Background Work-related musculoskeletal disorders (WMSDs) are a major occupational health concern, particularly among workers exposed to adverse ergonomic conditions. Manganese production involves heavy physical demands, yet research on WMSDs among manganese workers remains limited. Objective To investigate the prevalence and influencing factors of WMSDs among manganese workers in a manganese enterprise in Guangxi. Methods A cross-sectional survey was conducted from May to June 2024 on workers at a manganese factory in Guangxi. The Chinese Musculoskeletal Disorders Questionnaire was used to collect information on demographic characteristics, distribution of musculoskeletal symptoms, and work-related exposures. χ² test was applied to compare differences in positive WMSDs rates across groups, and logistic regression analysis was performed to identify associated factors. Results A total of 1476 workers were enrolled in the study after pre-determined inclusion and exclusion criteria. The overall prevalence of WMSDs was 34.15%. The most commonly affected body regions were the lower back (17.28%), neck (16.67%), and shoulders (13.82%). The results of logistic regression analysis indicated that female, older age, and education level of college or above were associated with a higher risk of WMSDs (P<0.05). Awkward working postures were significantly associated with WMSDs in corresponding body regions; in particular, awkward postures of the neck, upper limbs, trunk, and lower limbs were related to an increased risk of WMSDs in multiple body sites (P<0.05). In addition, poor lighting conditions, high workplace temperature, frequent or sustained arm support during work, and high job demands were associated with an increased risk of overall or site-specific WMSDs (P<0.05). Conclusion The high prevalence of WMSDs among manganese workers is closely associated with demographic characteristics, working postures, and work environment and organizational factors. Targeted ergonomic interventions focusing on high-risk body regions and key ergonomic exposures are warranted to reduce the risk of WMSDs among manganese workers.

Background Long-term occupational health surveillance facilitates the identification of chronic health risks arising from occupational hazard exposures. However, under low-level exposure conditions in chemical enterprises, traditional workplace-centered risk assessment models are insufficient to fully explain the observed health effects among workers, highlighting the need for individual-focused health management strategies that focus on the worker. Objective To characterize long-term health trends among workers in a chemical enterprise and examine the limitations of workplace hazard monitoring and health surveillance under low-level multiple exposure scenarios, thereby providing a scientific basis for more comprehensive worker health protection measures. Methods We analyzed 972 occupational health examination records collected over a 15-year period (2010–2024) from a chemical enterprise, integrating these with enterprise hazard monitoring reports and workshop air monitoring of volatile organic compounds (VOCs). The annual counts and prevalences of abnormalities in liver function tests, metabolic syndrome-related indicators, and liver imaging were summarized. Temporal trends were evaluated using the Cochran-Armitage trend test. Time-related changes in abnormal health indicators among active workers were evaluated by generalized linear mixed-effects models (GLMMs), adjusting for age and sex. Individual longitudinal profiles were described for nine workers with continuous 15-year records. In addition, paired comparisons of health outcomes were conducted for 81 workers with both pre-employment and periodic examinations. Results Workplace hazard monitoring indicated that airborne concentrations of major occupational contaminants including VOCs, acids and bases, dust, and physical factors were below national occupational exposure limits. However, 62 VOC species—including chlorobenzene, chloromethane, and cyclohexane—were detected in workshop air, suggesting complex mixed organic solvent exposure. From 2010 to 2015, occupational health examination records were primarily based on physicians’ qualitative assessment, yielding generally low abnormality detection rates. During 2016–2024, data collection was complete, and the prevalences of abnormalities in liver function, metabolic syndrome-related indicators, and liver imaging among active workers remained relatively high. Trend analysis indicated that only the abnormality rates of total bilirubin (TBIL) and hypertension showed statistically significant temporal trends; other indicators exhibited no significant linear changes despite high prevalences. After adjusting for age and sex, the GLMMs showed that the abnormality rates of aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), TBIL, and hypertension decreased over time, whereas those of total cholesterol, triglycerides, and fatty liver increased. In a subgroup of 9 workers with continuous 15-year follow-up data, the cumulative number of abnormal health indicators increased in several individuals after 2016. Among the 81 workers with both pre-employment and periodic records, abnormalities in total cholesterol, triglycerides, body mass index, and fatty liver were significantly more prevalent after employment over time, whereas changes in liver function enzymes were not statistically significant. Conclusion With increasing age, workers exhibit a gradual deterioration in liver function and metabolic-related health indicators, reaching abnormality rates comparable to those reported in the general population. These findings suggest that both workplace-related and non-occupational factors jointly contribute to the observed health changes. Consequently, occupational health management should shift towards an "individual-centered" approach. Enhancing workers' health literacy, strengthening workplace health promotion, and extending occupational health services beyond the workplace are essential to comprehensively protect workers' health.

Objective: To explore the longitudinal associations between dietary macronutrients and lung function in schoolaged children, so as to provide the nutritional research evidence for promoting children s lung health. Methods: In November 2021, two primary schools located in Chengdu, Sichuan Province were selected from the Southwest China Childhood Nutrition and Growth (SCCNG) cohort by a stratified cluster random sampling method, enrolling a total of 1 112 school aged children aged 8 to 13 years. At baseline, the dietary and sociodemographic characteristics of the children were assessed. One year later, the forced vital capacity (FVC) of the children was measured and converted into Z scores (FVC- Z ), while the vital capacity index (VCI) was also calculated. Generalized linear regression analysis was employed to examine the associations between dietary macronutrients and lung function, considering interactions with gender and age, followed by stratified analysis. Results: After adjusting for confounding factors, the analysis results of the generalized linear regression model showed that the carbohydrate energy ratio was negatively correlated with FVC- Z ( β =-0.02) and VCI ( β =-0.16), while the fat energy ratio showed a positive correlation with FVC- Z ( β =0.03) and VCI ( β =0.23) ( P <0.05). The protein energy ratio was positively correlated with FVC- Z ( β =0.09) and VCI ( β =0.60) specifically in girls ( P <0.05). Additionally, there was an interaction effect of age on the associations between macronutrients and lung function ( P <0.01); in children aged 8-9 and 10-11, the carbohydrate energy supply ratio was negatively correlated with FVC- Z ( β =-0.04, -0.03) and VCI ( β =-0.29, -0.21), and fat energy supply ratio was positively correlated with FVC- Z ( β =0.07, 0.05) and VCI ( β =0.46, 0.32) ( P <0.05). Conclusions There are age and sex differences in the association of dietary macronutrients with lung function, with a low carbohydrate, high fat diet promoting lung function in children. Additionally, protein intake appears to have a positive influence on the lung function of girls. The early school age period may represent a critical window for dietary interventions aimed at promoting lung health.

To screen new antigens for novel tuberculosis(TB)vaccine research,we used bioinformatics to predict the B and T cell epitopes of Rv2318,and evaluated the immunogenicity of Rv2318 and its T/B epitope peptides(Rv2318p).The recombinant plas-mids pET32a-Rv2318 and pET32a-Rv2318p were constructed through gene synthesis methods.The recombinant proteins were ex-pressed in a prokaryotic system and purified with nickel affinity chromatography.Proteins were identified with SDS-PAGE and western blotting.BALB/c mice were immunized subcutaneously with the recombinant proteins to evaluate immunogenicity.Sera were collected,and antigen specific antibody titers were evaluated with ELISA.Splenocytes were isolated,and cytokines and T cell proliferation were analyzed with ELISA and flow cytometry,respectively.Rv2318 included two epitope fragments,aa10-130 and 350-410.SDS-PAGE and western blotting indicated that the target proteins were expressed and purified correctly,and their relative molecular weights were-approximately 68 kD and 42 kD,respectively.Rv2318 and Rv2318p induced stronger humoral immune responses than observed in the control groups(P<0.000 1,n=6).Compared with Rv2318,Rv2318p showed significantly greater enhancement of specific IgG and IgG subclass antibodies(P<0.000 1,n=6).In addition,Rv2318p increased the ratio of IgG2a/IgG1,thus indicating that it primarily induced a cellular immune response biased toward the Th1 type.Cytokine experiments revealed that IFN-γ,IL-2,IL-6,and IL-4 significantly increased after immunization with Rv2318p(P all<0.01,n=6),particularly Th1 type cytokines(IFN-γ and IL-2).Furthermore,Rv2318 increased the expression of only IL-2 and IL-6,particularly IL-6(P all<0.01,n=6).Although Rv2318 in-duced more IFN-γ,we observed no significant difference between Rv2318 and PBS immunized mice.Importantly,Rv2318p stimu-lated mice to express IFN-γ at 842 pg/mL,approximately 3 times the level elicited by Rv2318.Whereas both proteins increased the proportions of CD4+and CD8+T cells,Rv2318p promoted greater proliferation of T lymphocytes.These data indicated that both Rv2318 and its epitope peptides enhanced humoral and cellular immune responses,whereas the epitope peptides notably triggered a stronger Th1 type cellular response.In conclusion,the recombinant protein Rv2318 and its epitope peptides showed favorable immunogenicity,and the immunogenicity of Rv2318p was superior to that of Rv2318.This study provides a theoretical basis for TB vaccine development.

Peer support can improve negative emotions, cognitive level, self-coping, and quality of life in adolescents and young adults with cancer. The rise of digital health technology has facilitated the rapid development of online medical interventions, providing an opportunity for the development of online peer support. This study reviewed the intervention modalities, application forms, application effects and should prospects of online peer support applied in adolescent and young adult cancer patients, to provide a reference for improving healthcare professionals to conduct high-quality online peer support interventions.

Objective:To systematically evaluate the qualitative study of perinatal bereavement care by obstetric nurses and midwives, and explore the barriers to perinatal bereavement care, so as to promote the development of domestic perinatal bereavement care services.Methods:Systematic search of qualitative studies on the experience of obstetric nurses and midwives in caring for perinatal bereaved mothers in PubMed, Web of Science, Embase, Cochrane Library, PsycINFO, CINAHL, China Biomedical Literature Service System, CNKI, Wanfang Database, and VIP database were searched from the establishment until June 30, 2024. The qualitative research quality evaluation was conducted using the 2016 version of the qualitative research quality assessment tool of the Joanna Briggs Institute Evidence-Based Health Care Centre in Australia, and the results of the study were summarized and integrated using the pooled integration method.Results:A total of 14 studies were included, with 3 Chinese literatures and 11 English literatures. A total of 55 themes were extracted, which were summarized and combined into 8 new categories, and 3 integrated results were summarized: insufficient bereavement care ability, insufficient bereavement care confidence, and imperfect allocation of bereavement care resources.Conclusions:The knowledge popularization and training of bereavement care should be strengthened, the organizational support should be strengthened, the confidence of obstetric nurses and midwives in bereavement care should be enhanced, a special perinatal bereavement care team should be set up, and multidisciplinary resources should be integrated to ensure the continuity and coordination of perinatal bereavement care.

Objective:To analyze the current status, hotspots, and trends of community integration (CI) at home and abroad, providing directions for subsequent research.Methods:The China National Knowledge Infrastructure and the Web of Science Core Collection data were used, and CiteSpace software was employed to analyze the publication, countries, disciplines, and keywords of CI.Results:A total of 932 Chinese and 2 319 English hits were included. The publication of CI had shown an increasing trend both domestically and internationally. Sociology and rehabilitation were the main disciplines in CI domestically and internationally, respectively. Domestically, CI research primarily focused on the community integration of migrant workers, floating populations, and accompanying family members. Internationally, the emphasis was on the integration of individuals with disabilities and other special groups. Future research directions in China were likely to focus on group work, the elderly, and relocated populations. Internationally, CI research would continue to concentrate on CI experiences and intervention methods for individuals with disabilities and special populations.Conclusion:CI is increasingly gaining attention both domestically and internationally. However, domestic research remains insufficient and needs to be expanded through more empirical studies in various vertical subfields. Future domestic scholars should continue to focus on CI of the elderly and engage in interdisciplinary research.

OBJECTIVE To deeply explore the in vivo pharmacodynamic substance basis of Zhigancao Decoction,a classic tradi-tional Chinese medicine formula,and provide scientific evidence for its rational application and development in modern clinical practice.METHODS Wistar rats were treated with 12.15 g·kg-1 Zhigancao Decoction by gavage.Rat plasma samples were collect-ed at 10 time points(5,15,30,60,120,240,360,480,600 and 720 min after administration)and rat heart(atrial and ventricu-lar)tissue samples were collected at 12 h after administration.Components in the plasma and heart samples were qualitatively identi-fied by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF/MS),and the distri-bution characteristics of Zhigancao Decoction in vivo were analyzed.At the same time,the time-concentration curve of the prototype components and metabolites in Zhigancao Decoction was drawn to observe the changes of blood drug concentration.RESULTS A total of 11 prototype components(Ajugol,Nicotiflorin,Isoschaftoside,4-Hydroxycinnamic acid,Rehmapicrogenin,4-Hydroxybenzoic acid,4′,7-Dihydroxyflavone,Calycosin,3′,4′,7-Trihydroxyflavone,Pinellic acid,Truxillic acid)and 7 metabolites were identified from the plasma samples of Zhigancao Decoction,mainly including flavonoids(flavonoids glycosides),organic acids,and iridoid glyco-sides,etc.Additionally,6 prototype components(Ajugol,Isoschaftoside,Rehmapicrogenin,4′,7-Dihydroxyflavone,Liquiritigenin,3′,4′,7-Trihydroxyflavone)and 3 metabolites were identified from the cardiac samples(the atrium and the ventricle showed the same results).The metabolic pathways mainly involved Phase Ⅰ metabolism and glucuronidation.CONCLUSION The prototype compo-nents and metabolites in plasma and heart tissue of Zhigancao Decoction is preliminarily determined,providing a reference for analyzing the active components of Zhigancao Decoction in heart tissue.

Objective:To evaluate the clinical utility of machine learning model based radiomics in predicting high-risk molecular subtypes of lower-grade gliomas(LrGGs).Methods:This was a cross-sectional study. A total of 287 patients diagnosed with LrGGs in the First Hospital of Shanxi Medical University, Shanxi Provincial People′s Hospital, and the Third Hospital of Shanxi Medical University from January 2011 to September 2023 were retrospectively collected, including 166 males and 121 females; 114 cases of high-risk molecular subtypes and 173 cases of non-high-risk molecular subtypes. All patients were divided into 201 cases in the training set and 86 cases in the test set according to 7∶3 in simple randomized grouping method. All patients underwent contrast-enhanced T 1WI (CE-T 1WI) and T 2-weighted fluid-attenuated inversion recovery sequence imaging (T 2-FLAIR), and the imaging features of high-risk and non-high-risk molecular subtypes were analyzed. Analysis of variance, recursive feature elimination, and Kruskal-Wallis were used for radiomics feature screening, and a support vector machine (SVM) classifier was used to construct a radiomics-based classifier model. Univariate and multivariate logistic regression were used to analyze clinical variables independently influencing high-risk molecular subtypes of LrGGs to construct a clinical model; a combined model was developed by integrating radiomics labels and clinical variables. Receiver operating characteristic curve and area under the curve (AUC), calibration curve, and decision curve were used to compare the predictive performance of different models. Results:The patient′s age ( OR=1.042, 95% CI 1.018-1.068, P=0.001), pathological grade ( OR=2.270, 95% CI 1.212-4.311, P=0.011), MGMT methylation status ( OR=0.456, 95% CI 0.238-0.866, P=0.017), and ependymal involvement ( OR=7.335, 95% CI 2.929-18.370, P<0.001) were independent influencing factors for the high-risk molecular subtype of LrGGs, and a clinical model was developed based on these factors. An SVM model was constructed based on 12 radiomics features (3 radiomics features based on CE-T 1WI and 9 radiomics features based on T 2-FLAIR). The radiomics score of the probability output by the SVM model was combined with age, pathological grade, MGMT methylation status, and ependymal involvement to develop a combined model. The AUC values of the SVM model for predicting the high-risk molecular subtype of LrGGs were 0.824 and 0.859 in the training set and test set, respectively; the AUC values of the clinical model in the training set and test set were 0.759 and 0.721, respectively; and the AUC values of the combined model in the training set and test set were 0.823 and 0.815, respectively. The combined model had a high clinical net benefit. Conclusion:The machine learning MRI radiomics model can preoperatively predict high risk molecular subtypes of LGGrs, assist in individualized treatment decisions.

Objective:To explore the clinical efficiency of cognitive behavioral training combined with methylphenidate hydrochloride sustained-release tablets on children with attention-deficit hyperactivity disorder (ADHD).Methods:118 children with ADHD in Northwest Women' s and Children' s Hospital were selected from June 2022 to July 2023. Based on the principle of baseline feature matching between groups, they were randomly divided into MPH group and combined group by coin tossing method, with 59 cases in each group. Children in the MPH group were treated with MPH sustained-release tablets orally (The initial dose was 18mg each time, whole tablet was swallowed in the morning, dose adjustment was increased by 18 mg each time, once a week, and maximum dose was not more than 54 mg), while the children in the combined group were combined with cognitive behavior training on the basis of the treatment in the MPH group. Children in both groups were continuously treated for 3 months. The clinical efficacy, scores of dimensions of Swanson Nolan and Pelham, rating scale-version IV (SNAP-IV) parent edition, scores of Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), scores of Wisconsin Card Sorting Test (WCST) and serological indicators [dopamine, 25 (OH)D 3, cortisol, brain-derived neurotrophic factor (BDNF)] before and after treatment and incidence of adverse reactions were compared between groups. Results:After 3 months of treatment, the combined group [93.2%(55/59)] had higher total effective rate than the MPH group [79.7% (47/59)] ( χ2=4.63, P=0.031). The scores of three dimensions, including attention deficit, hyperactivity-impulsion and oppositional defiance in both groups were lower than those before treatment, and the scores in combined group were lower than those in MPH group, the differences were statistically significant [(1.27±0.19) points vs (1.65±0.23) points, (1.35±0.25) points vs (1.78±0.27) points, (1.55±0.13) points vs (1.86±0.22) points, t=9.78, 8.98, 9.32,respectively, all P<0.001]. The control quotient score and attention quotient score were higher than those before treatment, and the scores in combined group were higher than those in MPH group, the differences were statistically significant [(99±6) points vs (91±3) points, (98±5) points vs. (92±3) points, t=8.47, 7.46,respectively, all P<0.001]. The total response count, completed categories count and correct response count were all higher than those before treatment, and the scores were higher in combination group than those in MPH group, the differences were statistically significant [(116±16) points vs(105±14) points, (4.57±0.35) points vs (4.15±0.25) points, (83±12) points vs (72±10) points, t=4.07, 7.50, 5.48, respectively, all P<0.001). Perspective response count was lower than that before treatment, and the score in combined group was lower than that in MPH group, the difference was statistically significant [(15.6±1.8) points vs (18.2±2.0) points, t=7.35, P<0.001]. Serum levels of dopamine, 25(OH)D 3 and BDNF were higher than those before treatment, and the levels in combined group were all higher than those in MPH group, the differences were statistically significant [(16.2±2.8) pmol/L vs (13.8±2.4) pmol/L, (78±10) nmol/L vs. (70±9) nmol/L, (1 060±135) pmol/L vs (986±126) pmol/L, t=5.00, 4.59, 3.08, respectively, all P<0.05]. Serum cortisol level was lower than that before treatment, and the level in combined group was lower than that in MPH group, the difference was statistically significant [(255±27) nmol/L vs (271±28) nmol/L, t=3.16, P=0.002]. There was no statistical significance difference in the incidence rate of adverse reactions between combined group and MPH group during treatment [6.8% (4/59) vs 5.1% (3/59)] ( χ2=0.00, P=1.000). Conclusion:Cognitive behavioral training combined with MPH sustained-release tablets in the treatment of children with ADHD can significantly enhance the efficacy, improve the ADHD symptoms and cognitive function, and increase the levels of serum dopamine and 25 (OH)D 3, and have good safety.