKI parameters being statistically different between groups,and a combined model was constructed.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)were calculated to assess the efficacy of each single DKI parameter and their combined model for predicting HER2-positive BC,and the correlations of these DKI parameters with MMP-2 or VEGFR-2 expressions were analyzed.Results Compared with HER2-negative group,MD value,MK value,positive expression proportion of MMP-2 and VEGFR-2 increased in HER2-positive group(all P＜0.05).Both MD(OR=1.423)and MK(OR=1.624)values were independent predictors of HER2-positive BC(both P＜0.05),with AUC for predicting HER2-positive BC of 0.819 and 0.836,respectively,while the AUC of combined model of MD and MK values was 0.916.MD value of BC was positively correlated with MMP-2(rs=0.222)and VEGFR-2 expression(rs=0.232)(both P＜0.05),while MK value of BC was not significantly correlated with MMP-2 or VEGFR-2 expression(both P＞0.05).Conclusion As parameters of MR DKI,MD and MK values could be used to effectively predict HER2-positive BC.

Objective:To investigate the effects of artificial light at night on the growth of mandibles in mice and its regulatory mechanisms.Methods:A mouse model of artificial light at night (night light pollution group) and normal lighting (normal light group) was established by controlling light exposure time, with 4 mice in each group. Micro-CT was employed to analyze the differences in bone quantities of the mandibles between the two groups. Real-time fluorescence quantitative PCR (RT-qPCR) was used to examine the expression levels of osteogenic differentiation and metabolism-related genes in the cortical bone and condylar ossification center of the mandibles. Enzyme-linked immunosorbent assay was utilized to assess the diurnal variation of serum melatonin concentrations between the two groups. The artificial light at night experimental group received daily timed injections of a defined dose of melatonin to restore the diurnal variation of serum melatonin concentration in the mice, while the normal light group and the artificial light at night control group received the same volume of saline. Bone quantities, mandibular tissue morphologies, ossification differentiation in the condylar region and cortical bone, as well as glucose metabolism expression differences were assessed across the three groups.Results:The cortical bone thickness of the mandibles in the artificial light at night group [(0.196±0.017) mm] was significantly less than that in the control group [ (0.228±0.007) mm] ( P=0.029). The bone volume fraction of the condylar ossification center in the artificial light at night group [(36.90±1.09) %] was significantly lower than that in the normal light group [(54.24±1.49) %] ( P<0.001). The length of the mandible in the artificial light at night group [(10.86±0.17) mm] was significantly shorter than that in the normal light group [(11.41±0.32) mm] ( P=0.032). RT-qPCR results indicated that the expressions of osteogenic-related genes alkaline phosphatase, liver/bone/kidney (Alpl), osteocalcin (Ocn), Runt-related transcription factor 2 (Runx2), and osterix (Osx) in the cortical bone and condylar ossification center of mice in the artificial light at night group were significantly lower than those in the normal light group (all P<0.05). The expression of metabolism-related genes protein kinase, AMP activated alpha 1 (Prkaa1), V-type proton ATPase subunit d1 (Atp6v0d1), and cytochrome C oxidase subunit Ⅳ isoform 1 (Cox4i1) in the cortical bone and condylar ossification center of mice in the artificial light at night group were also significantly reduced compared to normal mice (all P<0.01). The serum melatonin concentration peaked 8 hours after lights off in the normal light group, whereas the artificial light at night group exhibited a significantly reduced nocturnal serum melatonin concentration with no apparent peak compared to the normal light group. Micro-CT results demonstrated that after artificial light at night group mice received timed melatonin supplementation daily, the thickness of cortical bone, the bone volume fraction of the condylar ossification center, and the length of the mandible were all significantly higher than those in the artificial light at night group (all P<0.05). Histological staining results indicated that the cortical bone structure of the mandibles in the melatonin supplementation group was more organized than that of the artificial light at night group, with higher brain and muscle ARNT-like 1 (BMAL1) expression ( P=0.003). RT-qPCR results further showed that the expression levels of Prkaa1, Atp6v0d1, and Cox4i1 in the cortical bone and condylar ossification center significantly increased in the melatonin supplementation group compared to the artificial light at night group (all P<0.05), but still significantly lower than those in the normal light group (all P<0.05). Additionally, the RT-qPCR results further revealed that the expression levels of osteogenic differentiation-related genes Alpl, Ocn, and Runx2 in the cortical bone and condylar ossification center of the melatonin supplementation group were significantly higher than those in the artificial light at night group (all P<0.01). Western blotting analysis indicated that the expression levels of glucose metabolism and osteogenic-related proteins RUNX2, OSX, ATP6V0D1, and COX Ⅳ, along with the phosphorylation levels of AMPKα1/α2, were significantly higher in the melatonin supplementation group compared to the artificial light at night group (all P<0.01). Conclusions:Artificial light at night can inhibit melatonin secretion in mice, reduce glucose metabolism in mandibular tissues, and affect both intramembranous and chondrogenic ossification activities, ultimately leading to inadequate mandibular development.

OBJECTIVE To explore the effect of tracking methodology on investigation of contamination incidents of bronchoalveolar lavage fluid(BALF)specimens from the children.METHODS The onsite tracking was carried out for the contamination incidents of BALF specimens of the children through the tracking methodology,the quality control processes of cleaning and disinfection of bronchofiberscopes and the tracking routes were determined.The quality control process of cleaning and disinfection of bronchofiberscopes were evaluated,the existing risks were found out,and the specific improvement measures were formulated.RESULTS The onsite tracking was carried out for the incident of carbapenem-resistant Klebsiella pneumoniae(CRKP)that was caused by the contamination of 12 BALF specimens from pediatrics department wards before and after Nov.1,2021.No.2180014C bronchofiber-scope without biological surveillance was determined as the high-risk point of contamination of BALF specimens,the monitoring procedure of cleaning and disinfection of the bronchofiberscopes was revised.The BALF specimens that were submitted from Dec.1,2021 to Dec.31,2021 were tracked,and no CRKP was detected among the 23 submitted specimens.Totally 12 bronchofiberscope specimens were collected for biological surveillance,and the qualified rate was 100.00％.The treatment rooms of pediatrics department,hand disinfection effect of health care workers of cleaning and disinfection rooms and disinfection effect of object surfaces were monitored,and the quali-fied rate was increased from 98.39％to 100.00％.CONCLUSIONS The tracking methodology is an effective tool for quality management and can be used for evaluation of quality process of cleaning and disinfection of bronchofi-berscopes,which may find out the causes for adverse events in a timely manner and raise the medical safety.

Objective:To investigate the clinical manifestations, gene mutation characteristics, imaging and video electroencephalogram (VEEG) characteristics of patients with dentatorubral-pallidoluysian atrophy (DRPLA).Methods:The clinical data of 9 patients with genetically diagnosed DRPLA in the Neurology Center, Beijing Tiantan Hospital, Capital Medical University from January 2018 to January 2023 were collected, and the clinical data of DRPLA patients reported in China were retrieved and summarized.Results:A total of 45 cases were included. The clinical characteristics were summarized as follows: (1) The male to female ratio of 45 patients was 1.00∶1.25, and the age of onset was (28.11±14.58) years. (2) The main clinical symptoms of juvenile type, early-onset adult type and late-onset adult type were analyzed, and the results showed that the frequency of seizures in juvenile type (16/17) was higher than that in early-onset adult type (8/21) and late-onset adult type (2/7), with statistically significant difference (χ 2=15.971, P<0.001). In addition, the frequency of cognitive impairment in juvenile type (16/17) was also higher than that in early-onset adult type (15/21) and late-onset adult type (2/7), also with statistically significant difference (χ 2=10.177, P=0.005). Cognitive impairment, language disorder and involuntary movement were common in early-onset adult patients, and about half of the patients had ataxia. Ataxia and language disorder were more common in late-onset adult patients, while seizures and cognitive impairment were rare. (3) In imaging, cerebellum and brainstem atrophy was the most common, followed by cortical atrophy and white matter lesions. (4) The number of trinucleotide (CAG) repeats was 53-79, and there was a significant negative correlation between the number of CAG repeats and the age of onset ( r=-0.765, P<0.001), that means the younger the age of onset, the higher the number of CAG repeats. (5) In terms of electrophysiology, 21 patients provided complete VEEG data, of which slowed activity (52%, 11/21) and generalized discharge (71%, 15/21) were more common, and focal discharge (33%, 7/21) was uncommon. Conclusions:DRPLA patients can present with epilepsy, cerebellar ataxia, and other clinical manifestations. Brainstem and cerebellar atrophy and white matter lesions can be relatively characteristic in imaging. In terms of electrophysiology, slowed activity and generalized discharge are more common. DRPLA patients are easy to be misdiagnosed in clinical practice and genetic confirmation helps confirm the diagnosis.

Objective To compare the success rate and stability of rat models of comorbid chronic pain and depression induced by different doses of complete Freund's adjuvant(CFA).Methods Sixty SD rats were divided randomly into a control group,low-dose CFA group(CFA-L),and high-dose CFA group(CFA-H)(n=20 rats per group).Rats in the CFA-L and CFA-H groups were injected with 50 and 100 μL CFA,respectively,and rats in the control group were injected with 0.9％sodium chloride solution.The general state,body weight,mechanical withdrawal threshold(MWT),and thermal withdrawal latency(TWL)were observed at 0,7,14,21,and 28 days after modeling.Depressive behavior was evaluated using the open field test(OFT),forced swim test(FST),and tail suspension test(TST).Glutamate(Glu)and γ-aminobutyric acid(GABA)levels in the anterior cingulate cortex were detected by enzyme-linked immunosorbent assay.Brain-derived neurotrophic factor(BDNF)expression in the anterior cingulate cortex was detected by immunohistochemistry,and pathological changes in the anterior cingulate cortex were observed by HE staining.Results(1)Regarding the general condition of the rats,the left ankle joint and toes were obviously red and swollen in the CFA-L and CFA-H groups on the 7th day after modeling,and the swelling was more severe in the CFA-H group.The redness and swelling of the left hind foot and ankle joint and toes gradually recovered in the CFA-L group on days 14,21,and 28 after modeling,but were still obvious in the CFA-H group,and the water and food intake decreased.(2)The body mass was significantly lower in rats in the CFA-H group compared with those in the blank and CFA-L groups on days 14,21,and 28 after modeling(P＜0.05,P＜0.05).(3)Regarding pain-related behavior,the MWT and TWL were significantly decreased in the CFA-L and CFA-H groups on the 7th and 14th days after modeling,compared with the control group(P＜0.05,P＜0.05).On day 21 after modeling,MWT was significantly lower in the CFA-H group than in the blank and CFA-L groups(P＜0.05,P＜0.05),and TWL was significantly lower in the CFA-L and CFA-H groups than in the blank group(P＜0.05,P＜0.05).On day 28 after modeling,MWT and TWL were significantly lower in the CFA-H group than in the blank and CFA-L groups(P＜0.05,P＜0.05).(4)In terms of depression-related behaviors,the total OFT movement distance was significantly lower in the CFA-H group than in the blank and CFA-L groups on day 7 after modeling(P＜0.05,P＜0.05).The total OFT distance and central dwell time were significantly lower in the CFA-H group than in the blank and CFA-L groups on days 14,21,and 28 after modeling(P＜0.05,P＜0.05),and the result in the FST and TST were significantly higher than in the blank and CFA-L groups(P＜0.05,P＜0.05).(5)Glu,GABA,and BDNF expression levels were significantly higher in the CFA-H group than in the blank and CFA-L groups(P＜0.05,P＜0.05),while GABA,Glu/GABA,and BDNF levels were significantly lower in the CFA-H group than in the blank and CFA-L groups(P＜0.05,P＜0.05,P＜0.05).(6)The CFA-L group showed less damage in the anterior cingulate cortex,more pyramidal cells,more arranged cells,clear nucleoli,and a small number of cells with karyokynesis and deep staining.Compared with the CFA-L group,rats in the CFA-H group showed a disordered cell arrangement in the injured area of the anterior cingulate cortex,a large number of pyknotic and hyperchromatic neurons,significantly fewer or absent pyramidal cells,and vacuoles,red blood cells,and neurofibrillary tangles in the interstitial space.Conclusions Injection of CFA 100 μL can be used to establish a rat model of chronic inflammatory pain and depression,showing hyperalgesia,depression-like behavioral changes,changes in levels of Glu,GABA,and BDNF in the anterior cingulate cortex,and pathological changes in the anterior cingulate cortex,consistent with the pathophysiological characteristics of chronic pain and depression.

Objective:To construct a training program for expert patients with type 2 diabetes mellitus (T2DM), so as to provide reference for T2DM education and management.Methods:Guided by the iceberg quality model, a preliminary training program was developed based on literature analysis and qualitative interviews. Using convenience sampling method, 22 experts were selected for two rounds of Delphi expert consultation from March to April 2024, and the final draft of the training program was discussed and revised based on the experts' opinions.Results:In the two rounds of expert consultation, the effective response rates of the questionnaire were 100.00% (22/22) and 95.45% (21/22), respectively, and the authority coefficient of the experts was all 0.905. The Kendall harmony coefficients ranged from 0.110 to 0.293 and 0.139 to 0.301, respectively ( P<0.05). The finalized training program included five modules of training content, assessment evaluation, training instructors, training time, and training forms. Conclusions:The constructed training program for expert patients with T2DM is scientific, reliable, and comprehensive, which can provide guidance for the next step of T2DM expert patient training.

Objective:To establish graded forecast models of pollen concentration in spring and summer-autumn in northern China, based on long-term data of pollen and allergic rhinitis (AR) medical visits in 8 cities of northern China.Methods:Pollen concentration and the characteristics of AR patients from 8 cities of northern China, including Beijing, Baotou, Hohhot, Xi′an, Xining, Cangzhou, Liaocheng and Zibo, were analyzed. Spearman′s correlation was used to examine the relationship between pollen concentration and daily AR patient visits. A pollen concentration grading was establish, and a pollen forecast model was created using the eXtreme gradient boosting (XGBoost) algorithm. The model incorporated meteorological factors and the 3-day moving average of pollen concentrations.Results:The spring pollen period started early and lasted long in Beijing and Xi ′an, while the summer-autumn pollen period started earlier and persisted longer in Xining, Baotou and Hohhot. During summer-autumn pollen period, and the spring period in most cities (except Baotou and Cangzhou), average daily patient visits were significantly higher than those in non-pollen periods. A strong correlation was observed between daily AR patient visits and the 3-day moving average of pollen concentrations in both the spring and summer-autumn periods across all cities. Based on the correlation, a pollen concentration grading standard of northern China was established. The accuracy evaluation of pollen concentration prediction model showed that the percentage of forecasts with either completely accurate or within one level difference exceeded 91% in spring and 95% in summer-autumn. The most important predictive variable in the model was the pollen level from previous day, followed by the temperature and humidity.Conclusion:The grading prediction model for pollen concentration provides guidance for AR patients in term of travel, early defense and treatment, as well as the determining medication schedules for clinical drug research and specific immunotherapy.

Objective:To analyze the diagnostic value of video-electroencephalography(VEEG)combined with C-reactive protein(CRP)and procalcitonin(PCT)in infectious diseases of the central nervous system with convulsions.Methods:This study included 100 pediatric patients with convulsions who were suspected as central nervous system infection at Bengbu First People's Hospital from May 2022 to May 2024.VEEG and laboratory tests were performed on them.These patients were divided into the infection group(36 cases)and the non-infection group(64 cases)according to whether they were judged as central nervous system infection by using testing cerebrospinal fluid.The abnormal situation of VEEG test,CRP and PCT levels of two groups were compared,and the consistency between the diagnostic result of VEEG combined with CRP and PCT,and the tested result of cerebrospinal fluid was further analyzed.The receiver operating characteristic(ROC)curve was adopted to analyze the diagnostic efficiency of VEEG combined with CRP and PCT.Results:In 36 pediatric patients of infection group,2 cases(5.56%)were within normal range of VEEG examination,and 11 cases(30.56%)were at cutoffvalue,and 23 cases(63.89%)were abnormal.In 64 pediatric patients of non-infection group,54 cases(84.38%)were normal,and 6 cases(9.38%)were within normal range,and 3 cases(4.68%)were at cutoffvalue,and 1cases(1.56%)were abnormal.The abnormal results of the infection group were significantly higher than those of the non-infection group(Z=8.81,P＜0.05).The CRP and PCT levels of infection group were significantly higher than those of non-infection group(t=6.859,5.410,P＜0.05).There was higher consistency between the diagnosis of VEEG combined with CRP and PCT,and the tested result of cerebrospinal fluid(Kappa=0.867).The ROC analysis showed that the AUC value,sensitivity and specificity of VEEG combined with CRP and PCT in diagnosing the central nervous system infection with convulsions were respectively 0.963,86.11%and 98.44%,which were higher than those of the single VEEG diagnosis.Conclusion:There are significant differences in VEEG abnormalities,CRP and PCT levels between pediatric patients with central nervous system infection with convulsions,and pediatric patients without central nervous system infection with convulsions.The diagnosis of applying VEEG combined with CRP and PCT has higher diagnostic efficiency in clinical work.