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 explore the advantages of internet-based smart healthcare for full-cycle transcatheter edge-to-edge repair (TEER) management in reducing postoperative adverse events rate, improving cardiac function, and enhancing quality of life.Methods:This retrospective study enrolled patients with mitral regurgitation who underwent transcatheter TEER at Beijing Anzhen Hospital Valve Intervention Center between June 2021 and September 2023. Patients were classified into degeneration mitral regurgitation (DMR) and functional mitral regurgitation (FMR) according to etiology, with further stratification by enrollment period into usual care group (June 2021 to October 2022) and full-cycle management group (November 2022 to September 2023). The 1-year postoperative follow-up data were collected and compared between subgroups with the same etiology. Kaplan-Meier survival curves were plotted, and log-rank tests were used to compare the differences in major endpoint event-free survival rates between the two groups. Univariate and multivariate Cox regression and logistic regression analyses were performed to evaluate the impact of the full-cycle management system on patients′ outcomes.Results:A total of 130 patients were included, aged (72.0±8.6) years, including 82 (63%) males. DMR was identified in 84 cases (40 in the usual care group and 44 in the full-cycle management group), while FMR was observed in 46 cases (27 in the usual care group and 19 in the full-cycle management group). Kaplan-Meier analysis demonstrated higher 1-year major endpoint event-free survival rates in the full-cycle management group compared to the usual care group, though the difference was not statistically significant (log-rank P>0.05). Compared to the usual care group, the full-cycle management group showed significantly higher proportions of New York Heart Association classification Ⅰ-Ⅱ patients (DMR: 67% vs. 52%, P=0.031; FMR: 68% vs. 52%, P=0.021), greater 6-minute walking distances (DMR: (346.39±70.41) m vs. (294.11±60.47) m, P=0.012; FMR: (356.60±54.68) m vs. (318.55±39.02) m, P=0.004), and superior Kansas City Cardiomyopathy Questionnaire scores (DMR: 81.50 (74.50, 85.00) points vs. 71.00 (66.00, 82.25) points, P=0.014; FMR: 83.00 (76.00, 85.00) points vs. 74.00 (70.75, 80.00) points, P=0.030). Multivariate logistic regression confirmed the full-cycle management system as an independent predictor for the above improved outcomes (all P<0.05). Conclusion:Smart healthcare-based full-cycle management improves cardiac function and quality of life in mitral regurgitation patients after TEER, demonstrating lower rates of major endpoint events compared to usual care.

Objective:To explore the advantages of internet-based smart healthcare for full-cycle transcatheter edge-to-edge repair (TEER) management in reducing postoperative adverse events rate, improving cardiac function, and enhancing quality of life.Methods:This retrospective study enrolled patients with mitral regurgitation who underwent transcatheter TEER at Beijing Anzhen Hospital Valve Intervention Center between June 2021 and September 2023. Patients were classified into degeneration mitral regurgitation (DMR) and functional mitral regurgitation (FMR) according to etiology, with further stratification by enrollment period into usual care group (June 2021 to October 2022) and full-cycle management group (November 2022 to September 2023). The 1-year postoperative follow-up data were collected and compared between subgroups with the same etiology. Kaplan-Meier survival curves were plotted, and log-rank tests were used to compare the differences in major endpoint event-free survival rates between the two groups. Univariate and multivariate Cox regression and logistic regression analyses were performed to evaluate the impact of the full-cycle management system on patients′ outcomes.Results:A total of 130 patients were included, aged (72.0±8.6) years, including 82 (63%) males. DMR was identified in 84 cases (40 in the usual care group and 44 in the full-cycle management group), while FMR was observed in 46 cases (27 in the usual care group and 19 in the full-cycle management group). Kaplan-Meier analysis demonstrated higher 1-year major endpoint event-free survival rates in the full-cycle management group compared to the usual care group, though the difference was not statistically significant (log-rank P>0.05). Compared to the usual care group, the full-cycle management group showed significantly higher proportions of New York Heart Association classification Ⅰ-Ⅱ patients (DMR: 67% vs. 52%, P=0.031; FMR: 68% vs. 52%, P=0.021), greater 6-minute walking distances (DMR: (346.39±70.41) m vs. (294.11±60.47) m, P=0.012; FMR: (356.60±54.68) m vs. (318.55±39.02) m, P=0.004), and superior Kansas City Cardiomyopathy Questionnaire scores (DMR: 81.50 (74.50, 85.00) points vs. 71.00 (66.00, 82.25) points, P=0.014; FMR: 83.00 (76.00, 85.00) points vs. 74.00 (70.75, 80.00) points, P=0.030). Multivariate logistic regression confirmed the full-cycle management system as an independent predictor for the above improved outcomes (all P<0.05). Conclusion:Smart healthcare-based full-cycle management improves cardiac function and quality of life in mitral regurgitation patients after TEER, demonstrating lower rates of major endpoint events compared to usual care.

Objective To investigate the effect of early warning score system combined with(situation,background,ssessment,recommendation,SBAR)communication model in early warning of high-risk neonates,therefore to provide an effective communication method for an effective communication method to assess the changes of condition in neonates.Methods A before-after study model was adopted in the study.A total of 270 high-risk neonates admitted to the ward of the Department of Neonatology in a tertiary hospital between August and September 2022 were selected as research subjects.The high-risk neonates admitted in hospital in August were assigned in a control group,and those admitted in September were assigned in an trial group,with 135 neonates per group.Routine care was carried out in the control group,while early warning scoring combined with SBAR communication model were applied in the trial group on top of the cares offered to the control group.The occurrence of early warning events,concordance rate of nurse warning event and doctor handling events,and the satisfaction rate of doctors with the nursing performance were compared between the two groups.Results A total of 63.6%of early warning events were triggered by nurses in the control group,while it was 92.6%in the trial group,with a statistically significant difference between the groups(χ2=16.622,P<0.001).The consistency of handling of early warning events between the nurses and doctors in the trial group(Kappa coefficient=0.926)was higher than that in the control group(Kappa coefficient=0.641).The satisfaction rates of the doctors with the nurses about specialist knowledge,ability in emergency events,mastery of disease,timely observation of disease progress,collaboration between doctors and nurses,working enthusiasm,communication capability and the psychological quality in the trial group were all significantly higher than those in the control group[80.0%-95.0%vs.30.0%-55.0%,all P<0.01].Conclusions The Early Warning Score system combined with SBAR communication model can help nurses to accurately evaluate the changes of disease in neonates,complete the communication with doctors timely and effectively.It improves the observation,communication and handling capability among the nurses as well as the satisfaction rate of doctors with nursing work.

Objective: To investigate the sexual function, urinary function and quality of life in patients of ulcerative colitis(UC) and familial adenomatous polyposis(FAP) after total proctocolectomy and ileal pouch anal anastomosis (IPAA). Methods: The clinical data of patients with UC and FAP undergoing IPAA at Zhongnan Hospital of Wuhan University from Jan 2006 to Sep 2018 were reviewed , postoperative sexual function, urinary function, and long-term quality of life were assessed. Results: There were 45 patients with median age of 35 years , median follow-up time of 31 months. 18 were UC, 27 were FAP, 5 did 1-stage surgery, 37 did 2-stage surgery, 3 for 3-stage surgery, 13 underwent open surgery, and 32 underwent laparoscopic surgery. 7 patients suffered sexual dysfunction after IPAA, and there was no statistical difference between male and female (P=0.992), UC and FAP (P=0.153), 1-stage , 2-stage , and 3-stage surgery (P=0.363) , with statistically significant difference between the open group and the laparoscopic group (P=0.025). 6 patients complicated with urinary dysfunction after IPAA , and there was no statistical difference between male and female (P=0.562), UC and FAP (P=0.325), 1-stage, 2-stage, and 3-stage surgery (P=0.286) , with statistically significant difference between the open group and the laparoscopic group (P=0.007). The Cleveland Global Quality of Life (CGQL) score after IPAA was 0.696±0.085. There were no statistical difference on CGQL scores in males and females (P=0.635), UC and FAP (P=0.664), 1-stage, 2-stage, and 3-stage (P>0.05), open group and laparoscopic group (P=0.205), postoperative long-term QOL was significantly associated only with age at the time of surgery (P=0.001). Conclusions Compared with open surgery, laparoscopic TPC-IPAA patients had better postoperative sexual function and urination function.

Objective: To evaluate the efficacy and safety of a domestic human plasma derived coagulation Factor Ⅸ concentrate (pd-FⅨ) in patients with hemophilia B. Methods: The study was a multicenter, open-label and single-arm study. The efficacy of pd-F Ⅸ was evaluated by objective performance criteria. The doses of pd-FⅨ were calculated according to the bleeding symptom and disease severity. The infusion efficiency of pd-FⅨ and improvement of bleeding symptoms were measured at 30 minutes and (24±4) h after the first infusion, respectively. Adverse events were recorded. Viral infection and FⅨ inhibitor were detected 90 d after the first infusion. Results: All 36 subjects with hemophilia B were enrolled in the study. The median age of these patients was 31 years old and the median injection doses were 4 (1-17) times. The hemostatic effect of 27/36 (75.00%) and 9/36 (25.00%) acute bleeding events were rated as "excellent" and "better" , respectively. The recovery rate was 111.92% (65.55%-194.28%) at 30 minutes after infusion of FⅨ. There was no adverse event related to FⅨ. No reactivation of HBV, HCV or HIV and FⅨ inhibitor was detected at 90-104 d after the first FⅨ infusion. Conclusion: This domestically made human plasma derived FⅨ concentrate is safe and effective in the treatment of acute bleeding in patients with hemophilia B. Clinical trial registration China food and Durg Administration, 2016L08027.

Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected. Six hundred and fifteen patients who were more than 18 years old and less than or equal to 65 years old were included in young and middle-aged group (YM). Eighty-two patients aged more than 65 years old were included in elderly group (E). Data of age, gender, residence, education level, cause of injury, location of injury, season of injury, total burn area, occurrence and area of full-thickness burn injury, wound site, inhalation injury incidence and severity, post burn admission time, proportion of delayed resuscitation, proportion of escharectomy or tangential excision and skin grafting, preinjury systemic disease, system complication during hospitalization, length of hospital stay, outcome of treatment, and reason of abandoning treatment of patients were analyzed. Data were processed with chi-square test and Mann-Whitney U test. The odds ratios of preinjury systemic disease, system complication during hospitalization, and adverse outcome of patients in group YM were compared with those in group E. Results: (1) The majority of patients in the two groups were male, but the proportion of male patients in group YM was higher. There was statistically significant difference in gender distribution of patients between the two groups (χ²=18.727, P<0.001). The majority of patients in the two groups were from rural areas, but the proportion of rural patients in group E was higher. There was statistically significant difference in residence distribution of patients between the two groups (χ²=9.306, P=0.002). Patients in group YM mainly had secondary education, while patients in group E mainly had primary education. There was statistically significant difference in distribution of education level of patients between the two groups (χ²=146.797, P<0.001). (2) The most common causes of injury of patients in the two groups were both flame, but the proportion of patients with flame burn injury in group E was higher. There was statistically significant difference in distribution of cause of injury of patients between the two groups (χ²=25.063, P<0.001). The main locations of injury of patients in groups YM and E were respectively public place and private residence. There was statistically significant difference in location distribution of injury of patients between the two groups (χ²=46.313, P<0.001). The main seasons of injury of patients in groups YM and E were respectively summer and winter. There was statistically significant difference in season distribution of patients between the two groups (χ²=23.143, P<0.001). There was statistically significant difference in distribution of total burn area of patients between the two groups (χ²=25.799, P=0.002). The occurrences of full-thickness burn injury of patients in the two groups were similar (χ²=2.685, P=0.101), while there was statistically significant difference in area of full-thickness burn injury of patients between the two groups (χ²=26.702, P=0.002). There was no statistically significant difference in distribution of wound site of patients between the two groups (χ²=3.954, P=0.785). There were no statistically significant differences in incidence and severity distribution of inhalation injury of patients between the two groups (with χ² values respectively 0.425 and 0.672, P values above 0.05). (3) There was statistically significant difference in distribution of admission time of patients between the two groups (χ²=6.632, P=0.036), but there was no statistically significant difference in proportion of delayed resuscitation of patients between the two groups (χ²=1.261, P=0.261). The proportion of escharectomy or tangential excision and skin grafting of patients in group YM was 72.0% (443/615), which was significantly higher than 35.4% (29/82) of group E (χ²=44.498, P<0.001). The incidence of preinjury systemic disease of patients in group YM was 13.2% (81/615), which was significantly lower than 61.0% (50/82) of group E (χ²=108.337, P<0.001). The risk of preinjury systemic disease of patients in group E was 10.30 times of that of patients in group YM [with 95% confidence interval (CI) of 6.24-17.01, P<0.001]. During hospitalization, 59.8% (49/82) of patients in group E suffered from system complications, which was significantly higher than 36.6% (225/615) of group YM (χ²=16.282, P<0.001). The risk of system complication of patients in group E was 2.57 times of patients in group YM (with 95% CI of 1.61-4.12, P<0.001). The length of hospital stay of patients in group E was significantly shorter than that of group YM (U=36 735, P<0.001). There was statistically significant difference in treatment outcome of patients between the two groups (χ²=106.251, P<0.001). The risk of adverse outcome of patients in group E was 7.52 times of group YM (with 95% CI of 4.40-12.88, χ²=67.709, P<0.001). The proportion of abandoning treatment of patients in group E was significantly higher than that of group YM (χ²=150.670, P<0.001). The risk of abandoning treatment of patients in group E was 15.86 times of that of group YM (with 95% CI of 9.36-26.88, P<0.001). There was no statistically significant difference in distribution of reason of abandoning treatment of patients between the two groups (χ²=4.178, P=0.243). Conclusions There were significant differences in the epidemiological characteristics of patients in groups E and YM. In elderly burn patients, the proportion of rural population was higher and the education level was lower. Flame burn was common and burns mostly occurred in private residences and in winter. The total burn area was slightly lower but the area of full-thickness burn injury was larger. The length of hospital stay was shorter and the proportion of surgical treatment was lower. The incidences of preinjury systemic disease and system complication during hospitalization were higher, and therefore the risks of adverse outcome and abandoning treatment were higher.

The accurate diagnosis of burn depth is one of the important problems in the field of burn surgery.The diagnosis accuracy rate is directly related to the treatment plan and effect.The existed clinical diagnosis methods mainly depend on the experience of burn surgeon,making the accuracy rate from 50％ to 65％.In order to improve the accuracy rate of clinical burn depth diagnosis,a large number of diagnosis methods based on imaging are proposed,however,all of the methods are still in the stage of experimental research.In this paper,the research advances on the diagnosis techniques of burn depth are summarized,both the advantages and the shortcomings are pointed,and the development trend of diagnosis techniques of burn depth is expected.

BACKGROUNDThe hippocampus and amygdala exhibit structural and functional alterations in patients with depression. The objective of this study was to investigate the structural and functional relationships between these core regions.

METHODSBased on the severity of their condition, 60 patients and 20 healthy controls were equally divided into four groups (mild group, moderate group, major group and health controls group), scanned by T1-MR, functional magnetic resonance imaging (fMRI), and susceptibility weighted imaging (SWI). Structural image, BOLD image, and SWI image were collected for processing and analysis. The characteristics of the depression and controls were checked by analysis of variance test, and the difference between groups was checked by Dunnett's test.

RESULTSThe volume of hippocampus and amygdala varied with the severity of the condition. The signal obtained under the stimulation of negative events was linearly decreased in the mild, moderate and major groups revealed by fMRI. The length and diameter of the lateral ventricle vein was reduced in the mild group, whereas the number of branches increased. In the moderate and major groups, the reduction in the length, diameter and increase in the number of branches of the lateral ventricle vein were greater.

CONCLUSIONThe alterations of the volume, fMRI, and cerebral veins in these core regions may account for the causal relationship between structure and function.

Adult ; Amygdala ; pathology ; Depression ; pathology ; Female ; Hippocampus ; pathology ; Humans ; Magnetic Resonance Spectroscopy ; Male

Objective To explore the effect of applying personal digital assistant(PDA)in documenting medical orders and monitoring vital signs.Method There was significant diffenence the between two groups in dicumenting,inedical orders,monitoring vital signs(P<0.05).Result BPDA needed significantly shorter time for documenting medical orders and monitoring vital signs than the traditional method(P<0.05).Conclusions PDA may shorten the time for documenting medical orders and monitoring vital signs. It reduces the repetition of nursing routines,optimizes the work flow sheet so that nurses have more time for patients and the quality of nursing is improved.