Background As one of the primary operational methods in the power grid industry, the insulated glove working method imposes significant physical demands due to the constraints of insulating equipment and specific required postures, resulting in substantial occupational health hazards among workers in this sector, which have garnered widespread social attention. Objective To investigate the prevalence and influencing factors of work-related musculoskeletal disorders (WMSDs) in the neck, shoulder, and lumbar regions among workers wearing insulated gloves, and to provide targeted measures to reduce occupational hazards. Methods Using stratified cluster sampling, 1079 frontline workers were randomly selected from power supply enterprises across 3 provinces in China. The revised Chinese version of the Musculoskeletal Disorders Questionnaire was used to investigate the 1-year prevalence of WMSDs in the neck, shoulder, and lumbar regions among workers wearing insulated gloves, and to collect factors associated with multi-site WMSDs (defined as involvement of ≥2 sites among the neck, shoulder, and lumbar). Results The 1-year prevalence of WMSDs in the neck, shoulder, and lumbar regions was 39.9%, 30.0%, and 25.3%, respectively, with a multi-site WMSDs prevalence of 32.0%. Multiple logistic regression analysis showed that, compared to workers with technical secondary school education or senior high school education and below, workers with junior college education or bachelor’s degrees and above had a higher risk of multi-site WMSDs (OR=2.12, 95%CI: 1.47, 3.06). Compared to workers with <10 years of work experience, those with 10-<20 years of work experience had a higher risk of multi-site WMSDs (OR=1.96, 95%CI: 1.45, 2.67). Working in uncomfortable postures "sometimes" (OR=1.64, 95%CI: 1.14, 2.36), "frequently" (OR=2.75, 95%CI: 1.76, 4.29), and "very frequently" (OR=3.55, 95%CI: 2.04, 6.19) were significantly associated with an increased risk of multi-site WMSDs compared to never working in such postures. Frequent repetitive movements of the low back (OR=2.05, 95%CI: 1.48, 2.84) increased the risk of multi-site WMSDs, while sufficient rest time decreased the risk (OR=0.45, 95%CI: 0.34, 0.61). Conclusion The prevalences of single-site and multi-site WMSDs in the neck, shoulder, lumbar regions are relatively high among workers wearing insulated gloves. Factors associated with multi-site WMSDs include 10-<20 years of work experience, junior college education or bachelor’s degrees and above, uncomfortable working postures, frequent repetitive low-back movements, and lack of sufficient rest time.

Background As one of the primary operational methods in the power grid industry, the insulated glove working method imposes significant physical demands due to the constraints of insulating equipment and specific required postures, resulting in substantial occupational health hazards among workers in this sector, which have garnered widespread social attention. Objective To investigate the prevalence and influencing factors of work-related musculoskeletal disorders (WMSDs) in the neck, shoulder, and lumbar regions among workers wearing insulated gloves, and to provide targeted measures to reduce occupational hazards. Methods Using stratified cluster sampling, 1079 frontline workers were randomly selected from power supply enterprises across 3 provinces in China. The revised Chinese version of the Musculoskeletal Disorders Questionnaire was used to investigate the 1-year prevalence of WMSDs in the neck, shoulder, and lumbar regions among workers wearing insulated gloves, and to collect factors associated with multi-site WMSDs (defined as involvement of ≥2 sites among the neck, shoulder, and lumbar). Results The 1-year prevalence of WMSDs in the neck, shoulder, and lumbar regions was 39.9%, 30.0%, and 25.3%, respectively, with a multi-site WMSDs prevalence of 32.0%. Multiple logistic regression analysis showed that, compared to workers with technical secondary school education or senior high school education and below, workers with junior college education or bachelor’s degrees and above had a higher risk of multi-site WMSDs (OR=2.12, 95%CI: 1.47, 3.06). Compared to workers with <10 years of work experience, those with 10-<20 years of work experience had a higher risk of multi-site WMSDs (OR=1.96, 95%CI: 1.45, 2.67). Working in uncomfortable postures "sometimes" (OR=1.64, 95%CI: 1.14, 2.36), "frequently" (OR=2.75, 95%CI: 1.76, 4.29), and "very frequently" (OR=3.55, 95%CI: 2.04, 6.19) were significantly associated with an increased risk of multi-site WMSDs compared to never working in such postures. Frequent repetitive movements of the low back (OR=2.05, 95%CI: 1.48, 2.84) increased the risk of multi-site WMSDs, while sufficient rest time decreased the risk (OR=0.45, 95%CI: 0.34, 0.61). Conclusion The prevalences of single-site and multi-site WMSDs in the neck, shoulder, lumbar regions are relatively high among workers wearing insulated gloves. Factors associated with multi-site WMSDs include 10-<20 years of work experience, junior college education or bachelor’s degrees and above, uncomfortable working postures, frequent repetitive low-back movements, and lack of sufficient rest time.

Background Coal workers' pneumoconiosis is a serious occupational disease in China. Exhaled volatile organic compounds (VOCs) can serve as the "breath fingerprint" of internal pathological processes, which provides a theoretical basis for exhaled VOCs to be used as potential non-invasive biomarkers for early diagnosis of coal workers' pneumoconiosis. Objective To screen out the characteristic VOCs and important characteristic VOCs of exhaled air in patients with coal workers' pneumoconiosis, and to explore the potential of these VOCs as biomarkers for early non-invasive diagnosis of the disease. Methods In this study, 27 VOCs in the exhaled breath of 22 patients with stage I coal workers' pneumoconiosis, 77 workers exposed to dust, and 92 healthy controls were quantitatively detected by thermal desorption gas chromatography-mass spectrometry (TD-GC-MS). Substances with P<0.05 in univariate analysis and variable importance projection (VIP) >1 in supervised orthogonal partial least squares discriminant analysis (OPLS-DA) model were selected as the characteristic VOCs for early diagnosis of coal workers' pneumoconiosis. Age was included in the LASSO regression model as a covariate to screen out important characteristic VOCs, and the diagnostic performance was evaluated by receiver operating characteristic (ROC) curve. Spearman correlation was further used to explore the correlation between important characteristic VOCs and clinical lung function indicators. Results Through univariate analysis and OPLS-DA modeling, 8 VOCs were selected, including 2-methylpentane, 3-methylpentane, n-hexane, methylcyclopentane, n-heptane, methylcyclohexane, 4-methyl-2-pentanone, and 2-hexanone, in exhaled breath of patients with coal workers' pneumoconiosis. The concentrations of 4 VOCs, including 3-methylpentane, n-hexane, 4-methyl-2-pentanone, and 2-hexanone, showed a decreasing trend with the increase of dust exposure years. By LASSO regression, the important characteristic VOCs of the coal workers' pneumoconiosis group and the dust exposure group were n-hexane, methylcyclohexane and 4-methyl-2-pentanone, and the important characteristic VOCs of the coal workers' pneumoconiosis group and the healthy group were 2-methyl-pentane and 4-methyl-2-pentanone. The ROC analysis showed that the area under the curve (AUC) of n-hexane, methylcyclohexane, and 4-methyl-2-pentanone were 0.969, 0.909, and 0.956, respectively, and the AUC of combined diagnosis was 0.988 and its Youden index was 0.961, suggesting that these results can serve as a valuable reference for further research on early diagnosis. The Correlation analysis found that there was a positive correlation between n-hexane and lung function indicators in the important characteristic VOCs, indicating that it could indirectly reflect the obstruction of lung function ventilation, further proving that important characteristic VOCs have the potential to monitor lung function decline. Conclusion Three important characteristic VOCs selected in this study have the potential to be used as non-invasive biomarkers for early diagnosis and disease monitoring of coal workers' pneumoconiosis, and are worthy of further study and verification.

Objective:To evaluate the effect of smoking on the sedative potency of remimazolam combined with alfentanil in patients undergoing painless gastroscopy.Methods:This was a prospecctive single-center study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ male patients, aged 30-75 yr, with a body mass index of 18-28 kg/m 2, undergoing elective painless gastroscopy at Baoding First Central Hospital from October to December 2023, were divided into non-smoking group, mild smoking group (smoking index≤200), moderate smoking group (200 1 after 3 min of remimazolam injection or development of bucking, swallowing, body movement and other responses that affected operations during insertion of the endoscope. Results:A total of 85 patients were finally included, with 21 in non-smoking group, 21 in mild smoking group, 20 in moderate smoking group and 23 in heavy smoking group. The ED 50 of remimazolam was significantly higher in smoking groups than in non-smoking group ( P<0.05). The ED 50 of remimazolam gradually increased in mild, moderate and heavy smoking groups ( P<0.05). Conclusions:Smoking can decrease the sedative potency of remimazolam when combined with alfentanil in patients undergoing painless gastroscopy.

Objective:To investigate the effect of brain-computer interface (BCI) training on the upper limb function of stroke survivors and to observe any changes in cortical activation patterns after such training.Methods:Thirty ischemic stroke survivors with upper limb dysfunction were randomized into a treatment group ( n=15) and a control group ( n=15). Both groups were given conventional upper limb rehabilitation training, while the treatment group additionally underwent 30 minutes of upper limb BCI training daily, five days a week for four consecutive weeks. Their upper limb motor functioning was assessed using the Fugl-Meyer assessment (FMA) and their ability in the activities of daily living (ADL) was quantified using the modified Barthel Index (MBI) before the experiment and after two and four weeks. the functional near infrared spectroscopy (fNIRS) was employed to measure oxygenated hemoglobin (HbO 2) levels in six regions of interest: the premotor cortex (PMC), the supplementary motor area (SMA), and the sensorimotor cortex (SMC) of the affected and unaffected hemispheres. Changes in brain network topology and network efficiency during the upper limb training were also analyzed. Results:After two and four weeks of the treatment, both groups showed significant improvement in their average FMA and MBI scores. The improvement was significantly greater in the treatment group than among the controls, on average. Before the treatment, HbO 2 levels in the affected SMA were significantly lower than in the other regions of interest in both groups. However, after 4 weeks the treatment group had significantly increased HbO 2 in the affected PMC and SMA, with higher concentrations in the affected PMC than among the control group. The network efficiency in the treatment group was also significantly better than in the control group after four weeks. Conclusions:Supplementing conventional neuropharmacological and rehabilitation therapies with BCI training can significantly improve upper limb motor function and the ADL ability of stroke survivors. It enhances cortical activation in the affected PMC and SMA and increases inter-regional brain networks.

BACKGROUND:The α7 nicotinic acetylcholine receptor is highly expressed in the cerebral cortex and hippocampus,and has been shown to play an important regulatory role in the pathological development of Alzheimer's disease,making it a potential therapeutic target for Alzheimer's disease.OBJECTIVE:To summarize the close relationship and interaction mechanism between α7 nicotinic acetylcholine receptor and Alzheimer's disease.METHODS:Retrieve relevant literature was searched in CNKI and PubMed databases using the search terms of"alpha7 nicotinic acetylcholine receptor,Alzheimer's disease,beta amyloid protein,agonist,positive allosteric modulator,antagonist"in Chinese and English,respectively.The search time was from database inception to July 2024.According to the inclusion criteria,the search results were accepted or excluded,and ultimately 83 articles that met the criteria were included for review.RESULTS AND CONCLUSION:The α7 nicotinic acetylcholine receptor interacts with β-amyloid protein to reduce the neurotoxicity of β-amyloid protein,such as promoting synaptic plasticity and rapid transmission of cholinergic synapses in Alzheimer's disease,alleviating central nervous system inflammation induced by β-amyloid protein,resisting neuronal apoptosis,and thus having a protective effect on the brain of patients with Alzheimer's disease.The α7 nicotinic acetylcholine receptor has great potential as a therapeutic target for Alzheimer's disease,but there are still a series of issues that need to be addressed,such as desensitization of α7 nicotinic acetylcholine receptor,stability of moderate activity,and gene polymorphism.Screening for drugs with high specificity,safety and multi-target binding action centered on the α7 nicotinic acetylcholine receptor will be a future direction for the treatment of Alzheimer's disease.

The incidence of adenocarcinoma of esophagogastric junction (AEG) has been rising year by year. Because its management spans both thoracic and general surgery, there are notable differences in surgical approaches, the extent of lymph node dissection, and digestive tract reconstruction. Lymph node dissection is central to curative surgery for AEG. While achieving an R 0 resection, surgical planning should also balance preservation of gastrointestinal function and control of complications, with judicious selection of the digestive tract reconstruction method. The authors summarize their institutional practice regarding the selection of operative extent and reconstruction for AEG. They emphasize an esophageal invasion length (EIL)≥3 cm as a key criterion for adopting a transthoracic approach with mediastinal lymph-node dissection, and prioritize gastric function-preserving reconstruction whenever feasible, providing systematical experience.

Based on advancements in modern medical research regarding the intricate connection between the endocrine and exocrine functions of the pancreas， as well as the relationship between pancreatic functions and traditional Chinese medicine （TCM） spleen system， this paper discussed the categorization of the pancreas. It is proposed that the pancreas is neither a true zang organ nor a fu organ， but possessed the attributes of an extraordinary fu-organ and can be classified under the spleen. The spleen governs transportation and transformation， ascent of the clear and dispersion of essence， which encompasses the endocrine and exocrine functions， and pancreatic enzymes and glucose-regulating hormones form the material basis for the spleen's function of dispersing essence. Diseases of the pancreas exhibit characteristics of both zang-organ deficiency and fu-organ excess， so treatment should simultaneously supplement zang-organ disease and regulate fu-organ disease when pancreas showing endocrine and exocrine co-morbidities， with focus on restoring the pancreas （spleen）'s dispersing essence function. Therapeutic strategies include supplementing spleen qi， nourishing spleen yin to strengthen spleen earth， unblocking spleen collaterals， raising spleen yang， and removing spleen turbidity to support the spleen's dispersing essence function， so as to replenish the essential qi of zang-fu organs， ensure their distribution throughout the body， and improve the endocrine and exocrine functions of the pancreas.

Background China is the world's largest producer and consumer of cobalt. Skin exposure to excess cobalt can cause symptoms such as contact dermatitis. At present, there are few studies on skin contact of cobalt and its compounds. Objective To investigate the skin contact characteristics of cobalt and its compounds. Methods A cross-sectional study was conducted in February 2024 involving 70 workers from a hard metal tool manufacturing company and the workers were divided into four groups according to their job positions: powder mixing, sintering, automatic pressing, and grinding processing. General demographic information was collected through questionnaires. Workplace air samples were collected using personal samplers, and cobalt concentrations in workplace air were measured by inductively coupled plasma optical emission spectrometry (ICP-OES). Skin samples were collected from the workers' foreheads using cotton swabs, and urine samples were collected within 30 min after the end of their shift. Urine specific gravity was measured immediately after collection, and disqualified samples were discarded. Cobalt concentrations in the swab extracts and urine were determined by inductively coupled plasma mass spectrometry (ICP-MS). Statistical analysis was performed using Kruskal-Wallis test for multiple group comparisons, Mann-WhitneyU test for pairwise comparisons, Chi-square test for categorical variables, and Spearman's rank correlation analysis to examine the correlations among air, dermal, and urinary cobalt levels. Results The 8 h time-weighted average (TWA) cobalt concentration was (2.30±2.15) μg·m⁻³ (\begin{document}$ \bar{x}\pm s $\end{document}). The median skin exposure level was 53.8 ng·cm⁻², with a range of 4.25 ng·cm⁻² to 1090.2 ng·cm⁻². The median urinary cobalt level was 3.74 µg·L⁻¹, with a range of 0.83 to 382.9 µg·L⁻¹. Statistically significant differences in TWA cobalt concentration, skin exposure levels, and urinary cobalt levels were found between different work positions (H=9.012, P=0.029; H=16.348, P＜0.001; H=11.078, P=0.011). A positive correlation was observed between skin exposure levels and urinary cobalt levels (r=0.537, P＜0.01). Conclusion Skin contact may be one of the main sources of cobalt levels in urine. Therefore, it is essential for workers to improve skin protection and hygiene practices.

ObjectiveTo explore the regulation of hypothalamic-pituitary-gonadal （HPG） axis by modified Erxian decoction in rats with perimenopausal syndrome （PMS） and to further analyze the expression of proteins related to the silent information regulator 1 （SIRT1）/hypothalamic kisspeptin （Kisspeptin）/gonadotropin-releasing hormone （GnRH） signaling pathway in the arcuate nucleus region （ARC） of the hypothalamus， so as to reveal the potential target of action and molecular biological mechanism of modified Erxian decoction for the treatment of perimenopausal syndrome. MethodsAn animal model was established via the incomplete castration method， with successful modeling confirmed by the exfoliated cervical cell smear method. The 48 rats were divided into six groups based on the randomization principle after successful modeling， including a sham operation group， a model group， an estradiol valerate group （0.09 mg∙kg^-1∙d^-1）， high-， medium-， and low-dose modified Erxian decoction groups （7.614， 3.807，1.903 5 g∙kg^-1∙d^-1）， with 8 rats in each group. The estradiol valerate group and the high-， medium- and low-dose modified Erxian decoction groups were continuously administered by gavage for 28 days， and the indicators were detected 24 hours after the last administration. Body weights and uterine indices were measured. The pathological changes of the uterus were observed by hematoxylin-eosin （HE） staining. Enzyme-linked immunosorbent assay （ELISA） was performed to measure the levels of estradiol （E₂）， follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， and gonadotropin-releasing hormone （GnRH）. Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to determine the expression levels of SIRT1， Kisspeptin， kisspeptin receptor （GPR54）， and GnRH in the ARC region of the hypothalamus and gonadotropin-releasing hormone receptor （GnRH-R） in pituitary. ResultsCompared with the sham operation group， rats in the model group had a significantly increased body weight （P0.01）， reduced wet weight and index of uterus （P0.01）， endometrial thinning or atrophy， glandular atrophy， and a decreasing number of glands. Additionally， serum levels of E₂ and the expression of SIRT1 in the ARC region of the hypothalamus significantly decreased （P0.01）. Serum levels of FSH， LH， and GnRH， the expression of Kisspeptin， GPR54， and GnRH in the ARC region of the hypothalamus， and GnRH-R in pituitary significantly increased （P0.01）. Compared with the model group， the estradiol valerate group and the high-， medium-dose modified Erxian decoction groups had significantly reduced body weight， serum levels of FSH， LH， and GnRH， and expression of Kisspeptin， GPR54， and GnRH in the ARC region of the hypothalamus and GnRH-R in pituitary （P0.05， P0.01） and significantly increased wet weight and index of uterus， serum level of E₂， and expression of SIRT1 in the ARC region of the hypothalamus （P0.05， P0.01）. In addition， they showed thickened endometrium， increased number of endometrial glands， and improved glandular atrophy. ConclusionModified Erxian decoction regulates the function of the HPG axis through multi-targets， and its mechanism of action may be related to the up-regulation of the expression of SIRT1 in the ARC region of the hypothalamus， the inhibition of the over-activation of the Kisspeptin/GnRH signaling pathway， the regulation of the expression of GnRH-R in the pituitary， the restoration of secretion balance of gonadotropins， and the elevation of the estrogen level. This study provides an experimental basis for the interpretation of the scientific connotation of modified Erxian decoction in the treatment of perimenopausal syndrome and a theoretical reference for the development of a novel therapeutic strategy based on the SIRT1/Kisspeptin/GnRH pathway.