Objective To assess the current state and influencing factors of multi-site work-related musculoskeletal disorders (WMSDs) among front-line employees in the assembly workshop of an automobile manufacturing enterprise. Methods A total of 394 front-line workers in the assembly workshop of an automobile manufacturing enterprise in Beijing City were selected as the research subjects using the judgmental sampling method. The Chinese version Musculoskeletal Disorders Questionnaire was used to assess the presence of WMSDs over the past 12 months in nine body regions: neck, shoulders, upper back, lower back, elbows, wrists, hips and thighs, knees, ankles and feet. The multivariable logistic regression was employed to investigate the influencing factors. Results The detection rate of overall WMSDs was 32.7% (129/394), with the top three single-site WMSDs being in the neck, shoulders, and lower back, and their detection rates were 14.0%, 12.7% and 9.6%, respectively. The detection rate of multi-site WMSDs was 17.8% (70/394). The result of multivariable logistic regression analysis revealed that workers who turned or bent their upper body while keeping their legs stationary, frequently performed wrist flexion/extension/lateral bending/rotation, or stood for prolonged period of time had significantly higher risks of developing multi-site WMSDs compared with those who did not (all P<0.05). Workers who perceived uncomfortable workplace lighting had higher risk of multi-site WMSDs than those who perceived it as comfortable (P<0.01). Conclusion The development of multi-site WMSDs among workers in the assembly workshop of this automobile manufacturing enterprise is strongly related to poor working postures at work.

Objective To analyze the development trends and hot topics in the field of phosgene poisoning research in China. Methods The China National Knowledge Infrastructure was used as the retrieval source to search for academic literature on phosgene poisoning published in Chinese journals from the database's inception to December 31, 2023. CiteSpace 6.2.R6 software was used for bibliometric analysis and visualization. Results A total of 334 articles were included for analysis. The earliest literature was published in 1982, with publication peaks occurring in 2004-2005 and 2011, followed by a gradual decline in publications after 2013. Authors from 221 research institutions published related literature in 133 kinds of Chinese journals. There were 19 core authors with three or more publications, and some of these core authors formed relatively stable research teams. Grants were covered 32.0% of the literature, and case reports and articles accounted for 89.2% of the literature, with “pulmonary edema” being the earliest and most prominent keyword. Conclusion The field of phosgene poisoning research in China has achieved some progress, particularly in studies related to the mechanisms of pulmonary edema and lung injury. However, there is a need to enhance collaboration among research institutions, deepen research efforts, and improve the quality of scientific research outcomes.

Programmed death protein 1 (PD-1) and programmed death protein ligand-1 (PD-L1) play pivotal roles in maintaining immune homeostasis and a crucial link in tumour immune evasion. PD-1/PD-L1 inhibitors have achieved significant efficacy in many cancer immunotherapy, but the effect in the treatment of pancreatic cancer is limited, and the effect of monotherapy is suboptimal. The combined therapeatic effect of PD-1/PD-L1 and chemotherapy, radiotherapy, and molecular targeted therapy were explored. This article summarises the advancements in PD-1/PD-L1 inhibitor combination therapy in the treatment of pancreatic cancer.

Objective:To explore the influencing factors of abnormal blood pressure and electrocardiogram (ECG) in occupational motor vehicle drivers.Methods:In January 2024, a cluster sampling method was used to study 606 occupational motor vehicle drivers from a transportation service enterprise in Beijing who completed occupational health examination in 2023 in Peking University Third Hospital as observation group and 596 non-occupational motor vehicle drivers as control group. The data of personal history, occupational history, blood pressure and ECG were collected, and the effects of occupational motor vehicle driving on hypertension and ECG were analyzed by multivariate logistic regression.Results:The age of workers in the observation group was (34.1±7.8) years old, and the length of service was (7.0±7.1) years. The age of the control group was (33.8±7.6) years old, and the working age was (7.7±6.5) years. There was no significant difference in age and length of service between the two groups ( t=0.62, -1.90, P=0.538, 0.057). Systolic blood pressure (133.0±14.7) mmHg, diastolic blood pressure (83.7±11.6) mmHg, hypertension detection rate of 33.0% (200/606), ECG abnormality detection rate of 39.9% (242/606). They were significantly higher than those in the control group [ (127.8±14.4) mmHg, (77.5±11.0) mmHg, 24.7% (147/596), 31.0% (185/596) ], and the differences were statistically significant ( P<0.05). Multivariate logistic regression analysis showed that occupational motor vehicle driving were risk factors for hypertension and abnormal ECG ( OR= 1.210, 1.578; 95% CI: 1.145-1.231, 1.237-2.012; P<0.001) . Conclusion:Occupational motor vehicle driving may increase the risk of hypertension and abnormal ECG in workers.

Objective:To explore the influencing factors of abnormal blood pressure and electrocardiogram (ECG) in occupational motor vehicle drivers.Methods:In January 2024, a cluster sampling method was used to study 606 occupational motor vehicle drivers from a transportation service enterprise in Beijing who completed occupational health examination in 2023 in Peking University Third Hospital as observation group and 596 non-occupational motor vehicle drivers as control group. The data of personal history, occupational history, blood pressure and ECG were collected, and the effects of occupational motor vehicle driving on hypertension and ECG were analyzed by multivariate logistic regression.Results:The age of workers in the observation group was (34.1±7.8) years old, and the length of service was (7.0±7.1) years. The age of the control group was (33.8±7.6) years old, and the working age was (7.7±6.5) years. There was no significant difference in age and length of service between the two groups ( t=0.62, -1.90, P=0.538, 0.057). Systolic blood pressure (133.0±14.7) mmHg, diastolic blood pressure (83.7±11.6) mmHg, hypertension detection rate of 33.0% (200/606), ECG abnormality detection rate of 39.9% (242/606). They were significantly higher than those in the control group [ (127.8±14.4) mmHg, (77.5±11.0) mmHg, 24.7% (147/596), 31.0% (185/596) ], and the differences were statistically significant ( P<0.05). Multivariate logistic regression analysis showed that occupational motor vehicle driving were risk factors for hypertension and abnormal ECG ( OR= 1.210, 1.578; 95% CI: 1.145-1.231, 1.237-2.012; P<0.001) . Conclusion:Occupational motor vehicle driving may increase the risk of hypertension and abnormal ECG in workers.

Objective To investigate the effects of salidroside (Sal) on mitochondrial autophagy in ischemic cardiomyopathy (ICM) rats by modulating the PTEN-induced kinase 1 (PINK1)/E3 ubiquitin ligase (Parkin) signaling pathway. Methods Thirty SD rats were randomly divided into control group, model group, low-dose Sal group, high-dose Sal group, mitochondrial autophagy inhibitor (Mdivi-1) group and high-dose Sal + Mdivi-1 group, with five rats in each group. The ICM rat model was established. The left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-diastolic diameter (LVIDd) and left ventricular end-systolic diameters (LVIDs) were analyzed. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of lactate dehydrogenase (LDH), cardiac troponin I (cTnI), creatine kinase (CK) and N-terminal pro-brain natriuretic peptide (NT-proBNP). Hematoxylin and eosin (HE) staining was performed to observe pathological changes in myocardial tissue, and transmission electron microscopy was used to examine mitochondrial structure. The levels of reactive oxygen species (ROS), malondialdehyde (MDA) and superoxide dismutase (SOD) were measured. Western blot analysis was conducted to determine the expression levels of microtubule-associated protein light chain 3 (LC3), Beclin1, p62, PINK1 and Parkin in myocardial tissue. Results Compared with the control group, the model group showed more severe myocardial tissue and mitochondrial damage. The LVEF, LVFS, SOD and p62 levels in the model group were significantly lower than those in the control group, while the LVIDd, LVIDs, LDH, cTnI, CK, NT-proBNP, ROS, MDA, LC3II/LC3I, Beclin1, PINK1 and Parkin levels were significantly higher (P < 0.05). Compared with the model group, the low-dose and high-dose Sal groups exhibited reduced myocardial and mitochondrial damage. The LVEF, LVFS, SOD, LC3II/LC3I, Beclin1, PINK1 and Parkin levels in the low-dose and high-dose Sal groups were significantly higher than those in the model group, while the LVIDd, LVIDs, LDH, cTnI, CK, NT-proBNP, ROS, MDA and p62 levels were significantly lower (P < 0.05). Compared with the model group, the Mdivi-1 group showed more severe myocardial and mitochondrial damage. The LVEF, LVFS, SOD, LC3II/LC3I, Beclin1, PINK1 and Parkin levels in the Mdivi-1 group were significantly lower than those in the model group, while the LVIDd, LVIDs, LDH, cTnI, CK, NT-proBNP, ROS, MDA and p62 levels were significantly higher (P < 0.05). Compared with the low-dose Sal group, the high-dose Sal group demonstrated further improvement in myocardial and mitochondrial damage. The LVEF, LVFS, SOD, LC3II/LC3I, Beclin1, PINK1 and Parkin levels in the high-dose Sal group were significantly higher than those in the low-dose Sal group, while the LVIDd, LVIDs, LDH, cTnI, CK, NT-proBNP, ROS, MDA and p62 levels were significantly lower (P < 0.05). Mdivi-1 significantly inhibited mitochondrial autophagy and suppressed the activation of the PINK1/Parkin signaling pathway and the improvement in cardiac function induced by Sal (P < 0.05). Conclusion Sal may improve myocardial injury in ICM rats by activating the PINK1/Parkin signaling pathway and promoting mitochondrial autophagy.

OBJECTIVE: To review research advances of revision surgery after primary total hip arthroplasty (THA) for patients with Crowe type Ⅳ developmental dysplasia of the hip (DDH). METHODS: The recent literature on revision surgery after primary THA in patients with Crowe type Ⅳ DDH was reviewed. The reasons for revision surgery were analyzed and the difficulties of revision surgery, the management methods, and the related prosthesis choices were summarized. RESULTS: Patients with Crowe type Ⅳ DDH have small anteroposterior diameter of the acetabulum, large variation in acetabular and femoral anteversion angles, severe soft tissue contractures, which make both THA and revision surgery more difficult. There are many reasons for patients undergoing revision surgery after primary THA, mainly due to aseptic loosening of the prosthesis. Therefore, it is necessary to restore anatomical structures in primary THA, as much as possible and reduce the generation of wear particles to avoid postoperative loosening of the prosthesis. Due to the anatomical characteristics of Crowe type Ⅳ DDH, the patients have acetabular and femoral bone defects, and the repair and reconstruction of bone defects become the key to revision surgery. The acetabular side is usually reconstructed with the appropriate acetabular cup or combined metal block, Cage, or custom component depending on the extent of the bone defect, while the femoral side is preferred to the S-ROM prosthesis. In addition, the prosthetic interface should be ceramic-ceramic or ceramic-highly cross-linked polyethylene wherever possible. CONCLUSION The reasons leading to revision surgery after primary THA in patients with Crowe type Ⅳ DDH and the surgical difficulties have been clarified, and a large number of clinical studies have proposed corresponding revision modalities based on which good early- and mid-term outcomes have been obtained, but further follow-up is needed to clarify the long-term outcomes. With technological advances and the development of new materials, personalized prostheses for these patients are expected to become a reality.
Humans ; Arthroplasty, Replacement, Hip/methods* ; Hip Prosthesis ; Hip Dislocation, Congenital/surgery* ; Reoperation ; Developmental Dysplasia of the Hip/surgery* ; Acetabulum/surgery* ; Retrospective Studies ; Treatment Outcome

Objective:To investigate the application value of computed tomography (CT) and magnetic resonance imaging (MRI) examination in clinical diagnosis of gallbladder tumor with perigallbladder invasion.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 80 gallbladder tumor patients with perigallbladder invasion who were admitted to 3 medical centers (21 cases in The First Affiliated Hospital of Northwest University, 42 cases in The First Affiliated Hospital of the Air Force Medical University, 17 cases in The First Affiliated Hospital of Dalian Medical University) from January 2021 to December 2022 were collec-ted. There were 45 males and 35 females, aged (56±4)years. Observation indicators: (1) CT and MRI examinations; (2) surgical conditions. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) CT and MRI examinations. Of 80 patients, cases with gallbladder cancer and gallbladder adenoma were 73 and 7, respectively. Cases with endoluminal nodular type, mass type and localized thick-walled type were 33, 39 and 8, respectively, with tumor diameter as 1.55 cm×1.35 cm×1.33 cm, 1.64 cm×1.37 cm×1.36 cm and 5.72 cm×4.07 cm×4.36 cm. Results of CT examination of endoluminal nodular type showed local nodular protrusions into the endoluminal area, and local enhancement on enhanced scanning. Results of CT examination of localized thick-walled type showed the cavity wall of lesion was locally or diffusely irregul-arly thickened, with a thickness of 1.10(range, 1.10-2.21)cm. Of 80 patients, results of CT and MRI examinations showed invasion of liver parenchyma in 68 cases, which was manifested as local mass, blurred demarcation, and abnormal protrusion. The maximum depth was (4.22±0.25)cm, (4.22±0.22)cm, (4.28±0.16)cm of cross-sectional, coronal, sagittal view in CT examination, respectively. The minimum depth was (0.22±0.10)cm, (0.25±0.08)cm, (0.24±0.12)cm. The depth of liver parenchyma invaded was (1.64±1.38)cm, (1.68±1.46)cm, (1.66±1.40)cm. Results of CT and MRI examinations showed invasion of perigallbladder, which was manifested as local invasion of the gastric antrum in 12 cases. (2) Surgical conditions. Of 80 patients, results of CT and MRI examina-tions showed that 60 patients had localized masses in the gallbladder cavity with or without infiltration of surrounding tissues. After confirming the absence of other organs and distant metastasis, cases undergoing radical resection and palliative resection were 44 and 16, respectively. Results of CT and MRI examina-tions showed that 20 patients had malignant gallbladder tumors with peri-pheral liver infiltration and multiple intrahepatic metastases with distant organ metastases, which were unresectable.Conclusion:For patients with gallbladder cancer and perigallbladder invasion, CT or MRI examina-tions can show their structural characteristics.

Pancreaticoduodenectomy (PD) is the mainstay of treatment for periampullary space-occupying disease. The occurrence of pancreatic fistula after PD is still an unsolved clinical problem, which seriously affects the safety of surgery. Various methods have been reported in clinical practice to reduce the incidence of pancreatic fistula, such as improving pancreaticoenteric anastomosis, using biological sealants, applying somatostatin analogs, and continuous peritoneal irrigation, etc., but the incidence of pancreatic fistula remains at 5%-30%. There are many risk factors related to pancreatic fistula after PD, in which reasonable selection of suture materials is an important factor and also an important factor affecting the curative effect of surgery. The authors analyze the characteristics and shortcomings of various sutures used in PD, in order to provide help to improve the safety of surgery and reduce the incidence of pancreatic fistula after PD.

Objective To investigate the role of histone H4 in the polarization of alveolar macrophages (AM) in lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) in mice. Methods i) The specific pathogen free male C57BL/6 mice were randomly divided into control group and 2, 4, 6 and 8 mg/kg LPS groups, with six mice in each group. The mice in the LPS groups were intratracheally administered LPS according to their respective doses, while the mice in the control group received an equivalent volume of 0.9% saline. After 12 hours, the arterial blood gas was analyzed, and the pulmonary edema and histopathological changes in lung tissues of mice in each group were observed. The level of histone H4 in bronchoalveolar lavage fluid (BALF) of mice was detected using enzyme-linked immunosorbent assay , and mice AMs of the five group were isolated using adherent method. ii) AMs from normal mice were isolated using adherent method and randomly divided into control group, histone H4 injury group, BALF injury group and anti-histone H4 antibody (anti-H4) intervention group. In the histone H4 injury group, AMs were treated with histone H4 at a final concentration of 20 mg/L. In the BALF injury group and anti-H4 intervention group, AMs were treated with 200 μL BALF supernatant from mice intratracheally administered 6 mg/kg body weight LPS, with the latter group treated with 25 mg/L anti-H4 antibody. The control group AMs were treated with phosphate-buffered saline. iii) After 12 hours of stimulation, the cells were collected, and the relative expression of tumor necrosis factor-α (Tnfa), interleukin-1β (Il1b), differentiation antigen 206 (Cd206) and arginase 1 (Arg1) in AMs was detected using real-time quantitative polymerase chain reaction. Results i) Compared with the control group, mice in all four LPS groups exhibited rapid breathing, inflammatory reaction and lung edema in lung tissues, which were aggravated in a dose-dependent manner. The ratio of partial pressure of arterial oxygen to fraction of inspired oxygen in mice decreased with the increase of LPS dose (P<0.05). The wet/dry weight ratio of lung, the level of histone H4 in BALF and the relative expression of Tnfa and Il1b mRNA in AMs increased with the increase of LPS dose (all P<0.05). The mice in the 6 and 8 mg/kg LPS groups developed ARDS. The level of histone H4 in BALF and the relative expression of Tnfa and Il1b mRNA in AMs of mice in 6 and 8 mg/kg LPS groups were higher than those in the other three groups (all P<0.05). ii) The relative expression of Tnfa and Il1b mRNA increased (both P<0.05), and the relative expression of Cd206 and Arg1 mRNA decreased (both P<0.05) in AMs of histone H4 injury group and BALF injury group compared with the control group. Compared with BALF injury group, the relative mRNA expression of Tnfa and Il1b in AMs of anti-H4 intervention group decreased (both P<0.05), while the relative expression of Arg1 mRNA increased (P<0.05). Conclusion LPS can induce a dose-dependent increase in histone H4 levels in BALF in mice. Histone H4 drives the development of ARDS by activating AMs to M1 polarization. Antagonizing histone H4 to interfere with AM polarization to M1 could be a target for the treatment of ARDS.