Background The adverse effects of long working hours, shift rotation, and job stress on the physical and mental health of occupational populations require urgent attention. Objective To investigate and compare the positive rates of WMSDs between different industries, analyze the exposure status of long working hours, shift rotation, and job stress among key occupational groups, and evaluate the impacts of these factors on WMSDs in the manufacturing and service industries. Methods The study subjects were derived from key occupational populations in Yunnan Province, recruited by the Chinese National Occupational Health Literacy Monitoring Survey in 2022. A cross-sectional design was used for this survey. The key occupational populations were recruited from the secondary industry (manufacturing industry, metal mining and beneficiation industry, and non-metal mining and beneficiation industry) by stratified random sampling and from the tertiary industry (medical and healthcare industry, education industry, environmental sanitation industry, transportation industry, and express/takeaway delivery industry) by proportional probability sampling, and 12014 front-line workers were finally included as survey participants. General information, work-related factors (shift rotation, weekly working hours, job stress, etc.) and WMSDs assessment results were obtained through a web-based self-reported questionnaire, and the associations of long working hours, shift rotation, and job stress with WMSDs were analyzed using χ² test and logistic regression. Results The average positive rate of WMSDs among the key occupational groups in Yunnan Province was 77.2%. The positive rate of WMSDs in the secondary industry group was 69.4%, while it was 81.6% in the tertiary industry group, with a statistically significant difference (P<0.001). Among the eight surveyed sectors, the education sector had the highest positive rate of WMSDs (94.2%). The single-site WMSDs mainly involved the neck, shoulders, and low back. In the secondary industry, WMSDs was reported in 1−2 body parts, while in the tertiary industry, WMSDs was mainly reported in multiple (≥5) body parts. Long working hours (OR: 1.119, 1.165, 1.163, respectively), shift rotation (OR: 1.094, 1.199, 1.230, respectively), and job stress (OR: 1.795, 1.854, 2.006, respectively) were risk factors for WMSDs in the neck, shoulder, or low back, and all three were also risk factors for multi-site WMSDs. Moreover, as the number of involved body parts increased, the effects of long working hours and job stress became more pronounced. For 1-2, 3-4, and 5 or more body parts compared to no pain reported, their OR values were 0.971 (95%CI: 0.871, 1.082), 1.133 (95%CI: 1.004, 1.279), and 1.285 (95%CI: 1.155, 1.429) for long working hours, respectively, and the OR values were 1.009 (95%CI: 0.878, 1.160), 1.360 (95%CI: 1.174, 1.575), and 2.797 (95%CI: 2.471, 3.166) for job stress, respectively. Conclusion The positive rate of WMSDs is higher in the tertiary industry than that in the secondary industry among the key occupational groups in Yunnan Province. Long working hours, rotating shift work, and job stress could significantly increase the risk of WMSDs.

Objective:To investigate the relationship between the single nucleotide polymorphisms (SNP) rs174575 and rs2845574 in the fatty acid desaturase 2 ( FADS2) gene and gestational diabetes mellitus (GDM). Methods:A total of 1 514 pregnant women who visited West China Second University Hospital, Sichuan University, between January 1, 2013, and December 31, 2021, were enrolled in this study. Among them, 583 were diagnosed with gestational diabetes mellitus (GDM group), and 931 had normal pregnancies (control group). The SNPs rs174575 and rs2845574 in the FADS2 gene were analyzed using Sanger DNA sequencing. Plasma levels, insulin (INS), apolipoprotein A1 (apoA1) and apolipoprotein B (apoB) levels were measured using enzymatic methods, chemiluminescence and immunoturbidimetry. This study was approved by Medical Ethics Committee of the West China Second University Hospital, Sichuan University (Ethics No. 2020-036). Results:① The main type of genotype at the rs174575 C/G and rs2845574 C/T polymorphic sites were CC in both GDM and control groups. No statistically significant differences were observed between the GDM and control groups regarding the genotype frequencies or allele frequencies of rs174575 and rs2845574 sites ( P>0.05). ② Among the GDM group, individuals with the GG genotype at the rs174575 site had lower plasma HDL-C levels compared to those with the CC genotype ( P<0.05), and had higher atherogenic indices (AI) than CC and CG genotype ( P<0.05; P<0.05). Individuals with the TT genotype at the rs2845574 site had higher AI than CT genotype ( P<0.05). Among the control group, individuals with the GG genotype had lower diastolic blood pressure (DBP) compared to those with the CC genotype ( P<0.05). ③ Additional subgroup analysis demonstrated that the rs174575 polymorphism was associated with AI levels in obesity subgroup of GDM, TG levels in non-obese subgroup of control and DBP levels in obese subgroup of control ( P<0.05; P<0.05; P<0.05). Conclusion:The FADS2 rs174575 and rs2845574 polymorphisms in GDM patients were associated wit HDL-C and AI levels, and the FADS2 rs174575 polymorphisms was also associated with DBP levels in normal pregnant women. The AI and DBP levels have BMI-dependent effect.

OBJECTIVE: To assess the association between the single nucleotide polymorphisms (SNP) rs174575 and rs2845574 of the fatty acid desaturase 2 (FADS2) gene and gestational diabetes mellitus (GDM). METHODS: A total of 1 514 pregnant women who visited West China Second University Hospital of Sichuan University between January 1, 2013 and December 31, 2021 were enrolled in this study. Among them, 583 were diagnosed with gestational diabetes mellitus (GDM group), and 931 had normal pregnancies (control group). The SNPs rs174575 and rs2845574 of the FADS2 gene were analyzed using Sanger DNA sequencing. Plasma levels of insulin (INS), apolipoprotein A1 (apoA1) and apolipoprotein B (apoB) were measured using enzymatic methods, chemiluminescence and immunoturbidimetry. This study was approved by the Medical Ethics Committee of the West China Second University Hospital of Sichuan University (Ethics No.: 2020-036). RESULTS: The main genotype at the rs174575 C/G and rs2845574 C/T loci were CC in both GDM and control groups. No significant difference was found between the GDM and control groups regarding the genotypic or allelic frequencies of rs174575 and rs2845574 sites (P > 0.05). Among the GDM group, individuals with the GG genotype at the rs174575 site had lower plasma HDL-C levels compared to those with the CC genotype (P < 0.05), and had higher atherogenic indices (AI) compared with the CC and CG genotype (P < 0.05; P < 0.05). Individuals with the TT genotype at the rs2845574 site had higher AI compared with the CT genotype (P < 0.05). Among the control group, individuals with the GG genotype had lower diastolic blood pressure (DBP) compared to those with the CC genotype (P < 0.05). Additional subgroup analysis demonstrated that the rs174575 polymorphism was associated with AI levels in obesity subgroup of GDM, TG levels in non-obese subgroup of control and DBP levels in the obese subgroup of control (P < 0.05; P < 0.05; P < 0.05). CONCLUSION The FADS2 rs174575 and rs2845574 polymorphisms in GDM patients are associated wit HDL-C and AI levels, and the FADS2 rs174575 polymorphisms was also associated with DBP levels in normal pregnant women. The AI and DBP levels have a BMI-dependent effect.
Humans ; Female ; Pregnancy ; Fatty Acid Desaturases/genetics* ; Polymorphism, Single Nucleotide ; Adult ; Diabetes, Gestational/blood* ; Blood Pressure/genetics* ; Lipids/blood* ; Genotype ; Genetic Predisposition to Disease

Objective: To analyze the relationship between asthma and nocturia in women based on the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2018,so as to provide reference for the prevention and treatment of female nocturia. Methods: Female respondents aged ≥20 years with nocturia or asthma were selected from the 2005-2018 NHANES database.Those with both diabetes stroke and obstructive sleep apnea syndrome were excluded.A weighted analysis was conducted using a complex sampling design.The association between asthma and nocturia in women was evaluated with univariate analysis，propensity score matching (PSM)，and multivariate logistic regression models. Results: A total of 14 718 respondents were selected，of whom 1426 (9.7%) were diagnosed with asthma，and 4664 (31.7%) with nocturia.There is a significant correlation between asthma and nocturia (χ =39.846，P<0.01). Age，body mass index (BMI)，smoking and race were also associated with nocturia (P<0.01).Multivariate logistic regression analysis showed that，the age，BMI，smoking，race and asthma were correlated with the risk of nocturia，before PSM matching (P<0.05).To eliminate confounding bias，PSM was applied，and generalized linear mixed model analysis after matching showed that the risk of nocturia remained high in asthma patients (OR=1.540，95% CI：1.320-1.800，P<0.01). Conclusion: Asthma is associated with nocturia in women，indicating that it may be an important risk factor for female nocturia.

OBJECTIVE: To screen the optimal regimen of acupuncture and moxibustion for obstructive sleep apnea hypopnea syndrome (OSAHS), so as to provide the evidences for clinical decision-making. METHODS: From 7 databases in Chinese and English i.e. the Full-Text Database of China Journal Network (CNKI), Wanfang Data Knowledge Service Platform (Wanfang), VIP Information Chinese Journal Service Platform (VIP), Chinese Biomedical Literature Database (SinoMed), PubMed, Web of Science (WOS) and Cochrane Library, randomized controlled trial (RCT) articals of OSAHS treated with acupuncture and moxibustion were searched. The quality of evidence was evaluated with the modified Jadad scale, the evaluation index was established and the optimal regimen of acupuncture and moxibustion for OSAHS was screened by multi-index decision analysis. RESULTS: A total of 10 RCTs were included, and the filiform needling therapy was optimal in treatment of OSAHS. The acupoints included Lianquan (CV23), Danzhong (CV17), Zhongwan (CV12), and bilateral Kongzui (LU6), Pishu (BL20), Fenglong (ST40), Zusanli (ST36), Yinlingquan (SP9) and Zhaohai (KI6). Zusanli (ST36) received the reinforcing method, Pishu (BL20) and Fenglong (ST40) were stimulated with the reducing technique, and the rest acupoints with the uniform reinforcing-reducing. Each acupoint was manually manipulated once every 10 min during the needle retention for 30 min. Acupuncture was delivered once a day, 5 times a week and for consecutive 4 weeks. Among the included literature, the severity of disease was not reported in detail, the filiform needling was the dominant intervention, the local acupoints such as Lianquan (CV23) and Panglianquan (Extra) were mainly selected. The apnea-hypopnea index and the minimum oxygen saturation were taken as the evaluation indexes, and the effect was evaluated in reference to the generally accepted standards. The attention to safety evaluation was insufficient, the report on methodology was not adequate and the quality was low. CONCLUSION Filiform needling is the dominant therapy of acupuncture and moxibustion for OSAHS, and the local acupoints are considered specially. But the quality of clinical research should be improved.
Humans ; Moxibustion ; Acupuncture Therapy ; Sleep Apnea, Obstructive/therapy* ; Acupuncture Points ; Randomized Controlled Trials as Topic

Objective To develop a machine learning(ML)-based prediction model for assessing the therapeutic effects of resveratrol(RES)on the pathological damage of acute pancreatitis(AP),and to optimize RES administration strategies for AP through validation using an animal model.Methods AAn ML-based prediction model was constructed using published data.Interpretability analysis was applied to identify high-efficacy zones within the parameter space of administration dose and frequency,which was followed by rigorous screening to select the optimal dosing strategy that balanced therapeutic efficacy and experimental feasibility.A total of 32 C57BL/6 mice were randomly assigned to 4 groups(n=8 per group),including a control group(Ctrl),an AP model group induced by caerulein(CER)and referred to as CER-AP,a treatment group receiving RES via intraperitoneal injection(RES i.p.),and a treatment group receiving RES via intragastric gavage(RES i.g.).The Ctrl group received intraperitoneal injection of normal saline.The CER-AP and the treatment groups were induced with 10 intraperitoneal injections of CER at 50 μg/kg.RES was administered to the RES i.p.and RES i.g.groups according to the optimal dose and timing predicted by the ML model.Blood and tissue samples were collected 12 hours after the experiment started.Results The gradient boosting decision tree model,optimized via Hyperopt,yielded the best performance,predicting that the optimal dose and administration frequency were 19.992 mg/kg and 3.828 times,respectively.Accordingly,a regimen of 20 mg/kg RES,administered four times,was used in the animal experiments.Compared with the Ctrl group,the CER-AP group exhibited higher pancreatic pathology scores and elevated levels of serum amylase,lipase,pancreatic myeloperoxidase,and trypsin,with all differences reaching statistical significance(all P<0.05).The administration of 20 mg/kg RES via both intraperitoneal injection and intragastric gavage mitigated pancreatic inflammatory cell infiltration and necrosis,improved the overall pathology score,and reduced serum amylase,lipase,and pancreatic myeloperoxidase levels to varying degrees(all P<0.05).Conclusion A regimen of 20 mg/kg RES administered four times effectively alleviates the severity of CER-induced AP.The therapeutic benefits appear to arise from a multi-target regulatory network that simultaneously suppresses inflammatory cascades,mitigates oxidative stress,and reduces apoptosis,thereby reducing pancreatic tissue damage and systemic inflammatory responses.

Objective Based on the clinical data and imaging manifestations of patients with ischemic stroke to establish a simple clinical prediction model that is used for identifying intracranial atherosclerotic stenosis-acute large vessel occlusion(ICAS-LVO in posterior circulation before surgery.Methods The clinical data of patients with acute large vessel occlusion(LVO in the posterior circulation,who received endovascular intervention at the First Affiliated Hospital of Nanjing Medical University of China from January 2019 to September 2022,were retrospectively analyzed.According to the intraoperative angiographic findings,the patients were divided into ICAS-LVO group and non-ICAS-LVO group.Univariate analysis and multivariate logistic regression analysis were used to analyze the patient's demographic characteristics,clinical history,imaging findings,and laboratory results,based on which a clinical prediction model for ICAS-LVO was established,and according to the relevant parameters a nomogram prediction model was plotted.Results A total of 110 patients with LVO in the posterior circulation who received endovascular treatment were included in the final analysis.In 51 patients(49.6％)the cause of vascular occlusion was the atherosclerotic stenosis of the intracranial arteries.Compared with non-ICAS-LVO group,in ICAS-LVO group the patients were younger,the incidence of atrial fibrillation was lower,and the level of plasma D-dimer was lower.Three factors,including atrial fibrillation,occlusion site and collateral circulation status,were finally screened out to establish the prediction model for ICAS-LVO.This model demonstrated acceptable calibration(Hosmer-Lemeshow test,P=0.562)and good discrimination ability(AUC=0.956;95％CI:0.906-0.986).Conclusion The clinical prediction model for ICAS-LVO,which is established on the three predictive factors(absence of atrial fibrillation,occlusion located at the V4 segment of the vertebral artery or at the proximal to mid segment of the basilar artery,and a favorable collateral circulation),carries high sensitivity and accuracy.This model can help neurointervention physicians to make early identification of ICAS-LVO and to promptly formulate vascular recanalization treatment strategies.

Objective:To investigate the relationship between the single nucleotide polymorphisms (SNP) rs174575 and rs2845574 in the fatty acid desaturase 2 ( FADS2) gene and gestational diabetes mellitus (GDM). Methods:A total of 1 514 pregnant women who visited West China Second University Hospital, Sichuan University, between January 1, 2013, and December 31, 2021, were enrolled in this study. Among them, 583 were diagnosed with gestational diabetes mellitus (GDM group), and 931 had normal pregnancies (control group). The SNPs rs174575 and rs2845574 in the FADS2 gene were analyzed using Sanger DNA sequencing. Plasma levels, insulin (INS), apolipoprotein A1 (apoA1) and apolipoprotein B (apoB) levels were measured using enzymatic methods, chemiluminescence and immunoturbidimetry. This study was approved by Medical Ethics Committee of the West China Second University Hospital, Sichuan University (Ethics No. 2020-036). Results:① The main type of genotype at the rs174575 C/G and rs2845574 C/T polymorphic sites were CC in both GDM and control groups. No statistically significant differences were observed between the GDM and control groups regarding the genotype frequencies or allele frequencies of rs174575 and rs2845574 sites ( P>0.05). ② Among the GDM group, individuals with the GG genotype at the rs174575 site had lower plasma HDL-C levels compared to those with the CC genotype ( P<0.05), and had higher atherogenic indices (AI) than CC and CG genotype ( P<0.05; P<0.05). Individuals with the TT genotype at the rs2845574 site had higher AI than CT genotype ( P<0.05). Among the control group, individuals with the GG genotype had lower diastolic blood pressure (DBP) compared to those with the CC genotype ( P<0.05). ③ Additional subgroup analysis demonstrated that the rs174575 polymorphism was associated with AI levels in obesity subgroup of GDM, TG levels in non-obese subgroup of control and DBP levels in obese subgroup of control ( P<0.05; P<0.05; P<0.05). Conclusion:The FADS2 rs174575 and rs2845574 polymorphisms in GDM patients were associated wit HDL-C and AI levels, and the FADS2 rs174575 polymorphisms was also associated with DBP levels in normal pregnant women. The AI and DBP levels have BMI-dependent effect.

Objective:To investigate the predictive factors for the outcome of patients with complete recanalization after endovascular treatment (EVT) for acute basilar artery occlusion (ABAO).Methods:Patients with ABAO underwent EVT at Jiangsu Provincial People's Hospital and Nanjing Pukou People's Hospital from January 2015 to December 2022 were included retrospectively. Complete recanalization was defined as a modified Thrombolysis in Cerebral Infarction (mTICI) grade 3 after EVT. The main outcome measure was the clinical outcome evaluated by the modified Rankin Scale at 90 days after onset. 0-2 points were defined as good outcome and >2 points were defined as poor outcome. The secondary outcome measure was death within 90 days after onset. Multivariate logistic regression analysis was used to determine the independent predictive factors for poor outcome and mortality. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the independent predictive factors for poor outcome or mortality. Results:A total of 73 patients with completed recanalization after EVT for ABAO were enrolled, including 55 males (75.3%), aged 67.2±1.58 years, with the median baseline National Institutes of Health Stroke Scale (NIHSS) score 23, median baseline Basilar Artery on Computed Tomography Angiography (BATMAN) score 7, and median baseline posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) 8. After 90 days of onset, 34 patients (46.6%) had poor outcome and 16 (21.9%) died. Multivariate logistic regression analysis showed that higher baseline NIHSS score (odds ratio [ OR] 1.151, 95% confidence interval [ CI] 1.041-1.273; P=0.006), lower baseline pc-ASPECTS ( OR 0.096, 95% CI 0.024-0.386; P=0.001), lower baseline BATMAN score ( OR 0.394, 95% CI 0.162-0.961; P=0.041), and non-first-pass recanalization ( OR 5.011, 95% CI 1.675-23.343; P=0.016) were independently associated with the poor outcome. ROC curve analysis showed that the area under the curve for predicting poor outcome by combining these independent predictive factors was 0.966 (95% CI 0.930-0.964). Multivariate logistic regression analysis showed that older age ( OR 1.147, 95% CI 1.010-1.303; P=0.035), higher baseline NIHSS score ( OR 1.236, 95% CI 1.040-1.470; P=0.016), lower baseline pc-ASPECTS ( OR 0.011, 95% CI 0.002-0.249; P=0.015), and lower baseline BATMAN score ( OR 0.050, 95% CI 0.004-0.618; P=0.020) were independently associated with mortality within 90 days after onset. ROC curve analysis showed that the area under the curve for predicting mortality by combining these independent predictive factors was 0.948 (95% CI 0.899-0.997). Conclusion:For patients with ABAO who had complete recanalization after EVT, the baseline NIHSS score, baseline pc-ASPECTS, baseline BATMAN score, and non-first-pass recanalization are the independent predictive factors for poor outcome at 90 days after onset, while age, baseline NIHSS score, baseline pc-ASPECTS, and baseline BATMAN score are the independent predictive factors for mortality within 90 days after onset.

Objective:To explore the clinical effects of parallel combined flow-through perforator flaps in the treatment of circular hot crush injuries in limbs with blood supply disorder.Methods:The study was a retrospective observational study. From April 2016 to December 2022, 4 cases with circular hot crush injuries in limbs with blood supply disorder were admitted to the Department of Burns and Plastic Surgery of the 988 th Hospital of Joint Logistics Support Force of PLA, including 3 males and 1 female, aged from 24 to 48 years. Among them, 2 cases were injured in the calf and 2 cases were injured in the forearm. After emergency debridement, the area of skin and soft tissue defects was from 20 cm×20 cm to 44 cm×20 cm. The patients had defects in tibialis anterior and posterior tibial arteries with a length of 13 to 18 cm, and in ulnar and radial arteries with a length of 9 to 12 cm. Flaps were designed and cut, including a flow-through anterolateral thigh perforator flap with area of 20 cm×9 cm to 24 cm×21 cm carrying the descending branch of the lateral circumflex femoral artery and the accompanying veins of 8 to 18 cm in length; and a flow-through posterior tibial artery perforator flap with area of 21 cm×13 cm and 20 cm×14 cm carrying the posterior tibial artery, the accompanying veins with a length of 14 and 17 cm respectively, and the great saphenous vein with a length of 22 and 21 cm. The circular hot crush injury wounds in the calf with blood supply disorder were repaired by a parallel combination of flow-through posterior tibial artery perforator flap and flow-through anterolateral thigh perforator flap, and the circular hot crush injury wounds in the forearm with blood supply disorder were repaired by a parallel combination of bilateral flow-through anterolateral thigh perforator flap, and the injured main vessels were reconstructed. The donor site wounds of flap were closed directly or treated with split-thickness skin grafts from abdomen. After surgery, the blood supply and survival of the flap and distal affected limb, the healing of wounds in the donor and recipient sites, the survival of the skin graft in the flap donor site were observed. During follow-up, the condition of flaps, the appearance, blood supply, and function of affected limbs were observed. At the last follow-up, the foot and ankle functions were evaluated according to the scoring standards of American Orthopedic Foot and Ankle Association, and the wrist and hand function was evaluated according to the trial standard of replantation of amputated upper limb function assessment of the Hand Surgery of Chinese Medical Association. Results:The flaps and distal affected limbs of 4 patients had good blood circulation and successfully survived after surgery. The wounds of 3 cases successfully healed, while one patient with circular hot crush injury in the forearm experienced exudation in the recipient site in the later stage, and the wound healed after re-expansion and suturing. The donor site wounds healed smoothly, and the skin grafts successfully survived. During follow-up of 12 to 24 months after surgery, the flaps were slightly swollen, the limbs had good appearance, normal blood circulation, and fine functional recovery. At the last follow-up, the foot and ankle function of 2 patients with circular hot crush injuries in the calf was evaluated as good in 1 case and commonly in 1 case; the wrist and hand function of 2 patients with circular hot crush injuries in the forearm was evaluated as excellent in 1 case and good in 1 case.Conclusions:The parallel combined flow-through perforator flap can reconstruct the damaged main blood vessels and repair the wound at the same time. It can not only effectively save the limb, but also restore part of the function of the affected limb. It is one of the effective methods to treat the circular hot crush injuries in limbs with blood supply disorder.