Objective:To construct a structural equation model for neck work-related musculoskeletal disorders (WMSDs) in the footwear industry and analyze the mediating effect of fatigue in the model.Methods:From November 2018 to December 2019, stratified cluster sampling was adopted to select all the workers (3565 people) from 7 footwear enterprises in Fujian Province as the research subjects. The incidence of WMSDs, fatigue and work-related condition were investigated by using the Chinese version of the Musculoskeletal Disorders Questionnaire. A structural equation model of individual factors, work type, work posture, work organization factors, and fatigue on neck WMSDs was constructed to analyze the mediating effect of fatigue among them.Results:The incidence rate of WMSDs in the neck of footwear workers was 39.6% (1413/3565) , and the incidence rate of neck fatigue was 46.6% (1662/3565) .The final structural equation model was constructed with a χ2/ df of 9.927, a goodness-of-fit index of 0.961, an adjusted goodness-of-fit index of 0.946, and a root mean square error of approximation of 0.050. Except for the χ2/ df, all other fit indicators met the standard. Individual factors and work posture factors had a direct effect on neck WMSDs, with standardized path coefficients of 0.101 and 0.077, respectively ( P<0.05) . Individual factors, work type, work posture, and work organization had indirect effects on neck WMSDs through fatigue, the standardized path coefficients of indirect effects were 0.163, 0.090, 0.206, 0.105, respectively, and the standardized path coefficients of the total effect were 0.264, 0.090, 0.282, and 0.105 respectively ( P<0.05) . The indirect effects of individual factors and work posture factors on neck WMSDs through fatigue accounted for 61.74% and 73.05% of the total effects, respectively. The standardized path coefficient of fatigue on WMSDs was 0.689 ( P<0.001) , with the highest coefficient among all paths. Conclusion:Individual factors, work type, work posture, and work organization factors are important influencing factors in the occurrence and development of neck WMSDs in the footwear industry, and fatigue plays an important mediating role in them.

Objective To investigate the correlation between baseline plasma soluble triggering receptor expressed on myeloid cell-1(sTREM-1),steroid hormone cortisol and dehydroepiandrosterone(DHEA),immunoendocrine markers,and disease severity in patients with pulmonary tuberculosis(PTB).Methods From March 2020 to May 2022,76 PTB patients and 78 healthy controls were recruited.The plasma sTREM-1 levels were compared between controls and PTB patients.Plasma sTREM-1 and C-reactive protein(CRP),interleukin(IL)-6 and interferon(IFN)-y,erythrocyte sedimentation rate(ESR),steroid hormone cortisol and dehydroepiandrosterone(DHEA)were analyzed to correlate with inflammatory transcripts(IL-6,IFN-γ)in peripheral blood mononuclear cells.Results The sTREM,CRP,ESR,IL-6,IFN-γ,cortisol and cortisol/DHEA were significantly increased(P＜0.05)while DHEA was significantly decreased(P＜0.05)in PTB patients compared with the control group.Futhermore,severe PTB patients had higher sTREM-1 and ESR levels than mild and moderate PTB patients.Spearman correlation analysis showed that sTREM-1 was significantly positively correlated with CRP in all patients(P＜0.05).Only in patients with severe PTB,sTREM-1 was significantly positively correlated with cortisol/DHEA(P＜0.05),and significantly negatively correlated with DHEA(P＜0.05).Conclusions High plasma sTREM-1 levels may be an important factor contributing to the persistence of immunoendocrine imbalance specific to advanced disease in patients with PTB.

Objective:To evaluate the improvement effect of ergonomics in the assembly position of an automotive parts production company.Methods:From February to December 2023, the assembly positions and 8 operators of an automobile brake parts production company were selected as the research objects. The Swedish Ergonomic Hazard Identification Method and rapid upper limb assessment (RULA) were used to identify and evaluate the adverse ergonomic factors of work-related musculoskeletal disorders (WMSDs) in different parts of the body before and after the improvement. Through field investigation, observation and personnel interviews, three ergonomic problems were identified that need to be solved, namely, the height of the assembly table did not match the height of the operator, the storage space for small accessories was not set reasonably, and empty boxes were difficult to be placed. Technical improvements were made by designing an adjustable height assembly table, improving the layout of the workbench, and designing a mechanical pedal automation device. Statistical analysis was performed by t-test and paired rank sum test to evaluate the effectiveness of ergonomic improvements. Results:The operation of the assembly position could be divided into 13 actions, and the time to complete 1 cycle was (83.0±2.7) s. The Swedish Ergonomic Hazard Identification Method identified 28 adverse ergonomic factors of WMSDs in different parts before improvement, and 15 adverse ergonomic factors after improvement. Before ergonomics improvement, the RULA scores were 5 to 7 points, and the risk levels of 6 workers were Ⅳ (very high risk) and 2 workers were Ⅲ (moderate risk). After ergonomics improvement, the RULA score was 4 points, and the risk level was reduced to Ⅱ (low risk). Paired rank sum test results showed that there were statistically significant differences in upper arm, A-part (upper arm, lower arm and wrist) exertion and load, A-part muscle use, neck, total score, and risk level before and after improvement ( P<0.05). Per capita productivity of assembly post was (40.1±1.4) pieces/ (person·hour) before the improvement and (44.0±1.7) pieces/ (person·hour) after the improvement, the difference was statistically significant ( t=50.35, P<0.001) . Conclusion:The ergonomic improvement measures can reduce the adverse ergonomic factors in the assembly position of an automotive parts production company, reduce the risk of WMSDs, and improve the production efficiency.

Objective:To retrieve, evaluate and integrate the evidence related to postoperative exercise rehabilitation for hip fracture in elderly frail patients, and provide reference for clinical rehabilitation nursing.Methods:Evidence on postoperative exercise rehabilitation of hip fractures in elderly frail patients was systemically retrieved in the guideline websites, professional association websites and databases, such as BMJ Best Practice, UpToDate, PubMed, Web of Science, CINAHL, Cochrane Library, Embase, Chinese Biomedical Database, China National Knowledge Infrastructure, Wanfang and VIP, including Best practices, guidelines, clinical decisions, evidence summaries, systematic reviews, and expert consensus. The retrieval time was from the establishment of the database to March 31, 2024.Results:A total of 33 articles were involved, including 12 guidelines, 2 clinical decisions, 7 systematic reviews, 7 expert consensuses, 5 evidence summaries. Forty pieces of evidence were summarized in 7 aspects: the role of exercise, exercise assessment, exercise planning, exercise content, exercise intensity, exercise adherence, exercise nursing, exercise guidance.Conclusions:Healthcare professionals should combine patients' tolerance, rehabilitation goals, and specific clinical situations to target and guide patients in exercise rehabilitation to promote the recovery of postoperative limb function, mitigate frailty, and improve the quality of life.

Objective:To construct a structural equation model for neck work-related musculoskeletal disorders (WMSDs) in the footwear industry and analyze the mediating effect of fatigue in the model.Methods:From November 2018 to December 2019, stratified cluster sampling was adopted to select all the workers (3565 people) from 7 footwear enterprises in Fujian Province as the research subjects. The incidence of WMSDs, fatigue and work-related condition were investigated by using the Chinese version of the Musculoskeletal Disorders Questionnaire. A structural equation model of individual factors, work type, work posture, work organization factors, and fatigue on neck WMSDs was constructed to analyze the mediating effect of fatigue among them.Results:The incidence rate of WMSDs in the neck of footwear workers was 39.6% (1413/3565) , and the incidence rate of neck fatigue was 46.6% (1662/3565) .The final structural equation model was constructed with a χ2/ df of 9.927, a goodness-of-fit index of 0.961, an adjusted goodness-of-fit index of 0.946, and a root mean square error of approximation of 0.050. Except for the χ2/ df, all other fit indicators met the standard. Individual factors and work posture factors had a direct effect on neck WMSDs, with standardized path coefficients of 0.101 and 0.077, respectively ( P<0.05) . Individual factors, work type, work posture, and work organization had indirect effects on neck WMSDs through fatigue, the standardized path coefficients of indirect effects were 0.163, 0.090, 0.206, 0.105, respectively, and the standardized path coefficients of the total effect were 0.264, 0.090, 0.282, and 0.105 respectively ( P<0.05) . The indirect effects of individual factors and work posture factors on neck WMSDs through fatigue accounted for 61.74% and 73.05% of the total effects, respectively. The standardized path coefficient of fatigue on WMSDs was 0.689 ( P<0.001) , with the highest coefficient among all paths. Conclusion:Individual factors, work type, work posture, and work organization factors are important influencing factors in the occurrence and development of neck WMSDs in the footwear industry, and fatigue plays an important mediating role in them.

Objective To investigate the correlation between baseline plasma soluble triggering receptor expressed on myeloid cell-1(sTREM-1),steroid hormone cortisol and dehydroepiandrosterone(DHEA),immunoendocrine markers,and disease severity in patients with pulmonary tuberculosis(PTB).Methods From March 2020 to May 2022,76 PTB patients and 78 healthy controls were recruited.The plasma sTREM-1 levels were compared between controls and PTB patients.Plasma sTREM-1 and C-reactive protein(CRP),interleukin(IL)-6 and interferon(IFN)-y,erythrocyte sedimentation rate(ESR),steroid hormone cortisol and dehydroepiandrosterone(DHEA)were analyzed to correlate with inflammatory transcripts(IL-6,IFN-γ)in peripheral blood mononuclear cells.Results The sTREM,CRP,ESR,IL-6,IFN-γ,cortisol and cortisol/DHEA were significantly increased(P＜0.05)while DHEA was significantly decreased(P＜0.05)in PTB patients compared with the control group.Futhermore,severe PTB patients had higher sTREM-1 and ESR levels than mild and moderate PTB patients.Spearman correlation analysis showed that sTREM-1 was significantly positively correlated with CRP in all patients(P＜0.05).Only in patients with severe PTB,sTREM-1 was significantly positively correlated with cortisol/DHEA(P＜0.05),and significantly negatively correlated with DHEA(P＜0.05).Conclusions High plasma sTREM-1 levels may be an important factor contributing to the persistence of immunoendocrine imbalance specific to advanced disease in patients with PTB.

Objective:To retrieve, evaluate and integrate the evidence related to postoperative exercise rehabilitation for hip fracture in elderly frail patients, and provide reference for clinical rehabilitation nursing.Methods:Evidence on postoperative exercise rehabilitation of hip fractures in elderly frail patients was systemically retrieved in the guideline websites, professional association websites and databases, such as BMJ Best Practice, UpToDate, PubMed, Web of Science, CINAHL, Cochrane Library, Embase, Chinese Biomedical Database, China National Knowledge Infrastructure, Wanfang and VIP, including Best practices, guidelines, clinical decisions, evidence summaries, systematic reviews, and expert consensus. The retrieval time was from the establishment of the database to March 31, 2024.Results:A total of 33 articles were involved, including 12 guidelines, 2 clinical decisions, 7 systematic reviews, 7 expert consensuses, 5 evidence summaries. Forty pieces of evidence were summarized in 7 aspects: the role of exercise, exercise assessment, exercise planning, exercise content, exercise intensity, exercise adherence, exercise nursing, exercise guidance.Conclusions:Healthcare professionals should combine patients' tolerance, rehabilitation goals, and specific clinical situations to target and guide patients in exercise rehabilitation to promote the recovery of postoperative limb function, mitigate frailty, and improve the quality of life.

Objective:To evaluate the improvement effect of ergonomics in the assembly position of an automotive parts production company.Methods:From February to December 2023, the assembly positions and 8 operators of an automobile brake parts production company were selected as the research objects. The Swedish Ergonomic Hazard Identification Method and rapid upper limb assessment (RULA) were used to identify and evaluate the adverse ergonomic factors of work-related musculoskeletal disorders (WMSDs) in different parts of the body before and after the improvement. Through field investigation, observation and personnel interviews, three ergonomic problems were identified that need to be solved, namely, the height of the assembly table did not match the height of the operator, the storage space for small accessories was not set reasonably, and empty boxes were difficult to be placed. Technical improvements were made by designing an adjustable height assembly table, improving the layout of the workbench, and designing a mechanical pedal automation device. Statistical analysis was performed by t-test and paired rank sum test to evaluate the effectiveness of ergonomic improvements. Results:The operation of the assembly position could be divided into 13 actions, and the time to complete 1 cycle was (83.0±2.7) s. The Swedish Ergonomic Hazard Identification Method identified 28 adverse ergonomic factors of WMSDs in different parts before improvement, and 15 adverse ergonomic factors after improvement. Before ergonomics improvement, the RULA scores were 5 to 7 points, and the risk levels of 6 workers were Ⅳ (very high risk) and 2 workers were Ⅲ (moderate risk). After ergonomics improvement, the RULA score was 4 points, and the risk level was reduced to Ⅱ (low risk). Paired rank sum test results showed that there were statistically significant differences in upper arm, A-part (upper arm, lower arm and wrist) exertion and load, A-part muscle use, neck, total score, and risk level before and after improvement ( P<0.05). Per capita productivity of assembly post was (40.1±1.4) pieces/ (person·hour) before the improvement and (44.0±1.7) pieces/ (person·hour) after the improvement, the difference was statistically significant ( t=50.35, P<0.001) . Conclusion:The ergonomic improvement measures can reduce the adverse ergonomic factors in the assembly position of an automotive parts production company, reduce the risk of WMSDs, and improve the production efficiency.

Objective:To investigate the effects of evidence-based precision nursing in patients with sarcopenia undergoing total knee arthroplasty (TKA) .Methods:By convenience sampling, totally 41 TKA patients with sarcopenia treated in the Department of Orthopedics at The First Affiliated Hospital of Zhengzhou University from August 2021 to February 2022 were selected as the control group, and 41 TKA patients with sarcopenia treated from March 2022 to March 2023 as the observation group. Patients in the control group received conventional nursing care, while patients in the observation group received an evidence-based precision nursing plan. The differences in muscle mass, grip strength, physical activity ability, knee joint function, and quality of life between the two groups before and after the intervention were compared.Results:After the intervention, the total muscle mass, affected limb skeletal muscle mass, limb skeletal muscle mass, limb skeletal muscle mass index, and grip strength in the observation group were significantly higher than those in the control group ( P< 0.05). The scores on the Short Physical Performance Battery, Lysholm Score, and Sarcopenia Quality of Life Scale in the observation group were also significantly higher than those in the control group ( P<0.05) . Conclusions:Evidence-based precision nursing can improve postoperative muscle mass and strength, enhance physical activity ability and joint function, and improve the quality of life in TKA patients with sarcopenia.

Mammalian teeth,developing inseparable from epithelial-mesenchymal interaction,come in many shapes and the key factors governing tooth morphology deserve to be answered.By merging single-cell RNA sequencing analysis with lineage tracing models,we have unearthed a captivating correlation between the contrasting morphology of mouse molars and the specific presence of PRX1+cells within M1.These PRX1+cells assume a profound responsibility in shaping tooth morphology through a remarkable divergence in dental mesenchymal cell proliferation.Deeper into the mechanisms,we have discovered that Wnt5a,bestowed by mesenchymal PRX1+cells,stimulates mesenchymal cell proliferation while orchestrating molar morphogenesis through WNT signaling pathway.The loss of Wnt5a exhibits a defect phenotype similar to that of siPrx1.Exogenous addition of WNT5A can successfully reverse the inhibited cell proliferation and consequent deviant appearance exhibited in Prx1-deficient tooth germs.These findings bestow compelling evidence of PRX1-positive mesenchymal cells to be potential target in regulating tooth morphology.