Objective To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in passenger drivers and its influencing factors. Methods A total of 951 passenger drivers in Guangdong Province were selected as the research subjects using the judgmental sampling method. A Musculoskeletal Injury Questionnaire was employed to assess the prevalence of WMSDs in the past year. Results The prevalence of WMSDs in passenger drivers was 41.11%. The result of multivariable logistic regression analysis showed that married drivers had a higher risk of WMSDs than single drivers (P<0.05). The lower the frequency of physical exercise, the longer the driving time per week, the longer the continuous driving time, the more restricted the driving working space, the poorer the foot comfort during driving, and the more affected the normal meal, the higher the risk of WMSDs (all P<0.05). The risk of WMSDs in drivers with sleep time ≤ 8.0 h/d was higher than that in drivers with sleep time > 8.0 h/d (P<0.01), and the risk of WMSDs in drivers with the same posture for a long time on the shoulder was higher than that in drivers without this poor working posture (P<0.01). Conclusion WMSDs were prevalent among passenger drivers, which was associated with demographic and adverse ergonomic factors. Intervention on lifestyle and adverse ergonomic factors could further reduce the risk of WMSDs of passenger drivers.

Objective To analyze the factors influencing the occupational health literacy (OHL) level among workers in key industries from the perspectives of both individual workers and enterprises. Methods A total of 32 336 front-line workers from 12 key industries in the secondary industry in Guangdong Province were selected as the research subjects by a stratified cluster random sampling method. Their OHL level was investigated using Occupational Health Literacy Questionnaire of National Key Populations, and the influencing factors were analyzed. Results The OHL level of the research subjects was 48.5%. The OHL level of the research subjects in four dimensions from high to low was basic knowledge of occupational health protection, occupational health practice and behavior, legal knowledge of occupational health, and basic skills of occupational health protection (80.7%, 61.2%, 48.3% and 29.5%, respectively). The multivariable logistic regression analysis showed that the OHL level of female workers was lower than that of males (P<0.05). Lower OHL was also associated with older age, lower education level, lower personal monthly income of workers (all P<0.01). The workers with length of service < 3 years and ≥ 20 years had lower OHL level than those with length of service 3-<10 years and 10-<20 years, respectively (all P<0.05). Workers in larger enterprises had higher OHL levels (all P<0.01). The OHL level of workers in the sixth category of industries with occupational injuries had higher occupational injury risks than those in the third and fourth categories (all P<0.05). The OHL levels of workers in state-owned enterprises, private enterprises, foreign-funded enterprises, and other enterprises were higher than that of workers in public institutions (all P<0.05). Conclusion The influencing factors of workers′ OHL in key industries of the secondary industry include individual factors (gender, age, education level, personal monthly income, length of service) and enterprise factors (enterprise size, enterprise nature and industry injury risk category). Female, older workers, those with lower education or income, and those with short length of service represent priority groups for OHL interventions, while small and micro enterprises are priority units for future workplace health promotion intervention.

Receptor-interacting protein kinase 1 (RIPK1) plays an essential role in regulating the necroptosis and apoptosis in cerebral ischemia-reperfusion (I/R) injury. However, the regulation of RIPK1 kinase activity after cerebral I/R injury remains largely unknown. In this study, we found the downregulation of protein arginine methyltransferase 1 (PRMT1) was induced by cerebral I/R injury, which negatively correlated with the activation of RIPK1. Mechanistically, we proved that PRMT1 directly interacted with RIPK1 and catalyzed its asymmetric dimethylarginine, which then blocked RIPK1 homodimerization and suppressed its kinase activity. Moreover, pharmacological inhibition or genetic ablation of PRMT1 aggravated I/R injury by promoting RIPK1-mediated necroptosis and apoptosis, while PRMT1 overexpression protected against I/R injury by suppressing RIPK1 activation. Our findings revealed the molecular regulation of RIPK1 activation and demonstrated PRMT1 would be a potential therapeutic target for the treatment of ischemic stroke.

Objective To analyze the current status and influencing factors of occupational health literacy (OHL) among noise-exposed workers in the automotive manufacturing industry. Methods A total of 1 188 front-line workers in noise-exposed positions in the automotive manufacturing industry were selected by judgment sampling method. The OHL status of the workers was investigated using the Occupational Health Literacy Questionnaire of National Key Population, and the influencing factors of OHL were analyzed. Results The overall OHL level was 30.13% (358/1 188). The result of binary logistic regression analysis showed that marital status, educational level, personal monthly income, household registration, enterprise scale and weekly working hours were influencing factors of OHL level (all P<0.05). Specifically, being married, having a high school education or higher, monthly personal income >5 000 yuan, being from a non-agricultural household, working in a medium-sized enterprise, and working more than >40-48 hours per week were protective factors for high OHL levels (all P<0.05). Conclusion There is considerable room for improvement in the OHL of noise-exposed workers in the automotive manufacturing industry. Focus should be placed on workers who are unmarried, widowed, or divorced, have educational levels below high school, earn less than 5 000 yuan per month, have agricultural household registrations, work in small or micro-sized enterprises, or work ≤40 hours per week, with targeted strategies to improve their overall OHL level.

Objective:To investigate the clinical characteristics and prognosis of bloodstream infection caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) in preterm infants, and to provide basis for early clinical diagnosis and infection control. Methods:The clinical data of infants with CRKP bloodstream infection admitted to the Preterm Infants Ward of Children′s Hospital Affiliated to Zhengzhou University from January 2015 to December 2022 were retrospectively analyzed. The risk factors for death in preterm infants caused by CRKP bloodstream infection were explored through multivariate logistic regression analysis, and the receiver operating characteristic (ROC) curve was used to analyze the clinical value of each factor on evaluating prognosis. The area under curves (AUC) of each factor in different ROC curve were compared by Delong′s test.Results:A total of 96 preterm infants with CRKP bloodstream infection were included, including 70 in the survival group and 26 in the death group. The first onset symptoms of CRKP bloodstream infection in preterm infants were persistent tachycardia (heart rate>180 per minute) (69 cases, 71.9%), fever (61 cases, 63.5%), and apnea (59 cases, 61.5%). There were 88(91.7%) cases of infection combined with septic shock, and 91(94.8%) cases required vasoactive drug support. Multivariate logistic regression analysis showed that the maximum vasoactive-inotropic score (VIS) within 48 hours of onset (odds ratio ( OR)=1.058, 95% confidence interval (95% CI) 1.022 to 1.095, P=0.001), concurrent purulent meningitis ( OR=8.029, 95% CI 1.344 to 47.972, P=0.022), and concurrent necrotizing enterocolitis (NEC) ( OR=10.881, 95% CI 1.566 to 75.580, P=0.016) were independent risk factors for death in preterm infants with CRKP bloodstream infection. The ROC curve showed that the AUCs for evaluating the prognosis of preterm infants with NEC and purulent meningitis were 0.784 and 0.711, respectively. The AUC for evaluating the prognosis of preterm infants with a maximum VIS ≥52.5 points within 48 hours of onset was 0.840, and the AUC for combining the three factors was 0.931. Compared with NEC and purulent meningitis, the AUC for combining factors was higher, the differences were statistically significant ( P=0.002, P<0.001). Conclusions:Preterm infants with CRKP bloodstream infection who have a maximum VIS ≥52.5 points within 48 hours of onset, with NEC and purulent meningitis have a higher risk of death.

ObjectiveTo analyze the current occupational health literacy (OHL) level and its influencing factors among drivers in transportation industry. Methods A total of 880 drivers of taxi companies, passenger transport companies, freight companies and online booking companies were selected as the research subjects using the judgment sampling method. The Occupational Health Literacy Questionnaire of National Key Populations was used to conduct a survey on their OHL levels via online questionnaires, and the influencing factors of OHL were analyzed. Results The OHL level of the research subjects was 54.32% (478/880). The OHL levels in the dimensions of occupational health legal knowledge, basic knowledge of occupational health protection, basic skills of occupational health protection, healthy working style and behavior were 55.34%, 79.55%, 58.30% and 46.25%, respectively. The results of the multivariate logistic regression analysis showed that the OHL levels of drivers in passenger transport and freight companies were higher than that in taxi companies (all P<0.01). The OHL levels of drivers in private enterprises, foreign-funded enterprises, and other enterprises were lower than those in state-owned enterprises (all P<0.05). The OHL levels of drivers in large enterprises were lower than that of drivers in micro-enterprises (P<0.05). The OHL levels of drivers worked >5-10 years and >10 years were lower than that of drivers working 1-5 years (all P<0.05). Conclusion There is a considerable room for improvement in the OHL levels of drivers in the transportation industry. The category, economic type, and scale of the employing unit and driving work year of the current position are the main influencing factors of OHL levels.

Objective:To observe and analyze the correlation between erythrocyte count and hemoglobin level in early life and retinopathy of prematurity (ROP).Methods:A clinical retrospective study. From January 2020 to December 2022, a total of 303 premature infants, who underwent fundus screening in Children's Hospital of Henan Province were included. There were 219 males and 84 females, with the average gestational age of (30.36±1.52) weeks and the average birth weight of (1 368.43±171.37) g. Early life was defined as 14 days after birth. According to the screening results, patients were divided into ROP group and no ROP group (control group). The results of red blood cell count, hematocrit and hemoglobin concentration of the two groups were compared and observed on the 3rd, 7th and 14th day after birth. The measurement data were compared by t-test, and the count data were compared by χ2 test. The risk factors of ROP were analyzed by logistic regression. The correlation between red blood cell count as well as hemoglobin concentration in early life and ROP was analyzed by receiver operating characteristics (ROC) curve. Results:Among the 303 premature infants screened, a total of 101 preterm infants were included in the ROP group, with the average gestational age of (30.39±1.48) weeks. And a total of 202 preterm infants were included in the control group, with the average gestational age of (30.35±1.55) weeks. There was no significant difference between the two groups in sex composition ratio ( χ2=0.296) and gestational age ( t=0.251) ( P>0.05). There were significant differences in birth weight ( t=-2.024), blood transfusion times ( U=-4.957), invasive mechanical ventilation duration ( U=-2.215) and continuous positive airway pressure ventilation time ( U=-5.224) between the two groups ( P<0.05). The incidence of periventricular leukomalacia ( χ2=5.069), bronchopulmonary dysplasia ( χ2=9.794) and sepsis ( χ2=8.041) were significantly different ( P<0.05). The average hemoglobin level of patients in the ROP group on the 3rd, 7th and 14th day after birth were lower than those in the control group ( t=-3.813, -2.753, -2.847; P<0.05). Logistic regression analysis showed that low frequency of blood transfusion [odds ratio ( OR)=1.241, 95% confidence interval ( CI) 1.016-1.517] and short duration of continuous positive airway pressure ( OR=1.128, 95% CI 1.031-1.234) were protective factors for ROP. The ROC curve analysis indicated that the abnormal threshold values of hematocrit and hemoglobin were the highest on the 14th day after birth, which were 115.5 g/L and 36.25% respectively. The sensitivities were 88.1% and 83.2%, respectively. Conclusion:Red blood cell count and hemoglobin level in early life of preterm infants may have a certain correlation with the occurrence and development of ROP.

Objective To analyze the effect of night-shift work, anxiety and their interaction on work-related musculoskeletal disorders (WMSDs) among electronics manufacturing employees. Methods A total of 2 676 employees from 58 electronic manufacturing enterprises in the Pearl River Delta region of Guangdong Province were selected as the research subjects using the judgment sampling method. The Basic Situation Survey Scale, Generalized Anxiety Disorder 7-item Scale and Questionnaire of Musculoskeletal Disorders were used to assess night-shift work, anxiety and the prevalence of WMSDs in employees. The multivariate logistic regression model was used to analyze the effects of night-shift work, anxiety and their combined effects on the risk of WMSDs. Results The proportion of night-shift work was 30.3%, and the detection rates of anxiety and WMSDs were 26.8% and 41.3%, respectively. The results of multivariate logistic regression analysis showed that night-shift work and anxiety were independent risk factors of WMSDs in the research subjects, after excluding the influence of confounding factors such as age, marital status, enterprise size and length of service [odds ratio (OR) and 95% confidence interval (CI) were 1.307 (1.092-1.564) and 3.282 (2.739-3.934), respectively, both P<0.01]. Compared with those without night-shift work or anxiety, the risk of WMSDs was higher in individuals with only night-shift work, only anxiety, or both night-shift work and anxiety [OR and 95%CI were 1.347 (1.091-1.663), 3.395 (2.727-4.227) and 4.117 (3.072-5.519), respectively, all P<0.01]. Conclusion Both night-shift work and anxiety can increase the risk of WMSDs among electronic manufacturing employees, and these two factors exhibit a synergistic effect in increasing the risk of WMSDs.

Objective:To investigate the prognosis and risk factors of IgA vasculitis nephritis (IgAVN) in children.Methods:A retrospective cohort study was conducted. Clinical data were collected from 264 children who were pathologically diagnosed with IgAVN at Department of Pediatric Nephrology, Tongji Hospital, affiliated with Tongji Medical College, Huazhong University of Science and Technology, between January 2011 and December 2017. All patients had a follow-up period of more than 3 years. Clinical characteristics, renal pathology, 3-year and 5-year prognosis were analyzed. The patients were grouped based on gender, age of onset (≤6 years, >6-9 years, and >9 years), pathological classification (≤Ⅲ and>Ⅲ),whether the prognosis was complete remission at 3 and 5 years. Independent sample t-tests, ANOVA or chi-squared test were used for intergroup comparisons. Spearman correlation analysis was applied for ordinal data, and multivariate Logistic regression was used to analyze factors affecting the prognosis. Receiver operating characteristic (ROC) curve was utilized to evaluate the predictive value of these factors. Results:Of the 264 children with IgAVN, 153 were male and 111 were female, the age of onset was 8.3 (6.7, 10.3) years, 118 patients (45%) with onset age >6-9 years accounted for the highest proportion. All patients presented with skin purpura and renal involvement, primarily manifesting as hematuria and/or proteinuria. Microscopic hematuria was observed in 253 patients (95.8%), while 246 patients (93.2%) showed proteinuria. In 256 patients (97.0%), hematuria or proteinuria urinalysis was detected within 6 months of skin purpura onset, and 243 patients (92.0%) underwent renal biopsy within 6 months of renal involvement. The most common clinical subtype in 264 IgAVN children was hematuria and proteinuria (204 cases, 77.3%), with grade Ⅲ being the predominant pathological classification (181 cases, 68.6%). Among children ≤6 years old, the 3-year complete remission rate was higher in males than in females (83.9% (26/31) vs. 7/16, χ2=8.12, P=0.012). Factors independently associated with poor 5-year prognosis included time from hematuria or proteinuria urinalysis to renal biopsy >6 months, elevated serum cholesterol levels, and incomplete remission 3 years post-biopsy ( OR=5.41, 1.39, 6.02, 95% CI 1.40-20.86, 1.04-1.84, 2.61-13.88, all P<0.05). The serum cholesterol has a predictive value for 5-year prognosis ( P=0.020, AUC=0.62, 95% CI 0.52-0.71, Youden index=0.27, cutoff=4.37). Conclusions:For children with IgAVN aged≤6 years, the 3-year prognosis is better in males than in females. Time from hematuria or proteinuria urinalysis to renal biopsy >6 months, elevated serum cholesterol levels, and incomplete remission at 3 years post-biopsy may be independent risk factors for poor 5-year prognosis in children with IgAVN.

Objective:To investigate the clinical characteristics and prognosis of cytomegalovirus-sepsis-like syndrome (CMV-SLS) in premature infants, and to provide the evidence for early clinical identification and treatment.Methods:Premature infants with CMV-SLS admitted to Children′s Hospital Affiliated of Zhengzhou University from January 1, 2019 to December 31, 2022 were selected as the research subjects, and their clinical characteristics, treatment, and prognosis were retrospectively analyzed.Results:A total of seven cases of CMV-SLS were included, with a gestational age of (26.8±1.2) weeks and a birth weight of (890±121) g. The age of disease onset was 55(45, 60) days, and the age of diagnosis was 67(56, 71) days. All the seven cases were exclusively breast feeding after birth, and cytomegalovirus (CMV) DNA was detected positive in their breast milk when diagnosed with CMV-SLS. The common clinical features were fever, abdominal distension, liver function damage, decreased neutrophil and platelet counts. Pneumonia, neonatal necrotizing enterocolitis, hearing loss, and chorioretinitis were common. After the diagnosis was confirmed, all the seven cases were given intravenous treatment of ganciclovir and followed by oral formulations, with a course of treatment ranging from five to seven weeks. Two cases were treated with intravitreal injection of ganciclovir for chorioretinitis. All the seven cases survived. During the follow-up with a corrected gestational age of 12 months, one case had delayed intellectual and motor development, two cases had delayed motor development, and the remaining cases had normal development.Conclusions:CMV-SLS in premature infants mainly occurs in extremely low birth weight infants, with atypical clinical manifestations and may be misdiagnosed easily. If extremely low birth weight infants who receive CMV DNA positive breast feeding show sepsis-like symptoms, the possibility of CMV infection should be considered, and early diagnosis and treatment should be carried out to prevent adverse outcomes.