Objective: To investigate the distribution frequency and molecular mechanism of the rare blood type Lu(a-b-) in Shenzhen, and to compare the polymorphisms of the Lutheran blood group system encoding gene LU and the In (Lu) phenotype-related gene KLF1 among Han Chinese, Indian, and Uyghur populations in Xinjiang. Methods: Serological methods were used to screen the Lu(a-b-) phenotype of blood donors in Shenzhen. Third-generation sequencing was employed to sequence the full-length of the LU and KLF1 genes in Lu (a-b-) phenotype samples as well as the samples from the Han Chinese, Indians, and Uyghur population, followed by analysis of gene haplotypes frequencies. Results: Ten individuals with the Lu(a-b-) phenotype were screened out of 14 367 blood donors in Shenzhen, yielding a frequency of approximately 0.07%. Only 2 cases showed mutations in the coding region of the LU gene, while all individuals showed heterozygous mutations in the coding region of the KLF1 gene. The highest mutation frequencies of the LU and KLF1 genes were observed in the Uyghur population in Xinjiang and the Han Chinese in Shenzhen, respectively. Conclusion: All Lu(a-b-) phenotypes are of the In (Lu) type, and their formation mechanism is mainly related to KLF1 gene mutations. Both the LU and KLF1 genes exhibit significant polymorphism in the Han Chinese, Indians, and Uyghur populations.

Rheumatoid arthritis （RA） is a common autoimmune disease characterised clinically by symmetrical joint pain， swelling， and stiffness. Long-term chronic synovial inflammation can lead to severe joint damage and even disability， thereby affecting quality of life for patients. Current clinical treatment of RA emphasises an integrated approach combining traditional Chinese and Western medicine， with traditional Chinese medicine offering certain advantages in reducing disease activity of RA， preventing relapses， and other aspects. Modern clinical evidence confirms that Guizhi Shaoyao Zhimutang （GSZT） is effective in improving symptoms such as immune metabolism， joint stiffness， and joint pain in RA patients. Pharmacological studies have revealed that GSZT primarily contains components such as cinnamaldehyde， total glucosides of paeony， total alkaloids of Aconiti Lateralis Radix Praeparata， glycyrrhetinic acid， zingiberone， isoimperatorin， ephedra polysaccharides， and cedrol. It improves RA symptoms via multiple mechanisms and targets， including enhancing immune responses， exerting anti-inflammatory and analgesic effects， regulating relevant signalling pathways， inhibiting cell apoptosis， and suppressing bone destruction. This paper reviewed the syndrome patterns and pharmacological basis of GSZT in the treatment of RA， as well as its clinical applications and related mechanisms， thereby providing a theoretical basis and reference for the further development and utilisation of GSZT in the treatment of RA.

Rheumatoid arthritis （RA） is a common autoimmune disease characterised clinically by symmetrical joint pain， swelling， and stiffness. Long-term chronic synovial inflammation can lead to severe joint damage and even disability， thereby affecting quality of life for patients. Current clinical treatment of RA emphasises an integrated approach combining traditional Chinese and Western medicine， with traditional Chinese medicine offering certain advantages in reducing disease activity of RA， preventing relapses， and other aspects. Modern clinical evidence confirms that Guizhi Shaoyao Zhimutang （GSZT） is effective in improving symptoms such as immune metabolism， joint stiffness， and joint pain in RA patients. Pharmacological studies have revealed that GSZT primarily contains components such as cinnamaldehyde， total glucosides of paeony， total alkaloids of Aconiti Lateralis Radix Praeparata， glycyrrhetinic acid， zingiberone， isoimperatorin， ephedra polysaccharides， and cedrol. It improves RA symptoms via multiple mechanisms and targets， including enhancing immune responses， exerting anti-inflammatory and analgesic effects， regulating relevant signalling pathways， inhibiting cell apoptosis， and suppressing bone destruction. This paper reviewed the syndrome patterns and pharmacological basis of GSZT in the treatment of RA， as well as its clinical applications and related mechanisms， thereby providing a theoretical basis and reference for the further development and utilisation of GSZT in the treatment of RA.

Background Long working hours, as a common risk factor for occupational stress, is closely related to the occurrence of depressive symptoms. Understanding how long working hours affect occupational stress and depressive symptoms will inform occupational health interventions. Objective To quantify the impact of long working hours exposure on occupational stress and depressive symptoms among Internet industry employees, translate black-box outputs into actionable insights, and demonstrate the value of interpretable machine learning for early-warning occupational-health surveillance. Methods A dataset was derived from a cross-sectional survey involving 2866 internet industry employees in China. This survey was part of the project Risk Assessment Of Long Working Hour Exposure And Its Adverse Health Effects, conducted by the National Institute for Occupational Health and Poisoning Control, Chinese Center for Disease Control and Prevention, from 2021 to 2023. Working hours, occupational stress and depressive symptoms were quantified with a set of structured questionnaires including the Core Occupational Stress Scale and the Patient Health Questionnaire. Pairwise associations were screened by Mantel tests and variance-inflation factors. Key predictors identified through feature selection were fed into six machine-learning risk-prediction models. Visual interpretation was provided by feature importance, Shapley additive explanations (SHAP) and local interpretable model-agnostic explanations (LIME), while directed causal effects and intervention impacts of prolonged working hours exposure on occupational stress and depressive symptoms were dissected with causal explanation of features techniques. Results The positive rates of occupational stress and depressive symptoms among internet employees were 12.9% and 77.8% respectively. Twelve core features for occupational stress and nine for depressive symptoms were retained after selection. After these features were supplied to six predictive algorithms and evaluated on five metrics, the Light Gradient Boosting Machine (LGBM) achieved the highest accuracy—0.89 for occupational stress and 0.79 for depressive symptoms on the hold-out test set. The feature-importance rankings converged on fatigue accumulation and life satisfaction as dominant drivers for both outcomes, whereas weekly working hours and daily overtime emerged as the principal exposure-related predictors. The SHAP summary plots revealed that longer weekly hours and daily overtime systematically elevated the probability of occupational stress. The causal feature explanation further quantified that ascending one category in weekly working hours increased the probability of occupational stress by 7.04%. Conclusion Exposure to long working hours is associated with both occupational stress and depressive symptoms among internet industry employees. Interpretable machine-learning frameworks translate these associations into transparent, defensible drivers, enabling precise identification of the pivotal factors and their interplay. This evidence base equips occupational-health practitioners with actionable insights for designing targeted prevention and intervention strategies.

With industrial restruction, workplace transformation, and the emergence of new materials, technologies, and processes, mental health issues among working population have become a pressing concern in occupational health. Digital interventions, supported by their accessibility and personalization capabilities, may offer a promising solution to this challenge. This article reviewed key concepts and the developmental history of digital interventions and occupational health psychology, and systematically examined representative intervention approaches and their effectiveness in addressing workplace mental health concerns. It further explored the challenges and corresponding strategies in this field, including strengthening the evidence-based foundation, integrating theoretical models, incorporating organizational and ecological factors, and addressing technological issues. In the future, strengthening interdisciplinary and cross-sector collaboration should be enhanced to optimize and promote the application of digital mental health services for working population, thereby promoting workplace well-being and advancing the sustainable development of digital interventions.

Objective: To investigate the expression and functional role of FK506 binding protein 10 (FKBP10) in oral squamous cell carcinoma (OSCC), and to provide a research basis for the estimated prognosis and targeted therapy of OSCC. Methods: A total of 284 OSCC samples and 19 normal samples were selected from the Cancer Genome Atlas (TCGA) database, and diagnostic analysis was performed to determine mRNA expression. Survival analysis for FKBP10 and OSCC was conducted on a gene expression profile interaction analysis website. Real-time fluorescence quantitative PCR and Western Blot were used to detect the mRNA and protein expression of FKBP10 in four OSCC cell lines and SAS and SCC9 cells transfected with siRNA. The cell proliferation ability of FKBP10-silenced cells was detected using the CCK8 method, and the cell cycle distribution and apoptosis were detected by flow cytometry. Cell migration and invasion ability were detected through wound healing and invasion experiments. The expression changes of total protein and phosphatidylinositol 3-kinase (PI3K)-serine/threonine kinase (AKT) after FKBP10 silencing were analyzed by proteomics and Western Blot. Results: According to the analysis of gene expression levels, the mRNA expression level of FKBP10 in OSCC was significantly higher than that in normal tissues (P < 0.001). In terms of diagnosis, the expression level of FKBP10 has unique diagnostic value for OSCC (P < 0.05). The survival analysis of FKBP10 and OSCC showed that a high expression of FKBP10 led to a decrease in patient survival and poor prognosis (P < 0.05). The expression of FKBP10 mRNA and protein in OSCC cell lines was higher than that in normal oral keratinocytes (P < 0.001). Silencing FKBP10 can reduce the proliferation, invasion, and migration ability of SAS and SCC9 (P < 0.001), and also block their cell cycle in the G0/G1 phase (P < 0.001), with a significant increase in apoptosis (P < 0.05). Protein mass spectrometry and Western blot analysis revealed that FKBP10 silencing significantly downregulated the expression of multiple proteins in the RAP1 signaling pathway, mainly RAP guanine nucleotide exchange factor 1 (RAPGEF1) (P < 0.05) and the phosphorylation of PI3K-AKT proteins (P < 0.05). Conclusion FKBP10 is highly expressed in OSCC, leading to poor prognosis for patients. Downregulated FKBP10 expression can inhibit the proliferation, migration, and invasion ability of OSCC cells, hinder cell cycle progression, and promote apoptosis via the RAP1-PI3K-AKT axis. FKBP10 is a potential therapeutic target and prognostic biomarker for OSCC.

Objective To analyze the use of anticholinergic medications at discharge among elderly patients with chronic heart failure(CHF)and its associated risk factors.Methods Clinical data of 240 elderly CHF patients admitted in our Department of Cardiovascular Diseases between January 1,2020,and December 31,2023 were colloected.Based on ACB score,they were divided into an an-ticholinergic group(ACB score≥1,223 cases)and a non-anticholinergic group(ACB score of 0,17 cases).Using the ACB score,the anticholinergic burden was quantified,and the relationship be-tween anticholinergic burden and various related factors was analyzed using logistic regression.Results The anticholinergic group had significantly younger age[(75.17±7.21)years vs(79.12±8.75)years,P＜0.05],and larger number of discharge medications[8(6,10)vs 5(4,7),P＜0.01]when compared with the non-anticholinergic group.Logistic regression analysis showed that the number of discharge medications was an independent risk factor for increased anticholinergic bur-den in the elderly CHF patients(OR=1.575,95％CI:1.249-1.986,P=0.001).Conclusion The proportion of elderly CHF patients using anticholinergic medications is relatively high.Clinically,special attention should be given to polypharmacy to reduce the incidence of adverse events caused by anticholinergic drugs.

Objective:To investigate the changes in thyroid hormone levels and inflammatory markers in critically ill children，analyze their correlation with disease severity，and explore their potential impact on prognosis,providing references for clinical management and prognosis assessment in critical illness.Methods:A retrospective cohort study was conducted involving 394 pediatric patients admitted to the ICU of the Capital Pediatric Institute Affiliated Children's Hospital from 2019 to 2023.Based on the pediatric critical illness score,patients were divided into three groups:the extremely critical group (score ≤ 70, n=81),the critical group (score 71–80, n=150),and the non-critical group (score>80, n=163).Data collected included thyroid function indicators，inflammatory markers[C-reactive protein（CRP)，procalcitonin(PCT),tumor necrosis factor(TNF)-α，interleukin (IL)，etc.]，clinical information，and outcomes.The correlation between thyroid function indicators and inflammatory markers were analyzed.The predictive value of thyroid function indicators and inflammatory markers for prognosis in critically ill pediatric patients was assessed. Results:Of the 394 children,non-thyroidal disease syndrome occurred in 321 cases,with an overall incidence of 81.5%,which increased with disease severity.Thyroid hormone [total triiodothyronine (TT3),free triiodothyronine (FT3),and total tetraiodothyronine (TT4)] levels were significantly lower in the extremely critical group than in the other groups ( P<0.05).Inflammatory markers such as CRP,PCT,TNF-α,IL-6,IL-8,and IL-10 were significantly higher in the extremely critical group than in the other groups ( P<0.05).Thyroid hormones were negatively correlated with inflammatory markers,and the receivor operating characteristic curves analysis indicated that TT3,FT3,IL-6 and IL-8 levels,could effectively differentiate disease prognosis.Univariate regression model showed significant associations between TT3,FT3,TT4,PCT,IL-8,and IL-10 and disease prognosis.The multivariate Logistic regression model showed IL-6 and IL-8 were independent predictors of disease prognosis. Conclusion:Significant reductions in thyroid hormone levels are closely related to disease severity and poor prognosis.Changes in inflammatory markers reflect the inflammatory state and severity of the disease and impact prognosis.Monitoring thyroid function and inflammatory status is important in clinical management，which provids new insights into prognosis assessment and treatment strategies for critically ill children.

Objective:To summarize and analyze the clinical characteristics of pediatric pulmonary hypertension (PH) and the related factors affecting the prognosis，to provide a basis for the early diagnosis and treatment of the disease.Methods:The clinical data of 80 PH children hospitalized in the intensive care department of Children's Hospital of Capital Pediatric Research Institute from January 1,2019 to December 31,2022 were retrospectively analyzed,and general data,clinical symptoms, echocardiography, laboratory examination and treatment indicators were collected. According to survival death groups, multivariate Logistic regression was applied to analyze independent associated risk factors for PH death.Results:（1）Clinical characteristics of childhood PH: more common in infants, the average age of treatment was 0.9(0.3-5.3)years, the male to female ratio was 1.3∶1, and the average time from first symptoms to first diagnosis was 6.5 (2,14) days. The etiology of PH in children was complex, with arterial PH (PAH) (40%), pulmonary disease and(or) hypoxia (33.8%) being the most common. The main clinical manifestations were dyspnea, decreased activity endurance, poor appetite, and positive heart examination. Severe PH accounted for 53.8%, 30% of pulmonary hypertensive crisis.（2）Factors affecting the prognosis of childhood PH: childhood PH mortality was 20.8%, compared with the survival group, ICU length of stay, loss of appetite, decreased urine volume, cardiac function classification, right heart size, main pulmonary artery diameter/ascending aorta diameter ratio(MPAD/MAD), vasoactive inotropic score(VIS), use of invasive ventilator treatment had statistical significance (all P<0.05). A Logistic regression analysis of death-related factors showed that right heart enlargement ( OR=0.193,95% CI 0.040-0.919, P=0.039), higher MPAD/MAD value ( OR =11.883,95% CI 1.347-104.869, P=0.026), and higher VIS score ( OR= 1.029,95% CI 1.003-1.056, P=0.028) were independent risk factors for poor prognosis. Conclusion:（1）Children PH is mainly infants, the causes of PAH and pulmonary diseases, severe PH accounted for 53.8%, 30% of which have pulmonary hypertensive crisis.（2）An enlarged right heart, higher MPAD/MAD values, and higher VIS score are independent risk factors for death in children with PH.

Objective:To explore the application effect of health education path management model based on cloud platform in the perioperative period of patients with atrial fibrillation (AF), and analyze the feasibility of innovative education forms.Methods:Adopting a non synchronous historical control study design.A total of 291 patients who underwent transcatheter radiofrequency ablation in Fuzhou University Affiliated Provincial Hospital from January to June 2023 were selected by convenience sampling. To avoid contamination of research subjects by grouping them according to admission time, 144 patients admitted from January to March 2023 were used as the control group, and 147 patients admitted from April to June 2023 were used as the intervention group.The control group adopted the traditional health education method, and the intervention group adopted the health education path management mode based on the cloud platform.The postoperative recovery (length of hospital stay, time out of bed, surgical complications), the first postoperative bed urination, the degree of health knowledge related to atrial fibrillation, and the patient satisfaction were compared between the two groups.Results:There were 101 males and 43 females in the control group, was (61.74 ± 10.63) years old, and 103 males and 44 females in the intervention group, was (62.93 ± 8.79) years old.After the intervention, the hospitalization time of the intervention group was (4.25 ± 1.00) days, which was shorter than that of the control group (6.23 ± 1.16) days, and the difference was statistically significant ( t=5.92, P<0.05). The time of getting out of bed after operation in the intervention group was (6.69 ± 0.84) hours, which was earlier than that in the control group (12.69 ± 1.51) hours, and the difference was statistically significant ( t=25.68, P<0.05). There were 134 cases of no complications in the intervention group and 9 cases of subcutaneous hematoma, 2 cases of medical viscose-related skin injury, 1 case of pneumothorax/hemothorax, and 1 case of acute cerebrovascular event occurred, there were 113 cases of no complications in the intervention group, which had 16 cases of subcutaneous hematoma, 2 cases of medical viscose-related skin injury, 11 cases of pneumothorax/hemothorax, and 2 cases of acute cerebrovascular event, the difference was statistically significant ( χ2=12.38, P<0.05). There were 119 cases of spontaneous urination, 17 cases of dysuria and 11 cases of urinary retention in the intervention group, which were lower than 100 cases of spontaneous urination, 13 cases of dysuria and 31 cases of urinary retention in the control group, the difference was statistically significant ( χ2=11.68, P <0.05). Score of the health knowledge score of AF in the intervention group was (21.49 ± 0.16) points, which was higher than the control group's score of (18.30 ± 0.20) points, and the difference was statistically significant ( t=12.50, P<0.05). The satisfaction of intervention group's score was (20.12 ± 1.93) points, which was higher than the control group's score of (15.10 ± 3.13) points, and the difference was statistically significant ( t=16.51, P<0.05). Conclusions:The application of the health education path management model based on cloud platform in the perioperative period of patients with atrial fibrillation is conducive to promoting the rapid recovery of patients after surgery, improving their mastery of disease-related knowledge and satisfaction with health education, and has certain feasibility in clinical nursing health education.