Background Photovoltaic (PV) cells can convert solar energy into electricity and alleviate the dilemma of energy supply shortage. Shanghai's PV module industry is booming, but there are few reports on the health status of the workers and there is an urgent need for health risk assessment. Objective To evaluate the health status of PV module production workers and the association between work and health status, in order to provide a direction for the health management of the workers. Methods Among the PV module production workers who completed prescriptive occupational health examination by a designated medical institution in 2021, 2453 workers with more than one year of working age were selected as the exposure group and 538 newly hired workers as the control group. On the basis of the Technical specifications for occupational health surveillance (GBZ 188−2014), the health examination included physical examination and laboratory examination and information such as sociodemographics, living habits, and disease history. We compared the indicators of pure-tone hearing test, blood routine examination, electrocardiogram (ECG), liver function, and kidney function between the two groups. The blood routine results included erythrocyte-related indicators, leukocyte-related indicators, and platelet-related indicators, and the results of liver function included hepatocyte injury indicators, hepatic secretory function indicators, and hepatic synthesis function indicators. The workers were divided into four groups by quartiles of working age. Trend chi-square test was used to analyze differences in health status between the four working age groups. Multiple logistic regression models were used to evaluate the association between working age and health indicators. Results Among the exposure group workers, 2035 (83.0%) were male and 418 (17.0%) were female. The median (P₂₅, P₇₅) age was 34.0 (30.0, 39.0) years and the median (P₂₅, P₇₅) working age was 6.0 (3.0, 10.0) years. The abnormality rate of blood routine was 61.7%. Among them, the abnormality rates of platelet-related indicators and liver secretory function indicators were 39.8% and 48.1% respectively. The risks of abnormal hepatocyte injury-related indicators, fatty liver, and platelet-related indicator abnormalities among the exposure group were 1.471 (95%CI: 1.060, 2.054), 1.691 (95%CI: 1.208, 2.385), and 7.576 (95%CI: 4.967, 11.994) times higher than those in the control group respectively. The single-factor analysis demonstrated a positively linear trend between working age and hypertension prevalence, electrical audiometry abnormality rate, or liver secretory function indicator abnormality rate. Corrected for gender, age, smoking status, hypertension, etc., the results of logistic analysis showed that quartile working age was positively related to abnormal liver secretion function and abnormal platelet-related indicators respectively (OR=1.047, P=0.005; OR=1.037, P=0.014), and inversely associated with the abnormal rate of renal function (OR=0.953, P=0.044). Conclusion Negative associations between health status and working age are identified in PV module production workers. The target PV module production employees are in younger age, and with the increase of working age, the abnormalities of liver function and platelets may increase. Therefore, the enterprises should extend occupational health work from workplace to workers.

Background Under the guidance of achieving carbon peaking and carbon neutrality goals, the demand for lithium-ion batteries has increased significantly. However, during the production, use, and maintenance of lithium-ion batteries, workers are inevitably exposed to various occupational hazards, and some chemicals are nephrotoxic. Objective To evaluate the kidney function and potential determinants among male workers in a lithium-ion battery-related enterprise in Shanghai. Methods The data of occupational health examination carried out by an occupational disease prevention and control institution for workers in a lithium-ion battery-related enterprise in Shanghai were collected. The workers participating pre-employment occupational health examination were treated as a control group, and the other group was recruited from those participating periodic health examination. Serum creatinine, urea nitrogen, uric acid, and renal ultrasound were used to assess the kidney function of workers. Kidney function was classified according to the reference range of kidney function indicators in Diagnostics (9th Edition, national planning textbook for high education in medicine). Binary logistic regression and generalized linear regression were used to identify potential determinants of abnormal values in kidney function indicators in workers. Results There were 6184 workers in the control group (pre-employment) with a mean age of (27.40±4.50) years. There were 3526 workers on the job with a mean age of (29.40±4.99) years and the median time of service was 2.00 (1.00, 3.42) years. The prevalence rates of high serum creatinine, high urea nitrogen, and high uric acid, and abnormal kidney ultrasound among the control group were 0.66%, 2.47%, 30.32%, and 10.12%, respectively; the indicators in the on-the-job workers were 0.96%, 3.35%, 38.25%, and 12.68%, respectively, significantly higher than those in the control group (P<0.05). After adjusting for worker age, length of service, smoking status, drinking status, hypertension, and hyperglycemia, the binary logistic regression models showed that regular smokers had a higher risk of high urea nitrogen than nonsmokers (OR=1.411, 95%CI: 1.011, 1.969). The risk of high uric acid was lower in older workers (OR=0.966, 95%CI: 0.953, 0.979), and higher in workers with more years of service (≤1 year, OR=1.295, 95%CI: 1.093, 1.534; >1-3 years, OR=1.747, 95%CI: 1.494, 2.042; >3 years, OR=1.866, 95%CI: 1.511, 2.304), hypertension (OR=1.400, 95%CI: 1.055, 1.859), and hyperglycemia (OR=1.565, 95%CI: 1.221, 2.006). Workers who were older (OR=1.038, 95%CI: 1.022, 1.054) and had longer working years (>1-3 years, OR=1.518, 95%CI: 1.201, 1.920), occasional smoking habits (OR=1.239, 95%CI: 1.039, 1.478), regular drinking habits (OR=1.875, 95%CI: 1.139, 3.087), and hypertension (OR=1.465, 95%CI: 1.075, 1.998) were at a higher risk of renal ultrasound abnormalities. The generalized linear models showed that length of service (>1-3 years, β=1.120, 95%CI: 0.360, 1.880; >3 years, β=1.451, 95%CI: 0.543, 2.358), smoking status (occasional, β=0.818, 95%CI: 0.156, 1.479; regular, β=0.841, 95%CI: 0.066, 1.616), and hypertension (β=2.742, 95%CI: 1.390, 4.094) were the influencing factors of serum creatinine concentration in the workers. Age (β=0.014, 95%CI: 0.009, 0.019) and length of service (>1-3 years, β=0.079, 95%CI: 0.012, 0.146) were the influencing factors of urea nitrogen. Age (β=−1.759, 95%CI: −2.288, −1.231), length of service (≤1 year, β=10.676, 95%CI: 4.035, 17.316; >1-3 years, β=26.117, 95%CI: 19.962, 32.272; >3 years, β=34.558, 95%CI: 26.116, 43.001), hypertension (β=23.162, 95%CI: 11.617, 34.707), and hyperglycemia (β=15.017, 95%CI: 4.853, 25.180) were the influencing factors of uric acid. Conclusion The prevalence of abnormal kidney function of workers in selected lithium-ion battery-related enterprise is varied by age, length of service, smoking status, drinking status, hypertension, and hyperglycemia. There may be a trend that the longer the time working in a lithium-ion battery-related enterprise, the worse the workers' kidney function. Therefore, the enterprise should pay attention to the possible reasons for their changes and take targeted interventions.

Objective: To analyze the impact of persistent obesity on their lung function, so as to offer insights for implementing intervention measures to increase lung function in obese school age children. Methods: A total of 335 children from the Sheyang Mini Birth Cohort established in 2009 in Yancheng City, Jiangsu Province, who participated in the follow up at the ages of 7 years (2016) and 10 years (2019), were selected as the study participants. Physical measurements including height, weight, and lung function were recorded. According to the World Health Organization standard, that is, gender and age specific to correct the body mass index to calculate the body mass index Z score, was used to evaluate the obesity status of children at the age of 7 and 10. Children were divided into four groups, including sustained non obesity group, restored obesity group, newly classified obesity group, and persistent obesity group. Meanwhile, the lung function prediction equations recommended by the Global Lung Function Initiative were used to standardize the lung function indexes of children. Pulmonary function differences among these groups were examined, and the relationship between childhood obesity and pulmonary function was longitudinally analyzed using generalized estimating equations. Results: The prevalence of obesity were 9.0% and 16.1% at the age of 7 and 10 years, respectively. The proportion of both newly classified and persistent obesity group were 8.1%, respectively. The forced expiratory volume in one second (FEV 1) and forced vital capacity (FVC) were (1 269.90±202.70) and (1 415.70±230.00) mL, respectively, at the age of 7 years. FEV 1 and FVC at the age of 10 years were (1 440.80±403.20) and (1 555.60±517.60) mL, respectively. Cross sectional analysis at age 7 showed that forced expiratory flow at 75% vital capacity (FEF 75 ) ( β=-0.52, 95%CI =-0.96--0.07) and maximal mid expiratary flow (MMEF) ( β=-0.45, 95%CI =-0.89--0.00) were significantly lower in obese children compared to their non obese peers ( P < 0.05). Longitudinal analysis indicated that obese children had lower levels of lung pulmonary function, with a statistically significant difference in FEV 1 ( β=-0.44, 95%CI=-0.85--0.02, P <0.05). There was no significant difference among the various obesity groups ( P >0.05), while gender stratified results revealed significant reductions in FEV 1/FVC in newly classified obese girls at age 10 years ( β=-1.76, 95%CI =-3.13--0.38) and in MMEF in persistently obese girls at age 10 years ( β=-1.44, 95%CI = -2.79- -0.09) ( P <0.05). Conclusion Obesity may contribute to reduced lung function levels in school aged children, with newly classified and persistent obesity having more pronounced effects on lung function in girls.

Objective To investigate the characteristics and liver function of the population with occupational exposure to hepatotoxicants. Methods A total of 17 093 workers with occupational hepatotoxicants exposure who underwent occupational medical examination during their employment in a occupational medical examination institution of Shanghai in 2021 were selected as the research subjects by judgement sampling method. Occupational medical examination data were collected, and the prevalence of abnormal liver function and fatty liver were analyzed. The association between hepatotoxicants exposure and abnormal liver function were analyzed. Results The median and the 0th-100th percentiles of the duration of exposure to hepatotoxicants was 6.5(1.0-42.0) years. The prevalence of fatty liver was 48.4% and the incidence of abnormal liver function was 23.7%. Among the workers with fatty liver, the prevalence of abnormal liver function was higher in workers exposed to metals, metalloids and their compounds than in unexposed workers (33.9% vs 30.0%, P<0.01). The results of multivariate logistic regression analysis demonstrated that the risk of abnormal liver function increased with the number of different hepatotoxicants mixed exposures (all P<0.01), after correcting for confounding factors including gender, age, years of exposure, marital status, drinking, hypertension, fatty liver and blood sugar. Conclusion Exposure to hepatotoxicants is a risk factor for abnormal liver function. The more diverse types of hepatotoxicants an individual is exposed to, the stronger the association with this risk.

Objective:To explore the pathogenic spectrum and epidemiological characteristics of respiratory viruses in children with acute lower respiratory tract infection in Changsha, and provide scientific basis for disease prevention and treatment.Methods:A total of 1 092 respiratory tract specimens of children were collected and 12 respiratory viruses were detected by real-time quantitative transcription polymerase chain reaction.Results:Among the samples from 1 092 cases, those from 437 cases (40%) were positive for respiratory syncytial virus (RSV), 337 cases (30.9%) were positive for parainfluenza virus-3 (PIV-3), 263 cases (24.1%) were positive for human bocavirus (HBOV) and 228 cases (20.8%) were positive for adenovirus (ADV). The detection rates of boys and girls were 82.26% and 83.42%. The infection rate of RSV was higher in the group ≤ 6 months of age, the infection rates of PIV-3 and HBOV ≤2 years old were higher, and the infection rate of ADV was higher in the group between 6 months to 5 years old. The detection rates of virus infection of spring, summer, autumn and winter were 90.48%, 83.50%, 62.26% and 82.80%, respectively, there were significant differences among them.Conclusions:The main viruses in children with acute lower respiratory tract infection in Changsha were RSV and PIV-3. Mixed infections were common. Children under 2 years of age were more likely to get acute lower respiratory infections. Viruses had seasonal trends and peaked in winter and spring.

Objective To investigate the correlation between blood pressure variability (BPV) and early neurological deterioration (END) in patients with acute anterior circulation large artery atherosclerotic (LAA)stroke. Methods From January 2015 to June 2018, consecutive patients with anterior circulation acute ischemic stroke admitted to the Department of Neurology, the Affiliated Hospital of Yangzhou University were enrolled prospectively. According to the etiological classification, they were divided into LAA group and non-LAA group. By monitoring the blood pressure within 72 h of hospitalization, the mean, maximum (max)and minimum (min) values, and the difference between max and min (max-min), standard deviation (SD),and coefficient of variation (CV; CV = SD × 100/mean) were calculated. END was defined as the highest score of the National Institutes of Health Stroke Scale (NIHSS) within 72 h of admission increased by ≥2than the baseline. Multivariate logistic regression analysis was used to determine the correlation between BPV parameters and END. Results A total of 271 patients with anterior circulation acute ischemic stroke were enrolled, including 101 females (37. 3％) and 170 males (62. 7％), with an average age of 64. 99 ± 11. 51 years. There were 95 patients (35. 1％) with LAA and 176 (64. 9％) with non-LAA. In the LAA group and non-LAA group, 36 patients (37.9％) and 50 patients (28.4％) developed END respectively. The comparison between END patients and non-END patients in the LAA group showed that there were significant differences in age, sex, diabetes mellitus, baseline NIHSS score and C-reactive protein, as well as SBPmax , SBPmax-min , SBPSD , SBPCV, DBPmax , DBPmax-min , DBPSD , and DBPCV in BPV indices (all P < 0. 05).Multivariate logistic regression analysis showed that many BPV indices were the independent risk factors for END, including SBPmax (odds ratio [OR] 1. 027, 95％ confidence interval [CI] 1. 003-1. 052; P = 0. 027),SBPmax-min (OR 1. 041, 95％CI 1. 015-1. 068; P = 0. 002), SBPSD (OR 1. 177, 95％ CI 1. 048-1. 322; P =0. 006), SBPCV (OR 1. 226, 95％ CI 1. 036-1.451; P = 0. 018), DBPmax (OR 1. 073, 95％ CI 1. 017-1. 133;P = 0. 010), DBPmax-min (OR 1. 107, 95％CI 1. 044-1. 174; P = 0. 001), DBPSD (OR 1. 693, 95％CI 1. 268- 2. 260; P < 0. 001), and DBPCV(OR 1. 726, 95％CI 1. 311-2. 271; P < 0. 001). In the non-LAA group, there were no significant association between all BPV parameters and the occurrence of END. Conclusion BPV was significantly correlated with END in patients with anterior circulation LAA.

Objective: To investigate the human bocavirus (HBoV) infection in the children diagnosed with brochiolitis, incomparison with the clinical characteristics of bronchiolitis of HBoV vs. respiratory syncytial virus (RSV) infection alone. Methods: A total of 396 throat swabs were obtained from children diagnosed with bronchiolitis from January 2015 to December 2016 in Pediatric Asthma Center of Gansu Maternal and Child Health Care Hospital, Lanzhou. Specimens were tested for the nucleic acids of HBoV, RSV and other 6 common respiratory viruses by nested-polymerase chain reaction (nested PCR() and reverse transcription-polymerase chain reaction (RT-PCR), and the epidemic status, clinical characteristics of HBoV and RSV were analyzed and compared with each other. Results: The positive rate of virus infection was 53.54%, and HBoV and RSV infections were 9.84% and 24.49% in 396 cases. The numbers of cases of HBoV single infection, RSV single infection, HBoV and RSV mixed infection were 29, 86 and 5. The number of boys infected with HBoV was 27. There was statistical significance in the difference between the genders. The statistical significance also existed in difference of age. The babies at ages ranging from 6 to 12 months had the hifgest positive rate. The first incidence peak of the infection of HBoV was in October 2015. The children with HBoV infection, compared with RSV patients, presented more often with vomiting, diarrhea (P<0.05), while symptoms such as the occurrence of dyspnea, hypoxemia and the hospitalization time were all lower. Conclusions HBoV is one of the possible causes of brochiolitis in infants, its infection distributed over the whole year. The clinical symptoms, laboratory and radio-graphic changes are similar between the HBoV and RSV infections, the only difference was that the HBoV infection was comparatively mild.

Objective: To investigate the clinical and epidemiological characteristics of Coronavirus HKU1 (Human CoV-HKU1) and NL63 (Human CoV-NL63) in children with acute respiratory tract infection in Nanjing. Methods: From August 2009 to July 2011, 1 286 respiratory samples were collected from the outpatient and hospitalized children in the Children′s Hospital of Nanjing Medical University. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect HCoV-HKU1 and NL63 genes, besides, positive samples were used for common respiratory virus screening. The positive amplification products were cloned, sequenced, homologous and phylogenetic analysis was conducted by molecular biological method . Results: The detection rate of HCoV-HKU1 was 1.1% (14/1 286), the positive sequences shared a 98.2%-100% nucleotide identity with the HCoV-HKU1 strains and mixed infection rate was 92.9%. The main clinical diagnoses were bronchitis, bronchopneumonia and bronchiolitis. The clinical manifestations were cough, fever, wheezing. The detection rate of HCoV-NL63 was 1.5% (19/1 286), the positive sequences shared a 95.6%-100% nucleotide identity with the HCoV-NL63 strains and mixed infection rate were 63.2%. The main clinical diagnosis were acute upper respiratory tract infection, bronchitis, bronchopneumonia. The clinical manifestations were fever, cough, expectoration. No deaths were found in both HCoV-HKU1 and NL63 infections. Conclusions From August 2009 to July 2011, HCoV-HKU1 and NL63 were detected in children with respiratory tract infection in Nanjing area. HCoV-HKU1 infected cases were lower respiratory tract infection, epidemic in winter and spring, infected cases were mainly under 1 years of age, HCoV-NL63 infected cases including upper respiratory and lower respiratory tract infection, epidemic in the season of summer and autumn. The infected cases were mainly at the age rank from 1 year to 3 years. The clinical manifestations of children infected with coronavirus HKU1 and NL63 are not specificity.

Objective To explore the efficacy and safety of Tocilizumab in the treatment of systemic juvenile idiopathic arthritis (sJIA)in children.Methods Twenty-four sJIA patients were collected who were hospitalized at the Department of Rheumatology and Immunity,Jiangxi Provincial Children's Hospital from October 2015 to May 2016,and they received Tocilizumab combined with Methotrexate (MTX) treatment for 12 weeks.The clinical laboratory and physiological indices,including routine blood,liver and kidney function tests,number of joints with active arthritis,number of joints with limited range of motion,physicians and patients assessment of disease activity,childhood health questionnaire,erythrocyte sedimentation rate(ESR),C-reactive protein (CRP),and compliance rates of Pediatrics of American College of Rheumatology(ACR Ped) 30,50,70 were observed after 4,8 and 12 weeks of treatment,and the adverse reactions were recorded.Results After 4 weeks of treatment,the levels of white blood cells,platelet,ESR and CRP in 24 cases of sJIA significantly decreased compared with those of the patients before treatment [(15.1 ± 2.7) × 109/L vs.(24.2 ±3.5) × 109/L,(277 ±73) × 109/L vs.(368 ± 62) × 109/L,(25 ± 12) mm/1 h vs.(75 ± 15) mm/1 h,(20 ± 13) mg/L vs.(64 ± 1) mg/L],and the differences were statistically significant (t =10.08,4.65,70.71,26.78,all P ＜0.05);the hemoglobin was increased dramatically[(110 ± 12) g/L vs.(98 ± 10) g/L],and the difference was statistically significant(t =-3.76,P ＜ 0.05).The compliance rates of ACR Ped 30,50,70 after 4 weeks of treatment were 82％,74％,68％,and they were continuously improved after 8 weeks of treatment (90％,82％,78％)and 12 weeks of treatment (98％,93％,92％),and the differences were all statistically significant (F =7.11,7.29,8.86,all P ＜0.05).The levels of IL-6 after 12 weeks of treatment had no significant change compared with those of the patients pre-treatment [(10.8 ±2.5) ng/L vs.(12.7 ±3.0) ng/L,t =1.96,P ＞0.05].Conclusion Tocilizumab is effective and safe in the treatment of sJIA patients,which can improve the symptoms,signs and laboratory inflammatory activity indexes of sJIA in a short time.

Objective To observe the changes in CD4 + CD25 + regulatory T cells(Treg) and T helper 17 cells (Th17) cells' proportions in the peripheral blood in children with Kawasaki disease(KD) before and after the treatment,and to analyze the role of Treg/Th17 cell imbalance in the pathogenesis of KD.Methods Fifty-two children with acute KD(KD group) and 34 age-matched healthy children(healthy control group) were selected at Jiangxi Provincial Children's Hospital from April to December of 2014.Morning peripheral vein blood was collected from 2 groups:one before the treatment by Immunoglobulin and Aspirin,and the other 3 days after defervescence treatment.Flow cytometry was used to detect proportions of Treg cells and Th17 cells in the peripheral blood.The enzyme linked immunosorbent assay was used to detect the levels of interleukin(IL)-6,IL-10,IL-17,IL-23 and transforming growth factor(TGF)-β.Results Proportion of Treg cells in the acute KD group was remarkably lower than that in the healthy control group [(1.48 ± 0.21) ％ vs.(5.13-± 0.32) ％,t =28.41,P ＜ 0.05],but it was significantly increased after treatment,and there was a significant difference [(4.71 ± 0.36) ％ vs.(1.48 ± 0.21) ％,t =-23.32,P ＜ 0.05].Proportion of Th17 cells in the acute KD group was markedly higher than that in the healthy control group [(8.06 ± 0.48) ％ vs.(2.65 ± 0.50) ％,t =-23.47,P ＜ 0.05],which was significantly decreased after treatment [(3.04 ±0.35) ％ vs.(8.06 ± 0.48) ％,t =25.55,P ＜ 0.05].Compared with the healthy control group,the levels of serum IL-6,IL-17,IL-23 in the acute KD group were significantly increased before treatment,and there were significant differences [(34.53 ± 0.53) ng/L vs.(10.88 ± 0.83) ng/L,t =-72.36;(57.05 ± 0.78) ng/L vs.(14.29 ± 0.98)ng/L,t =-55.29;(45.18 ± 1.52) ng/L vs.(18.25 ± 1.08) ng/L,t =-43.27;all P ＜ 0.05],but after treatment the levels were significantly decreased [(14.94 ± 1.06) ng/L vs.(34.53 ± 0.53) ng/L,t =49.63;(27.64 ± 0.91)ng/Lvs.(57.05±0.78) ng/L,t =26.49;(24.50-±1.13) ng/L vs.(45.18-±1.52) ng/L,t =32.17;allP＜0.05].The levels of serum IL-10,TGF-β in the acute KD group significantly decreased than those of the healthy control group,and there were significant differences [(14.29-± 0.64) ng/L vs.(29.57 ± 0.87) ng/L,t =42.24;(16.88 ±-0.90) ng/L vs.(38.83 ±0.84) ng/L,t =53.51;all P ＜0.05],but after treatment the levels were significantly increased,and there were significant differences [(23.01-± 0.61) ng/L vs.(14.29-± 0.64) ng/L,t =-29.54;(33.47±-0.82) ng/Lvs.(16.88±-0.90) ng/L,t=-40.68;allP＜0.05].Conclusion Imbalance betweenTreg cells and Th17 cells may be an important cause for the immune disorder of KD,the changes in related cytokines are involved in the pathogenesis of KD.