Background Construction workers represent a high risk group for occupational injuries. Currently, domestic and international studies examining the factors affecting occupational injuries among construction workers focus on demographic and behavioural characteristics. However, there is limited attention to psychosocial, use of digital technology, and health status of workers. Objective To analyze the occurrence of occupational injuries among workers in the construction industry, explore impacts of psychosocial risk, use of digital technology, health status, and preventive measures at the workplace on occupational injuries, and provide a basis for the development of preventive measures. Methods Publicly available data from the European Union Occupational Safety and Health Administration were retrieved, comprising a sample of 2167 construction workers. The outcome indicator was the presence of occupational injuries among workers. A total of 25 variables in the dimensions of psychosocial risk, use of digital technology, health status, and preventive measures at the workplace were extracted after Chi-square test, and then a combination of Boruta's algorithm and logistic regression was applied to identify the key factors affecting occupational injuries. Results Among the 2167 construction workers surveyed, 182 (8.6%) reported experiencing occupational injuries. The Boruta algorithm identified eight characteristics which in descending order of importance were musculoskeletal disorders, job type, depression and anxiety, level of completed education, use of electronic smart products, timely solution of safety problems, overall fatigue, and age. The logistic regression results indicated that six variables had statistically significant effects on occupational injuries: age, job type, level of completed education, musculoskeletal disorders, overall fatigue, and timely solution of safety problems (P<0.05). Conclusion Occupational injuries in construction workers are influenced by a variety of factors, including age, job type, level of completed education, musculoskeletal disorders, overall fatigue, and timely solution of safety problems. Companies and workers should take targeted measures to reduce the incidence of occupational injuries.

There are difficulties in the treatment of Alzheimer's disease (AD) in medical community. Since the surgery of cervical deep lymphatic vessel/lymphatic node-vein anastomosis (LVA/LnVA) has made clinical improvement in patients with AD, it offers a surgical option to treat AD. Especially improvements in cognitive impairment. However the mechanism in treatment of AD is not yet made clear. This article preliminarily explores the mechanism in improvement of some symptoms in patients with AD through cervical deep LVA/LnVA on the basis of morphological characteristics of the cribriform plate-cervical lymphatic pathway.

Objective:To investigate the impact of the development of the digital economy on the unfair of healthcare resource allocation in China.Methods:The sample data from 23 provinces across the country from 2015 to 2021 were tested using econometric regression.Results:It is found that the development of the digital economy will exacerbate the unfairness of the allocation of medical and health resources in China.Further analysis results show that there are regional differences in the impact of digital economy on the distribution of medical resources,which is mainly manifested in the central and western regions,but weaker in the eastern region,and this impact will weaken with the improvement of the development level of digital economy.At the same time,it also explores the possible influencing mechanisms.It is found that due to the demand-oriented allocation of medical and health resources,the development of digital economy will lead to more unfair allocation of medical resources by affecting economic level,education level and income gap.Conclusion:In the face of the challenges brought by the digital economy to the allocation of medical and health resources,effective measures need to be taken to solve them,thus laying a solid foundation for achieving the goals of comprehensive health coverage and common prosperity.

Objective:To investigate the impact of the development of the digital economy on the unfair of healthcare resource allocation in China.Methods:The sample data from 23 provinces across the country from 2015 to 2021 were tested using econometric regression.Results:It is found that the development of the digital economy will exacerbate the unfairness of the allocation of medical and health resources in China.Further analysis results show that there are regional differences in the impact of digital economy on the distribution of medical resources,which is mainly manifested in the central and western regions,but weaker in the eastern region,and this impact will weaken with the improvement of the development level of digital economy.At the same time,it also explores the possible influencing mechanisms.It is found that due to the demand-oriented allocation of medical and health resources,the development of digital economy will lead to more unfair allocation of medical resources by affecting economic level,education level and income gap.Conclusion:In the face of the challenges brought by the digital economy to the allocation of medical and health resources,effective measures need to be taken to solve them,thus laying a solid foundation for achieving the goals of comprehensive health coverage and common prosperity.

There are difficulties in the treatment of Alzheimer's disease (AD) in medical community. Since the surgery of cervical deep lymphatic vessel/lymphatic node-vein anastomosis (LVA/LnVA) has made clinical improvement in patients with AD, it offers a surgical option to treat AD. Especially improvements in cognitive impairment. However the mechanism in treatment of AD is not yet made clear. This article preliminarily explores the mechanism in improvement of some symptoms in patients with AD through cervical deep LVA/LnVA on the basis of morphological characteristics of the cribriform plate-cervical lymphatic pathway.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

Objective To analyze the prognostic factors in the patients with HER2-positive breast cancer adjuvant treated with trastuzumab.Methods We conducted a retrospective analysis of clinical data of 1 246 patients diagnosed with HER2-positive breast cancer between January 2009 and December 2019 who received treatment with trastuzumab.We investigated the factors impacting their prognosis by the Log-rank test univariate analysis and multivariate COX regression analysis.Results HER2-positive patients treated with trastuzumab had a poor prognosis in pT2-3(HR=2.10,P=0.003),pN2-3(HR=2.81,P<0.001),and no endocrine therapy(HR=2.50,P<0.001),and that had a better prognosis combined with taxane or other chemotherapy regimens(HR=0.40,P=0.017).We divided the patients into two subgroups according to the status of lymph node metastasis,and we found that in the negative lymph nodes group the patients with pT2-3 stage had poor prognosis(P=0.020),while the patients combined with taxane or other chemotherapy had better prognosis(P=0.032).In the positive lymph nodes group the patients with pT2-3 stage and no endocrine therapy had poor prognosis(P=0.012,P=0.001).Conclusions The patients with HER2-positive breast cancer treated with trastuzumab can be managed in different categories,for individuals without lymph node involvement and small tumor sizes,combining therapy with non-anthracycline chemotherapy is preferable for achieving improved outcomes,for patients with lymph node metastasis and large tumor sizes,if chemotherapy options are available,it is more recommended to use an anthracycline-free regimen to ensure the same prognosis while reducing the harm caused by the toxic side effects of chemotherapy.

Objective:This study investigates the difference in the detection rate and symptomatology between ICD-10 and DSM-5 diagnostic criteria for bipolar disorder with mixed states.Methods:Based on the Phase Ⅰ (2012) and Phase Ⅱ (2021) databases of National Bipolar Mania Pathway Survey (BIPAS), patients with bipolar disorder were included. General demographic data, clinical characteristics, symptomatic phenotypes, and mixed characteristics were retrieved. The detection rates and symptomatic performances of patients with or without mixed states in Phase Ⅰ and Ⅱ were compared using the chi-square test.Results:For patients with mixed states, the detection rate during Phase Ⅱ (2021) using DSM-5 (18.79%, 199/1 059) criteria was significantly higher than that during Phase Ⅰ (2012) using ICD-10 (6.78%, 199/2 934; χ 2=125.05, P<0.001). Whether using ICD-10 or DSM-5 criteria, patients with mixed states had a significantly higher frequency of multiple symptomatic manifestations. Conclusion:The DSM-5 diagnostic criteria generate a high detection rate for bipolar disorder with mixed states. The clinical phenotypes of bipolar disorder with mixed states vary significantly using different diagnostic tools.

Objective The aim of this study was to investigate the effects of general practice mode combined with duloxetine on psychological status,sleep quality and serum inflammatory cytokines in patients with Fibromyalgia Syndrome(FMS).Methods A total of 105 FMS patients in Chengde Central Hospital from January 2019 to December 2021 were divided into the combined group(53 cases)and the control group(52 cases)by the random number table method.The two groups were treated with general practice mode combined with duloxetine or duloxetine alone.The single course of treatment lasted for 4 weeks.Their efficacy and safety were evaluated after 2 courses of intervention.Visual analogue scale(VAS),Hamilton Anxiety assessment scale(HAMA),Hamilton Depression Scale(HAMD)and Pittsburgh Sleep Quality Index(PSQI)were performed before and after treatment.The pain,psychological status and sleep quality of the patients were evaluated.Blood samples were taken to measure the serum levels of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1)and IL-6 before and after treatment.Results The total effective rate in the study group was 96.23%,which was higher than that in the control group(82.69%,P<0.05).Compared with those before treatment,VAS,HAMA,HAMD and PSQI scores,serum TNF-α,IL-1 and IL-6 levels in the two groups were all decreased after treatment,and those in the study group were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between two groups(7.55%vs.19.23%,P>0.05).Conclusion General practice mode combined with duloxetine was safe and effective in the treatment of FMS,which could significantly relieve anxiety and depression of patients,improve their sleep quality,and reduce the level of serum inflammatory cytokines.