Background As a pillar industry in China, the manufacturing sector has a high incidence of non-fatal occupational injuries. The factors influencing non-fatal occupational injuries in this industry are closely related at various levels, including individual, equipment, environment, and management, making the analysis of these influencing factors complex. Objective To identify influencing factors of non-fatal occupational injuries among manufacturing workers, providing a basis for targeted interventions and surveillance. Methods A total of 2243 frontline workers from cable and shipbuilding enterprises were selected as study subjects to investigate the incidence of non-fatal occupational injuries and collect information at four levels: individual, equipment, management, and environment in past 12 months. Data balancing was performed using resampling, and LASSO regression was used to select factors of non-fatal occupational injuries. The influence degree and type of variables were judged based on the magnitude of the estimated coefficients of each variable, where variables with estimated coefficients > 0 are risk factors, and those <0 are protective factors. The area under the receiver operating characteristic (ROC)curve (AUC) was used to test the performance of the model, with an AUC value > 0.7 indicating good model performance. Results Among the 2243 frontline workers, males accounted for 77.7% (1742 out of 2243), with the main age range being 40-49 years old, representing 29.5% (661 out of 2243), 82.7% of the workers (1854 out of 2243) were married, and 55.6% (1248 out of 2243) had a junior middle school education level. The average monthly income for 51.0% (1144 out of 2243) of the workers was between 5000 and 6999 Chinese Yuan. The incidence of non-fatal occupational injuries among the manufacturing workers was 8.4% (189/2243) in the past 12 months. Among the 22 factors associated with the occurrence of non-fatal occupational injuries (P<0.05), 10 were individual-level factors, including gender, smoking, alcohol consumption, colleague relationships, average exercise duration, job burnout, work fatigue, musculoskeletal disorders, cardiovascular diseases, and neurological and sensory organ diseases; 3 were equipment-level factors, including equipment operability, hazardous workpieces, and safety hazards; 5 were environmental-level factors, including low temperatures, special operations, noise, workspace size, and dirty and disorderly environment; and 4 were management-level factors, including daily working hours, weekly working days, overtime, and pre-job technical training. The AUC value of the LASSO regression model was 0.704 and the final model retained a total of 10 variables. Among them, there were 7 risk factors for non-fatal occupational injuries (coefficient > 0), including safety hazards, musculoskeletal disorders, dangerous workpieces, job burnout, dirty and disorderly environment, smoking, and male gender; and 3 protective factors (coefficient < 0), including pre-job technical training, good colleague relationship, and long working days per week. Conclusion Manufacturing enterprises need to focus on the incidence of non-fatal occupational injuries and conduct targeted interventions for non-fatal occupational injuries by controlling potential safety hazards, providing pre-job technical training, reducing dangerous workpieces, rectifying working environment, and reasonably arranging working hours.

Objective: Huntington’s disease (HD) is characterized by motor, cognitive, and neuropsychiatric symptoms. Oculomotor impairments and gait variability have been independently considered as potential markers in HD. However, an integrated analysis of eye movement and gait is lacking. We performed multiple examinations of eye movement and gait variability in HTT mutation carriers, analyzed the consistency between these parameters and clinical severity, and then examined the associations between oculomotor impairments and gait deficits. Methods: We included 7 patients with pre-HD, 30 patients with HD and 30 age-matched controls. We collected demographic data and assessed the Unified Huntington’s Disease Rating Scale (UHDRS) score. Examinations, including saccades, smooth pursuit tests, and optokinetic (OPK) tests, were performed to evaluate eye movement function. The parameters of gait include stride length, walking velocity, step deviation, step length, and gait phase. Results: HD patients have significant impairments in the latency and velocity of saccades, the gain of smooth pursuit, and the gain and slow phase velocities of OPK tests. Only the speed of saccades significantly differed between pre-HD patients and controls. There are significant impairments in stride length, walking velocity, step length, and gait phase in HD patients. The parameters of eye movement and gait variability in HD patients were consistent with the UHDRS scores. There were significant correlations between eye movement and gait parameters. Conclusion Our results show that eye movement and gait are impaired in HD patients and that the speed of saccades is impaired early in pre-HD. Eye movement and gait abnormalities in HD patients are significantly correlated with clinical disease severity.

To summarize the nursing experience of a patient with coronary heart disease who was left in the radial artery during the removal of the radial artery sheath after coronary angiography via the radial artery pathway.Nursing points:to start the emergency transfer process,to shorten the treatment transfer time;to assist to locate the position of the sheath to provide a basis for the selection of surgical incision;to conduct dynamic assessment of hemostatic effect,prevention of radial artery occlusion;to closely monitor pain and signs to prevent vasovagal reflex;to implement the whole psychological intervention,and to reduce the psychological burden of patients and their families.The ruptured sheath tube was successfully removed by emergency surgery of vascular surgery.A total of 6 days after the operation,the patient was transferred to cardiac surgery for coronary artery bypass grafting,and was discharged 23 days later.After 3 months of follow-up,the blood supply of the limbs was good,and the incision healed well.

Objective:To analyze the disease burden of respiratory syncytial virus (RSV)- associated lower respiratory tract infection (LRTI) in Chinese children under one year of age from 1990 to 2021.Methods:Using the Global Burden of Disease (GBD) 2021 database ( https://vizhub.healthdata.org/gbd-results/), we calculated deaths, mortality, age-standardized mortality rates (ASMR), disability- adjusted life years (DALYs), DALY rates, and age-standardized DALY rates (ASDR) to assess the disease burden of RSV-associated LRTI in Chinese children under one year of age. Joinpoint regression modeling was employed to analyze temporal trends in disease burden in China from 1990 to 2021, with stratification by time, age, and sex. Comparisons were made with global and high socio-demographic index (SDI) regions. Results:In 2021, there were 324 deaths (95% UI: 179-539) from RSV-LRTI in Chinese infants under one year of age, with a mortality rate of 2.82 per 100 000 (95% UI: 1.55-4.69), ASMR of 0.10 per 100 000 (95% UI: 0.06-0.16), DALYs of 29 131.28 years (95% UI: 16 050.27-48 398.30), DALY rate of 253.56 per 100 000 (95% UI: 139.70-421.26), and ASDR of 6.70 per 100 000 (95% UI: 3.72-11.12). All metrics were lower than global levels but significantly higher than high-SDI regions. From 1990 to 2021, substantial reductions were observed in deaths, mortality rates, DALYs, and DALY rates of RSV-LRTI among children under one year of age in China, globally, and in high-SDI regions. China achieved ASMR and ASDR reductions of－95.91% (95% CI:－97.75% to－92.96%) and－96.70% (95% CI:－98.19% to－94.33%), comparable to high-SDI regions but exceeding global averages. Joinpoint analysis showed average annual percentage changes (AAPC) in ASMR of－9.80% (95% CI:－10.45% to－9.14%) for China,－5.38% (95% CI:－5.83% to－4.91%) globally, and－7.13% (95% CI:－9.07% to－5.14%) for high-SDI regions (all P<0.001). The AAPC for ASDR were－10.41% (95% CI:－11.01% to－9.79%),－5.40% (95% CI:－5.82% to－4.97%), and－7.09% (95% CI:－9.70% to－4.41%) for China, the global average, and high-SDI regions, respectively, with the most pronounced decline occurring between 2019 and 2021 (ASMR decreased by 53.33%, 45.81%, and 61.31%, while ASDR declined by 52.50%, 44.54%, and 58.88% in China, globally, and in high-SDI regions, respectively). In 2021, both China and high-SDI regions exhibited declining mortality and DALY rates for RSV-LRTI with increasing age among children under one year, while neonates younger than 28 days consistently demonstrated the highest burden metrics. The rate of decline was comparable between China and high-SDI regions, with both exceeding the global average. Furthermore, from 1990 to 2021, male infants under one year of age in China, globally, and in high-SDI regions consistently showed higher overall trends in deaths, mortality rates, DALY, and DALY rates for RSV-LRTI compared to female infants. Conclusions:Although China's RSV-LRTI disease burden in infants under one year remains lower than global levels but higher than high-SDI regions, the country achieved reduction rates comparable to high-SDI regions, exceeding global averages. RSV-LRTI continue to pose significant health threats to neonates and male infants, necessitating age-specific and sex-specific prevention strategies.

Objective:To explore the prognosis of patients with acute aortic syndrome (AAS) in the real world and to examine the risk factors associated with poor outcomes in AAS.Methods:This is a single-center retrospective study. Patients diagnosed with AAS at Xinqiao Hospital from January 2021 to July 2023 were included. The primary endpoints were all-cause mortality and aorta-related mortality, while the secondary endpoints included stroke, myocardial infarction, secondary interventions, and readmission for any cause. Survival analysis was performed using Kaplan-Meier curves, and risk factors for primary endpoint events were analyzed using multivariate Cox regression.Results:A total of 254 AAS patients, aged (58.9±13.2) years were included in this study. There were 178 cases of aortic dissection, 69 cases of aortic intramural hematoma, and 7 cases of aortic penetrating ulcer. The median follow-up time was 545 days. Seventy-three all-cause deaths occurred among patients with AAS, including 61 aorta-related deaths; 3 strokes, 1 myocardial infarction, 9 secondary surgeries, and 35 readmissions for any cause were observed. Kaplan-Meier curve analysis demonstrated significant differences in all-cause mortality rates based on the Stanford classification, AAS disease classification, eGFR, and albumin levels (all P<0.05), and similar results were also observed in aorta-related death (all P<0.05). Multivariate Cox regression suggested that albumin<35 g/L ( HR=2.372, 95% CI 1.337-4.210, P=0.003), eGFR<90 ml·min -1·1.73 m -2 ( HR=2.457, 95% CI 1.261-4.786, P=0.008), and Stanford type A AAS ( HR=3.420, 95% CI 1.998-5.856, P<0.001) were independent risk factors for all-cause mortality in AAS patients; albumin<35 g/L( HR=2.432, 95% CI 1.295-4.570, P=0.006), eGFR<90 ml·min -1·1.73 m -2( HR=2.523,95% CI 1.243-5.122, P=0.010), and Stanford type A AAS ( HR=3.455,95% CI 1.819-6.564, P<0.001) were independent risk factors for aorta-related mortality in AAS patients. Conclusions:In the real world, the prognosis of patients with AAS remains pessimistic. Patients with type A AAS, renal dysfunction, hypoproteinemia may have a higher risk of poor prognosis.

Objective:To explore the impact of changes of myocardial infarct size on left ventricular adverse remodeling in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI).Methods:This was a prospective cohort study. The STEMI patients who underwent primary PCI in the First Medical Center of the Chinese People′s Liberation Army General Hospital, Beijing Anzhen Hospital, Hainan Hospital of the Chinese People′s Liberation Army General Hospital and Guangxi Yulin First People Hospital from January 1, 2017 to January 1, 2022 were enrolled. Cardiac magnetic resonance (CMR) was performed to dynamically assess the myocardial infarct size and calculate the rate of infarct size change between the acute phase (5 to 7 days post-primary PCI) and 6-month follow-up. The endpoint was left ventricular adverse remodeling which was defined as an increase of more than 20% in left ventricular end-diastolic volume (LVEDV) assessed by CMR at 6 months after primary PCI compared with LVEDV at 1 week after primary PCI. Based on serial CMR assessments, the patients were divided into left ventricular adverse remodeling group and non-remodeling group. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of infarct size change for left ventricular adverse remodeling, and according to the optimal cutoff value, improved infarct size was defined as a decrease of >20% in the infarct size measured by CMR at 6 months after primary PCI compared with infarct size at 1 week after primary PCI. Multivariate logistic regression analysis was performed to identify the protective factors and risk factors for left ventricular adverse remodeling.Results:A total of 267 patients were enrolled, aged (58±11) years, with 234 males (87.6%). And 73 cases in the left ventricular remodeling group and 194 cases in the non-remodeling group. Infarct size assessed by CMR at 6 months after primary PCI decreased significantly compared with infarct size at 1 week after primary PCI in the left ventricular remodeling group ((23±13)% vs. (27±12)%, P=0.004), the same as in the non-remodeling group ((18±10)% vs. (23±10)%, P<0.001). The area under the ROC curve for the rate of infarct size change in predicting left ventricular remodeling was 0.735 (95% CI 0.670-0.799, P<0.001), a 20% reduction was the optimal cut-off value. Compared to the patients with non-improved infarct size, the incidence of left ventricular adverse remodeling was significantly lower in the patients with improved infarct size (18% (24/133) vs. 37% (49/134), P=0.001). Multivariate logistic regression analysis showed that improvement in IS was a protective factor for left ventricular adverse remodeling ( OR=0.376, 95% CI 0.236-0.721, P=0.002). Conclusion:Patients with STEMI who experience obvious reduction in infarct size after primary PCI have a significantly reduced risk of left ventricular adverse remodeling.

Objective To investigate the association between plasma atherogenic index of plasma(AIP)and metabolism-associated steatotic liver disease(MASLD),and to evaluate the potential value of AIP as a predictive marker for MASLD risk.Methods We enrolled a total of 4 850 health check-up participants from The Second Affiliated Hospital of Xi'an Jiaotong University between June 2021 and May 2023.The participants were divided into quartiles(Q1-Q4)according to their AIP level.Biochemical indicators and MASLD prevalence were compared across groups.Logistic regression,subgroup analysis,and restricted cubic splines(RCS)were used to explore the relationship between AIP and MASLD.Results Among the 4 850 participants,the prevalence of MASLD was 26.08％(1 265/4 850).MASLD prevalence increased across AIP quartiles:4.0％,13.8％,30.8％,and 55.6％in Q1-Q4,respectively(P＜0.001).Compared with Q1,Q2-Q4 groups showed higher proportions of males,BMI,smokers,overweight/obesity,central obesity,prediabetes,hypertension,serum uric acid,and fatty liver index(FLI)(all P＜0.001).Lipid profiles worsened with increased AIP:total cholesterol,triglycerides,and LDL-C increased,while HDL-C decreased(P＜0.001).RCS analysis demonstrated a significant linear relationship between AIP and MASLD risk.After adjusting for confounders,the participants in Q4 had an 8.71-fold higher risk of MASLD than those in Q1(OR:8.71,95％CI:6.20-12.23,P＜0.001).A composite model incorporating AIP,BMI,and FLI showed superior discriminative performance(AUC:0.883,95％CI:0.873-0.892).Interaction analysis suggested that AIP had significant interactions with BMI,hypertension,and prediabetes(P＜0.05).In individuals without these metabolic abnormalities,the association between AIP and MASLD was more pronounced.Conclusion Elevated AIP was significantly associated with an increased risk of MASLD,with a stronger association observed in individuals with normal BMI,blood pressure,and blood glucose levels,suggesting that AIP may serve as a potential indicator for early screening of MASLD.

Medical image recognition is a technology that utilizes computer algorithms to process,analyze and understand medical images,aiming to identify various patterns,targets and objects,thereby aiding doctors in more accurate diagnosis and treatment.Current researches in medical image recognition mainly focuses on medical image classification,lesion location and segmentation,image registration and fusion,content-based image retrieval,as well as three-dimensional reconstruction and visualization.The review provides a summary of the research directions and trends in medical image recognition,introducing concepts and technologies such as deep learning,multimodal fusion,three-dimensional reconstruction and visualization.It also highlights the applications of medical image recognition in medical imaging diagnosis,pathological analysis and radiotherapy planning,while pointing out the existing problems and challenges.Furthermore,the future developments and challenges of medical image recognition technology are put forward for providing a reference for medical image recognition research and clinical medical image analysis.

End-stage dilated cardiomyopathy belongs to the irreversible cardiac decompensation stage,and neither drugs nor cardiac resynchronization therapy can improve the symptoms of heart failure in patients.Orthotopic heart transplantation is a surgical procedure that involves removing the diseased heart of the recipient and implanting the donor heart in its original position.With the advancements in surgical transplantation techniques and immunosuppressive therapy,it has become an effective treatment for end-stage heart disease.Coronary artery disease after heart transplantation is one of the issues that need attention after heart transplantation.This article reports a 68-year-old male who suffered from recurrent heart failure and ventricular tachycardia due to"dilated cardiomyopathy"and underwent allogeneic orthotopic heart transplantation 5 years ago.The patient underwent coronary angiography and intravascular ultrasound examination under local anesthesia.This case has certain guiding significance for studying the progression of coronary artery disease in heart transplant patients.

This study explored the effects and underlying mechanism of Raf kinase inhibitory protein(RKIP)on apoptosis in mast cells sensitized by Echinococcus granulosus cyst fluid.Bone marrow-derived mast cells(BMMCs)were isolated and cultured from RKIP knockout(KO)and wild-type(WT)C57BL/6 mice.Cells were divided into control and sensitized groups.The sensitized group was incubated for 24 h in RPMI1640 medium containing 10%serum from mice infected with E.granulosus,then activated for 3 h or 6 h with E.granulosus cyst fluid.The control group was incubated for 24 h in RPMI1640 medium,and then received an equal vol-ume of PBS.Cells and supernatants were collected for analysis.Flow cytometry was used to detect the expression of CD117 and FcεRⅠα on BMMCs.The levels of β-hexosaminidase,IL-4,and TNF-α in the supernatant were quantified with ELISA.Western blot analy-sis was used to assess expression changes in RKIP,apoptosis-related proteins,and pathway proteins in BMMC before and after sensi-tization.Flow cytometry analysis revealed that after 4 weeks of induction,the CD117 and FcεRⅠα double-positivity rates on both WT and KO BMMC exceeded 90%.ELISA indicated that the E.granulosus cyst fluid resulted in significantly greater β-hexosaminidase re-lease(F=16.88,P<0.05),and levels of IL-4(F=16.51,P<0.05)and TNF-α(F=9.78,P<0.05)in the KO sensitized group than the WT sensitized group.With respect to the WT control group,the WT sensitized group showed significantly down-regulated pro-tein expression levels of RKIP(F=8.20,P<0.05)and Bcl-2(F=101.40,P<0.01)after 3 h,but significantly up-regulated levels of p-PI3K(F=8.04,P<0.05),p-Akt(F=32.52,P<0.01),p-P65(F=13.29,P<0.05),and cleaved-caspase-3(F=46.34,P<0.01).With respect to the WT sensitized group,the KO sensitized group showed significantly up-regulated protein expression of p-PI3K(F=8.45,P<0.05),p-Akt(F=8.58,P<0.05),p-P65(F=11.02,P<0.05),and Bcl-2(F=84.50,P<0.001)after 3 h,but significantly down-regulated expression of cleaved-caspase-3(F=15.66,P<0.05).In conclusion,RKIP may inhibit the PI3K/Akt/NF-κB pathway,thereby inducing apoptosis in mast cells sensitized by E.granulosus cyst fluid.This process may help ease aller-gic reactions caused by mast cells in echinococcosis,thus offering a promising new approach for preventing and treating such reactions.