Background Health literacy is closely related to mental health, and improving health literacy has been shown to promote mental well-being. However, whether occupational stress among workers in mining and manufacturing is associated with their occupational health literacy remains inconclusive. Objective To study the levels of occupational health literacy and occupational stress among workers in three industrial sectors (metal ores mining, metal smelting, and manufacture of non-metallic mineral products) in Gansu Province, and to analyze the correlation between them. Methods Between May and December 2024, a stratified cluster random sampling method was employed to survey workers from 73 large, medium, and small and micro sized enterprises across the aforementioned industries in Gansu Province. Participants’ occupational health literacy and occupational stress levels were assessed. The LASSO regression model was applied to identifykey factors influencing occupational stress, and subsequently a multilevel random intercept mixed-effects logistic model was used to study factors influencing occupational stress and to explore the relationship between occupational health literacy and occupational stress. Results A total of 3611 workers across the three industries were surveyed, among whom 1031 (28.55%) experienced occupational stress. Workers with adequate occupational health literacy—whether assessed in terms of overall literacy or specific dimensions—demonstrated a significantly lower prevalence of occupational stress compared to those without adequate literacy (P<0.05). Through the LASSO regression analysis, it was found that the factors closely related to occupational stress were dimension one (occupational health legal knowledge), dimension two (basic knowledge of occupational health protection), and dimension four (healthy working methods and behaviors) of occupational health literacy, gender, average monthly income, and night shifts. The results from the three-level random intercept mixed-effects logistic regression model indicated that dimensions one (OR=0.69, 95%CI: 0.58, 0.82), two (OR=0.71, 95%CI: 0.58, 0.87), and four (OR=0.81, 95%CI: 0.67, 0.98) of occupational health literacy were negatively correlated with the risk of occupational stress. Workers with an average monthly income of 3001–≤5000, 5001–≤7000, and ≥7001 yuan reported occupational stress risks that were 61% (OR=0.61, 95%CI: 0.45, 0.81), 56% (OR=0.56, 95%CI: 0.41, 0.78), and 36% (OR=0.36, 95%CI: 0.24, 0.53) of those with an average monthly income ≤3000 yuan, respectively. Male workers (OR=1.66, 95%CI: 1.32, 2.10) and those on night shifts (OR=2.29, 95%CI: 1.90, 2.76) had a higher risk of occupational stress. The random effects variance showed that the intraclass correlation coefficient was 0.12. Conclusion There is a negative correlation between occupational stress and occupational health literacy among workers in mining and manufacturing. Being male, having a low income, and working night shifts are risk factors affecting workers' occupational stress. It is recommended to focus on these groups of workers and incorporate occupational health literacy into workplace mental health promotion.

OBJECTIVE To investigate the serum toll-like receptor 4(TLR4),matrix metalloproteinase-3(MMP-3),in-terleukin-1β(IL-1β)and peripheral blood helper T-cell 17/regulatory T-cell(Th17/Treg)levels in patients with chronic periodontitis infected with porphyromonas gingivalis(Pg),as well as their diagnostic value of Pg infection in patients with chronic periodontitis.METHODS Totally 390 cases of patients with chronic periodontitis who at-tended Tianjin Stomatological Hospital from Jan.2022 to Jan.2024 were selected as the study subjects,and were divided into the infected group(113 cases)and the uninfected group(277 cases)according to Pg infection,and those patients in the infected group were further classified into the mild group(31 cases),the moderate group(45 cases),and the severe group(37 cases)according to the condition of the disease.Serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg levels were compared between the infected and uninfected groups and patients with different conditions of chronic periodontitis Pg infection,and the infected group was included in the positive and the uninfected group was included in the negative,and the receiver's operating characteristics(ROC)curves were plotted to obtain the area under the curve(AUC)to analyze the diagnostic value of single and combined de-tection of serum TLR4,MMP-3,and IL-1β,Peripheral blood Th17/Treg for Pg infection in patients with chronic periodontitis.RESULTS Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the infected group were(20.41±5.12)ng/ml,(6.12±2.03)μg/L,(10.24±2.19)μg/L and(0.32±0.10),higher than those in the uninfected group(P＜0.05).Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the se-vere group were(22.58±6.10)ng/ml,(8.12±2.67)μg/L,(12.49±3.10)μg/L and(0.52±0.15),higher than those in the moderate group[(14.78±3.44)ng/ml,(6.15±2.07)μg/L,(7.23±1.99)μg/L and(0.22±0.07)]and mild group(P＜0.05),which in the moderate group was higher than those in the mild group(P＜0.05).The results of ROC analysis showed that the AUC of serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg combined test for diagnosing Pg infection in patients with chronic periodontitis was 0.937,which was higher than that of the four single tests(P＜0.05).CONCLUSION Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg were highly expressed in chronic periodontitis patients infected with Pg,and all four indicators can participate in the progression of the disease,and the combined detection of these four indicators has a higher diagnostic value for Pg infection in patients with chronic periodontitis.

OBJECTIVE To investigate the serum toll-like receptor 4(TLR4),matrix metalloproteinase-3(MMP-3),in-terleukin-1β(IL-1β)and peripheral blood helper T-cell 17/regulatory T-cell(Th17/Treg)levels in patients with chronic periodontitis infected with porphyromonas gingivalis(Pg),as well as their diagnostic value of Pg infection in patients with chronic periodontitis.METHODS Totally 390 cases of patients with chronic periodontitis who at-tended Tianjin Stomatological Hospital from Jan.2022 to Jan.2024 were selected as the study subjects,and were divided into the infected group(113 cases)and the uninfected group(277 cases)according to Pg infection,and those patients in the infected group were further classified into the mild group(31 cases),the moderate group(45 cases),and the severe group(37 cases)according to the condition of the disease.Serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg levels were compared between the infected and uninfected groups and patients with different conditions of chronic periodontitis Pg infection,and the infected group was included in the positive and the uninfected group was included in the negative,and the receiver's operating characteristics(ROC)curves were plotted to obtain the area under the curve(AUC)to analyze the diagnostic value of single and combined de-tection of serum TLR4,MMP-3,and IL-1β,Peripheral blood Th17/Treg for Pg infection in patients with chronic periodontitis.RESULTS Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the infected group were(20.41±5.12)ng/ml,(6.12±2.03)μg/L,(10.24±2.19)μg/L and(0.32±0.10),higher than those in the uninfected group(P＜0.05).Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the se-vere group were(22.58±6.10)ng/ml,(8.12±2.67)μg/L,(12.49±3.10)μg/L and(0.52±0.15),higher than those in the moderate group[(14.78±3.44)ng/ml,(6.15±2.07)μg/L,(7.23±1.99)μg/L and(0.22±0.07)]and mild group(P＜0.05),which in the moderate group was higher than those in the mild group(P＜0.05).The results of ROC analysis showed that the AUC of serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg combined test for diagnosing Pg infection in patients with chronic periodontitis was 0.937,which was higher than that of the four single tests(P＜0.05).CONCLUSION Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg were highly expressed in chronic periodontitis patients infected with Pg,and all four indicators can participate in the progression of the disease,and the combined detection of these four indicators has a higher diagnostic value for Pg infection in patients with chronic periodontitis.

In environmental epidemiological research, extensive non-random environmental exposures and complex confounding biases pose significant challenges when attempting causal inference. In recent years, the introduction of causal inference methods into observational studies has provided a broader range of statistical tools for causal inference research in environmental epidemiology. The instrumental variable (IV) approach, as a causal inference technique for effectively controlling unmeasured confounding factors, has gradually found application in the field of environmental epidemiological research. This article reviewed the basic principles of IV and summarized the current research progress and limitations of applying IV for causal inference in environmental epidemiology. IV application in the field of environmental epidemiology is still in the initial stage. Rational use of IV and effective integration with other causal inference methods will become the focus of the development of causal inference in environmental epidemiology. The aim of this paper is to provide a methodological reference and basis for future studies involving causal inference to target population health effects of environmental exposures in China.

Due to the non-targeted release and low solubility of anti-gastric cancer agent,apatinib(Apa),a first-line drug with long-term usage in a high dosage often induces multi-drug resistance and causes serious side effects.In order to avoid these drawbacks,lipid-film-coated Prussian blue nanoparticles(PB NPs)with hyaluronan(HA)modification was used for Apa loading to improve its solubility and targeting ability.Furthermore,anti-tumor compound of gamabufotalin(CS-6)was selected as a partner of Apa with reducing dosage for combinational gastric therapy.Thus,HA-Apa-Lip@PB-CS-6 NPs were constructed to synchro-nously transport the two drugs into tumor tissue.In vitro assay indicated that HA-Apa-Lip@PB-CS-6 NPs can synergistically inhibit proliferation and invasion/metastasis of BGC-823 cells via downregulating vascular endothelial growth factor receptor(VEGFR)and matrix metalloproteinase-9(MMP-9).In vivo assay demonstrated strongest anti-tumor growth and liver metastasis of HA-Apa-Lip@PB-CS-6 NPs adminis-tration in BGC-823 cells-bearing mice compared with other groups due to the excellent penetration in tumor tissues and outstanding synergistic effects.In summary,we have successfully developed a new nanocomplexes for synchronous Apa/CS-6 delivery and synergistic gastric cancer(GC)therapy.

Objective:To compare the effects of enhanced heat preservation strategies and conventional heat preservation strategies in the operation room on body temperature, coagulation function, and myocardial injury in patients with cervical spinal cord injuries.Methods:A retrospective cohort study was conducted to analyze the clinical data of 160 patients with cervical spinal cord injuries admitted to Second Affiliated Hospital of Xi′an Jiaotong University and Affiliated Honghui Hospital of Xi′an Jiaotong University from February to October 2022, including 82 males and 78 females, aged 38-64 years [(50.6±8.7)years]. Injured segments included C 3 in 19 patients, C 4 in 33, C 5 in 39, C 6 in 38, and C 7 in 31. According to American Spinal Injury Association (ASIA) classification, 10 patients were classified into grade A, 83 grade B, 39 grade C, and 28 grade D. All the patients underwent cervical laminoplasty, decompression and bone graft fusion surgery. According to different heat preservation strategies intraoperatively, the patients were divided into conventional heat preservation group ( n=80) and enhanced heat preservation group ( n=80). The body temperature changes before surgery, at 2 hours during surgery, immediately after surgery, at 2 and 24 hours after surgery were compared between the two groups. The changes of coagulation function before surgery and at 4 hours after surgery were compared between the two groups, including the prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time (APTT). The incidence of myocardial injury and the number of patients with myocardial injury measured by the indicators of cardiac troponin I (cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) at 48 hours after surgery. Before surgery and at 14 days after surgery, ASIA classification was used to evaluate the neurological functions, including sensory and motor functions between the two groups. The incidence of cardiovascular events at 12 months after surgery were compared between the two groups. Results:A total of 145 patients were followed up for 12-18 months [(15.7±1.6)months]. At 12 months after operation, there were 7 patients in the enhanced heat preservation group were lost to follow-up, compared to 8 patients in the conventional heat preserration group. There was no statistically significant difference in body temperature between the two groups before surgery or at 24 hours after surgery ( P>0.05). At 2 hours during surgery, immediately after surgery and at 2 hours after surgery, the body temperature was (36.90±0.12)℃, (37.00±0.06)℃, and (37.16±0.06)℃ in the enhanced heat preservation group, which were significantly higher than those in the conventional heat preservation group [(36.56±0.03)℃, (36.74±0.08)℃, and (36.84±0.08)℃] ( P<0.01). The serum levels of PT, TT and APTT were not significantly different between the two groups before surgery ( P>0.05), while they were (13.1±1.2)seconds, (19.2±1.1)seconds, and (36.2±3.3)seconds in the enhanced heat preservation group at 4 hours after surgery, which were significantly lower than those in the conventional heat preservation group [(14.3±1.0)seconds, (20.2±1.1)seconds, and (38.7±3.4)seconds] ( P<0.01). The incidence of myocardial injury in the enhanced heat preservation group was 5.0% (4/80) at 48 hours after surgery, which was lower than 12.5% (12/80) in the conventional heat preservation group ( P<0.05). With cTnI as the indicator of myocardial injury, there were 2 patients [2.6%(2/76)] with myocardial injury in the enhanced heat preservation group, which was much lower than 8 patients [11.8%(8/68)] in the conventional heat preservation group ( P<0.05). With hs-cTnT as the indicator of myocardial injury, 8 patients [10.5%(8/76)] in the enhanced heat preservation group experienced myocardial injury, similar with 10 patients [14.7%(10/68)] in the conventional heat preservation group ( P>0.05). There were no statistically significant differences in the ASIA scores of the sensory and motor functions between the two groups before surgery and at 14 days after surgery ( P>0.05). The incidence of cardiovascular events at 12 months after surgery in the conventional heat preservation group was 27.8% (20/72), which was significantly higher than 9.6% (7/73) in the enhanced heat preservation group ( P<0.01). Conclusion:For patients with cervical spinal cord injuries, compared with conventional heat preservation strategies, the enhanced heat preservation strategies in the operating room can improve the patients′ core body temperature and coagulation function, and significantly reduce the incidence of myocardial injury and cardiovascular events.

Hypoxia is associated with the occurrence and development of many diseases in clinical settings.Cell hypoxia not only serves as a vital marker for disease advancement,but also plays a pivotal role in exacerbating the disease process,and improving tissue hypoxia may thus provide new strategies for the treatment of related diseases.Further investigation of these diseases at the cellular and molecular levels requires the establishment of a cellular hypoxia model.Current extensively employed hypoxic cell models can be categorized primarily into three types:chemical hypoxia,physical hypoxia,and glucose deprivation hypoxia models.This article reviews the various types of hypoxic cell models and scrutinizes their applications and limitations in disease research.

Hypoxia is associated with the occurrence and development of many diseases in clinical settings.Cell hypoxia not only serves as a vital marker for disease advancement,but also plays a pivotal role in exacerbating the disease process,and improving tissue hypoxia may thus provide new strategies for the treatment of related diseases.Further investigation of these diseases at the cellular and molecular levels requires the establishment of a cellular hypoxia model.Current extensively employed hypoxic cell models can be categorized primarily into three types:chemical hypoxia,physical hypoxia,and glucose deprivation hypoxia models.This article reviews the various types of hypoxic cell models and scrutinizes their applications and limitations in disease research.

Objective To summarize and analyze the features of liver function in pediatric patients infected with Delta variant versus Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods In this study, an analysis was performed for the liver function test results of the locally transmitted or imported pediatric patients with SARS-CoV-2 infection during isolation who were admitted to Guangzhou Eighth People's Hospital, Guangzhou Medical University, since May 21, 2021, and the clinical data and the constituent ratio of liver injury were compared between the pediatric patients infected with Delta variant and those infected with Omicron variant. The independent samples t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results A total of 85 pediatric patients infected with SARS-CoV-2 were enrolled, among whom there were 32 (37.6%) pediatric patients infected with Delta variant and 53 (62.4%) pediatric patients infected with Omicron variant, and there were no significant differences between the two groups in age, sex, body height, body weight, and comorbidities (all P > 0.05). There were no significant differences between the two groups in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase, total bilirubin, albumin, and cholinesterase (all P > 0.05), and the pediatric patients infected with Omicron variant had a significantly higher level of total bile acid (TBA) than those infected with Delta variant ( Z =-2.336, P =0.020). However, the median values of TBA were within the normal range and the ratios of abnormal TBA were no significant difference between the two groups ( P > 0.05). Among the 85 pediatric patients, 10 (11.8%) had a mild increase in liver function parameters, among whom 7 had an increase in TBA, 1 had an increase in ALT, 1 had increases in ALT and AST, and 1 had an increase in ALP. The analysis of liver injury in the pediatric patients infected with Delta variant or Omicron variant showed that there was no significant difference in the constituent ratio of liver injury caused by the two variants (6.3% vs 15.1%, χ 2 =0.691, P =0.406). Conclusion Mild liver injury is observed in pediatric patients infected with Delta and Omicron variants of SARS-CoV-2, but further studies are needed to evaluate the long-term influence of such infection on liver function.

Objective:To investigate the influence of preoperative thyroid dysfunction on the 30-day postoperative mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 349 elderly patients with hip fracture who had been admitted to Department of Orthopedic Trauma, Beijing Luhe Hospital Affiliated to Capital Medical University from January 2018 to December 2019. They were 108 males and 241 females, with an average age of 76.3 years (from 60 to 104 years). There were 190 femoral intertrochanteric fractures and 159 femoral neck fractures. By the preoperative level of thyroid function, the patients were divided into a normal function group of 290 cases and a dysfunction group of 59 cases. The 2 groups were compared in terms of hospital stay, mortality and incidence of complications within 30 days postoperation.Results:In this cohort, the rate of 30-day postoperative mortality was 3.4%(12/349) and the incidence of 30-day postoperative complications 14.6%(51/349). The 2 groups were comparable because there was no significant difference between them in the preoperative general data except for the preoperative comorbidity of coronary heart disease ( P>0.05). In the dysfunction group, the hospital stay averaged (10.2±6.9) d, the rate of 30-d postoperative mortality 1.7%(1/59) and the incidence of 30-day postoperative complications 16.9%(10/59), which were insignificantly different from those in the normal function group [(10.7±7.5) d, 3.8%(11/290) and 14.1%(41/290), respectively] ( P> 0.05). Conclusion:Since preoperative thyroid dysfunction does not affect the 30-day postoperative mortality and postoperative complications in the elderly patients with hip fracture but no definite thyroid disease, routine thyroid function screening is not recommended for them.