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.

This case involves a 53-year-old female patient who underwent mechanical mitral valve replacement and has been on long-term warfarin anticoagulant therapy,subsequently developed diffuse ecchymoses of the limbs and progressive both lower extremities swelling after she self-adjusted her warfarin dosage from 3 mg to 6 mg daily over 5 consecutive days.After admission,the patient's international normalized ratio was 12.71,and creatine kinase level was 1,989.47 U·L-1,which led to the diagnosis of coagulopathy and rhabdomyolysis due to warfarin overdose.Following discontinuation of warfarin and initiation of fluid resuscitation therapy,the patient's creatine kinase levels returned to normal after 6 d.Thiscase underscores the necessity of refining long-term warfarin management strategies and enhancing patient education to improve medication adherence and ensure both the efficacy and safety of anticoagulation therapy.

Objective:To study distribution of CD24 in immune microenvironment and its relationship between pathological status of axillary lymph nodes during neoadjuvant therapy(NAT)for breast cancer.Methods:A total of 200 breast cancer patients admitted to the First People's Hospital of Chenzhou City from February 2021 to February 2024 were selected as research objects.According to CD24 expression,patients were divided into high expression group(n=126)and low expression group(n=74),and divided into pCR group(n=91)and non-pCR group(n=109)according to clinical treatment effect.Hierarchical regression model was used to analyze influence of different clinicopathological features on CD24 expression,generalized linear mixed model was constructed to judge relationship between CD24 and pCR,and dose-response relationship between CD24 and pCR was analyzed by restricted cubic spline method,GMDR model was used to analyze interaction of CD24 and immune microenvironment factors on pCR.Results:CD24 expression was correlated with TNM stage,vascular invasion,number of lymph nodes and tumor markers levels.CD24 mRNA level in patients after NAT showed a gradually decreasing trend.Compared with before treatment,CD24 mRNA expression at 1 month,3 months and 6 months after treatment had statistical significance(P<0.05),immune microenvironment factors levels in patients were signifi-cantly changed,and CD3+T,CD4+T,CD8+T,FOXP3,IL-10,IgG and IgM levels were increased,while CD10+T,IL-6 and IL-17 levels were decreased.TNM stage,vascular invasion,number of lymph nodes,CA125 and CEA levels were significant positive related with CD24 level(P<0.05).Tumor aspect ratio,TNM stage,vascular invasion,number of lymph nodes,HER-2,Ki-67,CD24 expres-sions and CD24 mRNA level were correlated with post-NAT axillary lymph node pCR in breast cancer patients.CD24 mRNA expres-sion was a risk factor for post-NAT axillary lymph node pCR,and probability of pCR in patients decreased significantly with increase of CD24 mRNA expression.CD24 interacted with CD3+T,CD4+T,CD8+T,CD10+T,FOXP3,IL-6,IL-10,IL-17,IgG and IgM on pCR.Conclusion:CD24 level in patients after NAT showes a gradually decreasing trend.CD24 mRNA expression is a risk factor for axillary lymph node pCR after NAT.With increase of CD24 mRNA expression,probability of pCR in patients decreases significantly.

Objective:To study distribution of CD24 in immune microenvironment and its relationship between pathological status of axillary lymph nodes during neoadjuvant therapy(NAT)for breast cancer.Methods:A total of 200 breast cancer patients admitted to the First People's Hospital of Chenzhou City from February 2021 to February 2024 were selected as research objects.According to CD24 expression,patients were divided into high expression group(n=126)and low expression group(n=74),and divided into pCR group(n=91)and non-pCR group(n=109)according to clinical treatment effect.Hierarchical regression model was used to analyze influence of different clinicopathological features on CD24 expression,generalized linear mixed model was constructed to judge relationship between CD24 and pCR,and dose-response relationship between CD24 and pCR was analyzed by restricted cubic spline method,GMDR model was used to analyze interaction of CD24 and immune microenvironment factors on pCR.Results:CD24 expression was correlated with TNM stage,vascular invasion,number of lymph nodes and tumor markers levels.CD24 mRNA level in patients after NAT showed a gradually decreasing trend.Compared with before treatment,CD24 mRNA expression at 1 month,3 months and 6 months after treatment had statistical significance(P<0.05),immune microenvironment factors levels in patients were signifi-cantly changed,and CD3+T,CD4+T,CD8+T,FOXP3,IL-10,IgG and IgM levels were increased,while CD10+T,IL-6 and IL-17 levels were decreased.TNM stage,vascular invasion,number of lymph nodes,CA125 and CEA levels were significant positive related with CD24 level(P<0.05).Tumor aspect ratio,TNM stage,vascular invasion,number of lymph nodes,HER-2,Ki-67,CD24 expres-sions and CD24 mRNA level were correlated with post-NAT axillary lymph node pCR in breast cancer patients.CD24 mRNA expres-sion was a risk factor for post-NAT axillary lymph node pCR,and probability of pCR in patients decreased significantly with increase of CD24 mRNA expression.CD24 interacted with CD3+T,CD4+T,CD8+T,CD10+T,FOXP3,IL-6,IL-10,IL-17,IgG and IgM on pCR.Conclusion:CD24 level in patients after NAT showes a gradually decreasing trend.CD24 mRNA expression is a risk factor for axillary lymph node pCR after NAT.With increase of CD24 mRNA expression,probability of pCR in patients decreases significantly.

This case involves a 53-year-old female patient who underwent mechanical mitral valve replacement and has been on long-term warfarin anticoagulant therapy,subsequently developed diffuse ecchymoses of the limbs and progressive both lower extremities swelling after she self-adjusted her warfarin dosage from 3 mg to 6 mg daily over 5 consecutive days.After admission,the patient's international normalized ratio was 12.71,and creatine kinase level was 1,989.47 U·L-1,which led to the diagnosis of coagulopathy and rhabdomyolysis due to warfarin overdose.Following discontinuation of warfarin and initiation of fluid resuscitation therapy,the patient's creatine kinase levels returned to normal after 6 d.Thiscase underscores the necessity of refining long-term warfarin management strategies and enhancing patient education to improve medication adherence and ensure both the efficacy and safety of anticoagulation therapy.

Objective:To investigate the effects of Porphyromonas gingivalis derived outer membrane vesicles (Pg OMV) on osteoclast differentiation of macrophages and its underlying mechanisms. Methods:The morphology and the size distribution of Pg OMV were analyzed by transmission electron microscopy and nanoparticle tracing analysis, respectively. The osteoclast precursors were treated with 1, 3 and 10 mg/L Pg OMV (1, 3 and 10 mg/L OMV treatment group) or phosphate buffer solution (PBS)(control group). The formation of osteoclasts was analyzed by tartrate-resistant acid phosphase (TRAP) staining and F-actin staining and real-time quantitative PCR (RT-qPCR) were used to detect the expression of Fos and matrix metallopeptidase 9 (MMP9). Polymyxin B (PMB) was used to block lipopolysaccharide (LPS) and then Pg OMV was used to treat osteoclast precursor (PMB-OMV treatment group), and OMV treatment group was used as control. TRAP and F-actin staining were used to observe the formation of osteoclasts and actin rings. The effect of Pg OMV on the expression of Toll-like receptor (TLR) 2 and TLR4 in preosteoclasts was detected by Western blotting. The osteoclast precursors were pretreated with 10, 50, 100 and 200 μmol/L C29, an inhibitor of TLR2, and then treated with Pg OMV(OMV+10, 50, 100 and 200 μmol/L C29 treatment group) and OMV treatment group without C29 pretreatment was control. TRAP and F-actin staining were used to observe the formation of osteoclasts and actin rings. The osteoclast precursor cells were treated with OMV (OMV treatment group) and OMV incubated with PMB (PMB-OMV treatment group) and the expression of TLR2 in osteoclast precursor was detected by Western blotting.Results:Pg OMV showed classical vesicular structures, and the average particle size of Pg OMV were 179.2 nm. A large number of actin rings were observed in the 3 and 10 mg/L OMV treatment groups. The percentages of TRAP-positive osteoclast area in 3 mg/L OMV treatment group [(22.6±2.1)%] and 10 mg/L OMV treatment group [(32.0±2.3)%] were significantly increased compared with control group [(4.9±0.5)%] ( P<0.001). Compared with the control group (1.000±0.029), the mRNA relative expression of Fos in 3 mg/L OMV treatment group (1.491±0.114) and 10 mg/L OMV treatment group (1.726±0.254) was significantly increased ( P=0.013, P=0.001). Compared with the control group (1.007±0.148), the mRNA relative expression of MMP9 in the group of 10 mg/L OMV (2.232±0.097) was significantly increased ( P<0.001). Actin ring formation was less in PMB-OMV treatment groups than in OMV treatment groups. The proportion of TRAP-positive osteoclasts area [(14.8±3.8)%] in PMB-OMV treatment group was significantly lower than OMV treatment group [(31.5±6.7) %] ( P=0.004). The relative expression of TLR2 in OMV treatment group (1.359±0.134) was significantly higher than that in the control group (1.000±0.000) ( t=4.62, P=0.044). Compared with the OMV treatment group [(29.4±1.7)%], 50, 100 and 200 μmol/L C29 significantly decreased the formation of osteoclasts [(24.0±1.7)%, (18.5±2.1)%, (9.1±1.3) %] ( P=0.026, P<0.001, P<0.001). TLR2 protein expression in PMB-OMV group (0.780±0.046) was significantly lower than that in OMV group (1.000±0.000)( t=8.32, P=0.001). Conclusions:Pg OMV can promote osteoclast differentiation by carrying LPS, TLR2 plays an important role in Pg OMV mediated osteoclast differentiation.

Objective:To investigate the characteristics of anorectal dynamics in elderly patients with functional defecation disorders(FDD), and to provide a basis for their diagnosis, treatment and prevention.Methods:In this retrospective study, 226 patients with FDD receiving 3D high-resolution anorectal manometry were divided into an elderly group(93 cases)and a non-elderly group(133 cases). Results from anorectal manometry parameters were compared and analysis of patterns of anorectal pressure changes in elderly participants based on sex, the Bristol stool classification and clinical symptoms was conducted.Results:The resting anal pressure, rectal pressure and anal relaxation rate were lower( t=-3.407, -2.051, Z=2.548, P=0.001, 0.040, 0.011)and the volume of first sensation was higher( t=1.998, P=0.047)in the elderly group than in the non-elderly group.The maximum anal squeezing pressure, residual anal pressure and maximum tolerated volume were higher( t=4.589, 4.730, 2.025, all P<0.05), whereas the anal relaxation rate and anorectal pressure gradient were lower in elderly men than in elderly women( Z=4.059, t=-3.714, P<0.001 for both). Regarding the types of FDD, both the elderly group and the non-elderly group were dominated with type Ⅱ defecation disorder, with more men than women having type Ⅱ defecation disorder in the elderly group( χ2=10.343, P=0.001). In cases of paradoxical sphincter contraction during simulated defecation, the incidence in the elderly group was 80.65%(75/93), which was higher than 68.42%(91/133)in the non-elderly group( χ2=4.194, P=0.041). The volume of first sensation, volume of first defecation sensation, and maximum tolerated volume of patients in the elderly group without the urge to defecate were(59.86±23.84)ml, (96.76±34.61)ml, and(144.32±30.57)ml, respectively, higher than those of patients with the urge to defecate(46.79±17.20)ml, (75.26±28.75)ml, and(120.00±40.28)ml( t=-2.241, -2.493, -2.891, P=0.027, 0.014, 0.005). The rectal pressure(26.52±16.08)mmHg of patients with defecation dyssynergia was lower than that of patients without defecation dyssynergia(39.91±8.82)mmHg(1 mmHg=0.133 kPa)( t=-3.128, P=0.002), while the resting anal pressure of patients with defecation dyssynergia(90.60±28.44)mmHg was higher than that of patients without defecation dyssynergia(73.65±27.10)mmHg( t=-2.201, P=0.030). The resting anal pressure and maximum anal squeezing pressure in patients with anal blockage sensation[(87.11±24.64)mmHg, (149.28±48.29)mmHg]were higher than those in patients without anal blockage sensation[(72.43±20.02)mmHg, (121.76±26.35)mmHg]( t=2.954、3.066, P=0.004、0.003). There was no significant difference in values from parameters of anorectal dynamics between patients with different Bristol stool types, with and without incomplete defecation or with different degrees of abdominal distension(all P>0.05). Conclusions:Anorectal dynamics in patients with FDD are characterized by paradoxical anal sphincter movements, but older patients with FDD are mainly characterized by inadequate rectal propulsion, pelvic floor muscle dysfunction and reduced rectal sensitivity.

Objective:The purpose of this study was to evaluate the effect of computer-assisted navigation in the removal of foreign bodies in the oral and maxillofacial regions.Methods:A retrospective analysis was performed on the patients who suffered from oral and maxillofacial foreign bodies and were treated with computer-aided navigation technology in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University from January 2014 to December 2018. All patients received the examination of spiral CT, and the CT data were imported into the computer navigation workstation to complete the presurgical planning. The surgical approach was through the original wound or local small incision, and the computer navigation system was used to accurately locate the foreign body and perform the foreign body removal. All patients underwent postoperative follow-up, and the oral and maxillofacial appearance and functional recovery were evaluated.Results:A total of 35 patients were involved in this study, including 29 males and 6 females, aged 2 to 77 years old(average age: 38.3±20.2 years). Foreign bodies included metals, fish bones, and broken glass. The operation time was 30-90 min [average time: (50.6±16.5) min]. The operation proceeded well in these patients. The foreign bodies were removed successfully. There was no infection in the wound or surgical incision, and the healing was normal. All patients recovered well in the oral and maxillofacial appearance and function during the one-to-twelve-month follow-ups after operation.Conclusions:Computer-assisted navigation is an effective technique that can be applied in the removal of oral and maxillofacial foreign bodies. It can accurately locate the foreign bodies and perform minimally invasive surgery, thereby reducing the impact on facial appearance.

Objective:The purpose of this study was to evaluate the effect of computer-assisted navigation in the removal of foreign bodies in the oral and maxillofacial regions.Methods:A retrospective analysis was performed on the patients who suffered from oral and maxillofacial foreign bodies and were treated with computer-aided navigation technology in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University from January 2014 to December 2018. All patients received the examination of spiral CT, and the CT data were imported into the computer navigation workstation to complete the presurgical planning. The surgical approach was through the original wound or local small incision, and the computer navigation system was used to accurately locate the foreign body and perform the foreign body removal. All patients underwent postoperative follow-up, and the oral and maxillofacial appearance and functional recovery were evaluated.Results:A total of 35 patients were involved in this study, including 29 males and 6 females, aged 2 to 77 years old(average age: 38.3±20.2 years). Foreign bodies included metals, fish bones, and broken glass. The operation time was 30-90 min [average time: (50.6±16.5) min]. The operation proceeded well in these patients. The foreign bodies were removed successfully. There was no infection in the wound or surgical incision, and the healing was normal. All patients recovered well in the oral and maxillofacial appearance and function during the one-to-twelve-month follow-ups after operation.Conclusions:Computer-assisted navigation is an effective technique that can be applied in the removal of oral and maxillofacial foreign bodies. It can accurately locate the foreign bodies and perform minimally invasive surgery, thereby reducing the impact on facial appearance.

AIM:To investigate the effect of fenbendazole (FBZ) on the proliferation of human chronic myelogenous leukemia (CML) cell line K562.METHODS:The CCK-8 assay was used to detect the effect of FBZ on viability of the K562 cells and normal peripheral blood mononuclear cells (PBMC).The cell growth was measured by the method of Trypan blue exclusion.The cell cycle was analyzed by flow cytometry.The cell cycle-related proteins were detected by Western blot.RESULTS:The growth of K562 was significantly inhibited by FBZ.However, it elicited little cytotoxic effect on PBMC.Furthermore, FBZ induced G2/M phase arrest and mitotic catastrophe in the K562 cells based on the changes of nuclear morphology, DNA content, mitotic marker analysis and the number of polykaryocytes.CONCLUSION:Fenbendazole significantly inhibits the proliferation of K562 cells and induces cell cycle arrest at G2/M phase by the regulation of cell cycle-related proteins.