{L-End}Objective To analyze the effects of night shift work and overweight/obesity on blood pressure of workers in chemical fiber industry. {L-End}Methods A total of 1 004 workers of a chemical fiber factory were selected as the study subjects using convenient sampling method, and their blood pressure and body mass index were measured. Multiple linear regression model was used to analyze the relationship between night shift work and blood pressure, and multiple logistic regression was used to assess the independent impact and combined impact of night shifts and overweight/obesity on the risk of hypertension. {L-End}Results Compared with the non-night shift workers, the prevalence of hypertension in night shift workers was increased (5.3% vs 13.0%, P<0.05), with elevated systolic and diastolic blood pressure (both P<0.05). The results of multiple linear regression analysis showed that the systolic blood pressure and diastolic blood pressure of the night shift workers were higher than those of the non-night shift workers (both P<0.05), and the systolic blood pressure and diastolic blood pressure of overweight/obesity workers were higher than those of non-overweight/obesity workers (both P<0.01). The results of multiple logistic regression analysis showed that the risk of hypertension in night shift workers and overweight/obesity workers was higher than that in non-night shift workers and non-overweight/obesity workers [odds ratio (OR) and 95% confidence interval (CI) were 2.49 (1.04-5.99) and 2.65 (1.77-3.95), both P<0.05]. Night shift work and overweight/obesity showed a synergistic effect on blood pressure of workers. Compared to non-overweight/obesity non-night shift workers, overweight/obesity night shift workers had a higher risk of hypertension (OR=4.93, 95%CI: 1.70-14.29, P<0.01). {L-End}Conclusion Night shift work could lead to elevated blood pressure in workers in the chemical fiber industry, which is a potential risk factor for hypertension. The synergistic effect of night shift work and overweight/obesity may contribute to the increased risk of hypertension.

Objective:To evaluate the relationship between hemoglobin(Hb) level and the risk of diabetic retinopathy(DR) in patients with type 2 diabetes mellitus(T2DM).Methods:This study was a prospective cohort study. A total of 1 730 T2DM patients without DR, who received regular management at the Li′s Clinic in Taiwan, China starting from 2002, were selected as the study population. All patients underwent annual dilated fundus examination by professional ophthalmologists. General patient information and laboratory results were collected and analyzed. Based on the occurrence of DR during patient follow-up, patients were divided into the DR group and the non-DR(NDR) group. The impact of Hb levels on DR was explored using a generalized linear mixed model, and the relationship between Hb levels and DR was studied using Cox proportional hazards regression model.Results:After an average follow-up of 9.79 years, 481 patients with DR were detected. Compared with NDR group, DR group displayed a longer course of diabetes, higher rates of cataract, insulin use, and anemia, and higher systolic blood pressure, HbA 1C, and UACR as well as lower Hb. The results of the generalized linear mixed model showed a negative correlation between Hb and the occurrence of DR( β=-0.015, P<0.001). The Cox proportional hazards regression model showed that, after adjusting for confounding variables and based on quartiles of average Hb levels during follow-up, the risk of developing DR increased by 56.9% in the Q1 group(Hb≤127 g/L) compared to the Q4 group(Hb≥142 g/L). The cumulative risk plot showed that, after adjusting for confounding variables, the Q1 group had the highest cumulative risk of developing DR, and the difference was statistically significant( P<0.05). Conclusion:Hb was negatively correlated with DR, and the lower Hb levels were associated with the occurrence of DR, independent of other influencing factors.

The fenrou zhijian is defined as potential gap between different layers in the three-dimensional network structure formed by the twelve meridian tendons. Various pathological changes of the meridian tendons lead to the adhesion and closure of fenrou zhijian, causing abnormal mechanical conduction of the meridian tendon system, which in turn leads to painful bi syndrome of meridian tendons. As such, restarting the fenrou zhijian is the key to acupuncture treatment for painful bi syndrome of meridian tendons. Under the guidance of musculoskeletal ultrasound, the level and the angle of needle insertion of acupuncture at fenrou zhijian could be accurately controlled, the efficacy of acupuncture is improved.
Humans ; Meridians ; Acupuncture Therapy ; Needles ; Pain ; Tendons/diagnostic imaging*

Mounting evidence has shown that exercise exerts extensive beneficial effects, including preventing and protecting against chronic diseases, through improving metabolism and other mechanisms. Recent studies have shown that exercise preconditioning affords significant cardioprotective effects. However, whether exercise preconditioning improves high fat diet (HFD)-induced obesity and lipid metabolic disorder remains unknown. The study was aimed to explore the effects of exercise preconditioning on HFD-induced obesity and lipid metabolic disorder in mice. 4-week-old C57BL/6 mice were subjected to swimming or sedentary control for 3 months, and then were fed with normal diet (ND) or HFD for 4 more months. The results showed that the blood glucose was decreased, and the glucose tolerance and grip strength were increased in exercised mice after training. Exercise preconditioning failed to improve HFD-induced body weight gain, but improved HFD-induced glucose intolerance. Exercise preconditioning showed no significant effects on both exercise capacity and physical activity in ND- and HFD-fed mice. HFD feeding increased total cholesterol and low density lipoprotein (LDL) levels in circulation, promoted subcutaneous fat and epididymal fat accumulation in mice. Exercise preconditioning increased circulating high density lipoprotein (HDL) and decreased circulating LDL, without affecting the subcutaneous fat and epididymal fat in HFD-fed mice. HFD feeding increased liver weight and hepatic total cholesterol contents, and dysregulated the expressions of several mitochondria function-related proteins in mice. These abnormalities were partially reversed by exercise preconditioning. Together, these results suggest that exercise preconditioning can partially reverse the HFD-induced lipid metabolic disorder and hepatic dysfunction, and these beneficial effects of exercise sustain for a period of time, even after exercise is discontinued.
Animals ; Cholesterol/metabolism* ; Diet, High-Fat/adverse effects* ; Lipids ; Liver ; Mice ; Mice, Inbred C57BL ; Obesity

Bacterial Proteins/metabolism* ; Operon/genetics* ; Phosphotransferases/metabolism* ; Quorum Sensing/genetics* ; Vibrio cholerae/genetics*

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases

OBJECTIVE: To investigate the cognition of remote consultation of pneumoconiosis and analysis of influencing factors on its use intention. METHODS: A total of 282 physicians from 216 hospitals were selected using a convenient sampling method. The cognition of remote consultation of pneumoconiosis was investigated using the Questionnaire of Use Intention of Remote Consultation Mode in the Diagnosis of Pneumoconiosis. A structural equation model was used to analyze the influencing factors of the willingness to use remote consultation. RESULTS: The average scores in the dimensions of subjective norms, attitude, trust, uncertainty, compatibility, comparative advantage, complexity, perceived risk and use intention of remote consultation for pneumoconiosis were(3.7±0.9),(3.7±0.8),(3.5±0.8),(3.7±0.9),(3.7±0.9),(3.8±0.9),(3.0±0.8) and(3.5±0.8), respectively. Structural equation model analysis results showed that, on use intention of remote consultation, the perceived risk and uncertainty had significant negative impact(standardized path coefficient=-0.148 and-0.828, respectively, P<0.01), and compatibility had a significant positive impact(standardized path coefficient=2.053, P<0.01). There was no significant effect of dimensions of subjective norms, attitude, trust, comparative advantage and complexity on use intention(P>0.05). CONCLUSION: Perceived risk, uncertainty and compatibility are the main factors affecting the willingness to use remote consultation for pneumoconiosis. Remote consultation for pneumoconiosis is helpful to meet the needs of pneumoconiosis diagnosis in all hospitals.

Objective To evaluate the magnetic resonance imaging (MRI) findings in differential diagnosis between the adult reversible splenial lesion syndrome (RESLES) and ischemic infarction of the splenium of the corpus callosum (SCC). Methods The MRI findings and clinical data of 7 RESLES patients and 13 patients with ischemic infarction of SCC who were clinically diagnosed and treated in our center from May 2015 to June 2017 were analyzed retrospectively. The main MRI findings included location,morphology,signal intensity,maximum cross-sectional area,diffusion weighted imaging (DWI),and apparent diffusion coefficient (ADC) value. Results On the MRI findings of 7 RESLES patients (5 males and 2 females),the centers of all lesions of the SCC were located in the midline of SCC,the lesion shapes were round,ellipse,or spindle,and the distribution of the lesions was bilateral and symmetric as the center of the midline of SCC. The lesions were hyperintense on DWI,and the mean maximum cross-sectional area of lesions was (56.9±32.6) mm and the mean ADC value was (0.3963±0.0715) ×10 mm/s. On the review MRI,all the lesions disappeared (mean interval:10 days). On the MRI findings of 13 patients with ischemic infarction of SCC (10 males and 3 females),the lesions were irregular or patchy in shape and were almost laterally and asymmetrically distributed. The lesions were hyperintense on DWI,and the mean maximum cross-sectional area was (55.1±43.9) mm and the mean ADC value was (0.4978±0.0123) ×10 mm/s. The mean maximum cross-sectional area (t=0.096,P=0.925) and the ADC value (t=-1.988,P=0.062) were not significantly different between RESLES group and ischemic infarction of SCC group. Conclusions The location,morphology,and distribution of the SCC lesions and the co-existence of other lesions in the brain are helpful for the differential diagnosis between RESLES and ischemic infarction of SCC. However,the mean maximum cross-sectional area and the ADC value show no obvious difference between these two diseases.

Objective To reduce the incidence of peritoneal dialysis related peritonitis for patients in rural area and to improve management quality of peritoneal dialysis center.Methods We established multidisciplinary collaborative research group involving departments of nephrology,nutrition,infection,and quality control.Risk factors of peritoneal dialysis related peritonitis in rural patients were analyzed,and prevention measures were designed.The rate of peritoneal dialysis related peritonitis in 89 patients after implementation was analyzed.Results The rate of peritoneal dialysis related peritonitis was decreased from 43 patient·month per time to 67 patient ·month per time.Conclusion The compound pathway can effectively reduce the rate of peritonitis,improve patient satisfaction,and prolong dialysis age.

Background: Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical expenditure for the diagnosis and treatment of esophageal cancer in China has not been fully quantified. This study aimed to examine the medical expenditure of Chinese patients with esophageal cancer and the associated trends. Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 37 hospitals in 13 provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. For each esophageal cancer patient diagnosed between 2002 and 2011, clinical information and expense data were extracted by using structured questionnaires. All expense data were reported in Chinese Yuan (CNY; 1 CNY= 0.155 USD) based on the 2011 value and inflated using the year-specific health care consumer price index for China. Results: A total of 14,967 esophageal cancer patients were included in the analysis. It was estimated that the overall average expenditure per patient was 38,666 CNY, and an average annual increase of 6.27％ was observed from 2002 (25,111 CNY) to 2011 (46,124 CNY). The average expenditures were 34,460 CNY for stage Ⅰ, 39,302 CNY for stage Ⅱ, 40,353 CNY for stage Ⅲ, and 37,432 CNY for stage IV diseases (P < 0.01). The expenditure also differed by the therapy type, which was 38,492 CNY for surgery, 27,933 CNY for radiotherapy, and 27,805 CNY for chemotherapy (P < 0.05). Drugs contributed to 45.02％ of the overall expenditure. Conclusions: These conservative estimates suggested that medical expenditures for esophageal cancer in China substantially increased in the last 10 years, treatment for early-stage esophageal cancer costs less than that for advanced cases, and spending on drugs continued to account for a considerable proportion of the overall expenditure.