Background With the rapid development of the food delivery industry, take-away deliverymen become an essential component of urban logistics. However, high labor intensity, unstable income, and extended working hours place them at considerable risk of occupational burnout. Available studies have paid insufficient attention to the mental health of this population, and effective predictive or preventive approaches remain limited. Objective To understand the status of occupational burnout among take-away deliverymen, identify influencing factors based on restricted cubic spline analysis, and develop a predictive model to provide a theoretical basis for improving their mental health. Methods A cross-sectional survey was conducted among full-time take-away deliverymen registered to the "Ele.me" and "Meituan" platforms in Hangzhou between September 1 and November 30, 2024, using both online and offline approaches. A questionnaire covered sociodemographic, household, and occupational information, and the Maslach Burnout Inventory–General Survey were used in this survey. Univariate analyses and logistic regression were used to identify factors associated with burnout and to construct a predictive model. Model performance was evaluated using receiver operating characteristic (ROC) curve and calibration curve. Furthermore, restricted cubic spline was used to further explore the relationship between age, working hours, and occupational burnout. Results Among the 1192 participants, 735 (61.66%) experienced occupational burnout. The logistic regression model indicated that older age (OR=1.021, P=0.010), educational attainment of college level or above compared to junior high school or below, (OR=2.837, P<0.001), and longer daily working hours (OR=1.081, P=0.001) were positively associated with occupational burnout. In contrast, work experience of 3−5 years (OR=0.666, P=0.016) and more than 5 years (OR=0.382, P<0.001) compared to those with <3 years, as well as providing three social insurances (OR=0.655, P=0.006) or five social insurances (OR=0.478, P<0.001) compared to those without any social insurances coverage, were negatively associated with occupational burnout. The predictive model based on these variables achieved an area under the curve (AUC) of 0.783 (95% CI: 0.756~0.809), and good agreement between calibration curves. The restricted cubic spline analysis revealed that the risk of occupational burnout was highest among delivery workers aged 33−46 years. Those with daily working hours between 3.5 and 8.1 h had a lower risk, while the risk significantly increased when working hours exceeded 8.1 h per day. Conclusion The prevalence of reporting occupational burnout among take-away deliverymen in Hangzhou is high. The developed predictive model provides valuable insights for the prevention and control of burnout in this population. Measures such as optimizing social security systems, rational work schedule allocation, and enhancing psychological support may help reduce occupational burnout among take-away deliverymen.

Hereditary angioedema (HAE) is a rare and potentially life-threatening hereditary disease. In recent years, with the country′s high emphasis on rare diseases, the diagnosis and treatment system for HAE in China has embraced unprecedented development opportunities. This article aims to review the current status of HAE diagnosis and treatment in China, including improvements in diagnostic capabilities, breakthroughs in the accessibility of targeted drugs, and the challenges faced at present. It also offers perspectives on future directions, such as innovative diagnostic approaches, clinical trials of novel therapeutic drugs, and the application of artificial intelligence, with the hope of providing references for enhancing the overall diagnosis and treatment level of HAE in China.

Objective To evaluate the safety of rush immunotherapy(RIT)with allergen products of Peking Union Medical College Hospital in allergic rhinitis with/without asthma.Methods One hundred and eight patients with allergic rhinitis with/without asthma who received RIT with allergen products of Peking Union Medical College Hospital were retrospectively analyzed.The occurrence characteris-tics of adverse reactions and their risk factors of RIT were summarized.Results A total of 840 injections were administered to 108 pa-tients.Local reactions occurred in 57(52.8％)patients and 57(6.8％)injections.Systemic reactions were observed in 3(2.8％)pa-tients and 3(0.4％)injections.One of systemic reactions was grade Ⅱ and the other two were grade Ⅲ.The incidence of adverse reac-tions in patients using pollen RIT was significantly higher than those using house dust mite or mold(48.1％vs 4.6％,P=0.001).Among 79 patients receiving pollen RIT,the incidence of local reactions was higher in patients who initiated RIT during pollen season than those out of pollen season(54.4％vs 11.4％,P=0.001).The skin test strength of pollen was defined as the sum of"+"in pollen pollen allergenic skin test.Greater strength of tree(P＜0.05,OR=1.631)and weed(P＜0.05,OR=1.334)pollen seemed to pro-mote local reactions.Conclusion RIT with single or multiple allergens significantly reduces the build-up phase and frequency of hospi-tal visits,and has low occurrence of systemic reactions.Thus,RIT can improve the compliance for allergen immunotherapy.

Objective To evaluate the safety of rush immunotherapy(RIT)with allergen products of Peking Union Medical College Hospital in allergic rhinitis with/without asthma.Methods One hundred and eight patients with allergic rhinitis with/without asthma who received RIT with allergen products of Peking Union Medical College Hospital were retrospectively analyzed.The occurrence characteris-tics of adverse reactions and their risk factors of RIT were summarized.Results A total of 840 injections were administered to 108 pa-tients.Local reactions occurred in 57(52.8％)patients and 57(6.8％)injections.Systemic reactions were observed in 3(2.8％)pa-tients and 3(0.4％)injections.One of systemic reactions was grade Ⅱ and the other two were grade Ⅲ.The incidence of adverse reac-tions in patients using pollen RIT was significantly higher than those using house dust mite or mold(48.1％vs 4.6％,P=0.001).Among 79 patients receiving pollen RIT,the incidence of local reactions was higher in patients who initiated RIT during pollen season than those out of pollen season(54.4％vs 11.4％,P=0.001).The skin test strength of pollen was defined as the sum of"+"in pollen pollen allergenic skin test.Greater strength of tree(P＜0.05,OR=1.631)and weed(P＜0.05,OR=1.334)pollen seemed to pro-mote local reactions.Conclusion RIT with single or multiple allergens significantly reduces the build-up phase and frequency of hospi-tal visits,and has low occurrence of systemic reactions.Thus,RIT can improve the compliance for allergen immunotherapy.

Acute ST-segment elevation myocardial infarction with multivessel disease is one of the high-risk types of coronary heart disease.Early opening of infarct-related artery and reperfusion of myocardium could significantly reduce the mortality in acute phase.However,the presence of non-culprit lesions in non-infarct-related arteries is still at risk and has an important impact on the long-term prognosis of patients.It remains controversial on how to precisely evaluate the clinical significance and revascularization value of non-culprit lesions.This article aims to review the research status and progress of guidance strategies of non-culprit lesion revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease.

With the popularization and development of modern imaging techniques,a phenomenon of rapid progression of coronary atherosclerosis with increasing risk of cardiovascular events has attracted more attention.Rapid progression of coronary atherosclerosis is related to a variety of pathophysiological mechanisms,such as iatrogenic injury,subclinical cycle of plaque rupture and healing,inflammation and so on.Predictive value of plaque morphological features,glycolipid-related metabolites and inflammatory factors for rapid progression of coronary atherosclerosis has been intensively studied.Lipid-lowering therapy is currently the main method to hinder the rapid plaque progression,and new effective therapeutic targets are still under investigations.In this review,we summarize the pathophysiology,predictors,evaluation methods and treatments of rapid progression of coronary atherosclerosis,aiming to provide useful information for the clinical practice.

With the popularization and development of modern imaging techniques,a phenomenon of rapid progression of coronary atherosclerosis with increasing risk of cardiovascular events has attracted more attention.Rapid progression of coronary atherosclerosis is related to a variety of pathophysiological mechanisms,such as iatrogenic injury,subclinical cycle of plaque rupture and healing,inflammation and so on.Predictive value of plaque morphological features,glycolipid-related metabolites and inflammatory factors for rapid progression of coronary atherosclerosis has been intensively studied.Lipid-lowering therapy is currently the main method to hinder the rapid plaque progression,and new effective therapeutic targets are still under investigations.In this review,we summarize the pathophysiology,predictors,evaluation methods and treatments of rapid progression of coronary atherosclerosis,aiming to provide useful information for the clinical practice.

Background::Dermatophagoides pteronyssinus is a common allergen causing allergic diseases in China. The aim of this study was to evaluate the efficacy and safety of D. pteronyssinus extracts produced by Peking Union Medical College Hospital (PUMCH) for the skin prick test (SPT) in the diagnosis of D. pteronyssinus allergy. Methods::A total of 910 subjects with allergic diseases were prescribed D. pteronyssinus SPT and specific sIgE (sIgE) test among the Outpatients of Department of Allergy, PUMCH from August 10, 2015 to August 30, 2017. Receiver operating characteristic curve (ROC) analysis was performed according to the results of D. pteronyssinus-sIgE detection. The accuracy of D. pteronyssinus extracts used for SPT in the diagnosis of D. pteronyssinus allergy was evaluated under different cutoff values. Adverse events after SPT were recorded to evaluate safety. Results::There were 796 and 618 subjects in the full analysis set (FAS) and the per protocol set (PPS), respectively. The areas under the curve of FAS and PPS were 0.871 and 0.873, respectively. According to the ROC of PPS, the optimal and 95% specificity diagnostic cutoff values of D. pteronyssinus SPT mean wheal diameter were 3.25 and 3.75 mm, respectively. No adverse events occurred. Conclusion::The extracts of D. pteronyssinus for SPT were simple, highly accurate, and safe and should be considered for recommendation in the clinical diagnosis of D. pteronyssinus allergy.

Objective:The preseason prophylactic treatment of seasonal allergic rhinitis (AR) caused by pollens could alleviate AR symptoms during the pollen season. This study aimed to evaluate the effect of prophylaxis usage of suplatast tosilate on the life quality of AR patients in the pollen season, and investigate the potential mechanism of action through transcriptomic analysis.Methods:This is a randomized controlled study. AR patients allergic to weed pollens were recruited from Allergy Clinic of Peking Union Medical College Hospital from January 2020 to June 2020, and divided into prophylactic group who started to take suplatast tosilate as prophylaxis 2 weeks before the spread of weed pollens[n=10, 4 men and 6 women with age range of (34±6) years old] and control group who did not use any prophylactic treatment[n=24, 12 men and 12 women with age range of (33±9) years old]. The differences of age ( t=0.381, P=0.706) and gender ( χ2=0.595, P=0.715) distribution between the patients of two groups were not statistically significant. All the subjects filled in the rhinoconjunctivitis quality of life questionnaire (RQLQ) while onset of AR symptoms, and peripheral blood was drawn for transcriptomic analysis 1 month before and during the pollen season. Differences between groups were statistically analyzed through chi-square test and t test. Results:There was no significant difference in visual analogue scale of rhinitis symptom in the last pollen season between prophylactic group and control group[ 8.0 (6.4, 9.3) vs 7.3 (6.1, 8.0), Z=1.180, P=0.254]. The RQLQ score of prophylactic group was superior to that of control group in the weed pollen season (2.9±0.9 vs 3.7±0.9, t=-2.438, P=0.026). 210 differentially expressed genes of fold change ≥2 were identified, with 147 genes upregulated and 63 genes downregulated in the prophylactic group compared to the control group. Gene Ontology annotation showed that IL-12 and IL-23 related pathways were downregulated in prophylactic group ( P=0.006 48). Polymerase Chain Reaction (PCR) verification of differentially expressed genes indicated that the relative expression level of HLA-G in prophylactic group was significantly lower than that in control group (0.23±0.19 vs 1.00±0.49, t=4.016, P=0.006). Conclusion:The prophylactic treatment of suplatast tosilate showed some benefit to the life quality of seasonal AR patients during the pollen season, and the potential mechanism might be related with the downregulation of IL-12 and IL-23 pathways and decreased expression of HLA-G.

Objective:The preseason prophylactic treatment of seasonal allergic rhinitis (AR) caused by pollens could alleviate AR symptoms during the pollen season. This study aimed to evaluate the effect of prophylaxis usage of suplatast tosilate on the life quality of AR patients in the pollen season, and investigate the potential mechanism of action through transcriptomic analysis.Methods:This is a randomized controlled study. AR patients allergic to weed pollens were recruited from Allergy Clinic of Peking Union Medical College Hospital from January 2020 to June 2020, and divided into prophylactic group who started to take suplatast tosilate as prophylaxis 2 weeks before the spread of weed pollens[n=10, 4 men and 6 women with age range of (34±6) years old] and control group who did not use any prophylactic treatment[n=24, 12 men and 12 women with age range of (33±9) years old]. The differences of age ( t=0.381, P=0.706) and gender ( χ2=0.595, P=0.715) distribution between the patients of two groups were not statistically significant. All the subjects filled in the rhinoconjunctivitis quality of life questionnaire (RQLQ) while onset of AR symptoms, and peripheral blood was drawn for transcriptomic analysis 1 month before and during the pollen season. Differences between groups were statistically analyzed through chi-square test and t test. Results:There was no significant difference in visual analogue scale of rhinitis symptom in the last pollen season between prophylactic group and control group[ 8.0 (6.4, 9.3) vs 7.3 (6.1, 8.0), Z=1.180, P=0.254]. The RQLQ score of prophylactic group was superior to that of control group in the weed pollen season (2.9±0.9 vs 3.7±0.9, t=-2.438, P=0.026). 210 differentially expressed genes of fold change ≥2 were identified, with 147 genes upregulated and 63 genes downregulated in the prophylactic group compared to the control group. Gene Ontology annotation showed that IL-12 and IL-23 related pathways were downregulated in prophylactic group ( P=0.006 48). Polymerase Chain Reaction (PCR) verification of differentially expressed genes indicated that the relative expression level of HLA-G in prophylactic group was significantly lower than that in control group (0.23±0.19 vs 1.00±0.49, t=4.016, P=0.006). Conclusion:The prophylactic treatment of suplatast tosilate showed some benefit to the life quality of seasonal AR patients during the pollen season, and the potential mechanism might be related with the downregulation of IL-12 and IL-23 pathways and decreased expression of HLA-G.