Background Work-related musculoskeletal disorders (WMSDs) are considered to be one of the biggest health problems in the workplace, seriously affecting the productivity and quality of life of the working population. Long working hours may associate with WMSDs, and leisure-time physical activity (LTPA) is beneficial for WMSDs. However, the independent and combined effects of these two factors on WMSDs remain poorly understood. Objective To explore the independent and joint relationships between long working hours, leisure time physical activity (LTPA), and WMSDs, and to provide a basis for prevention and intervention of WMSDs. Methods A cross-sectional survey was conducted among 1227 frontline workers from multiple secondary industry companies in Nanchong City in 2023 using cluster random sampling. Demographic characteristics information, weekly working hours, LTPA, personal health behaviors, and occupational factors were collected through questionnaires. The Chinese version of Musculoskeletal Disorders Questionnaire was used to assess WMSDs. χ² test and logistic regression were used to analyze the relationships between long working hours and/or LTPA and WMSDs. Results A total of 1227 workers were surveyed with a mean age of (41.3±9.3) years and 855 (69.7%) were male and 372 (30.3%) were female. Among then, 855 (69.7%) workers reported working >40 h per week, and 254 (20.7%) reported working ≥ 55 h per week; 561 (45.7%) reported no LTPA and 192 (15.6%) reported high LTPA. The overall positive rate of WMSDs was 57.4%. The positive rate of WMSDs was 71.3% in those working ≥55 h per week, which was significantly higher than those in the other groups (51.3%-58.2%, P<0.05). Comparison among the positive rate of WMSDs in the weekly working 41-48 h group (54.4%), the 49-54 h group (58.2%), and the ≤40 h group (51.3%) showed no statistically significant difference (P>0.05). The positive rate of WMSDs was higher in workers with no LTPA (59.0%)/low LTPA (58.9%) than in those with high LTPA (49.0%) (P<0.05). The logistic regression models showed that after adjusting gender, age, work experience, income per month, night shift, industry, prolonged fixed posture, prolonged repetition, smoking and alcohol drinking, compared with weekly working ≤40 h, the risk of WMSDs was higher in those with extra-long working hours (≥55 h·week⁻¹ ) (OR=2.155, 95%CI: 1.504, 3.088), whereas those with high LTPA had a lower risk of WMSDs (OR=0.614, 95% CI: 0.432, 0.874 ). The combination of no LTPA and extra-long working hours (≥55 h·week⁻¹) and low LTPA and extra-long working hours (≥55 h·week⁻¹) showed associations with WMSDs, with 2.360 and 2.049 times higher risk of WMSDs than that of the combination of no LTPA and standard working hours (≤40 h ·week⁻¹) respectively (P<0.05), whereas the combination of high LTPA and long working hours was not observed statistical significance (P>0.05). Conclusion Extra-long working hours and/or LTPA show different associations with the risk of WMSDs. Extra-long working hours are significantly positively associated with the risk of WMSDs, whereas high LTPA is significantly negatively associated with the risk of WMSDs. The combination of extra-long working hours with no or low LTPA is associated with elevated risk of reporting WMSDs, whereas no statistical significance is observed for the high LTPA-long work hours combination.

Objective:To explore the establishment and validation of a risk model for postoperative olfactory impairment in pa-tients with chronic sinusitis with nasal polyps(CRSwNP)based on immunoinflammatory indexes.Methods:Retrospective analysis of 100 patients who attended CRSwNP in the Second Affiliated Hospital of Hainan Medical College from October 2020 to October 2022 all underwent nasal endoscopic surgery and were divided into no olfactory impairment group(44 cases)and olfactory impairment group(56 cases)according to the results of postoperative olfactory test,baseline data and routine examination indexes of the two groups were compared and analyzed,independent risk variables affecting olfactory impairment in CRSwNP patients were analyzed by Logistic multifactorial regression,and columnar graph prediction model was constructed and validated.Results:There were statistical-ly significant differences in staging,lesion site,Lund-Mackay score,anterior olfactory fissure score,posterior olfactory fissure score,percentage of serum eosinophils,olfactory marker protein-positive cell count in the upper turbinate mucosa,and urea nitrogen be-tween the two groups of CRSwNP patients(P<0.05).IL-5,human eosinophil cationic protein(ECP)/peroxidase(MPO),tissue inhib-itor of metalloproteinases 1(TIMP1),chemokine 2(CCL2),chemokine 3(CCL3),chemokine 4(CCL4),total immunoglobulin E(IgE)of tissue specimens,and total IgE of serum specimens in the olfactory impairment group were higher than those in the group without olfactory impairment,the differences were statistically significant(P<0.05).The multifactorial logistic results were that stag-ing,lesion site,Lund-Mackay score,anterior olfactory fissure score,posterior olfactory fissure score,IL-5,ECP/MPO,CCL4,and total IgE of tissue specimens were all independent risk factors affecting olfactory impairment in patients with CRSwNP;while olfactory marker protein-positive cell count in the upper turbinate mucosa was an independent protective factor for olfactory impairment in pa-tients with CRSwNP.The results were validated by establishing a line graph model.The validation results of building the column line graph model suggested that the C-index of the training and validation sets were 0.858 and 0.825,respectively,and the area under the characteristic curve(AUC)of the subject patients were 0.853 and 0.815,respectively.Conclusion:A model to explore the risk of postoperative olfactory impairment in CRSwNP patients based on immunoinflammatory indexes has been established,the model with high predictive performance to help guide clinical decision making.

The “hospital-community” hospice care model involves multiple stakeholders，including demander，executor，leader，and fundraiser of medical and health services.The degree of benefit correlation，policy influence，and implementation willingness of various stakeholders were analyzed to provide reference for terminal cancer patients to obtain continuous，convenient，and high-quality hospice care.Health department and medical insurance department are the main driving forces for cross-institutional hospice care，but there are differences in their driving paths.The financial department is an important guarantor of policy implementation，and needs to ensure that its core interests are not lost.Community medical institutions are an important driving factor for policy implementation，but they require policy support and hospital drive. Medical staff in hospitals and communities，have weak willingness to implement policies，which can easily become obstacles to policy implementation in the absence of incentive and compensation mechanisms.Patients and their caregivers are important beneficiaries，but lack of publicity，education，and interactive communication can also lead to rejection and contradiction.Therefore，it is necessary to leverage the collaboration and coordination between policy enforcement departments，innovate the development model of hospitals，lead community medical institutions，and promote interactive communication and decision-making sharing of “doctor-doctor” and “doctor-patient”.

From December 2022 to January 2023, 4 lung transplant recipients (3 males and 1 female, aged 52-60 years, all received transplantation less than 1 year) were hospitalized in the Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University due to COVID-19 after surgery. The clinical manifestations were mostly characterized by elevated body temperature accompanied by shortness of breath, and indicators such as heart rate, oxygen saturation, and oxygenation index could reflect the severity of the condition. The therapy was timely adjusted to immunosuppressive drugs, upgraded oxygen therapy, anti-bacterial and anti-fungal therapy, prone ventilation, general treatment, and anticoagulant therapy, depending on the situation. Finally, 3 patients were cured and discharged from hospital, and 1 died.

Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (https://hlse.cn/), with the aim of synthesizing, evaluating, translating, and applying lifestyle-related evidence resources. This paper aims to introduce the functional module design of the evidence translation system, the system development process and testing, introduce the interface design and function demonstration, and explain the significance of constructing the HLSE.

Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (https://hlse.cn/), with the aim of synthesizing, evaluating, translating, and applying lifestyle-related evidence resources. This paper aims to introduce the functional module design of the evidence translation system, the system development process and testing, introduce the interface design and function demonstration, and explain the significance of constructing the HLSE.

Chaihu Guizhi Decoction is an excellent prescription of ZHANG Zhongjing;however,nowadays the application of Chaihu Guizhi Decoction is primarily derived from the text.The xiang thinking is the source of traditional Chinese medicine thinking.Understanding Chaihu Guizhi Decoction from the xiang thinking,it is easy to perceive the true meaning of ZHANG Zhongjing,and grasp the location of the disease and the patient's overall qi,so as to make better use of this formula.This article discusses the understanding of Chaihu Guizhi Decoction from five perspectives:firstly,it gives an overview of the xiang thinking,pointing out the source and essential value of the xiang thinking;secondly,it analyses the disease position and the patient's qi of Chaihu Guizhi Decoction under the perspective of the xiang thinking as a whole;thirdly,it discusses the disease position and the patient's qi of the original text of Chaihu Guizhi Decoction from the xiang thinking;fourthly,it discusses how to understand the principle of formula formation and the main and minor parts of Chaihu Guizhi Decoction by xiang thinking;finally,it analyses the primary medicines in Chaihu Guizhi Decoction by using xiang thinking based on the records of Shennong Bencao Jing.Based on these five points,we hope to reveal the traditional Chinese medicine thinking behind Chaihu Guizhi Decoction,and provide new ideas for the clinical application of Chaihu Guizhi Decoction.

Objective:To investigate the association between regional white matter hyperintensity (WMH) volumes and cognitive impairment in Parkinson′s disease (PD) patients.Methods:The consecutive samples of PD cohort between October 2018 and August 2019 from the Department of Movement Disorders, Beijing Tiantan Hospital, Capital Medical University were retrospectively analyzed. Demographic and disease profiles, three-dimensional brain magnetic resonance imaging data were collected. Cognition was evaluated by Mini-Mental State Examination (MMSE), and mood was evaluated by Hamilton Anxiety Scale and Hamilton Depression Scale (HAMD). According to the MMSE score, patients were divided into PD with dementia group and PD without dementia group. WMH volume was automatically calculated using unidentified bright objects detector pipeline based on anatomical autonomic labeling atlas. Firstly, demographic and disease profiles, and WMH total volume were compared between groups with and without dementia. Then, partial correlation analysis [false discovery rate (FDR) corrected] and principal component (PC) regression analysis were used to assess the association between regional WMH volumes and the MMSE score.Results:Compared with PD without dementia group, PD with dementia group showed significantly higher WMH volume [5 125 (2 727, 13 718) mm 3vs 3 214 (1 959, 7 205) mm 3, Z=-2.256, P=0.024]. After adjusting for age, low density lipoprotein, cholesterol, and HAMD score, partial correlation analysis (FDR corrected) showed that WMH volumes in the right calcarine ( r=-0.204, PFDR-corrected=0.034), the right fusiform ( r=-0.180, PFDR-corrected=0.046), the right lingual ( r=-0.146, PFDR-corrected=0.047), the left middle temporal ( r=-0.168, PFDR-corrected=0.047), the left inferior parietal lobes ( r=-0.145, PFDR-corrected=0.047) and the right inferior parietal lobes ( r=-0.148, PFDR-corrected=0.047) were significantly associated with MMSE score. PC regression analysis demonstrated that MMSE score was significantly associated with PC2 ( B=-0.632, 95% CI -1.222--0.041, P=0.036), PC13 ( B=-1.384, 95% CI -2.155--0.613, P=0.001), and PC14 ( B=-0.913, 95% CI -1.599--0.227, P=0.009); PC2, PC13 and PC14 were mainly composed of temporo-parieto-occipital WMHs in the posterior brain, and the related WMH components accounted for 9.668% of WMH variance. Conclusions:The posterior WMH burden may be associated with cognitive impairment in PD patients. However, WMH burden may not be the main contributor to cognitive impairment in PD patients.

Objective To explore the feasibility of electrical impedance tomography(EIT)for real-time and accurate monitoring of respiration during HP anti-G movements and the key parameters of pulmonary ventilation.Methods Twelve healthy male students in our university were enrolled in September 2023 and subjected in this study.HP anti-G movements were performed 3 times each for 30 s in the anti-G physiological training apparatus,during which EIT and ophthalmic horizontal arterial pressure were measured to analyze the relationship of the global and local parameters of pulmonary ventilation,including inspiratory volume(IV),expiratory uniform(EU),expiratory speed(ES),center of ventilation(COV)and right-to-left lung ventilation ratio(RtoL)with anti-G ability of anti-G straining maneuver(AGSM).Results The average eye horizontal systolic blood pressure(SBP)at the eye level was 148.82±22.75 mmHg during HP anti-G movements,which was significantly higher than that during quiet breathing(PJ)(95.17±8.51 mmHg,P＜0.001).From the global pulmonary ventilation,the participants had significantly increased IV during HP anti-G movements(P＜0.001).According the d value(mean increase of eye horizontal SBP=SBPHP-SBPPJ),the subjects were divided into 3 groups,with the d value of＞60,30～60 and＜30 mmHg,respectively.The inspiratory volume ratio(IVHP/IVPJ)was the highest in the＞60 mmHg group and the smallest in the＜30 mmHg group(P＜0.01).The subjects had significantly decreased EU and more evenly expiration(P＜0.05),but no change was seen in the expiratory uniformity ratio(EUHP/EUPJ)among the 3 groups.ES was obviously faster during HP anti-G movements(P＜0.001),and the expiratory speed ratio(ESHP/ESPJ)had no significant difference among the 3 groups.The inspiratory time and expiratory time were 0.77±0.32 and 1.59±0.21 s,respectively,and both of them were notably shorter during HP anti-G movements(P＜0.001,P＜0.01).From the local pulmonary ventilation,COV during HP anti-G movements was significantly smaller than that during PJ(P＜0.001),and the ventilation center deviated to the ventral side,and RtoL was decreased and the ventilation distribution deviated to the left lung(P＜0.05).Conclusion EIT can perform real-time imaging of pulmonary global and local ventilation during HP anti-G movements,and it has a great application prospect in AGSM training and monitoring.

Post-stroke depression is a common complication after a stroke. Based on the theory of ＂deficiency of heart qi leading to sadness＂recorded in Huangdi Neijing, our team proposes that deficiency of heart qi is the basic pathogenesis of post-stroke depression, with sadness being its main manifestation. Therefore, we advocate treating post-stroke depression from the perspective of the heart, and clinically, it can be divided into four stages: heart-liver stage, heart-lung stage, heart-spleen stage, and heart-kidney stage. Treating post-stroke depression with the principle of regulating qi and nourishing the heart, patients in the heart-liver and heart-lung stages are mainly middle-aged and young adults, with a pathological nature of qi stagnation and mild deficiency of heart qi, and therefore, the method of promoting the flow of meridians and regulating qi should be adopted. In contrast, patients in the heart-spleen and heart-kidney stages are mainly middle-aged and elderly, with a pathological nature of qi deficiency and severe deficiency of heart qi, and therefore, nourishment and tonification should be prioritized. In response to the above four stages, our team has achieved good clinical efficacy by administering Xiaoyao Powder, Baihe Dihuang Decoction, Ganmai Dazao Decoction and Jingui Shenqi Pill respectively. This study discusses the approach to treating post-stroke depression from the perspective of a "deficiency of heart qi leading to sadness" by examining three aspects: the theoretical basis of Chinese and Western medicine to treat post-stroke depression from the heart, the basic pathogenesis and staging of post-stroke depression, and the treatment principle of regulating qi and nourishing the heart. The study also briefly analyzes the clinical experience of the medications used for this condition to provide a reference for the treatment of post-stroke depression.