Background The positive rate of work-related musculoskeletal disorders (WMSDs) among coal mine workers remains high, which seriously affects the quality of life of the workers. Objective To estimate the prevalence of WMSDs among coal miners in Shanxi Province and analyze their influencing factors. Methods From May to December 2023, 2315 coal miners from a coal mine enterprise inShanxi Province were selected by convenience sampling, and the self-administered Basic Situation Survey Scale, Musculoskeletal Disorders Questionnaire, Effort-Reward Imbalance Questionnaire, and Pittsburgh Sleep Quality Scale were used to evaluate general demographic characteristics, work organization characteristics, living habits, sleep quality, occupational stress, and occurrence of WMSDs symptoms and the corresponding absences (sickness absence) in past 1 year. The positive rate and absenteeism rate of WMSDs were caculated, and Pearson's chi-square test was used for identify influencing factors of WMSDs, and finally a binary logistic regression method was used to further studying the factors. Results A total of 2577 questionnaires were distributed in this survey, and 2315 valid questionnaires were recovered, with an effective recovery rate of 89.9%. The positive rate of WMSDs symptoms was 48.7% (1127/2315), the absenteeism rate due to WMSDs was 22.6% (523/2315), and the waist (17.5%), neck (11.7%), and knee (9.0%) were the most common areas presenting WMSDs symptoms. The results of logistic regression showed that compared with ≤10 years of service, the risk of WMSDs was higher for those with > 20 years of service (OR=2.167, 95%CI: 1.419, 3.311). Compared with the daily working time of ≤8 h, the risk of WMSDs was higher for those >8 h daily working time (OR=1.463, 95%CI: 1.211, 1.767). A higher risk of WMSDs was reported in workers with moderate labor intensity (OR=1.247, 95%CI: 1.009, 1.542) or heavy labor intensity (OR=1.570, 95%CI: 1.215, 2.027) than those with light labor intensity. The higher the education level (OR _{high school and technical secondary school}=1.866, 95%CI: 1.435, 2.425; OR _{junior college/bachelor degree or above}=1.953, 95%CI: 1.445, 2.639), the higher the risk of WMSDs. The risk of WMSDs was higher in workers reporting smoking (OR=1.225, 95%CI: 1.021, 1.470) or alcohol consumption (OR=1.345, 95%CI: 1.122, 1.612). The risk of WMSDs in coal miners with high occupational stress (OR=1.229, 95%CI:1.030, 1.466) or those with sleep disorders (OR=3.616, 95%CI:2.824, 4.629) was higher than that in workers with low occupational stress or no sleep disorders respectively. Conclusion The positive rate of WMSDs among coal mine personnel in Shanxi Province is high, and education level, length of service, daily working hours, smoking, alcohol consumption, labor intensity, sleep disorders, and occupational stress are influencing factors for WMSDs.

Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.

ObjectiveTo investigate the infestation and disposal of bedbugs in Shanghai， and provide scientific evidence for comprehensive prevention and control of bedbugs. MethodsA questionnaire survey was conducted in the pest control operations （PCOs） of Shanghai Association for Health Promotion to investigate the infestation and disposal of bedbugs. The questionnaire included basic information of the unit， bedbug disposal experience， type of environment of bedbug infestation， main disposal site， main treatment method， main drug and formulation， and evaluation of the disposal. Chi-square test was used for comparison between groups. ResultsOf the 116 PCOs， 78 （67.24%） had conducted bedbug disposal， and 29.49% had conducted the disposal no less than 5 times in the past three years. The main types of environment of bedbug infestation were dormitories （46.96%）， hotels （18.78%）， and households （20.44%）. Additionally， bedbug infestation was found in nursing homes， prisons and detention centers， and transport vehicles. Bed frame/bed board/mattress （32.42%） was the main site of bedbug infestation， followed by mat （19.63%）. Chemical spraying was the most common method for bedbug disposal （98.72%）， followed by high-temperature steam （11.54%）. The main drug used in chemical spraying were pyrethroids （69.23%）， nicotinoids （60.26%） and organophosphorus （42.31%）， for which the main formulation were suspended insecticides （55.13%）， followed by wettable powders （43.59%） and emulsifiers （43.59%）. Furthermore， 89.74% of the PCOs performed the assessment after disposal， in which the control effect was generally satisfactory. ConclusionBedbug infestation is relatively common in Shanghai. Dormitories， hotels and households are places where bedbug infestation is more likely to occur. Bed frame， bed board and mattress are the most vulnerable sites to bedbug infestation. Combination of physical and chemical methods should be used for disposal of bedbug infestation.

Objective:To investigate the distribution and hantavirus (HV) carrying state in host animals of hemorrhagic fever with renal syndrome (HFRS) in Henan Province from 2019 to 2022.Methods:Host animal monitoring was carried out at the monitoring sites of HFRS in Henan Province. The real-time fluorescence quantitative PCR was used to detect hantavirus in rat lungs. The types of hantavirus were analyzed. The positive samples were sequenced and then sequence homology and variation were analyzed.Results:A total of 1 308 rodents were captured from 2019 to 2022, 16 specimens of rat lungs tested positive for hantavirus nucleic acid. The positive rate of HV was 1.22% (16/1 308). According to type, the positive rate of HV in Apodius agrarius was the highest (68.75%, 11/16). According to distribution, the positive rate of HV in field samples was the highest (2.50%, 12/480), and the positive rate of HV in residential samples was 0.53% (4/759). The typing results of 16 positive samples showed that all viruses were hantavirus type Ⅰ (hantaan virus). The positive samples were sequenced and eight S gene fragments (GenBank number: OQ681444-OQ681451) and six M gene fragments (OQ681438-OQ681443) were obtained. The S and M gene fragments were similar to the Shaanxi 84FLi strain and Sichuan SN7 strain. Phylogenetic analysis of S and M gene fragments showed that they all belonged to the hantaan virus-H5 subtype. Amino acid sequence analysis revealed that, compared with the hantaan virus vaccine strain 84FLi, the 74th amino acid encoded by eight S fragments was replaced by aspartamide with serine. Tryptophan was replaced by glycine at the 14th position of Gn region in XC2022047, and isoleucine was replaced by alanine at the 359 position of XC2022022 and XC2022024.Conclusion:The hantavirus carried by host animals in Henan Province from 2019 to 2022 belongs to the type Ⅰ (hantaan virus), and Apodemus agrarius is still the dominant host animal of the hantaan virus. Compared with the vaccine strains, amino acid sites are replaced in the immune epitopes of the S and M gene fragments.

To analyze the biological characteristics of Pasteurella multocida in bovine respiratory tract and its prevalence in large-scale cattle farms,bacterial isolation,culture,and morphological observation were conducted on the lungs and liver samples of dead cows suffering from respiratory diseases in Hohhot,Inner Mongolia.The isolated strains were studied through biochemical testing,16S rRNA gene sequencing,specific primer PCR identification,capsule serotyping,pathogenicity testing,virulence gene testing,drug sensitivity testing,and drug resistance gene detection methods.The results showed that six strains of Pasteurella multocida serotype A were isolated and identi-fied from the lungs of diseased and dead cows.After sequencing the 16S rRNA sequence of the bac-teria,it was found that the six strains of Pasteurella multocida had the closest genetic relationship with the Chongqing isolate CQ2(CP033599.1).The results of mouse pathogenicity test and viru-lence gene detection showed that all isolates were pathogenic and carried at least 16 or more related virulence genes such as exbB,nanB,sodC,oma 87,etc.,but no hsf1 and toxA were detected.The results of drug sensitivity tests and resistance gene detection showed that the isolated strains were sensitive to different degrees of antibiotics such as ciprofloxacin,ofloxacin,and cefotaxime.They were resistant to streptomycin,clindamycin,and lincomycin,and resistance genes of str A,strB,and tet(H)were detected.The results indicate that there is a certain correlation between the pathoge-nicity and virulence genes,drug resistance phenotype,and drug resistance genes of Pasteurellamultocida type A in cattle.It is recommended to use quinolones(such as ciprofloxacin)and cepha-losporins(such as cefotaxime)antibacterial drugs in clinical practice,which can provide scientific basis and prevention and control plans for the prevention and treatment of respiratory diseases caused by Pasteurella multocida in cattle farms,and lay a foundation for the epidemiological mo-nitoring of bovine respiratory multocida pasteurellosis.

Objective To explore the role of serum Irisin,Nesfatin-1 and chitinase like protein 40(YKL-40)levels detection in evaluating the condition of patients with multiple sclerosis(MS).Methods A total of 160 MS patients who visited the First Hospital of Handan City from August 2017 to November 2023 were selected as the study subjects.According to clinical classification,they were separated into a remission group(n=115)and a progression group(n=45),and according to the severity of condition,they were separated into a mild group(n=109)and a severe group(n=51).ELISA method was applied to detect the levels of Irisin,Nesfatin-1 and YKL-40 in serum.Pearson was applied to analyze the correlation between serum Irisin,Nesfatin-1,YKL-40 levels and expanded disability status scale(EDSS)score in MS patients.Multivariate Logistic regression was applied to analyze the influencing factors of Ms Necerity.ROC curve was applied to analyze the evaluation value of serum Irisin,Nesfatin-1 and YKL-40 levels for the progression of MS patients.Results In the advanced stage group,the serum levels of Irisin(8.25±2.17 ng/ml)and Nesfatin-1(5.94±1.76 ng/ml)in MS patients were lower than those in the remission stage group(14.94±3.58 ng/ml,9.92±2.15 ng/ml),while the YKL-40(42.98±10.89 ng/ml)level was higher than that in the remission stage group(22.78±7.95 ng/ml),and the differences were statistically significant(t=11.709,11.048,12.956,all P<0.05).In the severe group,the serum levels of Irisin(8.86±2.21 ng/ml)and Nesfatin-1(6.32±1.91 ng/ml)in MS patients were lower than those in the mild group(15.02±4.42 ng/ml,9.96±2.30 ng/ml),while the disease course(5.84±1.65 years)and YKL-40(37.28±10.15 ng/ml)levels were higher than those in the mild group(3.65±1.45 years,24.34±7.62 ng/ml),and the differences were statistically significant(t=8.514,9.407,9.823,8.971,all P<0.05).Serum Irisin and Nesfatin-1 levels in MS patients were negatively correlated with EDSS scores(r=-0.504,-0.517,all P<0.05),while YKL-40 levels were positively correlated with EDSS scores(r=0.509,P<0.05).Irisin(OR=0.724,95%CI:0.589～0.889)and Nesfatin-1(OR=0.813,95%CI:0.669～0.945)were protective factors for disease progression in MS patients,while YKL-40(OR=2.964,95%CI:1.795～4.894)was a risk factor for disease progression in MS patients(all P<0.05).The AUCs of serum Irisin,Nesfatin-1 and YKL-40 levels in evaluating the progression of MS patients were 0.844,0.849 and 0.823,respectively,which were lower than the AUC(0.957)of their combination(Z=3.158,3.096,3.324,all P<0.05).Conclusion Serum Irisin,Nesfatin-1 and YKL-40 detection levels can effectively evaluate the progression of MS patient condition.

Objective To explore the clinical value of serum histone deacetylase 2(HDAC2)and histone deacetylase 6(HDAC6)levels combined with Doppler ultrasound indicators in diagnosing the occurrence of preeclampsia(PE)and fetal growth restriction(FGR)in pregnant women.Methods A total of 176 PE and FGR pregnant women who underwent regular prenatal examination and delivered at Cangzhou Integrated Tra-ditional Chinese and Western Medicine Hospital from March 2021 to May 2023 were selected as the study sub-jects and separated into PE group(94 cases)and FGR group(82 cases),pregnant women with normal prena-tal examination results and delivery during the same period were selected as control group(91 cases).Enzyme linked immunosorbent assay was applied to detect the levels of serum HDAC2 and HDAC6,respectively.Doppler ultrasound was applied to detect resistance index(RI),pulsatile index(PI),and the ratio of maximum systolic and diastolic blood flow velocity of the umbilical artery(S/D).Receiver operating characteristic(ROC)curve was applied to analyze the clinical diagnostic value of Doppler ultrasound indicators(RI,PI,S/D)and HDAC2,HDAC6 for PE and FGR.Results The gestational age and spontaneous delivery rate in the PE and FGR groups were obviously lower than those in the control group(P＜0.05).The levels of serum HDAC2 and HDAC6 in the PE and FGR groups were obviously lower than those in the control group(P＜0.05).RI,PI,and S/D in the PE and FGR groups were obviously higher than those in the control group(P＜0.05).The area under the curve(AUC)of Doppler ultrasound indicators combined with serum HDAC2 and HDAC6 for diagnosing PE and FGR was 0.968 and 0.949,respectively,which was better than that of single detection(all P＜0.001).Conclusion The serum levels of HDAC2 and HDAC6 in pregnant women with PE and FGR are obviously reduced,and the combination of the two and Doppler ultrasound indicators has good di-agnostic value for the occurrence of PE and FGR.

Objective:To determine the expression and diagnostic value of peripheral blood lymphocytes and functional activation status in non-Hodgkin lymphoma with hemophagocytic lymphohistiocytosis (NHL-HLH) .Methods:We retrospectively analyzed clinical data from 30 newly diagnosed NHL-HLH patients admitted to Jiangsu Province Hospital from September 2022 to September 2023. We assessed peripheral blood lymphocytes and activation status by flow cytometry. Forty newly diagnosed patients with NHL who received treatment at our hospital during the same period and had lymphocyte and functional activation indexes were selected as the control group. The differences in relative and absolute lymphocyte counts and functional activation indexes between the two groups were compared. The optimal cutoff values for continuous variables were calculated from the receiver operating characteristic curve and logistic regression analysis was used to evaluate the risk factors in NHL patients with HLH.Results:A total of 30 NHL-HLH patients were evaluated, including 12 T-cell lymphoma and 18 B-cell lymphoma patients. Forty individuals were in the control group, which included 19 T-cell lymphoma and 21 B-cell lymphoma patients. The absolute counts of CD3 + T, CD4 + T, CD8 + T, and NK cells, along with the relative count of NK cells, were significantly lower in the HLH group compared with that in the control group (all P values<0.01) . The expression of CD38 and HLA-DR on CD8 + T-cell activated subgroups was significantly higher in the NHL-HLH group compared with that in the control group (CD8 +CD38 +/CD8 + T expression median: 57.4% vs 21.5%, P<0.001; CD8 +CD38 +/CD8 + T expression median: 49.7% vs 33.5%, P=0.028, respectively) . In addition, CD28 expression on CD4 + and CD8 + T cells was significantly higher in NHL-HLH patients ( P<0.01) . ROC curve and multivariate logistic regression analyses revealed that absolute NK cell count ≤72.0 cells/μl, CD4 +CD28 +/CD4 + T >94.2%, and CD8 +CD28 +/CD8 + T >38.4% were risk factors for predicting the occurrence of NHL-HLH patients. The sensitivity and specificity of the regression model were 86.7% and 86.1%, respectively, with an area under the curve of 0.94 ( P<0.001) . Conclusions:In NHL patients with HLH, there was a significant reduction in the absolute number of peripheral blood lymphocyte subpopulations, whereas T-cell function was notably activated. Specifically, absolute counts of NK cells ≤72.0 cells/μl, CD4 +CD28 +/CD4 + T >94.2%, and CD8 +CD28 +/CD8 + T >38.4% were identified as risk factors for predicting the development of NHL-HLH patients. This will assist in early clinical diagnosis and treatment.

OBJECTIVE In this study,the effects of live Lactobacillus murinus(L.m)and heat-killed L.muri-nus(H-k L.m)on DA neuronal damage in rats and the underlying mechanisms were investigated.METHODS Male SD rats were randomly divided into five groups:vehicle group,L.m/H-k L.m(1×109 cfu)group,6-OHDH group,6-OHDH + L.m/H-k L.m(1×107 cfu)group,and 6-OHDH + L.m/H-k L.m(1×109 cfu)group.Wild-type and NLRP3 knockout mice were divided into three groups:sham(vehicle),6-OHDH,and 6-OHDH + H-k L.m(1×109 cfu).The model was established after five weeks of pre-administration.Motor ability of experimental mice was assessed by rotarod,mine,and stepping experiments;the expression of dopaminergic neuron markers—tyro-sine hydroxylase(TH),microglial cell markers—ionized calnexin 1(IBA-1),and NOD-like receptor family protein 3(NLRP3)in the substantia nigra was detected by immunohistochemistry and immunofluorescence experi-ments.The expression changes of TH,IBA-1,NLRP3,apoptosis-associated microparticle protein(ASC),cas-pase 1,and inflammatory factors such as interleukin-1β(IL-1β),IL-18,and tumor necrosis factor-α(TNF-α)were detected by immunoblotting experiments.RESULTS H-k L.m ameliorated 6-OHDH-induced motor dysfunctions and loss of substantia nigra DA neurons,while no protec-tion was shown in live L.m treatment.At the same time,H-k L.m reduced the activation of NLRP3 inflammasome in microglia and the secretion of pro-inflammatory factors,thus inhibiting the development of neuroinflammation.Fur-thermore,H-k L.m failed to display its original neuropro-tective properties in NLRP3 inflammasome knockout mice.CONCLUSION H-k L.m conferred neuroprotec-tion against DA neuronal loss via the inhibition of microglial NLRP3 inflammasome activation,these findings provide a promising potential for future applications of L.m,and also beneficial strategy for PD treatment.

The outpatient and emergency electronic medical record system is an important part of the hospital information system. By analyzing the current outpatient and emergency electronic medical record system in hospitals in China, this paper rounded up weaknesses in the development of the outpatient and emergency electronic medical record system in terms of management standards, support, technology bottleneck, data sharing and security. On such basis, the authors suggested to improve the policy standards, clarify the construction objectives, increase the support, optimize the system functions and strengthen the security management, which aimed at promoting the high-quality development of the construction of outpatient and emergency electronic medical record system in China′s hospitals.