Background The adverse effects of long working hours, shift rotation, and job stress on the physical and mental health of occupational populations require urgent attention. Objective To investigate and compare the positive rates of WMSDs between different industries, analyze the exposure status of long working hours, shift rotation, and job stress among key occupational groups, and evaluate the impacts of these factors on WMSDs in the manufacturing and service industries. Methods The study subjects were derived from key occupational populations in Yunnan Province, recruited by the Chinese National Occupational Health Literacy Monitoring Survey in 2022. A cross-sectional design was used for this survey. The key occupational populations were recruited from the secondary industry (manufacturing industry, metal mining and beneficiation industry, and non-metal mining and beneficiation industry) by stratified random sampling and from the tertiary industry (medical and healthcare industry, education industry, environmental sanitation industry, transportation industry, and express/takeaway delivery industry) by proportional probability sampling, and 12014 front-line workers were finally included as survey participants. General information, work-related factors (shift rotation, weekly working hours, job stress, etc.) and WMSDs assessment results were obtained through a web-based self-reported questionnaire, and the associations of long working hours, shift rotation, and job stress with WMSDs were analyzed using χ² test and logistic regression. Results The average positive rate of WMSDs among the key occupational groups in Yunnan Province was 77.2%. The positive rate of WMSDs in the secondary industry group was 69.4%, while it was 81.6% in the tertiary industry group, with a statistically significant difference (P<0.001). Among the eight surveyed sectors, the education sector had the highest positive rate of WMSDs (94.2%). The single-site WMSDs mainly involved the neck, shoulders, and low back. In the secondary industry, WMSDs was reported in 1−2 body parts, while in the tertiary industry, WMSDs was mainly reported in multiple (≥5) body parts. Long working hours (OR: 1.119, 1.165, 1.163, respectively), shift rotation (OR: 1.094, 1.199, 1.230, respectively), and job stress (OR: 1.795, 1.854, 2.006, respectively) were risk factors for WMSDs in the neck, shoulder, or low back, and all three were also risk factors for multi-site WMSDs. Moreover, as the number of involved body parts increased, the effects of long working hours and job stress became more pronounced. For 1-2, 3-4, and 5 or more body parts compared to no pain reported, their OR values were 0.971 (95%CI: 0.871, 1.082), 1.133 (95%CI: 1.004, 1.279), and 1.285 (95%CI: 1.155, 1.429) for long working hours, respectively, and the OR values were 1.009 (95%CI: 0.878, 1.160), 1.360 (95%CI: 1.174, 1.575), and 2.797 (95%CI: 2.471, 3.166) for job stress, respectively. Conclusion The positive rate of WMSDs is higher in the tertiary industry than that in the secondary industry among the key occupational groups in Yunnan Province. Long working hours, rotating shift work, and job stress could significantly increase the risk of WMSDs.

With the increasing proportion of laboratory projects in the revenue of public hospitals,how to adjust the prices of labo-ratory projects and improve the income structure of public hospitals has become one of the important contents of China's medical re-form.It is based on a systematic introduction and summary of the pricing methods for inspection projects in British Columbia,Canada,the US,and WHO.Combining with China's national conditions,it proposes three policy recommendations:establishing a cost cal-culation system and cost calculation tools for inspection projects,adopting differentiated pricing strategies based on social medical secu-rity levels,and regularly reviewing and updating the prices of inspection projects.

It summarizes the practical experience of medical insurance payment methods for medical services provided by Canadian medical staff,covering payment methods for medical services and alternative payment methods.Taking into account the current situation and conditions of the medical insurance payment method for medical services provided by medical personnel in China,it proposes policy recommendations for exploring diversified payment models,introducing direct settlement of health insurance,optimizing payment methods,considering regional differences,and ensuring the long-term sustainability of healthcare personnel health insurance payment methods.

Objective To investigate the effects and mechanism of modified Ditan Decoction in regulating miR-149 on liver injury in rats with chronic intermittent hypoxia.Methods Totally 18 male SD rats were randomly divided into control group,model group,and modified Ditan Decoction,with 6 rats in each group.The model group and the modified Ditan Decoction group were modeled in a low oxygen chamber.During the modeling period,the modified Ditan Decoction group was given gavage of the modified Ditan Decoction for 12 consecutive weeks.HE staining was used to observe the pathological changes of liver tissue;the ultrastructural changes of liver tissue were observed by transmission electron microscopy,TUNEL staining was used to observe hepatocyte apoptosis,the contents of ALT,AST,SOD and MDA in liver tissue were detected,the mRNA and protein expression of miR-149,ATF6,GRP78 and CHOP in liver tissue were detected by RT-qPCR and Western blot.The correlation between the mRNA transcription levels of miR-149 and ATF6 was analyzed.Results Compared with the control group,a small amount of inflammatory cell infiltration in liver tissue of the model group,with irregular arrangement of liver cells,varying degrees of edema,expansion of endoplasmic reticulum,ribosome shedding,mitochondrial membrane rupture,and apoptosis rate of liver cells increased(P<0.05),the contents of ALT,AST and MDA significantly increased(P<0.05),while the content of SOD significantly decreased(P<0.05),the expression of miR-149 mRNA in liver tissue decreased(P<0.05),while the mRNA and protein expression of ATF6,GRP78 and CHOP increased(P<0.05).Compared with the model group,no obvious edema or inflammatory cell infiltration was observed in liver tissue of rats in the modified Ditan Decoction group,the liver cells were arranged in a regular manner,with slightly expanded endoplasmic reticulum and more uniform distribution of ribosomes,the mitochondrial membrane was relatively intact,and the apoptosis rate of liver cells decreased(P<0.05),the contents of ALT,AST and MDA decreased(P<0.05),while the content of SOD increased(P<0.05),the expression of miR-149 mRNA in liver tissue significantly increased(P<0.05),while the mRNA and protein expression of ATF6,GRP78 and CHOP significantly decreased(P<0.05).The level of miR-149 mRNA was significantly negatively correlated with that of ATF6 mRNA(r=-0.766).Conclusion Modified Ditan Decoction may inhibit liver oxidative stress response in chronic intermittent hypoxia rats and improve liver injury by regulating the miR-149/ATF6 pathway.

ObjectiveTo analyze the fingerprint of six pungent herbs based on the molecular connectivity index（MCI）and the matching frequency total statistical moment method， and to study the division and integration of the "imprinting template" of their volatile components， so as to find the common "imprinting template" characteristics of the pungent herbs. MethodThe volatile components of six pungent herbs were extracted by steam distillation， and their fingerprints were established by gas chromatography-mass spectrometry（GC-MS） with a programmed temperature increase（80 ℃ for 5 min， 5 ℃·min^-1 to 200 ℃ for 5 min， 2 ℃·min^-1 to 230 ℃ for 10 min）， a splitting ratio of 20∶1， an electron bombardment ion source（EI） and the detection range of m/z 35-650， and the average MCI and total statistical moment parameters of the fingerprints were calculated. Then the matching frequency method was used to classify， integrate and confirm the chromatographic peaks of the fingerprints of six pungent herbs. ResultThe average zero order， first-order and second-order MCI values of the volatile components of Pogostemonis Herba， Artemisiae Argyi Folium， Atractylodis Rhizoma， Asari Radix et Rhizoma， Magnoliae Flos and Schizonepetae Herba were 9.02， 5.28 and 5.05， respectively. The average values of peak number， total zero-order moment， total first-order moment and total second-order moment were 60， 169×10⁷， 22.49 min and 36.82 min²， respectively. The 20 integrated imprinting templates were obtained by the matching frequency method for the six pungent herbs， among which three were common imprinting templates with the retention times of （25.97±0.21），（26.90±0.20），（31.64±1.24） min， respectively， and the representative components were valencene，β-elemene， caryophyllin， etc. ConclusionMCI combined the matching frequency total statistical moment can divide and integrate the characteristics of imprinting templates of six pungent herbs， and find their common chromatographic imprinting characteristics， which can provide a reference for the determination of effective substances of pungent herbs.

Objective:To investigate the chronic disease self efficacy, mental resilience and spiritual well-being level in patients undergoing chemotherapy after radical mastectomy for breast cancer, and to explore whether there is a mediating effect among them.Methods:This study was a cross-sectional study. A total of 376 patients undergoing chemotherapy after radical mastectomy for breast cancer were selected as the survey objects by convenience sampling method from July 2020 to April 2021 in Shandong Provincial Hospital Affiliated to Shandong First Medical University. The chronic disease self efficacy, mental resilience and spiritual well-being were evaluated by Self-Efficacy Scale for Managing Chronic Disease, Functional Assessment of Chronic Illness Therapy Spiritual Well-being, Connor-Davidson Resilience Scale. The correlation among the chronic disease self efficacy, mental resilience and spiritual well-being was tested by Pearson correlation analysis. Structural equation model was used to analyze the intermediary mechanism of the chronic disease self efficacy, mental resilience and spiritual well-being.Results:The total score for chronic disease self-efficacy of the research objects was (33.34 ± 12.77) points, the total score for mental resilience was (66.13 ± 21.67) points, and the total score for spiritual well-being was (28.41 ± 10.13) points. The chronic disease self-efficacy, mental resilience, and spiritual well-being were all positively correlated ( r values were 0.689-0.949, all P<0.01). The chronic disease self-efficacy played a partially mediating role in spiritual well-being and mental resilience in patients undergoing chemotherapy after radical mastectomy for breast cancer ( β=0.387, P<0.01), the mediating effect accounted for 43.33% of the total effect. Conclusions:The chronic disease self-efficacy can indirectly affect the level of spiritual well-being in patients undergoing chemotherapy after radical mastectomy for breast cancer. Clinical medical staff should pay attention to their psychological counseling, broaden their minds, enhance spiritual well-being, and help them recover from adversity.

【Objective】 To reveal the integral in vivo polypharmacokinetics (PPK) similarity or difference between Jinyinhua (Lonicerae Japonicae Flos, LJF) and Shanyinhua (Lonicerae Flos, LF), and provide reference for their clinical application. 【Methods】 The PPK model and its total quantum statistical moment similarity (TQSMS) method were used to compare the integral PPK profiles of nine components with anti-inflammatory efficacy (rutin, caffeic acid, chlorogenic acid, cryptochlorogenic acid, dispsacoside B, macranthoidin B, isochlorogenic acid A, isochlorogenic acid B, and isochlorogenic acid C) of LJF and LF. A total of 54 Specific Pathogen Free (SPF) grade Kunming (KM) mice were randomized into LJF group and LF group (n = 27), and each group was divided into nine subgroups (n = 3) according to different time points. Subsequently, mice model of p-xylene-induced ear edema was constructed by oral administration of LJF and LF. The concentrations of the nine anti-inflammatory components in plasma samples of the mice were determined by ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS/MS). And the pharmacokinetics (PK) parameters of single component and the integral PPK parameters [total quantum statistical moment (TQSM) and TQSMS] of multiple components were calculated by Drug And Statistics (DAS) software and home-brew programs with Excel, respectively. 【Results】 There were significant differences in single-component PK parameters between LJF and LF (P < 0.05). Whereas, no significant differences were found in multi-component TQSM parameters, including total quantum zero moment (AUCT0-t, AUCT0-∞) and total quantum first moment (MRTT0-t, MRTT0-∞) for the total quanta (P > 0.05). Accordingly, single-component TQSMS varied from 0.220 4 to 0.968 9, and that for the total quanta was 0.828 4, suggesting no significant differences in the speed and extent of bioavailability between LJF and LF. Furthermore, in light of high TQSMS (0.828 4), the integral PPK profiles of the nine anti-inflammatory components of LJF and LF were similar under 90% confidence intervals. 【Conclusion】 The PPK model and its TQSMS method are appropriate and efficient to compare the similarity or difference of integral PPK profiles of multi-component herbal medicines. It is suggested in this research that LJF can be replaced with LF or vice versa for anti-inflammatory treatment.

Objective To express the monkeypox virus (MPXV) A23R protein in Escherichia coli and purify by Ni-NTA affinity column, and to prepare mouse antiserum against MPXV A23R. Methods The recombinant plasmid pET-28a-MPXV-A23R was constructed and transformed into Escherichia coli BL21 to induce the expression of A23R protein. After optimizing the conditions of expression, A23R protein was highly expressed. Recombinant A23R protein was purified by Ni-NTA affinity column and identified by Western blot analysis. The purified protein was used to immunize mice for preparing the A23R polyclonal antibody, and the antibody titer was detected by ELISA. Results The expression of A23R recombinant protein reached the peak under the induced conditions of 0.6 mmol/L isopropyl-β-D-thiogalactoside (IPTG), 37 DegreesCelsius and 20 hours. The purity of the protein was about 96.07% and was identified by Western blot analysis. The mice were immunized with recombinant protein, and the titer of antibody reached 1:102 400 at the 6th week after immunization. Conclusion MPXV A23R is expressed highly and purified with a high purity and its antiserum from mouse is obtained with a high titre.
Animals ; Mice ; Monkeypox virus ; Antibodies ; Enzyme-Linked Immunosorbent Assay ; Blotting, Western ; Recombinant Proteins ; Escherichia coli/genetics*

Objective:To explore the mediating effect of chronic disease self-efficacy between fatigue and social support in breast cancer patients undergoing chemotherapy.Methods:This study was a cross-sectional study. From July 2020 to April 2021, convenience sampling was used to select 376 patients with breast cancer undergoing chemotherapy in the Shandong Provincial Hospital Affiliated to Shandong First Medical University as the research object. The General Information Questionnaire, Fatigue Scale-14, Chronic Disease Self-Efficacy Scale and Social Support Rating Scale were used to investigate the patients. Structural equation modeling was used to test the mediating effect among variables. A total of 376 questionnaires were distributed, and 372 valid questionnaires were recovered, with a valid recovery rate of 98.94%.Results:Among 372 breast cancer patients undergoing chemotherapy, the total scores of the Fatigue Scale-14, Chronic Disease Self-Efficacy Scale and Social Support Rating Scale were (10.61±1.81) , (5.00±2.53) and (43.42±12.59) , respectively. Chronic disease self-efficacy was positively correlated with social support in breast cancer patients undergoing chemotherapy ( r=0.493-0.648, P<0.01) , and social support was negatively correlated with fatigue ( r=-0.703--0.234, P<0.01) , and self-efficacy was negatively correlated with fatigue ( r=-0.729--0.220, P<0.01) . Chronic disease self-efficacy played a partial mediating role between fatigue and social support in breast cancer patients undergoing chemotherapy (β=-0.335, P<0.01) , and the mediating effect accounted for 47.59% of the total effect. Conclusions:Social support can indirectly affect fatigue through chronic disease self-efficacy in breast cancer patients undergoing chemotherapy. Nurses should focus on improving the chronic disease self-efficacy and social support of breast cancer patients undergoing chemotherapy.

Objective:To construct a plan for relieving fatigue in breast cancer patients undergoing chemotherapy.Methods:We combined literature and clinical experience to construct a fatigue relief plan for breast cancer chemotherapy patients from August to October 2020. A total of 21 domestic two-glandular surgeons, nursing experts, and surgical nursing teachers were invited to conduct 2 rounds of Delphi expert letter inquiries, and analyzed the positive coefficient of experts and the degree of expert authority to evaluate the reliability of experts, and evaluated the coordination degree of expert opinions through the coefficient of variation and Kendall's harmony coefficient.Results:The effective response rate of the two rounds of questionnaires was 100%, the enthusiasm coefficient of experts was very high. The authority coefficients of the 2 rounds of consulting experts were 0.89 and 0.90 respectively (all>0.7), expert authority coefficient was very high. The Kendall harmony coefficients of the first-level and second-level indicators in the first round were 0.160 and 0.086, statistically significant (all P<0.05). In the second round, the Kendall′s harmony coefficients of dimension, first-level and second-level indicators were 0.190, 0.211, 0.378, statistically significant (all P<0.05). The coefficient of variation of each item in the second round was 0.04-0.12, and the full score rate was 28.57%-95.24%. All met the index screening standards established by the scheme. Finally, 3 dimensions, 3 first-level indicators and 16 third-level indicators were determined. Conclusions:The fatigue relief plan for breast cancer chemotherapy patients has necessity, practicality and scientificity.It has guiding significance for standardizing the fatigue relief of patients undergoing chemotherapy after radical mastectomy.