Objective To identify potential ergonomic risk factors of works and quickly assess their risks of developing work-related musculoskeletal disorders (WMSDs) in the medical staff. Methods A total of 188 medical staff were selected as the research objects using a two-stage random sampling method. The method for the identification of musculoskeletal stress factors (PLIBEL) was used to analyze the adverse ergonomic factors in the work process, and the rapid entire body assessment (REBA) was used to quickly assess the whole-body posture load. Results The PLIBEL assessment results showed that various adverse ergonomic factors affected different parts of the body during the work process of medical staff. Specifically, 18 adverse ergonomic factors were identified in the neck, shoulders, and upper back, while 10 adverse ergonomic factors were identified in the elbow, forearm, hand, and lower back. Rehabilitation therapists and nurses engaged in patient handling in general wards and medication preparation and blood collection were exposed to ≥35 adverse ergonomic factors. The REBA assessment showed that the REBA score was 3-12 points for medical staff during their work process. Rehabilitation therapists were classified as having an extremely high ergonomic risk. High-risk occupations included ward housekeeping nurses, surgery assistant nurses, operating-room instrument nurses, and surgeons. Medium-risk occupations included general ward nurses (medication preparation and blood collection, venipuncture/infusion, and patient handling), intensive care unit (ICU) nurses, internal medicine residents, and dentists. Low-risk occupations included administrative front-desk nurses, outpatient internal medicine physicians, and technicians/physicians in ultrasonography, laboratory medicine, physical examination, and occupational health departments. Conclusion Adverse ergonomic factors of medical staff predominantly affect the neck, shoulders, upper back, elbows, forearms, hands, and the lower back during the work process. Rehabilitation therapists, ward housekeeping nurses, ICU nurses, operating-room instrument nurses, and surgeons are high-risk groups for WMSDs. Attention should be paid to the management and control of adverse ergonomic factors for medical staff to prevent the occurrence of WMSDs.

Objective To explore the effects of Qingre Yiqi Huayu Chinese Medicine Plaster,an hospital preparation of Shenzhen Traditional Chinese Medicine Hospital,on acute soft tissue injury in rabbits from the perspective of the apoptosis caspase-3.Methods Forty rabbits were randomly divided into blank control group,model group,Qingre Huayu Chinese Medicine Plaster group(called original prescription plaster group for short),Qingre Yiqi Huayu Chinese Medicine Plaster group[called combined(with Astragali Radix)plaster group for short],and Qingre Huayu Chinese Medicine impregnating group[called combined(with Astragali Radix)impregnating group for short],with eight rabbits in each group.Except for the blank control group,rabbits in all other groups were used to construct acute soft tissue injury model by striking method.The changes in caspase-3 expression and PGE2 level were observed in the injured tissues after 24-hour and 72-hour drug administration.Results After 24-hour drug administration,compared with the blank control group,the caspase-3 positive expression level of the three treatment groups and the model group were increased(P<0.05),among which the combined plaster group had the least expression of caspase-3 and the lowest pathological score,followed by the combined impregnating group and the original prescription plaster group.After 72-hour drug administration,the caspase-3 positive expression level of the three treatment groups was not statistically significant compared with that of the blank control group(P>0.05),while the positive expression level of caspase-3 in the model group was still higher than that of the blank control group(P<0.05).After 24-hour drug administration,the serum PGE2 level of the model group was significantly higher than that of the blank control group(P<0.05),while the difference of the serum PGE2 levels between the three treatment groups and the blank control group or the model group being not statistically significant(P>0.05);after 72-hour drug administration,the difference of the serum PGE2 level between the original prescription plaster group and the model group being not statistically significant(P>0.05),while the serum PGE2 level of the combined plaster group and combined impregnating group was lower than that of the model group,respectively(P<0.05).Conclusion All of Qingre Huayu Chinese Medicine Plaster,Qingre Yiqi Huayu Chinese Medicine Plaster,Qingre Yiqi Huayu Chinese Medicine impregnation can effectively accelerate the apoptosis of injured muscle tissue cells in rabbits with acute soft tissue injury,reduce inflammatory reaction and accelerate the repair of tissue damage,and the effect of Qingre Yiqi Huayu Chinese Medicine Plaster was superior to that of Qingre Huayu Chinese Medicine Plaster and Qingre Yiqi Huayu Chinese Medicine impregnation.

This article presents a case study of a patient who visited the Geriatric Department of Peking Union Medical College Hospital due to "palpitations, shortness of breath for more than 2 years, limb weakness for 6 months, edema, and nocturnal dyspnea for 2 months". The patient exhibited decreased muscle strength in the limbs and involvement of swallowing and respiratory muscles, alongside complications of heart failure and various arrhythmias which were predominantly atrial. Laboratory tests revealed the presence of multiple autoantibodies and notably anti-mitochondrial antibodies. Following a comprehensive multidisciplinary evaluation, the patient was diagnosed with anti-mitochondrial antibody-associated inflammatory myopathy. Treatment involved a combination of glucocorticoids and immunosuppressants, along with resistance exercises for muscle strength and rehabilitation training for lung function, resulting in significant improvement of clinical symptoms. The case underscores the importance of collaborative multidisciplinary approaches in diagnosing and treating rare diseases in elderly patients, where careful consideration of clinical manifestations and subtle abnormal clinical data can lead to effective interventions.

Heart failure(HF)is the final stage of various cardiovascular diseases.The period of high incidence of death and readmission in patients with HF within 2 to 3 months after discharge is defined as the"vulnerable period".The management of vulnerable period focuses on how to identify high-risk groups with the need of close follow-up and more active intervention.Despite the application of various effective medical treatment and nursing strategies,readmissions in HF patients remain high,which not only poses a significant financial burden on the healthcare system but also carries the prognostic impact of worsening survival associated with repeated hospitalizations.Remote monitoring is a promising approach for early detection of worsening HF and intervention before apparent decompensation.Remote monitoring includes patient reporting of remote vital signs monitoring,wearable devices,information from cardiac implantable electronic devices and invasive remote hemodynamic monitoring.Remote cardiac monitoring devices have developed rapidly.A wide variety of monitoring devices have been developed,and trials have been conducted to explore the availability and safety of remote monitoring devices and their effectiveness in reducing the risk of HF re-hospitalization.Wearable devices are easy to be accepted by patients because of their non-invasive,portable,cost and other factors.

Ergonomic Principle for the Prevention of Work-Related Musculoskeletal Disorders Part 1: General Principles (T/WSJD 14.1-2020) is the first guideline standard for the prevention of work-related musculoskeletal disorders provided to employers and occupational health technical service institutions in China, which covers ergonomic risk factors and their hazard definition, ergonomic prevention principles, risk assessment process, risk control process and risk evaluation principles. The standard specifically clarify the specific types of adverse ergonomic risk factors and control strategies and the standard process of systematic ergonomic risk assessment, providing implementation paths and practical guidance for eliminating/reducing adverse ergonomic risks and enhance workplace environments to prevent work-related musculoskeletal disorders. This paper interprets and analyzes the background of standard establishment, formulation process, fundamental basis, and main content, etc., to provide scientific and accurate technical support for enterprise managers, labours and technical personnel of occupational health institutions to optimize the use of this standard.

Objective To determine the expression of type Ⅲ interferon(IFNL)and IFNL receptor 1(IFNLR1)in the genital tract in rhesus macaques to elucidate the biological characteristics of rhesus macaque IFNL system and promote the use of these monkeys in studies on the pathology,drugs and vaccines for human diseases.Methods IFNL1,IFNL3,and IFNLR1 mRNA levels in normal and simian-human immunodeficiency virus(SHIV)/simian immunodeficiency virus(SIV)-infected genital tract tissues of rhesus macaques were detected by gene-specific reverse transcription-polymerase chain reaction,and IFNLR1 immunoreactivity was examined by confocal microscopy.Results IFNL1 and IFNL3 mRNA levels in the uterus and vagina in normal rhesus macaques were below the measurement threshold,but mRNA levels of IFNLR1 and its variant lacking exon 6 could be readily detected.IFNLR1 immunoreactivity was primarily detected in the covering or glandular epithelia of the uterus and vagina.IFNL1 and IFNL3 mRNA levels were increased in some SHIV/SIV-infected macaques,while mRNA levels of IFNLR1 were unchanged and mRNA levels of IFN-stimulated genes(Mx1,Mx2,and OAS)were significantly increased.Conclusions These data indicate that the type Ⅲ IFN system is expressed in the reproductive tract of rhesus macaques,as in humans,thus providing a scientific basis for the use of rhesus macaques in studies of human infectious diseases,such as AIDS.

Objective:To explore the value of three-dimensional automatic right ventricular quantitive analysis（3D Auto RVQ）technology in predicting the improvement of left ventricular ejection fraction（LVEF）in patients with heart failure with reduced ejection fraction（HFrEF）.Methods:A retrospective analysis was conducted on 89 HFrEF patients admitted to the Cardiology Department of Central China Fuwai Hospital of Zhengzhou University from April 2022 to June 2024. All patients received medication treatment and were further divided into heart failure with improved ejection fraction（HFimpEF）group and non HFimpEF group based on changes detected by echocardiography in LVEF after treatment. The clinical data，biological indicators，and medication treatment status of patients were collected，routine echocardiographic parameters and right ventricular strain parameters were measured，3D right ventricular ejection fraction（3D-RVEF），3D right ventricular stroke volume index（3D-RVSVI），3D right ventricular end-diastolic volume index（3D-RVEDVI），3D right ventricular end-systolic volume index（3D-RVESVI），3D tricuspid annular plane systolic excursion（3D-TAPSE），and 3D right ventricular fractional area change（3D-RVFAC）were measured using 3D Auto RVQ technology. The differences of the above parameters between the two groups were compared. The ROC curve was used to analyze the predictive efficiency of right ventricular parameters for HFimpEF，and the area under ROC curve（AUC）was calculated and compared. Logistic regression models were used to analyze the predictive value of right ventricular parameters for HFimpEF.Results:Compared with the non HFimpEF group，the HFimpEF group had a younger age，shorter heart failure course，a smaller proportion of males，New York Heart Association（NYHA）functional class ≥Ⅲ，and patients with concomitant coronary heart disease. The baseline LVEF，absolute value of two dimensional right ventricular global longitudinal strain（2D-RVGLS），3D-RVEF，3D-TAPSE，and 3D-RVSVI were higher in the HFimpEF group（all P<0.05）. ROC curve analysis showed that the AUC of 3D-RVEF for predicting HFimpEF was 0.858，and the predictive efficiency was higher than other right ventricular parameters. According to the Yoden index，the optimal cutoff value for predicting HFimpEF based on 3D-RVEF was 36.2%，with a corresponding sensitivity of 84.0% and specificity of 75.0%. After adjusting for clinical and other echocardiographic parameters，the logistic regression model showed that 3D-RVEF was an independent predictor of HFimpEF（ OR=1.435，95% CI=1.145-1.800， P<0.05）. Conclusions:The 3D-RVEF evaluated by 3D Auto RVQ technology has high predictive value for HFimpEF，which can provide a reference for clinical treatment，thereby improving the prognosis of HFrEF patients.

AIM:To investigate the effect and mechanism of Shen-Huang granule(SHG)on Aβ25-35-induced ferroptosis in HT22 cells.METHODS:An in vitro model of Alzheimer disease(AD)was established by treating HT22 cells with Aβ25-35.The cells were divided into the following groups:control group,model group(Aβ25-35 group),ferroptosis inhibitor ferrostatin-1(Fer-1)group,low-dose SHG(SHG-L)group,and high-dose SHG(SHG-H)group.Cell viability was assessed using the Cell Counting Kit-8(CCK-8)assay.Ultrastructural changes in each group were observed via trans-mission electron microscopy.The intracellular levels of reactive oxygen species(ROS)were measured by flow cytometry.Iron deposition and lipid peroxidation levels were evaluated by examining Fe2+,total superoxide dismutase(SOD),and malondialdehyde(MDA)levels.Western blot analysis was employed to detect the protein expression of cyclooxygenase 2(TfR1),ferritin heavy chain 1(FTH1),nuclear factor E2-related factor 2(Nrf2),and heme oxygenase-1(HO-1).RE-SULTS:Compared to the control group,the model group exhibited mitochondrial shrinkage,increased membrane densi-ty,and decreased cristae.Levels of ROS,Fe2+,and MDA were significantly elevated,while SOD levels were markedly re-duced.The protein expression of SLC7A11,GPX4,FTH1,Nrf2,and HO-1 was significantly down-regulated,whereas the expression of COX2 and TfR1 was significantly up-regulated.In comparison to the model group,the morphology and structure of mitochondria improved in the Fer-1,low-dose SHG,and high-dose SHG groups.ROS,Fe2+,and MDA levels decreased while SOD levels increased.Furthermore,the expression of SLC7A11,GPX4,FTH1,Nrf2,and HO-1 was sig-nificantly up-regulated,while COX2 and TfR1 expression was significantly down-regulated.CONCLUSION:Shen-Huang granule can inhibit Aβ25-35-induced ferroptosis in HT22 cells,and the underlying mechanism may involve the Nrf2/HO-1/GPX4 signaling pathway.

Objective:To explore the value of three-dimensional automatic right ventricular quantitive analysis（3D Auto RVQ）technology in predicting the improvement of left ventricular ejection fraction（LVEF）in patients with heart failure with reduced ejection fraction（HFrEF）.Methods:A retrospective analysis was conducted on 89 HFrEF patients admitted to the Cardiology Department of Central China Fuwai Hospital of Zhengzhou University from April 2022 to June 2024. All patients received medication treatment and were further divided into heart failure with improved ejection fraction（HFimpEF）group and non HFimpEF group based on changes detected by echocardiography in LVEF after treatment. The clinical data，biological indicators，and medication treatment status of patients were collected，routine echocardiographic parameters and right ventricular strain parameters were measured，3D right ventricular ejection fraction（3D-RVEF），3D right ventricular stroke volume index（3D-RVSVI），3D right ventricular end-diastolic volume index（3D-RVEDVI），3D right ventricular end-systolic volume index（3D-RVESVI），3D tricuspid annular plane systolic excursion（3D-TAPSE），and 3D right ventricular fractional area change（3D-RVFAC）were measured using 3D Auto RVQ technology. The differences of the above parameters between the two groups were compared. The ROC curve was used to analyze the predictive efficiency of right ventricular parameters for HFimpEF，and the area under ROC curve（AUC）was calculated and compared. Logistic regression models were used to analyze the predictive value of right ventricular parameters for HFimpEF.Results:Compared with the non HFimpEF group，the HFimpEF group had a younger age，shorter heart failure course，a smaller proportion of males，New York Heart Association（NYHA）functional class ≥Ⅲ，and patients with concomitant coronary heart disease. The baseline LVEF，absolute value of two dimensional right ventricular global longitudinal strain（2D-RVGLS），3D-RVEF，3D-TAPSE，and 3D-RVSVI were higher in the HFimpEF group（all P<0.05）. ROC curve analysis showed that the AUC of 3D-RVEF for predicting HFimpEF was 0.858，and the predictive efficiency was higher than other right ventricular parameters. According to the Yoden index，the optimal cutoff value for predicting HFimpEF based on 3D-RVEF was 36.2%，with a corresponding sensitivity of 84.0% and specificity of 75.0%. After adjusting for clinical and other echocardiographic parameters，the logistic regression model showed that 3D-RVEF was an independent predictor of HFimpEF（ OR=1.435，95% CI=1.145-1.800， P<0.05）. Conclusions:The 3D-RVEF evaluated by 3D Auto RVQ technology has high predictive value for HFimpEF，which can provide a reference for clinical treatment，thereby improving the prognosis of HFrEF patients.

Objective:To evaluate the effect of sevoflurane on mitochondrial-associated endoplasmic reticulum membranes (MAMs) in mouse microglia and the relationship with silent information regulator-related enzyme 3 (SIRT3)/adenosine triphosphatase family protein 3A (ATAD3A) signaling pathway.Methods:After normal culture of mouse microglia (BV-2 cell line), the cells were divided into 4 groups ( n=33 each) by a random number table method: empty adenovirus-control group (group C), empty adenovirus-sevoflurane exposure group (group Sev), SIRT3 overexpression adenovirus-control group (group SIRT3 + C) and SIRT3 overexpression adenovirus-sevoflurane exposure group (group SIRT3 + Sev). The cells were infected with SIRT3 overexpression adenovirus 100 pmol/well in SIRT3+ C group and SIRT3+ Sev group and with empty adenovirus 100 pmol/well in C group and Sev group. After 48 h of infection, the cells were routinely cultured for 48 h in C group and SIRT3+ C group, the cells were incubated with 3% sevoflurane for 2 h, once a day for 3 consecutive days, followed by routine culture for 48 h in Sev group and SIRT3+ Sev group. The contents of mitochondrial Ca 2+ and reactive oxygen species (mtROS) were measured by flow cytometry. The mitochondrial membrane potential (MMP) was measured by JC-1 probe. The mitochondrial ATP content was measured by luciferase luminescence method. The expression of SIRT3 was detected by Western blot. The expression of acetylated ATAD3A was detected by immunoprecipitation. The co-localization of endoplasmic reticulum and mitochondria was determined by confocal fluorescence microscopy, and the Manders co-localization coefficient was calculated to evaluate the development of MAMs. Results:Compared with group C, the contents of mitochondrial Ca 2+ and mtROS were significantly increased, the contents of MMP and mitochondrial ATP were decreased, the expression of SIRT3 was down-regulated, the expression of acetylated ATAD3A was up-regulated, and the development of MAMs was increased in group Sev ( P<0.05). Compared with Sev group, the contents of mitochondrial Ca 2+ and mtROS were significantly decreased, the contents of MMP and mitochondrial ATP were increased, the expression of SIRT3 was up-regulated, the expression of acetylated ATAD3A was down-regulated, and the development of MAMs was decreased in SIRT3 + Sev group ( P<0.05). Compared with SIRT3+ C group, the contents of mitochondrial Ca 2+ and mtROS were significantly increased, the contents of MMP and mitochondrial ATP were decreased, the expression of SIRT3 was down-regulated, the expression of acetylated ATAD3A was up-regulated, and the development of MAMs was increased in SIRT3+ Sev group ( P<0.05). Conclusions:The mechanism by which sevoflurane induces mitochondrial dysfunction in mouse microglia may be related to the inhibition of SIRT3/ATAD3A signaling pathway, leading to excessive development of MAMs.