Objective:To explore the structural relationship between WMSDs in the upper limbs and various risk factors in the occupational population in China, based on a large sample epidemiological survey and structural equation analysis, and to establish a structural equation model, so as to lay a foundation for the prevention and control of such diseases.Methods:The Chinese version of the Musculoskeletal Disorders Electronic Questionnaire was used to conduct a nationwide survey on the prevalence of WMSDs in the upper extremity. Six factors related to WMSDs in the upper extremity were extracted by the classification standard of adverse ergonomic factors and their source and confirmatory factor analysis, including work organization, work type, upper extremity work posture, individual factors, upper extremity fatigue and upper extremity WMSDs. The structural equation analysis was carried out and the structural equation model was established.Results:The incidence of WMSDs and fatigue in the upper limbs was 24.44% and 43.76%, respectively. The adjusted structural equation model fitting indicators were generally up to the standard (GFI=1.000, AGFI=1.000, RMSEA=0.043, NFI=0.808, TLI=0.784) . The four exogenous latent variables of work organization, work type, upper limb work posture and individual factors were correlated. There was a strong positive correlation between job type and upper limb work posture ( r=0.865) , a moderate positive correlation between work organization and job type and upper limb work posture ( r=0.570, 0.490) , and a weak negative correlation between individual factors and the other three exogenous latent variables. Upper limb work posture and individual factors had direct effects on upper limb WMSDs, and the effect coefficients were 0.10 and 0.06, respectively. Upper limb fatigue played a mediating role between work organization, work type, upper limb work posture and upper limb WMSDs. The effect coefficient was 0.46, and the composition ratios of indirect effects were 100.0%, 100.0%, and 38.3%, respectively. The direct path effect of upper limb work posture, individual factors and upper limb WMSDs was weaker than the mediating path through upper limb fatigue. Conclusion:When carrying out the prevention and control of upper limbWMSDs, it is necessary to comprehensively consider the pathogenesis path of upper limb muscle fatigue and upper limb WMSDs caused by work organization, work type, and upper limb work posture, so as to provide theoretical reference for improving the prevention and control level of such diseases.

Blood from a case of group B epidemic cerebrospinal meningitis identified in February 2024 in Ganzhou City,Jiangxi Province,and throat swabs from close contacts were collected for isolation and culture.The isolates were subjected to serogrouping,drug sensitivity testing,and whole genome sequencing and analysis,to provide a basis for epidemiological inves-tigation and clinical drug use.One strain of Neisseria meningitidis was isolated from the blood of the case and denoted group B.The MLST type was ST-7962,with no clonal group attribution.The phylogenetic tree showed that it was genetically close to the 1977 Shanghai carrier isolate(id-52231).Drug sensitivity results indicated that the strain was sensitive to 8 drugs:azithro-mycin,cefotaxime,minocycline,ceftriaxone,chloramphenicol,meropenem,rifampicin,and benzylpenicillin;resistant to cot-rimoxazole,levofloxacin,and ciprofloxacin;and showed an intermediate response to penicillin.This report describes the first case of ST-7962 group B meningoencephalitis found in Jiangxi Province.Monitoring of Neisseria meningitidis carriage,drug re-sistance,and molecular characteristics of strains in the healthy population in this region should be strengthened,to provide la-boratory support for the clinical use of medications,traceability,and control of the pathogen underlying meningoencephalitis infection.

Objective To investigate the potential value of nobiletin(NOB)in the treatment of dry eyes in type 2 di-abetes mellitus(T2DM-DE)and its effect on the expression of cystic fibrosis transmembrane conductance regulators(CFTRs).Methods The T2DM mouse model was established by a high-fat diet combined with streptozotocin,and then the T2DM-DE mouse model was induced by benzalkonium chloride.These mice were divided into 6 groups:the NC group,the T2DM-DE group,the L-NOB group,the M-NOB group,the H-NOB group,and the CFTR inhibitor group.Mice in the NC and T2DM-DE groups were provided with phosphate buffer saline(PBS)containing 0.5％Tween80 through oral ga-vage;those in the L-NOB,M-NOB,and H-NOB groups were provided with 50,100,and 200 mg?kg-1?d-1 NOB solu-tions,respectively,through oral gavage;those in the CFTR inhibitor group were provided with 200 mg?kg-1?d-1 NOB solution through oral gavage and intraperitoneally injected with 1 mg?kg-1?d-1 CFTR(inh)-172.The intervention in these groups was provided for 4 weeks.The fasting blood glucose(FPG),tear secretion,tear film break-up time(BUT),corne-al fluorescein sodium staining grade,and interleukin-1 β(IL-1 β),IL-6,IL-8,and tumor necrosis factor-α(TNF-α)levels in tears of mice were detected.Besides,the periodic acid-Schiff(PAS)staining of conjunctival goblet cells and the terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining of the cornea were performed respectively.The mRNA and protein expression levels of CFTRs,Bax,and Bcl-2 in the cornea were measured by the real-time quantitative polymerase chain reaction(RT-qPCR)and Western blot.Results Compared with the NC group,the FPG of mice in the T2DM-DE group increased;the level of IL-1β,IL-6,IL-8,and TNF-α in tears increased;the corneal fluorescein sodium staining grade and TUNEL positive rate increased(all P＜0.05);the tear secretion,BUT,and the number of conjunctival goblet cells decreased;the mRNA and protein expression levels of CFTRs decreased(all P＜0.05).Compared with the T2DM-DE group,the FPG of mice in the L-NOB,M-NOB,and H-NOB groups decreased;the levels of IL-1β,IL-6,IL-8,and TNF-α in tears decreased;the corneal fluorescein sodium staining grade and TUNEL positive rate decreased(all P＜0.05),the tear secretion,BUT,and the number of conjunctival goblet cells increased;the mRNA and protein expression levels of CFTRs increased(all P＜0.05).Compared with the H-NOB group,the FPG of mice in the CFTR inhibitor group increased;the levels of IL-1 β,IL-6,IL-8,and TNF-α in tear increased;the corneal fluorescein sodium staining grade and TUNEL positive rate increased(all P＜0.05);the tear secretion,BUT,and the number of conjunctival goblet cells de-creased;the mRNA and protein expression levels of CFTRs decreased(all P＜0.05).Conclusion NOB can reduce the blood glucose level by activating CFTRs,inhibit inflammation,and promote the survival of conjunctival goblet cells and cor-neal cells in T2DM-DE mice,thus playing a role in the treatment of T2DM-DE.

Objective: To analyze the demographic characteristics of patients with red blood cell transfusion reactions, the usage of red blood cell preparations, and the differences in the composition ratio of adverse reactions based on multi-center data from the Haemovigilance Network, in order to reveal the clinical characteristics of red blood cell transfusion and its underlying issues. Methods: Clinical data of patients who experienced transfusion reactions after red blood cell transfusion in the Haemovigilance Network from 2018 to 2023 were collected. The demographic characteristics of patients who experienced transfusion reactions with different types of red blood cell preparations, the utilization of these preparations, and the differences of the composition ratios of transfusion reactions were analyzed. Count data were expressed as numbers (n) or percentages (%), and comparisons between groups were performed using the Chi-square test. Results: Red blood cell transfusion reactions were more common in females (53.56%), with the majority of patients aged 50-69 years (35.54%). The Han polulation accounted for the vast majority of patients (92.77%), and patients in the hematology and obstetrics/gynecology departments had a relatively high proportion of transfusion reactions (13.26% and 14.26%, respectively). Leukocyte-reduced red blood cells and suspended red blood cells were the most common types of transfusion reactions reported among red blood cell preparations. Allergic reactions and non-hemolytic febrile reactions were the most common transfusion reactions, and there were significant differences in the composition ratios of allergic reactions (χ =869.89, P<0.05) and non-hemolytic febrile reactions (χ =812.75, P<0.05) across various types of red blood cell preparations. Conclusion: There are differences in the demographic characteristics and composition ratio of transfusion reactions among different red blood cell preparations. The management of red blood cell transfusion reactions should be tailored to patient characteristics and conditions, and the selection and use of blood products should be optimized to reduce or avoid the occurrence of transfusion reactions, such as considering the use of washed red blood cells for patients with a history of transfusion allergies or those prone to allergies.

Objective To explore the brain damage of SD rats under different time points of hypobaric hypoxia exposure.Methods A rat high-altitube cerebral edema(HACE)model was constructed by simulating an altitude of 6 000 m in a hypobaric hypoxia animal experimental chamber.Thirty-six SD male rats were randomly divided into the control group and the hypobaric hypoxia exposure 3,7 and 14 d groups,with 9 rats in each group.Except for the control group,the rats in each group were continuously exposed to hypobaric hypoxia for 3,7,and 14 d.At the end of the modeling period,serum was collected by blood sampling via the abdominal aorta,and brain tissue samples were taken.The wet-to-dry ratio(W/D)of brain tissue was calculated,and the levels of relevant oxidative enzymes in serum and brain tissue were measured.The expression levels of hypoxia-inducible factor-1α(HIF-1α)and aquaporin 4(AQP4)mRNAs in brain tissue were detected by real-time fluorescence quantitative polymerase chain reaction.Results The W/D of brain tissues in the control group and the group exposed to hypobaric hypoxia for 3,7 and 14 d were 4.46±0.12,4.98±0.16,5.07±0.18 and 4.95±0.07;the superoxide dismutase contents were(111.86±2.45),(90.73±1.48),(79.64±2.56)and(55.33±1.45)U·g-1;the glutathione contents were(126.91±5.18),(125.26±1.53),(56.20±2.17)and(122.73±1.78)μg·mL-1;the malondialdehyde contents were(230.94±2.00),(362.65±3.28),(407.34±3.47)and(237.50±1.59)nmol·g-1;the relative expression levels of HIF-1 α mRNA were 1.00±0,2.99±0.49,4.72±0.49 and 1.91±0.28;the relative expression levels of AQP4 mRNA were 1.00±0,2.62±0.34,8.38±0.84 and 5.27±0.42,respectively.Statistically significant differences were found between the above indexes in the 3,7 and 14 d of hypobaric hypoxia exposure group compared with the control group(P＜0.05,P＜0.01).Conclusion Different time of hypobaric hypoxia exposure can up-regulate the expression of AQPs proteins in HACE rats and cause the disruption of the blood-brain barrier,and the HACE model constructed in the hypobaric hypoxia chamber with 6 000 m intervention for 7 d was more stable.

Objective:To investigate exercise fear condition and its influencing factors in patients with coronary heart dis-ease(CHD)involving in phase Ⅱ cardiac rehabilitation after percutaneous coronary intervention(PCI).Methods:Conven-ience sampling was performed among cardiac rehabilitation patients from a Shanxi grade-A tertiary hospital between Janu-ary 2023 and June 2023.General data questionnaire,Tampa Scale for Kinesiophobia-Short Version for Heart patients(TSK-SV H),the Multidimensional Scale of Perceived Social Support(MSPSS)and the Post Percutaneous Coronary In-tervention Health Literacy Scale(PPCIHLS)were used for assessment.Pearson and Spearman rank correlation analyses were applied to investigate the relationships between social support factors and health literacy factors with patients'fear of exercise;multivariate linear regression models and quantile regression models were used to analyze the influencing factors of fear of exercise.Results:Among the 118 patients,average TSK-SV H score was(33.78±3.79)points;10.2％patients showed significant fear.The correlation analysis showed that PPCIHLS score was negatively correlated with TSK-SV H score(r=-0.423,P＜0.001).Results from multivariate regression analysis indicated that health literacy,cardiac func-tion class and drinking status affected the average score of exercise fear(P＜0.05 all).The quantile regression model pro-vided additional insights,showing that the impact of factors such as living situation,drinking status,cardiac function class and health literacy on exercise fear varied across different quantiles.Notably,cardiac function class had a consistently posi-tive effect on TSK-SV H score at various quantiles.Conclusion:Improving health literacy and tailored rehabilitation plans are vital to reduce exercise fear and improve cardiac rehabilitation effect.

Objective To explore the brain damage of SD rats under different time points of hypobaric hypoxia exposure.Methods A rat high-altitube cerebral edema(HACE)model was constructed by simulating an altitude of 6 000 m in a hypobaric hypoxia animal experimental chamber.Thirty-six SD male rats were randomly divided into the control group and the hypobaric hypoxia exposure 3,7 and 14 d groups,with 9 rats in each group.Except for the control group,the rats in each group were continuously exposed to hypobaric hypoxia for 3,7,and 14 d.At the end of the modeling period,serum was collected by blood sampling via the abdominal aorta,and brain tissue samples were taken.The wet-to-dry ratio(W/D)of brain tissue was calculated,and the levels of relevant oxidative enzymes in serum and brain tissue were measured.The expression levels of hypoxia-inducible factor-1α(HIF-1α)and aquaporin 4(AQP4)mRNAs in brain tissue were detected by real-time fluorescence quantitative polymerase chain reaction.Results The W/D of brain tissues in the control group and the group exposed to hypobaric hypoxia for 3,7 and 14 d were 4.46±0.12,4.98±0.16,5.07±0.18 and 4.95±0.07;the superoxide dismutase contents were(111.86±2.45),(90.73±1.48),(79.64±2.56)and(55.33±1.45)U·g-1;the glutathione contents were(126.91±5.18),(125.26±1.53),(56.20±2.17)and(122.73±1.78)μg·mL-1;the malondialdehyde contents were(230.94±2.00),(362.65±3.28),(407.34±3.47)and(237.50±1.59)nmol·g-1;the relative expression levels of HIF-1 α mRNA were 1.00±0,2.99±0.49,4.72±0.49 and 1.91±0.28;the relative expression levels of AQP4 mRNA were 1.00±0,2.62±0.34,8.38±0.84 and 5.27±0.42,respectively.Statistically significant differences were found between the above indexes in the 3,7 and 14 d of hypobaric hypoxia exposure group compared with the control group(P＜0.05,P＜0.01).Conclusion Different time of hypobaric hypoxia exposure can up-regulate the expression of AQPs proteins in HACE rats and cause the disruption of the blood-brain barrier,and the HACE model constructed in the hypobaric hypoxia chamber with 6 000 m intervention for 7 d was more stable.

Blood from a case of group B epidemic cerebrospinal meningitis identified in February 2024 in Ganzhou City,Jiangxi Province,and throat swabs from close contacts were collected for isolation and culture.The isolates were subjected to serogrouping,drug sensitivity testing,and whole genome sequencing and analysis,to provide a basis for epidemiological inves-tigation and clinical drug use.One strain of Neisseria meningitidis was isolated from the blood of the case and denoted group B.The MLST type was ST-7962,with no clonal group attribution.The phylogenetic tree showed that it was genetically close to the 1977 Shanghai carrier isolate(id-52231).Drug sensitivity results indicated that the strain was sensitive to 8 drugs:azithro-mycin,cefotaxime,minocycline,ceftriaxone,chloramphenicol,meropenem,rifampicin,and benzylpenicillin;resistant to cot-rimoxazole,levofloxacin,and ciprofloxacin;and showed an intermediate response to penicillin.This report describes the first case of ST-7962 group B meningoencephalitis found in Jiangxi Province.Monitoring of Neisseria meningitidis carriage,drug re-sistance,and molecular characteristics of strains in the healthy population in this region should be strengthened,to provide la-boratory support for the clinical use of medications,traceability,and control of the pathogen underlying meningoencephalitis infection.

Objective To investigate the potential value of nobiletin(NOB)in the treatment of dry eyes in type 2 di-abetes mellitus(T2DM-DE)and its effect on the expression of cystic fibrosis transmembrane conductance regulators(CFTRs).Methods The T2DM mouse model was established by a high-fat diet combined with streptozotocin,and then the T2DM-DE mouse model was induced by benzalkonium chloride.These mice were divided into 6 groups:the NC group,the T2DM-DE group,the L-NOB group,the M-NOB group,the H-NOB group,and the CFTR inhibitor group.Mice in the NC and T2DM-DE groups were provided with phosphate buffer saline(PBS)containing 0.5％Tween80 through oral ga-vage;those in the L-NOB,M-NOB,and H-NOB groups were provided with 50,100,and 200 mg?kg-1?d-1 NOB solu-tions,respectively,through oral gavage;those in the CFTR inhibitor group were provided with 200 mg?kg-1?d-1 NOB solution through oral gavage and intraperitoneally injected with 1 mg?kg-1?d-1 CFTR(inh)-172.The intervention in these groups was provided for 4 weeks.The fasting blood glucose(FPG),tear secretion,tear film break-up time(BUT),corne-al fluorescein sodium staining grade,and interleukin-1 β(IL-1 β),IL-6,IL-8,and tumor necrosis factor-α(TNF-α)levels in tears of mice were detected.Besides,the periodic acid-Schiff(PAS)staining of conjunctival goblet cells and the terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining of the cornea were performed respectively.The mRNA and protein expression levels of CFTRs,Bax,and Bcl-2 in the cornea were measured by the real-time quantitative polymerase chain reaction(RT-qPCR)and Western blot.Results Compared with the NC group,the FPG of mice in the T2DM-DE group increased;the level of IL-1β,IL-6,IL-8,and TNF-α in tears increased;the corneal fluorescein sodium staining grade and TUNEL positive rate increased(all P＜0.05);the tear secretion,BUT,and the number of conjunctival goblet cells decreased;the mRNA and protein expression levels of CFTRs decreased(all P＜0.05).Compared with the T2DM-DE group,the FPG of mice in the L-NOB,M-NOB,and H-NOB groups decreased;the levels of IL-1β,IL-6,IL-8,and TNF-α in tears decreased;the corneal fluorescein sodium staining grade and TUNEL positive rate decreased(all P＜0.05),the tear secretion,BUT,and the number of conjunctival goblet cells increased;the mRNA and protein expression levels of CFTRs increased(all P＜0.05).Compared with the H-NOB group,the FPG of mice in the CFTR inhibitor group increased;the levels of IL-1 β,IL-6,IL-8,and TNF-α in tear increased;the corneal fluorescein sodium staining grade and TUNEL positive rate increased(all P＜0.05);the tear secretion,BUT,and the number of conjunctival goblet cells de-creased;the mRNA and protein expression levels of CFTRs decreased(all P＜0.05).Conclusion NOB can reduce the blood glucose level by activating CFTRs,inhibit inflammation,and promote the survival of conjunctival goblet cells and cor-neal cells in T2DM-DE mice,thus playing a role in the treatment of T2DM-DE.

Objective:To investigate exercise fear condition and its influencing factors in patients with coronary heart dis-ease(CHD)involving in phase Ⅱ cardiac rehabilitation after percutaneous coronary intervention(PCI).Methods:Conven-ience sampling was performed among cardiac rehabilitation patients from a Shanxi grade-A tertiary hospital between Janu-ary 2023 and June 2023.General data questionnaire,Tampa Scale for Kinesiophobia-Short Version for Heart patients(TSK-SV H),the Multidimensional Scale of Perceived Social Support(MSPSS)and the Post Percutaneous Coronary In-tervention Health Literacy Scale(PPCIHLS)were used for assessment.Pearson and Spearman rank correlation analyses were applied to investigate the relationships between social support factors and health literacy factors with patients'fear of exercise;multivariate linear regression models and quantile regression models were used to analyze the influencing factors of fear of exercise.Results:Among the 118 patients,average TSK-SV H score was(33.78±3.79)points;10.2％patients showed significant fear.The correlation analysis showed that PPCIHLS score was negatively correlated with TSK-SV H score(r=-0.423,P＜0.001).Results from multivariate regression analysis indicated that health literacy,cardiac func-tion class and drinking status affected the average score of exercise fear(P＜0.05 all).The quantile regression model pro-vided additional insights,showing that the impact of factors such as living situation,drinking status,cardiac function class and health literacy on exercise fear varied across different quantiles.Notably,cardiac function class had a consistently posi-tive effect on TSK-SV H score at various quantiles.Conclusion:Improving health literacy and tailored rehabilitation plans are vital to reduce exercise fear and improve cardiac rehabilitation effect.