Background Construction workers represent a high risk group for occupational injuries. Currently, domestic and international studies examining the factors affecting occupational injuries among construction workers focus on demographic and behavioural characteristics. However, there is limited attention to psychosocial, use of digital technology, and health status of workers. Objective To analyze the occurrence of occupational injuries among workers in the construction industry, explore impacts of psychosocial risk, use of digital technology, health status, and preventive measures at the workplace on occupational injuries, and provide a basis for the development of preventive measures. Methods Publicly available data from the European Union Occupational Safety and Health Administration were retrieved, comprising a sample of 2167 construction workers. The outcome indicator was the presence of occupational injuries among workers. A total of 25 variables in the dimensions of psychosocial risk, use of digital technology, health status, and preventive measures at the workplace were extracted after Chi-square test, and then a combination of Boruta's algorithm and logistic regression was applied to identify the key factors affecting occupational injuries. Results Among the 2167 construction workers surveyed, 182 (8.6%) reported experiencing occupational injuries. The Boruta algorithm identified eight characteristics which in descending order of importance were musculoskeletal disorders, job type, depression and anxiety, level of completed education, use of electronic smart products, timely solution of safety problems, overall fatigue, and age. The logistic regression results indicated that six variables had statistically significant effects on occupational injuries: age, job type, level of completed education, musculoskeletal disorders, overall fatigue, and timely solution of safety problems (P<0.05). Conclusion Occupational injuries in construction workers are influenced by a variety of factors, including age, job type, level of completed education, musculoskeletal disorders, overall fatigue, and timely solution of safety problems. Companies and workers should take targeted measures to reduce the incidence of occupational injuries.

Background Diseases severely affect the efficiency of workers. Comorbidity refers to the coexistence of two or more chronic diseases or health problems in the same individual. Previous studies have primarily focused on occupational injuries caused by environmental exposures, while the analysis of the epidemiological characteristics of self-reported diseases and occupational injuries among manufacturing workers has been insufficient. Objective To analyze the distribution of self-reported diseases and occupational injuries among manufacturing workers, the strength of correlation between different diseases, and common disease combinations, and to preliminarily explore the relationship between self-reported diseases and occupational injuries. Methods A cross-sectional survey was conducted to investigate the occupational injuries of 2382 workers in 2 manufacturing enterprises over the past year, and 2355 questionnaires were valid after cleaning. The questionnaire included three parts: basic information, occupational injury occurrence, and disease prevalence. The self-reported diseases diagnosed by physicians included musculoskeletal diseases, cardiovascular diseases, respiratory diseases, mental health problems, neurological and sensory organ diseases, digestive organ diseases, reproductive and urinary organ diseases, skin diseases, tumors, endocrine and metabolic system diseases, blood diseases and birth defects, a total of 11 types. Log-binomial model was used to calculate the prevalence ratio (PR) value of the association between different diseases, and UpSet diagram was used to present the disease combination pattern. Results In total, 40.2% (946/2355) of the study participants reported at least one disease, while 8.6% (203/2355), 5.2% (122/2355), and 5.9% (140/2355) reported having two, three, and four or more diseases, respectively. A higher prevalence was observed for musculoskeletal diseases, neurological and sensory organ diseases, digestive organ diseases, and skin diseases, which accounted for 18.0% (423/2355), 13.8% (324/2355), 9.3% (218/2355), and 9.1% (214/2355), respectively. Workers with musculoskeletal disorders, cardiovascular diseases, or neurological and sensory organ diseases reported significantly higher incidence of occupational injuries compared with workers without the corresponding diseases (P<0.001, P=0.041, and P=0.006, respectively). Musculoskeletal diseases were strongly associated with comorbidities of neurological and sensory organ diseases (PR values were 1.86 and 1.98, respectively), and the other patters were musculoskeletal diseases and digestive organ diseases (PR and OR values were 1.57 and 2.35, respectively), and musculoskeletal diseases and cardiovascular diseases (PR and OR values were 1.46 and 2.22, respectively). The largest binomial comorbidity group involved musculoskeletal diseases and neurological and sensory organ diseases, accounting for 5.4% (25/465) of the comorbid workers. Conclusion Among the self-reported diseases of manufacturing workers, musculoskeletal diseases, neurological and sensory organ diseases, digestive organ diseases, and skin diseases are more common. Musculoskeletal diseases and neurological and sensory organ diseases are the most common in all comorbidities. Musculoskeletal diseases, cardiovascular diseases, and neurological and sensory organ diseases are associated with occupational injuries. In the prevention and control of occupational injuries, joint prevention strategies targeting multiple diseases should be strengthened.

Hypertrophic cardiomyopathy, a genetic hereditary disease, is highly regarded in clinical practice due to its unique pathophysiological changes, course characteristics, and hemodynamic features. With the continuous advance of treatment methods such as medications and surgeries, the prevention, treatment and prognosis of hypertrophic cardiomyopathy has gradually improved. However, inappropriate use of positive inotropic drugs may lead to serious consequences that are difficult to reverse. Therefore, how to smoothly navigate through the perioperative period and ensure clinical safety poses a great challenge for anesthesiologists. This paper discusses the perioperative management of patients with hypertrophic cardiomyopathy, with the hope of enhancing anesthesiologists' management capabilities for this type of disease.

Objective: To assess the dynamic changes of microcirculation at acupoints in patients with primary dysmenorrhea and cold congelation and blood stasis syndrome using laser speckle blood flow imaging. Methods: Patients with primary dysmenorrhea and cold coagulation and blood stasis syndrome (primary dysmenorrhea group, n=53) and healthy female college students(control group, n=57) who met the inclusion and exclusion criteria from October 2020 to July 2022 were enrolled at Hebei University of Chinese Medicine. On the premenstrual and first day of menstruation, a laser speckle blood flow imaging system was used to measure the microcirculation blood flow perfusion on the surface of acupoints related to the conception, thoroughfare, and governor vessels, and stomach, spleen, and bladder meridians in the abdomen and lumbosacral regions. The dynamic changes in microcirculation were calculated based on the difference in average blood flow perfusion at each acupoint before and after menstruation. Receiver operating curve (ROC) analysis was used to analyze the diagnostic efficacy of dynamic changes in microcirculation on the surface of each acupoint. The microcirculation sensitization rate of acupoints was calculated. Results: Compared with the control group, the dynamic changes in microcirculation at the following acupoints in the primary dysmenorrhea group were increased (P<0.05): conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]); left thoroughfare vessel (left Huangshu[KI16], left Zhongzhu[KI15], left Siman[KI14], left Qixue[KI13], left Dahe[KI12], left Henggu[KI11]); left stomach meridian (left Tianshu[ST25], left Wailing[ST26], left Qichong[ST30]); left spleen meridian (left Daheng[SP15], left Fujie[SP14]); right thoroughfare vessel (right Huangshu[KI16], right Zhongzhu[KI15], right Siman[KI14], right Qixue[KI13], right Dahe[KI12], right Henggu[KI11]); right stomach meridian (right Wailing[ST26], right Daju[ST27], right Shuidao[ST28], right Guilai[ST29], right Qichong[ST30]); and right spleen meridian (right Fujie[SP14]). The area under the ROC curve of conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]), thoroughfare vessel (right Siman[KI14], left Huangshu[KI16], right Qixue[KI13], right Zhongzhu[KI15], right Dahe[KI12], left Zhongzhu[KI15], left Siman[KI14], right Huangshu[KI16], left Qixue[KI13], right Henggu[KI11], left Henggu[KI11], left Dahe[KI12]); stomach meridian (left Tianshu[ST25], right Guilai[ST29], left Wailing[ST26], right Shuidao[ST28], right Daju[ST27], right Wailing[ST26], right Qichong[ST30], left Qichong[ST30]), and spleen meridian (left Daheng[SP15], left Fujie[SP14], right Fujie[SP14]) was 0.610-0.682 (P<0.05). Compared with the control group, the sensitization rate of some acupoints in the primary dysmenorrhea group increased (P<0.05). Conclusion With the onset of menstruation, the blood flow perfusion of some acupoints in the abdomen (thoroughfare, and conception vessels, and stomach and spleen meridians) of patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome increased, and the status of acupoints changed from a resting state to an active state. These acupoints are sensitive in patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome and have a certain diagnostic efficacy, providing a basis for further analyzing the efficacy and mechanism of acupuncture and moxibustion to treat primary dysmenorrhea with cold blood coagulation and blood stasis syndrome.

Objective:The traction method for correcting congenital nipple inversion was observed to induce varying degrees of hemodynamic compromise in the nipple skin microcirculation after surgery. In this study, the laser Doppler scattering flowmetry was employed to measure the postoperative nipple skin microcirculation perfusion to verify the difference in nipple skin microcirculation perfusion with different grades of hemodynamic disorders. Furthermore, we aimed to describe the trend of postoperative nipple skin microcirculation perfusion and to elucidate the patterns of nipple breast skin microcirculation in healthy women.Methods:From October 2016 to October 2022, the Department of Plastic and Reconstructive Surgery of Peking Union Medical College Hospital performed traction correction of 72 congenital inverted nipples using wire braces in 37 women. The age of the patients in the surgical group ranged from 21 to 51 years with a mean age of 27.4±1.8 years. Concurrently, the control group consisted of 65 normal nipples of 34 healthy women aged between 18 to 50 years (mean age 26.5±1.7 years). In both groups, nipple and areola skin microcirculatory perfusion was measured using a laser Doppler scatter flow meter PeriCam PSI system. The control group underwent a single measurement whereas the surgical group was evaluated three times postoperatively at two days, five days, and one month.Results:In the control group, the mean value of nipple skin microcirculation perfusion was 137.77±22.94, significantly higher than that for breast skin, which stood at 68.94±10.43 ( t=-14.116, P<0.001). The mean value of nipple skin microcirculation perfusion in the surgical group was 179.57±41.48 at two days postoperatively, which resulted in a significant increase in postoperative nipple skin microcirculation perfusion compared to the control group nipple skin microcirculation perfusion (137.77±22.94), and a decrease in nipple skin microcirculation perfusion at five days postoperatively (167.28±38.16), which was normalized at one month postoperatively (131.45±39.64). Notably, instances of hemodynamic disturbances such as skin breakdown or partial necrosis, the nipple skin microcirculation perfusion were significantly reduced (118.63±58.66), supporting the postoperative nipple hemodynamic classification. Conclusions:The nipple skin microcirculation perfusion in healthy female is significantly higher than breast skin microcirculation perfusion. Surgical interventions for correcting congenital inverted nipples markedly enhance nipple skin microcirculatory perfusion, though the perfusion rate is prone to reduction in the case of postoperative hemodynamic disorders, manifesting as nipple skin breakdown or localized necrosis. The integrity of nipple skin can be used as a crucial metric for clinical evaluation. Notably, following postoperative dressing changes, all instances of nipple skin breakdowns heal with the microcirculation perfusion values reverting to normal by one month.

Objective To explore the effect of evidence-based health education combined with non-invasive positive pressure ventilation on the clinical efficacy of menopausal women with chronic obstructive pulmonary disease(COPD)and respiratory failure.Methods From February 2021 to February 2024,100 patients with menopausal COPD complicated with respiratory failure admitted to Wenzhou TCM Hospital were observed.According to the different intervention methods,100 patients were divided into routine group and study group,with 50 patients in each group.The patients in routine group were given routine intervention combined with non-invasive positive pressure ventilation,and the patients in study group were given health education under the evidence-based concept on the basis of routine group.The blood gas index,psychological state,general comfort question naire(GCQ)and Pittsburgh sleep quality index(PSQI)scores,treatment effect and complications were compared between two groups.Results Before intervention,insignificant changes existed in arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen partial pressure(PaO2),and oxygen saturation of blood(SaO2)levels between both groups(P＞0.05).After the intervention,the PaCO2 of study group fell below than that of routine group,while PaO2 and SaO2 soared beyond than those of routine group(P＜0.05).Before intervention,no variance noted in self-rating depression scale(SDS)and self-rating anxiety scale(SAS)scores in both groups(P＞0.05).After the intervention,the SDS score points and SAS score points of study group were lower than those of routine group,and were statistically different(P＜0.05).Before intervention,there was no difference in GCQ and PSQI scores between two groups(P＞0.05).After intervention,The study group exhibited a superior GCQ score compared to routine group,coupled with an inferior PSQI score(P＜0.05).Comparing the ratings,the study group achieved a slightly higher proficiency rate(92％ vs.84％ )yet no significant disparity emerged(P＞0.05).Study group's complication rate at 4.00％ was significantly lower than routine group's at 16.00％ .Statistically significant difference observed(P＜0.05).Conclusion Under the concept of evidence-based health education combined with non-invasive positive pressure ventilation,the blood gas index,anxiety,depression and sleep quality of patients with climacteric chronic obstructive pulmonary disease and respiratory failure were significantly improved,which could reduce the occurrence of complications.

Objective To investigate the association between abdominal visceral fat content and the occur-rence of type 2 diabetes mellitus(T2DM)and the potential of predicting the incidence of T2DM with abdominal visceral fat content.Methods The study included 45 patients with T2DM who underwent 3.0T MRI and 80 control patients,recruited from the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology.IDEAL software was utilized for automated image recombination to obtain fat fraction,relaxation rate(R2*),lipid phase,water phase,and in-phase images.Fat fraction images were transferred to AW 4.6 workstation for measurement of fat fraction plots by two observers using a double-blind approach.ITK-SNAP software was employed for semi-automatic delineation of abdominal visceral fat and subcutaneous adipose tissue through threshold segmentation method,followed by volume calculation.Statistical analysis of the data was performed using SPSS 26.0 software.Results(1)The T2DM group exhibited significantly higher levels of abdominal visceral adipocyte volume(VATV),hepatic fat fraction(HFF),pancreatic fat fraction(PFF),triglyceride(TG),and fasting blood glucose(FBG)compared to the control group.Conversely,the high density lipoprotein(HDL)level was significantly lower in the T2DM group than in the control group(P＜0.05).The correlation analysis revealed that in male patients,abdominal VATV exhibited positive associations with body mass index(BMI),waist circumference,subcutaneous adipose tissue volume(SATV),hepatic fat fraction(HFF),TG,and FBG;while displaying a negative association with HDL.In female patients,VATV demonstrated positive correlations with BMI,waist circumference,SATV,and HFF.(2)The ROC curve analysis demonstrated that the area under the curve(AUC)for PFF in diagnosing T2DM was 0.656(P＜0.01,95%CI:0.534～0.777).The determined cut-off value was 8.44%,yielding a sensitivity of 50%and specificity of 82.5%.Similarly,HFF exhibited an AUC of 0.744(P＜0.05,95%CI:0.637～0.851),with a cut-off value of 2.99%,sensitivity of 97.5%,and specificity of 42%.In male patients,VATV displayed an optimal threshold for T2DM diagnosis at a volume of approximately 3 466 cm3,resulting in a sensitivity of 63.2%,specificity of 89.5%,and AUC of 0.78(P＜0.01).The sensitivity was 78.9%and specificity was 84.2%when SATV,PFF and HFF were combined and the AUC was 0.839(P＜0.01).The optimal threshold for diagnosing T2DM with VATV in female patients was 2 103cm3,and the sensitivity,specificity and AUC of T2DM with VATV were 66.7%,66.7%and 0.68(P＜0.05).When SATV,PFF and HFF were combined,the sensitivity was 90.5%.The specificity was 76.2%and the AUC was 0.909(P＜0.01).(3)For each additional unit of TG and FBG,the risk of T2DM respectively increased by 3986.3%and 417.1%,in other words,TG and FBG were independent predictors of the occurrence of T2DM.Conclusion The predictive value of pancreatic fat fraction,liver fat fraction,and abdominal visceral fat tissue volume for the onset of type 2 diabetes is limited.However,combining abdominal visceral adipose tissue volume with subcutaneous adipose tissue volume,pancreatic fat fraction,and liver fat fraction significantly enhances the efficacy,sensitivity,and specificity of predicting type 2 diabetes occurrence.The IDEAL-IQ technique offers a convenient method for quantitatively evaluat-ing intra-abdominal ectopic adipose tissue deposition in patients with type 2 diabetes mellitus.It demonstrates advantages such as simplicity,good stability,high reproducibility and holds great potential.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the seroprevalence of Toxoplasma gondii infections among patients with hematological diseases, so as to provide insights into improving the prognosis and quality of life among patients with hematological diseases. Methods A total of 240 patients with hematological diseases (including 170 patients with hematological tumors and 70 patients with non-tumor hematological diseases) admitted to The Affiliated Hospital of Putian University during the period from January 1, 2021 through October 10, 2023 and 500 healthy volunteers in the hospital during the same period were enrolled. Subjects’ demographics and serum samples were collected, and serum specific IgG and IgM antibodies against T. gondii were detected using the chemiluminescence assay, with any of a positive IgG or IgM antibody defined as a positive T. gondii infection. The seroprevalence of specific IgG and IgM antibodies against T. gondii was compared between patients with hematological diseases and healthy volunteers. Results The mean age (F = 2.034, P > 0.05) and gender distribution (χ² = 0.462, P > 0.05) were comparable among patients with hematological tumors, patients with non-tumor hematological diseases and healthy volunteers, and there was no significant difference in the proportion of history of cat or dog contacts between patients with hematological diseases and healthy volunteers (χ² = 0, P > 0.05). The seroprevalence of anti-T. gondii antibody was significantly higher among patients with hematological diseases than among healthy volunteers (15.8% vs. 0.6%; χ² = 71.902, P < 0.01), and there was a significant difference in the seroprevalence of anti-T. gondii antibody among patients with hematological tumors (18.2%), patients with non-tumor hematological diseases (10.0%) and healthy volunteers (χ² = 78.327, P < 0.01). The seroprevalence of anti-T. gondii antibody was significantly higher among patients with hematological tumors and non-tumor hematological diseases than among healthy volunteers (both P values < 0.05), while no significant difference was seen in the seroprevalence of anti-T. gondii antibody between patients with hematological tumors and non-tumor hematological diseases (P > 0.05). In addition, the proportion of history of cat or dog contacts was significantly higher among patients with hematological diseases that were positive for serum anti-T. gondii anti-body than among those negative for serum anti-T. gondii antibody (21.1% vs. 5.4%; χ² = 8.653, P < 0.05). Conclusions There is a high seroprevalene rate of T. gondii infections among hematological diseases, which is significantly greater than that among healthy volunteers.

ObjectiveTo investigate the effect of Shugan Quyu Jiedu prescription （SGQYJDF） on inducing ferroptosis in hepatocellular carcinoma cells based on the tumor protein 53 （p53）/solute carrier family 7 member 11 （SLC7A11）/glutathione peroxidase 4 （GPX4） pathway. MethodMHCC97H cells were divided into the blank serum group （10% blank serum medium）， SGQYJDF-containing serum low concentration group （5% SGQYJDF-containing serum and 5% blank serum medium）， SGQYJDF-containing serum medium concentration group （7.5% SGQYJDF-containing serum and 2.5% blank serum medium）， SGQYJDF-containing serum high concentration group （10% SGQYJDF-containing serum medium） and sorafenib group （sorafenib concentration of 10 μmol·L^-1 in 10% blank serum medium）. After 24 hours of intervention， the cell survival rate was detected by cell counting kit-8 （CCK-8） assay. The cell proliferation ability was detected by 5-ethynyl-2′-deoxyuridine （EdU） staining. The intracellular ferrous ion （Fe²⁺） level was detected by ferrous ion fluorescent probe （FerroOrange） staining. The intracellular malondialdehyde （MDA） and glutathione （GSH） levels were detected by colorimetric assays. The ultrastructure of mitochondria was observed by transmission electron microscopy. The expression levels of ferroptosis-related proteins p53， SLC7A11 and GPX4 were detected by Western blot. ResultIn terms of cell viability， compared with the blank serum group， the SGQYJDF group showed a dose-dependent decrease in the survival rate of MHCC97H cells. Effect of the medium and high concentrations of SGQYJDF on the survival rate of MHCC97H cells were significantly decreased （P<0.01）. Additionally， the results of the EdU assay showed that both the medium and high concentrations of SGQYJDF were able to inhibit the proliferation ability of MHCC97H cells （P<0.05， P<0.01）. Regarding the biochemical indicators of ferroptosis， compared to the blank serum group， the medium and high concentrations of SGQYJDF were able to dose-dependently increase the intracellular Fe²⁺ level （P<0.01）. The low， medium， and high concentrations of SGQYJDF were able to dose-dependently decrease the level of GSH in MHCC97H cells （P<0.01） and increase the level of MDA in the cells （P<0.05， P<0.01）. In terms of pathway-related protein expression， compared to the blank serum group， the medium and high concentrations of SGQYJDF could significantly increase the expression of p53 （P<0.01）. The low， medium， and high concentrations of SGQYJDF could significantly decrease the expression of GPX4 （P<0.01）. The high concentration of SGQYJDF could decrease the expression of SLC7A11 （P<0.01）. In terms of the cell morphology of ferroptosis， compared with the blank serum group， transmission electron microscopy revealed that the low concentration of SGQYJDF caused mitochondrial deformation， while the medium and high concentrations of SGQYJDF resulted in reduced mitochondrial volume， increased double-layer membrane density， and decreased mitochondrial cristae. These features were similar to those of sorafenib-induced ferroptosis. Furthermore， compared with the sorafenib group， the high concentration of SGQYJDF showed no statistically significant differences in cell survival rate， proliferation ability， Fe²⁺ level， MDA level， and GSH level. ConclusionThe results suggest that SGQYJDF may induce ferroptosis and inhibit proliferation in hepatocellular carcinoma MHCC97H cells by upregulating the expression of p53， suppressing the expressions of GPX4 and SLC7A11， downregulating the level of GSH， and leading to the accumulation of intracellular Fe²⁺ and MDA.