Background Although hand-arm vibration syndrome has traditionally been reported more frequently in colder northern regions, recent cases in Guangdong Province, a subtropical region in the south, exhibit a certain degree of clustering in terms of industry distribution and company size, and for a period of time, they account for a high proportion of the total number of cases reported nationwide. Objective To describe the occupational exposure profile of hand-transmitted vibration (HTV) in Guangdong Province in 2025 and to compare exposure levels across industries, enterprise sizes, and occupational categories. Methods Data were sourced from the Guangdong Provincial Occupational Health Quality Control Platform, to which occupational health technical service institutions across Guangdong Province submitted relevant reports in 2025. The dataset included employers with documented HTV hazards, measurement results, and the number of exposed workers. Exposure levels were categorized into four grades according to the 4-h energy-equivalent frequency-weighted vibration acceleration: Grade I (<1 m·s⁻²), Grade II (1-2.5 m·s⁻²), Grade III (>2.5-5 m·s⁻²), and Grade IV (>5 m·s⁻²). Results A total of 12468 employers with identifiable HTV exposure were identified through the platform in 2025, of which 11710 (93.92%) were in the manufacturing sector. By enterprise scale, 274 (2.20%) were large, 934 (7.49%) were medium-sized, 8 749 (70.17%) were small, and 2511 (20.14%) were micro-sized enterprises, with small enterprises accounting for the largest proportion. Among 22298 job posts with identified HTV exposure, grinding, assembly, polishing, burnishing, and welding were the most common tasks. The M (P₂₅, P₇₅) 4-h energy-equivalent frequency-weighted acceleration [a(4)] was 2.1 (1.5, 2.7) m·s⁻², with values ranging from 0.1 to 16.2 m·s⁻². Exposure levels were distributed as follows: Grade I, 2835 posts (12.71%); Grade II, 12761 posts, (57.23%); Grade III, 6690 posts, (30.00%); and Grade IV, 12 posts (0.05%), with Grade Ⅱ posts accounting for the largest proportion. Within the manufacturing sector, 21013 exposed job posts were identified, accounting for 94.24% of all exposed posts. Twelve job posts exceeded the occupational exposure limit, of which nine were polishing positions. A total of 115955 workers were exposed to HTV, primarily in manufacturing (110879; 95.62%). Among the exposed workers, 21237, 23454, 65047, and 6217 were employed in large, medium, small, and micro-sized enterprises, respectively. Grinding, assembly, polishing, deburring, and welding were the five most common occupational categories among the exposed workers. The distribution of worker by exposure grade was similar to that of exposed posts: Grade I, 11921 workers (10.28%); Grade II, 65463 workers (56.46%); Grade III, 38447 workers (33.16%); and Grade IV, 124 workers (0.11%). Conclusion In Guangdong Province, HTV exposure is mainly concentrated in the manufacturing sector, particularly in metal product manufacturing, and commonly involves tasks such as grinding, assembly, and polishing. Both exposed enterprises and exposed workers are predominantly concentrated in small enterprises. Grade II exposure accounts for the largest proportion of both exposed job posts and exposed workers, and some workers are at a risk of developing hand-arm vibration syndrome. These findings suggest that targeted occupational management and comprehensive control measures should be strengthened to reduce HTV exposure and prevent hand-arm vibration syndrome.

Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children, which can lead to severe pneumonia and even death. Early diagnosis and intervention are crucial for reducing complications and sequelae and improving prognosis. This study presents the complete diagonsis and treatment process of a typical severe RSV pneumonia patient. For high-risk children, the condition can progress rapidly after RSV infection, and may present with respiratory failure and multiple extrapulmonary complications, such as heart failure, liver and kidney function impairment, coagulation dysfunction. After active symptomatic and supportive treatment, the prognosis is generally good. RSV infection will not lead to long-lasting immunity, but as the child grows older and their immune function gradually improves, the condition of a secondary infection is generally relatively mild. Currently, there are no specific antiviral drugs or safe and effective vaccines for RSV. Long-acting monoclonal antibodies are one of the effective means to prevent RSV infection in infants and young children and have been approved for use in China.

Objectives:Utilizing an advanced and high-capacity data acquisition system tailored for elderly patients with valvular heart disease,we aimed to establish standardized data acquisition protocols and define variable sets for a clinical research big data platform dedicated to this condition.Guided by clinical treatment decisions,we implemented a standardized and uniform evaluation process for valvular heart disease.This initiative might culminate in the creation of the first comprehensive database for elderly valvular heart disease,encompassing clinical information,functional assessments,multimodal imaging,treatment modalities,and follow-up data.Methods:Variables were selected based on past clinical studies and literature,both domestic and international,and considering key guidelines,advancements in valvular heart disease,and China's clinical practices.Standards for data variables,imaging techniques,data acquisition,multi-channel verification,and quality control were established.Variables are then classified by their properties and generation time.Results:This comprehensive set of variables encompassed a total of 567 relevant variables,which were generated throughout the entire diagnosis and treatment process of patients with valvular heart disease,starting from admission and extending to those required for clinical research.The variable set was divided into six distinct parts:clinical information(encompassing demographics,admission details,clinical manifestations,comorbidities,medical history,physical examination,auxiliary examinations,and comprehensive assessment of frailty in the elderly),echocardiography,cardiac computed tomography(CT),treatment(including surgery,valve intervention therapy,non-valve intervention therapy,and medication therapy),clinical outcomes,and follow-up.Specifically,it included 14 variables related to demographic and admission information;22 variables encompassing clinical manifestations and physical examination;63 variables concerning medical history and comorbidities;49 variables for inspection and examination;15 variables for the comprehensive evaluation of frail elderly individuals;55 variables of echocardiography,including complete dynamic images at 4 time points,6 cross-sections per point,and corresponding Doppler spectra);131 variables for cardiac CT,including baseline and postoperative raw image uploads(encompassing non-enhanced electrocardiography[ECG]-gated cardiac CT scans,ECG-gated full-phase CT angiography(CTA)scans,and large-scale non-ECG-gated spiral CTA scans);51 variables for surgical diagnosis and treatment;72 variables for valve intervention therapy;33 variables for non-valvular interventional therapy;27 variables for medication information;and 35 variables for clinical outcomes.The follow-up integration comprises 140 variables,along with the upload of raw echocardiography and CT images.Conclusions:Through the establishment of data collection standards and variable standards for the big data platform of valvular heart disease,the standardization and normalization of comprehensive evaluation,diagnosis and treatment,and clinical research of patients with valvular heart disease can be achieved.As a national level big data research platform that can be sustainably used for clinical research and innovative development of valvular heart disease,it will provide support for long-term monitoring of valvular heart disease,real-world data analysis,clinical research(observational and randomized controlled trials),technological innovation,drug and device development,and post market evaluation.

Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children, which can lead to severe pneumonia and even death. Early diagnosis and intervention are crucial for reducing complications and sequelae and improving prognosis. This study presents the complete diagonsis and treatment process of a typical severe RSV pneumonia patient. For high-risk children, the condition can progress rapidly after RSV infection, and may present with respiratory failure and multiple extrapulmonary complications, such as heart failure, liver and kidney function impairment, coagulation dysfunction. After active symptomatic and supportive treatment, the prognosis is generally good. RSV infection will not lead to long-lasting immunity, but as the child grows older and their immune function gradually improves, the condition of a secondary infection is generally relatively mild. Currently, there are no specific antiviral drugs or safe and effective vaccines for RSV. Long-acting monoclonal antibodies are one of the effective means to prevent RSV infection in infants and young children and have been approved for use in China.

Objectives:Utilizing an advanced and high-capacity data acquisition system tailored for elderly patients with valvular heart disease,we aimed to establish standardized data acquisition protocols and define variable sets for a clinical research big data platform dedicated to this condition.Guided by clinical treatment decisions,we implemented a standardized and uniform evaluation process for valvular heart disease.This initiative might culminate in the creation of the first comprehensive database for elderly valvular heart disease,encompassing clinical information,functional assessments,multimodal imaging,treatment modalities,and follow-up data.Methods:Variables were selected based on past clinical studies and literature,both domestic and international,and considering key guidelines,advancements in valvular heart disease,and China's clinical practices.Standards for data variables,imaging techniques,data acquisition,multi-channel verification,and quality control were established.Variables are then classified by their properties and generation time.Results:This comprehensive set of variables encompassed a total of 567 relevant variables,which were generated throughout the entire diagnosis and treatment process of patients with valvular heart disease,starting from admission and extending to those required for clinical research.The variable set was divided into six distinct parts:clinical information(encompassing demographics,admission details,clinical manifestations,comorbidities,medical history,physical examination,auxiliary examinations,and comprehensive assessment of frailty in the elderly),echocardiography,cardiac computed tomography(CT),treatment(including surgery,valve intervention therapy,non-valve intervention therapy,and medication therapy),clinical outcomes,and follow-up.Specifically,it included 14 variables related to demographic and admission information;22 variables encompassing clinical manifestations and physical examination;63 variables concerning medical history and comorbidities;49 variables for inspection and examination;15 variables for the comprehensive evaluation of frail elderly individuals;55 variables of echocardiography,including complete dynamic images at 4 time points,6 cross-sections per point,and corresponding Doppler spectra);131 variables for cardiac CT,including baseline and postoperative raw image uploads(encompassing non-enhanced electrocardiography[ECG]-gated cardiac CT scans,ECG-gated full-phase CT angiography(CTA)scans,and large-scale non-ECG-gated spiral CTA scans);51 variables for surgical diagnosis and treatment;72 variables for valve intervention therapy;33 variables for non-valvular interventional therapy;27 variables for medication information;and 35 variables for clinical outcomes.The follow-up integration comprises 140 variables,along with the upload of raw echocardiography and CT images.Conclusions:Through the establishment of data collection standards and variable standards for the big data platform of valvular heart disease,the standardization and normalization of comprehensive evaluation,diagnosis and treatment,and clinical research of patients with valvular heart disease can be achieved.As a national level big data research platform that can be sustainably used for clinical research and innovative development of valvular heart disease,it will provide support for long-term monitoring of valvular heart disease,real-world data analysis,clinical research(observational and randomized controlled trials),technological innovation,drug and device development,and post market evaluation.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

To investigate the clinical characteristics,genetic mutation patterns,and therapeutic strategies of an infant with interstitial lung disease associated with a surfactant protein C(SFTPC)gene mutation,and systematic review of 188 cases of SFTPC mutation-elated childhood ILD(chILD)reported in Chinese and English literature(from database inception to December 2024)was conducted.The patient in this study was a girl aged 11 months.She presented with progressive dyspnea,hypoxemia,and severe growth retardation starting at 2 months of age.Whole-exome sequencing identified a heterozygous missense mutation in SFTPC(c.187A>G,p.K63E),inherited from her mother.Symptoms significantly improved after treatment with glucocorticoids and azithromycin,though pulmonary bullae persisted at 5-year follow-up.Literature analysis revealed that the hotspot mutation I73T was located in the linker domain,while BRICHOS domain mutations exhibited the highest genetic diversity.BRICHOS domain mutations were associated with earlier onset,whereas non-BRICHOS mutations predominantly manifested in infancy with chronic cough,hypoxemia,and growth retardation.Oxygen therapy and glucocorticoids were the most common treatments.Hydroxychloroquine was more frequently used in linker domain mutations.The overall survival rate was 84%.SFTPC mutations are a critical genetic etiology of chILD in infants.Early genetic testing combined with glucocorticoid/macrolide therapy improves prognosis,but long-term monitoring for structural lung damage(e.g.,pulmonary bullae)is essential.

Objective To investigate the prevalence and risk factors of work-related musculoskeletal disorders (WMSDs) among construction workers. Methods A total of 5 783 workers were selected as participants from 12 construction companies in Guangdong Province, Guangxi Zhuang Autonomous Region and Zhejiang Province using a convenient sampling method. The revised Musculoskeletal Disorders Questionnaire was used to investigate the prevalence and influencing factors of WMSDs. Results The prevalence of WMSDs was 27.4% among the construction workers. The prevalence of WMSDs in shoulder, neck, waist/lower back and hand/wrist was 10.6%, 9.5%, 9.5% and 9.4% respectively, which was higher than that in other body parts. Bianry logistic regression analysis showed that the risk of WMSDs in construction workers with junior high school education and below was higher than that of high school/ college and above (P<0.05). The risk of WMSDs was higher in drinkers than that in non-drinkers (P<0.01). The worse the health status of construction workers, the higher the risk of WMSDs (P<0.01). The risk of WMSDs in those who exercised once or twice a month was lower than that in those who did not exercise (P<0.05). The risk of WMSDs was higher in construction workers with longer working hours in uncomfortable postures and greater back bending amplitude at work (all P<0.01). The risk of WMSDs in construction workers with hands holding above the shoulder was higher than that with hands below the shoulder (P<0.05). Construction workers who repeated the same work daily, involved in high-temperature work, often worked overtime, had insufficient rest time, and had a shortage of department personnel had a relatively high risk of WMSDs (all P<0.01). Conclusion The prevalence of WMSDs among the construction workers was relatively high, and the most common WMSDs occurred in shoulder, neck, waist/lower back and hand/wrist. Individual characteristic, work type, work posture and work organization are the influencing factors of WMSDs. Comprehensive measures, especially ergonomic measures based on personal and occupational characteristics should be taken to reduce the risk of WMSDs among construction workers.

Objective:To explore the advantages of robotic-arm assisted total hip arthroplasty (rTHA) in acetabular component positioning and lower limb length assessment in patients with severe pelvic coronal tilt.Methods:A retrospective analysis was conducted on the data of 122 patients with unilateral end-stage hip disease and coronal pelvic tilt angle >3° who underwent total hip arthroplasty (THA) at the First Medical Center of PLA General Hospital from June 2022 to December 2023. Among them, 44 patients underwent rTHA, and 78 underwent manual THA (mTHA). The rTHA group included 18 males and 26 females, with an average age of 60.5±9.3 years; the mTHA group included 41 males and 37 females, with an average age of 58.5±8.4 years. Compare the differences in the anteversion angle, abduction angle, pelvic tilt angle, leg length discrepancy (LLD) of the acetabular prosthesis, and the proportions of patients with LLD>0.5 cm and >1 cm between the two groups of patients after surgery. Calculate the proportion of outlier rates of acetabular abduction angle (<30° or >45°), and proportions within Callanan's safe zone. The early efficacy of the hip joint was evaluated by using the modified Harris score and joint range of motion.Results:All patients were followed up for 6 to 12 months, with an average of 8 months. All the surgical incisions of the patients achieved primary healing. Postoperative comparisons showed no statistically significant differences in acetabular abduction angle (39.5°±3.3° vs. 38.4°±7.3°) or anteversion angle (20.7°±1.6° vs. 19.7°±1.6°) between rTHA and mTHA groups ( P>0.05). However, pelvic tilt angle [2.5° (1.1°, 3.6°) vs. 3.5° (2.3°, 5.9°)] showed a statistically significant difference ( U=4.371, P=0.008). The rTHA group exhibited smaller absolute LLD [0.2 (0.1, 0.4) cm vs. 0.5 (0.2, 0.5) cm] and lower proportions of LLD >0.5 cm [14% (6/44) vs. 49% (38/78)] and >1 cm [2% (1/44) vs. 18% (14/78)], with statistical significance ( P<0.05). The rTHA group had a lower outlier rate for acetabular abduction angle (<30°or >45°) compared to the mTHA group [2% (1/44) vs. 33% (26/78)], with statistical significance (χ 2=10.388, P<0.001). Taking the Callanan safety zone as the standard, the proportion of acetabular cups within the safe zone was significantly higher in the rTHA group (98%, 43/44) compared to the mTHA group (67%, 52/78), with a statistically significant difference (χ 2=13.998, P<0.001). The modified Harris score and hip joint range of motion in the mTHA group increased from 47.6±6.6 points and 83° (73°, 88°) before the operation to 83.5±11.2 points and 118° (110°, 122°) at the last follow-up, respectively. The rTHA group increased from 46.5±9.2 points and 79° (71°, 90°) before the operation to 85.0±12.5 points and 124° (116°, 130°) at the last follow-up. The differences in the modified Harris score and hip joint range of motion between the two groups before the operation and at the last follow-up were statistically significant ( P<0.05). However, there was no statistically significant difference between the groups at the last follow-up ( P>0.05). No THA-related complications occurred during follow-up period. Conclusion:For patients with end-stage hip joint diseases with coronal tilt exceeding 3°, robotic-assisted technology significantly improves the accuracy of acetabular component placement during THA and offers better control of postoperative LLD.

OBJECTIVES: To create a mixed valvular heart disease (MVHD)-related age-adjusted comorbidity index (MVACI) model for predicting mortality risk of patients with MVHD. METHODS: A total of 4080 patients with moderate or severe MVHD in the China-VHD study were included. The primary endpoint was 2-year all-cause mortality. A MVACI model prediction model was constructed based on the mortality risk factors identified by univariate and multivariate Cox regression analysis. Restricted cubic splines were used to assess the relationship between MVACI scores and 2-year all-cause mortality. The optimal threshold, determined by the maximum Youden index from receiver operator characteristic (ROC) curve analysis, was used to stratify patients. Kaplan-Meier method was used to calculate 2-year all-cause mortality and compared using the Log-rank test. Univariate and multivariate Cox proportional hazards models were employed to calculate hazard ratios (HR) and 95% confidence intervals (CI), evaluating the association between MVACI scores and mortality. Paired ROC curves were used to compare the discriminative ability of MVACI scores with the European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE Ⅱ) or the age-adjusted Charlson comorbidity index (ACCI) in predicting 2-year clinical outcomes, while calibration curves assessed the calibration of these models. Internal validation was performed using the Bootstrap method. Subgroup analyses were conducted based on etiology, treatment strategies, and disease severity. RESULTS: Multivariate analysis identified the following variables independently associated with 2-year all-cause mortality in patients: pulmonary hypertension, myocardiopathy, heart failure, low body weight (body mass index <18.5 kg/m²), anaemia, hypoalbuminemia, renal insufficiency, cancer, New York Heart Association (NYHA) class and age. The score was independently associated with the risk of all-cause mortality, and exhibited good discrimination (AUC=0.777, 95%CI: 0.755-0.799) and calibration (Brier score 0.062), with significantly better predictive performance than EuroSCORE Ⅱ or ACCI (both adjusted P<0.01). The internal validation showed that the MVACI model's predicted probability of 2-year all-cause mortality was generally consistent with the actual probability. The AUCs for predicting all-cause mortality risk were all above 0.750, and those for predicting adverse events were all above 0.630. The prognostic value of the score remained consistent in patients regardless of their etiology, therapeutic option, and disease severity. CONCLUSIONS The MVACI was constructed in this study based on age and comorbidities, and can be used for mortality risk prediction and risk stratification of MVHD patients. It is a simple algorithmic index and easy to use.
Humans ; Prognosis ; Comorbidity ; Heart Valve Diseases/epidemiology* ; Female ; Male ; Middle Aged ; Aged ; Proportional Hazards Models ; Risk Factors ; China/epidemiology* ; Age Factors ; Risk Assessment ; Adult ; ROC Curve