OBJECTIVES: Nasopharyngeal carcinoma is often diagnosed at a late stage due to its concealed location and exhibits marked regional clustering, posing a significant public health challenge in China. This study aims to analyze the disease burden of nasopharyngeal carcinoma in China using the latest 2021 Global Burden of Diseases (GBD) database, providing epidemiological evidence for precise prevention and control of nasopharyngeal carcinoma. METHODS: Age-standardized incidence rate (ASIR), mortality rate, and disability-adjusted life year (DALY) rate were used as indicators of disease burden. Stratified analyses were conducted by age, sex, socio-demographic index (SDI), and relevant risk factors. The autoregressive integrated moving average (ARIMA) model and Bayesian age-period-cohort (BAPC) model were employed to project ASIR trends through 2050. RESULTS: In 2021, China's age-standardized incidence, mortality, and DALY rates of nasopharyngeal carcinoma were 3.4/100 000, 1.5/100 000, and 48.7/100 000, respectively, all higher than the global average. Across all age groups, Chinese males exhibited higher ASIR, mortality, and DALY rates than females. From 1990 to 2021, the disease burden of nasopharyngeal carcinoma in China decreased gradually with rising SDI. The proportion of nasopharyngeal carcinoma burden attributed to alcohol consumption, smoking, and occupational formaldehyde exposure in China exceeded global levels, especially among males. Projections from both models indicate a rising trend in ASIR for males, females, and the general population in China and globally from 2022 to 2050. CONCLUSIONS Over the past 30 years, the disease burden of nasopharyngeal carcinoma in China has decreased with the increasing SDI values but remains higher than the global average. Furthermore, ASIR is projected to increase over the next 30 years. It is imperative for China to enhance healthcare resource allocation for nasopharyngeal carcinoma prevention, diagnosis, and treatment, particularly among high-risk male populations.
Humans ; China/epidemiology* ; Male ; Nasopharyngeal Carcinoma/mortality* ; Female ; Middle Aged ; Nasopharyngeal Neoplasms/mortality* ; Adult ; Incidence ; Global Burden of Disease ; Disability-Adjusted Life Years ; Aged ; Risk Factors ; Adolescent ; Databases, Factual ; Young Adult ; Cost of Illness ; Child ; Bayes Theorem

Objective:To investigate the incidence of shoulder work-related musculoskeletal disorders (WMSDs) among occupational population in China, and to explore their intrinsic association with personal and work-related factors.Methods:In April 2024, 73497 valid questionnaires of the Chinese version of the Musculoskeletal Disorders Electronic Questionnaire were retrospectively analyzed from June 2018 to December 2023 in 22 provinces and 29 key industries in China, and the general information, occurrence of WMSDs and related risk factors of key occupational populations in different regions in China were collected. By using Chi-square test and confirmatory factor analysis, the relationship between shoulder fatigue and pain in key occupational groups and individual factors, work type, work posture and work organization was discussed, and the internal relationship was analyzed based on structural equation model.Results:Higher incidence of shoulder fatigue and pain were associated with female, lack of physical exercise, uncomfortable working posture and neck leaning forward ( P<0.05). Structural equation model analysis showed that work type, work posture and work organization were strongly correlated ( r=0.58, 0.55). Work organization and work type were strongly correlated with shoulder fatigue ( r=0.65) and moderately correlated with shoulder fatigue ( r=0.21). Shoulder fatigue was moderately associated with shoulder pain ( r=0.40). Individual factors, work type, work posture and shoulder fatigue could directly affect shoulder pain ( OR=0.07, -0.09, 0.17 and 0.40), and work type and work posture could also indirectly affect shoulder pain through shoulder fatigue ( OR=0.08, 0.03). Work organization only indirectly affected shoulder pain through shoulder fatigue ( OR=0.26) . Conclusion:The main influencing factor of shoulder pain is shoulder fatigue, followed by work posture and individual factors. Structural equation model can better reflect the complex relationship between work type, work posture and work organization and shoulder WMSDs. Improving work posture and work organization may be an effective way to control the influence of shoulder fatigue on shoulder pain.

Objective:To explore the structural equation model to explore the levels of work-related musculoskeletal disorders (WMSDs) and various risk factors in the feet and ankle of China's occupational population, providing scientific basis for for preventing WMSDs in feet and ankles.Methods:Data of 73497 national occupational epidemiological cases were selected from June 2018 to December 2023 used the Chinese version of the Electronic Questionnaire on Musculoskeletal Disorders. The adverse ergonomic factors and their source classification standard and confirmatory factor analysis were used to investigate foot and ankle WMSDs and their related risk factors (including individual factors, work organization, work posture, work type, fatigue, etc.) in key occupational groups in China, and structural equation model hypothesis, fitting, verification, and path and intermediary effect analysis were carried out. The model fit evaluation indexes included Chi-square specific degrees of freedom ( χ2/ df), gauge fit index (NFI), Tucker Lewis index (TLI), goodness of Fit index (GFI), adjusted Goodness of Fit index (AGFI) and approximate root mean square error (RMSEA) . Results:A total of 73497 occupational workers were surveyed, with local muscle fatigue and WMSDs incidence rates in the feet and ankles being 17.17% and 12.06%, respectively. The fitting index of the adjusted structural equation model basically meets the standard (GFI=1, AGFI=1, RMESA=0.042, NFI=0.716, TLI=0.663). The top three factors affecting feet and ankle WMSDs are feet and ankle muscle fatigue, work type, and work organization, with standardized path coefficients of 0.221, 0.105, and 0.095, respectively. The top two factors affecting feet and ankle muscle fatigue are work organization and work type, with standardized path coefficients of 0.548 and 0.383, respectively. Feet and ankle muscle fatigue, work type, work organization, and work posture have a direct effect on feet and ankle WMSDs, with effect values of 0.221, 0.105, 0.095, and 0.077, respectively. The organization and type of work can also have indirect effects through feet and ankle muscle fatigue, with effect values of 0.121 and 0.084, respectively.Conclusion:Feet and ankle muscle fatigue has a direct impact on WMSDs, and plays a mediating role between ankle and ankle WMSDs caused by work organization and work type. Feet and ankle muscle fatigue is an important pathway leading to feet and ankle WMSDs. It is recommended that employers and managers detect job fatigue early and take corresponding prevention and intervention measures, which can play a key role in preventing feet and ankle WMSDs.

Objective:To explore the structural relationship between WMSDs in the upper limbs and various risk factors in the occupational population in China, based on a large sample epidemiological survey and structural equation analysis, and to establish a structural equation model, so as to lay a foundation for the prevention and control of such diseases.Methods:The Chinese version of the Musculoskeletal Disorders Electronic Questionnaire was used to conduct a nationwide survey on the prevalence of WMSDs in the upper extremity. Six factors related to WMSDs in the upper extremity were extracted by the classification standard of adverse ergonomic factors and their source and confirmatory factor analysis, including work organization, work type, upper extremity work posture, individual factors, upper extremity fatigue and upper extremity WMSDs. The structural equation analysis was carried out and the structural equation model was established.Results:The incidence of WMSDs and fatigue in the upper limbs was 24.44% and 43.76%, respectively. The adjusted structural equation model fitting indicators were generally up to the standard (GFI=1.000, AGFI=1.000, RMSEA=0.043, NFI=0.808, TLI=0.784) . The four exogenous latent variables of work organization, work type, upper limb work posture and individual factors were correlated. There was a strong positive correlation between job type and upper limb work posture ( r=0.865) , a moderate positive correlation between work organization and job type and upper limb work posture ( r=0.570, 0.490) , and a weak negative correlation between individual factors and the other three exogenous latent variables. Upper limb work posture and individual factors had direct effects on upper limb WMSDs, and the effect coefficients were 0.10 and 0.06, respectively. Upper limb fatigue played a mediating role between work organization, work type, upper limb work posture and upper limb WMSDs. The effect coefficient was 0.46, and the composition ratios of indirect effects were 100.0%, 100.0%, and 38.3%, respectively. The direct path effect of upper limb work posture, individual factors and upper limb WMSDs was weaker than the mediating path through upper limb fatigue. Conclusion:When carrying out the prevention and control of upper limbWMSDs, it is necessary to comprehensively consider the pathogenesis path of upper limb muscle fatigue and upper limb WMSDs caused by work organization, work type, and upper limb work posture, so as to provide theoretical reference for improving the prevention and control level of such diseases.

Objective To compare the safety and efficacy of directional atherectomy with anti-restenosis therapy(DAART,drug-coated balloon)versus conventional balloon angioplasty(bare-metal stent,BMS)in elderly patients with femoropopliteal artery disease.Methods A retrospec-tive cohort study was conducted on 116 elderly patients undergoing endovascular intervention due to femoropopliteal artery disease in our hospital between May 2016 and September 2019,divided into DAART group(57 cases)and BMS group(59 cases).Results No statistical differences were observed between the DAART and BMS groups in terms of age,risk factors,distribution of Ruth-erford classification,lesion length,lesion type,lesion location,Global Limb Anatomic Staging Sys-tem grade,infra-popliteal runoff status,or preoperative ankle-brachial index(P＞0.05).However,the BMS group had significantly larger proportion of chronic limb-threatening ischemia than the other group(P＜0.05).Both groups achieved a 100％success rate of surgery.The DAART group obtained obviously higher primary patency rates at 1 and 2 years than the BMS group(90.4％vs 75.0％,76.3％vs 57.3％;P＜0.045).There were no significant differences in the rate of freedom from target lesion revascularization at 1 and 2 years between the two group(96.1％vs 88.8％,91.6％vs 77.7％;P＞0.05).In 2 years of follow-up,the incidence of major adverse events was 10.0％(5 cases)in the DAART group and 20.8％(12 cases)in the BMS group,but no obvious difference(P＞0.05).Conclusion DAART demonstrates superior mid-term efficacy than BMS in treating femoropopliteal artery disease in elderly patients.However,comprehensive preoperative assessment is essential to optimize individualized treatment strategies for this population.

Objectives:To investigate the clinical efficacy and safety of posterior O-arm navigated internal fixation+osteotomy orthopedic surgery and anterior oblique lumbar interbody fusion(OLIF)+posterior O-arm navi-gated internal fixation in the treatment of patients with degenerative scoliosis.Methods:A retrospective anal-ysis was performed on the 55 patients with degenerative scoliosis who were treated in our hospital between May 2016 and June 2023.According to surgical method,the patients were divided into posterior O-arm navi-gated internal fixation+osteotomy orthopedic group(group A,20 cases)and anterior OLIF+posterior O-arm navi-gated internal fixation group(group B,25 cases).Group A consisted of 8 males and 12 females,aged 47-81(66.4±7.4)years old;Group B consisted of 8 males and 17 females,aged 52-81(67.4±8.2)years old.The pe-rioperative data of the patients were collected,and the visual analogue scale(VAS)score and Oswestry disabil-ity index(ODI)were recorded before operation,at postoperative 1 week and final follow-up to evaluate the clinical efficacy,and full-length spinal X-ray were taken in the standing position at the same time point to measure the coronal Cobb angle,sagittal vertical axis(SVA),lumbar lordosis(LL),intervertebral space height,vertebral fusion rate.The complications were recorded and compared between groups.Results:The patients were followed up for 18-38(26.5±5.3)months in group A and 20-36(24.3±4.2)months in group B,with no statistical difference(P＞0.05).Statistical differences(P＜0.05)were observed between group A and group B in operative time(219.0±25.7min vs 169.4±25.6min),intraoperative blood loss(1087.5±353.1mL vs 672.5±308.6mL),postoperative drainage volume(364.7±22.9mL vs 109.3±25.3mL),postoperative ambulation time(11.0±3.4d vs 6.3±1.8d),and number of blood transfusions(18 vs 8).The VAS scores were 6.2±0.9 points and 1.8±0.8 points in group A at postoperative 1 week and final follow-up respectively,which were 4.4±0.9 and 1.3±0.5 in group B,and group B was lower than group A at the same postoperative time point(P＜0.05).The ODI of group A and group B at postoperative 1 week were(22.8±4.8)％and(19.9±2.9)％,and group B was lower than group A(P＜0.05),while there was no significant difference between the two groups at final follow-up(P＞0.05).At postoperative 1 week and final follow-up,the sagittal SVA of group A was 47.0±1 1.5mm and 43.9±19.7mm,which was 35.2±19.9mm and 30.9±19.9mm in group B,and the sagittal correction in group A was better than that in group B(P＜0.05).There was no statistical difference between the two groups in coronal Cobb angle and LL at postoperative 1 week and final follow-up(P＞0.05).The intervertebral space height of group A was 48.1±8.2mm and 46.1±8.5mm at postoperative 1 week and final follow-up,which was 57.4±5.4mm and 56.3±5.6mm in group B,and group B was better than group A(P＜0.05).There were 2 cases of postoperative cerebrospinal fluid leakage,2 cases of delayed incision healing,1 case of nail and rod fracture,1 case of screw loosening in group A,and the complication rate was 30％(6/20);2 cases in group B had postoperative pain on the anteromedial side of the left thigh,and 2 cases had transient left hip flexion weak-ness,all of which recovered at follow-up,and the complication rate was 16％(4/25).The complication rate was higher in group A than group B(P＜0.05).Both groups had no incision infection or spinal cord injury complications.At final follow-up,the bone graft and fusion device were osseous fusion in both groups.Con-clusions:Both posterior O-arm navigated internal fixation+osteotomy orthopedic surgery and anterior OLIF+posterior O-arm navigated internal fixation can achieve satisfactory clinical efficacy in the treatment of degen-erative scoliosis,the former has better sagittal orthopedic effect,but has the problems of long operative time,large amount of bleeding,long postoperative bed rest,and many complications,while the latter has a similar scoliosis correction,as well as the advantages of minimally invasive,less traumatic,fast recovery and fewer complications,which can provide a new option for the minimally invasive treatment of degenerative scoliosis.

BACKGROUND: Diabetic foot is a complex condition with high incidence, recurrence, mortality, and disability rates. Current treatments for diabetic foot ulcers are often insufficient. This study was conducted to identify potential therapeutic targets for diabetic foot. METHODS: Datasets related to diabetic foot and diabetic skin were retrieved from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified using R software. Enrichment analysis was conducted to screen for critical gene functions and pathways. A protein interaction network was constructed to identify node genes corresponding to key proteins. The DEGs and node genes were overlapped to pinpoint target genes. Plasma and chronic ulcer samples from diabetic and non-diabetic individuals were collected. Western blotting, immunohistochemistry, and enzyme-linked immunosorbent assays were performed to verify the S100 calcium binding protein A9 (S100A9), inflammatory cytokine, and related pathway protein levels. Hematoxylin and eosin staining was used to measure epidermal layer thickness. RESULTS: In total, 283 common DEGs and 42 node genes in diabetic foot ulcers were identified. Forty-three genes were differentially expressed in the skin of diabetic and non-diabetic individuals. The overlapping of the most significant DEGs and node genes led to the identification of S100A9 as a target gene. The S100A9 level was significantly higher in diabetic than in non-diabetic plasma (178.40 ± 44.65 ng/mL vs. 40.84 ± 18.86 ng/mL) and in chronic ulcers, and the wound healing time correlated positively with the plasma S100A9 level. The levels of inflammatory cytokines (tumor necrosis factor-α, interleukin [IL]-1, and IL-6) and related pathway proteins (phospho-extracellular signal regulated kinase [ERK], phospho-p38, phospho-p65, and p-protein kinase B [Akt]) were also elevated. The epidermal layer was notably thinner in chronic diabetic ulcers than in non-diabetic skin (24.17 ± 25.60 μm vs. 412.00 ± 181.60 μm). CONCLUSIONS S100A9 was significantly upregulated in diabetic foot and was associated with prolonged wound healing. S100A9 may impair diabetic wound healing by disrupting local inflammatory responses and skin re-epithelialization.
Calgranulin B/therapeutic use* ; Diabetic Foot/metabolism* ; Humans ; Datasets as Topic ; Computational Biology ; Mice, Inbred C57BL ; Animals ; Mice ; Protein Interaction Maps ; Immunohistochemistry

Objectives:To investigate the clinical efficacy and safety of posterior O-arm navigated internal fixation+osteotomy orthopedic surgery and anterior oblique lumbar interbody fusion(OLIF)+posterior O-arm navi-gated internal fixation in the treatment of patients with degenerative scoliosis.Methods:A retrospective anal-ysis was performed on the 55 patients with degenerative scoliosis who were treated in our hospital between May 2016 and June 2023.According to surgical method,the patients were divided into posterior O-arm navi-gated internal fixation+osteotomy orthopedic group(group A,20 cases)and anterior OLIF+posterior O-arm navi-gated internal fixation group(group B,25 cases).Group A consisted of 8 males and 12 females,aged 47-81(66.4±7.4)years old;Group B consisted of 8 males and 17 females,aged 52-81(67.4±8.2)years old.The pe-rioperative data of the patients were collected,and the visual analogue scale(VAS)score and Oswestry disabil-ity index(ODI)were recorded before operation,at postoperative 1 week and final follow-up to evaluate the clinical efficacy,and full-length spinal X-ray were taken in the standing position at the same time point to measure the coronal Cobb angle,sagittal vertical axis(SVA),lumbar lordosis(LL),intervertebral space height,vertebral fusion rate.The complications were recorded and compared between groups.Results:The patients were followed up for 18-38(26.5±5.3)months in group A and 20-36(24.3±4.2)months in group B,with no statistical difference(P＞0.05).Statistical differences(P＜0.05)were observed between group A and group B in operative time(219.0±25.7min vs 169.4±25.6min),intraoperative blood loss(1087.5±353.1mL vs 672.5±308.6mL),postoperative drainage volume(364.7±22.9mL vs 109.3±25.3mL),postoperative ambulation time(11.0±3.4d vs 6.3±1.8d),and number of blood transfusions(18 vs 8).The VAS scores were 6.2±0.9 points and 1.8±0.8 points in group A at postoperative 1 week and final follow-up respectively,which were 4.4±0.9 and 1.3±0.5 in group B,and group B was lower than group A at the same postoperative time point(P＜0.05).The ODI of group A and group B at postoperative 1 week were(22.8±4.8)％and(19.9±2.9)％,and group B was lower than group A(P＜0.05),while there was no significant difference between the two groups at final follow-up(P＞0.05).At postoperative 1 week and final follow-up,the sagittal SVA of group A was 47.0±1 1.5mm and 43.9±19.7mm,which was 35.2±19.9mm and 30.9±19.9mm in group B,and the sagittal correction in group A was better than that in group B(P＜0.05).There was no statistical difference between the two groups in coronal Cobb angle and LL at postoperative 1 week and final follow-up(P＞0.05).The intervertebral space height of group A was 48.1±8.2mm and 46.1±8.5mm at postoperative 1 week and final follow-up,which was 57.4±5.4mm and 56.3±5.6mm in group B,and group B was better than group A(P＜0.05).There were 2 cases of postoperative cerebrospinal fluid leakage,2 cases of delayed incision healing,1 case of nail and rod fracture,1 case of screw loosening in group A,and the complication rate was 30％(6/20);2 cases in group B had postoperative pain on the anteromedial side of the left thigh,and 2 cases had transient left hip flexion weak-ness,all of which recovered at follow-up,and the complication rate was 16％(4/25).The complication rate was higher in group A than group B(P＜0.05).Both groups had no incision infection or spinal cord injury complications.At final follow-up,the bone graft and fusion device were osseous fusion in both groups.Con-clusions:Both posterior O-arm navigated internal fixation+osteotomy orthopedic surgery and anterior OLIF+posterior O-arm navigated internal fixation can achieve satisfactory clinical efficacy in the treatment of degen-erative scoliosis,the former has better sagittal orthopedic effect,but has the problems of long operative time,large amount of bleeding,long postoperative bed rest,and many complications,while the latter has a similar scoliosis correction,as well as the advantages of minimally invasive,less traumatic,fast recovery and fewer complications,which can provide a new option for the minimally invasive treatment of degenerative scoliosis.

To explore the effect of simulation technology in the training of flexible fiberoptic intubation for undergraduate students. The research subjects were 39 students majoring in dentistry at Air Force Medical University, including 22 males and 17 females with an average age of 20.62 years. The study subjects were randomly divided into two groups, with 19 in experimental group and 20 in control group. There were no significant differences in gender and age distribution. The experimental group used the flexible fiberoptic bronchoscopy to perform 5 times in endoscopic operation training module, while the control group was only familiar with flexible fiberoptic bronchoscopy without simulation training. The two groups were evaluated for their skills after training. The evaluation included the duration of placing the fiberoptic bronchoscope into the airway and the time to find the target pattern. The duration of placing and finding the target pattern were compared between two groups. The Global rating scale(GRS) was used to evaluate the proficiency of positioning, operation and direction. The students gave self-confidence feedback before and after the training, and the rating was based on the Liker five-level scale. The experimental group of students had a bronchoscopy insertion time of 18.0 (18.0, 20.0) s and a target pattern search time of 20.0 (17.0, 21.0) s, both of which were significantly faster than the control group′s times of 30 (36.0, 47.0) s and 39.0 (30.0, 41.0) s, respectively, P<0.001. The experimental and control groups′ GRS scores for task proficiency were 3.0 (3.0, 4.0) and 3.0 (3.0, 4.0), respectively, which were substantially higher than those in the control group (2.0, 1.0, 2.0) and 2.0 (1.0, 2.0) ( P<0.001). There was no statistically significant difference in confidence feedback between the two groups prior to training, according to the results of the trainees′ feedback on operational confidence. The control group had a confidence feedback score of 2.0 (1.0, 2.0) after training, while the experimental group earned a feedback score of 3.0 (2.0, 3.0), showing a substantial gain in student confidence ( P<0.001). Fiberoptic bronchoscopy intubation simulation training is excellent for novices to quickly understand this technology, increase their academic performance and confidence, and provide an effective reference for undergraduate teaching of this technology.