Objective To analyze the core elements of standardized diagnosis of occupational carpal tunnel syndrome (OCTS). Methods Data of first reported OCTS case in Guangdong Province were retrospectively analyzed, including occupational exposure history, clinical manifestations, auxiliary examinations, and on-site occupational health investigation results. Furthermore, standardized diagnostic approaches for such occupational diseases were explored. Results The patient worked in a garment manufacturing enterprise, engaged in fabric cutting. The patient had a occupational history of at least three consecutive years of repetitive right wrist work, holding a 15.2 kg electric cutting tool for a cumulative 6.6 hours per day, with awkward wrist movements repeated 13 times per minute. Clinical symptoms included numbness and reduced muscle strength in the areas of median nerve distribution of the right hand, which were aggravated during work and relieved after rest. Physical examination showed inability of right hand to perform fine motor opposition movements of the thumb with the index, middle, and ring fingers; decreased tactile, pain, vibration, graphesthesia, and kinesthetic sensations below the right wrist; and positive Tinel′s sign over the median nerve at the wrist crease level, Phalen′s test, and reverse Phalen′s test of right wrist. Both wrist high-frequency color Doppler ultrasonography and nerve conduction studies and electromyography indicated damage to the right median nerve. However, only the findings from high-frequency color Doppler ultrasonography of the wrist meet the diagnostic criteria specified in GBZ 336-2025 Diagnostic Standard for Occupational Carpal Tunnel Syndrome. On-site occupational health investigation confirmed that the work involved typical repetitive wrist work, and three co-workers in similar positions exhibited comparable symptoms. The case was ultimately diagnosed as OCTS. Conclusion The definitive diagnosis of OCTS requires comprehensive evaluation of four core elements: a clear occupational exposure history, typical clinical symptoms and signs, characteristic objective examination findings, and quantitative on-site occupational health investigation data. Only when these four elements corroborate each other and non-occupational causative factors are excluded can a definitive diagnosis be made.

Objective: To analyze the characteristics and key risk factors of abnormal blood disposal throughout the 2024-2025 blood collection and supply process based on nationwide multi-site monitoring data, develop a comprehensive prevention and control strategy across the entire chain, reduce preventable blood waste, and ensure clinical blood safety. Methods: According to the Guidelines for Haemovigilance (T/CSBT 001-2026), we extracted 74 cases of abnormal blood disposal events reported by the China Blood Transfusion Association′s Blood Safety Monitoring System from January 1 2024, to December 31 2025, and conducted descriptive statistical analysis on the distribution of events, types of deviations, root causes, and classifications of disposal manifestations. Results: A total of 664 adverse events related to blood collection and supply were reported over two years, with 74 cases involving discarded abnormal blood units, accounting for 11.1% of the total. Among these, blood component preparation (40.5%) and blood collection (37.8%) remained traditional high-risk stages. The proportion of blood waste occurring during storage, distribution, and transportation increased from 7.7% in 2024 to 34.3% in 2025. Deviations from standard operating procedures (SOP) by personnel were the primary cause, accounting for 74.3% of cases. Discarded blood units were categorized into four types: compromised closed blood bag systems (40 cases), mainly due to inadequate heat sealing, physical damage, or dropped bags; blood out of the cold chain (12 cases), primarily resulting from blood being left at work sites; imbalanced proportion of preservation solution (10 cases), mostly caused by blood collection volumes exceeding the standard capacity of blood bags; and other causes (12 cases). Conclusion: Human operational errors are the core cause of abnormal blood waste. The collection and preparation stages have long been at high-risk, and the risks in the storage and transportation stages have been increasing year by year. We should focus on standardizing personnel management, improving specialized operation norms such as heat sealing, transportation, and storage, establishing a full-process intelligent cold chain monitoring and multi-node visual verification mechanism, and systematically reducing the occurrence rate of abnormal blood waste through a closed-loop quality intervention system, thereby improving the utilization efficiency of voluntary blood donation resources.

Serine protease inhibitor Kazal-type (SPINK) is a skin keratinizing protease inhibitor, which was initially found in animal serum and is widely present in plants, animals, bacteria, and viruses, and they act as key regulators of skin keratinizing proteases and are involved in the regulation of keratinocyte proliferation and inflammation, primarily through the inhibition of deregulated tissue kinin-releasing enzymes (KLKs) in skin response. This process plays a crucial role in alleviating various skin problems caused by hyperkeratinization and inflammation, and can greatly improve the overall condition of the skin. Specifically, the different members of the SPINK family, such as SPINK5, SPINK6, SPINK7, and SPINK9, each have unique biological functions and mechanisms of action. The existence of these members demonstrates the diversity and complexity of skin health and disease. First, SPINK5 mutations are closely associated with the development of various skin diseases, such as Netherton’s syndrome and atopic dermatitis, and SPINK5 is able to inhibit the activation of the STAT3 signaling pathway, thereby effectively preventing the metastasis of melanoma cells, which is important in preventing the invasion and migration of malignant tumors. Secondly, SPINK6 is mainly distributed in the epidermis and contains lysine and glutamate residues, which can act as a substrate for epidermal transglutaminase to maintain the normal structure and function of the skin. In addition, SPINK6 can activate the intracellular ERK1/2 and AKT signaling pathways through the activation of epidermal growth factor receptor and protease receptor-2 (EphA2), which can promote the migration of melanoma cells, and SPINK6 further deepens its role in stimulating the migration of malignant tumor cells by inhibiting the activation of STAT3 signaling pathway. This process further deepens its potential impact in stimulating tumor invasive migration. Furthermore, SPINK7 plays a role in the pathology of some inflammatory skin diseases, and is likely to be an important factor contributing to the exacerbation of skin diseases by promoting aberrant proliferation of keratinocytes and local inflammatory responses. Finally, SPINK9 can induce cell migration and promote skin wound healing by activating purinergic receptor 2 (P2R) to induce phosphorylation of epidermal growth factor and further activating the downstream ERK1/2 signaling pathway. In addition, SPINK9 also plays an antimicrobial role, preventing the interference of some pathogenic microorganisms. Taken as a whole, some members of the SPINK family may be potential targets for the treatment of dermatological disorders by regulating multiple biological processes such as keratinization metabolism and immuno-inflammatory processes in the skin. The development of drugs such as small molecule inhibitors and monoclonal antibodies has great potential for the treatment of dermatologic diseases, and future research on SPINK will help to gain a deeper understanding of the physiopathologic processes of the skin. Through its functions and regulatory mechanisms, the formation and maintenance of the skin barrier and the occurrence and development of inflammatory responses can be better understood, which will provide novel ideas and methods for the prevention and treatment of skin diseases.

Objective:To investigate the dynamic changes of plasma high-mobility group box 1 (HMGB1) and its correlation with functional outcome and symptomatic intracranial hemorrhage (sICH) after endovascular treatment (EVT) in patients with acute large vessel occlusion stroke (ALVOS).Methods:Patients with ALVOS admitted to the Department of Neurology, Zengcheng District, Nanfang Hospital, Southern Medical University from June 2021 to April 2023 were included retrospectively. Plasma HMGB1 before EVT and at 6, 24, and 48 hours after procedure was detected, and the dynamic changes of plasma HMGB1 were compared and analyzed. The primary endpoint was the functional outcome evaluated using the modified Rankin Scale at 90 days of onset. A score of 0-2 was defined as good outcome and >2 was defined as poor outcome. The secondary endpoint was sICH, which was defined as the occurrence of hemorrhagic infarction after EVT and an increase of ≥4 in the National Institutes of Health Stroke Scale (NIHSS) score from baseline. Multivariate logistic regression analysis was used to evaluate the predictive value of HMGB1 for poor outcome and sICH. Results:A total of 73 patients with ALVOS received EVT were included. There were 54 males (74.0%), aged 62±12 years. The median time from onset to door was 90 minutes (interquartile range, 40-180 minutes), and the median time from onset to femoral artery puncture was 181 minutes (interquartile range, 140-280 minutes). Twenty-nine patients (39.7%) underwent bridging intravenous thrombolysis (IVT). At 90 days after onset, 37 patients (50.7%) had poor outcome, and 12 (16.4%) died during follow-up. Eleven patients (15.1%) developed sICH. After EVT, plasma HMGB1 showed a temporal increase, reaching its peak at 48 hours (median, 102.57 μg/L). Subgroup analysis showed that HMGB1 in the bridging IVT group at 6 hours ( P<0.05) and 24 hours ( P<0.05) after procedure were significantly higher than that at baseline. The non-bridging IVT group showed a significant increase at 6 hours after procedure ( P<0.05). There was no statistically significant difference in HMGB1 between the bridging IVT group and the non-bridging IVT group at the same time point. Multivariate logistic regression analysis showed that after adjusting for age, ischemic heart disease, triglycerides, uric acid, baseline NIHSS score, and sICH, the third quartile (adjusted odds ratio 7.087, 95% confidence interval 1.243-40.419; P=0.027) and fourth quartile (adjusted odds ratio 7.544, 95% confidence interval 1.260-45.172; P=0.027) of plasma HMGB1 were independent risk factors for poor outcome at 6 hours after procedure. The postoperative plasma HMGB1 in the sICH group was significantly higher than that in the non-sICH group ( P<0.05), but multivariate analysis showed no independent correlation between plasma HMGB1 and sICH. Conclusion:The elevation of plasma HMGB1 in patients with ALVOS at 6 hours after EVT is independently associated with poor outcome at 90 days after onset, but not with sICH.

Objective:To explore the mediating effect of self-rated health status between living space and social frailty of the elderly in community, and to provide reference for intervention strategies.Methods:From December 2023 to March 2024, 550 community elderly in Yandun Community, Yicheng Community and Binhu Community in Baohe District of Hefei City were selected as the research objects by convenient sampling method. The general information questionnaire, self-rated health questionnaire, social frailty index and living space assessment scale were used to investigate a cross-sectional survey. Spearman correlation analysis was used to explore the correlation between self-rated health, living space and social frailty of community elderly. Bootstrap method was used to test the mediating effect.Results:A total of 542 valid questionnaires were collected. Among the 542 elderly residents in the community, aged 65-94 (71.69 ± 6.54) years, there were 267 males and 275 females. Among the 542 community elderly, the self-rated health score, living space score and social frailty index were (2.52 ± 0.95), (73.39 ± 16.77) and 0.0 (0.0, 3.0), respectively. Spearman analysis showed that the total score of living space was negatively correlated with the scores of self-rated health and social frailty ( r=-0.477, -0.538, both P<0.01), and the score of self-rated health was positively correlated with the score of social frailty ( r=0.711, P<0.01).The mediating effect results showed that the living space could play a partial mediating effect on social frailty through the mediating variable of self-rated health (-0.028), accounting for 49.12% of the total effect. Conclusions:The self-rated health status of the elderly in the community has an indirect mediating effect between living space and social frailty. Medical workers should take the improvement of the living space mobility of the elderly as the starting point, and improve their self-rated health level through diversified intervention means, so as to reduce the occurrence of social frailty and promote active aging.

Objective:To explore the effect of horizontal Baduanjin guided by interactive standard reaching theory(ISRT)on cardiac function and quality of life in patients with chronic heart failure(CHF).Methods:This random-ized controlled study enrolled 114 patients diagnosed with CHF in Bozhou People's Hospital between September 2024 and February 2025.Patients were randomly divided into control group(n=57,routine nursing care)and interven-tion group(n=57,horizontal Baduanjin under the guidance of interactive standard theory).Both groups were con-tinuously treated for 3 months.Cardiac function indexes,N-terminal pro-brain natriuretic peptide(NT-proB-NP),self-care ability,quality of life and incidence of major adverse cardiovascular events(MACE)were com-pared between the two groups.Results:Compared to patients in the control group,those in the intervention had significant higher left ventricular ejection fraction(LVEF)[(56.34±0.86)％vs.(46.69±0.91)％],6min walking distance(6MWD)[(477.16±6.62)m vs.(451.39±4.17)m]and the proportion of New York Heart Association(NYHA)class Ⅱ(70.18％vs.35.09％),and significant lower NT-proBNP[(237.76±6.41)pg/ml vs.(377.46±6.85)pg/ml],scores of the European heart failure self-care behavior scale 9(EHFSCB-9)[(12.61±1.81)points vs.(25.51±1.71)points],the physical domain[(3.96±0.91)points vs.(11.05±0.79)points],emotional domain[(4.00±0.85)points vs.(11.95±0.81)points]and other domain[(4.05±0.83)points vs.(13.47±1.15)points]of MLHFQ(P＜0.001 all).Compared to those in the control group,patients in intervention group had significant lower incidence of MACE(7.02％vs.22.81％,P=0.035).Conclusion:Under the guidance of the interactive standard theory,the horizontal Baduanjin exercise may enhance the cardiac function,improve self-care ability and quality of life in patients with chronic heart failure.

Aim To explore the mechanism of the syn-ergistic effect of the ferroptosis inducer erastin com-bined with shikonin in promoting ferroptosis in human hypertrophic scar fibroblasts(HSFBs).Methods Hypertrophic scar tissues provided by the General Hos-pital of Ningxia Medical University were collected,and HSFBs were extracted.HSFBs were identified by HE staining and immunofluorescence.The inhibitory rates of Era and SHK on HSFBs at different concentrations were detected by CCK-8 assay,and the IC50 value was calculated.CompuSyn software was used to calculate the co-use index(CI).Control group,Erastin(Era)group,shikonin(SHK)group and Era+SHK group were set up,and the number and morphological chan-ges of cells were observed after 24 hours of interven-tion.The ability of cell migration and invasion was de-tected by scratch test and Transwell test.The changes of malondialdehyde(MDA),total iron ion and reactive oxygen species(ROS)were detected by corresponding biochemical kits.The expressions of collagen I,α-SMA and GOT1,SLC7A11,GPX4 and FTH1 were detected by Western blot.Results The IC50 value of Era and SHK of primary HSFBs was 2.22 μmol·L-1 and 3.94μmol·L-1 respectively,which was used as the single drug concentration for subsequent experiments.The CompuSyn software was employed to calculate the CI value when the two drugs were used in combination,and the concentrations corresponding to CI=0.39597(Era:1.2 μmol·L-1+SHK:1.5 μmol·L-1)were selected as subsequent combination concentrations(Because when CI was equal to 0.395 97,the concen-tration of each drug was lower than the concentration of single drug,and the inhibition rate of combined drug was greater than 50％).Compared with the monother-apy group,the number of HSFBs in the SHK+Era group was significantly reduced,cell membrane showed breakage and vesiculation,cell wrinkling became smal-ler,and cytoplasm was concentrated.The migration and invasion ability of HSFBs in the SHK+Era group were obviously weakened(P＜0.05),and the expres-sion of fibrosis-related proteins collagen Ⅰ and α-SMA was reduced(P＜0.05);the contents of MDA,total i-ron ions,and ROS in HSFBs of the SHK+Era group increased(P＜0.05),and the protein expression lev-els of SLC7A11,GOT1,GPX4,and FTH1 further de-creased(P＜0.05).Conclusions Erastin in combi-nation with shikonin can synergistically inhibit the pro-liferation,migration and fibrosis levels of HSFBs.The mechanism may be that erastin enhances the inhibition of shikotin on GOT1,increases the levels of cellular i-ron ions,ROS,and lipid peroxides,thereby promoting ferroptosis in HSFBs.

Objective:To evaluate the clinical outcomes of applying an enhanced workflow in robotic-assisted total hip revision arthroplasty.Methods:A retrospective study was conducted to analyze the 25 consecutive patients who had undergone robotic-assisted total hip revision arthroplasty in which an enhanced workflow was applied at Department of Orthopaedic Surgery, Beijing Jishuitan Hospital from September 2021 to October 2024. The cohort consisted of 8 males and 17 females with an age of (64.0±12.8) years. The left side was affected in 18 cases and the right side in 7 cases. The time from initial total hip arthroplasty to revision was (159.6±86.7) months. In all patients, no significant difference was found in the preoperative femoral cortical thickness between the healthy and the affected sides. The enhanced workflow included preoperative CT modeling and planning, intraoperative registration, prosthetic removal and reconstruction, and verification of prosthesis position. A total of 18 patients underwent total hip revision involving both the acetabular and the femoral sides; 6 patients underwent simple acetabular reconstruction with retention of the original femoral stem and replacement of the femoral head; 1 patient underwent femoral revision with retention of the acetabular cup and replacement of the acetabular liner. The operative time, intraoperative blood loss, modified Harris Hip Score (mHHS) and visual analogue scale (VAS) for hip pain at the final follow-up, and follow-up complications were recorded.Results:All patients successfully completed robotic registration during surgery, with no case of intraoperative robotic termination. For the 25 patients, the operative time was (152.2±43.8) minutes, the intraoperative blood loss 600 (400, 1,000) mL, and the follow-up time 12.0 (6.0, 31.5) months. At the final follow-up, their mHHS improved from 66.0 (26.4, 75.6) points preoperatively to 93.5 (80.3, 98.9) points, and their VAS pain score decreased from 5.0 (3.0, 7.0) points preoperatively to 0.0 (0.0, 2.0) point ( P<0.05). Follow-ups revealed no case of reoperation, prosthetic loosening, joint dislocation, periprosthetic infection, or periprosthetic fracture. Conclusion:The enhanced workflow can achieve satisfactory outcomes in robotic-assisted total hip revision for patients with adequate proximal femoral bone stock.

Objective To explore the expression of leukemia inhibitory factor receptor(LIFR)in patients with non-ST-segment elevation myocardial infarction(NSTEMI)and its possible associa-tion with myocardial remodeling.Methods A total of 188 patients with acute myocardial infarc-tion who underwent coronary angiography in our hospital from January 2023 to November 2024 were prospectively enrolled and divided into a control group(94 cases)and an NSTEMI group(94 cases)according to being diagnosed with NSTEMI or not.General clinical data of the patients were collected,and the correlation between serum LIFR level and other indicators was analyzed using linear regression analysis.Results Compared with the control group,the NSTEMI group had significantly higher ratios of smoking history,elevated levels of LIFR,NT-proBNP,cTnⅠ,Cr and UA,increased WBC count,but lower LVEF value[48.94％vs 13.83％,P＜0.01;5.82(4.23,8.11)mmol/L vs 0.97(0.60,1.41)mmol/L,P＜0.01;2.53(1.24,9.71)pg/L vs 0.03(0.02,0.04),P＜0.01;18.57(4.11,250.00)ng/L vs 0.00(0.00,0.00)ng/L,P＜0.01;82.50(68.00,121.25)μmol/L vs 68.50(53.00,88.25)μmol/L,P＜0.01;411.00(349.00,521.25)μmol/L vs 337.00(286.75,406.00)μmol/L,P＜0.01;10.21(8.71,13.09)× 109/L vs 6.22(4.67,7.46)× 109/L,P＜0.01;47.00(38.00,54.00)％vs 59.00(56.00,60.00)％,P＜0.01].Serum LIFR level in the patients was posi-tively correlated with NT-proBNP,cTnⅠ,Cr and WBC count(β=1.403,95％CI:10 597.867-17 327.087,P=0.000;β=0.232,95％CI:114.558-1769.808,P=0.026;β=0.336,95％CI:0.164-0.617,P=0.001).Conclusion LIFR may be involved in the development of myocardial remode-ling and heart failure after myocardial infarction through its role in inflammation.

Fibrinogen-like protein 1(FGL1)is a novel hepatic factor and a member of the fibrinogen family.FGL1 has diverse and complex functions and is involved in the regulation of multiple biological processes.FGL1 has an important role in the study of metabolic diseases,but further studies are needed to reveal its underlying mechanisms and the feasibility of clinical applications.This review is to summarize the role of FGL1 in the development and progression of DM,obesity,metabolic associated fatty liver disease and polycystic ovarian syndrome.