Work-related musculoskeletal disorders (WMSDs) represent a significant occupational health challenge among healthcare professionals globally, posing substantial threats to physical and mental well-being as well as work sustainability. Adopting preventive behaviors—including ergonomic postural adjustments, optimized work-rest scheduling, proper use of protective and assistive equipment, and regular physical activity—is essential for mitigating the risk of WMSDs. Guided by the social ecological model, the review synthesized current evidence on the determinants of WMSDs preventive behaviors across four levels: intrapersonal characteristics, work environment conditions, interpersonal support, and policy/institutional factors. The findings suggest that higher educational attainment, favorable health-related behavioral patterns, optimized ergonomic work environments, adoption of supportive collaborative systems, strong organizational support, as well as policy safeguards facilitate preventive behavior adoption. Conversely, limited prevention-related knowledge, low risk perception, insufficient physical activity, excessive workload, lack of appropriate protective equipment, inadequate ergonomic training, a prevailing culture of presenteeism, and inadequate policy implementation constitute significant barriers. Multi-dimensional intervention strategies targeting these determinants are warranted to enhance preventive behaviors, reduce the risk of WMSDs, and strengthen occupational health protection for healthcare professionals.

Objective: To compare the consistency between bioelectrical impedance analysis (BIA) and dual energy X ray absorptiometry (DXA) in measuring body composition among Tibetan children and adolescents and to explore the applicability of BIA in plateau region, so as to provide scientific and convenient body composition measurement support among children and adolescents. Methods: From May to June, 2022, a total of 344 Tibetan children and adolescents aged 6-17 years were selected from Golmud Municipal National Middle School and Changjiangyuan Nationality Primary School in Qinghai Province by cluster sampling method, and their fat mass, fat mass percentage and lean mass were measured by DXA and BIA. The consistency and correlation between the two methods were assessed by using the Wilcoxon rank-sum test, Spearman correlation analysis, intraclass correlation coefficient (ICC), and Bland-Altman analysis. Results: DXA measured fat mass and fat mass percentage were significantly higher than those obtained by BIA (6-12 years old: Z =9.91, 11.28; 13-17 years old: Z =9.02, 10.21), while lean mass and lean mass percentage were significantly lower than BIA results (6-12 years old: Z =-11.60, -11.30; 13-17 years old: Z =-10.77, -10.36) (all P < 0.05 ). The two methods showed strong correlations in fat mass and lean mass (all r >0.80, all ICC >0.90), but exhibited poor agreement in fat mass percentage and lean mass percentage (6-12 years old: Lin s CCC =0.64, 0.41; 13-17 years old: Lin s CCC = 0.79 , 0.35). Bland-Altman analysis showed that the difference between the two methods was negatively correlated with the average value in FM%(6-12 years old: r =-0.75, 13-17 years old: r =-0.79, both P <0.01). Conclusion BIA and DXA show high consistency in measuring body fat mass and lean body mass in Tibetan children and adolescents, although some bias is still present in certain individuals.

Objective:To summarize clinical characteristics and prognosis of immune checkpoint inhibitor (ICI) -related Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) .Methods:A retrospective analysis was conducted on patients diagnosed with ICI-related SJS/TEN in Zhongda Hospital, Southeast University from January 2018 to October 2023. Data on clinical manifestations, laboratory examinations, treatment and prognosis of the patients were analyzed.Results:A total of 9 patients were diagnosed with ICI-related SJS/TEN, including 8 males and 1 female, with the onset age ranging from 58 to 77 (67.56 ± 7.33) years. ICI were applied to all the 9 patients before onset of SJS/TEN. The latent period was 6 - 261 d, and the median duration was 76 d. All the patients presented with erythema as initial lesions, 3 cases with target lesions, 6 with blisters, and 5 cases with a positive Nikolsky's sign. Oral mucosal damage occurred in 7 cases, eye damage occurred in 6 cases, and urogenital damage occurred in 6 cases. All the 9 cases were treated with systematic glucocorticoids, 7 cases with intravenous immunoglobulin and 7 cases with antibiotics. Eight cases recovered and 1 case died. Among 6 patients followed for an average of 6.92 months, none achieved complete or partial remission, 3 died and 3 experienced disease progression.Conclusions:ICI-related SJS/TEN occurred with a relatively long latent period, and all the cases presented with erythema initially, with mucosal damage present in most of the cases. Management required discontinuation of ICI, and most patients recovered with corticosteroids and intravenous immunoglobulin, however, the prognosis for the primary malignancy remained poor.

Objective This study aims to evaluate the effectiveness of intelligent bed management model in integrating bed resources in a large comprehensive hospital.Methods Inpatient data from a tertiary hospital between January 2021 and De-cember 2024 were collected.An intelligent hospital-wide bed management platform was constructed to implement bed resource sharing mechanisms and establish a standardized bed reservation grading system.The implementation effect of the system was e-valuated from the perspective of bed occupancy rate,average length of stay,and patient satisfaction.Results After implementa-tion,bed occupancy rates in key monitored departments moved into a reasonable range:Rehabilitation Medicine Department fell from 113.18％to 101.48％(t=4.26,P＜0.01),while Neurology Department increased from 88.18％to 96.20％(t=3.85,P＜0.01).Annual inpatient admissions increased from 83,931 to 103,852(x2=156.82,P＜0.001),and average length of stay shortened from 7.15 days to 6.21 days(t=4.73,P＜0.01).The admission waiting time was cut by 72.7 hours(-43.1％),and satisfaction with bed allocation rationality improved by 11.2 points(t=5.94,P＜0.001).Staff time spent on bed-assignment fell by 42 minutes per shift(t=8.92,P＜0.001),and cross-department transfers increased by 378 episodes per month(x2=145.26,P＜0.001).Conclusion The intelligent bed management model can effectively improve hospital bed utili-zation efficiency,enhance healthcare service quality,reduce staff workload,and merits wider application in similar hospitals.

Objective This study aims to evaluate the effectiveness of intelligent bed management model in integrating bed resources in a large comprehensive hospital.Methods Inpatient data from a tertiary hospital between January 2021 and De-cember 2024 were collected.An intelligent hospital-wide bed management platform was constructed to implement bed resource sharing mechanisms and establish a standardized bed reservation grading system.The implementation effect of the system was e-valuated from the perspective of bed occupancy rate,average length of stay,and patient satisfaction.Results After implementa-tion,bed occupancy rates in key monitored departments moved into a reasonable range:Rehabilitation Medicine Department fell from 113.18％to 101.48％(t=4.26,P＜0.01),while Neurology Department increased from 88.18％to 96.20％(t=3.85,P＜0.01).Annual inpatient admissions increased from 83,931 to 103,852(x2=156.82,P＜0.001),and average length of stay shortened from 7.15 days to 6.21 days(t=4.73,P＜0.01).The admission waiting time was cut by 72.7 hours(-43.1％),and satisfaction with bed allocation rationality improved by 11.2 points(t=5.94,P＜0.001).Staff time spent on bed-assignment fell by 42 minutes per shift(t=8.92,P＜0.001),and cross-department transfers increased by 378 episodes per month(x2=145.26,P＜0.001).Conclusion The intelligent bed management model can effectively improve hospital bed utili-zation efficiency,enhance healthcare service quality,reduce staff workload,and merits wider application in similar hospitals.

Objective:To summarize clinical characteristics and prognosis of immune checkpoint inhibitor (ICI) -related Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) .Methods:A retrospective analysis was conducted on patients diagnosed with ICI-related SJS/TEN in Zhongda Hospital, Southeast University from January 2018 to October 2023. Data on clinical manifestations, laboratory examinations, treatment and prognosis of the patients were analyzed.Results:A total of 9 patients were diagnosed with ICI-related SJS/TEN, including 8 males and 1 female, with the onset age ranging from 58 to 77 (67.56 ± 7.33) years. ICI were applied to all the 9 patients before onset of SJS/TEN. The latent period was 6 - 261 d, and the median duration was 76 d. All the patients presented with erythema as initial lesions, 3 cases with target lesions, 6 with blisters, and 5 cases with a positive Nikolsky's sign. Oral mucosal damage occurred in 7 cases, eye damage occurred in 6 cases, and urogenital damage occurred in 6 cases. All the 9 cases were treated with systematic glucocorticoids, 7 cases with intravenous immunoglobulin and 7 cases with antibiotics. Eight cases recovered and 1 case died. Among 6 patients followed for an average of 6.92 months, none achieved complete or partial remission, 3 died and 3 experienced disease progression.Conclusions:ICI-related SJS/TEN occurred with a relatively long latent period, and all the cases presented with erythema initially, with mucosal damage present in most of the cases. Management required discontinuation of ICI, and most patients recovered with corticosteroids and intravenous immunoglobulin, however, the prognosis for the primary malignancy remained poor.

Objective To investigate the effect and mechanism of M2 macrophage polarization induced by HCT116 with highly metastatic colorectal cancer cells on immune escape in colorectal cancer.Methods After the co-cul-ture of colorectal cancer cells conditioned medium(CM)and PMA-induced M0 macrophages,the polarization of M2 macrophages was observed by flow cytometry,real-time polymerase chain reaction(qPCR)and enzyme-linked immunosorbent assay(ELISA)experiments.The CMM0,CMSW480-Mφand CMHCT116-Mφ were co-cultured with HCT116 cells,and the expression of programmed death-ligand 1(PD-L1)was detected by Western blot and qPCR.At the same time,the stimulated HCT116 cells were co-cultured with human T lymphocytes to detect the survival of HCT116 cells and the levels of tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ).The difference of kruüppel-like factor 4(KLF4)expression between SW480 and HCT116 cells was detected by Western blots,qPCR and ELISA.After pretreatment of HCT116 cells with KFL4 inhibitor Kenpaullone(Ken),the CMHCT116 and CMHCT116+Ken were co-cultured with M0 macrophages and the polarization of M2 macrophages was observed by flow cytometry,qPCR and ELISA.The CMHCT116-Mφ and CM(HCT116+Ken)-Mφ was co-cultured with HCT116 cells,and the PD-L1 expression of HCT116 cells was detected by Western blot and qPCR.Results After the stimulation of M0 macrophages with CM,the proportion of CD11b+CD206+cells in HCT116-Mφ cells was higher,and the expres-sion of M2 macrophage markers interleukin(IL-10)and transforming growth factor-β(TGF-β)were higher.Com-pared with the CMSW480-Mφ group,the PD-L1 protein expression level was higher in the CMHCT116-Mφ group.After co-culture with T lymphocytes,the cell survival rate are the most in CMHCT116-Mφ group,while the levels of TNF-α and IFN-γ were the lowest.After the addition of Ken,the polarization ratio and markers of M2 macrophages decreased.Compared with CMHCT116-Mφ group,the expression of PD-L1 in HCT116 cells of the CM(HCT116+Ken)-Mφ group de-creased.Conclusion Highly metastatic colorectal cancer cells induce polarization of M2 macrophages by secreting KLF4,promote PD-L1 expression in colorectal cancer cells,facilitate tumor immune escape,and provide potential targets for clinical immunotherapy.

Objective:To study the risk factors of venous thromboembolism(VTE)and the predictive value of the improved VTE score model to identify the risk of VTE in gynecological surgery patients.Methods:From Janu-ary 1,2020 to December 31,2022,41 patients with VTE after gynecological surgery were selected as the VTE group,and a total of 164 patients with adjacent gynecological surgeries during the same period were selected as the non-VTE group with a ratio of 1 :4.Univariate and multivariate Logistic regression analysis were used to ana-lyze the risk factors of VTE after gynecological surgery,and a modified VTE risk factor rapid assessment model(referred to as the improved VTE score model)was constructed.The receiver operating characteristic(ROC)curve was used to study the predictive value for VTE for in gynecological surgery,and compared with the Caprini score model(Caprini table for short).Results:①Multivatiate Logistic regression analysis showed that there were independent risk factors for postoperative VTE in gynecology surgery(OR＞1,P＜0.05),including age≥60 years,BMI≥28 kg/m2,malignant tumors,surgery time＞3 hours,history of thrombosis,and the increased D-di-mer difference before and after surgery.②The Area under Curve(AUC)of ROC was 0.963 in the improved VTE score model with a Youden index 81.10％,sensitivity 87.80％and specificity 93.29％.The AUC of the Caprini score model was 0.888 with Youden index 63.41％,sensitivity 73.17％and specificity 90.24％.The improved VTE score model the Caprini score model identified 92.68％and 85.37％of VTE patients as high-risk or ex-tremely high-risk,respectively,but the difference was not statistically significant(P＜0.05).Conclusions:More attention should be paid to the six independent risk factors for postoperative VTE in gynecology surgery.The two score models showed a similar identified level.However,the improved VTE score model is more simple and easier to operate,has better practicality,and has certain clinical promotion value.

Objective To investigate the enhanced CT and MRI imaging features of nasal sinus squamous cell carcinoma(SCC)and lymphoma(NHL),and to analyze the efficacy of different imaging features in differentiating nasal sinus SCC from NHL.Methods The imaging,clinical and pathological data of 67 patients with sinus SCC and NHL who underwent sinus CT and MRI with contrast CT and MRI in our hospital and confirmed by surgical pathology were retrospectively analyzed,and the tumor origin,maximum diameter,CT density,MRI signal intensity,enhancement degree,tumor internal necrosis,adjacent bone destruction,invasion of surrounding tissues,and The imaging features such as cervical lymph node metastasis within the scanning range were analyzed,and the receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the efficacy of different imaging features to distinguish nasal sinus SCC and NHL.Results There were statistically significant differences between the five imaging features of nasal sinus SCC and NHL,including tumor origin,maximum diameter,internal tumor necrosis,surrounding bone destruction and peripheral tissue invasion(P＜0.05),and the AUC of differentiating SCC and NHL were 0.708,0.694,0.785,0.850 and 0.629,respectively.The AUC of SCC and NHL was 0.969,and the sensitivity and specificity were 83.9%and 97.2%,respectively.Conclusion On contrast-enhanced CT and MRI,the imaging signs of tumor origin,maximum diameter,tumor internal necrosis,bone destruction and surrounding tissue invasion are helpful to distinguish nasal sinus SCC from NHL,especially if the tumor originates in the nasal cavity,necrosis is rare,bone destruction is mild,and the possibility of nasal sinus NHL should be given priority.Contrast-enhanced CT and MRI can help differentiate nasal sinus SCC from NHL,and the combination can help improve differential diagnostic performance.

Objective To investigate the value of enhanced CT radiomics combined with CT features model(combined model)for differentiating squamous cell carcinoma(SNSCC)and sinonasal lymphoma(SL).Methods Totally 68 patients with SNSCC and 63 patients with SL were retrospectively collected and divided into training set(n=92,including 48 SNSCC and 44 SL)and verification set(n=39,including 20 SNSCC and 19 SL)at the ratio of 7:3.Univariate analysis and logistic regression were used to analyze clinical data and CT manifestations in training set,and the independent predictive factors for differentiating SNSCC and SL were screened and used to construct a CT features model.Based on enhanced venous phase CT of training set,the best radiomics features of lesions were extracted and screened.The radiomics model was then established,and the radiomics label was calculated.The combined model was finally constructed based on CT model and radiomics labels,and its nomogram was drawn.Receiver operating characteristic(ROC)curve were drawn,and the areas under the curve(AUC)were calculated to evaluate the efficacy of each model for differentiating SNSCC and SL.Calibration and decision curve analysis were used to evaluate the calibration efficacy and clinical benefit of the obtained combined model.Results The primary location of the lesion and bone invasion showed on CT were both independent predictive factors for SNSCC and SL(both P＜0.05),and CT model was constructed.Based on enhanced venous phase CT,3 best radiomics features were selected to establish the radiomics model.The AUC of CT,radiomics and combined model in training set was 0.895,0.730 and 0.925,respectively,and significant differences of AUC were found among 3 models(Z=-3.964 to-1.833,all P＜0.05).The AUC of CT,radiomics and combined model in verification set was 0.845,0.684 and 0.868,respectively,of combined model was greater than of radiomics model(Z=-2.568,P=0.010).The combined model had good calibration.Taken 15％-62％ and 85％-92％ as the thresholds in training set and 88％ to 95％ in validation set,the clinical net benefit of combined model was high.Conclusion The obtained enhanced CT radiomics combined with CT features model could be used to effectively differentiate SNSCC and SL.