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 analyze whether there are differences in reproductive outcomes between preimplantation genetic testing for aneuploidies (PGT-A) and conventional in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) in patients with recurrent spontaneous abortion (RSA). Methods:A retrospective cohort study was conducted at the Reproductive Center of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, including RSA patients who underwent assisted reproductive technology (ART) between January 2018 and June 2023. Patients were categorized into two groups based on the type of ART, the PGT-A group (78 patients, 100 embryo transfer cycles) and the IVF/ICSI group (95 patients, 105 embryo transfer cycles). Multivariate logistic regression analysis was performed to compare the impact of these two techniques on reproductive outcomes. Further analysis was conducted to evaluate the effects of maternal age, number of miscarriages, and previous chromosomal abnormalities in miscarried embryos on pregnancy outcomes. The primary outcome measure was the live birth rate, while secondary outcomes included the pregnancy rate and the miscarriage rate.Results:The live birth rate in the PGT-A group [50.0% (50/100)] was higher than that in the IVF/ICSI group [37.1% (39/105)], while the miscarriage rate [20.6% (13/63)] was lower than that in the IVF/ICSI group [39.1% (25/64)], with both differences being statistically significant ( P=0.043, P=0.023). Among RSA patients aged 37-45 years with ≥3 miscarriages, the miscarriage rate in the PGT-A group (0%) was significantly lower than that in the IVF/ICSI group [46.2%(6/13), P=0.017], whereas the differences in live birth rate and pregnancy rate between the two groups were not statistically significant (all P>0.05). For RSA patients with previous chromosomal abnormalities in miscarried embryos, the miscarriage rate in the PGT-A group [21.1% (12/57)] was significantly lower than that in the IVF/ICSI group [71.4% (5/7), P=0.012]. Additionally, the pregnancy rate [66.3% (57/86)] and the live birth rate [52.3% (45/86)] in the PGT-A group were significantly higher than those in the IVF/ICSI group [33.3% (7/21), P=0.006; 9.5% (2/21), P<0.001]. Among 37-45 years patients, the miscarriage rate in the PGT-A group [5.9% (1/17)] was significantly lower than that in the IVF/ICSI group [38.7% (12/31), P=0.035], and the live birth rate [57.1% (16/28)] was significantly higher than that in the IVF/ICSI group [31.7% (19/60), P=0.023]. These differences were statistically significant. Conclusion:Compared with conventional IVF/ICSI-assisted reproduction, the use of PGT-A in RSA patients younger than 37 years, with or without a history of chromosomally normal miscarried embryos, did not significantly improve reproductive outcomes, regardless of whether they had experienced more than three miscarriages. However, for RSA patients with chromosomal abnormalities in miscarried embryos, PGT-A significantly reduced the miscarriage rate across the age range of 26-45 years. In RSA patients aged 37-45 years, PGT-A significantly improved reproductive outcomes. However, for patients with two miscarriages and a history of chromosomally normal miscarried embryos, the therapeutic benefit of PGT-A was limited.

OBJECTIVE: Hepatocellular carcinoma (HCC) is sensitive to ferroptosis, a new form of programmed cell death that occurs in most tumor types. However, the mechanism through which ferroptosis modulates HCC remains unclear. This study aimed to investigate the oncogenic role and prognostic value of FANCD2 and provide novel insights into the prognostic assessment and prediction of immunotherapy. METHODS: Using clinicopathological parameters and bioinformatic techniques, we comprehensively examined the expression of FANCD2 macroscopically and microcosmically. We conducted univariate and multivariate Cox regression analyses to identify the prognostic value of FANCD2 in HCC and elucidated the detailed molecular mechanisms underlying the involvement of FANCD2 in oncogenesis by promoting iron-related death. RESULTS: FANCD2 was significantly upregulated in digestive system cancers with abundant immune infiltration. As an independent risk factor for HCC, a high FANCD2 expression level was associated with poor clinical outcomes and response to immune checkpoint blockade. Gene set enrichment analysis revealed that FANCD2 was mainly involved in the cell cycle and CYP450 metabolism. CONCLUSION To the best of our knowledge, this is the first study to comprehensively elucidate the oncogenic role of FANCD2. FANCD2 has a tumor-promoting aspect in the digestive system and acts as an independent risk factor in HCC; hence, it has recognized value for predicting tumor aggressiveness and prognosis and may be a potential biomarker for poor responsiveness to immunotherapy.
Humans ; Carcinoma, Hepatocellular/diagnosis* ; Liver Neoplasms/diagnosis* ; Immunotherapy ; Fanconi Anemia Complementation Group D2 Protein/metabolism* ; Prognosis ; Male ; Female ; Middle Aged ; Biomarkers, Tumor/metabolism*

Objective To explore the effect of moxibustion on bone metabolism and the mechanism of bone protection,the effect of moxibustion,a traditional Chinese treatment in patients with rheumatoid arthritis(RA),especially the levels of two biomarkers,interleukin 35(IL-35)and β-catenin in the serum of rheumatoid arthritis patients were investigated.Methods A total of 72 RA patients were randomly assigned equally to the treatment group(36 cases)and 36 patients each of the control group(36 cases).The control group was intervened with standardized Western medicine treatment.For the treatment group,moxibustion intervened on Zusanli,Shenshu,and Ashi acupoints three times a week for 5-week treatment,with the remaining treatments being the same as the control group.The clinical symptom-related scores,routine clinical test indicators,and serum IL-35,β-catenin,BMP-2,IL-1β contents of RA patients before and after treatment were compared between the two groups.Results After treatment,VAS score,DAS28 score,morning stiffness score and BMP-2,β-catenin and IL-1β in serum in 2 groups significantly decreased(P<0.01),while IL-35 content in treatment group significantly increased(P<0.01).VAS score,DAS28 score,morning stiffness score and BMP-2,β-catenin and IL-1β in serum showed the obvious advantage of the treatment group over the control group(P<0.05),but the two groups(P>0.05)have no significant discrepancy in serum IL-35 content.For the treatment group,the improvement values of morning stiffness score and joint swelling number were positively correlated with the improvement values of BMP-2 and β-catenin in serum(P<0.01,P<0.05,r>0).The improvement of serum IL-35 was negatively correlated with the improvement of DAS28 score in the treatment group(P<0.05,r<0).Conclusion On the basis of conventional western medicine treatment,moxibustion may inhibit the levels of IL-35 and IL-1β in serum of RA patients,regulate the Wnt/β-catenin signaling pathway,regulate the levels of β-catenin and BMP-2,reduce the inflammatory response of RA,regulate bone metabolism,and achieve the purpose of bone protection.Thus,bone and joint teratogenesis or disability in RA patients was prevented and delayed.

Objective:To analyze whether there are differences in reproductive outcomes between preimplantation genetic testing for aneuploidies (PGT-A) and conventional in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) in patients with recurrent spontaneous abortion (RSA). Methods:A retrospective cohort study was conducted at the Reproductive Center of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, including RSA patients who underwent assisted reproductive technology (ART) between January 2018 and June 2023. Patients were categorized into two groups based on the type of ART, the PGT-A group (78 patients, 100 embryo transfer cycles) and the IVF/ICSI group (95 patients, 105 embryo transfer cycles). Multivariate logistic regression analysis was performed to compare the impact of these two techniques on reproductive outcomes. Further analysis was conducted to evaluate the effects of maternal age, number of miscarriages, and previous chromosomal abnormalities in miscarried embryos on pregnancy outcomes. The primary outcome measure was the live birth rate, while secondary outcomes included the pregnancy rate and the miscarriage rate.Results:The live birth rate in the PGT-A group [50.0% (50/100)] was higher than that in the IVF/ICSI group [37.1% (39/105)], while the miscarriage rate [20.6% (13/63)] was lower than that in the IVF/ICSI group [39.1% (25/64)], with both differences being statistically significant ( P=0.043, P=0.023). Among RSA patients aged 37-45 years with ≥3 miscarriages, the miscarriage rate in the PGT-A group (0%) was significantly lower than that in the IVF/ICSI group [46.2%(6/13), P=0.017], whereas the differences in live birth rate and pregnancy rate between the two groups were not statistically significant (all P>0.05). For RSA patients with previous chromosomal abnormalities in miscarried embryos, the miscarriage rate in the PGT-A group [21.1% (12/57)] was significantly lower than that in the IVF/ICSI group [71.4% (5/7), P=0.012]. Additionally, the pregnancy rate [66.3% (57/86)] and the live birth rate [52.3% (45/86)] in the PGT-A group were significantly higher than those in the IVF/ICSI group [33.3% (7/21), P=0.006; 9.5% (2/21), P<0.001]. Among 37-45 years patients, the miscarriage rate in the PGT-A group [5.9% (1/17)] was significantly lower than that in the IVF/ICSI group [38.7% (12/31), P=0.035], and the live birth rate [57.1% (16/28)] was significantly higher than that in the IVF/ICSI group [31.7% (19/60), P=0.023]. These differences were statistically significant. Conclusion:Compared with conventional IVF/ICSI-assisted reproduction, the use of PGT-A in RSA patients younger than 37 years, with or without a history of chromosomally normal miscarried embryos, did not significantly improve reproductive outcomes, regardless of whether they had experienced more than three miscarriages. However, for RSA patients with chromosomal abnormalities in miscarried embryos, PGT-A significantly reduced the miscarriage rate across the age range of 26-45 years. In RSA patients aged 37-45 years, PGT-A significantly improved reproductive outcomes. However, for patients with two miscarriages and a history of chromosomally normal miscarried embryos, the therapeutic benefit of PGT-A was limited.

Objective To understand the epidemiological characteristics and trends of postoperative pneumonia(POP)in tertiary general hospitals in Jiangsu Province,and provide theoretical basis for carrying out targeted pre-vention and control measures.Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north,central,and south of Jiangsu Province from January 1,2022 to December 31,2023 were chosen as studied subjects,occurrence of POP was analyzed and compared.Results A total of 848 274 surgical procedures were performed in 22 hospitals,and 3 606 cases of POP occurred,with an incidence of 0.43％.The incidence in 2023 was 0.37％,which was lower than that in 2022(0.49％),with statistically significant difference(P＜0.001).The top three de-partments with high incidence of POP were neurosurgery(6.71％),cardiothoracic surgery(2.91％),and general surgery(0.77％).Among hospitals of different grades,the incidence of POP in tertiary first-class hospitals was 0.44％,which was higher than that in other tertiary hospitals(0.37％).There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals(P＞0.05).The incidence of POP in hospitals with a bed:infection control full-time staff ratio＜200∶1 was lower than that in hospitals with the ratio ≥200∶1(0.39％vs 0.47％,P＜0.001),while the incidence of POP in hospitals with a proportion ≥30％of full-time staff being doctors was higher than that in hospitals with a proportion＜30％(0.45％vs 0.36％,P＜0.001).The incidence of POP in male patients was higher than that in female patients(0.62％vs 0.26％,P＜0.001).The incidence of POP in elderly patients aged≥65 was higher than that in patients aged＜65(0.73％vs 0.26％,P＜0.001).A total of 2 667 strains of infectious pathogens were detected,with the top three being Acine-tobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 28.95％,22.72％,and 15.45％,respectively.The detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB),carba-penem-resistant Klebsiella pneumoniae(CRKP),and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were 60.75％,21.45％,and 32.28％,respectively.The detection rate of CRKP decreased in 2023 compared with 2022,with statistically significant difference(P＜0.05).Conclusion The overall incidence of POP in tertiary general hos-pitals in Jiangsu Province is relatively low,but there are significant differences among different hospitals.There-fore,perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.

Objective To explore the effect and mechanism of Slc1a2 overexpression on cognitive dysfunction in sleep-deprived mice.Methods A total of 130 mice were divided into five groups:normal sleep(NS),NS+ov-Slc1a2,sleep deprivation(SD),SD+ov-NC,and SD+ov-Slc1a2,with 26 mice in each group.The SD mice model was established using an automatic system based on a rotating rod,and overexpress Slc1a2 adenovirus was injected into the prefrontal cortex(PFC).Immunofluorescence and Western blotting were used to detect the expression of Slc1a2 in the mouse PFC.Electrophysiological tests were used to evaluate non-rapid eye movement(NREM)sleep time,rapid eye movement(REM)sleep time,and wakefulness time in mice.Real-time quantitative PCR was used to detect the expression of glutamate(Glu)and gamma-aminobutyric acid(GABA)metabolic enzymes in the mouse PFC.Whole-cell patch-clamp recording was used to detect the frequency and amplitude of miniature excitatory postsynaptic currents(mEPSC)in mouse PFC.Immunofluorescence was used to detect the proportion of GABA-positive cells in the mouse PFC.The C11-BODIPY fluorescent probe was used to detect lipid reac-tive oxygen species(ROS)levels in mouse PFC.Commercial kits were used to detect Fe2+and malondialdehyde(MDA)levels in the mouse PFC.Cognitive function in mice was evaluated using the open field,novel object recognition,and Y-maze tests.Results Compared with the NS group,the NREM sleep time,REM sleep time,central area stay time,recognition index,and novel wall selection index increased significantly,while wakefulness time decreased significantly in the NS+ov-Slc1a2 group(all P＜0.05).The percentage of Slc1a2+GFAP+cells,expression of Slc1a2 protein,expression of Glul,Slc6a1,and Abat mRNA,frequency and amplitude of mEPSC,and proportion of GABA-positive cells in the PFC increased significantly,whereas lipid ROS,Fe2+,and MDA levels decreased significantly(all P＜0.05).Compared with the NS group,the NREM sleep time,REM sleep time,central area stay time,recognition index,and novel wall selection index of the SD group and the SD+ov-NC group were significantly decreased,whereas wakefulness time was significantly increased(all P＜0.05).The percentage of Slc1a2+GFAP+cells,expression of Slc1a2 protein,expression of Glul,Slc6a1,and Abat mRNA,frequency and amplitude of mEPSC,and proportion of GABA-positive cells in the mouse PFC decreased significantly,whereas lipid ROS,Fe2+,and MDA levels increased significantly(all P＜0.05).Compared with the SD and SD+ov-NC groups,the NREM sleep time,REM sleep time,central area stay time,recognition index,and novel wall selection index of the SD+ov-Slc1a2 group increased significantly,whereas the wakeful-ness time decreased significantly(all P＜0.05).The percentage of Slc1a2+GFAP+cells,the expression of Slc1a2 protein,the expression of Glul,Slc6a1,and Abat mRNA,the frequency and amplitude of mEPSC,and the proportion of GABA-positive cells in the mouse PFC increased significantly,whereas lipid ROS,Fe2+,and MDA levels decreased significantly(all P＜0.05).Conclusion Ectopic overexpres-sion of Slc1a2 in the PFC can improve sleep disorders in SD mice,reduce the damage caused by SD to excitatory synaptic transmission and GABAergic neuron function in the PFC,and alleviate cognitive impairment and anxiety-like behavior in these mice.Its mechanism may be related to the improvement of Glu/GABA metabolic imbalance in the PFC and inhibition of ferroptosis.

To investigate the effects of Biyan Jiedu Capsules on the proliferation and apoptosis of nasopharyngeal carcinoma cells and their molecular mechanism, nasopharyngeal carcinoma cells CNE1 and CNE2 were used. They were divided into control group(30% blank serum medium), low-(10% drug-containing serum + 20% blank serum medium), medium-(20% drug-containing serum + 10% blank serum medium), and high-(30% drug-containing serum medium) concentration group of Biyan Jiedu Capsules according to in vitro experiment. After 24 h of intervention, the effects of Biyan Jiedu Capsules on the proliferation of CNE1 and CNE2 were detected by CCK-8 assay, clonal formation experiment, and EdU staining. The effect of Biyan Jiedu Capsules on apoptosis of CNE1 and CNE2 was detected by flow cytometry. Western blot was used to detect the effect of Biyan Jiedu Capsules on the expression of X-linked apoptosis inhibitor protein(XIAP), survivin, proliferating cell nuclear antigen(PCNA), and PI3K/Akt pathway-related proteins in CNE1 and CNE2. The results showed that compared with the control group, the survival rate of CNE1 and CNE2 in the medium and high concentration groups of Biyan Jiedu Capsules could be decreased in a concentration-dependent way(P<0.05, P<0.01). At the same time, EdU staining and clonal formation experiments showed that the proliferation of CNE1 and CNE2 was significantly inhibited in the medium and high concentration groups of Biyan Jiedu Capsules(P<0.05, P<0.01). Flow cytometry showed that the apoptosis rate of CNE1 and CNE2 was significantly increased in all concentration groups of Biyan Jiedu Capsules(P<0.01), and the apoptosis rate was concentration-dependent. Western blot showed that the expressions of XIAP, survivin, PCNA, p-PI3K, and p-Akt in all concentration groups of Biyan Jiedu Capsules were significantly down-regulated(P<0.05, P<0.01). In conclusion, Biyan Jiedu Capsules can inhibit the proliferation and induce apoptosis of nasopharyngeal carcinoma cells possibly by down-regulating the PI3K/Akt signaling pathway.
Humans ; Apoptosis/drug effects* ; Cell Proliferation/drug effects* ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms/physiopathology* ; Proto-Oncogene Proteins c-akt/genetics* ; Cell Line, Tumor ; Drugs, Chinese Herbal/pharmacology* ; Phosphatidylinositol 3-Kinases/genetics* ; Signal Transduction/drug effects* ; Capsules ; Carcinoma/drug therapy*

Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

This study aimed to characterize and identify the non-volatile components in aqueous and ethanolic extracts of the stems and leaves of Rhododendron tomentosum by using sensitive and efficient ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry(UHPLC-Q-TOF-MS) combined with a self-built information database. By comparing with reference compounds, analyzing fragment ion information, searching relevant literature, and using a self-built information database, 118 compounds were identified from the aqueous and ethanolic extracts of R. tomentosum, including 35 flavonoid glycosides, 15 phenolic glycosides, 12 flavonoids, 7 phenolic acids, 7 phenylethanol glycosides, 6 tannins, 6 phospholipids, 5 coumarins, 5 monoterpene glycosides, 6 triterpenes, 3 fatty acids, and 11 other types of compounds. Among them, 102 compounds were reported in R. tomentosum for the first time, and 36 compounds were identified by comparing them with reference compounds. The chemical components in the ethanolic and aqueous extracts of R. tomentosum leaves and stems showed slight differences, with 84 common chemical components accounting for 71.2% of the total 118 compounds. This study systematically characterized and identified the non-volatile chemical components in the ethanolic and aqueous extracts of R. tomentosum for the first time. The findings provide a reference for active ingredient research, quality control, and product development of R. tomentosum.
Rhododendron/chemistry* ; Chromatography, High Pressure Liquid/methods* ; Drugs, Chinese Herbal/chemistry* ; Mass Spectrometry/methods* ; Plant Leaves/chemistry*