Background Health literacy is closely related to mental health, and improving health literacy has been shown to promote mental well-being. However, whether occupational stress among workers in mining and manufacturing is associated with their occupational health literacy remains inconclusive. Objective To study the levels of occupational health literacy and occupational stress among workers in three industrial sectors (metal ores mining, metal smelting, and manufacture of non-metallic mineral products) in Gansu Province, and to analyze the correlation between them. Methods Between May and December 2024, a stratified cluster random sampling method was employed to survey workers from 73 large, medium, and small and micro sized enterprises across the aforementioned industries in Gansu Province. Participants’ occupational health literacy and occupational stress levels were assessed. The LASSO regression model was applied to identifykey factors influencing occupational stress, and subsequently a multilevel random intercept mixed-effects logistic model was used to study factors influencing occupational stress and to explore the relationship between occupational health literacy and occupational stress. Results A total of 3611 workers across the three industries were surveyed, among whom 1031 (28.55%) experienced occupational stress. Workers with adequate occupational health literacy—whether assessed in terms of overall literacy or specific dimensions—demonstrated a significantly lower prevalence of occupational stress compared to those without adequate literacy (P<0.05). Through the LASSO regression analysis, it was found that the factors closely related to occupational stress were dimension one (occupational health legal knowledge), dimension two (basic knowledge of occupational health protection), and dimension four (healthy working methods and behaviors) of occupational health literacy, gender, average monthly income, and night shifts. The results from the three-level random intercept mixed-effects logistic regression model indicated that dimensions one (OR=0.69, 95%CI: 0.58, 0.82), two (OR=0.71, 95%CI: 0.58, 0.87), and four (OR=0.81, 95%CI: 0.67, 0.98) of occupational health literacy were negatively correlated with the risk of occupational stress. Workers with an average monthly income of 3001–≤5000, 5001–≤7000, and ≥7001 yuan reported occupational stress risks that were 61% (OR=0.61, 95%CI: 0.45, 0.81), 56% (OR=0.56, 95%CI: 0.41, 0.78), and 36% (OR=0.36, 95%CI: 0.24, 0.53) of those with an average monthly income ≤3000 yuan, respectively. Male workers (OR=1.66, 95%CI: 1.32, 2.10) and those on night shifts (OR=2.29, 95%CI: 1.90, 2.76) had a higher risk of occupational stress. The random effects variance showed that the intraclass correlation coefficient was 0.12. Conclusion There is a negative correlation between occupational stress and occupational health literacy among workers in mining and manufacturing. Being male, having a low income, and working night shifts are risk factors affecting workers' occupational stress. It is recommended to focus on these groups of workers and incorporate occupational health literacy into workplace mental health promotion.

Pediatric liver tumors are predominantly primary malignant tumors. Due to the delicate anatomical structures of the liver in children, the typically large tumor size, and frequent involvement of major hepatic vessels, surgical intervention poses significant challenges. Complete tumor resection while preserving sufficient remnant functional liver tissue is critical for improving prognosis. With the emergence of precision surgery concepts and advancements in computer tech-nology, three-dimensional visualization technology has gained increasing attention in the diagnosis and treatment of pediatric liver tumors. This technology can enhance surgical accuracy and safety through precise preoperative planning, intraoperative guidance, and postoperative follow-up. To standardize the application of three-dimensional visualization technology in pediatric liver tumor management, professor Dong Qian from The Affiliated Hospital of Qingdao University has collabora-ted with 36 multidisciplinary experts from 8 countries to establish an international expert consensus on the clinical implementation of this technology in precision surgery for pediatric liver tumors. The authors provide an interpretation of the proposed consensus, aiming to guide clinicians in the standardized application of three-dimensional visualization technology during pediatric liver tumor resections.

The blood products industry,both domestically and internationally,exhibits distinct features in product research,development,and technological innovation.International companies possess extensive expertise in developing immunoglobulins,coagulation factors,and recombinant plasma protein products,demonstrating continuous advancements-particularly in specific immunoglobulin development,long-acting formulation optimization,and manufacturing process improvements.In recent years,Chinese enterprises have also achieved notable progress in related fields,especially in immunoglobulin process refinement and the development of novel recombinant coagulation factor products.However,there remains significant scope for improvement in areas such as the application of recombinant protein technologies,efficient utilization of plasma resources,and the adoption of advanced manufacturing techniques.Additional challenges include the accumulation of patented technologies,the supply of critical raw materials,and access to comprehensive epidemiological data.Driven by ongoing advances in gene recombination technologies,innovations in drug delivery systems,digital transformation,and the rise of personalized medicine,the blood products industry is poised for broader development prospects.To foster sustained and stable domestic industry growth and enhance global competitiveness,Chinese blood product enterprises should intensify their technological accumulation,upgrade manufacturing processes,and optimize plasma resource utilization.

Objective To assist drug and pharmaceutical packaging material manufacturers in understanding and utilizing the functionality evaluation methods for prefilled syringe with Luer conical fittings,thereby scientifically specifying product quality.Methods By comparing the standards status both domestically and internationally,and in conjunction with the product characteristics,production,and actual usage situation of prefilled syringe with Luer conical fittings,the test contents and key points of related functionality evaluation methods were analyzed.Results The functionality evaluation methods for prefilled syringe with Luer conical fittings represent improvements and supplements to domestic standard,appropriate methods should be selected based on the product type.Conclusion Developing functionality evaluation methods for prefilled syringe with Luer conical fittings will provide guidance to standardized quality control for drug and pharmaceutical packaging material manufacturers.It will also better meet the requirements for market regulation,and is an effective way to promote the overall development of the industry.

Objective:To explore the applied effectiveness of the Skin and/or tissue,Education,Cooperation,Understanding,Report and Evaluate (SECURE) nursing pathway based on action research method in the prevention process of medical device-related pressure injuries (MDRPI) of patients in the Intensive Care Unit (ICU). Methods:The SECURE nursing pathway based on action research method included the establishment of a skin care team to identify problems,and the formulation of conducting intervention plan,and the development of targeting nursing interventions to prevent the occurrence of MDRPI. A total of 84 patients hospitalized in the ICU of Hebei General Hospital from March 2022 to March 2023 were selected,and they were randomly divided into a control group and an observation group,with 42 patients in each group. The control group implemented routine method to prevent MDRPI during ICU treatment,while the observation group implemented SECURE nursing pathway based on action research method to conduct prevention. The MDRPI incidence,the quality scores of ICU nursing,the scores of the Short Form Health Survey-36 (SF-36) of patients,the assessment of the improvement of MDRPI patients,and the satisfaction of patients for nursing care were compared between the two groups. Results:The MDRPI incidence during ICU treatment in the observation group was 4.76％ (2/42),which was significantly lower than that in the control group,with a statistically significant difference (x2=11.052,P<0.05). The average scores for device usage,prevention assessment,positioning management and preventive nursing after nursing intervention in the observation group were respectively (88.45±2.05),(89.36±2.11),(89.25±2.15) and (91.45±2.25),all of which were significantly higher than those in the control group,with statistically significant differences (t=11.425,12.052,10.052,13.478,P<0.05). After nursing intervention,the average scores for physical function,social function,psychological function and material life as the SF-36 scale in the observation group were (85.47±2.05),(86.48±2.05),(88.46±2.15) and (90.25±2.44),respectively,which were respectively higher than those in the control group,with statistically significant differences (t=12.414,11.045,10.252,10.478,P<0.05). The occurrence time,improvement time of wound and ICU treatment time of presenting MDRPI patients in the observation group were respectively (4.05±0.54) days,(3.45±0.15) days,and (8.12±2.14) days. Compared to the control group,the occurrence time of the observation group was longer,while both the improvement time of wound and ICU treatment time of the observation group were shorter,with statistically significant differences (t=8.485,10.012,13.001,P<0.05). The satisfaction degree of nursing care of patients in the observation group was 95.24％ (40/42),which was significantly higher than that in the control group (x2=12.054,P<0.05). Conclusion:The SECURE nursing pathway based on action research method,which prevents MDRPI of ICU patients,can reduce the MDRPI incidence rate of ICU patients,and enhance the work quality of nursing care for MDRPI. It is helpful to the recovery of ICU patients,which can also shorten the treatment time of ICU patients.

Objective:To construct a medical education metaverse based on cloudytization virtual reality (VR) technique,so as to resolve various issues encountered with conventional VR devices in use process,and enhance the user's experience and teaching effect of virtual space education. Methods:The technical architecture of the medical education metaverse was conducted from the perspectives included the underlying technique layer,learning interface layer,teaching activity space and knowledge layer. The medical education mateverse,which based on cloudytization VR technique,was constructed,and the system performance and user's experience were optimized from a supporting environment included the content layer,platform layer,cloud computing layer,network layer and terminal layer. Results:The medical students could conduct practical operation in virtual environment at any time and any place by the deployment approach on cloudy terminal and lightweight devices. The efficient and convenient cross-disciplinary collaborative learning was convenient for students to acquire knowledge from multiple perspectives,to better response complex medical environments. The real-time interactive remote medical approach expanded the boundaries of medical education,and ensured equity and inclusivity in medical education. Conclusion:The application of medical education metaverse based on cloudytization VR technique in medical teaching can effectively reduce the application threshold of medical education metaverse,and expand the coverage of educational resources of high quality,and enhance the use experience of teaching of the virtual space of medical education based on VR,and meet the demands of medical teaching for diverse application scenarios.

Objective:To explore clinical characteristics of multiple sclerosis(MS)patients in Suzhou,and to analyze main factors affecting their prognosis.Methods:General data,clinical symptoms,cerebrospinal fluid and imaging examinations of 51 MS patients admitted to Department of Neurology of the Second Hospital of Soochow University from July 31,2009 to July 31,2021 were retrospectively analyzed,and main factors affecting their prognosis were discussed.Results:Average age of onset of 51 MS patients was(43.3±15.6)years old,female accounted for 56.9%,male/female=1/1.3.Adult onset MS(AOMS)accounted for 62.8%,male/female=1/1.7;late onset MS(LOMS)accounted for 37.2%,male/female=1/0.9.Relapsing remitting MS(RRMS)accounted for 76.5%,and chronic onset accounted for 60.8%.Average annual recurrence rate was 8.8%.The first symptoms were numbness and weakness of limbs.Dizziness and numbness were more common in patients without recurrence after diagnosis of MS,and limb weak-ness and numbness were more common in patients with recurrence.Among lesions of MRI,62.7%(32/51)of periventricular involve-ment,52.9%(27/51)of spinal cord involvement,51.0%(26/51)of infratentorial involvement.Proportion of subtentorial and spinal cord(cervical,thoracic)involved were significantly higher in patients with recurrent MS than without recurrence.Values of albumin,IgG,IgA and IgM in cerebrospinal fluid increased with increase of recurrence times.EDSS score of male was higher than female,and LOMS score was higher than AOMS.MS patients without relapse had a low EDSS score,and median EDSS score at current follow-up was 0(0,1.00)score.MS score with relapse was relatively high,and median EDSS score at current follow-up was 2.75(0.25,7.25)score.Conclusion:MS patients with chronic onset are more common,with a high proportion of LOMS,and proportion of males increases with increasing age of onset.High EDSS score at first onset,cervical,thoracic and subtentorial lesions,increased values of cerebrospinal fluid albumin,IgG,IgA,IgM,age at first onset(50+years old),male associate with poor MS prognosis.

Objective:To investigate gut microbiota differences between individuals with and without colorectal adenoma(CRA)and to identify gut microbes associated with CRA.Methods:This cross-sectional study analyzed the gut microbiota of 100 patients with CRA and 68 individuals without CRA(aged 40-75 years)who underwent colonoscopies between March 2021 and March 2022 at Tianjin Nankai Hospital.Fecal samples were sequenced for the V3-V4 region of the bacterial 16S rRNA gene using the Illumina NovaSeq platform.Results:Compared to the non-CRA group,the CRA group exhibited reduced relative abundances of identified and unidentified Lachnospiraceae,with increased Faecalibacterium and Streptococcus.In the non-CRA group,the relative abundances of Coprococcus,unidentified Clostridiaceae,and Clostridium were higher.LEfSe analysis revealed significant enrichment of Gammaproteobacteria,Proteobacteria,Enterobacteriales,and Faecalibacterium in the CRA group,while the non-CRA group was enriched for Moraxellaceae,Acinetobacter,and Anaerostipes.Conclusions:These findings suggest a discernible disparity in the gut microbiota structure between CRA patients and individuals without adenoma.The enrichment of potential pathogenic taxa,such as Faecalibacterium and Streptococcus,in the CRA group suggests a possible association with adenoma development.

Objective To explore the effect of diet therapy on alcohol-induced chronic liver injury in rats and its relationship with TLR4 pathway.Methods According to Pueraria:Poria:Amomum villosum:Pericarpium Citri Reticulatae:Codonopsis:Zingiberis Rhizoma=15∶15∶10∶10∶10∶6,the water extract of the therapeutic prescription was prepared.A total of 78 female SD rats were randomly divided into 6 groups:normal group(n=12),model group(n=18),Hugan tablet group(0.35 g·kg-1,n=12),low-,medium-and high-dose Shiliaofang groups(2,6,18 g·kg-1,n=12).Except for the normal group,the rats in each group were induced alcoholic liver disease(ALD)by gradient alcohol gavage.After 10 weeks of intervention,the changes of body weight and water intake of rats were observed.The whole blood routine,serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),triglyceride(TG),total cholesterol(TC)and liver malondialdehyde(MDA)were measured.The levels of serum alcohol dehydrogenase(ADH),aldehyde dehydrogenase(ALDH),lipopolysaccharide(LPS),D-lactic acid(D-LA),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-10(IL-10)were detected by enzyme-linked immunosorbent assay.HE staining was used to observe the pathological changes of liver and ileum.Oil red staining was used to observe liver fat deposition.Immunohistochemistry was used to detect the expression of ileal tight junction component occludin.Western blot was used to detect the expression of TLR4,MyD88 and NF-κB p65 protein in liver.Results Compared with the model group,the levels of WBC,LYC,TC,ALT,AST,LPS,D-LA,TNF-α and IL-6 in each diet group decreased,IL-10 increased,liver inflammatory cell infiltration and red lipid droplets decreased,intestinal villi were intact and densely arranged,the expression of occludin protein in ileum increased,and the expression of TLR4,MyD88 and NF-κB p65 protein in liver decreased.Conclusion The self-made dietotherapy prescription has a significant protective effect on chronic liver injury induced by alcohol in rats,which may be related to its down-regulation of TLR4-MyD88-NF-κB p65 protein expression and up-regulation of ileal occludin protein expression,improvement of intestinal mucosal barrier function,reduction of endotoxin entry into the liver,activation of TLR4/MyD88/NF-κB pathway,thereby reducing the second hit to the liver.This diet can be developed as a potential anti-alcoholic liver injury drug.

Objective:To explore clinical characteristics of multiple sclerosis(MS)patients in Suzhou,and to analyze main factors affecting their prognosis.Methods:General data,clinical symptoms,cerebrospinal fluid and imaging examinations of 51 MS patients admitted to Department of Neurology of the Second Hospital of Soochow University from July 31,2009 to July 31,2021 were retrospectively analyzed,and main factors affecting their prognosis were discussed.Results:Average age of onset of 51 MS patients was(43.3±15.6)years old,female accounted for 56.9%,male/female=1/1.3.Adult onset MS(AOMS)accounted for 62.8%,male/female=1/1.7;late onset MS(LOMS)accounted for 37.2%,male/female=1/0.9.Relapsing remitting MS(RRMS)accounted for 76.5%,and chronic onset accounted for 60.8%.Average annual recurrence rate was 8.8%.The first symptoms were numbness and weakness of limbs.Dizziness and numbness were more common in patients without recurrence after diagnosis of MS,and limb weak-ness and numbness were more common in patients with recurrence.Among lesions of MRI,62.7%(32/51)of periventricular involve-ment,52.9%(27/51)of spinal cord involvement,51.0%(26/51)of infratentorial involvement.Proportion of subtentorial and spinal cord(cervical,thoracic)involved were significantly higher in patients with recurrent MS than without recurrence.Values of albumin,IgG,IgA and IgM in cerebrospinal fluid increased with increase of recurrence times.EDSS score of male was higher than female,and LOMS score was higher than AOMS.MS patients without relapse had a low EDSS score,and median EDSS score at current follow-up was 0(0,1.00)score.MS score with relapse was relatively high,and median EDSS score at current follow-up was 2.75(0.25,7.25)score.Conclusion:MS patients with chronic onset are more common,with a high proportion of LOMS,and proportion of males increases with increasing age of onset.High EDSS score at first onset,cervical,thoracic and subtentorial lesions,increased values of cerebrospinal fluid albumin,IgG,IgA,IgM,age at first onset(50+years old),male associate with poor MS prognosis.