Background Work-related musculoskeletal disorders (WMSDs) are one of the major occupational health problems faced by bus drivers and should receive special attention. Objective To explore the associations of weekly working hours and sleep quality with neck and lower back WMSDs among bus drivers, as well as assess the potential mediating role of sleep quality. Methods From June to December 2022, we recruited bus drivers from 5 subsidiaries of the Shenzhen Bus Group by convenient sampling method. Demographic characteristics, lifestyles, and work-related features of the bus drivers were collected through a questionnaire survey. The Pittsburgh Sleep Quality Index (PSQI) scale and the Musculoskeletal Disorders Survey Questionnaire were used to assess sleep quality and WMSDs respectively. Logistic regression models were applied to analyze the associations of weekly working hours and sleep quality with WMSDs in neck and lower back. Furthermore, mediation analysis was performed to investigate the role of sleep quality in the associations between weekly work hours and neck and lower back WMSDs. Results A total of 1792 valid questionnaires were collected, with a response rate of 95.07%. Among these, 89.3% of the bus drivers worked more than 40 h per week, and the positive rate of poor sleep quality was 28.2%. The overall positive rate of WMSDs within one year before the survey was 69.12%. Among different body regions, the leading positive rates were identified in neck and lower back regions, at 55.92% and 53.68%, respectively. The logistic regression model showed that compared to the bus drivers with weekly work hours ≤40 h, those weekly worked (40~48] h (OR=1.43, 95%CI: 1.02, 2.01; OR=1.65, 95%CI: 1.17, 2.34), (48~56] h (OR=2.69, 95%CI: 1.89, 3.83; OR=2.30, 95%CI: 1.62, 3.29) and ＞56 h (OR=2.63, 95%CI: 1.86, 3.74; OR=3.23, 95%CI: 2.27, 4.62) had significantly increased risk of WMSDs in neck and lower back. Additionally, when compared to those with good sleep quality, bus drivers with poor sleep quality had higher risks of both neck and lower back WMSDs (OR=4.08, 95%CI: 3.20, 5.23; OR=4.15, 95%CI: 3.26, 5.30, respectively). Further mediation analysis indicated that sleep quality partially mediated the associations between weekly working hours and both neck and lower back WMSDs, with 36.15% and 33.68% as the respective proportion of mediation. Conclusion The positive rate of WMSDs is high among bus drivers, and the most common WMSDs occur in neck and lower back. Long working hours and poor sleep quality are significantly associated with increased risks of neck and lower back WMSDs. Sleep quality may mediate the associations of weekly working hours with neck and lower back WMSDs.

Objective To investigate the effects of plateau hypoxia on the growth and tumor microenvironment of colorectal carcinoma in vivo.Methods A total of 16 male BALB/C mice(6 weeks old,weight 18-20 g)were randomly divided into plateau hypoxic group and plain normoxic group,with 8 mice in each group,while 14 male C57BL/6 mice were grouped in same way,with 7 mice in each group.The mice in the plateau hypoxic group were housed in a low-pressure oxygen(10%)chamber to simulate an altitude of approximately 5 600 m,while the mice of the other group was maintained in SPF-grade normal atmospheric conditions(21%oxygen,at an altitude of about 300 m).Colorectal tumor MC38 cells and colon adenocarcinoma CT26 cells were subcutaneously implanted into C57BL/6 mice and BALB/C mice,respectively to construct subcutaneous tumor-bearing mouse models.Then the tumor size and weight were measured in 4 groups of mice.After the tumor tissues,spleen and blood samples were collected in the C57BL/6 mice.Flow cytometry was used to determine the percentages of macrophages,T lymphocytes,IFN-γ+T lymphocytes,and myeloid-derived suppressor cells(MDSC).The differences in these immune cells were compared between the cells from the plateau hypoxic group and those from the plain normoxic group.Results The weight of subcutaneous tumor mass was significantly inhibited in both C57BL/6 and BALB/C mice from the plateau hypoxic group than those from the 2 plain normoxic groups(0.17 vs 0.09 g,1.38 vs 0.51 g,P<0.01).When compared with the immune cells from the tumor mass of the plain normoxic C57BL/6 mice,the percentage of M2-type macrophages was reduced in the tumor tissue from the plateau hypoxic mice(22.13%vs 15.90%,P<0.05),so was that of MDSC(2.06%vs 1.05%,P<0.01),particularly in the monocytic(M)-MDSC subgroup(60.97%vs 41.13%,P<0.01).While,no significant change was observed in the proportion of the polymorphonuclear(PMN)-MDSC subgroup(10.97%vs 9.70%,P>0.05).Additionally,the percentage of CD4+T cells was significantly reduced(48.70%vs 41.93%,P<0.05),whereas that of CD8+T cells was obviously increased(41.25%vs 51.18%,P<0.05),along with a notable rise in the proportions of IFN-γ+T,IFN-γ+CD4+T and IFN-γ+CD8+T cells(28.58%vs 59.65%,23.33%vs 53.65%,36.9%vs 66.48%,P<0.01).However,between the peripheral blood samples of the 2 groups of C57BL/6 mice,the proportions of M1-type macrophages and CD4+T cells were reduced(84.98%vs 78.43%,5.86%vs 4.01%,P<0.01),and those of MDSC and PMN-MDC were increased(4.47%vs 16.43%,36.56%vs 62.97%,P<0.01).In the spleen tissues,notable decreases were observed in the proportions of CD8+T cells and IFN-γ+CD8+T cells between the 2 groups(33.05%vs 27.68%,5.13%vs 1.58%,P<0.01).Conclusion Plateau hypoxia improves the immune response within the tumor microenvironment,and inhibits subcutaneous tumor growth of colorectal cancer,but suppresses systemic immune response.

Objective To investigate the social support needs of medical staff in Guangzhou during the post-COVID-19 period,providing a basis for relevant departments to offer targeted social support for medical staff in Guangzhou and improve their of occupational quality of life.Methods A cross-sectional survey was conducted,employing a combination of quota and conven-ience sampling to select subjects,eligible medical staff were invited to complete an online questionnaire.Results The social sup-port with a total score of 20 for medical staff in Guangzhou scored 9(7,11).Among the dimensions of social support,media sup-port scored the lowest.Social support as a whole scored with statistically significant differences across groups of different age,ed-ucational background,and job position(all P＜0.05).The median score was the lowest for those under 25 years,for those with a college degree or below,and highest among administrative staff,with other positions showing equal median score.The five di-mensions of social support ranked on the top concerning the total number of the respondents included patients'understanding and trust for medical staff(93.03％),increasing in salaries and benefits(86.06％),accurate policy promotion and public opinion guidance by media(83.41％),attention to the living conditions of medical staff by media(80.29％),and enhanced regulation of false reporting and inappropriate commentary by media(76.92％).Medical staff under the age of 25 had a high need for pa-tients'following doctor's advice,and medical staff with a collegiate degree or below had a high need for family members or friends to care about their physical and mental health.The five strongest needs for social support ranked on the top concerning the total number of respondents included understanding and trust from patients(75.72％),increased salaries and benefits(53.85％),assistance with household matters by family or friends(42.55％),correct policy promotion and public opinion guidance by media(34.62％),and attention to the living conditions of medical staff from media(33.41％).Conclusion Social support for medical staff in Guangzhou are at a relatively low level,indicating a need for social support from all levels of society.

In recent years, endovascular treatment has emerged as the preferred approach for aortic aneurysms. From an anatomical perspective, the current focus of research remains on the reconstruction of iliac artery branches, multiple branches of visceral arteries, and branches of the aortic arch. Substantial clinical evidence has been accumulated in these areas. Simultaneously, future research is expected to explore the reconstruction of the aortic root involving coronary arteries openings and the inhibition of small arterial aneurysm progression through pharmacological means. This article aims to provide a review of significant research data in recent years related to the treatment of aortic aneurysms, offering insights and prospects for future research directions.

Objective: To understand the current situation and associated factors of cellphone usage and addiction among Chinese children and adolescents, to provide reference for effective prevention and intervention of cellphone addiction. Methods: Using a stratified random sampling approach, 11 213 children and adolescents and their parents from 31 provinces, municipalities and autonomous regions in China were recruited and surveyed. Results: The median of daily mobile phone use time among Chinese children and adolescents were 120.00 minutes, as reported by either children or parents. Child s age( β =0.12), hedonic( β =0.11) and social( β =0.09) cellphone use motivations positively related to time spent on cellphone( P <0.01). Cellphone related parental communication( β =-0.06) and knowledge( β =-0.03), as well as cellphone usage on instrumental( β =-0.04) or self representation( β =-0.16) motivation negatively related to time spent on cellphone( P <0.05). Child s age( β =-0.04), cellphone related parental communication( β =-0.09) and awareness( β =-0.14), cellphone use on instrumental motivation( β =-0.22) were negatively associated with cellphone addiction among children and adolescents( P <0.05). Cellphone related parental monitoring( β =0.07), as well as cellphone usage on self representation motivation( β =0.03) or hedonic motivation( β =0.29) positively related to cellphone addiction in children and adolescents( P <0.05). Conclusion Time spent on mobile phone and mobile phone addiction of Chinese children and adolescents are influenced by various internal and external factors, such as the mobile phone use motivation and parenting style.Future school education should help children develop scientific motivation for mobile phone use. Family education should help parents develop positive parenting behaviors such as communication and awareness, so as to reduce the possibility of improper mobile phone use.

Objective:To investigate the clinico-pathological characteristics and outcomes of adult patients with thin basement membrane nephropathy (TBMN).Methods:Patients with biopsy-proven TBMN in National Clinical Research Center of Kidney Diseases, Jinling Hospital during Jan 1, 2008 to Dec 31, 2017 were collected. The clinico-pathological characteristics, prognosis, the influencing factors of proteinuria and renal chronic lesions were retrospectively analyzed.Results:Among 135 adult patients included, 116 cases (85.9%) were female, and 19 cases were males. The age was (40.56±10.30) years old. There were 30 cases (22.2%) with hypertension and 32 cases (23.7%) with overweight or obesity. Proteinuria was found in 41 patients (30.4%) with (0.65±0.19) g/24 h of urine protein, and microscopic hematuria was found in all 135 patients. Serum creatinine was normal in all patients. Glomerulosclerosis was observed in 102 cases (75.6%), in which 51 cases (37.8%) had glomerulosclerosis>10%. There were 79 cases (58.5%) with mild chronic tubulointerstitial lesions, and 53 patients (39.3%) with vascular hyalinosis. The proportions of proteinuria, chronic tubular interstitial lesion and renal vascular lesion in patients with overweight/obesity and/or hypertension were higher than those without complications (all P<0.05). Multivariate logistic regression results showed that overweight/obesity ( OR=7.550, 95% CI 2.091-27.257, P=0.002) and hypertension ( OR=4.424, 95% CI 1.091-17.935, P=0.037) were independent influencing factors for proteinuria, while proteinuria was the independent influencing factor for chronic tubular interstitial lesion ( OR=3.151, 95% CI 1.046-9.491, P=0.041). Four patients were lost to follow-up, and the median follow-up time of the remaining patients was 64.0(24.0, 96.5) months. At the end of the follow-up, urine protein increased in 10 patients (7.4%) and estimated glomerular filtration rate decreased in 3 patients (2.2%). The above 13 cases were all complicated with overweight/obesity and 4 cases with hypertension. The urine test and renal function in the remaining 118 patients didn't change significantly from baseline. Conclusions:The incidences of proteinuria and renal chronic lesion are high in adult TBMN patients. Overweight/obesity and hypertension may cause a poor prognosis, and TBMN patients without metabolic abnormalities probably have good prognosis, but need long-term follow-up.

Objective:To investigate the correlation among clinical manifestations, pathological changes and immunofluorescence in children with primary IgA nephropathy (IgAN).Methods:The data of a total of 222 cases diagnosed with IgAN by the Department of Nephrology, Jiangxi Children′s Hospital in recent 10 years were collected for the analysis of clinical and pathological features and their correlation.Results:(1)Immunofluorescence showed that 115 cases (51.8%) IgA patients had only mesangial deposition, and 107 cases (48.2%) IgA patients had both mesangial deposition and capillary loop deposition.Most IgA patients (122 cases, 55.0%) had immunofluorescence intensity+ + .In IgA patients, IgM deposition was the most common [168 cases (75.7%)], followed by C 3 deposition [160 cases (72.1%)]. Patients with C 4 deposition were the least[7 cases (3.2%)]. (2) Hypertension were positively correlated with IgM, C 3 deposition, IgA deposition intensity and IgA with vascular loop deposition(all P<0.05). Hyperuricemia was positively correlated with IgM deposition, IgG deposition, C 3 deposition and IgA with vascular loop deposition(all P<0.05); hypoalbuminemia was negatively correlated with IgM deposition, C 3 deposition, IgA deposition intensity and IgA with vascular loop deposition(all P<0.05). Hypercholesterolemia were positively correlated with C 3 deposition and IgA with vascular loop deposition(all P<0.05). Urine protein quantification were positively related to IgM, IgG and IgA with vascular loop deposition (all P<0.05). The estimated glomerular filtration rate(eGFR)was negatively related to IgA with vascular loop deposition( P<0.05). (3) Lee′s grade were positively correlated with IgM and C 3 deposition, IgA deposition intensity and IgA with capillary loop deposition(all P<0.05). (4) Oxford type mesangial hypercellularity(M1)were positively correlated with C 3 deposition and IgA deposition intensity(all P<0.001). Endocapillary hypercellularity(E1)lesions were positively correlated with IgA deposition intensity and IgA with capilla-ry loop deposition(all P<0.05). Segmental glomerulosclerosis(S1)lesions had no correlation with immunofluorescence pathology.Tubular atrophy and interstitial fibrosis(T1)was positively correlated with IgG and C 3 deposition(all P<0.05). (5) There was no correlation between glomerulosclerosis and immunofluorescence pathology.Crescent was positively correlated with IgM deposition, IgG deposition, C 3 deposition, IgA deposition intensity and IgA capillary loop deposition(all P<0.05). Renal artery thickening was positively correlated with IgG deposition and IgA capillary loop deposition(all P<0.05). Conclusions:IgA intensity of + + and IgM deposition are most commonly found in immunofluorescence of children with primary IgAN.IgA patients with capillary loops or C 3 deposition have more severe clinical manifestations and light microscopy results.

Objective To investigate the correlations of serum prealbumin and albumin with the shortterm outcome in patients with acute cerebral infarction in different age groups.Methods Patients with acute ischemic stroke admitted to hospital with 48 h were prospectively enrolled in the study.The modified Rankin Scale was used to assess the functional outcomes at 14 d after onset,0-2 was defined as a good outcome.According to the age of the patients,they were divided into either a young and middle-aged group (＜ 60 years) or an elderly group (≥60 years).The demography,baseline clinical data and laboratory findings of the patients were compared in the overall patients and the different age groups between the good outcome group and the poor outcome group.Multivariate logistic regression analysis was used to determine the independent influencing factors of short-term outcomes.Results A total of 622 patients with acute ischemic stroke were enrolled,including 402 (64.6％) males and 220 (35.4％) females;206 (33.1％) were in the young and middle-aged group,and 416 (66.9％) were in the elderly group;310 (49.8％) had good outcomes and 312 (50.2％) had poor outcomes.There were significant differences in the proportions of patients in male,old people,hyperlipidemia,diabetes mellitus,history of previous stroke or transient ischemic attack (TIA),as well as age,body mass index,levels of prealbumin,albumin,triglyceride,high-density lipoprotein cholesterol low-density lipoprotein cholesterol total bilirubin,direct bilirubin,indirect bilirubin,urea nitrogen,and uric acid between the good outcome group and the poor outcome group (all P ＜0.05).Multivariate logistic regression analysis showed that the female (odds ratio [OR] 1.522,95％ confidence interval [CI] 1.023-2.266;P =0.038),diabetes (OR 1.789,95％ CI 1.171-2.735;P =0.007) and higher low-density lipoprotein cholesterol (OR 1.251,95％ CI 1.017-1.539;P =0.034),total bilirubin (OR 1.054,95％ CI 1.029-1.081;P＜0.001),urea nitrogen (OR 1.245,95％ CI 1.100-1.409;P=0.001),and baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 2.854,95％ CI 1.027-3.628;P =0.019) were the independent risk factors for poor outcomes,and higher prealbumin (OR 0.798 95％ CI 0.633-0.979;P =0.034) and albumin (OR 0.741,95％ CI 0.693-0.988;P =0.020) were the independent predictors of good outcomes.In the young and middle-aged patients,there were significant differences in the proportions of patients with small artery occlusion as well as age,triglyceride,and high-density lipoprotein cholesterol levels between the good outcome group and the poor outcome group (all P ＜0.05);multivariate logistic regression analysis showed that diabetes (OR 2.343 95％ CI 1.127-4.871;P=0.023) and higher baseline NIHSS scores (OR 2.041,95％ CI 1.304-4.125;P =0.027) were the independent risk factors for poor outcome,and higher high-density lipoprotein cholesterol (OR 0.742 95％ CI 0.639-0.937;P =0.044)was an independent predictor for good outcome.In the elderly patients,there were significant differences in the proportions of patients in male,previous stroke or TIA,and cardiogenic embolism,as well as prealbumin,low-density lipoprotein cholesterol,total bilirubin,direct bilirubin,indirect bilirubin,and uric acid levels between the good outcome group and the poor outcome group (all P ＜ 0.05);multivariate logistic regression the analysis showed that diabetes (OR 2.797,95％ CI 1.153-4.756;P =0.039),higher baseline NIHSS score (OR 2.586,95％ CI 1.033-3.435;P =0.035) and higher low-density lipoprotein cholesterol (OR 1.304,95％ CI 1.027-1.656;P =0.029) were the independent risk factors for poor outcome,and higher prealbumin was an independent predictor for good outcome (OR 0.795,95％ CI 0.691-0.998;P =0.002).Conclusions Prealbumin and albumin are the independent predictors for short-term good outcome in patients with acute ischemic stroke.The protective effect of serum prealbumin is more obvious in the elderly population (≥60 years).

Diabetic gastroparesis (DGP) is one of the most common complications of diabetes. Acupuncture is an ef-fective treatment for DGP in recent years. Literatures on acupuncture therapy for DGP treatment were screened for the past 10 years. Statistical analysis was made on acupoints used in the literatures in order to find the most com-monly used acupoints and combinations. This article was aimed to explore and summarize the use of the acupuncture law for the better service of clinical practice.

OBJECTIVETo investigate natural foci of tsutsugamushi disease whose incidence has increased in the Nan Peng Lie Islands in China, an area where this disease has not been previously recorded.

METHODSWe recorded the natural foci and isolated Orientia tsutsugamushi (O. tsutsugamushi) organism. We also studied prevention measures.

RESULTSThese islands had the natural foci of a south subtropical zone. The main host and vector were Rattus norvegicus and Leptotrombidium deliens (L. deliens), respectively. The seasonal quantity trends of Rattus norvegicus and Leptotrombidium deliens were consistent with the incidence of human infection. Thirty-five strains of O. tsutsugamushi were isolated from Rattus norvegicus and L. deliense. The identification of 7 strains showed that most strains were Karp. Seroepidemiology showed a high prevalence of antibody against O. tsatsugamushi among local people. After prevention measures were used, the incidence was decreased.

CONCLUSIONThis was the first successful confirmation that the Nan Peng Lie Islands were natural foci of tsutsugamushi disease.

Animals ; Antibodies, Bacterial ; blood ; Cattle ; China ; epidemiology ; DNA, Bacterial ; genetics ; Geography ; Humans ; Incidence ; Orientia tsutsugamushi ; genetics ; growth & development ; isolation & purification ; Polymorphism, Restriction Fragment Length ; Rats ; Scrub Typhus ; epidemiology ; microbiology ; Seasons ; Sheep ; Species Specificity ; Tropical Climate