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.

The pathophysiological process of ischemic stroke (IS) is highly complex. Current clinical treatments are limited by a narrow therapeutic time window and are inadequate for improving residual neurological dysfunction. Therefore, animal models have become essential tools for exploring the pathological mechanisms of this disease from both traditional Chinese medicine (TCM) and Western medicine perspectives,as well as for evaluating innovative therapeutic strategies. This review systematically outlines existing IS modeling methods and cutting-edge advances. It comparatively integrates the multi-layered pathogeneses in Western medicine, including excitotoxicity, oxidative stress, inflammatory responses, blood-brain barrier injury, ferroptosis, and PANoptosis, with the core TCM pathogenesis characterized by disorders of Qi and blood and functional imbalance caused by "wind, fire/heat, phlegm, blood stasis, and deficiency." Furthermore, this paper categorizes and compares the specific modeling techniques, evaluation indicators, and respective advantages and limitations of focal cerebral ischemia models, global cerebral ischemia models, and TCM disease-syndrome combined models, such as the Qi deficiency and blood stasis syndrome. Literature review suggests that, by exploring emerging cell death mechanisms like PANoptosis and introducing environmental stress or dietary interventions on the basis of ischemic modeling, specific TCM syndromes associated with IS can be preliminarily screened out and replicated. It provides a feasible approach for objectively elucidating the biological basis of TCM interventions involving multiple targets and pathways. Given that traditional single-disease models fail to fully capture the complexity and individual heterogeneity of the cerebral network microenvironment in clinical patients, future research on IS animal models should focus on the deep integration of TCM and Western medicine in pathogenesis. By leveraging multidisciplinary technologies, such as gene editing, high-resolution in vivo imaging, artificial intelligence-driven multi-omics analysis, and brain organoids, researchers can construct high-biomimetic, multi-dimensional models that closely mirror clinical scenarios, thereby effectively improving the success rate of translating innovative IS therapies from basic research to clinical application.

ObjectiveTo investigate the association between endothelin receptor type A gene （EDNRA） and congenital bilateral absence of the vas deferens （CBAVD）. MethodsThis case-control study consisted of 124 subjects with CBAVD and 100 fertile controls.Two single nucleotide polymorphisms （SNPs： rs5335 and rs1801708） in the EDNRA gene were genotyped via PCR， PCR-RFLP analysis， and direct sequencing. ResultsNo significant differences existed between EDNRA polymorphisms and CBAVD phenotype （rs1801708： P=0.220 2， 0.163 2； rs5335： P=0.805 8， 0.818 6）. However， the rs1801708-rs5335 haplotype AG was notably associated with an increased risk of CBAVD （P=0.008 6， OR=2.178， 95% CI： 1.207-3.929）. A significantly protective effect of rs1801708-rs5335 haplotype GG on CBAVD （P=0.038 5， OR= 0.671， 95% CI： 0.460-0.980） was observed. After Bonferroni correction， the result for haplotype A-G remained significant （P =0.008 6<0.012 5）， while haplotype G-G was not significant. ConclusionThe rs1801708-rs5335 AG haplotype of EDNRA is a potential risk factor for CBAVD development in Han Chinese.

ObjectiveTo investigate the effect of growth hormone （GH） pretreatment on the clinical outcomes of in vitro fertilization/intracytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET） in patients with diminished ovarian reserve （DOR）. MethodsA retrospective analysis was conducted on the clinical data of 359 DOR patients undergoing IVF/ICSI-ET. Based on the use of GH pretreatment before ovarian stimulation and/or its addition during the stimulation cycle， patients were divided into three groups： the Control group （n=119）， receiving no GH pretreatment or addition； the Non-GH pretreatment group （n=115）， receiving GH （4 IU/d） only during ovarian stimulation without pretreatment； and the GH pretreatment group （n=125）， pretreated with GH （2 IU/d） for 4-6 weeks before stimulation and also receiving GH （4 IU/d） during stimulation. The basic characteristics， ovarian stimulation parameters， embryological data， and cumulative live birth rate （CLBR） were compared among the groups. Results① No significant differences were found among the three groups regarding female age， male age， duration of infertility， body mass index （BMI）， basal hormone levels， distribution of ovarian stimulation protocols， endometrial thickness， serum estradiol （E2） and luteinizing hormone （LH） levels on the day of HCG trigger， or the number of blastocysts transferred per cycle. ② The GH pretreatment group required significantly lower total gonadotropin （Gn） dosage and fewer days of stimulation than the Control and Non-GH pretreatment group（P<0.05）. Compared to the Control group， the GH pretreatment group showed significantly higher numbers of retrieved oocytes， the number of mature oocytes， 2-pronuclei （2PN） zygotes， 2PN cleaved embryos， transferable embryos， high-quality embryos， as well as higher cumulative clinical pregnancy rates and CLBR （P<0.05）. Compared to the Non-GH pretreatment group， the GH pretreatment group had significantly more transferable embryos， high-quality embryos， and a higher CLBR （P<0.05）. ③ Compared to the Control group， the Non-GH pretreatment group only had a significantly higher number of retrieved oocytes （P<0.05）， with no significant differences in the number of mature oocytes， 2PN fertilized oocytes， 2PN cleaved embryos， transferable blastocysts， high-quality blastocysts， cumulative clinical pregnancy rate， and CLBR. ConclusionFor DOR patients， GH pretreatment for 4-6 weeks prior to ovarian stimulation can improve oocyte yield， embryo quality， cumulative clinical pregnancy rate， and CLBR， thereby enhancing the clinical outcomes of IVF/ICSI-ET.

Objective:To explore the clinical characteristics of neonatal necrotizing enterocolitis（NEC）and analyze the risk factors for early-onset NEC.Methods:A total of 220 children with NEC admitted to the Department of Pediatrics，Tianjin Medical University General Hospital from January 1st，2018 to February 29th，2024 were retrospectively selected as the research objects. According to the time of onset，the early-onset group（ n=120）and the late-onset group（ n=100）were established，and the clinical characteristics of the two groups were compared. Another 150 cases of normal healthy newborns born in this hospital in the same period were selected as the control group，and the clinical data of the control group were collected. The clinical characteristics of the early-onset group and the control group were compared，and the risk factors of early-onset NEC were analyzed by multivariate Logistic regression. Results:Compared with the late-onset group，the early-onset group had fever［50.0%（60/120）vs. 40%（40/100）， χ2=7.333， P=0.007］，apnea［39.17%（47/120）vs. 28%（28/100）， χ2=7.568， P=0.006］，no rise in body temperature［56.67%（68/120）vs. 39%（39/100）， χ2=6.815， P=0.009］，abdominal distension［25%（30/120）vs. 40%（40/100）， χ2=13.200， P<0.001］，vomiting［30.83%（37/120）vs. 45%（45/100）， χ2=12.797， P<0.001］was significantly different（all P<0.05）；Multivariate Logistic regression analysis：weight<1 500 g（ OR=5.871，95% CI：3.153～9.673， P<0.001），gestational age<30 weeks（ OR=4.256，95% CI：2.641～7.896， P=0.007），hemodynamically significant patent ductus arteriosus（hs-PDA）（ OR=3.113，95% CI：1.865～5.133， P=0.033），severe anemia（ OR=3.057，95% CI：2.165～4.802， P=0.001），feeding intolerance（ OR=4.215，95% CI：1.579～10.802， P=0.005），amniotic fluid pollution（ OR=2.452，95% CI：1.579～3.111， P<0.001）were the independent risk factors for early-onset NEC（all P<0.05）. Conclusion:Weight<1 500 g，gestational age<30 weeks，hs-PDA，severe anemia，feeding intolerance，and amniotic fluid contamination are independent risk factors for early-onset NEC. In clinical practice，more attention should be paid to these factors for disease prevention，early identification，and timely intervention in newborns to reduce the occurrence of NEC.

Objective To modify the dosage form of Guoganglong Sugar-Coated Tablets,and to investigate the chemical equivalence and pharmacodynamic equivalence between the new and old dosage forms of Guoganglong Tablets.Methods The preparation technology was screened by single-factor exploration with the indexes of hardness and dispersion uniformity,the quality standard was established by thin layer chromatography identification,high performance liquid chromatography(HPLC)content determination and charactertistics chromatograms,the constituents absorbed into blood were analyzed by ultra-high performance liquid chromatography quadrupole time of flight mass spectrometry(UHPLC-Q-TOF-MS),and the pharmacodynamics was evaluated by anti-inflammatory experiment and analgesic experiment in mice model with inflammatory pain.Results The molding process of Guoganglong Dispersible Tablets was determined.A thin layer chromatographic identification method was established.A method for detecting the content of Guoganglong Tablets and the charactertistic chromatograms was established by HPLC,and a total of 15 common peaks were identified,with the similarity of the new-old dosage forms being greater than 0.9.A total of 12 constituents absorbed into blood were identified.Guoganglong Tablets could alleviate swelling degree of toes in mice with inflammatory pain,reduce the levels of interleukin 6(IL-6)in serum,improve spleen index,and increase the thermal pain threshold and acetic acid twisting frequency in mice.Conclusion The prescription process of Guoganglong Dispersible Tablets is stable,the quality standard is feasible,the chemical composition and pharmacological actions between the new and old dosage forms are basically the same,and in terms of certain indexes,Dispersible Tablets of Guoganglongare superior to Sugar-Coated Tablets.

Objective To explore the efficacy of endoscopic minimally invasive release surgery and ultrasound-guided percutaneous needle knife release in treating carpal tunnel syndrome(CTS).Methods A total of 96 patients with CTS,who received treatment at Yixing People's Hospital and Wuxi Ninth Hospital Orthopedic Hospital from January 2021 to December 2024,were selected for this study.Using a random number table method,the 96 patients were divided into an endoscopic group and an ultrasound group,with 48 patients in each group.The patients of endoscopic group received endoscopic minimally invasive release surgery,while the patients of ultrasound group received ultrasound-guided needle knife treatment.The surgical indicators,efficacy,wrist function,median nerve electrophysiological indicators,anatomical indicators,efficacy,and safety were compared between the two groups.Results In the ultrasound group,the surgical duration and postoperative recovery time were shorter than those in the endoscopic group(P＜0.05),and the surgical cost was lower than that in the endoscopic group(P＜0.05).The postoperative Symptom Severity Score(SSS)and Functional Status Scale(FSS)score of both groups were decreased when compared with their preoperative values(P＜0.05),and the SSS and FSS of the ultrasound group were lower than those of the endoscopic group(P＜0.05).After treatment,the resting pain score and activity pain score of both groups were decreased when compared with their preoperative values(P＜0.05),and the resting pain score and activity pain score in the ultrasound group were lower than those in the endoscopic group(P＜0.05).After treatment,both groups showed a reduction in median nerve flattening ratio(FR)and transverse carpal ligament(TCL)thickness when compared with their preoperative values(P＜0.05),and the reduction degree in the ultrasound group was greater than that in the endoscopic group(P＜0.05).After treatment,both groups showed an increase in sensory nerve conduction velocity(SNCV),sensory nerve action potential amplitude(SNAP),and motor nerve action potential amplitude(CMAP)when compared with their preoperative values(P＜0.05),which in the ultrasound group showed a greater improvement than those in the endoscopic group(P＜0.05).The postoperative distal motor latency(DML)was decreased in both groups(P＜0.05),and the DML in the ultrasound group was lower than that in the endoscopic group(P＜0.05).The therapeutic efficacy in the ultrasound group was higher than that in the endoscopic group(P＜0.05).Conclusion Compared to endoscopic minimally invasive release surgery,ultrasound-guided needle knife treatment is more effective in promoting the recovery of wrist joint function in patients with CTS.It can effectively decrease the pain severity of patients,repair anatomical injuries in the wrist,promote the recovery of nerve electrophysiological indicators of the median nerve,with good safety and lower medical costs.

Objective To investigate the diagnostic value of serum bromodomain-containing pro-tein 4(BRD4)combined with gastrin-17(G-17)in Helicobacter pylori(Hp)-positive early gastric cancer.Methods A total of 88 patients with Hp-positive early gastric cancer admitted to our hospital from September 2021 to September 2023 were selected as early gastric cancer group.Meanwhile,92 patients with Hp-positive precancerous lesions and 80 patients with Hp-positive gastritis admitted dur-ing the same period were selected as precancerous lesion group and gastritis group,respectively.En-zyme-linked immunosorbent assay(ELISA)was used to detect the serum levels of BRD4 and G-17.Multivariate logistic regression analysis was performed to screen the influencing factors of Hp-positive early gastric cancer.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of serum BRD4 and G-17 in Hp-positive early gastric cancer.Results Compared with the gastritis group,the levels of BRD4 and G-17 in the precancerous lesion group and early gastric cancer group were significantly increased(P＜0.05).Furthermore,compared with the precancerous le-sion group,the levels of BRD4 and G-17 in the early gastric cancer group were also significantly elevated(P＜0.05).The proportion of patients with a family history of gastric cancer,those who preferred hot food,cold food,or high-salt food,as well as the levels of PG Ⅱ,BRD4,and G-17 were signifi-cantly higher in the early gastric cancer group than in the non-gastric cancer group,while the level of pepsinogen(PG)Ⅰ was significantly lower(P＜0.05).Logistic regression analysis revealed that preference for hot food,high-salt food,PG Ⅱ,BRD4,G-17,and PG Ⅰ were all influencing factors for Hp-positive early gastric cancer(P＜0.05).The area under the curve(AUC)values for serum BRD4,G-17,and their combination in diagnosing Hp-positive early gastric cancer were 0.793,0.830,and 0.912,respectively.The diagnostic efficacy of the combined detection was superior to that of single detection(P＜0.05).Conclusion The serum levels of BRD4 and G-17 are elevated in patients with Hp-positive early gastric cancer,and both exhibit certain diagnostic value for Hp-positive early gastric cancer,suggesting their potential as serum biomarkers for the diagnosis of Hp-positive early gastric cancer.

Objective:To evaluate the efficacy and safety of regional citrate anticoagulation (RCA) during plasma exchange (PE) in pediatric patients.Methods:We conducted a retrospective analysis of 12 critically ill children admitted to the Pediatric Intensive Care Unit (PICU) of Jinan Children's Hospital, who underwent 28 PE sessions with RCA between December 2023 and August 2024. Clinical records were reviewed to assess bleeding events, extracorporeal circuit performance, and changes in arterial blood gas parameters, serum total calcium (Ca tot), and activated clotting time before and after treatment. Results:No patients exhibited signs of increased bleeding. In one case, the procedure was discontinued prematurely due to elevated venous pressure. A significant decrease in ionized calcium (Ca ion) was observed 0.5 hours post-treatment. At the end of PE, pH, HCO 3?, base excess (BE), lactate, PaCO 2, Ca tot, and Na + levels increased, while K + and Ca ion levels decreased, with all changes being statistically significant. Four hours post-treatment, pH, HCO 3?, BE, PaCO 2, and Na + remained elevated, whereas Ca ion, lactate, and K + returned to baseline. By 12–15 hours post-treatment, all parameters—including pH, HCO 3?, BE, PaCO 2, Na +, K +, Ca ion, and lactate—had normalized, showing no significant differences from pre-treatment levels. Conclusions:RCA provides effective extracorporeal anticoagulation during pediatric PE without increasing bleeding risk. However, metabolic complications—primarily metabolic alkalosis—are common. These disturbances typically resolve spontaneously and do not lead to severe adverse events. While no ideal anticoagulant for PE has yet been established, RCA remains a safe and effective option, particularly for pediatric patients at higher risk of bleeding.

Objective: To evaluate the clinical efficacy of preimplantation genetic testing for monogenic disorders(PGT-M) in families with hereditary epilepsy. Methods : Whole-exome sequencing(WES) and familial co-segregation analysis were performed to validate the pathogenicity of variants(PCDH19 c. 1031C > G and LGI1 c. 856T >G) in two monogenic epilepsy families. A clinical PGT-M pathway was implemented,and reproductive outcomes were tracked. Results: In Family 1(PCDH19 likely pathogenic variant),13 blastocysts were biopsied over two ovarian stimulation cycles,yielding 3 unaffected euploid embryos(23. 1%). After the third frozen embryo transfer,a healthy male infant was successfully delivered. Prenatal diagnosis confirmed that the fetus did not carry the pathogenic variant PCDH19. Family 2(LGI1 variant of uncertain significance,VUS) screened 14 blastocysts,identifying 2 unaffected euploid embryos(14. 3%),with the first transfer unsuccessful. A clinical pregnancy was currently ongoing following the second frozen-thawed embryo transfer(FET). Conclusion PGT-M can precisely block the vertical transmission of monogenic epileptic pathogenic variants,offering an effective reproductive intervention strategy for families with hereditary epilepsy.