Background Bus drivers are a high-risk group for work-related musculoskeletal disorders (WMSDs). There are a large number of bus drivers in mega-cities. High volumes of passenger traffic and complexity of road conditions may elevate their risk of WMSDs, but there are few studies related to this group. Objective To investigate the prevalence of WMSDs among bus drivers in a mega-city and to analyze potential influencing factors. Methods Based on cross-sectional study design and self-administered questionnaire, the prevalence of WMSDs in past 12 months were estimated by stratified cluster sampling among bus drivers in a mega-city. Pearson χ² and logistic regression models were used to analyze the influencing factors for the body regions with a high prevalence. Results The overall prevalence of WMSDs in past 12 months among bus drivers in a mega-city was 49.5% (551/1113). The prevalence of WMSDs by body regions ranged from 4.0% to 38.5%, and led by neck pain (38.5%), lower back pain (25.5%), and shoulder pain (20.8%). The results of logistic regression showed that the risk factors for neck pain were age (>50 years), smoking, tiredness after work (moderate, severe), long sitting (frequently), awkward postures (sometimes, often, frequently), overtime(occasionally, often), workplace temperature (uncomfortable), and noise (severe) (OR=2.014、1.577、2.793、3.025、2.708、2.032、3.406、2.746、1.442、2.998、1.456、3.506；P<0.05); the lower back pain risk factors were current work experience (6-10 years, 11-15 years, and 16-20 years), smoking, tiredness after work (moderate, severe), and awkward postures(sometimes, often, frequently)(OR=1.777、2.130、2.400、1.503、2.951、3.364、1.836、4.569、2.786，P<0.05); and the shoulder pain risk factors were age (46-50 years, and >50 years), smoking, tiredness after work (moderate, severe), vehicle type (hybrid power, diesel oil), awkward postures (often, frequently), overtime (often), and workplace temperature (uncomfortable) (OR=1.737、2.357、1.553、2.259、2.489、1.659、3.295、2.777、3.320、2.266、1.426，P<0.05). Identified protective factors for neck and lower back pain were off-duty physical activity (1-2 times per week, and ≥3 times per week) (OR=0.553、0.470、0.586、0.485，P<0.05). Conclusion Nearly half of the bus drivers in the mega-city report symptoms of WMSDs, mainly in the neck, lower back, and shoulders. The prevalence is related to individual and occupational factors, and prevention and intervention measures should be actively taken.

Objective:To discuss the distinctive sonographic feature and the biological behavior of renal angiomyolipoma(RAML),and to provide the reference for the clinicians to make the accurate diagnosis of RAML.Methods:The clinical data of one patient with invasive classical RAML combined with pseudaneurysm formation were collected.The sonographic appearances were analyzed in conjunction with the pathological characteristics to clarify the biological behavior of RAML,and the relevant literatures were reviewed.Results:The patient,a 60-year-old female,visited the local hospital due to discomfort in the lumbar area,and received CT examination,and the CT examination results revealed a left renal mass,so the patient came to our hospital.The specialist clinical examinations and laboratory investigations were unremarkable.The ultrasound results indicated an enlarged left kidney with a cystic and solid mass at the upper pole,which featured pseudaneurysm formation(originating from the interlobar arteries);the enhanced CT image results suggested a high probability of upper pole renal carcinoma combined with aneurysmal formation within the tumor,alongside invasion into the left adrenal gland.The patient underwent laparoscopic radical left nephrectomy,and the postoperative pathology confirmed the diagnosis of invasive classical RAML.Conclusion:The classical RAML can exhibit the invasive biological behavior.The pseudaneurysm formation is a special sonographic manifestation of RAML,which can be challenging to differentiate from the other renal tumors.

Objective:To analyze the epidemiological features of respiratory syncytial virus (RSV) infection in Beijing, and monitor the sequence variations in RSV glycoprotein (G) gene and clinical features of infected children.Methods:Respiratory tract specimens were collected from children with acute respiratory infection in the Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 1, 2023 to December 31, 2023. RSV-positive specimens screened by multiple nucleic acid testing were subjected to PCR to amplify the full-length RSV G gene. A phylogenetic tree was constructed after gene sequencing to analyze RSV subtypes and trace G gene variants. Clinical data were retrieved from the medical record system to analyze the clinical features of children with RSV infection in Beijing.Results:A total of 5 489 respiratory specimens were collected from 3 046 male patients and 2 443 female patients. The average age of the patients was 4.36 years. A total of 589 RSV-positive specimens (10.7%, 589/5 489) were detected with 349 from male patients and 240 from female patients. The average age of children with RSV infection was (2.51±2.78) years and the median age was 0.48 years. RSV had been circulating among children in Beijing since March 2023 with two epidemic peaks in May (24.6%, 122/496) and December (18.2%, 126/693). The predominant subtype of RSV in the first half of 2023 was subtype A, but it was replaced by subtype B from November 2023. Phylogenetic analysis revealed a novel G gene of RSV subtype B (RSV-B-BA9-954bp) with a length of 954 bp, which belonged to a new cluster in the phylogenetic tree. The percentage of patients admitted to the Intensive Care Unit (ICU) was higher in children with new variant of RSV subtype B infection than in those with common RSV subtype B infection [44.1% (15/34) vs 25.2% (31/123), χ 2=4.600, P=0.032], while the counts of white blood cells and the levels of C-reactive protein were lower in the children with new variant infection ( P<0.05). Conclusions:RSV has been prevalent among children in Beijing since March 2023 with two epidemic peaks. The predominant A subtype is gradually replaced by to B subtype. A new variant of RSV B G gene (RSV-B-BA9-954bp) is detected among the children.

Objective:To analyze the differentially expressed genes of human respiratory syncytial virus (RSV) subtype A genotype ON1, a predominant genotype in Beijing, after infecting A549 cells using transcriptomic sequencing, and provide potential targets for RSV prevention and treatment.Methods:A local strain (61397-ON1) identified by whole-genome sequencing as ON1 genotype of RSV subtype A was selected to infect A549 cells. Total mRNA was extracted, and the differentially expressed genes in infected and uninfected A549 cells were screened by transcriptomic sequencing. GO analysis and KEGG pathway analysis were performed. Besides, six genes with differential expression ratio greater than two times were randomly selected for qRT-PCR verification.Results:There were 1 632 differentially expressed genes between infected and uninfected A549 cells, of which 807 genes were up-regulated and 825 genes were down-regulated. The differentially expressed genes were mainly involved in immune response-related biological processes such as cytokine response and positive regulation of MAPK cascades, and were enriched in MAPK signaling pathway, NOD-like receptor signaling pathway, p53 signaling pathway, TNF signaling pathway, IL-17 signaling pathway and NF-κB signaling pathway. The results of qRT-PCR for six differentially expressed genes were consistent with the trend of transcriptome data.Conclusions:The differentially expressed genes of RSV A subtype ON1 genotype after infecting A549 cells are mainly involved in cytokine response and immune-related signaling pathways. This study provides basic data for further study of the molecular mechanism of RSV infection and the development of prevention and treatment strategies.

Objective To explore the application value of heparin binding protein(HBP),neutrophil to lymphocyte ratio(NLR),lymphocyte to monocyte ratio(LMR),and platelet to lymphocyte ratio(PLR)in the evaluation of immune function reconstruction in human immunodeficiency virus(HIV)infected individuals/acquired immunodeficiency syndrome(AIDS)patients.Methods Collect 138 HIV/AIDS patients from the Outpatient Department of Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University from January 1,to June 30,2023.According to CD4+T lymphocyte counts after antiretroviral treatment,categorize patients into groups with good immune function reconstruction(n=108)and poor immune function reconstruction(n=30).Compare the levels of HBP,NLR,LMR,and PLR between two groups,receiver operating characteristic(ROC)curve was used to evaluate the application value of HBP,NLR,LMR,and PLR in the reconstruction of patient immune function.Results The NLR and PLR of group with good immune function reconstruction was significantly higher than that of group with poor immune function reconstruction(P＜0.05).The LMR of group with good immune function reconstruction were significantly lower than those of group with poor immune function reconstruction(P＜0.05).The HBP between two groups was no significant differences(P＞0.05).LMR had the best efficacy in evaluating whether immune function reconstruction was good in HIV/AIDS patients area under the curve(AUC)=0.803,PLR was the second(AUC)=0.796,NLR was poor(AUC)=0.728.Conclusion NLR,LMR,and PLR are closely related to the immune function of HIV/AIDS patients and can be used as detection indicators to evaluate whether the immune function reconstruction of HIV/AIDS patients is good.

Objective:To explore the effect of a nursing model based on Watson humanistic care theory in patients with end-stage heart failure (ESHF) .Methods:From January 2017 to January 2020, convenience sampling was used to select ESHF patients who underwent treatment in the Chengbei District of Hangzhou First People's Hospital as the study subject. Patients were randomly divided into an observation group ( n=135) and a control group ( n=123). The control group received routine nursing model, while the observation group received nursing model based on Watson humanistic care theory. The intervention effect was evaluated using the Self-Care of Heart Failure Index (SCHFI), Heart Failure Knowledge Test (HFKT), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) . Results:After intervention, the HFKT and SCHFI scores of the observation group were higher than those of the control group, and the SAS and SDS scores were lower than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The nursing model based on Watson humanistic care theory can improve the knowledge and self-care ability of ESHF patients, and relieve their anxiety and depression.

Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.

Humans ; HIV-1/genetics* ; Anti-Retroviral Agents/therapeutic use* ; Mutation/genetics* ; Treatment Failure ; HIV Infections/genetics* ; Drug Resistance, Viral/genetics* ; Anti-HIV Agents/therapeutic use* ; Genotype

Alzheimer' disease(AD)is a neurodegenerative disorder characterized by memory impairment and multiple cognitive deterioration.Acupuncture intervention in AD has potential efficacy,but the mechanism of onset is not clear.Blood oxygen level-dependent functional magnetic resonance imaging(BOLD-fMRI)has the unique advantages of accurately locating abnormal AD brain areas and monitoring and analyzing functional activities,providing technical support for the study of AD brain effects.It have found that abnormal changes in functional activity in response to brain regions and brain networks are closely related to the development of AD.Previous studies have shown that acupuncture can exert therapeutic effects by improving the functional impairment of multiple cognitive-related brain regions and brain networks in AD,which may be the mechanism of brain function in AD.Based on BOLD-fMRI technology,this paper elaborates on three aspects:commonly used data analysis methods of AD,the brain function mechanism of AD pathogenesis,and the brain effect study of acupuncture intervention in AD.In order to provide a reference for further exploring the brain effect of acupuncture intervention in AD.

Objective:To analyze the dosimetric differences of volumetric modulated arc therapy (VMAT) plans for lung cancer caused by different dose calculation algorithms and radiation field settings and thus to provide a reference for designing clinical VMAT plans for lung cancer.Methods:This study randomly selected 20 patients with lung cancer and divided them into four groups of VMAT plans, namely, a group adopting two fields and two arcs based on the AAA algorithm (2F2A_AAA), a group employing two fields and two arcs based on the AXB algorithm (2F2A_AXB), a group using two fields and two arcs based on the MC algorithm (2F2A_MC), and a group adopting one field and two arcs based on the MC algorithm (1F2A_MC). Then, this study evaluated the target coverage, high-dose control, dose homogeneity index (HI), conformity index (CI), and organs at risk (OARs) of the plans using different algorithms and radiation field settings.Results:The planning target volume (PTV) results of two fields combined with two arcs (2F2A) of three groups using different algorithms are as follows. 2F2A_MC achieved better results in both D1% and V 95% (the relative volume of the target volume surrounded by 95% of the prescribed dose) of planning gross target volume (PGTV) than 2F2A_AAA (D1%: t=-2.44, P=0.03; V95%:z=-2.04, P=0.04) and 2F2A_AXB (D1%: t=2.34, P=0.03; z=-3.21, P < 0.01). 2F2A_AXB outperformed 2F2A_AAA ( z=-3.66, P < 0.01) and was comparable to 2F2A_MC in terms of the CI of PGTV. Regarding OARs, 2F2A_AXB and 2F2A_MC decreased the V5 Gy of the whole lung by 0.68% ( z=-2.69, P=0.01) and 3.05% ( z=-3.52, P < 0.01), respectively compared to 2F2A_AAA. 2F2A_AXB achieved a whole-lung Dmean of 1776.44 cGy, which was superior to that of 2F2A_MC ( t=2.67, P=0.02) and 2F2A_AAA ( t=8.62, P < 0.01). Compared to 2F2A_AAA and 2F2A_MC, 2F2A_AXB decreased the V20 Gy of Body_5 mm by 1.45% ( z=-3.88, P < 0.01) and 2.01% ( z=-3.66, P < 0.01), respectively. The results of the two groups with different field settings showed that 1F2A_MC was superior to 2F2A_MC in both the CI of PTV1 and the HI of PTV2 (CI: t=2.61, P=0.02; HI: z=-2.20, P=0.03). Moreover, 1F2A_MC increased the Dmean of the whole lung by 26.29 cGy compared to 2F2A_MC ( t=2.28, P=0.04). Conclusions:Regarding the design of VMAT plans for lung cancer, the MC algorithm is suitable for the target priority and the AXB algorithm is suitable for the OAR priority. When only the MC algorithm is available, it is recommended to choose 1F2A in the case of target priority and select 2F2A in the case of OAR priority.