Work-related musculoskeletal disorders (WMSDs) represent a significant occupational health challenge among healthcare professionals globally, posing substantial threats to physical and mental well-being as well as work sustainability. Adopting preventive behaviors—including ergonomic postural adjustments, optimized work-rest scheduling, proper use of protective and assistive equipment, and regular physical activity—is essential for mitigating the risk of WMSDs. Guided by the social ecological model, the review synthesized current evidence on the determinants of WMSDs preventive behaviors across four levels: intrapersonal characteristics, work environment conditions, interpersonal support, and policy/institutional factors. The findings suggest that higher educational attainment, favorable health-related behavioral patterns, optimized ergonomic work environments, adoption of supportive collaborative systems, strong organizational support, as well as policy safeguards facilitate preventive behavior adoption. Conversely, limited prevention-related knowledge, low risk perception, insufficient physical activity, excessive workload, lack of appropriate protective equipment, inadequate ergonomic training, a prevailing culture of presenteeism, and inadequate policy implementation constitute significant barriers. Multi-dimensional intervention strategies targeting these determinants are warranted to enhance preventive behaviors, reduce the risk of WMSDs, and strengthen occupational health protection for healthcare professionals.

ObjectiveTo analyze the characteristics and influencing factors of elderly hospitalized patients with carbapenem-resistant gram-negative bacillus (CRO) infection in the intensive care unit (ICU) of a gradeⅡ level A general hospital in Yangpu District of Shanghai, and to provide scientific basis for the prevention and control of hospital-acquired CRO infection in such hospitals. MethodsThe clinical data of elderly ICU patients (age ≥60 years) from January 2019 to December 2023 were retrospectively collected. A total of 122 cases with hospital-acquired CRO infection were used as the case group, and a total of 68 cases with carbapenem-sensitive gram-negative (CSO) infection were used as the control group. The clinical characteristics of the two groups were analyzed, and univariate analysis and logistic regression analysis were performed for screening for possible influencing factors on hospital-acquired CRO infection. ResultsThe main pathogens of CRO infection were carbapenem-resistant Acinetobacter baumannii (CRAB) (53 cases, 43.44%) and carbapenem-resistant Klebsiella pneumoniae (CRKP) (46 cases, 37.70%), and 17 patients (13.93%) had more than two types of CRO infection. Among the CRO infection, the main sites were lower respiratory tract infection (58 cases, 47.54%), ventilator-associated pneumonia (21 cases, 17.21%), and catheter-associated urinary tract infections (16 cases, 13.11%). The incidence rate of poor prognosis was higher in the CRO infection group (54.10%) than that in the CSO infection group (36.76%) (P=0.021). The results of univariate analysis showed that male, history of hospitalization within three months, chronic respiratory disease, hypoproteinemia, anemia, and history of invasive procedures prior to infection, including indwelling central venous catheter, invasive mechanical ventilation, urinary catheter, gastric tube placement and parenteral nutrition, in addition, heparin anticoagulation, the use of broad-spectrum penicillin, third-generation cephalosporins, fluoroquinolones, carbapenems, carbapenems combined with fluoroquinolones, carbapenems combined with glycopeptides, use of ≥3 antibiotics and long time of antibiotic use prior to infection were all associated with the CRO infection (P<0.05). The results of logistic regression analysis showed that use of carbapenems (OR=7.739, 95%CI: 2.226‒26.911), ≥3 types of antibiotics (OR=6.307, 95%CI: 1.674‒23.754), invasive mechanical ventilation (OR=4.082, 95%CI: 1.795‒9.281), urinary catheter (OR=3.554, 95%CI: 1.074‒11.758), and comorbid hypoproteinemia (OR=4.741, 95%CI: 2.039‒11.022) and diabetes (OR=3.245, 95%CI: 1.344‒7.839) were positively correlated with the risk of CRO infection. ConclusionConcurrent use of carbapenems with multiple other antibiotics, as well as the use of invasive mechanical ventilation, urinary catheter, and comorbid hypoproteinemia and diabetes, may be associated with an increased influencing of CRO infection. More attention should be paid to the prevention and control of infection in elderly patients with the above-mentioned risk factors, and active screening of drug-resistant bacteria should be strengthened. Besides, the rational use of broad-spectrum antibiotics such as carbapenems, avoiding unnecessary invasive operations, and paying attention to patient nutrition and blood glucose control all can reduce the incidence of CRO infection and help to improve clinical outcomes.

Objective To explore the clinical efficacy and mechanism of Tanreqing injection on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)based on network pharmacology and cell experiments.Methods The 80 patients with AECOPD were divided into a control group and a combination group of 40 cases according to the random number method.Both groups were given conventional Western medicine treatment,and the combined group was treated with Tanreqing injection.The clinical efficacy of TCM,inflammatory factors and safety were compared between the two groups of patients.Databases such as TCMSP and software such as Cytoscape 3.7.0 were used to screen out the mechanism of Tanreqing injection in the treatment of AECOPD,and human bronchial epithelial cells 16HBE were used for experimental verification.Results The clinical effective of TCM in the combined group was higher than that in the control group(P<0.05).WBC,hs-CRP,IL-6 and SAA in the two groups were lower than before treatment(P<0.05),and those of the combined group were lower than control group(P<0.05).There was no statistically difference in adverse reactions between the two groups(P>0.05).Key targets such as MAPK1,IL-6,AKT1,and key pathways such as IL-17 signaling pathway and PI3K-Akt signaling pathway were obtained by network pharmacology methods.The level of MAPK1,IL-6,p-AKT/AKT and PI3K in the model group were significantly lower than the blank group(P<0.01);Compared with the model group,the expression of MAPK1,IL-6,pAKT/AKT and PI3K protein in the Tanreqing extract group significantly and dose-dependently reduced(P<0.05).Conclusion Tanreqing injection can reduce the inflammation level and improve the clinical efficacy in AECOPD patients.Its mechanism may be related to the inhibition of protein expression including IL-6,PI3K and p-AKT/AKT,and the regulation of the PI3K-Akt signaling pathway.

Objective To explore the trajectory of disability acceptance and the factors influencing it in first stroke patients.Methods A total of 202 first-ever stroke patients admitted to Wenzhou Central Hospital from December 2022 to December 2023 were selected,low acceptance group(n=38),medium acceptance group(n=96),and high acceptance group(n=68)based on the trajectory of disability acceptance after discharge.Multivariate Logistic regression was applied to explore the factors affecting disability acceptance in first-episode stroke patients.Results The total score of acceptance of disability scale-revised(ADS-R)in stroke patients was(89.93±13.51)points.There were differences between three groups in terms of age,education level,family income,caregiver or no caregiver,severity of illness,medical social support scale(MOS-SSS)scores,herth hope index(HHI)scores,and patient health questionnaire depression scale-9 scores(P＜0.05).Multivariate Logistic regression analysis reveled that age(OR=12.419,95％CI:3.967-38.882),absence of caregiver(OR=5.793,95％CI:1.989-16.875),severity of the condition(OR=5.724,95％CI:1.927-16.999)were risk factors affecting disability acceptance in first-episode stroke patients(P＜0.05),while educational level(OR=0.207,95％CI:0.069-0.624),household income(OR=0.238,95％CI:0.079-0.712),and MOS-SSS score(OR=0.502,95％CI:0.303-0.832)were protective factors(P＜0.05).Conclusion There are three different trajectories of disability acceptance in first-episode stroke patients.Age,presence or absence of caregivers,severity of the condition,education level,household income,and MOS-SSS score are influencing factors of disability acceptance in first-episode stroke patients and can be used as predictive factors for disability acceptance trajectories.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective:To assess the association of single nucleotide polymorphisms (SNP) of the cell division cycle 42 ( CDC42) gene with Pulmonary artery systolic pressure (PASP) among patients with Congenital heart disease (CHD). Methods:In this observational study, clinical data and blood samples were collected from 579 CHD patients with left-to-right shunt who presented to our hospital between January 2012 and January 2017. SNPs of the CDC42 gene were genotyped using an improved multiple ligase detection reaction. Multiple linear regression was applied to evaluate the association of CDC42 gene variants with PASP. This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University (Ethics No.: 20180222-102). Results:Polymorphisms at rs2501256 and rs34896897 of the CDC42 gene were significantly associated with PASP. Compared with the CC genotype at rs2501256, TT and CT carriers displayed higher PASP [TT vs. CC: B (95% CI) = 4.01 (1.95, 6.07), P<0.001; CT vs. CC: B (95% CI)=2.91 (0.63, 5.19), P< 0.001]. Similarly, GG and GA genotypes at rs34896897 were associated with higher PASP compared to the AA genotype [GG vs. AA: B (95% CI) = 26.15 (20.45, 31.84), P<0.001; GA vs. AA: B (95% CI)=7.19 (4.31, 10.08), P<0.001]. Genetic model analyses demonstrated significant differences for both rs2501256 and rs34896897 under dominant, additive, and recessive models ( P<0.05). TT carriers at rs2501256 exhibited larger left-and right-atrial diameters, whereas GG carriers at rs34896897 showed greater right-atrial and right-ventricular end-diastolic dimensions. Subgroup analyses revealed no association between rs2501256 and PASP in males, individuals younger than 18 years, Uyghur ethnicity, or those with ventricular septal defects. Conclusion:CHD patients carrying the minor alleles of rs2501256 and rs34896897 in the CDC42 gene present higher incidence of PASP compared to those carrying the common alleles.

OBJECTIVE: To assess the association of single nucleotide polymorphisms (SNP) of the cell division cycle 42 (CDC42) gene with Pulmonary artery systolic pressure (PASP) among patients with Congenital heart disease (CHD). METHODS: In this observational study, clinical data and blood samples were collected from 579 CHD patients with left-to-right shunt who presented to our hospital between January 2012 and January 2017. SNPs of the CDC42 gene were genotyped using an improved multiple ligase detection reaction. Multiple linear regression was applied to evaluate the association of CDC42 gene variants with PASP. This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University (Ethics No.: 20180222-102). RESULTS: Polymorphisms at rs2501256 and rs34896897 of the CDC42 gene were significantly associated with PASP. Compared with the CC genotype at rs2501256, TT and CT carriers displayed higher PASP [TT vs. CC: B (95%CI) = 4.01 (1.95, 6.07), P < 0.001; CT vs. CC: B (95%CI) = 2.91 (0.63, 5.19), P < 0.001]. Similarly, GG and GA genotypes at rs34896897 were associated with higher PASP compared to the AA genotype [GG vs. AA: B (95%CI) = 26.15 (20.45, 31.84), P < 0.001; GA vs. AA: B (95%CI) = 7.19 (4.31, 10.08), P < 0.001]. Genetic model analyses demonstrated significant differences for both rs2501256 and rs34896897 under dominant, additive, and recessive models (P < 0.05). TT carriers at rs2501256 exhibited larger left-and right-atrial diameters, whereas GG carriers at rs34896897 showed greater right-atrial and right-ventricular end-diastolic dimensions. Subgroup analyses revealed no association between rs2501256 and PASP in males, individuals younger than 18 years, Uyghur ethnicity, or those with ventricular septal defects. CONCLUSION CHD patients carrying the minor alleles of rs2501256 and rs34896897 in the CDC42 gene present higher incidence of PASP compared to those carrying the common alleles.
Humans ; Male ; Female ; Heart Defects, Congenital/physiopathology* ; Polymorphism, Single Nucleotide ; cdc42 GTP-Binding Protein/genetics* ; Adult ; Child ; Genotype ; Adolescent ; Child, Preschool ; Genetic Predisposition to Disease ; Pulmonary Artery/physiopathology*

Objective To explore the impact of the TINCR-MAF:MAFB transcription factor network on the expression of proliferation and differentiation-related genes in keratinocytes,to verify the role of this network in the occurrence and development of psoriasis and its potential mechanisms.Methods Employed RNA interference technology to knock down TINCR gene expression,and the proliferation ability of keratinocytes was assessed using the CCK-8 method.Additionally,qRT-PCR and Western blot analyses were conducted to evaluate the RNA and protein expression levels of TINCR,MAFB,and KLF4 genes.Immunohistochemical methods were used to detect the expression of KLF4 protein in psoriasis tissues.Results After TINCR gene siRNA interference,the proliferation ability of keratinocytes significantly decreased at 24,48,and 72 hours(P<0.001),indicating that the TINCR gene plays a critical role in cell proliferation.The results of qRT-PCR and Western blot analyses showed that the RNA and protein expression levels of TINCR,MAFB,and KLF4 genes were significantly reduced(P<0.001),suggesting that TINCR may influence the differentiation of keratinocytes by regulating the expression of MAFB transcription factor and KLF4 differentiation-related genes.Furthermore,immunohistochemical results indicated that the expression of KLF4 protein was significantly elevated in psoriasis tissues compared to normal skin tissues,suggesting that KLF4 plays an important role in the pathogenesis of psoriasis.Conclusions The TINCR-MAF:MAFB transcription factor network may participate in the occurrence and development of psoriasis by affecting the proliferation and differentiation of keratinocytes.This finding provides a new perspective on the pathogenesis of psoriasis and potential targets for future therapeutic strategies.

Objective To explore the clinical efficacy and mechanism of Tanreqing injection on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)based on network pharmacology and cell experiments.Methods The 80 patients with AECOPD were divided into a control group and a combination group of 40 cases according to the random number method.Both groups were given conventional Western medicine treatment,and the combined group was treated with Tanreqing injection.The clinical efficacy of TCM,inflammatory factors and safety were compared between the two groups of patients.Databases such as TCMSP and software such as Cytoscape 3.7.0 were used to screen out the mechanism of Tanreqing injection in the treatment of AECOPD,and human bronchial epithelial cells 16HBE were used for experimental verification.Results The clinical effective of TCM in the combined group was higher than that in the control group(P<0.05).WBC,hs-CRP,IL-6 and SAA in the two groups were lower than before treatment(P<0.05),and those of the combined group were lower than control group(P<0.05).There was no statistically difference in adverse reactions between the two groups(P>0.05).Key targets such as MAPK1,IL-6,AKT1,and key pathways such as IL-17 signaling pathway and PI3K-Akt signaling pathway were obtained by network pharmacology methods.The level of MAPK1,IL-6,p-AKT/AKT and PI3K in the model group were significantly lower than the blank group(P<0.01);Compared with the model group,the expression of MAPK1,IL-6,pAKT/AKT and PI3K protein in the Tanreqing extract group significantly and dose-dependently reduced(P<0.05).Conclusion Tanreqing injection can reduce the inflammation level and improve the clinical efficacy in AECOPD patients.Its mechanism may be related to the inhibition of protein expression including IL-6,PI3K and p-AKT/AKT,and the regulation of the PI3K-Akt signaling pathway.

Objective To explore the trajectory of disability acceptance and the factors influencing it in first stroke patients.Methods A total of 202 first-ever stroke patients admitted to Wenzhou Central Hospital from December 2022 to December 2023 were selected,low acceptance group(n=38),medium acceptance group(n=96),and high acceptance group(n=68)based on the trajectory of disability acceptance after discharge.Multivariate Logistic regression was applied to explore the factors affecting disability acceptance in first-episode stroke patients.Results The total score of acceptance of disability scale-revised(ADS-R)in stroke patients was(89.93±13.51)points.There were differences between three groups in terms of age,education level,family income,caregiver or no caregiver,severity of illness,medical social support scale(MOS-SSS)scores,herth hope index(HHI)scores,and patient health questionnaire depression scale-9 scores(P＜0.05).Multivariate Logistic regression analysis reveled that age(OR=12.419,95％CI:3.967-38.882),absence of caregiver(OR=5.793,95％CI:1.989-16.875),severity of the condition(OR=5.724,95％CI:1.927-16.999)were risk factors affecting disability acceptance in first-episode stroke patients(P＜0.05),while educational level(OR=0.207,95％CI:0.069-0.624),household income(OR=0.238,95％CI:0.079-0.712),and MOS-SSS score(OR=0.502,95％CI:0.303-0.832)were protective factors(P＜0.05).Conclusion There are three different trajectories of disability acceptance in first-episode stroke patients.Age,presence or absence of caregivers,severity of the condition,education level,household income,and MOS-SSS score are influencing factors of disability acceptance in first-episode stroke patients and can be used as predictive factors for disability acceptance trajectories.