Objective To investigate the prevalence and influencing factors of work-related musculoskeletal disorders (WMSDs) among bus drivers. Methods A total of 962 drivers from a bus company in Shenzhen City were selected as the research subjects using the judgment sampling method. The Musculoskeletal Disorders Questionnaire for Bus Drivers was used to investigate the prevalence of WMSDs among the research subjects. Results The prevalence of WMSDs was 37.8% in the bus drivers. The prevalence of WMSDs was higher in the low back/waist, neck, and shoulder compared with other body parts, with prevalence of 24.0%, 20.2%, and 14.8%, respectively. The prevalence of single-site and multi-site WMSDs was 18.5% and 19.3%, respectively. The results of the multivariable logistic regression analysis showed that longer job tenure and higher alcohol consumption frequency were associated with higher WMSDs risks (all P<0.01). Weekly work time >48 hours, insufficient rest, work-related fatigue, uncomfortable auxiliary lenses, non-upright trunk posture, prolonged static trunk posture, prolonged wrist flexion, and habitual staying up late were risk factors of WMSDs in the bus drivers (all P<0.05). Conclusion The prevention and treatment of WMSDs among the bus drivers cannot be ignored. Personal characteristics, work organization, work environment, working posture and sleeping habits are the factors that influence the development of WMSDs.

Objective To compare the effect of cold therapy at different temperature on the pain and motor function of delayed onset muscle soreness(DOMS)in the upper limbs of young men.Methods From April to July,2024,24 healthy young men(aged 22 to 26 years)were selected from the Key Laboratory of Winter Sports Technical Diagnosis and Skill Evaluation of the General Administration of Sport of China at Shenyang Sport University,and randomly divided into control group,group A and group B equally.An isokinetic muscle strength testing system was used to establish a DOMS movement model for elbow joint.Then,group A re-ceived cold therapy at a constant temperature of 10℃for 10 minutes,group B received cold therapy at a con-stant temperature of 6℃for 10 minutes,and the control group received natural recovery.They were measured relative peak torque(rPT)of the elbow flexor muscles at angular velocities of 60°/s,120°/s and 180°/s with iso-kinetic muscle strength testing system,and root mean square(RMS)of EMG amplitude of biceps brachii was synchronously collected using a wireless surface EMG system,immediately,and 24,48 and 72 hours after model establishment;while,they were assessed with Visual Analogue Scale(VAS)for pain.Results The main effects of VAS score,rPT and RMS were significant in both intra-group(F>15.716,P<0.001)and inter-group(F>6.478,P<0.01).At 24,48 and 72 hours after model establishment,the VAS scores showed a trend of control group>group A>group B(P<0.05).Although the pairwise comparison results of rPT and RMS among the groups varied at different time points after model establishment under different angular veloci-ties,overall,rPT presented a trend of control groupgroup A>group B(P<0.05).The higher the angular velocity and the longer the time,the more obvious this trend was.Conclusions Cold therapy can relieve the pain of DOMS in the upper limbs of young men and promote the recovery of muscle strength,especially at a constant temperature of 6℃.

Objective:To examine the near-complete genomic analysis of norovirus (NoV) subtype GⅡ.17 [P17] outbreaks in Beijing Chaoyang District from 2014 to 2024.Methods:Data and specimens related to outbreaks of the NoV aggregation in Beijing′s Chaoyang District from 2014 to 2024 were collected. The NoV was identified using real-time fluorescence reverse transcription polymerase chain reaction (RT-PCR). Specimens with positive nucleic acid were amplified by standard PCR, whole genome sequencing and evolutionary analysis. Amino acid site variations were compared.Results:In Chaoyang District, from 2014 to 2024, a total of 637 aggregated outbreaks caused by the NoV infection were reported, of which 584 were successfully typed. The epidemic caused by the GⅡ.17 [P17] subtype accounted for 8.79% (56/637), which was the dominant epidemic gene subtype in 2014-2015, sporadic in 2016-2019, reappeared in 2022, and significantly increased in 2024 (27.27%, 24/88). Outbreaks caused by the GⅡ.17 [P17] subtype occurred mainly from October to December, with the main sites of occurrence in primary schools and kindergartens. This study yielded 53 near-complete genome sequences of the GⅡ.17 [P17] subtype from 46 incidents in Chaoyang District. The GⅡ.17 [P17] subtype sequences of Chaoyang District from 2014 to 2024 were segmented into three subgroups on the evolutionary tree, with sequences from 2014 to 2019, 2022 to April 2024, and May to December 2024 clustered into the d, e, and b subgroups, respectively. In the VP1 region′s P2 area, particularly at the HBGA binding site, subgroups b and e exhibited mutations in 22 and two sites, while subgroups b and e showed mutations in four and one sites, predominantly in the RdRp region.Conclusion:The outbreak caused by the NoV GⅡ.17 [P17] subtype in Chaoyang District from 2014 to 2024 continues, with a significant increase in 2024, and it becomes the dominant gene subtype from October to December. The sequence formation of the NoV GⅡ.17 [P17] subtype in Chaoyang District from January to April 2022 and from May to December 2024 shows two different evolutions, with specific mutation sites, requiring continuous monitoring of the NoV GⅡ.17 [P17] subtype.

Objective To investigate the effects of Remimazolam combined with Esketamine on cellular immunity,cognitive function,and sleep quality in elderly patients with lung cancer during surgery.Methods A total of 106 elderly lung cancer patients who underwent elective thoracoscopic lobectomy from September 2023 to March 2025 were selected and divided into the control group(n=53)and the research group(n=53)according to random number table method.The control group received Midazolam combined with Esketamine for general anesthesia,while the research group received Remimazolam combined with Esketamine for general anesthesia.The intraoperative and postoperative conditions,hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP)]before anesthesia induction(T0),at tracheal intubation(T1),at 1 min before one-lung ventilation(OLV)(T2),at skin incision(T3),at 1 h after OLV(T4),and immediately after extubation(T5),as well as pain and inflammatory factors[5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],cellular immunity[peripheral blood natural killer(NK)cells,CD3+,CD4+,CD4+/CD8+],the levels of serum interleukin(IL)-2,interferon-γ(IFN-γ),cognitive function[Mini-Mental State Examination(MMSE)],sleep quality[Pittsburgh Sleep Quality Index(PSQI)],and recovery quality[Postoperative Quality of Recovery-15(QoR-15)score]were compared between the two groups of patients.The adverse reactions and complications were also compared between the two groups.Results There was no significant difference in duration of surgery,duration of anesthesia,intraoperative blood loss,and time to spontaneous breathing recovery of patients between the two groups(P>0.05).The total dosage of Sufentanil in the research group was less than that in the control group,and time to postoperative eye opening,duration of recovery room stay and length of postoperative hospitalization were shorter than those in the control group(P<0.05).At T0 and T5,there was no significant difference in HR and MAP between the two groups(P>0.05),and at T1-T4,HR and MAP in the research group were higher than those in the control group(P<0.05).At the time of recovery,the levels of serum 5-HT,PGE2,hs-CRP,and TNF-α in the research group were lower than those in the control group(P<0.05),and at the time of recovery,the peripheral blood NK cells,CD3+,CD4+,and CD4+/CD8+ratio,serum IL-2 and IFN-γ levels in the research group were higher than those in the control group(P<0.05).At 1 d after surgery,the MMSE and QoR-15 scores of the research group were higher than those of the control group,while the PSQI score was lower than that of the control group(P<0.05).The incidence of adverse reactions and complications in the research group[5.66%(3/53)and 3.77%(2/53)],was lower than that of the control group[18.87%(10/53)and 15.09%(8/53)](P<0.05).Conclusion The combination of Remimazolam and Esketamine in elderly patients undergoing thoracoscopic lobectomy can better maintain intraoperative hemodynamics,stabilize cellular immune function,reduce serum pain and inflammatory factor levels,improve postoperative cognitive function and sleep quality,reduce adverse reactions and complications,and promote postoperative recovery.

Objective:To examine the near-complete genomic analysis of norovirus (NoV) subtype GⅡ.17 [P17] outbreaks in Beijing Chaoyang District from 2014 to 2024.Methods:Data and specimens related to outbreaks of the NoV aggregation in Beijing′s Chaoyang District from 2014 to 2024 were collected. The NoV was identified using real-time fluorescence reverse transcription polymerase chain reaction (RT-PCR). Specimens with positive nucleic acid were amplified by standard PCR, whole genome sequencing and evolutionary analysis. Amino acid site variations were compared.Results:In Chaoyang District, from 2014 to 2024, a total of 637 aggregated outbreaks caused by the NoV infection were reported, of which 584 were successfully typed. The epidemic caused by the GⅡ.17 [P17] subtype accounted for 8.79% (56/637), which was the dominant epidemic gene subtype in 2014-2015, sporadic in 2016-2019, reappeared in 2022, and significantly increased in 2024 (27.27%, 24/88). Outbreaks caused by the GⅡ.17 [P17] subtype occurred mainly from October to December, with the main sites of occurrence in primary schools and kindergartens. This study yielded 53 near-complete genome sequences of the GⅡ.17 [P17] subtype from 46 incidents in Chaoyang District. The GⅡ.17 [P17] subtype sequences of Chaoyang District from 2014 to 2024 were segmented into three subgroups on the evolutionary tree, with sequences from 2014 to 2019, 2022 to April 2024, and May to December 2024 clustered into the d, e, and b subgroups, respectively. In the VP1 region′s P2 area, particularly at the HBGA binding site, subgroups b and e exhibited mutations in 22 and two sites, while subgroups b and e showed mutations in four and one sites, predominantly in the RdRp region.Conclusion:The outbreak caused by the NoV GⅡ.17 [P17] subtype in Chaoyang District from 2014 to 2024 continues, with a significant increase in 2024, and it becomes the dominant gene subtype from October to December. The sequence formation of the NoV GⅡ.17 [P17] subtype in Chaoyang District from January to April 2022 and from May to December 2024 shows two different evolutions, with specific mutation sites, requiring continuous monitoring of the NoV GⅡ.17 [P17] subtype.

Objective To investigate the effects of Remimazolam combined with Esketamine on cellular immunity,cognitive function,and sleep quality in elderly patients with lung cancer during surgery.Methods A total of 106 elderly lung cancer patients who underwent elective thoracoscopic lobectomy from September 2023 to March 2025 were selected and divided into the control group(n=53)and the research group(n=53)according to random number table method.The control group received Midazolam combined with Esketamine for general anesthesia,while the research group received Remimazolam combined with Esketamine for general anesthesia.The intraoperative and postoperative conditions,hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP)]before anesthesia induction(T0),at tracheal intubation(T1),at 1 min before one-lung ventilation(OLV)(T2),at skin incision(T3),at 1 h after OLV(T4),and immediately after extubation(T5),as well as pain and inflammatory factors[5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],cellular immunity[peripheral blood natural killer(NK)cells,CD3+,CD4+,CD4+/CD8+],the levels of serum interleukin(IL)-2,interferon-γ(IFN-γ),cognitive function[Mini-Mental State Examination(MMSE)],sleep quality[Pittsburgh Sleep Quality Index(PSQI)],and recovery quality[Postoperative Quality of Recovery-15(QoR-15)score]were compared between the two groups of patients.The adverse reactions and complications were also compared between the two groups.Results There was no significant difference in duration of surgery,duration of anesthesia,intraoperative blood loss,and time to spontaneous breathing recovery of patients between the two groups(P>0.05).The total dosage of Sufentanil in the research group was less than that in the control group,and time to postoperative eye opening,duration of recovery room stay and length of postoperative hospitalization were shorter than those in the control group(P<0.05).At T0 and T5,there was no significant difference in HR and MAP between the two groups(P>0.05),and at T1-T4,HR and MAP in the research group were higher than those in the control group(P<0.05).At the time of recovery,the levels of serum 5-HT,PGE2,hs-CRP,and TNF-α in the research group were lower than those in the control group(P<0.05),and at the time of recovery,the peripheral blood NK cells,CD3+,CD4+,and CD4+/CD8+ratio,serum IL-2 and IFN-γ levels in the research group were higher than those in the control group(P<0.05).At 1 d after surgery,the MMSE and QoR-15 scores of the research group were higher than those of the control group,while the PSQI score was lower than that of the control group(P<0.05).The incidence of adverse reactions and complications in the research group[5.66%(3/53)and 3.77%(2/53)],was lower than that of the control group[18.87%(10/53)and 15.09%(8/53)](P<0.05).Conclusion The combination of Remimazolam and Esketamine in elderly patients undergoing thoracoscopic lobectomy can better maintain intraoperative hemodynamics,stabilize cellular immune function,reduce serum pain and inflammatory factor levels,improve postoperative cognitive function and sleep quality,reduce adverse reactions and complications,and promote postoperative recovery.

Objective To compare the effect of cold therapy at different temperature on the pain and motor function of delayed onset muscle soreness(DOMS)in the upper limbs of young men.Methods From April to July,2024,24 healthy young men(aged 22 to 26 years)were selected from the Key Laboratory of Winter Sports Technical Diagnosis and Skill Evaluation of the General Administration of Sport of China at Shenyang Sport University,and randomly divided into control group,group A and group B equally.An isokinetic muscle strength testing system was used to establish a DOMS movement model for elbow joint.Then,group A re-ceived cold therapy at a constant temperature of 10℃for 10 minutes,group B received cold therapy at a con-stant temperature of 6℃for 10 minutes,and the control group received natural recovery.They were measured relative peak torque(rPT)of the elbow flexor muscles at angular velocities of 60°/s,120°/s and 180°/s with iso-kinetic muscle strength testing system,and root mean square(RMS)of EMG amplitude of biceps brachii was synchronously collected using a wireless surface EMG system,immediately,and 24,48 and 72 hours after model establishment;while,they were assessed with Visual Analogue Scale(VAS)for pain.Results The main effects of VAS score,rPT and RMS were significant in both intra-group(F>15.716,P<0.001)and inter-group(F>6.478,P<0.01).At 24,48 and 72 hours after model establishment,the VAS scores showed a trend of control group>group A>group B(P<0.05).Although the pairwise comparison results of rPT and RMS among the groups varied at different time points after model establishment under different angular veloci-ties,overall,rPT presented a trend of control groupgroup A>group B(P<0.05).The higher the angular velocity and the longer the time,the more obvious this trend was.Conclusions Cold therapy can relieve the pain of DOMS in the upper limbs of young men and promote the recovery of muscle strength,especially at a constant temperature of 6℃.

Objective: To understand trends and related factors influencing overweight and obesity among primary and secondary school students in Tianjin, so as to provide a basis for formulating overweight and obesity prevention and control strategies. Methods: In September of each year from 2019 to 2023, a survey was conducted among 197 707 primary and secondary school students in 16 districts of Tianjin through a stratified random cluster sampling method. Physical examination was carried out in accordance with the Technical Standard for Physical examination for Student, and overweight and obesity survey was carried out. Basic information, smoking, drinking, diet, physical exercise, and sleep status were collected through questionnaire surveys. Results: The detection rates of overweight and obesity among primary and secondary school students in Tianjin from 2019 to 2023 were 39.07%, 43.33%, 41.54%, 43.92%, and 40.24%, respectively，showing an increasing trend(χ2trend=7.96,P<0.01). The detection rates of overweight increased in both vocational high schools and suburban counties (χ2trends=9.08, 47.18, P<0.01). The detection rates of obesity increased among both male and female students, in primary and vocational high schools and suburban counties (χ2trends=108.34, 15.99, 7.32, 10.95, 14.75, P<0.01). Multivariate Logistic regression analysis showed that smoking, drinking, unhealthful diet, and lack of proper physical exercise had a higher risk of obesity among primary and secondary school students (OR=1.26, 1.13, 1.08, 1.21, P<0.05). Stratified analysis showed that the risk of obesity was higher among boys with unhealthful and moderate lifestyle habits, as well as primary school students with unhealthful lifestyle habits (OR=1.15, 1.11, 1.27, P<0.05). Boys, girls and primary school students with unhealthful lifestyle habits, girls and ordinary high school students with moderate lifestyle habits had higher risk of being overweight (OR=1.14, 1.32, 1.21, 1.18, 1.40, P<0.05). Conclusions The detection rates of overweight and obesity among primary and secondary school students in Tianjin shows an increasing trend. Comprehensive lifestyle should be implemented to better prevent and control the risk of overweight and obesity.

Objective:To investigate the changes of artemin protein expression in diabetic peripheral neuropathy (DPN) and to explore the regulatory effect of human adipose-derived stem cell (ADSC) exosomes on the change of artemin protein expression.Methods:This research was a prospective observational clinical research combined with experimental research. Thirteen DPN patients (9 males and 4 females, aged 32 to 68 years) who were admitted to the First Affiliated Hospital of Air Force Medical University (hereinafter referred to as our hospital) from May 2022 to October 2023 and met the inclusion criteria were selected as DPN group, and 5 non-diabetes patients (4 males and 1 female, aged 29 to 61 years) who were admitted to our hospital in the same period of time and met the inclusion criteria were selected as control group. The toe nerve or sural nerve tissue in the abandoned tissue after debridement or amputation of patients in the two groups was collected. The pathological changes of nerve tissue were observed after hematoxylin-eosin staining; the protein expressions of S100β and artemin in nerve tissue were observed after immunofluorescence staining, and the artemin protein expression was quantified; the protein and mRNA expressions of artemin were detected by Western blotting and real-time fluorescent quantitative reverse transcription polymerase chain reaction, respectively (the sample number in DPN group and control group was 13 and 5, respectively). Twelve male C57BL/6 mice aged 3 to 5 days were collected to isolate Schwann cells, and the cells were divided into conventional culture group cultured routinely, high glucose alone group (cultured with high concentration of glucose solution only), and high glucose+exosome group (cultured with high concentration of glucose solution and extracted human ADSC exosomes). After 24 hours of culture, the cell proliferation activity was detected by cell counting kit 8 ( n=6). After 48 hours of culture, the protein expression of artemin was detected by Western blotting ( n=3). Results:Compared with those in control group, the neural supporting cells decreased and the inflammatory cells increased in the nerve tissue of patients in DPN group, showing typical manifestations of nerve injury. Immunofluorescence staining showed that compared with those in control group, the nuclei was more, and the protein expression of S100β was lower in nerve tissue of patients in DPN group. The protein expression of artemin in nerve tissue of patients in DPN group was 71±31, which was significantly lower than 1 729±62 in control group ( t=76.92, P<0.05). Western blotting detection showed that the protein expression of artemin in nerve tissue of patients in DPN group was 0.74±0.08, which was significantly lower than 0.97±0.06 in control group ( t=5.49, P<0.05). The artemin mRNA expression in nerve tissue of patients in DPN group was significantly lower than that in control group ( t=7.65, P<0.05). After 24 hours of culture, compared with that in conventional culture group, the proliferation activities of Schwann cells in high glucose alone group and high glucose+exosome group were significantly decreased ( P<0.05); compared with that in high glucose alone group, the proliferation activity of Schwann cells in high glucose+exosome group was significantly increased ( P<0.05). After 48 hours of culture, compared with those in conventional culture group, the protein expressions of artemin of Schwann cells in high glucose alone group and high glucose+exosome group were significantly decreased ( P<0.05); compared with that in high glucose alone group, the protein expression of artemin of Schwann cells in high glucose+exosome group was significantly increased ( P<0.05). Conclusions:The protein expression of artemin in nerve tissue of DPN patients is lower than that in normal nerve tissue, which may be related to the reduction of proliferation activity of Schwann cells by high glucose. Human ADSC exosomes may improve the proliferation activity of Schwann cells by increasing artemin protein expression, thereby delaying the progression of DPN.

BACKGROUND:Among the pathogenic factors of cervical spondylosis,herniation of the intervertebral disc,dislocation of the facet joint and the stenosis of the intervertebral foramen are important factors leading to symptoms in patients.Moreover,inappropriate manipulation may aggravate the possibility of cervical disc rupture,leading to exacerbation of symptoms in patients. OBJECTIVE:To compare the effect between sagittal cervical manipulation and traditional cervical rotation manipulation on the area of the intervertebral disc,facet joint and intervertebral foramen at the operative segment by the finite element analysis. METHODS:The neck CT data of a male volunteer with a normal neck were selected and imported into Mimics 17.0 three-dimensional reconstruction software.Geo-magic Studio 12.0,Solidworks 2017 and Ansys Workbench 17.0 software were used for the construction of the finite element model of cervical vertebrae(C3-6)including intervertebral disc and articular cartilage.The lower end plate of the C5 vertebral body was fixed.A uniformly distributed vertical downward 50 N load was applied on the upper surface of the upper vertebral body(C3).The stress,deformation and deformation direction of the C4-5 intervertebral disc,joint capsule stress,the displacement of facet joints and the area of bilateral intervertebral foramen were compared between sagittal cervical manipulation and traditional rotation reduction. RESULTS AND CONCLUSION:(1)When using the rotation technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 8.06 MPa;the total deformation was 1.05 mm,and the fiber ring expanded to the left and outside.When using the sagittal tip lifting technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 2.60 MPa;the total deformation was 0.90 mm,and the fiber ring expanded to the left and back.Compared with the rotation technique,the pressure of the cervical manipulation technique on the disc was less(about 32.3%of the rotation technique),and the deformation degree of the disc was also light(about 85.7%of the rotation technique).(2)When the rotation technique was used,the maximum stresses of the left and right articular capsule ligaments were 0.37 MPa and 1.69 MPa,respectively.The overall displacement of the facet joint was 2.21 mm.The area of the right intervertebral foramen decreased by about 3.8%and the area of the left intervertebral foramen increased by about 0.9%.When the sagittal end lifting manipulation was performed,the maximum stresses of the left and right articular capsule ligaments were 0.27 MPa and 1.70 MPa,respectively;the overall displacement of the facet joint was 1.63 mm;the area of the right intervertebral foramen increased by about 2.6%,and the area of the left intervertebral foramen decreased by about 0.9%.Compared with rotation manipulation,sagittal end lifting manipulation had fewer changes in the displacement of facet joint,joint capsule stress and intervertebral foramen area,so it was safer to operate.(3)In conclusion,compared with cervical rotation manipulation,sagittal end lifting manipulation has fewer changes in facet joint displacement,intervertebral disc stress/deformation degree,joint capsule stress,and foraminal area.In clinical practice,more appropriate manipulation should be selected based on biomechanical results after an accurate assessment of patients'conditions.