Background The adverse effects of long working hours, shift rotation, and job stress on the physical and mental health of occupational populations require urgent attention. Objective To investigate and compare the positive rates of WMSDs between different industries, analyze the exposure status of long working hours, shift rotation, and job stress among key occupational groups, and evaluate the impacts of these factors on WMSDs in the manufacturing and service industries. Methods The study subjects were derived from key occupational populations in Yunnan Province, recruited by the Chinese National Occupational Health Literacy Monitoring Survey in 2022. A cross-sectional design was used for this survey. The key occupational populations were recruited from the secondary industry (manufacturing industry, metal mining and beneficiation industry, and non-metal mining and beneficiation industry) by stratified random sampling and from the tertiary industry (medical and healthcare industry, education industry, environmental sanitation industry, transportation industry, and express/takeaway delivery industry) by proportional probability sampling, and 12014 front-line workers were finally included as survey participants. General information, work-related factors (shift rotation, weekly working hours, job stress, etc.) and WMSDs assessment results were obtained through a web-based self-reported questionnaire, and the associations of long working hours, shift rotation, and job stress with WMSDs were analyzed using χ² test and logistic regression. Results The average positive rate of WMSDs among the key occupational groups in Yunnan Province was 77.2%. The positive rate of WMSDs in the secondary industry group was 69.4%, while it was 81.6% in the tertiary industry group, with a statistically significant difference (P<0.001). Among the eight surveyed sectors, the education sector had the highest positive rate of WMSDs (94.2%). The single-site WMSDs mainly involved the neck, shoulders, and low back. In the secondary industry, WMSDs was reported in 1−2 body parts, while in the tertiary industry, WMSDs was mainly reported in multiple (≥5) body parts. Long working hours (OR: 1.119, 1.165, 1.163, respectively), shift rotation (OR: 1.094, 1.199, 1.230, respectively), and job stress (OR: 1.795, 1.854, 2.006, respectively) were risk factors for WMSDs in the neck, shoulder, or low back, and all three were also risk factors for multi-site WMSDs. Moreover, as the number of involved body parts increased, the effects of long working hours and job stress became more pronounced. For 1-2, 3-4, and 5 or more body parts compared to no pain reported, their OR values were 0.971 (95%CI: 0.871, 1.082), 1.133 (95%CI: 1.004, 1.279), and 1.285 (95%CI: 1.155, 1.429) for long working hours, respectively, and the OR values were 1.009 (95%CI: 0.878, 1.160), 1.360 (95%CI: 1.174, 1.575), and 2.797 (95%CI: 2.471, 3.166) for job stress, respectively. Conclusion The positive rate of WMSDs is higher in the tertiary industry than that in the secondary industry among the key occupational groups in Yunnan Province. Long working hours, rotating shift work, and job stress could significantly increase the risk of WMSDs.

Objective To develop an assessment scale for post-intensive care syndrome in pediatrics(PICS-p)and evaluate its reliability and validity,aiming to provide a scientifically sound and feasible tool for clinical assessment.Methods Based on the PICS-p conceptual framework,combined with literature review,semi-structured interviews,and Delphi expert consultation,a preliminary scale was developed.From June to December 2023,a survey was conducted among 330 pediatric patients who were discharged from a tertiary children's hospital in Hangzhou,followed by a two-week retest with 30 children to assess the reliability and validity of the scale.Results Finally 304 children completed the survey.The Post-Intensive Care Syndrome Scale for Children consists of 4 dimensions of physical dysfunction,cognitive dysfunction,psychological dysfunction and social dysfunction,with a total of 29 entries,with a cumulative variance contribution of 61.705％.The content validity index for individual items ranged from 0.800 to 1.000,and the content validity index for the scale as a whole was 0.98.The dimensions of the scale showed positive correlations with the Functional Status Scale(r=0.438-0.581,P＜0.001).The overall Cronbach's α coefficient of the scale was 0.847;the split-half reliability was 0.868;the test-retest reliability was 0.832.Conclusion The scale demonstrates good reliability and validity,and it is suitable for assessing the severity of PICS-p in pediatric patients discharged from the PICU.

Objective To develop an assessment scale for post-intensive care syndrome in pediatrics(PICS-p)and evaluate its reliability and validity,aiming to provide a scientifically sound and feasible tool for clinical assessment.Methods Based on the PICS-p conceptual framework,combined with literature review,semi-structured interviews,and Delphi expert consultation,a preliminary scale was developed.From June to December 2023,a survey was conducted among 330 pediatric patients who were discharged from a tertiary children's hospital in Hangzhou,followed by a two-week retest with 30 children to assess the reliability and validity of the scale.Results Finally 304 children completed the survey.The Post-Intensive Care Syndrome Scale for Children consists of 4 dimensions of physical dysfunction,cognitive dysfunction,psychological dysfunction and social dysfunction,with a total of 29 entries,with a cumulative variance contribution of 61.705％.The content validity index for individual items ranged from 0.800 to 1.000,and the content validity index for the scale as a whole was 0.98.The dimensions of the scale showed positive correlations with the Functional Status Scale(r=0.438-0.581,P＜0.001).The overall Cronbach's α coefficient of the scale was 0.847;the split-half reliability was 0.868;the test-retest reliability was 0.832.Conclusion The scale demonstrates good reliability and validity,and it is suitable for assessing the severity of PICS-p in pediatric patients discharged from the PICU.

Objective To investigate the-75 G/A single-nucleotide polymorphism in the promoter region of apolipoprotein A1 gene(apoA1)and its association with gestational diabetes mellitus(GDM)in pregnant women and to provide references for the exploration in the molecular genetic basis of GDM.Methods A total of 626 GDM patients and 1022 normal pregnant women,ie,the controls,were included in the study.The genotyping of apoA1-75 G/A polymorphism was performed by polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP)analysis.Total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and glucose(Glu)were measured by enzymatic methods.Plasma insulin(INS)was measured by chemiluminescence immunoassay.The protein levels of apoA1 and apoB were measured by the turbidimetric immunoassay.Results Allele frequencies of G and A were 0.718 and 0.282 in the GDM group and 0.713 and 0.287 in the control group,respectively.Distribution of the genotype frequencies was found to be in Hardy-Weinberg equilibrium in both the GDM and control groups.There was no significant difference in the frequencies of alleles G and A and the genotypes of apoA1-75 G/A polymorphism between the GDM and the control group(P>0.05).In the GDM group,the carriers with the genotype AA were associated with significantly higher levels of TC,HDL-C,and apoA1 than those with genotypes GG and GA did(all P<0.05).After the GDM patients were divided into obese and non-obese subgroups,the genotype-related apoA1 variation was observed only in obese patients,while the genotype-related TC and HDL-C variations were evident in non-obese patients(P<0.05).In the control group,carriers of genotypes AA and GA had higher systolic blood pressure(SBP)and HDL-C than the carriers of genotype GG did(all P<0.05).Carriers of genotypes AA had significantly lower Glu levels than carriers of genotypes GG and GA did(P<0.05).The control subjects were further divided into subgroups according to their body mass index(BMI).Analysis of the subgroups showed that AA carriers were associated with higher SBP levels in the obese control women only,while lower Glu levels were evident in both obese and non-obese control women.Conclusion These results suggest that-75 G/A polymorphism in the apoA1 gene is not associated with GDM.However,the genetic variation is closed associated with the plasma apoA1,HDL-C,and TC levels in GDM patients and plasma HDL-C,Glu,and SBP levels in the control subjects.The apoA1 variant-associated lipids and SBP variation is BMI dependent in both groups.

Objective:To examine the expression of human leukocyte antigen G (HLA-G) in the peripheral blood and cancerous tissues of patients with papillary thyroid carcinoma (PTC) .Methods:The expression of soluble HLA-G (sHLA-G) in the peripheral blood of 50 individuals with PTC (PTC group) , 25 patients with benign thyroid tumors (BTT group) from Department of Thyroid and Breast Surgery, Beilun branch of the First Affiliated Hospital of Zhejiang University and 20 healthy controls (healthy control group) from physical examination center was assessed by ELISA. Immunohistochemical examination of HLA-G levels was also performed on tissue specimens from patients in the PTC and BTT groups, and their correlation with clinicopathological features of thyroid cancer was analyzed. SPSS 19.0 was used for statistical analysis. The measurement data of normal distribution were tested by two independent samples t test. Chi square test was used to compare the rates between the two groups. Results:The sHLA-G expression in peripheral blood was 21.33 (±5.54) , 22.73 (±4.99) , and 18.29 (±4.43) ng/mL in the preoperative PTC, BTT, and healthy control groups, respectively. Compared to the healthy group, sHLA-G levels were considerably higher in the PTC and BTT groups, with statistically significant differences (totally P < 0.05) . There was no significant difference in statistically sHLA-G levels between the BTT and PTC groups ( P > 0.05) . The positive HLA-G expression rate in PTC tissues was 78% (39/50) . There was no evidence of HLA-G expression in common tissues adjacent to PTC. HLA-G was not expressed in benign tumors. HLA-G was linked with the PTC tumor diameter, and the rate of positive expression was considerably greater with tumor diameters >1 cm than with those ≤1 cm ( P<0.05) . The rate of HLA-G positive expression was not significantly correlated with sex, age, multiple foci, extra-glandular invasion, metastasis of lymph nodes, or the TNM stage in PTC individuals ( P > 0.05) . Conclusions:HLA-G is significantly expressed at high levels in PTC tissues, is correlated with the tumor diameter, and may probably have a significant role in this disease. Peripheral blood sHLA-G may be associated with thyroid tumorigenesis, and its value in PTC requires further verification.

Objective:To compare the clinical efficacies of endovascular treatments in patients with acute basilar artery occlusion (ABAO) caused by large-artery atherosclerosis (LAA) and cardioembolism (CE).Methods:From March 2018 to February 2021, 104 patients with ABAO accepted endovascular treatments in Department of Neurology and Department of Interventional Radiology, Xuyi County People's Hospital of Huaian City were enrolled; these patients were classified into either a LAA group or a CE group according to Trial of ORG 10172 in Acute Stroke Treatment classification (TOAST). The differences in general data, procedure information, and clinical efficacies were compared between the 2 groups. Univariate and multivariate Logistic regression analyses were used to identify the influencing factors for poor prognosis.Results:In these 104 patients, 51 patients (49.0%) were into the LAA group and 53 patients (51.0%) into the CE group. Ninety-six patients (92.3%) acquired successful revascularization, and 35 patients (33.7%) had good prognosis (modified Rankin scale scores of 0-2) 90 d after surgery. LAA group had significantly lower percentage of patients with atrial fibrillation, significantly lower baseline National Institutes of Health Stroke Scale scores, statistically higher percentages of patients with lower and middle basilar artery occlusion and patients accepted rescued stenting, and statistically longer procedure time ( P<0.05). There were no significant differences between the two groups in terms of successful recanalization percentage, symptomatic intracranial hemorrhage incidence, and prognosis 90 d after surgery ( P>0.05). Age ( OR=0.935, 95%CI: 0.891-0.981, P=0.006) and semiquantitative scores of basilar artery based on computed tomography angiography ( OR=1.520, 95%CI: 1.180-1.959, P=0.001) were independent influencing factors for poor prognosis. TOAST etiology (LAA/CE) was not an independent influencing factors for poor prognosis ( OR=1.175, 95%CI: 0.461-2.933, P=0.736). Conclusion:There are differences in risk factors, vascular occlusion sites, endovascular treatment, and procedure time between patients with ABAO caused by LAA and CE; however, no obvious difference in clinical outcomes is noted, and there was no obvious correlation between stroke etiology and prognoses.

Objective To investigate the clinical effect of laparoscopic inguinal hernia repair in the treatment of elderly patients with inguinal hernia.Methods The clinical data of 80 elderly patients with inguinal hernia in the Second People＇s Hospital of Yuyao from November 2011 to October 2014 were analyzed retrospectively and divided into two groups according to the different operative methods.The laparoscopic group(47 cases) was treated with laparoscopic inguinal hernia repair,33 cases of the traditional group were treated with traditional inguinal hernia repair.The complication rate and recurrence rate were compared between the two groups.Results The intraoperative bleeding of the laparoscopic group[(42.27 ± 8.77) mL] was less than that of the traditional group[(54.24 ± 10.61) mL],the operative time [(44.78 ± 12.45)min],hospitalization time[(7.39 ± 2.52)d] in the laparoscopic group were shorter than those in the traditional group[(55.27 ± 20.61) min,(10.27 ± 3.67) d],the differences were statistically significant(t =5.508, 2.833,4.164,all P<0.05).At 1 d,2 d,5 d after operation,the pain scores of the laparoscopic group were lower than those of the traditional group(all P<0.05).The incidence rate of complications and recurrence rate in the laparoscopic group were 4.26% ,2.13% ,respectively,which were lower than those in the traditional group(33.33% ,18.18% ) (χ2 =12.045,6.258,all P<0.05).Conclusion For elderly patients with inguinal hernia,laparoscopic inguinal hernia repair treatment is significantly better than traditional inguinal hernia repair,the recurrence rate is lower.

Objective To investigate the clinical effect of laparoscopic inguinal hernia repair in the treatment of elderly patients with inguinal hernia. Methods The clinical data of 80 elderly patients with inguinal hernia in the Second People's Hospital of Yuyao from November 2011 to October 2014 were analyzed retrospectively and divided into two groups according to the different operative methods. The laparoscopic group(47 cases) was treated with laparoscopic inguinal hernia repair,33 cases of the traditional group were treated with traditional inguinal hernia repair. The complication rate and recurrence rate were compared between the two groups. Results The intraoperative bleeding of the laparoscopic group[(42. 27 ± 8. 77) mL] was less than that of the traditional group[(54. 24 ± 10. 61) mL],the operative time [(44. 78 ± 12. 45)min],hospitalization time[(7. 39 ± 2. 52)d] in the laparoscopic group were shorter than those in the traditional group[(55. 27 ± 20. 61)min,(10. 27 ± 3. 67)d],the differences were statistically significant(t = 5. 508, 2. 833,4. 164,all P < 0. 05). At 1 d,2 d,5 d after operation,the pain scores of the laparoscopic group were lower than those of the traditional group(all P < 0. 05). The incidence rate of complications and recurrence rate in the laparoscopic group were 4. 26％ ,2. 13％ ,respectively,which were lower than those in the traditional group(33. 33％ ,18. 18％ ) (χ2 = 12. 045,6. 258,all P < 0. 05). Conclusion For elderly patients with inguinal hernia,laparoscopic inguinal hernia repair treatment is significantly better than traditional inguinal hernia repair,the recurrence rate is lower.

Singular periosseous osteochondroma-like hyperplasia is often misdiagnosed, because of its atypical skin lesion. The clinical reports in China are rare. On May 29, 2018, a patient with osteochondroma-like hyperplasia of singular bone on the right foot was diagnosed at the Department of Dermatology, First Affiliated Hospital of Zhengzhou University. Tissue biopsy was performed for histopathological confirmation. The incision healed well after operation, and there was no recurrence observed in the follow-up period of 5 months.

OBJECTIVETo investigate effects of GSTM1 and GSTT1 gene polymorphisms on serum lipid and apopoprotein levels in healthy normolipidemic and endogenous hypertriglyceridemic subjects.

METHODSTwo hundred and thirty-seven healthy normolipidemic and 102 endogenous hypertriglyceridemic subjects from a population of Chinese Han nationality in Chengdu area were studied using the multiplex polymerase chain reaction (PCR). Serum lipids were measured by enzymatic kits and apolipoproteins AⅠ, AⅡ, B100, CⅡ, CⅢ and E were measured by the RID kits.

RESULTSThe non-null and null genotype frequencies for GSTM1 site were 39.2% and 60.8% in the control group, respectively, and 47.6% and 52.4% in the HTG group, respectively. The non-null and null genotype frequencies for GSTT1 site were 51.5% and 48.5% in the control group, respectively, and 57.3% and 42.7% in the HTG group, respectively. The GSTM1 and GSTT1 genotype frequencies in HTG subjects were not different from those in the controls, respectively (P>0.05). However, in control group subjects with both null genotypes (GSTT1- and GSTM1-) showed the lowest plasma HDL-C levels (1.29±0.30 mmol/L), whereas those with each of the other three genotype combinations showed relatively higher HDL-C levels. There was significant difference of HDL-C levels between subjects with GSTT1-/GSTM1-and those with GSTT1+/GSTM1-(P<0.05). Similar result was not observed in HTG group. No significant changes of lipid and lipoprotein levels were observed in either GSTM1 or GSTT1 polymorphism alone in control or HTG group.

CONCLUSIONThe present study provides an evidence that the presence of double deletion genotypes is associated with low HDL-cholesterol levels in normal Chinese subjects. However, these polymorphisms are not associated with lipid levels in endogenous hypertriglyceridemia in Chinese population of Chengdu area.