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.

Objective: To explore the effects of sleep on subsequent day physical activity (PA) in children and adolescents, so as to provide a reference for refining PA intervention strategies and further investigating their underlying mechanisms. Methods: Through searching databases including Web of Science Core Collection, PubMed, EBSCOhost, ScienceDirect, Cochrane Library, CNKI, Wanfang and VIP cross sectional, cohort and experimental studies on sleep and subsequent day PA among children and adolescents were identified, with the searching period spanning from database inception to June, 2025. Based on the characteristics of the included literature, two sleep variables[sleep duration (SD) and sleep efficiency (SE)] and three physical activity variables[moderate to vigorous physical activity (MVPA), light physical activity (LPA), and total physical activity (TPA)] were selected. The relationship between these two types of variables was analyzed for pooled effect sizes using Stata 17.0. Results: A total of 14 studies were included, with 64.3% published in 2018 or later, involving 11 361 children and adolescents from 17 countries. Meta analysis results showed that both SD ( ES=0.04, 95%CI =0.01-0.07) and SE ( ES=0.24, 95%CI =0.01-0.47) were positively correlated with subsequent day MVPA (both P <0.05). However, no statistically significant associations were found with LPA ( ES=-0.04, 95%CI =-0.13 to 0.06; ES=-0.02, 95%CI =-0.15 to 0.11) or TPA( ES=0.09, 95%CI =-0.02 to 0.20; ES=0.02, 95%CI = -0.03 to 0.06)(all P >0.05). Subgroup analysis revealed that in the "≤6 years" subgroup, SD and SE were positively correlated with TPA ( ES=0.22, 95%CI =0.09-0.35) and MVPA ( ES=1.19, 95%CI =1.06-1.32), respectively; in the "6-12 years" subgroup, SD was positively correlated with MVPA ( ES=0.05, 95%CI =0.02-0.08); in the "≥12 years" subgroup, SE was positively correlated with LPA ( ES=0.08, 95%CI =0.00-0.16), while SD was negatively correlated with LPA ( ES=-0.23, 95%CI = -0.31 to -0.16) (all P <0.05). Conclusion Adequate SD and good SE can effectively enhance subsequent day MVPA among children and adolescents, although these sleep effects vary by age group.

Objective To explore the application efficacy of refined management on antimicrobial agents in a chest specialty hospital.Methods Multiple measures were implemented through perfecting management systems and processes,as well as conducting knowledge training,such as multi-dimensional specialized prescription reviewing,optimizing information systems,and implementing grid-based management of clinical pharmacist.A refined manage-ment mode for antimicrobial agents in a chest specialty hospital has been established.Antimicrobial management in-dicators for the whole hospital and each clinical specialty in 2023(before management)and 2024(after manage-ment)were analyzed.Results Compared with 2023,antimicrobial use rate among hospitalized patients in 2024 de-creased from 47.48％to 45.92％,and antimicrobial use density(AUD)decreased from 46.28 defined daily doses(DDDs)/(100 person·day)to 39.73 DDDs/(100 person·day).The ratio of antimicrobial cost to total drug cost decreased from 12.71％to 9.51％,and the per capita cost of antimicrobial use decreased from 1 344.18 Yuan to 975.52 Yuan.The use rate of prophylactic antimicrobial agents for class Ⅰ incision surgery increased from 84.48％to 89.52％,and the rationality rate increased from 69.25％to 94.53％.The management indicators of each clinical specialty improved significantly.Conclusion Through adopting a series of refined management measures,antimi-crobial management modes that are suitable for the actual situation of the hospital has been constructed,and obvious efficacy was achieved.Clinical application of antimicrobial agents is more standardized and rational.

Metabolic disorders and immunosuppression exist in peripartal cows,and glutamine(GLN)has the potential efficacy to improve the negative energy balance(NEB)and the function of neutrophil(polymorphonuclear granulocyte,PMN)in peripartal cows.The aim of the present study was to investigate the effects of supplementation with rumen-protected GLN on the metabo-lism and the phagocytosis function of PMN in peripartal cows.Twenty Chinese Holstein cows with similar age,parity,body condition score and expected date of delivery were selected and divided into CON(n=10,fed basal diet)and GLN groups(n=10,supplemented with 180 g/d of rumen-protected GLN).During the test period of 42 d,blood samples were collected at-21,-14,-7,0,7,14 and 21 d.Milk production was recorded at 7,14 and 21 d,respectively.The results showed that:serum GLN concentrations in peripartal cows continued to decrease until they increased after 7 d postpartum,suggesting that peripartal cows may be in a state of GLN deficiency.The serum GLN content of the cows increased significantly(P＜0.05)from-7 to 21 d after GLN supple-mentation,indicating that supplementation was effective.The blood glucose concentration of peri-partal cows increased on the day of parturition but decreased postpartum,and the concentrations of non-esterified fatty acid(NEFA)and β-hydroxybutyrate(BHBA)in the blood increased postpar-tum,which indicated that peripartal cows had a physiological NEB.Blood glucose concentration in-creased significantly(P＜0.01)at-7,14 and 21 d after GLN supplementation,and blood concen-trations of NEFA and BHBA decreased significantly(P＜0.01)postpartum,suggesting that peri-partal cows had a NEB alleviated by GLN supplementation.Serum malondialdehyde(MDA)con-centration of periparturient cow peaked on the day of parturition but declined postpartum,and the concentration of MDA reached a peak on the day of delivery but declined postpartum,and the total antioxidant capacity(T-AOC)level continued to decline until it increased on the day of parturi-tion,indicating that peripartal cows were in a state of oxidative stress.Serum MDA concentration significantly decreased(P＜0.05)and serum T-AOC level significantly increased(P＜0.05)after GLN supplementation,indicating that antioxidant capacity of peripartal cows was improved by GLN supplementation.The concentration of serum pro-inflammatory factor IL-β peaked on the day of parturition and then decreased,the concentration of TNF-α peaked on the day of parturition and then decreased,and the concentration of anti-inflammatory factor IL-10 continued to decrease,which indicated that there was an inflammatory reaction in the cows during the periparturient peri-od.However,the levels of IL-1β on the day of delivery and postpartum decreased significantly(P＜0.01),the levels of TNF-α decreased(P＜0.05),and the levels of IL-10 increased significantly(P＜0.01)throughout the peripartum period,which indicated that GLN supplementation im-proved the anti-inflammatory ability of periparturient dairy cows.The phagocytosis function of PMN in peripartal cows was significantly reduced from-14 d to the day of parturition(P＜0.01),and the phagocytosis function of neutrophils was significantly enhanced after GLN supple-mentation at-14(P＜0.05),14 and 21 d(P＜0.01),which indicated that intrinsic immune func-tion of peripartal cows was enhanced by supplementation of GLN.GLN supplementation did not significantly affect milk production of cows at three weeks postpartum.In conclusion,supplemental rumen-protected GLN alleviated NEB,alleviated systemic oxidative stress and inflammatory re-sponse,and enhanced phagocytosis of PMN in peripartal cows,which has some potential for clini-cal application.

Metabolic disorders and immunosuppression exist in peripartal cows,and glutamine(GLN)has the potential efficacy to improve the negative energy balance(NEB)and the function of neutrophil(polymorphonuclear granulocyte,PMN)in peripartal cows.The aim of the present study was to investigate the effects of supplementation with rumen-protected GLN on the metabo-lism and the phagocytosis function of PMN in peripartal cows.Twenty Chinese Holstein cows with similar age,parity,body condition score and expected date of delivery were selected and divided into CON(n=10,fed basal diet)and GLN groups(n=10,supplemented with 180 g/d of rumen-protected GLN).During the test period of 42 d,blood samples were collected at-21,-14,-7,0,7,14 and 21 d.Milk production was recorded at 7,14 and 21 d,respectively.The results showed that:serum GLN concentrations in peripartal cows continued to decrease until they increased after 7 d postpartum,suggesting that peripartal cows may be in a state of GLN deficiency.The serum GLN content of the cows increased significantly(P＜0.05)from-7 to 21 d after GLN supple-mentation,indicating that supplementation was effective.The blood glucose concentration of peri-partal cows increased on the day of parturition but decreased postpartum,and the concentrations of non-esterified fatty acid(NEFA)and β-hydroxybutyrate(BHBA)in the blood increased postpar-tum,which indicated that peripartal cows had a physiological NEB.Blood glucose concentration in-creased significantly(P＜0.01)at-7,14 and 21 d after GLN supplementation,and blood concen-trations of NEFA and BHBA decreased significantly(P＜0.01)postpartum,suggesting that peri-partal cows had a NEB alleviated by GLN supplementation.Serum malondialdehyde(MDA)con-centration of periparturient cow peaked on the day of parturition but declined postpartum,and the concentration of MDA reached a peak on the day of delivery but declined postpartum,and the total antioxidant capacity(T-AOC)level continued to decline until it increased on the day of parturi-tion,indicating that peripartal cows were in a state of oxidative stress.Serum MDA concentration significantly decreased(P＜0.05)and serum T-AOC level significantly increased(P＜0.05)after GLN supplementation,indicating that antioxidant capacity of peripartal cows was improved by GLN supplementation.The concentration of serum pro-inflammatory factor IL-β peaked on the day of parturition and then decreased,the concentration of TNF-α peaked on the day of parturition and then decreased,and the concentration of anti-inflammatory factor IL-10 continued to decrease,which indicated that there was an inflammatory reaction in the cows during the periparturient peri-od.However,the levels of IL-1β on the day of delivery and postpartum decreased significantly(P＜0.01),the levels of TNF-α decreased(P＜0.05),and the levels of IL-10 increased significantly(P＜0.01)throughout the peripartum period,which indicated that GLN supplementation im-proved the anti-inflammatory ability of periparturient dairy cows.The phagocytosis function of PMN in peripartal cows was significantly reduced from-14 d to the day of parturition(P＜0.01),and the phagocytosis function of neutrophils was significantly enhanced after GLN supple-mentation at-14(P＜0.05),14 and 21 d(P＜0.01),which indicated that intrinsic immune func-tion of peripartal cows was enhanced by supplementation of GLN.GLN supplementation did not significantly affect milk production of cows at three weeks postpartum.In conclusion,supplemental rumen-protected GLN alleviated NEB,alleviated systemic oxidative stress and inflammatory re-sponse,and enhanced phagocytosis of PMN in peripartal cows,which has some potential for clini-cal application.

Objective To explore the application efficacy of refined management on antimicrobial agents in a chest specialty hospital.Methods Multiple measures were implemented through perfecting management systems and processes,as well as conducting knowledge training,such as multi-dimensional specialized prescription reviewing,optimizing information systems,and implementing grid-based management of clinical pharmacist.A refined manage-ment mode for antimicrobial agents in a chest specialty hospital has been established.Antimicrobial management in-dicators for the whole hospital and each clinical specialty in 2023(before management)and 2024(after manage-ment)were analyzed.Results Compared with 2023,antimicrobial use rate among hospitalized patients in 2024 de-creased from 47.48％to 45.92％,and antimicrobial use density(AUD)decreased from 46.28 defined daily doses(DDDs)/(100 person·day)to 39.73 DDDs/(100 person·day).The ratio of antimicrobial cost to total drug cost decreased from 12.71％to 9.51％,and the per capita cost of antimicrobial use decreased from 1 344.18 Yuan to 975.52 Yuan.The use rate of prophylactic antimicrobial agents for class Ⅰ incision surgery increased from 84.48％to 89.52％,and the rationality rate increased from 69.25％to 94.53％.The management indicators of each clinical specialty improved significantly.Conclusion Through adopting a series of refined management measures,antimi-crobial management modes that are suitable for the actual situation of the hospital has been constructed,and obvious efficacy was achieved.Clinical application of antimicrobial agents is more standardized and rational.

Uveal melanoma(UM)is a rare form of melanoma arising in the uveal tract of the eye.UM has different molecular driving and metastasis patterns as well as different tumor immune microenvironment which are distinct from their more common cutaneous counterparts.These differences lead to poor clinical response to systemic drug therapy,including immune checkpoint inhibitors(ICIs).Treatment of primary UM with radiotherapy,enucleation or other modalities achieves local control in more than 90%of UM patients,although 50%or more eventually develop into distant metastases during disease progression,most commonly in the liver.To date,studies have identified a number of biological features and clinical characteristics of the disease,including the highly prevalent early,oncogenic genomic aberrations in tumor initiation,later recurrent prognostic changes,and immunological features.These advances have contributed to the development of many novel therapies.This review summarizes the biology of UM,management and treatment strategies for primary and recurrent disease,with an emphasis on the current standard treatment for metastatic UM,as well as emerging systemic therapies.

Objective To explore the effects and influencing factors of traditional occupational health training on occupational health literacy (OHL) of employees in micro-, small- and medium-sized enterprises. Methods A total of 540 employees from 154 micro-, small- and medium-sized enterprises, who participated (347 employees) and not-participated (193 employees) in traditional occupational health training, and 171 community residents/students (not-participated in occupational health training) were selected as the research subjects using the convenient sampling method. The OHL level was investigated using Occupational Health Literacy Questionnaire of National Key Populations. Results The overall OHL level of employees was 43.3% (234/540). Among them, the overall OHL level of untrained and trained employees was 38.9% and 45.8%, respectively, and the overall OHL level of community residents/students was 43.3%. The results of multivariate logistic regression analysis showed that the higher the educational level, the higher the OHL level (all P<0.01). The OHL level of untrained and trained employees was higher than that of untrained community residents/students (all P<0.05). The interaction of education level and training status had no statistical difference on the OHL level of the research subjects (P>0.05). The results of factorial design analysis of variance showed that the overall OHL score rate of untrained employees and trained employees was higher than that of untrained community residents/students (all P<0.05). However, there was no significant difference in overall OHL score rate between untrained and trained employees (P>0.05). Conclusion The role of traditional occupational health training in improving the OHL level of employees in micro-, small- and medium-sized enterprises needs to be improved. The responsibility of enterprise occupational health training should be implemented, and multiple measures should be taken to enrich the ways and approaches of occupational health education for enterprise employees, to effectively improve the OHL of workers.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective:To explore the status and influencing factors of incontinence-associated dermatitis among elderly inpatients in 52 hospitals nationwide, and to analyze the nursing of elderly inpatients with incontinence, so as to provide a reference for clinical intervention.Methods:On March 31, 2021, convenience sampling was used to select 14 675 elderly inpatients from 52 hospitals across the country as the research object. The self-designed Incontinence-associated Dermatitis Questionnaire for Elderly Inpatients was used to collect general demographic data, health status, incontinence, and skin nursing. Binomial Logistic regression was used to investigate the influencing factors of incontinence-associated dermatitis in elderly inpatients.Results:Among 14 675 elderly inpatients, the prevalence rates of xerosis cutis, incontinence and incontinence-associated dermatitis were 38.78% (5 691/14 675) , 11.06% (1 623/14 675) and 1.91% (280/14 675) , respectively. The prevalence of mild, moderate and severe incontinence-associated dermatitis were 1.27% (186/14 675) , 0.55% (81/14 675) , and 0.09% (13/14 675) , respectively. Among the nursing of 1 623 elderly inpatients with incontinence, the items with low implementation rate were the use neutral lotion to clean skin (14.17%, 230/1 623) , use of skin protectant after moisturizing (17.68%, 287/1 623) , moisturizing after cleansing the skin (28.90%, 469/1 623) . The results of binomial Logistic regression analysis showed that xeroderma, fecal incontinence, urinary and fecal incontinence, ≥2 kinds of combined medication, and hospital stay >30 days were risk factors for incontinence-associated dermatitis in elderly inpatients.Conclusions:The risk factors of incontinence-associated dermatitis in elderly inpatients mainly include xerosis cutis, type of incontinence, ≥2 kinds of combined medication, and hospital stay >30 days.