BACKGROUND: As an essential part of health services, rehabilitation is of great significance to improve the health and quality of life of the whole population. Accelerating aging calls for a significant expansion of rehabilitation services in China, but rehabilitation needs remain unclear. We conducted the study to explore the rehabilitation needs in China and project the trend of rehabilitation needs from 2020 to 2034. METHODS: The data of health conditions that might potentially benefit from rehabilitation were obtained from Global Burden of Disease (GBD) study. Estimated annual percentage changes (EAPCs) were calculated to quantify the trends of the age-standardized rates. Projections of rehabilitation needs were made until 2034 using Bayesian age-period-cohort analysis (BAPC). RESULTS: Approximately 460 million persons (33.3% of the total population) need rehabilitation in China, contributing to 63 million years lived with disabilities (YLDs) in 2019. The number of prevalent cases that need rehabilitation increased from around 268 (95% uncertainty interval [UI]: 257-282) million in 1990 to almost 460 (95% UI: 443-479) million in 2019, representing an increase of 71.3%. The highest contribution to the need for rehabilitation was musculoskeletal disorders with about 322 (95% UI: 302-343) million persons in seven aggregate disease and injury categories, and hearing loss with over 95 (95% UI: 84-107) million people among 25 health conditions. Based on the projection results, there will be almost 636 million people (45% of the total population) needing rehabilitation services in China by 2034, representing an increase of 38.3%. The rehabilitation needs of neoplasms, cardiovascular diseases, and neurological disorders are expected to increase significantly from 2019 to 2034, with increases of 102.3%, 88.8% and 73.2%, respectively. CONCLUSIONS The need for rehabilitation in China substantially increased over the last 30 years. It is predicted that over two in five people will require rehabilitation by 2034, thus suggesting the need to develop rehabilitation services that meet individuals' rehabilitation needs.
Humans ; China/epidemiology* ; Global Burden of Disease ; Female ; Male ; Musculoskeletal Diseases/epidemiology* ; Rehabilitation/trends* ; Quality of Life ; Middle Aged ; Aged ; Bayes Theorem

Background Workers engaged in benzene-exposed or benzene-containing solvent-exposed operations in China are predominantly subjected to a low concentration of benzene series compounds, and prolonged exposure to low concentrations of benzene, toluene, and xylene (BTX) may have implications for blood pressure. Objective To investigate the influence of low-concentration BTX exposure on the blood pressure of workers, aiming to provide a basis for enterprises to devise associated health management strategies to mitigate the occurrence of hypertension among workers exposed to low concentrations of BTX. Methods Using a cross-sectional design, 884 workers from a petroleum refining enterprise in Hainan who participated in an occupational health examination in 2022 were selected as the study population, and were divided into an exposure group of 649 workers and a control group of 235 workers based on their reporting of BTX exposure or not. Data on workplace BTX concentrations and health examinations of the study subjects were collected and questionnaires were administered. In addition, S-phenylmercapturic acid (S-PMA), hippuric acid (HA), and methyl hippuric acid (MHA, including the three isomers 2-MHA, 3-MHA, and 4-MHA) were measured in the urine of the workers using high-performance liquid chromatography-tandem triple quadrupole mass spectrometry to assess internal BTX burden. The effects of low-concentration BTX exposure on blood pressure were analyzed. Results In 2022, the concentrations of benzene, toluene, and xylene of all monitoring points did not exceeded the national limits by either time-weighted average (TWA) or short-term exposure limit (STEL), indicating low-concentration BTX exposure. Regarding the internal burden of BTX, the concentrations of benzene metabolite S-PMA, toluene metabolite HA, and xylene metabolites 3-MHA and 4-MHA in the urine samples in the exposure group were higher than those in the control group (P < 0.05). The correlation analysis showed a positive correlation between urinary S-PMA concentration and diastolic blood pressure in the workers (r=0.265, P < 0.05). Differences in systolic and diastolic blood pressure distributions were statistically significant among workers grouped by sex, age, work years, educational levels, monthly income, body mass index (BMI), alcohol use, dietary oil, and types of residential address (P < 0.05). Significant differences in systolic blood pressure distribution were observed among workers by smoking status and levels of labor intensity (P < 0.05). Compared with the control group, the workers in the exposure group exhibited a significant increase in diastolic blood pressure (P < 0.05). The results of multiple linear regression showed that age, sex, and BMI had statistically significant effects on systolic blood pressure (P < 0.05), while age, work years, and BMI had statistically significant effects on diastolic blood pressure (P < 0.05). The systolic blood pressure of age > 35 years, male, overweight and obese workers was significantly higher than that of age ≤ 35 years, female, and underweight workers, and the diastolic blood pressure of age > 35 years, work years > 5 years, and obese workers was higher than age ≤35 years, ≤5 years of service, and underweight workers. Low-concentration BTX exposure was one of the main influencing factors for elevated diastolic blood pressure, and the exposed workers showed a 1.337 mmHg increase in diastolic blood pressure compared to the control group (P < 0.05). Conclusion Low-concentration BTX exposure, work years > 5 years, and obesity may elevate blood pressure among petroleum refininig workers. Regular blood pressure monitoring and enhanced health interventions for this occupational group are warranted.

Objective To analyze the current status and influencing factors of elevated blood pressure among employees in a large petroleum refining enterprise in Hainan Province. Methods A total of 940 workers from a petroleum refining enterprise in Hainan Province was selected as the study subjects using the convenience sampling method. The results of their health status survey, occupational medical examination, and occupational stress measurement were collected. Results The detection rate of elevated blood pressure in the study subjects was 23.9% (225/940), with the detection rate of normal blood pressure and hypertension of 17.7% (166/940) and 6.3% (59/940), respectively. The detection rate of occupational stress was 28.8% (271/940). The result of multivariate logistic regression analysis showed that workers aged 30 -<40, 40 -<50, and ≥50 years had a higher risk of elevated blood pressure than those aged <30 years after controlling for confounding factors such as gender, residential address, length of service, education level, personal monthly income, smoking status, physical exercise, salt intake, oil intake, occupational stress, and high temperature exposure (all P<0.05). Workers in the body mass index (BMI) overweight group and obese group had a higher risk of elevated blood pressure than those in the normal group (all P<0.05). The risk of elevated blood pressure was higher in workers who drinks than those who did not (P<0.05). Workers exposed to noise levels of 85-90 dB(A) had a lower risk of elevated blood pressure compared to those exposed to noise levels >90 dB(A) (P<0.05). Conclusion Age, BMI, drinking status, and noise exposure levels are independent influencing factors for elevated blood pressure among workers in this petroleum refining enterprise. Blood pressure management should be strengthened for workers aged ≥30 years, overweight, obesity, alcohol consumption and with noise exposure intensity > 90 dB(A).

Objective:To analyze the clinical and pathological characteristics of chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) and not receiving antiviral therapy.Methods:This study retrospectively included CHB patients diagnosed by liver biopsy at the Third Hospital of Hebei Medical University from January 2008 to December 2022. According to the HBV DNA and HBeAg status of "immune tolerance period and immune control period", these patients were divided into three groups: chronic HBV carrier group, inactive HBsAg carrier group and indeterminate group including the patients that did not meet the inclusion criteria of the above two groups. Kruskal-Wallis H test was used for comparison of continuous data between multiple groups. Mann-Whitney U test was used for comparison of continuous data and ordered categorical data between two groups. Chi-square test or Fisher′s exact test was used for comparison of categorical data between two groups. Results:A total of 284 CHB patients with normal ALT were enrolled. There were 64, 88 and 132 cases in the chronic HBV carrier group, inactive HBsAg carrier group and indeterminate group, respectively. Histopathological analysis revealed that there were 182 (64.08%) cases with pathological inflammation grade (G) and/or fibrosis stage (S)≥2, 155 (54.58%) with S≥2 and 120 (42.25%) with G≥2. The proportion of patients with G and/or S≥2 in the indeterminate group [70.45% (93/132)] was higher than that in the chronic HBV carrier group [48.44% (31/64)] and inactive HBsAg carrier group [65.91% (58/88)] (both P<0.05). Patient′s age and the ratio of patients with S≥2 in the chronic HBV carrier group [33 years old, 39.06% (25/64)] were smaller than those in the inactive HBsAg carrier group [39 years old, 56.82% (50/88)] and the indeterminate group [39 years old, 60.61% (80/132)] (all P<0.05). Patients in the inactive HBsAg carrier group (19 U/L) had lower ALT levels than those in the chronic HBV carrier group (26 U/L) and the indeterminate group (23 U/L) (both P<0.05). The proportion of patients with cytoplasmic/cytoplasmic nuclear-type HBcAg was higher in patients with G and/or S≥2 than in patients with G and S<2 [73.08% (57/78) vs 32.08% (17/53), P<0.05], and the proportion of patients with cytoplasmic/cytoplasmic nuclear-type HBcAg increased gradually with age. The proportion of patients with cytoplasmic/cytoplasmic nuclear-type HBcAg was higher in patients with G and/or S≥2 than in patients with G and S<2 in the chronic HBV carrier status and indeterminate groups [93.33% (28/30) vs 43.33%(13/30), P<0.05; 59.46% (22/37) vs 12.50% (2/16); both P<0.05]. There was a statistically significant difference in the incidence of significant liver injury between patients≤ 30 years old and >30 years old [52.7% (39/74) vs 68.1% (143/210), P<0.05]. Conclusions:Significant liver injury occurred in 64.08% (182/284) of CHB patients with normal ALT not receiving antiviral therapy, which required the attention of clinicians. Among CHB patients with normal ALT, the expression site of HBcAg in hepatocytes was related to the occurrence of significant liver injury and could be expected to serve as an important indicator for predicting the patient′s status and the necessity of antiviral treatment. CHB patients with positive HBV DNA who were older than 30 years required antiviral treatment, and CHB patients≤30 years with normal ALT and significant hepatic tissue damage also required antiviral treatment.

Objective : To investigate the mechanism of sertoli/spermatogenic injury induced by cigarette smoke extract(CSE) based on ROS/NLRP3 signaling pathway. Methods : The sertoli/spermatogenic of rat were cultured in vitro , and they were divided into control group , cigarette Smoke extract (CSE) group and CSE + NLRP3 inflammosome inhibitor MCC950 group. Cell viability was detected by CCK⁃8 assay; Lactate dehydrogenase ( LDH) was used to detect cell membrane damage ; reactive oxygen species ( ROS) production was used to detect oxidative stress level ; Hoechst/PI fluorescent staining was used to detect cell pyroptosis. Real⁃time quantitative PCR ( RT⁃qPCR) was used to determine the mRNA level of NLRP3 , ASC , Caspase⁃1 , GSDMD , IL⁃1β and IL⁃18. Western blot was used to determine the protein level of NLRP3 , ASC , Caspase⁃1 , GSDMD , IL⁃1β and IL⁃18. Results: CCK⁃8 assay showed that cell viability decreased in CSE group (P < 0. 001) , LDH leakage rate (P < 0. 001) and ROS (P < 0. 001) production increased. Compared to the CSE group , cell viability increased (P < 0. 001) , LDH leakage rate (P < 0. 01) and ROS (P < 0. 001) production decreased in CSE + MCC950 group. The number of PI staining cells in CSE group was more than that in control group and CSE + MCC950 group , but staining cells in CSE + MCC950 group was less than that in CSE group. RT⁃qPCR and Western blot results showed that the expression levels of NLRP3 , ASC , Caspase⁃1 , GSDMD , IL⁃1β and IL⁃18 increased in CSE group but decreased in CSE+ MCC950 group. Conclusion The oxidative stress and inflammation of sertoli/spermatogenic induced by ciga⁃ rette smoke may be related to the activation of ROS/NLRP3 signaling pathway.

Background Occupational stress has become one of the main factors affecting people's physical and mental health, and there are many sources of occupational stress in petrochemical enterprises. Objective To evaluate the current situation of occupational stress and its related factors among employees in a petrochemical enterprise, and to provide a scientific basis for reduing the risk of occupational stress among employees in petrochemical enterprises. Methods In June 2022, a cross-sectional questionnaire survey was conducted in a petrochemical enterprise in Hainan, including a general information questionnaire for basic information, the Effort-Reward Imbalance (ERI) for occupational stress, and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. Chi-square test was used to compare differences in positive occupational stress by demographic characteristics, occupational characteristics, behavior, and occupational disease hazards. Logistic regression was employed to evaluate factors associated with occupational stress. Results Of the 1129 questionnaire distributed, a total of 999 valid questionnaire were returned,with a valid recovery rate of 88.5%. The positive rate of occupational stress among employees in the petrochemical enterprise was 29.5%. There were statistically significant differences in the positive rate of occupational stress among the employees grouped by gender, age, marital status, body mass index (BMI), monthly income, length of service, smoking, weekly working hours, type of work, working mode, sleep quality, noise exposure, and high temperature exposure (P<0.05). In terms of positive occupational stress among subcategories: workers being male (vs. female), working ＞40 h per week (vs. ≤40 h per week), regular day shift (vs. shift work), smoking (vs. not smoking), with exposure to noise and heat (vs. without such exposure), and having poor sleep quality (vs. good sleep quality) reported higher positive occupational stress rates (P＜0.05). The results of pairwise comparison showed that the positive rate of occupational stress in divorced (50.0%) or married (32.0%) workers was higher than that in single (27.1%) workers, and higher in operation workers (30.6%) than in other types of work (20.5%) (P＜0.05). The trend chi-square results showed that the positive rate of occupational stress increased linearly with the increase of age, length of service, BMI, or monthly income (P＜0.05). The results of logistic regression analysis after adjustment showed that workers who worked ＞40 h a week had a higher risk of occupational stress than those who worked ≤40 h a week, and the OR (95%CI) was 1.909 (1.135, 3.211); the workers of other types of work had a lower risk of reporting occupational stress than operation workers, and the OR (95%CI) was 0.513 (0.272, 0.968); the workers with noise exposure had a higher risk of occupational stress than the workers without, and the OR (95%CI) was 2.457 (1.070, 5.642). Conclusion The positive rate of occupational stress among employees in this petrochemical enterprise is high. Among them, operators, working hours per week＞40 h, and noise exposure may increase the incidence of occupational stress. The enterprise should actively take measures to reduce the occurrence of occupational stress among employees.

Liver fibrosis occurs due to damages caused by liver diseases of various etiologies and activation of hepatic stellate cells, leading to the repairing and damaging cycle by secreting a large amount of extracellular matrix and formation of fibrosis tissues in the liver. Early reversal of this process could prevent further development and progression of the disease, which may reduce incidence of the end-stage liver disease and even liver cancer. This review summarized and discussed recent advancements and mechanisms of liver sinusoidal endothelial cells, Notch signaling pathway, YAP/TAZ signaling pathway, and autophagy in regulation of liver fibrosis and then enumerated the Traditional Chinese Medicine in reversal of liver fibrosis process and the underlying molecular mechanisms. It expects to provide novel approaches and research ideas for future control of liver fibrosis using Traditional Chinese Medicine.

Objective To investigate the clinical and pathological features of children with glycogen storage disease (GSD). Methods A retrospective analysis was performed for ten children with GSD who were admitted to the Third Hospital of Hebei Medical University and The Fifth Medical Center of Chinese PLA General Hospital from January 2002 to January 2022, based on medical history, liver biochemistry, and liver biopsy, and population characteristics, clinical manifestations, biochemical parameters, and liver histopathological characteristics were compared and analyzed. Results All ten children had developmental retardation and a short stature, with the manifestations of abnormal liver function, mild weakness, poor appetite, yellow urine, and yellow eyes, and four children had hepatosplenomegaly. Among the ten children, six had the clinical manifestations of hypoglycemia, and one had bilateral gastrocnemius hypertrophy and positive Gower sign. Two children had positive CMV IgG. Liver histopathological manifestations included diffuse enlargement of hepatocytes, light cytoplasm, and small nucleus in the middle like plant cells, with or without fibrous tissue proliferation. Conclusion Most patients with GSD have developmental retardation and abnormal aminotransferases, and liver pathological examination shows specific pathological features.

Objective It is important to precisely determinate the single nucleotide polymorphisms (SNPs) in many genes in‐cluding genes related with base excision repair (BER) pathway .This research is conducted to evaluate the role of polymerase chain reaction with confronting two‐pair primers (PCR‐CTPP) in analyzing the SNPs of BER pathway .Methods Four common SNPs of BER pathway (OGG1 Ser326Cys ,XRCC1 Arg399Gln ,APE1 Asp148Glu and‐141T/G in the promoter region) was detected with PCR‐CTPP .10 of the products were sent for genotype sequencing .Compare the results of PCR and sequencing to evaluate the accu‐racy of PCR‐CTPP .Results The genotypes were exactly the same as the sequencing .Conclusion The PCR‐CTPP was a reliable and rapid detective technology for SNPs genotyping .Its broadest application would be great help for gene variant analysis .

Objective To compare the diagnostic value of CT and MRI in the diagnosis of far lateral lumbar disc herniation (FLLDH). Methods The CT and MRI imagine data of 34 patients with FLLDH were retrospectively analyzed and compared. Results The positive rate of CT in diagnosis FLLDH was 88.24%(30/34), and the positive rate of MRI was 94.12%(32/34). There was no statistical difference (P>0.05). There were no statistical differences in the diagnosis of disease region and image representation between CT and MRI (P>0.05). Conclusions There is higher coincidence rate of CT and MRI in the diagnosis of FLLDH, but the two imaging methods have their own advantages and disadvantages. In clinical practice, the two imaging methods can be used to improve the clinical diagnosis rate, and provide a reliable basis for determining the surgical treatment options.