Background Work-related musculoskeletal disorders (WMSDs) are a major occupational health concern, particularly among workers exposed to adverse ergonomic conditions. Manganese production involves heavy physical demands, yet research on WMSDs among manganese workers remains limited. Objective To investigate the prevalence and influencing factors of WMSDs among manganese workers in a manganese enterprise in Guangxi. Methods A cross-sectional survey was conducted from May to June 2024 on workers at a manganese factory in Guangxi. The Chinese Musculoskeletal Disorders Questionnaire was used to collect information on demographic characteristics, distribution of musculoskeletal symptoms, and work-related exposures. χ² test was applied to compare differences in positive WMSDs rates across groups, and logistic regression analysis was performed to identify associated factors. Results A total of 1476 workers were enrolled in the study after pre-determined inclusion and exclusion criteria. The overall prevalence of WMSDs was 34.15%. The most commonly affected body regions were the lower back (17.28%), neck (16.67%), and shoulders (13.82%). The results of logistic regression analysis indicated that female, older age, and education level of college or above were associated with a higher risk of WMSDs (P<0.05). Awkward working postures were significantly associated with WMSDs in corresponding body regions; in particular, awkward postures of the neck, upper limbs, trunk, and lower limbs were related to an increased risk of WMSDs in multiple body sites (P<0.05). In addition, poor lighting conditions, high workplace temperature, frequent or sustained arm support during work, and high job demands were associated with an increased risk of overall or site-specific WMSDs (P<0.05). Conclusion The high prevalence of WMSDs among manganese workers is closely associated with demographic characteristics, working postures, and work environment and organizational factors. Targeted ergonomic interventions focusing on high-risk body regions and key ergonomic exposures are warranted to reduce the risk of WMSDs among manganese workers.

ObjectiveTo explore the application of virtual reality biofeedback training combined with oral localization therapy in dysphagia after oral cancer surgery. MethodsFrom May, 2023 to July, 2024, 86 patients with dysphagia after oral cancer surgery in Zhejiang Provincial People's Hospital were randomly divided into control group (n = 43) and experimental group (n = 43). The control group received conventional swallowing function training, while the experimental group added virtual reality biofeedback training combined with oral positioning therapy, for four weeks. The Standardized Swallowing Function Assessment Scale (SSA), Functional Oral Intake Scale (FOIS) and M.D.Anderson Dysphagia Inventory (MDADI) were used for evaluation before intervention, and two weeks, four weeks and eight weeks after intervention. ResultsFor scores of SSA , the main effects of group (F = 150.190, P < 0.001, η²_p = 0.641) and time (F = 230.870, P < 0.001, η²_p = 0.733), as well as the interaction effect (F = 16.910, P < 0.001, η²_p = 0.168) were all significant. For scores of FOIS, the main effects of group (F = 59.601, P < 0.001, η²_p = 0.415) and time (F = 89.464, P < 0.001, η²_p = 0.516), as well as the interaction effect (F = 7.990, P < 0.001, η²_p = 0.087) were all significant. For scores of MDADI, the main effects of group (F = 33.133, P < 0.001, η²_p = 0.283) and time (F = 49.650, P < 0.001, η²_p = 0.371), as well as the interaction effect (F = 3.224, P = 0.023, η²_p = 0.037) were all significant. ConclusionVirtual reality biofeedback training combined with oral localization therapy could improve the swallowing function, oral feeding ability and overall quality of life of patients with dysphagia after oral cancer surgery.

To summarize the nursing experience of a patient infected with human parvovirus B19 induced epilepsy after double lung transplantation.The contents of nursing care were as follows:improving the early recognition of epileptic seizures and emergency response efficiency;implementing accurate assessment to master the best time for first aid;paying attention to the fear of epilepsy after lung transplantation,and implementing a matching exercise management program.Dynamic management of anti-rejection drugs and antiepileptic drugs were used to prevent adverse reactions;multipronged infection prevention measures were implemented to reduce the risk of transmission;psychological support and counseling should be paid attention to improve the treatment confidence and compliance of patients and their families.After careful treatment and nursing care,the patient recovered and was discharged 50 days after operation,and was followed up for 8 months with good recovery.

Objective To analyze the disability level and long-term care needs assessment policies issued by 49 pilot cities in China's long-term care insurance system,providing insights for further improvement of the system.Methods Policy documents related to long-term care insurance,published between June 2016 and December 2024 on official platforms of local governments,the Ministry of Human Resources and Social Security,the National Healthcare Security Administration,and the National Public Service Platform for Standards Information,were retrieved.A comparative analysis was used to summarize and compare the content of these policy texts.Results Currently,there are 49 pilot cities implementing the long-term care insurance system in China.47 cities have issued disability level assessment standards,with 38 cities adopting the trial standards issued by the National Healthcare Security Administration.In 42 pilot cities,the disability level assessment includes indicators such as activities of daily living,cognitive function,and sensory and communication abilities.22 cities have issued policies related to care needs assessment.In most cities,the care needs assessment partially or fully includes indicators from the disability level assessment.Conclusion There is no national uniformity in disability level assessment standards,and the care needs assessment framework needs further improvement.It is recommended to standardize disability level assessment criteria,clearly delineate the boundaries and content of disability level and care needs assessments,and enhance the development of the care needs assessment system.

OBJECTIVE To identify Bupleurum chinense pieces and its counterfeits based on the characteristic chromatogram and UPLC-Q-TOF/MS technology.METHODS Thin layer chromatography was used to identify Bupleurum chinense and its counterfeits collected from different origins and different producing areas.Then,the chemical constituents of Bupleurum chinense and its counter-feits were compared according to the established HPLC characteristic chromatogram,and the representative differential markers of Bup-leurum chinense counterfeits were further identified by UPLC-Q-TOF/MS technology.RESULTS Thin layer chromatography showed that different original Bupleurum chinense pieces had saikosaponin A and saikosaponin D,which could be distinguished according to the intensity and position of fluorescent spots.There were 14 and 16 common peaks in the specific chromatogram of Bupleurum chinense and its vinegar-processed products respectively,and 6 components were identified.The chemical components of Bupleurum chinense pieces from different producing areas were similar,and the established method could better reflect the characteristics of Bupleurum chinense.Further comparison of the specific chromatogram of Bupleurum chinense and its counterfeits showed that the composition of B.marginatum Wall.was close to that of the authentic Bupleurum chinense.,B.bicaule Helm and B.longiradiatum Turcz.had their own characteristic peaks with high response values.The content of saponins in B.marginatum var.stenophyllum was significantly high-er.A total of 69 Bupleurum compounds were identified by UPLC-Q-TOF/MS mainly triterpenoid saponins,followed by flavonoids,a few chromones,phenylpropanoids and alkynes.The results of cluster analysis showed that the interspecific differences of Bupleurum chinense were obvious,and different Bupleurum counterfeits had representative differential markers.CONCLUSION The established characteristic chromatogram and UPLC-Q-TOF/MS method can be used for the chemical identification of Bupleurum chinense and its counterfeits,which provide a basis for the comprehensive and rational development and utilization of Bupleurum resources.

This study was aimed at preliminarily investigating the molecular biological functions of the PPE65 protein from Myco-bacterium tuberculosis,and providing foundational data for tuberculosis prevention and control.The basic biological properties of the PPE65 gene-encoded protein were predicted with bioinformatics tools.Sequence information for the Mycobacterium tuberculosis Rv3621c gene and PPE65 protein was retrieved from the NCBI database.The Rv3621c gene was amplified through PCR with the H37Rv genome as a template,then cloned into the pET22b(+)expression vector.The recombinant pET22b(+)-PPE65 plasmid was transformed into Escherichia coli BL21(DE3)competent cells for IPTG-induced expression.Solubility analysis,purification,and identification of the recombinant PPE65 protein were performed.BEAS-2B cells were treated with various concentrations of PPE65 protein for 24 h,and cell proliferation was assessed with CCK-8 assays.PPE65 was found to be composed of 413 amino acids and to have a molecular formula of C????H????N???O???S??,a relative molecular mass of 40 679.88,a theoretical isoelectric point of 4.60,an ali-phatic index of 81.94,and an average hydrophilicity value of 0.319,thus indicating a stable hydrophobic protein lacking signal pep-tides or transmembrane domains.Secondary structure analysis revealed 53.03%α-helix(Hh),2.66%β-sheet(Ee),and 44.31%ran-dom coil(Cc).Bioinformatics predictions identified 38 B-cell epitopes and 22 CTL/Th-cell epitopes.The full-length PPE65 gene(1 308 bp)was confirmed through double restriction enzyme digestion and sequencing,thereby validating the correct construction of the pET22b(+)-PPE65 recombinant plasmid.SDS-PAGE analysis demonstrated that the recombinant protein was found in inclusion bodies,and a single band at 43.7 kDa was observed after purification.Western blotting revealed specific binding to mouse-derived His monoclonal antibodies,thereby confirming successful expression of the PPE65 protein.BEAS-2B cells treated with a PPE65 protein concentration gradient(2.5-20 μg/mL)exhibited a dose-dependent increase in cell number.Compared with those in the PBS control group,TGF-β relative expression levels were significantly higher in all treatment groups(t2.5=4.893,P<0.001,t5.0=4.640,P<0.05,t10=7.535,P<0.05,t20=16.44,P<0.000 1).This study elucidated the structural characteristics of the PPE65 protein,successfully obtained the recombinant protein through prokaryotic expression and purification,and demonstrated its ability to promote BEAS-2B cell proliferation.The underlying mechanism might involve suppression of TGF-β/S mad signaling pathway activation.These findings provide a theoretical basis for understanding the role and regulatory mechanisms of PPE65 during M.tuberculosis infection.

Objective To explore the relationship between serum phospholipase A2(PLA2),S100 calcium-binding protein B(S100B) and carotid plaque in elderly patients with acute progressive cerebral infarction. Methods From January 2021 to June 2022,120 elderly patients with acute progressive cerebral infarction were enrolled in the study group,while 115 patients with non-progressive cerebral infarction were classified as non-progressive group and 100 healthy people as healthy group. The study group was divided into three groups:no plaque group (34 cases),stable plaque group (45 cases) and unstable plaque group (41 cases). To analyze the relationship between serum PLA2 and S100B levels and carotid plaque. ROC analysis of their predictive value for carotid plaque. Follow-up for 1 year,the survival rate was analyzed with recurrence and death as the end points. Results The levels of serum PLA2 and S100B in stable and unstable plaque groups were higher than those in non-plaque group,and the difference was statistically significant (P<0.05). Serum PLA2 and S100B were positively correlated with carotid plaque. ROC showed that the value of joint prediction was higher (P<0.05). Conclusion The levels of serum PLA2 and S100B are increased in elderly patients with acute progressive cerebral infarction,which is closely related to carotid plaque.

Objective:To study the effect of anti-melanoma differentiation-related gene 5(MDA5) antibody positive dermatomyositis on the heart of patients.Methods:A total of 71 patients with dermatomyositis diagnosed in Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 1, 2014 to December 31, 2019 were enrolled as the sample group, including anti-MDA5 (+) group( n=28); anti-MDA5(-) groups( n=43). Electrocardiogram and echocardiography were performed in the sample group and the control group. The electrocardiogram, echocardiography and other relevant clinical data of the anti-MDA5 (+) group, anti-MDA5 (-) group and the healthy control group were retrospectively analyzed. The logistic regression analysis model was used to analyze the related factors influencing cardiac involvement in anti-MDA5 (+) patients. Results:In the anti-MDA5 (+) group, more than half of the patients showed elevated levels of lactate dehydrogenase (21/28, 75%) and α-hydroxybutyrate dehydrogenase (16/28, 57%), and 11%(3/28) showed elevated levels of creatine kinase isoenzyme and myoglobin. Compared with the anti-MDA5 (-) group, the white blood cell count in the blood routine of the anti-MDA5 (+) group [5.2 (4.0, 6.5) ×10 9/L vs. 7.8 (5.6, 10.6)×10 9/L, Z=-3.447, P=0.001], creatine kinase [62.5 (29.3, 108.3) U/L vs. 481.0 (179.0, 2 738.0) U/L, Z=-5.895, P<0.001], lactate dehydrogenase [313.0 (239.0, 362.0) U/L vs. 448.0 (291.0, 542.0) U/L, Z=-3.236, P<0.001], creatine kinase isoenzyme [1.9 (1.1, 3.9)ng/ml vs. 17.7 (4.0, 67.2) ng/ml, Z=-4.724, P<0.001], myoglobin [28.2 (20.0, 43.0) ng/ml vs. 307.4 (48.1, 612.2) ng/ml, Z=-4.800, P<0.001]. Electrocardiogram analysis showed that QRS axis [33.5±265.9 vs. 46.9±22.4, t=-2.900, P=0.004], SV1 amplitude [0.7 (0.4, 0.9) vs. 0.9 (0.7, 1.0), Z=-2.148, P=0.023] in anti-MDA5 antibody (+) group in anti-MDA5 antibody (+) group were lower than anti-MDA5 antibody (-) group. QRS duration [84.0 (78.0, 96.5) vs.92.0 (87.8, 100.5), Z=-2.900, P=0.004], QRS axis [33.5±265.9 vs. 46.9±20.4, Z=-2.32, P=0.023] in the anti-MDA5 antibody (+) group were lower than those in healthy control group. Echocardiographic analysis showed that the E peak of anti-MDA5 (+) group [63.0 (52.5, 69.5)] was significantly lower than that of anti-MDA5 (-) group [85.0 (68.0, 108.0), Z=-4.926, P<0.001)]and healthy control group [67.0 (62.8, 80.3), Z=-2.897, P=0.004]. The peak A of anti-MDA5 (+) group [65.5 (56.5, 80.0)] was significantly lower than that of anti-MDA5 (-) group [76.0 (65.0, 90.0), Z=-2.631, P=0.011], but higher than that of healthy control group [55.0(51.0, 66.5), Z=-4.550, P<0.001]. There was no significant difference in echocardiographic findi-ngs among the other groups. All patients with anti-MDA5 (+) dermatomyositis had interstitial lung disease (28/28, 100%). Patients with MDA5 antibody (+++) are more likely to have cardiac involvement than patients with MDA5 antibody (++). Conclusion:The results of relevant examinations in anti-MDA5-DM patients suggest that there is damage to myocardial cells and cardiac function.

Aim To explore the effects of exercise during pregnancy on renal structure,function and angiotensin Ⅱ(Ang Ⅱ)/transforming growth factor-β1(TGF-β1)/connective tissue growth factor(CTGF)signaling pathway in 3-month-old offspring of spontaneously hypertensive rats(SHR),the aim of this study was to provide experimental basis for early intervention of hypertension and protection of key target organs.Methods After mating SHR and WKY rats,pregnant rats were randomly divided into sedentary group(p-WKY-SED,p-SHR-SED)and exercise group(p-WKY-EX,p-SHR-EX).Blood pressure,serum urea nitrogen and creatinine were measured by caudal artery non-invasive blood pressure system and colorimetry in 3-month-old offspring rats.HE staining,Masson staining,ELISA and Western blot were used to detect the renal structure,collagen volume fraction,Ang Ⅱ concentration,renin-angiotension-aldosterone sys-tem(RAAS)and protein expression related to fibrogenic signal pathway in 3-month-old rats.Results(1)The sys-tolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP)of offspring rats in p-SHR-SED group were significantly higher than those in p-WKY-SED group.The SBP,DBP and MAP of SHR male off-spring rats were significantly decreased by exercise during pregnancy(P＜0.05),but had no effect on the female offspring rats(P＞0.05).(2)There was no significant difference in serum urea nitrogen and creatinine among the groups(P＞0.05).(3)The glomerular volume and the collagen volume fraction in p-SHR-SED group were significantly higher than those in p-WKY-SED group(P＜0.05),and the glomerular volume and the collagen volume fraction in p-SHR-EX group were significantly lower than those in p-SHR-SED group(P＜0.05).(4)Renal Ang Ⅱ level of offspring rats in p-SHR-SED group was significantly higher than that in p-WKY-SED group,and renal Ang Ⅱ level of offspring rats in p-SHR-EX group was significantly lower than that in p-SHR-SED group(P＜0.05).(5)The expression levels of angiotensin Ⅱ type 1 receptor(AT1R),TGF-β1 and CTGF protein in p-SHR-SED group were significantly higher than those in p-WKY-SED group(P＜0.05),while the expression levels of angiotensin converting enzyme 2(ACE2),angiotensin Ⅱ type 2 receptor(AT2R)and MasR protein in p-SHR-SED group were significantly lower than those in p-WKY-SED group(P＜0.05).Conclusion(1)Exercise during pregnancy can significantly decrease the blood pressure of 3-month-old male offspring rats of hypertensive rats,but has no significant effect on that of 3-month-old female offspring.(2)Exercise during preg-nancy may reduce renal fibrosis in 3-month-old female/male offspring of hypertensive rats by regulating RAAS balance and inhibiting Ang Ⅱ/TGF-β1/CTGF signaling pathway.

Objective:To evaluate the long-term outcomes and predictors of coronary atherosclerotic lesions deemed functionally non-ischemic (quantitative flow ratio(QFR)>0.80) and deferred from intervention.Methods:This study is a post-hoc analysis of the FAVOR Ⅲ China trial, which enrolled 3 825 patients with stable or unstable angina pectoris or with myocardial infarction occurring at least 72 hours prior to screening, between December 5, 2018 and January 9, 2020 from 26 research centers in China. Coronary vessels with QFR>0.80 and without interventional treatment were analyzed in this study. The primary endpoint was 3-year target vessel revascularization. Vessels with revascularization (revascularized group) during follow-up were matched 1∶1 using propensity score matching to comparable vessels without revascularization (non-revascularized group). Multivariate Cox regression analysis was used to identify the risk factors for target vessel revascularization (TVR).Results:A total of 6 212 functionally negative vessels with deferred intervention were included in the final analysis, among which 153 vessels (2.5%) underwent TVR during a 3-year follow-up. Prior to propensity score matching, 6 059 vessels comprised the non-revascularized group. At the vessel level, compared to the non-revascularized group, the revascularized group exhibited a significantly higher proportion of males (79.1% (121/153) vs. 70.2% (4 253/6 059), P=0.018), higher body mass index ((25.6±4.0) kg/m2 vs. (24.3±5.2) kg/m2, P=0.003), and a higher prevalence of hypertension (73.9% (113/153) vs. 65.1% (3 944/6 059), P=0.025). And 152 pairs of vessels were successfully matched. Multivariate Cox regression analysis identified in-stent restenosis lesions ( HR=2.59, 95% CI 1.28-5.23, P=0.008) as an independent risk factor for target vessel revascularization. Conclusions:Coronary lesions classified as functionally non-ischemic at baseline are not entirely stable and may progress to lesions that requiring revascularization over time. In-stent restenosis emerges as a critical independent predictor of revascularization.