1.Study on the effects and mechanisms of Lycium ruthenicum Murr. in improving sleep
Ming QIAO ; Yao ZHAO ; Yi ZHU ; Yexia CAO ; Limei WEN ; Yuehong GONG ; Xiang LI ; Juanchen WANG ; Tao WANG ; Jianhua YANG ; Junping HU
China Pharmacy 2026;37(1):24-29
OBJECTIVE To investigate the effects and mechanisms of Lycium ruthenicum Murr. in improving sleep. METHODS Network pharmacology was employed to identify the active components of L. ruthenicum and their associated disease targets, followed by enrichment analysis. A caffeine‑induced zebrafish model of sleep deprivation was established , and the zebrafish were treated with L. ruthenicum Murr. extract (LRME) at concentrations of 0.1, 0.2 and 0.4 mg/mL, respectively; 24 h later, behavioral changes of zebrafish and pathological alterations in brain neurons were subsequently observed. The levels of inflammatory factors [interleukin-6 (IL-6), IL-1β, IL-10, tumor necrosis factor-α (TNF-α)], oxidative stress markers [superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), catalase (CAT)], and neurotransmitters [5- hydroxytryptamine (5-HT), γ-aminobutyric acid (GABA), glutamic acid (Glu), dopamine (DA), and norepinephrine (NE)] were measured. The protein expression levels of protein kinase B1 (AKT1), phosphorylated AKT1 (p-AKT1), epidermal growth factor receptor (EGFR), B-cell lymphoma 2 (Bcl-2), sarcoma proto-oncogene,non-receptor tyrosine kinase (SRC), and heat shock protein 90α family class A member 1 (HSP90AA1) in the zebrafish were also determined. RESULTS A total of 12 active components and 176 intersecting disease targets were identified through network pharmacology analysis. Among these, apigenin, naringenin and others were recognized as core active compounds, while AKT1, EGFR and others served as key targets; EGFR tyrosine kinase inhibitor resistance signaling pathway was identified as the critical pathway. The sleep improvement rates in zebrafish of LRME low-, medium-, and high-dose groups were 54.60%, 69.03% and 77.97%, 开发。E-mail:hjp_yft@163.com respectively, while the inhibition ratios of locomotor distance were 0.57, 0.83 and 0.95, respectively. Compared with the model group, the number of resting counts, resting time and resting distance were significantly increased/extended in LRME medium- and high-dose groups (P<0.05). Neuronal damage in the brain was alleviated. Additionally, the levels of IL-6, IL-1β, TNF-α, MDA, Glu, DA and NE, as well as the protein expression levels of AKT1, p-AKT1, EGFR, SRC and HSP90AA1, were markedly reduced (P<0.05), while the levels of IL-10, SOD, GSH-Px, CAT, 5-HT and GABA, as well as Bcl-2 protein expression, were significantly elevated (P<0.05). CONCLUSIONS L. ruthenicum Murr. demonstrates sleep-improving effects, and its specific mechanism may be related to the regulation of inflammatory responses, oxidative stress, neurotransmitter balance, and the EGFR tyrosine kinase inhibitor resistance signaling pathway.
2.Mechanisms of reproductive toxicity and ferroptosis induced by polystyrene microplastics in male mice
Jiabo WANG ; Rong LI ; Setiniaz NAZIRA ; Chengqing LIU ; Nan YANG ; Qi YAN
Journal of Environmental and Occupational Medicine 2025;42(2):224-231
Background Polystyrene microplastics (PS-MPs) attract widespread public attention due to their adverse effects on mammalian reproductive systems. However, it is currently unclear whether ferroptosis is related to testicular damage and decreased sperm quality in mice exposed to PS-MPs. Objective To clarify the reproductive damage in male mice exposed to PS-MPs and investigate the mechanism of ferroptotic effects. Methods Five-week-old male BALB/c mice were randomly divided into four experimental groups, including one control group and three PS-MPs groups at low dose (0.5 mg·kg−1), medium dose (5 mg·kg−1), and high dose (50 mg·kg−1), respectively, with 6 mice in each group. The treatment was delivered by gavage for 35 consecutive days (one time per day). After the mice were neutralized, the wet weights of testis and epididymis were measured, and organ coefficients were then calculated. Sperm was counted by hematimetry, and sperm motility and adenosine triphosphate (ATP) level were evaluated using CCK-8 and CellTiter Glo ® Kit 2.0 Assay respectively. In addition, serum testosterone, follicle-stimulating hormone, and luteinizing hormone were determined using ELISA kit, total testicular iron content was measured using tissue iron kit, and pathological changes in testicular tissue were observed after hematoxylin-eosin (HE) staining. We also used glutathione (GSH), malondialdehyde (MDA), and superoxide dismutase (SOD) assays to examine their changes to better understand the physiological status of testicular tissue. Finally, the expression levels of ferroptosis-associated proteins glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11) were detected by Western blotting. Results Compared with the control group, the testicular index in the high dose group decreased, and the epididymal index decreased in all dose groups (P<0.05). The results of sperm quality analysis showed that the sperm count in each dose group was lower than that of the control group; the sperm motility decreased, sperm malformation rate increased, and ATP level in sperm decreased in the medium and high dose groups. The results of HE staining showed that the spermatogenic epithelium was disordered and the arrangement of spermatogenic cells were loose in the low dose group, the spermatogenic gap was enlarged in the middle dose group, and the cells in the high dose group were vacuolated and even azoospermic. The results of serum sex hormone levels showed that the serum testosterone levels decreased in each dose group, the serum follicle-stimulating hormone levels decreased in the medium and high dose groups, and the serum luteinizing hormone levels decreased in the high dose group (P<0.05). The iron content in the testicular tissue homogenate of the high dose group increased (P<0.05). The levels of GSH and SOD in the homogenate of testicular tissue decreased in the medium and high dose groups, while the levels of MDA increased (P<0.05). The results of Western blotting showed that the protein expression level of GPX4 in the testis in the high dose group was lower than that in the control group. The protein expression levels of SLC7A11 in the medium and high dose groups were lower than that in the control group. The results of correlation analysis showed that the expression level of GPX4 was positively correlated with sperm count, and negatively correlated with MDA level (P<0.05). SLC7A11 expression level was positively correlated with sperm count, and negatively correlated with sperm malformation rate and MDA level (P<0.05). Conclusion PS-MPs exposure leads to decreased sperm quality, testicular damage, and decreased serum sex hormone levels in male mice, and its mechanism of action may involve ferroptosis.
3.Blood management strategy for massive transfusion patients in frigid plateau region
Haiying WANG ; Jinjin ZHANG ; Lili CHEN ; Xiaoli SUN ; Cui WEI ; Yongli HUANG ; Yingchun ZHU ; Chong CHEN ; Yanchao XING
Chinese Journal of Blood Transfusion 2025;38(2):268-273
[Objective] To explore the strategy of blood management in patients with massive transfusion in the frigid plateau region. [Methods] The treatment process of a patient with liver rupture in the frigid plateau region was analyzed, and the blood management strategy of the frigid plateau region was discussed in combination with the difficulties of blood transfusion and literature review. [Results] The preoperative complete blood count (CBC) test results of the patient were as follows: RBC 3.14×1012/L, Hb 106 g/L, HCT 30.40%, PLT 115.00×109/L; coagulation function: PT 18.9 s, FiB 1.31 g/L, DD > 6 μg/mL, FDP 25.86 μg/mL; ultrasound examination and imaging manifestations suggested liver contusion and laceration / intraparenchymal hematoma, splenic contusion and laceration, and massive blood accumulation in the abdominal cavity; it was estimated that the patient's blood loss was ≥ 2 000 mL, and massive blood transfusion was required during the operation; red blood cell components were timely transfused during the operation, and the blood component transfusion was guided according to the patient's CBC and coagulation function test results, providing strong support and guarantee for the successful treatment of the patient. The patient recovered well after the operation, and the CBC test results were as follows: RBC 4.32×1012/L, Hb 144 g/L, HCT 39.50%, PLT 329.00×109/L; coagulation function: APTT 29.3 s, PT 12.1 s, FiB 2.728 g/L, DD>6 μg/mL, FDP 25.86 μg/mL. The patient was discharged after 20 days, and regular follow-up reexamination showed no abnormal results. [Conclusion] Individualized blood management strategy should comprehensively consider the patient’s clinical symptoms, the degree of hemoglobin decline, dynamic coagulation test results and existing treatment conditions. Efficient and reasonable patient blood management strategies can effectively improve the clinical outcomes of massive transfusion patients in the frigid plateau region.
4.Characteristics analysis of pediatric medicines with priority review and approval for marketing in China
Haoyu YANG ; Kan TIAN ; Xue YOU ; Hongwei DAN ; Qian WANG ; Xiaoyong YU
China Pharmacy 2025;36(5):519-523
OBJECTIVE To analyze the characteristics of pediatric medicines with priority review and approval for marketing in China, providing a reference for promoting enterprise R&D and production, as well as improving the supply guarantee mechanism for pediatric medicines. METHODS Based on publicly available data sources such as List of Approved Information for Pediatric Medications Subject to Priority Review and Approval, Pharnexcloud biomedical database, and National Medical Insurance Drug Directory, this study conducted a comprehensive analysis of the main characteristics of pediatric medicines with priority review and approval for marketing. RESULTS As of June 30, 2024, a total of 68 pediatric medicines had been approved through the priority review and approval process, covering 12 therapeutic areas, with oral dosage forms accounting for 64.71%. The median time from application to inclusion in priority review was 35.50 days, with an average of 41.69 days. The median time from inclusion in priority review to market approval was 1.24 years, with an average of 1.42 years. This included 12 domestic new medicines, 21 domestic generic medicines, 35 imported medicines, as well as 29 pediatric-specific medicines and 21 orphan medicines. Additionally, 31 of these medicines had been included in the medical insurance catalog, representing a proportion of 45.59%. CONCLUSIONS Currently, a trend of differentiated competition is emerging between domestic and imported pediatric medicines. The therapeutic areas for pediatric medicines are continuously expanding, and the dosage forms are becoming more tailored to children’s needs. However, there are still issues such as slow progress in new medicine development, insufficient stability in the medicine review and approval process, and a need to increase the proportion of medicines included in medical insurance.
5.Effect of Shenge Bushen Capsules and Its Polysaccharides and Flavonoids on Precocious Puberty in Young Mice
Hong SUN ; Fan LEI ; Chenggong LI ; Shixian HU ; Weihua WANG ; Bin REN ; Juan HAO ; Rui LUO ; Lijun DU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):95-103
ObjectiveTo explore the effect of Shenge Bushen Capsules (SBC) on sexual development in normal 3-week-old mice. MethodsThe experiment consisted of two parts. In the first part, mice were divided into four groups: The control group and the low, medium, and high-dose SBC groups (234.7, 469.4, 938.7 mg·kg-1, respectively). In the second part, mice were divided into four groups: Control group, Pseudostellariae Radix polysaccharide (PRP) group, total flavonoids group, and SBC group, all receiving a dose of 469.4 mg·kg-1. After 7 days of administration, the vaginal opening of female mice and the descent of testes and scrotum in male mice, as well as the ovarian and testicular organ indices, were observed. After 4 weeks of administration, female and male mice were housed together for 2 days, and the pregnancy rate of females was monitored. After delivery, the pregnant female mice continued receiving the treatment for 4 weeks, and the sexual development of their offspring, including vaginal opening, testicular descent, and organ indices of ovaries and testes, was observed. Serum sex hormones were measured by enzyme-linked immunosorbent assay (ELISA), and the expression of gonadotropin-releasing hormone (GnRH) and growth hormone (GH) proteins in the hypothalamus was assessed by Western blot. ResultsCompared with the control group, there was no significant effect on the vaginal opening of female mice or the descent of testes in male mice after 7 days of SBC administration. After 4 weeks of administration, the pregnancy rate in the low-dose group was significantly reduced (P<0.05), but no significant effects were observed in the other groups. The three doses of SBC did not significantly affect the ovarian or testicular organ indices, and there was no significant upregulation in the expression of GnRH or GH in the hypothalamus. The primary component of SBC, Pseudostellariae Radix polysaccharide, significantly reduced the vaginal opening in female mice after 7 days of administration (P<0.05). After 4 weeks, the serum estradiol levels of non-pregnant female mice were decreased (P<0.05), but there was no significant effect on the expression of GnRH or GH proteins in the hypothalamus of either male or female mice. Additionally, there were no significant effects on precocious puberty indicators, such as vaginal opening and testicular descent, in the offspring mice. ConclusionSBC does not significantly promote precocious puberty in young mice, and it does not have any noticeable effects on the pregnancy rate of adult mice or the sexual development of their offspring.
6.Clinical research on corneal epithelium remodeling after small incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis
Yangjing ZHANG ; Liwei MA ; Fan ZHANG ; Chunmei KE ; Ruifu WANG ; Lipye ZU
International Eye Science 2025;25(1):37-41
AIM: To compare the changes in corneal epithelial thickness(CET)after small incision lenticule extraction(SMILE)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK).METHODS: A total of 187 patients(187 eyes)who underwent either SMILE or FS-LASIK at Urumqi Aier Eye Hospital between December 2022 and November 2023 were collected. The patients were divided into SMILE group and FS-LASIK group according to surgical methods. The CET of the patients was measured by optical coherence tomography(OCT)system before surgery and at 1 wk, 1, 3, and 6 mo postoperatively.RESULTS: Changes in corneal epithelial thickness(△CET)in the central, paracentral, and mid-peripheral regions were compared at 6 mo postoperatively. The SMILE group was characterized by the most significant thickening in the central area and the least thickening in the mid-peripheral area; while the FS-LASIK group was characterized by the most significant thickening in the paracentral area and the least thickening in the mid-peripheral region. At 1 wk, 1, 3, and 6 mo postoperatively, within the 0-7 mm corneal area, the △CET for both the SMILE and FS-LASIK groups was correlated with the preoperative spherical equivalent.CONCLUSION: Within 6 mo postoperatively, both SMILE and FS-LASIK showed a similar trend in epithelial thickening but with distinct characteristics. The change in corneal epithelial thickness for both procedures was positively correlated with the preoperative diopter.
7.Advances in the impact of obesity on ocular diseases
Di ZHANG ; Huixian WANG ; Xu ZHANG ; Wenjing LI
International Eye Science 2025;25(1):88-93
Obesity is a risk factor and pathological basis for various chronic non-communicable diseases and is an important risk factor leading to human mortality and disability. The harm of obesity to the body includes not only various systemic diseases but also some ocular diseases. Currently, the higher pursuit of life and visual quality has led to increased attention to the etiology and prevention of ocular diseases, and the impact of obesity on ocular diseases has been gradually discovered. This article reviews the impact of obesity on certain ocular diseases to deepen the understanding of obesity's impact on ocular diseases and provide a reference for the prevention and treatment of ocular diseases.
8.Randomized Controlled Trail of Ganlu Qingwen Prescription for Treatment of Community-acquired Pneumonia
Xiangpeng LI ; Fengsen LI ; Ling WANG ; Zheng LI ; Dan XU ; Jiangtao LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):225-236
ObjectiveTo explore the regulatory effect of Ganluqingwen prescription on inflammation and immunity by observing the clinical efficacy of Ganluqingwen prescription in the treatment of community-acquired pneumonia (CAP), so as to provide a clinical basis for the treatment of CAP by traditional Chinese medicine (TCM). MethodsA randomized controlled trial was conducted by selecting patients who were diagnosed with CAP and identified as wind-heat attacking lungs in Xinjiang Uygur Autonomous Region Hospital of TCM from January 2024 to May 2024 and assigning the patients to a control group (treated by western medicine treatment) or an experimental group (treated by Ganluqingwen prescription combined with western medicine). The data of the enrolled patients before treatment, for three-day treatment, for seven-day treatment, and for 14-day treatment were collected, including basic information, medical history, pneumonia severity index (PSI) classification, and distribution and difference of laboratory and imaging information indexes. The peripheral blood specimens were collected from the patients. and the changes of inflammatory factors in peripheral blood were detected by using enzyme-linked immunosorbent assay (ELISA) reagent kits and flow-type multifactor microarrays to evaluate the clinical safety and efficacy of Ganluqingwen prescription in CAP. ResultsCompared with those in the groups before treatment, the total scores of TCM syndromes significantly decreased in both groups (P<0.05). Compared with those in the control group after treatment, the total scores of TCM syndromes decreased more significantly in the experimental group (P<0.05). Compared with the control group after treatment, the experimental group displayed a significantly reduced number of days of fever in patients (P<0.05). Compared with those in the groups before treatment, the leukocyte, neutrophil counts, C-reactive protein (CRP), procalcitonin (PCT), interleukin (IL)-6, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (Cr), creatine kinase (CK), and creatine kinase isoenzymes (CK-MB) in both groups decreased (P<0.05) after treatment. Compared with that in the control group after treatment, the decrease of leukocyte, neutrophil counts, CRP, PCT, IL-6, ALT, AST, Cr, CK, and CK-MB was more pronounced in the experimental group (P<0.05). Compared with those in the group before treatment, the partial pressure of carbon dioxide increased in the experimental group for 3 d of treatment (P<0.05), and the standard alkali residual, actual alkali residual, standard bicarbonate concentration, and actual bicarbonate concentration increased in the experimental group for 7 d of treatment (P<0.05). Compared with that in the group before treatment, D-dimer decreased in the control group for 7 d of treatment (P<0.05). D-dimer and activated partial thromboplastin time (APTT) decreased in the experimental group for 3 d of treatment (P<0.05), and D-dimer, fibrinogen (FIB), and APTI significantly decreased in the group for 7 d of treatment (P<0.05). Compared with the group for 3 d of treatment, the experimental group for 7 d of treatment showed decreased FIB (P<0.05). Compared with those in the groups before treatment, the levels of inflammatory factors IL-4, IL-10, and IL-13 were elevated in the peripheral blood of the two groups after treatment, and the levels of B lymphocyte chemoattractant (BLC), interferon gamma-induced protein 10 (IP-10), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), monocyte chemoattractant protein-1 (MCP-1), CRP, IL-2, IL-6, IL-8, IL-17, IL-22, and IL-23p19 were significantly reduced (P<0.01). Compared with the control group after treatment, the experimental group exhibited more significant improvement in indexes above (P<0.01). ConclusionThe group treated by Ganluqingwen prescription combined with western medicine shows more significant effects on reducing total scores of TCM syndromes, lowering the ability of leukocyte and neutrophil counts, decreasing BLC, IP-10, TNF-α, IFN-γ, MCP-1, CRP, IL-2, IL-6, IL-8, IL-17, IL-22, and IL-23p19 in the peripheral blood of the patients, and elevating levels of IL-4, IL-10, and IL-13 than the group treated by western drugs alone.
9.Randomized Controlled Trail of Ganlu Qingwen Prescription for Treatment of Community-acquired Pneumonia
Xiangpeng LI ; Fengsen LI ; Ling WANG ; Zheng LI ; Dan XU ; Jiangtao LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):225-236
ObjectiveTo explore the regulatory effect of Ganluqingwen prescription on inflammation and immunity by observing the clinical efficacy of Ganluqingwen prescription in the treatment of community-acquired pneumonia (CAP), so as to provide a clinical basis for the treatment of CAP by traditional Chinese medicine (TCM). MethodsA randomized controlled trial was conducted by selecting patients who were diagnosed with CAP and identified as wind-heat attacking lungs in Xinjiang Uygur Autonomous Region Hospital of TCM from January 2024 to May 2024 and assigning the patients to a control group (treated by western medicine treatment) or an experimental group (treated by Ganluqingwen prescription combined with western medicine). The data of the enrolled patients before treatment, for three-day treatment, for seven-day treatment, and for 14-day treatment were collected, including basic information, medical history, pneumonia severity index (PSI) classification, and distribution and difference of laboratory and imaging information indexes. The peripheral blood specimens were collected from the patients. and the changes of inflammatory factors in peripheral blood were detected by using enzyme-linked immunosorbent assay (ELISA) reagent kits and flow-type multifactor microarrays to evaluate the clinical safety and efficacy of Ganluqingwen prescription in CAP. ResultsCompared with those in the groups before treatment, the total scores of TCM syndromes significantly decreased in both groups (P<0.05). Compared with those in the control group after treatment, the total scores of TCM syndromes decreased more significantly in the experimental group (P<0.05). Compared with the control group after treatment, the experimental group displayed a significantly reduced number of days of fever in patients (P<0.05). Compared with those in the groups before treatment, the leukocyte, neutrophil counts, C-reactive protein (CRP), procalcitonin (PCT), interleukin (IL)-6, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (Cr), creatine kinase (CK), and creatine kinase isoenzymes (CK-MB) in both groups decreased (P<0.05) after treatment. Compared with that in the control group after treatment, the decrease of leukocyte, neutrophil counts, CRP, PCT, IL-6, ALT, AST, Cr, CK, and CK-MB was more pronounced in the experimental group (P<0.05). Compared with those in the group before treatment, the partial pressure of carbon dioxide increased in the experimental group for 3 d of treatment (P<0.05), and the standard alkali residual, actual alkali residual, standard bicarbonate concentration, and actual bicarbonate concentration increased in the experimental group for 7 d of treatment (P<0.05). Compared with that in the group before treatment, D-dimer decreased in the control group for 7 d of treatment (P<0.05). D-dimer and activated partial thromboplastin time (APTT) decreased in the experimental group for 3 d of treatment (P<0.05), and D-dimer, fibrinogen (FIB), and APTI significantly decreased in the group for 7 d of treatment (P<0.05). Compared with the group for 3 d of treatment, the experimental group for 7 d of treatment showed decreased FIB (P<0.05). Compared with those in the groups before treatment, the levels of inflammatory factors IL-4, IL-10, and IL-13 were elevated in the peripheral blood of the two groups after treatment, and the levels of B lymphocyte chemoattractant (BLC), interferon gamma-induced protein 10 (IP-10), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), monocyte chemoattractant protein-1 (MCP-1), CRP, IL-2, IL-6, IL-8, IL-17, IL-22, and IL-23p19 were significantly reduced (P<0.01). Compared with the control group after treatment, the experimental group exhibited more significant improvement in indexes above (P<0.01). ConclusionThe group treated by Ganluqingwen prescription combined with western medicine shows more significant effects on reducing total scores of TCM syndromes, lowering the ability of leukocyte and neutrophil counts, decreasing BLC, IP-10, TNF-α, IFN-γ, MCP-1, CRP, IL-2, IL-6, IL-8, IL-17, IL-22, and IL-23p19 in the peripheral blood of the patients, and elevating levels of IL-4, IL-10, and IL-13 than the group treated by western drugs alone.
10.Analysis of the current situation of occupational protection knowledge-attitude-practice of noise-exposed workers at an airport apron
Huimin YU ; Mei WANG ; Xuefei LIU ; Wanjun LI ; Li ZHANG ; Jun LIU ; Baoli LU
China Occupational Medicine 2025;52(1):56-60
Objective To analyze the current situation of the knowledge-attitude-practice among noise-exposed workers at an airport apron. Methods A total of 494 noise-exposed workers from an airport apron were selected as the study subjects using the judgmental sampling method. A self-designed "Occupational Protection Knowledge, Attitudes, and Practices Questionnaire" was used to assess the current situation of knowledge-attitude-practice on occupational protection. Results Regarding the awareness of noise hazards among the study subjects, the awareness rates of noise-induced impairment on digestive function and reproductive system were the lowest (44.9% and 37.7%, respectively). The awareness rate of noise-induced negative emotions increased with length of service (P<0.01). Regarding the occupational protection knowledge for noise, the awareness rate of occupational noise-induced deafness was “incurable” was the lowest (39.1%). The support rate for five kinds of occupational protection attitudes for noise was generally >85.0%, while only 58.3% of the study subjects consistently or frequently wearing earplugs during work. The most common source of noise hazard and protection knowledge was pre-employment training (76.9%), followed by occupational disease prevention and control campaigns (76.1%). Conclusion Noise-exposed workers in this airport apron have incomplete awareness of non-auditory system hazards caused by noise, and the awareness of knowledge of some occupational protection is relatively low. Although their attitudes toward occupational protection are positive, many workers still fail to consistently wear personal protective equipment at work.

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