ObjectiveTo observe the clinical efficacy and safety of Guben Quyu Jiedu prescription in treating nocturnal hypoxemia of chronic obstructive pulmonary disease （COPD） combined with Obstructive sleep apnea hypopnea syndrome （ OSAHS ） （deficiency of lung， spleen and kidney with blood stasis and toxicity）. MethodsThe paper used a forward-looking， random double-blind， placebo-controlled design method to select 96 patients with COPD combined with OSAHS， and their traditional Chinese medicines （TCM） syndrome differentiation was deficiency of lung， spleen and kidney with blood stasis and toxicity. These patients were randomly divided into the observation group and the control group， with 48 cases in each group. Based on conventional Western medicine treatment， the observation group was treated with Guben Quyu Jiedu prescription and the control group was treated with traditional Chinese medicine placebo. Both courses of treatment were 90 days. Then the paper compared the changes in minimum pulse oxygen saturation （SpO₂） during the night， apnea index （AHI）， OSAHS efficacy evaluation， TCM syndrome efficacy evaluation， and TCM symptom score before and after treatment between the two groups. ResultsThere were 5 withdrawals in the observation group and 8 withdrawals in the control group， so 43 cases in the observation group and 40 cases in the control group completed the trial. Compared with the condition before treatment， the minimum SpO₂ during the night and AHI in the observation group were significantly improved at night （P<0.01） and were better than those in the control group （P<0.01）. OSAHS efficacy in the observation group was better than in the control group （χ²=7.085， P<0.05）. In terms of TCM syndrome efficacy， the total effective rate was 81.40% （35/43） in the observation group， significantly higher than that in the control group， which was 15.00% （6/40） （χ²=36.78， P<0.01）. The TCM symptom scores of the two groups were improved compared with the condition before treatment， and the effect of the two groups was similar in the four main symptoms of snoring， choking， lethargy， and cough. However， the observation group was better than the control group in 10 details such as dizziness， headache， chest tightness， chest pain， wheezing， dry mouth， and thirst （P<0.05）. ConclusionUsing Guben Quyu Jiedu prescription combined with conventional Western medicine can treat COPD combined with OSAHS hypoxemia at night （deficiency of lung， spleen and kidney with blood stasis and toxicity）. In this way， the minimum pulse oxygen saturation （SpO₂） of patients， the level of disease control， and the quality of life of patients can be improved， and the clinical symptoms can be relieved.

Background High-sensitivity C-reactive protein (hs-CRP) is a sensitive biomarker for cardiovascular disease (CVD) and can independently predict the risk of cardiovascular events. Although the association between per- and polyfluoroalkyl substances (PFAS) exposure and CVD risk has been widely reported, studies on the association between hs-CRP and PFAS remain limited. Objective To investigate the association between PFAS and hs-CRP levels, to provide a scientific basis for early identification and prevention of environment-related cardiovascular events. Methods This study utilized data from the National Health and Nutrition Examination Survey (NHANES) database (2015–2018). Based on predefined inclusion and exclusion criteria, a total of 3219 participants were included for subsequent analysis. Five PFAS with detection rates exceeding 90% were selected as exposure factors and log-transformed (lnPFAS) for subsequent analysis, including perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorodecanoic acid (PFDA). After selecting potential confounders through a change-in-estimate approach, logistic regression was employed to examine the effects of individual PFAS on serum hs-CRP level. Additionally, quantile g-computation and Bayesian kernel machine regression (BKMR) were applied to assess the combined effects of PFAS mixtures on hs-CRP. Results The study included 3219 participants with a mean age of (50.4±17.6) years, of whom 1554 (48.28%) were male. The median concentrations of the five PFAS compounds were: 1.20 ng·mL⁻¹ (PFHxS), 0.50 ng·mL⁻¹ (PFNA), 1.50 ng·mL⁻¹ (PFOA), 5.20 ng·mL⁻¹ (PFOS), and 0.20 ng·mL⁻¹ (PFDA). The Wilcoxon rank-sum tests revealed statistically significant differences between the elevated serum hs-CRP (≥2 mg·L⁻¹) and normal (<2 mg·L⁻¹) groups for all five PFAS compounds (PFHxS: P=0.005; PFNA: P=0.009; PFOA: P<0.001; PFOS: P<0.001; PFDA: P<0.001). After adjusting for potential confounders, the analysis of individual PFAS exposure demonstrated significant negative associations between serum hs-CRP levels and both ln-PFOS (OR: 0.87; 95%CI: 0.79, 0.96; P=0.0036) and lnPFDA (OR: 0.78; 95%CI: 0.71, 0.86; P < 0.001). The joint effect analysis using quantile g-computation revealed an overall inverse association between PFAS mixtures and hs-CRP, with lnPFDA emerging as a primary contributor; an similar association was observed in males, but not significant in females. Further evaluation through BKMR showed that when PFAS mixture concentrations reached or exceeded P₇₀, their combined effect on hs-CRP became significantly lower than when all PFAS concentrations were at P₅₀, establishing a clear negative dose-response relationship. Conclusion The mixed exposure to PFAS showed a significant negative joint effect on serum hs-CRP levels, with PFDA being the key component contributing to this combined effect. Future prospective cohort studies are warranted to further validate these findings and elucidate the underlying mechanisms involved.

ObjectiveTo explore the effectiveness of feedforward control mode on improving occupational burnout among operating room nurses through theoretical research and clinical practice， with a view to promoting their physical and mental health and enhancing the quality of surgical nursing. MethodsA total of 440 operating room nurses from different regions， scales， and nursing experiences in Shaanxi Province from November 2023 to December 2023 were randomly divided into an experimental group and a control group， with 220 nurses in each group. While the control group received routine intervention measures， the experimental group introduced a feedforward control mode based on the control group， with “emotional exhaustion，” “depersonalization，”and“personal achievement” as observation indicators. ResultsThe incidence of occupational burnout in the experimental group was 11.4%， while that in the control group was 20.0%. The experimental group showed a significantly lower incidence than the control group （P=0.013）. ConclusionThe feedforward control mode can significantly alleviate nurses’ sense of job burnout， promote the improvement of surgical nursing quality， as well as continuously improve the scientific rigor， advancement， and humanistic nature of nursing services， which is conducive to building a harmonious and efficient nursing team. The spirit of teamwork， reflected in mutual support， mutual trust， and joint efforts for surgical success and patient health， has become an important component of nurses’ professional ethics.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People

Objective To analyze the difference of diseases between the coal mine workers and the general population inpatients by the disease spectrum in Datong City. Methods A total of 282 639 hospitalized patients in Datong City in 2023 were included as the study subjects. Participants were divided into a general population group and a coal mine workers group based on health insurance types, with 247 897 and 34 742 cases, respectively. The disease spectrum of participants in both groups was coded and analyzed according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). The standardized constituent ratios of disease categories were calculated and compared between the two groups. Results Patients aged 60-<70 years had the largest standardized proportion in both cohorts (29.02% in the general population group and 33.08% in coal mine workers group). Circulatory system diseases had the highest standardized proportion in both groups. Within the top six disease categories ranked by standardized composition ratio in the coal mine workers, three demonstrated a higher burden, including neoplasms (C00-D48), symptoms, signs and abnormal clinical/laboratory findings not elsewhere classified (R00-R99), and factors influencing health status/contact with health services (Z00-Z99), compared with the general population (11.82% vs 10.44%, 12.99% vs 8.03%, and 6.17% vs 2.04%, respectively). In both groups, male workers had higher standardized constituent ratios of circulatory, respiratory, and digestive system diseases than females (coal mine workers group, 19.53% vs 14.31%, 13.56% vs 9.10%, 10.61% vs 8.43%; general population group, 26.15% vs 22.42%, 15.45% vs 11.87%, 11.52% vs 10.41%). Conversely, the ratios for conditions classified under symptoms, signs and abnormal clinical/laboratory findings not elsewhere classified (R00-R99). and factors influencing health status/contact with health services (Z00-Z99) were higher in females than males (coal mine workers group, 13.31% vs 12.68%, 7.26% vs 5.13%; general population group, 8.91% vs 7.18%, 2.35% vs 1.74%). Mental and behavioral disorders (F00-F99) were most prevalent in the 22-<50-year age group in the general population (9.92%) and in the 50-<60-year age group in coal mine workers (8.58%). The standardized proportion of respiratory system diseases ranked first in≥80-year age workers in general population group and coal mine workers group (29.54% and 26.46%, respectively). Regarding specific malignancies, unspecified malignant neoplasm of the bronchus or lung was the most common cancer among males in both groups (3.44% and 3.62%). Among females, the standardized proportion of unspecified malignant neoplasm of breast was higher in coal mine workers group than in the general population group (2.60% vs 2.09%). Conclusion Neoplasms, abnormal symptoms, and mental health disorders should be prioritized in disease prevention strategies for coal mine workers. Greater attention should be paid to mental health screening in younger populations, and medical resource allocation should be optimized according to sex-specific high-incidence cancers.

Objective To analyze the status and influencing factors of carpal tunnel syndrome (CTS) among sonographers. Methods A total of 449 sonographers from 33 hospitals across five regions in Heilongjiang Province were selected as the study subjects using the judgment sampling method. A self-designed Musculoskeletal Disorders Questionnaire was used in the survey. Hand and wrist examinations, neuro electrophysiological testing, and high-frequency ultrasonography were conducted. Results The detection rate of CTS among the participants was 23.8% (107/449). Result of multivariable logistic regression analysis showed that sonographers with ≥20 years of work experience had a higher risk of CTS compared with those with <5 years, with an odds ratio (OR) and 95% confidence interval (CI) of 3.408 (1.535-8.407) (P<0.01). Sonographers with a proportion of obese patients ≥60% had a higher risk of CTS than those with <50% obese patients, with an OR and 95% CI of 3.083 (1.170~8.229) (P<0.05). Conclusion The detection rate of CTS among sonographers is relatively high. Work experience and proportion of obese patient are independent influencing factors of CTS. It is recommended to strengthen health monitoring for high-risk sonographer groups and adopt comprehensive preventive measures, such as optimizing work approaches and improving equipment to reduce the risk of CTS.

To perform the phylogenetic characterization of an isolated porcine rotavirus(PoRV)and investigate its pathogenicity in suckling mice and piglets.A G4P[23]genotype PoRV strain JSJR2023 was successfully isolated from the diarrheic piglet feces through propagation in MA104 cells.The viral proliferation kinetics were analyzed using TCID50 assays,followed by complete genome sequencing through Sanger sequencing platforms.Comprehensive genotyping and phylogenetic reconstruction were conducted using MEGA7.0 with maximum likelihood algorithms.Pathogenicity was assessed in the following animal models:5-day-old C57BL/6 mice and 3-day-old piglets.Multidimensional evaluation included clinical monitoring(diarrhea scoring,growth parameters),virological detection,and histopathological analysis of intestinal tissues.The virus strain JSJR2023 could replicate efficiently in MA104 cells,achieving peak titers of 107.5 TCID50/mL.Whole genome genotype analysis showed that the strain belonged to G4-P[23]-I5-R1-C1-M1-A8-N1-T1-E1-H1.Phylogenetic analysis indicated that the VP3 and NSP4 genes of JSJR2023 strain were most closedrelated to human species rotaviruses,suggesting genetic reassortment between human and porcine RV strains.The animal experiments in suckling mice showed that the JSJR2023 strain infection caused diarrhea symptoms,intestinal edema and congestion,and shedding of intestinal villus epithelial cells.The pathogenicity experiments in piglets showed that compared with the control group,the challenged group of pig-lets had severe diarrhea symptoms,accompanied by reduced appetite and listlessness.Post-mortem examination revealed that the intes-tines were significantly thinner,congested,and filled with yellow watery contents.The challenged piglets showed typical pathological changes such as thinning of the intestinal wall and shortening and shedding of intestinal villi.In conclusion,this study successfully iso-lated a human-porcine recombinant G4P[23]PoRV strain and established the infection models in suckling mice and piglets,providing important tools for investigating the pathogenic mechanism of PoRV,evaluating vaccines and developing antiviral drug.

Objective To analyze the epidemiological characteristics of human papillomavirus(HPV)infection in women in the Zhongguancun area of Beijing,and to evaluate the infection rates and genotype distribution between different populations and age groups.Methods A retrospective analysis was conducted on HPV genotyping results of 13,105 women who visited the gynecology outpatient department or underwent routine health check-ups at Zhongguancun Hospital from March 2019 to April 2024.High-risk HPV genotypes(15 types)were detected using a fluorescence PCR assay.Positive cases were classified as single,dual or multiple(≥3)infections based on the number of genotypes.Subjects were stratified into six age groups(≤30,31-40,41-50,51-60,61-70,and≥71 years),and the characteristics of infection by type and age group were analyzed.Results The overall HPV positivity rate was 10.78%(1,413/13,105),with a significantly higher rate in the outpatient group than that in the health check-up group(16.36%vs.6.06%,P<0.01).The three most prevalent genotypes were HPV52(18.83%),HPV58(13.85%),and HPV16(11.28%).Single infections accounted for 79.19%of cases,dual infections for 15.93%and multiple infections for 4.88%.Age distribution showed a U-shaped pattern,with higher infection rate in women aged≤30 years(15.06%)and 61-70 years(13.19%),and the lowest rate in the≥71 years(8.09%).Notably,women aged≤30 years had the highest proportion of multiple infections(31.72%).Conclusion These findings provide a basis for cervical cancer screening strategies,HPV vaccination promotion and individualized prevention of cervical cancer in this region.

Objective:To compare the advantages and disadvantages and training costs of different training methods for microsurgical vascular anastomosis, and to provide a basis for establishing a systematic training model and improving surgeons microsurgical skills and clinical competence.Methods:Doctors came from various primary hospitals and exchange groups from foreign hospitals to China, and several groups of data statistics from 2018-2023 were randomly selected for this study. The microsurgical vascular anastomosis training lasted 10 days, including 1 day of theoretical study and 9 days of practical training. A total of 48 doctors were equally divided into group A (one-person operation), group B (two-person cooperation), and group C (two-person cooperation in the first four days and one-person operation in the last five days). The differences in anastomosis time and number of anastomoses between the groups were analysed by one-way ANOVA using the software GraphPad Prism 8.3.0, with P<0.05 indicating that there were statistically significant differences in the variable data. The cost of the three training methods was investigated, and a questionnaire survey of the trainees was conducted. Results:For all the three groups, the speed of anastomosis and the number of anastomoses increased with the course of training. The duration of single-vessel anastomosis was significantly different between groups A and B as well as between groups A and C at all time points except on day 1 (A1 d vs. B1 d, P=0.335; A1 d vs. C1 d, P=0.064; P<0.05 for all the other time points); groups B and C showed no significant differences on day 1 ( P=0.196) and day 3 ( P=0.115) but had significant differences on days 5, 7, and 9 (all P<0.05) in the duration of anastomosis. The number of anastomoses was not significantly different between A1 d and B1 d ( P=0.081), between A3 d and B3 d ( P=0.160), between B1 d and C1 d ( P=0.695), between B3 d and C3 d ( P=0.520), and between A1 d and C1 d ( P=0.123), with significant differences at the other time points (all P<0.05). The training costs were group A > group C > group B. The training questionnaire showed that the proportion of trainees who applied this technique in their daily work was 100.00% (48/48), the proportion of those who wished to participate in the training of this technique occasionally was 100.00% (48/48), the proportion of participants whose institutions had no relevant training conditions was 37.50% (18/48), the proportion of those whose institutions lacked necessary instruments and equipment was 35.42% (17/48), the proportion of those who had difficulties in access to laboratory animals was 68.75% (33/48), and the proportion of inability to carry out relevant training due to the lack of animal experimentation techniques such as anesthesia, preservation, and euthanasia was 91.67% (44/48), indicating that there is a great need for microsurgical vascular anastomosis training. Conclusions:The three training modes have their own advantages and disadvantages. The A mode is suitable for small-scale training. The B mode is suitable for training with adequate funds, a large number of personnel, and a high use frequency. The C mode is the best choice for microsurgical vascular anastomosis training, in which trainees can not only practice the whole vascular anastomosis process but also cooperative skills for anastomosis.

Objective:To investigate the correlation of serum FGF21 and SOST with bone mineral density and their predictive value in predicting osteoporosis in menopausal women.Methods:A total of 86 menopausal women who were examined in Northwest Women and Children's Hospital from Jan. 2021 to Jan. 2024 were chosen and separated into osteoporosis group ( n=47) and normal group ( n=39) according to whether they had osteoporosis. Serum fibroblast growth factor 21 (FGF21), osteosclerosis protein (SOST) and bone mineral density (BMD) were measured, and general data such as age, body mass index (BMI), smoking, drinking, hypertension, hyperlipidemia, and diabetes were collected and recorded. The risk factors of osteoporosis in menopausal women were analyzed by logistics regression, and the value of serum FGF21 and SOST levels in predicting osteoporosis in menopausal women was analyzed by receiver operating characteristic (ROC) curve. Results:Serum FGF21 level and bone mineral density T-value in osteoporosis group were lower than those in normal group, while SOST level was higher ( t=5.18,19.30,7.85, P<0.05). Serum FGF21 level was positively correlated with BMD, and serum SOST level was negatively correlated with it ( r=0.476、-0.424, P<0.05). The proportion of smokers and drinkers in osteoporosis group was higher than that in normal group ( χ 2=4.98、5.68, P<0.05). Serum FGF21 level was a protective factor for osteoporosis in menopausal women, and serum SOST level was a risk factor ( OR=0.770,1.194, P<0.05). The area under the curve (AUC) of serum FGF21, SOST and the combination of the two indexes for predicting osteoporosis in menopausal women were 0.800, 0.899 and 0.951, respectively, and the Jordon index were 0.505, 0.723 and 0.787, respectively. Conclusion:Serum FGF21 and SOST levels in menopausal women are correlated with BMD, which has certain predictive value for the occurrence of osteoporosis.