Objective To report a case of urethral stricture, bladder stones and right ureteral stones in a patient with bilateral lower limb paralysis treated with innovative ureteral flexible endoscopic lithotripsy through cystostomy, so as to provide a new therapeutic approach for such complex cases.Case Report The patient, a 63-year-old male, was admitted due to fever for 45 days.He had been paraplegic in both lower limbs for 19 years and underwent cystostomy 2 years ago at another hospital. Abdominal computed tomography (CT) revealed right ureteral calculi complicated with multiple bladder stones.After adequate anti-infective therapy, cystoscopy was performed, during which complete posterior urethral atresia was identified.A flexible ureteral lithotripsy via the cystostomy site was successfully completed, with favorable therapeutic outcomes.On day 23 postoperatively, a follow-up plain radiograph of the urinary tract showed that the ureteral stent was in good position, with only a small number of residual stones in the prostatic fossa and no other stone remnants.Conclusion This provides a novel minimally invasive treatment approach for ureteral stones in patients who cannot undergo ureteroscopic intervention.

Objective To analyze the factors influencing occupational health literacy (OHL), work-related musculoskeletal disorders (WMSDs), and occupational stress in medical staff, and to investigate the potential associations between OHL and WMSDs as well as occupational stress. Methods A total of 880 medical staff members from 18 medical institutions were selected as the study subjects using a probability proportional method. Data on OHL, WMSDs, and occupational stress were investigated using the National Key Populations Occupational Health Literacy Surveillance Individual Questionnaire (including the Musculoskeletal Disorders Questionnaire and the Core Occupational Stress Scale), and the influencing factors and potential relationships were analyzed. Results The OHL level was 63.1%, the prevalence of WMSDs was 88.1%, and the detection rate of occupational stress was 24.0% in the study subjects. Multivariable logistic regression analysis showed that female medical staff had lower OHL levels than males (P<0.05). Medical staff with higher education levels and those working in higher-level medical institutions had higher OHL levels (all P<0.05). Medical staff working >40-<49 hours per week and those working ≥49 hours per week had higher OHL levels than those working ≤40 hours per week (all P<0.01). Medical staff with higher education levels or longer working hours had a higher risk of WMSDs (all P<0.05). Medical staff with lower monthly personal income, longer weekly working hours, and lower OHL levels had a higher risk of occupational stress (all P<0.05), and those working night shifts had a higher risk of occupational stress than those who did not (P<0.01). Conclusion The study participants had a relatively high level of OHL, a high prevalence of WMSDs, and a low detection rate of occupational stress. It is recommended that medical institutions effectively implement occupational health promotion and support measures to improve the OHL level of medical staff, to reduce the risk of WMSDs and occupational stress.

Objective:To investigate the level of occupational health literacy (OHL) among workers in the electronic manufacturing industry, analyze the influencing factors, and provide a scientific basis for occupational health promotion work.Methods:From July to September 2022, a stratified cluster random sampling method was adopted, and 870 workers from 20 large, medium, small and micro electronic manufacturing enterprises in Guangdong Province were selected as the research subjects. The OHL level of workers was investigated by using the "Personal Questionnaire for Monitoring and Surveying Occupational Health Literacy of National Key Populations", and the influencing factors were analyzed by binary logistic regression.Results:The OHL level of workers in electronic manufacturing industry was 36.09% (314/870). The OHL levels in the four dimensions of occupational health legal knowledge, basic knowledge of occupational health protection, healthy work methods and behaviors, and basic skills of occupational health protection were 39.08% (340/870), 78.97% (687/870), 56.55% (492/870), and 22.41% (195/870), respectively. logistic regression analysis showed that junior high school, senior high school/vocational high school/technical secondary school education, and average monthly income of 5000-6999 yuan and ≥7000 yuan were protective factors for high OHL levels among workers ( P<0.05) . Conclusion:The OHL level of workers in the electronic manufacturing industry is relatively low, and the promotion and intervention of OHL should be actively carried out to effectively improve the health literacy level of workers, focusing on workers with low education and low income.

Objective:To investigate the prevalence and influencing factors of depression,anxiety and comorbid depression-anxiety symptoms among college freshmen,providing a theoretical basis for promoting their mental health.Methods:From Jan to Feb 2022,an online questionnaire survey was conducted,involving 483 online questionnaires from college freshmen(184 males,299 females).The depression-anxiety-stress self-rating scale,smartphone dependence self-rating scale for adolescents,and Pittsburgh sleep quality index(PSQI)were used for online surveys.The influencing factors of depression,anxiety,and their comorbidity among college freshmen were analyzed by multivariable logistic regression analysis.Results:The detection rates of smartphone dependence,sleep disorders,depression,anxiety and comorbid depression-anxiety symptoms among college freshmen were 26.1%,12.8%,26.3%,32.1%,and 23.6%,respectively.The detection rates of depression,anxiety and comorbid depression-anxiety symptoms in male students were significantly higher than those in female students(P＜0.05).Multivariable logistic regression analysis showed that self-perceived poor mental health,smartphone dependence and sleep disorders were risk factors for depression,anxiety and comorbid depression-anxiety symptoms.Low satisfaction with college life was a risk factor for depression.Medical specialty was a risk factor for anxiety and comorbid depression-anxiety symptoms(P＜0.05).Conclusions:Male college freshmen show higher rates of depression,anxiety,and their comorbidity.Low satisfaction with college life,self-perceived poor mental health,high academic pressure,smartphone dependence,medical specialty,and sleep disorders may be risk factors for depression,anxiety and comorbid depression-anxiety symptoms among college freshmen.

Objective:To investigate the level of occupational health literacy (OHL) among workers in the electronic manufacturing industry, analyze the influencing factors, and provide a scientific basis for occupational health promotion work.Methods:From July to September 2022, a stratified cluster random sampling method was adopted, and 870 workers from 20 large, medium, small and micro electronic manufacturing enterprises in Guangdong Province were selected as the research subjects. The OHL level of workers was investigated by using the "Personal Questionnaire for Monitoring and Surveying Occupational Health Literacy of National Key Populations", and the influencing factors were analyzed by binary logistic regression.Results:The OHL level of workers in electronic manufacturing industry was 36.09% (314/870). The OHL levels in the four dimensions of occupational health legal knowledge, basic knowledge of occupational health protection, healthy work methods and behaviors, and basic skills of occupational health protection were 39.08% (340/870), 78.97% (687/870), 56.55% (492/870), and 22.41% (195/870), respectively. logistic regression analysis showed that junior high school, senior high school/vocational high school/technical secondary school education, and average monthly income of 5000-6999 yuan and ≥7000 yuan were protective factors for high OHL levels among workers ( P<0.05) . Conclusion:The OHL level of workers in the electronic manufacturing industry is relatively low, and the promotion and intervention of OHL should be actively carried out to effectively improve the health literacy level of workers, focusing on workers with low education and low income.

Objective To evaluate the efficacy rebound of congenital auricle deformation after noninvasive cor-rection of EarWell and study the environmental factors that may affect the occurrence of the disease.Methods ① A total of 86 children diagnosed with congenital auricle deformation in the First Hospital of Jilin University were se-lected as the treatment group(treated with EarWell),and the rebound after treatment was compared among differ-ent age groups(group A:3-7 days,31 ears,group B:8-42 days,59 ears,group C:＞42 days,33ears).② 77 chil-dren with normal auricle with similar age were selected as the control group,and the relevant information of the two groups of children was collected by questionnaire survey to analyze the risk factors that may affect the occurrence of the disease.Results ① A total of 13.0％of deformed ears developed rebound,with about 81.3％occurring within three months after the end of treatment.The rebound rate of group C was higher than those of groups A and B(P＜0.001),and there was no significant difference between groups A and B(P＞0.05).② Compared with the con-trol group,the parents in the treatment group were older at birth,the incidence of smoking of the father,abortion of the mother,hypertension and anemia of pregnancy was higher,and the incidence of folic acid supplementation and cesarean section of the mother was lower(P＜0.05).Multivariate logistic regression model analysis showed that paternal age(OR=1.58,P=0.003),hypertension during pregnancy(OR=4.39,P=0.004),and anemia during pregnancy(OR=3.72,P=0.005)were independent risk factors for congenital auricle deformation.Folic acid sup-plementation for mothers(OR=0.44,P=0.049)and cesarean section(OR=0.35,P=0.008)were the protective factors.Conclusion The rebound of congenital auricular deformation after non-invasive correction mostly occurred within three months after treatment,and the rebound rate of deformed ear with children of age greater than 42 days was higher.Moreover,its occurrence may be related to the age of the father,whether the mother regularly supple-ments folic acid,the mode of production,whether have hypertension or anemia during pregnancy.

Objective To investigate the levels of serum adrenomedullin precursor(pro-ADM),soluble leukocyte differentiation antigen 14 subtype(presepsin),and eosinophil chemotactic factor-1(Eotaxin-1)in patients with acute stroke(AS)complicated with pulmonary infection and their relationship with prognosis.Methods A total of 146 patients with AS admitted to the hospital from January 2022 to January 2024 were selected as the research subjects.According to whether the research subjects were complicated with pulmonary infection,they were divided into the infection group with 54 cases and the non-infection group with 92 cases.In addition,100 healthy individuals who underwent physical examinations in the hospital during the same period were selected as the control group.The prognosis of patients was evaluated using the modified Rankin scale score,which was divided into good prognosis and poor prognosis.The levels of serum pro-ADM,presepsin,Eotaxin-1 and C-reactive protein(CRP)were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze the influencing factors of AS complicated with pulmonary infection,and the receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum CRP,pro-ADM,presepsin,and Eotaxin-1 levels for patients with AS complicated with pulmonary infection.Compare the levels of serum pro-ADM,presepsin and Eotaxin-1 in patients with different prognoses.The rela-tionship between the levels of serum pro-ADM,presepsin and Eotaxin-1 and the prognosis of patients was ana-lyzed by the Kaplan-Meier method.Results The levels of smoking history and serum CRP,pro-ADM,presep-sin,and Eotaxin-1 in the infection group were higher than those in the non-infection group and the control group,and the difference was statistically significant(P<0.05).The results of multivariate Logistic regres-sion analysis showed that the levels of serum CRP,pro-ADM,presepsin and Eotaxin-1 were the influencing factors of AS complicated with pulmonary infection(P<0.05).The results of the ROC curve analysis show that the area under the curve(AUC)of the combined diagnosis of AS complicated with pulmonary infection by serum pro-ADM,presepsin and Eotaxin-1 levels was higher than AUC of the individual diagnosis of CRP,pro-ADM,presepsin and Eotaxin-1(Z=3.921,2.445,2.825,3.076,P<0.05).The levels of serum pro-ADM,presepsin and Eotaxin-1 in patients with poor prognosis were higher than those in patients with good progno-sis,and the difference was statistically significant(P<0.05).The results of survival analysis by the Kaplan-Meier method showed that the survival rate of patients with high expression of serum pro-ADM,presepsin,and Eotaxin-1 was lower than that of patients with low expression(P<0.05).Conclusion The levels of ser-um pro-ADM,presepsin and Eotaxin-1 in patients with AS complicated with pulmonary infection are related to their prognosis.

Azvudine and nirmatrelvir/ritonavir (Paxlovid) are recommended for COVID-19 treatment in China, but their safety and efficacy in the elderly population are not fully known. In this multicenter, retrospective, cohort study, we identified 5131 elderly hospitalized COVID-19 patients from 32,864 COVID-19 patients admitted to nine hospitals in Henan Province, China, from December 5, 2022, to January 31, 2023. The primary outcome was all-cause death, and the secondary outcome was composite disease progression. Propensity score matching (PSM) was performed to control for confounding factors, including demographics, vaccination status, comorbidities, and laboratory tests. After 2:1 PSM, 1786 elderly patients receiving azvudine and 893 elderly patients receiving Paxlovid were included. Kaplan-Meier and Cox regression analyses revealed that compared with Paxlovid group, azvudine could significantly reduce the risk of all-cause death (log-rank P = 0.002; HR: 0.71, 95% CI: 0.573-0.883, P = 0.002), but there was no difference in composite disease progression (log-rank P = 0.52; HR: 1.05, 95% CI: 0.877-1.260, P = 0.588). Four sensitivity analyses verified the robustness of above results. Subgroup analysis suggested that a greater benefit of azvudine over Paxlovid was observed in elderly patients with primary malignant tumors (P for interaction = 0.005, HR: 0.32, 95% CI: 0.18-0.57) compared to patients without primary malignant tumors. Safety analysis revealed that azvudine treatment had a lower incidence of adverse events and higher lymphocyte levels than Paxlovid treatment. In conclusion, azvudine treatment is not inferior to Paxlovid treatment in terms of all-cause death, composite disease progression and adverse events in elderly hospitalized COVID-19 patients.

Objective To evaluate the efficacy rebound of congenital auricle deformation after noninvasive cor-rection of EarWell and study the environmental factors that may affect the occurrence of the disease.Methods ① A total of 86 children diagnosed with congenital auricle deformation in the First Hospital of Jilin University were se-lected as the treatment group(treated with EarWell),and the rebound after treatment was compared among differ-ent age groups(group A:3-7 days,31 ears,group B:8-42 days,59 ears,group C:＞42 days,33ears).② 77 chil-dren with normal auricle with similar age were selected as the control group,and the relevant information of the two groups of children was collected by questionnaire survey to analyze the risk factors that may affect the occurrence of the disease.Results ① A total of 13.0％of deformed ears developed rebound,with about 81.3％occurring within three months after the end of treatment.The rebound rate of group C was higher than those of groups A and B(P＜0.001),and there was no significant difference between groups A and B(P＞0.05).② Compared with the con-trol group,the parents in the treatment group were older at birth,the incidence of smoking of the father,abortion of the mother,hypertension and anemia of pregnancy was higher,and the incidence of folic acid supplementation and cesarean section of the mother was lower(P＜0.05).Multivariate logistic regression model analysis showed that paternal age(OR=1.58,P=0.003),hypertension during pregnancy(OR=4.39,P=0.004),and anemia during pregnancy(OR=3.72,P=0.005)were independent risk factors for congenital auricle deformation.Folic acid sup-plementation for mothers(OR=0.44,P=0.049)and cesarean section(OR=0.35,P=0.008)were the protective factors.Conclusion The rebound of congenital auricular deformation after non-invasive correction mostly occurred within three months after treatment,and the rebound rate of deformed ear with children of age greater than 42 days was higher.Moreover,its occurrence may be related to the age of the father,whether the mother regularly supple-ments folic acid,the mode of production,whether have hypertension or anemia during pregnancy.

Objective To explore the association between long working hours, anxiety symptoms, and insomnia symptoms among footwear industry workers, and to examine the mediating effect of anxiety symptoms between long working hours and insomnia symptoms. Methods A total of 710 workers from 15 footwear manufacturing enterprises in Guangdong Province were selected as study subjects using a stratified random sampling method. Long working hours, anxiety symptoms, and insomnia symptoms among the workers were assessed using the National Key Population Occupational Health Literacy Monitoring Questionnaire, the Chinese version of the Generalized Anxiety Disorder Self-Rating Scale, and the Self-Rating Sleep Questionnaire. Binary logistic regression was applied to analyze the associations of long working hours and anxiety symptoms with insomnia symptoms, and a mediation effect model was used to examine the mediating role of anxiety symptoms. Results The workers with long working hours accounted for 69.6% of participants. The detection rates of anxiety symptoms and insomnia symptoms were 17.0% and 20.7% in these workers, respectively. Binary logistic regression analysis showed that both long working hours and anxiety symptoms were influencing factors for insomnia symptoms (both P<0.01). Mediation analysis indicated that long working hours had a direct effect on insomnia symptoms, accounting for 67.9% of the total effect. Anxietysymptoms played a partial mediating role between long working hours and insomnia symptoms, with an effect value of 0.18 (95% confidence interval 0.07-0.30, P<0.01), accounting for 32.1% of the total effect. Conclusion Both long working hours and anxiety symptoms are influencing factors for insomnia symptoms among the footwear industry workers, and anxiety symptoms partially mediate the impact of long working hours on insomnia symptoms.