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.

Objective:To screen the active components, target genes and signaling pathways of Shaoteng Decoction in the treatment of Sjogren's syndrome by network pharmacology; To conduct relevant experimental verification to explore the mechanism of action of Shaoteng Decoction in the treatment of Sjogren's syndrome.Methods:The active components and targets of Shaoteng Decoction were collected by retrieving TCMSP. The target genes of Sjogren's syndrome were collected through the GeneCards database. The intersection targets of drugs and diseases were obtained by using Venn. The intersection targets were imported into the STRING database to obtain PPI networks, and the "drug-active component -therapeutic target-disease" network was constructed by Cytospace 3.7.2 software. The DAVID database was used for GO function enrichment analysis and KEGG pathway analysis. The 18 NOD mice were divided into model group, TCM group, hydroxychloroquine group, with 6 mice in each group, and 6 Balb/C mice were set as normal control group. TCM group was gavaged with 2.3 g/kg of Shaoteng Decoction, hydroxychloroquine group was gavaged with 60 mg/kg of hydroxychloroquine, and model group and normal control group were gavaged with equal volume of deionized water once a day for 4 consecutive weeks. The daily water intake of mice during the administration period was recorded, the pathological changes of submandibular gland tissue were observed by HE staining, and the levels of serum inflammatory factors IL-17 and TNF-α were determined by ELISA method.Results:39 main active components of Shaoteng Decoction, 1 062 targets of Sjogren's syndrome, and 64 targets of drug and disease intersection were obtained, including TNF, IL6, NCOA1, AKT1, TP53, etc. The treatment targets of Sjogren's syndrome mainly affected biological processes such as response to bacterium and cellular response to lipid, and regulated TNF-α pathway and IL-17 signaling pathway. The experimental results showed that the levels of TNF-α and IL-17 in the TCM group were lower than those in the model group ( P<0.05). Conclusion:Shaoteng Decoction can regulate IL-17 and TNF-α signaling pathways, inhibit inflammation, delay submandibular gland disruption, and alleviate the symptoms of Sjogren's syndrome.

Objective:To investigate the relationship between three-dimensional choroidal vascularity index (3D CVI) and the severity of diabetic retinopathy (DR) using swept-source optical coherence tomography angiography (SS-OCTA).Methods:A cross-sectional study was conducted.A total of 139 eyes of 139 subjects, including 115 eyes with diabetes mellitus and 24 control eyes without diabetes, were enrolled in the Second People's Hospital of Hefei from March to December 2022.DR was graded according to the standard seven-field ETDRS color fundus photographs.Eyes with diabetes mellitus were divided into non-DR (NDR) group (34 eyes), non-proliferative DR (NPDR) group (42 eyes), NPDR with diabetic macular edema (DME) group (21 eyes) and PDR group (18 eyes).3D CVI in central fovea 1 mm (C1) and parafoveal 3 mm (C3), choroidal vascular volume (CVV), and choroidal thickness were measured by SS-OCTA in the area of 3 mm×3 mm centered on the fovea using the built-in automated quantification software.Parafoveal region was divided into superior, inferior, temporal and nasal quadrants, and 3D CVI of the different quadrants was detected.3D CVI was defined as the ratio of CVV to total choroidal volume.The monocular data were analyzed to compare 3D CVI among the five groups, and multiple linear regression analysis was used to evaluate the influencing factors.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University (No.2022064).All subjects were aware of the study purpose and agreed to participate the study.Results:There were significant differences in 3D CVI-C1 and 3D CVI-C3 among all groups ( F=3.103, 3.036, both at P<0.05).In PDR group, 3D CVI-C1 was lower than in non-DR group, and 3D CVI-C3 was lower than in control group and non-DR group, with statistically significant differences (all at P<0.05).There were significant differences in 3D CVI in the inferior and nasal quadrants among all groups ( F=2.714, 4.020, both at P<0.05).In PDR group, 3D CVI in the inferior quadrant was lower than that in non-DR group, and 3D CVI in nasal quadrant in PDR group was lower than that in control group, non-DR group, NPDR group and NPDR with DME group, with statistically significant differences (all at P<0.05).Multiple linear regression showed that after controlling for age, course of disease and glycosylated hemoglobin, the severity of DR was the influencing factor of 3D CVI in fovea and parafovea.PDR eyes had the greatest impact on 3D CVI in fovea and parafovea.Compared with non-DR eyes, there was a -0.019(95% CI: -0.031--0.007, P=0.003) decrease in central foveal 3D CVI and a -0.019(95% CI: -0.030--0.008, P=0.001) decrease in parafoveal 3D CVI in PDR eyes, followed by a 0.014(95% CI: -0.027-0.000, P=0.044) decrease in central foveal 3D CVI in NPDR with DME eyes. Conclusions:Macular foveal 3D CVI correlates with DR severity, and a decrease in 3D CVI of large vessels in the macular choroid may be a sensitive indicator of DR exacerbation.

Objective To predict the constitutive parameters of a superelastic model of plantar soft tissues based on random forest(RF)and backpropagation(BP)neural network algorithms to improve the efficiency and accuracy of the method for obtaining constitutive parameters.Methods First,a finite element model for a spherical indentation experiment of plantar soft tissues was established,and the spherical indentation experiment process was simulated to obtain a dataset of nonlinear displacement and indentation force,divided into training and testing sets.The established RF and BP neural network(BPNN)models were trained separately.The constitutive parameters of plantar soft tissues were predicted using experimental data.Finally,the mean square error(MSE)and coefficient of determination(R2)were introduced to evaluate the accuracy of the model prediction,and the effectiveness of the model was verified by comparison with the experimental curves.Results Combining the RF and BPNN models with finite element simulation was an effective and accurate method for determining the superelastic constitutive parameters of plantar soft tissues.After training,the MSE of the RF model reached 1.370 2×10-3,and R2 was 0.982 9,whereas the MSE of the BPNN model reached 4.858 1×10-5,and R2 was 0.999 3.The inverse-determined constitutive parameters of the plantar soft tissues suitable for simulation were obtained.The calculated response curves for the two predicted sets of constitutive parameters were in good agreement with the experimental curves.Conclusions The prediction accuracy for the superelastic constitutive parameters of plantar soft tissues based on an artificial intelligence algorithm model is high,and the relevant research results can be applied to study other mechanical properties of plantar soft tissues.This study provides a new method for obtaining the constitutive parameters of plantar soft tissues and helps to quickly diagnose clinical problems,such as plantar soft tissue lesions.

Objective:To study the pharmacodynamics of Shaoteng Decoction obtained by three different extraction methods; To explore the immunosuppressive effect of Shaoteng Decoction; To optimize the extraction process.Methods:The extract of Shaoteng Decoction was prepared by water extraction, 70% ethanol extraction and water extraction and alcohol precipitation respectively. Totally 30 NOD mice were randomly divided into Shaoteng Decoction water extraction group (processⅠ), Shaoteng Decoction 70% ethanol extraction group (processⅡ), Shaoteng Decoction water extraction and alcohol precipitation group (processⅢ), model group and hydroxychloroquine group according to their body weight, with 6 mice in each group. Another 6 Balb/C mice were set as normal control group. In the processⅠ, process Ⅱ, and process Ⅲ groups, 16 g/kg of Shaoteng Decoction extract was given by gavage, while in the hydroxychloroquine group, 60 mg/kg of hydroxychloroquine sulfate was given by gavage. The normal control group and the model group were given the same volume of deionized water once a day for 4 weeks. After the last administration, the spleen index and submandibular gland index were calculated, the pathological morphology of submandibular gland was observed by HE staining, and the serum levels of IL-1β, IL-6, TNF-α, dehydroepiandrosterone (DHEA), estradiol (E 2) and immunoglobulin G (IgG) were determined by ELISA. Results:Compared with the model group, the spleen index of each drug group decreased ( P<0.01 or P<0.05), and the submandibular gland index of the process Ⅲ group and hydroxychloroquine group increased ( P < 0.01). The pathological score of submandibular gland in each administration group decreased ( P<0.01 or P<0.05), the serum levels of IL-1β, IL-6, TNF-α and IgG decreased ( P<0.01 or P<0.05), and the DHEA level increased ( P<0.01 or P < 0.05). The level of serum E 2 in process group Ⅰ, process group Ⅲ and hydroxychloroquine group increased ( P<0.01 or P<0.05). Conclusion:Shaoteng Decoction can effectively reduce inflammation and inhibit immunity of NOD mice. In addition, the extract under the process of water extraction and alcohol precipitation has better efficacy, which is the optimal technology.

Objective To investigate the value of a clinical-CT radiomics model in predicting cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods A total of 262 cases with PTC confirmed by pathology after surgery were selected.On CT arterial phase images,the PTC was outlined layer by layer via software 3D-slicer to extract CT radiomics features.The least absolute shrinkage and selection operator(LASSO)algorithm was used for dimensionality reduction and feature screening in relation to CLNM.The Mann-Whitney U test or Chi square test was performed to identify clinical parameters significantly associated with CLNM.The statistically significant CT radiomics features and clinical parameters were all selected for the multivariate logistic regression analysis to construct the clinical-CT radiomics model.The predictive efficiency of model was evaluated via the receiver operating characteristic(ROC)curve.Results The clinical-CT radiomics model demonstrated favorable predictive performance in both the training group[area under the curve(AUC)0.804,sensitivity 68.7％,specificity 82.4％]and the validation group(AUC 0.782,sensitivity 84.4％,specificity 61.8％).Conclusion The clinical-CT radiomics model demonstrates significant value in predicting CLNM of PTC,thereby,aiding in the development of personalized clinical plans for cervical lymph node(CLN)dissection.

The pathogenesis of Sjögren's syndrome （SS） was considered to involve external dryness， internal injured essence and blood， yin-deficiency endowment， and abnormal emotion and spirit， and it was believed that SS has the characteristics of dryness and impassability， and the pathogenesis of deficiency-excess in complexity. According to the theory “upper dryness treats qi， and lower dryness treats blood” in YE Gui's monograph “Medical Records for Clinical Guidance”， the dryness was divided into upper dryness and lower dryness syndromes to be differentiated and treated. When treating dryness syndrome， the patient should follow the characteristics of the five zang organs， using soft and cool medicines， avoiding warm and dry medicines， and valuing the animal products. The upper dryness could be treated with Sangxiang Decoction （桑杏汤） to clear the qi and moisten the dryness， Qiaohe Decoction （翘荷汤） to clear the upper with pungent-cool， and Shashen Maidong Decoction （沙参麦冬汤） to nourish yin and promote the production of body fluid. The lower dryness could be treated with Fumai Decoction （复脉汤） to enrich and nourish the five kinds of fluid. Liuwei Dihuang Pill （六味地黄丸） to nourish the kidneys and supplement essence， and Wuren Pill （五仁丸） to moisten the dryness and nourish the blood， which provided a new way of thinking for differentiation of the dryness syndrome.

【Objective:】 To explore the network structure characteristics and core items of meaning in life and coping styles among college students, and provide a basis for understanding their relationships and related interventions. 【Methods:】 A survey was conducted among college students using the Simplified Coping Style Questionnaire and Meaning in Life Questionnaire . The network analysis method was used to construct a network of college students’ meaning in life and coping styles, and R software was used for statistical analysis and visualization. 【Results:】 In the network of college students’ meaning in life and coping styles, "believing that time will change the status quo, and the only thing to do is to wait" and "trying to forget the whole thing" had the closest connection. "Learning from others to handle similar difficult situations" had the highest expected impact. "Seeking the meaning in life" and "pursuing hobbies and actively participating in cultural and sports activities" had the highest bridge expected influence. The average predictability value of all nodes was 0.775. 【Conclusions:】 Interventions aimed at "learning from others to handle similar difficult situations", "changing one’s own ideas and rediscovering what is important in life" and "changing some of the original practices or problems" may maximize the coping effect of college students. "Seeking the meaning in life" can furthest influence the coping styles, and "pursuing hobbies and actively participating in cultural and sports activities" can maximize the improvement of meaning in life.

【Objective】 To report the early clinical effects and surgical complications of endoscopic spinal fusion technology （Endo-LIF） in the treatment of degenerative lumbar disease. 【Methods】 The clinical data of 31 patients with degenerative lumbar spine disease treated with Endo-LIF from June 2019 to May 2021 were retrospectively analyzed. All the 31 patients underwent endoscopic spinal fusion therapy. We recorded the operation time， hospital stay duration， postoperative complications， visual analogue scale for pain （VAS）， oswestry dysfunction Index （ODI） and low back pain in the Chinese Orthopaedic Association Spine Group Surgery scoring standards before operation， immediately after operation， and the last follow-up to evaluate clinical efficacy. 【Results】 The operation time of the 31 patients was （134.80±34.98） min， the intraoperative blood loss was （100.13±18.49） mL， the hospital stay was （6.65±0.17） days， and the follow-up time was 6 to 18 （14±2.3） months. One patient had hematoma compression after surgery； he had incision made immediately to clear the hematoma and healed after bed rest. Two patients developed spinal hypertension and healed after bed rest. All the patients had no symptoms of nerve injury after operation， and the clinical symptoms were significantly relieved. We compared the perioperative VAS score and ODI index of all the patients， which were lower immediately after operation and at the last follow-up than those before the operation （P<0.05）， and the difference was statistically significant. 【Conclusion】 Endo-LIF technology has good short-term clinical effects and the advantages of milder trauma， less blood loss， and quick recovery after surgery. It is a safe and minimally invasive lumbar fusion surgery.

Growth plate,the developmental center of endochondral osteogenesis,can be divided morphologically and functionally into a resting zone,a proliferative zone,a prehypertrophic zone and a hypertrophic zone.Injuries to growth plate often lead to bone growth defects including limb length discrepancy and angulation deformity in children.Currently,their orthopedic corrective surgeries are invasive and limitedly effective and no effective biotherapy has been available.Previous studies on animal models of growth plate damage have investigated the related cellular and molecular events in the repair of damaged growth plates in the 4 distinct inflammatory,fibrogenic,osteogenic and remodeling phases.Related molecules involved in the regulation of the above processes,such as inflammatory cytokines tumor necrosis factor alpha,mitogenic platelet-derived growth factor and bone morphogenetic protein,are found to participate in the regulation of growth plate injury.Exploration of the mechanisms may provide new targets for biotherapy.In addition,development of cartilage tissue engineering,especially application of mesenchymal stem cells,also provides potential interventions for growth plate injury.