1.Improvement effects and mechanism of astragaloside Ⅳ on neuroinflammation
Mimi WANG ; Yonggang FENG ; Yun HAN ; Kaixin SHAN ; Fuyu LIU ; Mingsan MIAO ; Xiaoyan FANG
China Pharmacy 2026;37(1):30-35
OBJECTIVE To investigate the improvement effects and mechanism of astragaloside Ⅳ (AS- Ⅳ ) on lipopolysaccharide (LPS)-induced neuroinflammation. METHODS BV2 cells were divided into control group, LPS group, AS-Ⅳ groups at concentrations of 20 and 40 μmol/L, and dexamethasone group (2 μmol/L). Except for control group, neuroinflammation model was established with LPS (1 μg/mL) in other groups after medication. The levels of inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and nitric oxide (NO)] in cell supernatant were measured in each group. Mice were randomly divided into normal group, model group, positive control group (Aspirin enteric-coated tablet, 20 mg/kg), AS-Ⅳ low- and high-dose groups (10, 20 mg/kg), with 6 mice in each group. Mice in each group were administered the corresponding drug/normal saline via gavage/intraperitoneal injection, once a day, for 14 consecutive days. Except for normal group, other groups were intraperitoneally injected with LPS (250 μg/kg) 1 hour after daily administration of the drug/normal saline to establish neuroinflammation model. Serum levels of IL-6 and TNF-α were measured 2 h after the last medication; histopathological morphology of cerebral tissue in mice were observed; the co-localization of inducible nitric oxide synthase (iNOS)/ionized calcium binding adapter molecule 1 (Iba1) and CD206/Iba1 in the cerebral cortex region of mice was observed; the expressions of proteins related to the nuclear factor-κB (NF-κB)/mitogen-activated protein kinase (MAPK) signaling pathway in brain tissue of mice were also determined, including NF-κB p65, phosphorylated NF-κB p65(p-NF-κB p65), p38 MAPK, phosphorylated p38 MAPK (p-p38 MAPK), extracellular signal-regulated kinase (ERK), and phosphorylated ERK (p-ERK). RESULTS In the cell experiments, compared with control group, the levels of IL-6, TNF- α and NO in the cell supernatant of the LPS group were increased significantly (P<0.05); compared with LPS group, the levels of IL-6, TNF-α and NO were decreased significantly in the administration groups (P<0.05). In the animal experiments, compared with the normal group, the serum levels of IL-6 and TNF- α, the number of iNOS/Iba1 co-localization positive cells in the cerebral cortex, and the phosphorylation levels of p38 MAPK, NF- κB p65 and ERK proteins in brain tissue were all significantly increased/elevated in model group (P<0.05); the number of CD206/ Iba1 co-localization positive cells in the cerebral cortex region significantly decreased (P<0.05). The neurons in the cerebral cortex and the CA3 region of the hippocampus displayed a disordered arrangement. Compared with model group, above quantitative indexes of mice were all reversed significantly in administration groups (P<0.05); the neuronal cells in the cerebral cortex and the CA3 region of the hippocampus exhibited a relatively orderly arrangement. CONCLUSIONS AS-Ⅳ may inhibit the activation of the NF-κB/MAPK signaling pathway, promote the M2-type polarization of microglia, and thereby suppress neuroinflammatory responses.
2.Value of MRI radiomics based on intratumoral and peritumoral heterogeneity in predicting spatial patterns of locally recurrent high-grade gliomas
Hanwei WANG ; Linlan ZENG ; Mimi ZHAO ; Xuan LI ; Huan XIE ; Xiaoguang LI ; Liang YI ; Yi WU ; Shunan WANG
Journal of Army Medical University 2025;47(14):1577-1586
Objective To establish and validate a multimodal MRI radiomics model based on intratumoral and peritumoral heterogeneity for prediction of spatial pattern of locally recurrent high-grade gliomas(HGGs).Methods A retrospective analysis was conducted on the clinical and imaging data of all HGGs patients who underwent maximum safe resection followed by postoperative radiotherapy combined with temozolomide treatment and experienced in local recurrence in Army Medical Center of PLA from 2012 to 2021.Two radiologists independently assessed the spatial patterns of locally recurrence HGGs through continuous follow-up MRI data,and primarily categorized the pattern into intra-resection cavity recurrence and extra-resection cavity recurrence.The subjected patients were randomly divided into a training set and a validation set in a 7∶3 ratio.In the training set,Pearson or Spearman correlation analysis and least absolute shrinkage and selection operator(LASSO)analysis were employed to screen radiomic features within the intratumoral and peritumoral regions,as well as to calculate radiomic scores.A radiomics model was established using logistic regression analysis.The performance of the model was assessed using calibration curves,Hosmer-Lemeshow goodness-of-fit test,and the area under the receiver operating characteristic curve(AUC).Validation of the model was performed in the validation set.Results A total of 121 patients with locally recurrent HGGs were enrolled in this study,including 54 in intra-resection cavity recurrence group and 67 in extra-resection cavity recurrence group.Among them,84 were assigned into the training set and 37 into the validation set.In the training set,the radiomics score for the extra-resection cavity recurrence group was 0.424(0.278,0.573),which was higher than that for the intra-resection cavity recurrence group[-0.030(-0.226,0.248),P<0.001].In the validation set,the radiomics score for the extra-resection cavity recurrence group was 0.369(0.258,0.487),which was higher than that for the intra-resection cavity recurrence group[0.277(0.103,0.322),P=0.033].The established radiomics model exhibited good calibration and performed well in predicting spatial recurrence patterns,with an AUC value of 0.844(95%CI:0.749~0.914)in the training set and 0.706(95%CI:0.534~0.844)in the validation set.Conclusion Our multimodal radiomics model combined with intratumoral and peritumoral heterogeneity can predict the spatial pattern of locally recurrent HGGs,providing a basis for individualized treatment of HGGs.
3.Structural equation analysis of the incidence of shoulder WMSDs and individual and work-related factors
Shuang ZHOU ; Zhongxu WANG ; Ruijie LING ; Qing XU ; Huadong ZHANG ; Yimin LIU ; Gang LI ; Yan YIN ; Hua SHAO ; Jue LI ; Hengdong ZHANG ; Bing QIU ; Dayu WANG ; Qiang ZENG ; Yan YE ; Bin XIAO ; Hua ZOU ; Jianchao CHEN ; Dongxia LI ; Yongquan LIU ; Jixiang LIU ; Enfei JIANG ; Jun QI ; Liangying MEI ; Xianfeng ZHAO ; Mimi YANG ; Ning JIA
Chinese Journal of Industrial Hygiene and Occupational Diseases 2025;43(2):91-100
Objective:To investigate the incidence of shoulder work-related musculoskeletal disorders (WMSDs) among occupational population in China, and to explore their intrinsic association with personal and work-related factors.Methods:In April 2024, 73497 valid questionnaires of the Chinese version of the Musculoskeletal Disorders Electronic Questionnaire were retrospectively analyzed from June 2018 to December 2023 in 22 provinces and 29 key industries in China, and the general information, occurrence of WMSDs and related risk factors of key occupational populations in different regions in China were collected. By using Chi-square test and confirmatory factor analysis, the relationship between shoulder fatigue and pain in key occupational groups and individual factors, work type, work posture and work organization was discussed, and the internal relationship was analyzed based on structural equation model.Results:Higher incidence of shoulder fatigue and pain were associated with female, lack of physical exercise, uncomfortable working posture and neck leaning forward ( P<0.05). Structural equation model analysis showed that work type, work posture and work organization were strongly correlated ( r=0.58, 0.55). Work organization and work type were strongly correlated with shoulder fatigue ( r=0.65) and moderately correlated with shoulder fatigue ( r=0.21). Shoulder fatigue was moderately associated with shoulder pain ( r=0.40). Individual factors, work type, work posture and shoulder fatigue could directly affect shoulder pain ( OR=0.07, -0.09, 0.17 and 0.40), and work type and work posture could also indirectly affect shoulder pain through shoulder fatigue ( OR=0.08, 0.03). Work organization only indirectly affected shoulder pain through shoulder fatigue ( OR=0.26) . Conclusion:The main influencing factor of shoulder pain is shoulder fatigue, followed by work posture and individual factors. Structural equation model can better reflect the complex relationship between work type, work posture and work organization and shoulder WMSDs. Improving work posture and work organization may be an effective way to control the influence of shoulder fatigue on shoulder pain.
4.Structural equation analysis and modeling of fect and ankles WMSDs and its adverse ergonomic factors
Xi ZHANG ; Ning JIA ; Xin SUN ; Meibian ZHANG ; Qing XU ; Huadong ZHANG ; Ruijie LING ; Yimin LIU ; Gang LI ; Yan YIN ; Hua SHAO ; Hengdong ZHANG ; Yanmin QI ; Bing QIU ; Tiebing LIU ; Dayu WANG ; Qiang ZENG ; Yan YE ; Bin XIAO ; Hua ZOU ; Jianchao CHEN ; Dongxia LI ; Yongquan LIU ; Jixiang LIU ; Enfei JIANG ; Jun QI ; Liangying MEI ; Tianlai LI ; Mimi YANG ; Xinwei GUO ; Zhongxu WANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2025;43(2):101-109
Objective:To explore the structural equation model to explore the levels of work-related musculoskeletal disorders (WMSDs) and various risk factors in the feet and ankle of China's occupational population, providing scientific basis for for preventing WMSDs in feet and ankles.Methods:Data of 73497 national occupational epidemiological cases were selected from June 2018 to December 2023 used the Chinese version of the Electronic Questionnaire on Musculoskeletal Disorders. The adverse ergonomic factors and their source classification standard and confirmatory factor analysis were used to investigate foot and ankle WMSDs and their related risk factors (including individual factors, work organization, work posture, work type, fatigue, etc.) in key occupational groups in China, and structural equation model hypothesis, fitting, verification, and path and intermediary effect analysis were carried out. The model fit evaluation indexes included Chi-square specific degrees of freedom ( χ2/ df), gauge fit index (NFI), Tucker Lewis index (TLI), goodness of Fit index (GFI), adjusted Goodness of Fit index (AGFI) and approximate root mean square error (RMSEA) . Results:A total of 73497 occupational workers were surveyed, with local muscle fatigue and WMSDs incidence rates in the feet and ankles being 17.17% and 12.06%, respectively. The fitting index of the adjusted structural equation model basically meets the standard (GFI=1, AGFI=1, RMESA=0.042, NFI=0.716, TLI=0.663). The top three factors affecting feet and ankle WMSDs are feet and ankle muscle fatigue, work type, and work organization, with standardized path coefficients of 0.221, 0.105, and 0.095, respectively. The top two factors affecting feet and ankle muscle fatigue are work organization and work type, with standardized path coefficients of 0.548 and 0.383, respectively. Feet and ankle muscle fatigue, work type, work organization, and work posture have a direct effect on feet and ankle WMSDs, with effect values of 0.221, 0.105, 0.095, and 0.077, respectively. The organization and type of work can also have indirect effects through feet and ankle muscle fatigue, with effect values of 0.121 and 0.084, respectively.Conclusion:Feet and ankle muscle fatigue has a direct impact on WMSDs, and plays a mediating role between ankle and ankle WMSDs caused by work organization and work type. Feet and ankle muscle fatigue is an important pathway leading to feet and ankle WMSDs. It is recommended that employers and managers detect job fatigue early and take corresponding prevention and intervention measures, which can play a key role in preventing feet and ankle WMSDs.
5.Structural equation analysis and modeling of upper limb WMSDs and their adverse ergonomic factors
Siwu ZHONG ; Ning JIA ; Xin SUN ; Meibian ZHANG ; Qing XU ; Huadong ZHANG ; Ruijie LING ; Yimin LIU ; Gang LI ; Yan YIN ; Hua SHAO ; Jue LI ; Hengdong ZHANG ; Bing QIU ; Dayu WANG ; Qiang ZENG ; Rugang WANG ; Yan YE ; Bin XIAO ; Hua ZOU ; Jianchao CHEN ; Dongxia LI ; Yongquan LIU ; Qinghua SHI ; Jixiang LIU ; Enfei JIANG ; Jun QI ; Liangying MEI ; Xianfeng ZHAO ; Mimi YANG ; Xinwei GUO ; Zhi WANG ; Zhongxu WANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2025;43(4):254-263
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.
6.Inhibitory effect of calycosin-7-glucoside on lipopolysaccharide-induced neuroinflammation via the TLR4/MyD88/NF-κB signaling pathway
Yun HAN ; Yonggang FENG ; Mimi WANG ; Kaixin SHAN ; Mingsan MIAO ; Xiaoyan FANG
Chinese Journal of Comparative Medicine 2025;35(8):48-57
Objective To explore the effects and mechanism of calycosin-7-glucoside(CG)on lipopolysaccharide(LPS)-induced inflammatory injury in BV-2 cells and in a mouse model of neuroinflammation.Methods An in vitro neuroinflammation model was induced by LPS stimulation of BV-2 cells.BV-2 cells were divided into blank(CON),model(LPS),dexamethasone(DEX),and low-and high-dose CG(CG 10 μmol/L,CG 20 μmol/L,respectively)groups.The cell viability in each group was detected by Cell Counting Kit-8 assay,interleukin(IL)-6 and tumor necrosis factor(TNF)-α levels in the supernatant were detected by enzyme-linked immunosorbent assay(ELISA),and nitric oxide levels were detected using the Griess method.LPS was also used to induce neuroinflammation in mice in vivo.The mice were then divided randomly into blank(CON),model(LPS),aspirin,and low-and high-dose CG(CG 5 mg/kg,CG 10 mg/kg,respectively)groups.Pathological changes in the hippocampus were detected by hematoxylin/eosin staining.Serum levels of IL-6 and TNF-α were detected by ELISA,polarization of microglia was detected by immunofluorescence staining,and protein expression levels of Toll-like receptor 4(TLR4),myeloid differentiation primary response 88(MyD88),nuclear factor κB(NF-κB,P65)and phosphorylated-NF-κB(p-P65)in the cortex were detected by Western blot.Results CG alone or in combination with LPS in the concentration range of 2.5~160 μmol/L had no significant toxicity in BV-2 cells in vitro,compared with the CON group(P>0.05).IL-6,TNF-α,and NO levels in the cell supernatant were increased in the LPS group compared with the CON group(P<0.01),but were significantly reduced by CG(P<0.05,P<0.01).Hippocampal neurons were arranged loosely and disordered in the LPS group in vivo,compared with the CON group,and nuclear pyknosis was observed.Serum levels of IL-6 and TNF-α were increased(P<0.05,P<0.01).The number of ionized calcium binding adaptor molecule 1(Iba1)/inducible nitric oxide synthase(iNOS)cells was increased(P<0.01),the number of CD206/Iba1 cells was decreased(P<0.01),and expression levels of TLR4,MyD88,and p-P65 protein in the cortex were increased(P<0.05).Compared with the LPS group,CG improved the pathological damage to the hippocampus and inhibited serum levels of IL-6 and TNF-α(P<0.01).CG also decreased the number of iNOS/Iba1 cells,increased the number of CD206/Iba1 cells(P<0.05,P<0.01),and significantly down-regulated TLR4,MyD88,and p-P65 protein levels in the cortex(P<0.05).Conclusions CG can ameliorate neuroinflammation in mice by suppressing the TLR4/MyD88/NF-κB pathway.
7.Inhibitory effect of calycosin-7-glucoside on lipopolysaccharide-induced neuroinflammation via the TLR4/MyD88/NF-κB signaling pathway
Yun HAN ; Yonggang FENG ; Mimi WANG ; Kaixin SHAN ; Mingsan MIAO ; Xiaoyan FANG
Chinese Journal of Comparative Medicine 2025;35(8):48-57
Objective To explore the effects and mechanism of calycosin-7-glucoside(CG)on lipopolysaccharide(LPS)-induced inflammatory injury in BV-2 cells and in a mouse model of neuroinflammation.Methods An in vitro neuroinflammation model was induced by LPS stimulation of BV-2 cells.BV-2 cells were divided into blank(CON),model(LPS),dexamethasone(DEX),and low-and high-dose CG(CG 10 μmol/L,CG 20 μmol/L,respectively)groups.The cell viability in each group was detected by Cell Counting Kit-8 assay,interleukin(IL)-6 and tumor necrosis factor(TNF)-α levels in the supernatant were detected by enzyme-linked immunosorbent assay(ELISA),and nitric oxide levels were detected using the Griess method.LPS was also used to induce neuroinflammation in mice in vivo.The mice were then divided randomly into blank(CON),model(LPS),aspirin,and low-and high-dose CG(CG 5 mg/kg,CG 10 mg/kg,respectively)groups.Pathological changes in the hippocampus were detected by hematoxylin/eosin staining.Serum levels of IL-6 and TNF-α were detected by ELISA,polarization of microglia was detected by immunofluorescence staining,and protein expression levels of Toll-like receptor 4(TLR4),myeloid differentiation primary response 88(MyD88),nuclear factor κB(NF-κB,P65)and phosphorylated-NF-κB(p-P65)in the cortex were detected by Western blot.Results CG alone or in combination with LPS in the concentration range of 2.5~160 μmol/L had no significant toxicity in BV-2 cells in vitro,compared with the CON group(P>0.05).IL-6,TNF-α,and NO levels in the cell supernatant were increased in the LPS group compared with the CON group(P<0.01),but were significantly reduced by CG(P<0.05,P<0.01).Hippocampal neurons were arranged loosely and disordered in the LPS group in vivo,compared with the CON group,and nuclear pyknosis was observed.Serum levels of IL-6 and TNF-α were increased(P<0.05,P<0.01).The number of ionized calcium binding adaptor molecule 1(Iba1)/inducible nitric oxide synthase(iNOS)cells was increased(P<0.01),the number of CD206/Iba1 cells was decreased(P<0.01),and expression levels of TLR4,MyD88,and p-P65 protein in the cortex were increased(P<0.05).Compared with the LPS group,CG improved the pathological damage to the hippocampus and inhibited serum levels of IL-6 and TNF-α(P<0.01).CG also decreased the number of iNOS/Iba1 cells,increased the number of CD206/Iba1 cells(P<0.05,P<0.01),and significantly down-regulated TLR4,MyD88,and p-P65 protein levels in the cortex(P<0.05).Conclusions CG can ameliorate neuroinflammation in mice by suppressing the TLR4/MyD88/NF-κB pathway.
8.Structural equation analysis of the incidence of shoulder WMSDs and individual and work-related factors
Shuang ZHOU ; Zhongxu WANG ; Ruijie LING ; Qing XU ; Huadong ZHANG ; Yimin LIU ; Gang LI ; Yan YIN ; Hua SHAO ; Jue LI ; Hengdong ZHANG ; Bing QIU ; Dayu WANG ; Qiang ZENG ; Yan YE ; Bin XIAO ; Hua ZOU ; Jianchao CHEN ; Dongxia LI ; Yongquan LIU ; Jixiang LIU ; Enfei JIANG ; Jun QI ; Liangying MEI ; Xianfeng ZHAO ; Mimi YANG ; Ning JIA
Chinese Journal of Industrial Hygiene and Occupational Diseases 2025;43(2):91-100
Objective:To investigate the incidence of shoulder work-related musculoskeletal disorders (WMSDs) among occupational population in China, and to explore their intrinsic association with personal and work-related factors.Methods:In April 2024, 73497 valid questionnaires of the Chinese version of the Musculoskeletal Disorders Electronic Questionnaire were retrospectively analyzed from June 2018 to December 2023 in 22 provinces and 29 key industries in China, and the general information, occurrence of WMSDs and related risk factors of key occupational populations in different regions in China were collected. By using Chi-square test and confirmatory factor analysis, the relationship between shoulder fatigue and pain in key occupational groups and individual factors, work type, work posture and work organization was discussed, and the internal relationship was analyzed based on structural equation model.Results:Higher incidence of shoulder fatigue and pain were associated with female, lack of physical exercise, uncomfortable working posture and neck leaning forward ( P<0.05). Structural equation model analysis showed that work type, work posture and work organization were strongly correlated ( r=0.58, 0.55). Work organization and work type were strongly correlated with shoulder fatigue ( r=0.65) and moderately correlated with shoulder fatigue ( r=0.21). Shoulder fatigue was moderately associated with shoulder pain ( r=0.40). Individual factors, work type, work posture and shoulder fatigue could directly affect shoulder pain ( OR=0.07, -0.09, 0.17 and 0.40), and work type and work posture could also indirectly affect shoulder pain through shoulder fatigue ( OR=0.08, 0.03). Work organization only indirectly affected shoulder pain through shoulder fatigue ( OR=0.26) . Conclusion:The main influencing factor of shoulder pain is shoulder fatigue, followed by work posture and individual factors. Structural equation model can better reflect the complex relationship between work type, work posture and work organization and shoulder WMSDs. Improving work posture and work organization may be an effective way to control the influence of shoulder fatigue on shoulder pain.
9.Structural equation analysis and modeling of fect and ankles WMSDs and its adverse ergonomic factors
Xi ZHANG ; Ning JIA ; Xin SUN ; Meibian ZHANG ; Qing XU ; Huadong ZHANG ; Ruijie LING ; Yimin LIU ; Gang LI ; Yan YIN ; Hua SHAO ; Hengdong ZHANG ; Yanmin QI ; Bing QIU ; Tiebing LIU ; Dayu WANG ; Qiang ZENG ; Yan YE ; Bin XIAO ; Hua ZOU ; Jianchao CHEN ; Dongxia LI ; Yongquan LIU ; Jixiang LIU ; Enfei JIANG ; Jun QI ; Liangying MEI ; Tianlai LI ; Mimi YANG ; Xinwei GUO ; Zhongxu WANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2025;43(2):101-109
Objective:To explore the structural equation model to explore the levels of work-related musculoskeletal disorders (WMSDs) and various risk factors in the feet and ankle of China's occupational population, providing scientific basis for for preventing WMSDs in feet and ankles.Methods:Data of 73497 national occupational epidemiological cases were selected from June 2018 to December 2023 used the Chinese version of the Electronic Questionnaire on Musculoskeletal Disorders. The adverse ergonomic factors and their source classification standard and confirmatory factor analysis were used to investigate foot and ankle WMSDs and their related risk factors (including individual factors, work organization, work posture, work type, fatigue, etc.) in key occupational groups in China, and structural equation model hypothesis, fitting, verification, and path and intermediary effect analysis were carried out. The model fit evaluation indexes included Chi-square specific degrees of freedom ( χ2/ df), gauge fit index (NFI), Tucker Lewis index (TLI), goodness of Fit index (GFI), adjusted Goodness of Fit index (AGFI) and approximate root mean square error (RMSEA) . Results:A total of 73497 occupational workers were surveyed, with local muscle fatigue and WMSDs incidence rates in the feet and ankles being 17.17% and 12.06%, respectively. The fitting index of the adjusted structural equation model basically meets the standard (GFI=1, AGFI=1, RMESA=0.042, NFI=0.716, TLI=0.663). The top three factors affecting feet and ankle WMSDs are feet and ankle muscle fatigue, work type, and work organization, with standardized path coefficients of 0.221, 0.105, and 0.095, respectively. The top two factors affecting feet and ankle muscle fatigue are work organization and work type, with standardized path coefficients of 0.548 and 0.383, respectively. Feet and ankle muscle fatigue, work type, work organization, and work posture have a direct effect on feet and ankle WMSDs, with effect values of 0.221, 0.105, 0.095, and 0.077, respectively. The organization and type of work can also have indirect effects through feet and ankle muscle fatigue, with effect values of 0.121 and 0.084, respectively.Conclusion:Feet and ankle muscle fatigue has a direct impact on WMSDs, and plays a mediating role between ankle and ankle WMSDs caused by work organization and work type. Feet and ankle muscle fatigue is an important pathway leading to feet and ankle WMSDs. It is recommended that employers and managers detect job fatigue early and take corresponding prevention and intervention measures, which can play a key role in preventing feet and ankle WMSDs.
10.Structural equation analysis and modeling of upper limb WMSDs and their adverse ergonomic factors
Siwu ZHONG ; Ning JIA ; Xin SUN ; Meibian ZHANG ; Qing XU ; Huadong ZHANG ; Ruijie LING ; Yimin LIU ; Gang LI ; Yan YIN ; Hua SHAO ; Jue LI ; Hengdong ZHANG ; Bing QIU ; Dayu WANG ; Qiang ZENG ; Rugang WANG ; Yan YE ; Bin XIAO ; Hua ZOU ; Jianchao CHEN ; Dongxia LI ; Yongquan LIU ; Qinghua SHI ; Jixiang LIU ; Enfei JIANG ; Jun QI ; Liangying MEI ; Xianfeng ZHAO ; Mimi YANG ; Xinwei GUO ; Zhi WANG ; Zhongxu WANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2025;43(4):254-263
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.

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