Prevalence and associated factors of musculoskeletal disorders among Chinese healthcare professionals working in tertiary hospitals: a cross-sectional study.

BACKGROUND: Musculoskeletal disorders (MSDs) are prevalent in working populations and could result in a number of detrimental consequences. In China, healthcare professionals (HCP) in large hospitals may be likely to suffer from MSDs considering the facts of shortages in medical staff, the large Chinese population base, the aging of the population and patients' inclination to go to large hospitals. This study aimed to determine the prevalence and factors associated with MSDs among HCP working in tertiary hospitals. METHODS: A self-administered questionnaire incorporating the Nordic Musculoskeletal Questionnaire and the Dutch Musculoskeletal Questionnaire was conducted among 14,720 HCP in eight tertiary hospitals selected by random cluster sampling in Shandong, China. Multivariable logistic regression analysis was used to quantify the association of psychological, ergonomic, organizational and individual factors with MSDs. RESULTS: The 12-month period prevalence rate of experiencing an MSD in at least one body region for at least 24 h, experiencing an MSD for at least three months, and seeking health care for this condition were 91.2, 17.1 and 68.3%, respectively; these rates were highest for the lower back (72.8, 14.3, 60.3%) and knees (65.7, 8.1, 46.7%), followed by the shoulders (52.1, 6.2, 38.9%), neck (47.6, 4.8, 32.6%), wrists/hands (31.1, 3.2, 23.1%), ankles/feet (23.6, 1.9, 13.4%), upper back, hips/thighs and elbows. MSDs were associated with workload (work hours per week, break times during workday), psychological factors (psychological fatigue, mental stress), employment status and ergonomic factors. Regarding the ergonomic factors, lower back MSDs were associated with bending the trunk frequently, heavy or awkward lifting, and bending or twisting the neck; knee MSDs were associated with walking or standing for long periods of time; and shoulder MSDs were associated with maintaining shoulder abduction for long periods of time and bending or twisting the neck. CONCLUSIONS: MSDs among HCP in tertiary hospitals in Mainland China were highly prevalent. The many factors listed above should be considered in the prevention of MSDs in HCP.

Manganese-doped carbon quantum dots for fluorometric and magnetic resonance (dual mode) bioimaging and biosensing.

Manganese-doped carbon quantum dots (MnCQDs) were prepared through one-step hydrothermal method using citric acid and manganese tetraphenyl porphyrin as carbon sources in aqueous media. The structure of MnCQDs was confirmed by TEM, XRD, and XPS. The MnCQDs display a typical excitation-dependent emission behavior and exhibit bright green luminescence (with a peak at 482 nm) under UV irradiation (365 nm) and a fluorescence quantum yield of 13%. The MnCQDs can be used as a fluorescent probe for ferric ion in aqueous solution with a 220 nM detection limit. The MTT assay demonstrated the low cytotoxicity of MnCQDs towards HeLa cells. Due to the excitation-dependent emission properties, MnCQDs can be used as a multi-color (blue, green, and red) bioimaging agent in cancer cells and in living zebrafish. The application of MnCQDs as selective biosensing probe for Fe3+ was also realized in cells and zebrafish mode. Because of the existence of paramagnetic ions, MnCQDs demonstrate an enhanced magnetic resonance (MR) signal. Thus, the MnCQDs can serve as a positive contrast agent for MR imaging. Graphical abstract Schematic presentation of the preparation of luminescent manganese-doped carbon quantum dots (MnCQDs). MnCQDs showed good magnetic resonance effect and can be used as a fluorescence probe for the detection of Fe3+ in HeLa cells and zebrafish.

An epigenetic breeding system in soybean for increased yield and stability.

Epigenetic variation has been associated with a wide range of adaptive phenotypes in plants, but there exist few direct means for exploiting this variation. RNAi suppression of the plant-specific gene, MutS HOMOLOG1 (MSH1), in multiple plant species produces a range of developmental changes accompanied by modulation of defence, phytohormone and abiotic stress response pathways along with methylome repatterning. This msh1-conditioned developmental reprogramming is retained independent of transgene segregation, giving rise to transgene-null 'memory' effects. An isogenic memory line crossed to wild type produces progeny families displaying increased variation in adaptive traits that respond to selection. This study investigates amenability of the MSH1 system for inducing agronomically valuable epigenetic variation in soybean. We developed MSH1 epi-populations by crossing with msh1-acquired soybean memory lines. Derived soybean epi-lines showed increase in variance for multiple yield-related traits including pods per plant, seed weight and maturity time in both glasshouse and field trials. Selected epi-F2:4 and epi-F2:5 lines showed an increase in seed yield over wild type. By epi-F2:6, we observed a return of MSH1-derived enhanced growth back to wild-type levels. Epi-populations also showed evidence of reduced epitype-by-environment (e × E) interaction, indicating higher yield stability. Transcript profiling of epi-lines identified putative signatures of enhanced growth behaviour across generations. Genes related to cell cycle, abscisic acid biosynthesis and auxin response, particularly SMALL AUXIN UP RNAs (SAURs), were differentially expressed in epi-F2:4 lines that showed increased yield when compared to epi-F2:6 . These data support the potential of MSH1-derived epigenetic variation in plant breeding for enhanced yield and yield stability.

Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors.

BACKGROUND: This study aimed to determine the prevalence of sleep disturbances among clinical nurses in general hospitals in Mainland China, and identify its associate factors. METHODS: Using a cross-sectional design, a total of 5012 clinical nurses selected by random cluster sampling completed the survey on the Pittsburgh Sleep Quality Index (PSQI), measures of quality of life indexed by the Medical Outcomes Study 12-item Short-Form Health Survey, occupational stress evaluated by the Job Content Questionnaire, lifestyle and sociodemographic details. RESULTS: The average PSQI score of 4951 subjects was 7.32 ± 3.24, including 3163 subjects with PSQI ≥5, accounting for 63.9%. Multivariate Logistic regression analysis showed that the risk factors for sleep disturbances in nurses were female gender, the Emergency department and ICU, many years of service, high night shift frequency, professional status: primary and intermediate, employment status: temporary, poor quality of life: poor mental health, low perceived health, high occupational stress (high psychological demand, low job control and low workplace social support). CONCLUSIONS: Sleep disturbances are highly prevalent among clinical nurses in general hospitals in Mainland China. Many of the factors listed above were associated with the prevalence of sleep disturbances in nurses, and occupational stress plays an important role in the development of sleep disturbances in Chinese clinical nurses.

MutS HOMOLOG1-derived epigenetic breeding potential in tomato.

Evidence is compelling in support of a naturally occurring epigenetic influence on phenotype expression in land plants, although discerning the epigenetic contribution is difficult. Agriculturally important attributes like heterosis, inbreeding depression, phenotypic plasticity, and environmental stress response are thought to have significant epigenetic components, but unequivocal demonstration of this is often infeasible. Here, we investigate gene silencing of a single nuclear gene, MutS HOMOLOG1 (MSH1), in the tomato (Solanum lycopersicum) 'Rutgers' to effect developmental reprogramming of the plant. The condition is heritable in subsequent generations independent of the MSH1-RNA interference transgene. Crossing these transgene-null, developmentally altered plants to the isogenic cv Rutgers wild type results in progeny lines that show enhanced, heritable growth vigor under both greenhouse and field conditions. This boosted vigor appears to be graft transmissible and is partially reversed by treatment with the methylation inhibitor 5-azacytidine, implying the influence of mobile, epigenetic factors and DNA methylation changes. These data provide compelling evidence for the feasibility of epigenetic breeding in a crop plant.

MutS HOMOLOG1 is a nucleoid protein that alters mitochondrial and plastid properties and plant response to high light.

Mitochondrial-plastid interdependence within the plant cell is presumed to be essential, but measurable demonstration of this intimate interaction is difficult. At the level of cellular metabolism, several biosynthetic pathways involve both mitochondrial- and plastid-localized steps. However, at an environmental response level, it is not clear how the two organelles intersect in programmed cellular responses. Here, we provide evidence, using genetic perturbation of the MutS Homolog1 (MSH1) nuclear gene in five plant species, that MSH1 functions within the mitochondrion and plastid to influence organellar genome behavior and plant growth patterns. The mitochondrial form of the protein participates in DNA recombination surveillance, with disruption of the gene resulting in enhanced mitochondrial genome recombination at numerous repeated sequences. The plastid-localized form of the protein interacts with the plastid genome and influences genome stability and plastid development, with its disruption leading to variegation of the plant. These developmental changes include altered patterns of nuclear gene expression. Consistency of plastid and mitochondrial response across both monocot and dicot species indicate that the dual-functioning nature of MSH1 is well conserved. Variegated tissues show changes in redox status together with enhanced plant survival and reproduction under photooxidative light conditions, evidence that the plastid changes triggered in this study comprise an adaptive response to naturally occurring light stress.

How does the location of high-speed railway stations affect the emission reduction effect of industrial structure upgrading?

The opening of high-speed railway (HSR) has accelerated the reorganization and reallocation of regional production elements, and constantly promoted the adjustment and upgrading of industrial structure. The cleaner production effect produced by industrial structure upgrading is of great significance to industrial pollution reduction. As a bridge connecting resources within the city and elements outside the city, the location of HSR stations has become an important factor affecting the structural emission reduction effect. Based on the data of 285 prefecture level and above cities in China from 2004 to 2018, this paper investigates the structural emission reduction effects of HSR opening and the impact of HSR station location on it by employing difference-in-differences (DID) model combined with mediation effect method. The results demonstrate that the opening of HSR has significant structural emission reduction effect, and the upgrading of inter-industry structure and the intra-industry structure are important mechanisms for HSR to achieve industrial emission reduction. The structural emission reduction effect of HSR opening is closely related to the location of HSR stations. With the increase of the distance between HSR station and city center, the industrial structure upgrading effect will continue to weaken, thus inhibiting the exertion of structural emission reduction effect, of which 10 km away from the city center is the optimal site strategy for the HSR service to give full play to the structural emission reduction effect, and exceeding 50 km will be significantly detrimental to its role in promoting industrial structure upgrading.

Bifunctional Inhibitor Reveals NEK2 as a Therapeutic Target and Regulator of Oncogenic Pathways in Lymphoma.

Expression of the serine/threonine kinase never in mitosis gene A (NIMA)-related kinase 2 (NEK2) is essential for entry into mitosis via its role in facilitating centrosome separation. Its overactivity can lead to tumorigenesis and drug resistance through the activation of several oncogenic pathways, including AKT. Although the cancer-enabling activities of NEK2 are documented in many malignancies, including correlations with poor survival in myeloma, breast, and non-small cell lung cancer, little is known about the role of NEK2 in lymphoma. Here, in tumors from patients with diffuse large B-cell lymphoma (DLBCL), the most common, aggressive non-Hodgkin lymphoma, we found a high abundance of NEK2 mRNA and protein associated with an inferior overall survival. Using our recently developed NEK2 inhibitor, NBI-961, we discovered that DLBCL cell lines and patient-derived cells exhibit a dependency on NEK2 for their viability. This compromised cell fitness was directly attributable to efficient NEK2 inhibition and proteasomal degradation by NBI-961. In a subset of particularly sensitive DLBCL cells, NBI-961 induced G2/mitosis arrest and apoptosis. In contrast, an existing indirect NEK2 inhibitor, INH154, did not prevent NEK2 autophosphorylation, induce NEK2 proteasomal degradation, or affect cell viability. Global proteomics and phospho-proteomics revealed that NEK2 orchestrates cell-cycle and apoptotic pathways through regulation of both known and new signaling molecules. We show the loss of NEK2-sensitized DLBCL to the chemotherapy agents, doxorubicin and vincristine, and effectively suppressed tumor growth in mice. These studies establish the oncogenic activity of NEK2 in DLBCL and set the foundation for development of anti-NEK2 therapeutic strategies in this frequently refractory and relapse-prone cancer.

A screening study on the detection strain of Coxsackievirus A6: the key to evaluating neutralizing antibodies in vaccines.

The increasing incidence of diseases caused by Coxsackievirus A6 (CV-A6) and the presence of various mutants in the population present significant public health challenges. Given the concurrent development of multiple vaccines in China, it is challenging to objectively and accurately evaluate the level of neutralizing antibody response to different vaccines. The choice of the detection strain is a crucial factor that influences the detection of neutralizing antibodies. In this study, the National Institutes for Food and Drug Control collected a prototype strain (Gdula), one subgenotype D1, as well as 13 CV-A6 candidate vaccine strains and candidate detection strains (subgenotype D3) from various institutions and manufacturers involved in research and development. We evaluated cross-neutralization activity using plasma from naturally infected adults (n = 30) and serum from rats immunized with the aforementioned CV-A6 strains. Although there were differences between the geometric mean titer (GMT) ranges of human plasma and murine sera, the overall trends were similar. A significant effect of each strain on the neutralizing antibody test (MAX/MIN 48.0 ∼16410.3) was observed. Among all strains, neutralization of the S112 strain by 15 different sera resulted in higher neutralizing antibody titers (GMTS112 = 132.0) and more consistent responses across different genotypic immune sera (MAX/MIN = 48.0). Therefore, S112 may serve as a detection strain for NtAb testing in various vaccines, minimizing bias and making it suitable for evaluating the immunogenicity of the CV-A6 vaccine.

The chloroplast triggers developmental reprogramming when mutS HOMOLOG1 is suppressed in plants.

Multicellular eukaryotes demonstrate nongenetic, heritable phenotypic versatility in their adaptation to environmental changes. This inclusive inheritance is composed of interacting epigenetic, maternal, and environmental factors. Yet-unidentified maternal effects can have a pronounced influence on plant phenotypic adaptation to changing environmental conditions. To explore the control of phenotypy in higher plants, we examined the effect of a single plant nuclear gene on the expression and transmission of phenotypic variability in Arabidopsis (Arabidopsis thaliana). MutS HOMOLOG1 (MSH1) is a plant-specific nuclear gene product that functions in both mitochondria and plastids to maintain genome stability. RNA interference suppression of the gene elicits strikingly similar programmed changes in plant growth pattern in six different plant species, changes subsequently heritable independent of the RNA interference transgene. The altered phenotypes reflect multiple pathways that are known to participate in adaptation, including altered phytohormone effects for dwarfed growth and reduced internode elongation, enhanced branching, reduced stomatal density, altered leaf morphology, delayed flowering, and extended juvenility, with conversion to perennial growth pattern in short days. Some of these effects are partially reversed with the application of gibberellic acid. Genetic hemicomplementation experiments show that this phenotypic plasticity derives from changes in chloroplast state. Our results suggest that suppression of MSH1, which occurs under several forms of abiotic stress, triggers a plastidial response process that involves nongenetic inheritance.

Purification, crystallization and preliminary crystallographic analysis of 3-hydroxyacyl-CoA dehydrogenase from Caenorhabditis elegans.

3-Hydroxyacyl-CoA dehydrogenase (HAD; EC 1.1.1.35) is the enzyme that catalyzes the third step in fatty-acid ß-oxidation, oxidizing the hydroxyl group of 3-hydroxyacyl-CoA to a keto group. The 3-hydroxyacyl-CoA dehydrogenase from Caenorhabditis elegans (cHAD) was cloned, overexpressed in Escherichia coli and purified to homogeneity for crystallography. Initial crystals were obtained by the hanging-drop vapour-diffusion method. Optimization of the precipitant concentration and the pH yielded two types of well diffracting crystals with parallelepiped and cuboid shapes, respectively. Complete diffraction data sets were collected and processed from both crystal types. Preliminary crystallographic analysis indicated that the parallelepiped-shaped crystal belonged to space group P1, while the cuboid-shaped crystal belonged to space group P212121. Analyses of computed Matthews coefficient and self-rotation functions suggested that there are two cHAD molecules in one asymmetric unit in both crystals, forming identical dimers but packing in distinct manners.

Does the digital economy empower the green development of foreign trade?

The digital economy has become a new driving force for China's economic development in recent years, and it may contribute to solving the corresponding problems of resource and environmental pressure. Therefore, this study strives to explore whether the digital economy contributes to the green development of foreign trade. First, this study measures the digital economy development in China. Second, this study presents a list of environmental and polluting products and examines the impact of digital economy development on exports of representative products based on an extended gravity model. The main findings are as follows. First, the digital economy significantly promotes the green development of foreign trade. Second, the signing of Free Trade Agreements (FTAs) and the income level of importing countries and regions strengthen the role of the digital economy in promoting the green development of foreign trade. Third, the digital economy promotes the green development of foreign trade through green technological innovation. Finally, some policy implications are proposed based on the findings of this study.

Xuanfei Baidu decoction in the treatment of coronavirus disease 2019 (COVID-19): Efficacy and potential mechanisms.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide and become a major global public health concern. Although novel investigational COVID-19 antiviral candidates such as the Pfizer agent PAXLOVID™, molnupiravir, baricitinib, remdesivir, and favipiravir are currently used to treat patients with COVID-19, there is still a critical need for the development of additional treatments, as the recommended therapeutic options are frequently ineffective against SARS-CoV-2. The efficacy and safety of vaccines remain uncertain, particularly with the emergence of several variants. All 10 versions of the National Health Commission's diagnosis and treatment guidelines for COVID-19 recommend using traditional Chinese medicine. Xuanfei Baidu Decoction (XFBD) is one of the "three Chinese medicines and three Chinese prescriptions" recommended for COVID-19. This review summarizes the clinical evidence and potential mechanisms of action of XFBD for COVID-19 treatment. With XFBD, patients with COVID-19 experience improved clinical symptoms, shorter hospital stay, prevention of the progression of their symptoms from mild to moderate and severe symptoms, and reduced mortality in critically ill patients. The mechanisms of action may be associated with its direct antiviral, anti-inflammatory, immunomodulatory, antioxidative, and antimicrobial properties. High-quality clinical and experimental studies are needed to further explore the clinical efficacy and underlying mechanisms of XFBD in COVID-19 treatment.

The immunologic injury composite with balloon injury leads to dyslipidemia: a robust rabbit model of human atherosclerosis and vulnerable plaque.

Atherosclerosis is a condition in which a lipid deposition, thrombus formation, immune cell infiltration, and a chronic inflammatory response, but its systemic study has been hampered by the lack of suitable animal models, especially in herbalism fields. We have tried to perform a perfect animal model that completely replicates the stages of human atherosclerosis. This is the first combined study about the immunologic injury and balloon injury based on the cholesterol diet. In this study, we developed a modified protocol of the white rabbit model that could represent a novel approach to studying human atherosclerosis and vulnerable plaque.

Double-strand break repair processes drive evolution of the mitochondrial genome in Arabidopsis.

BACKGROUND: The mitochondrial genome of higher plants is unusually dynamic, with recombination and nonhomologous end-joining (NHEJ) activities producing variability in size and organization. Plant mitochondrial DNA also generally displays much lower nucleotide substitution rates than mammalian or yeast systems. Arabidopsis displays these features and expedites characterization of the mitochondrial recombination surveillance gene MSH1 (MutS 1 homolog), lending itself to detailed study of de novo mitochondrial genome activity. In the present study, we investigated the underlying basis for unusual plant features as they contribute to rapid mitochondrial genome evolution. RESULTS: We obtained evidence of double-strand break (DSB) repair, including NHEJ, sequence deletions and mitochondrial asymmetric recombination activity in Arabidopsis wild-type and msh1 mutants on the basis of data generated by Illumina deep sequencing and confirmed by DNA gel blot analysis. On a larger scale, with mitochondrial comparisons across 72 Arabidopsis ecotypes, similar evidence of DSB repair activity differentiated ecotypes. Forty-seven repeat pairs were active in DNA exchange in the msh1 mutant. Recombination sites showed asymmetrical DNA exchange within lengths of 50- to 556-bp sharing sequence identity as low as 85%. De novo asymmetrical recombination involved heteroduplex formation, gene conversion and mismatch repair activities. Substoichiometric shifting by asymmetrical exchange created the appearance of rapid sequence gain and loss in association with particular repeat classes. CONCLUSIONS: Extensive mitochondrial genomic variation within a single plant species derives largely from DSB activity and its repair. Observed gene conversion and mismatch repair activity contribute to the low nucleotide substitution rates seen in these genomes. On a phenotypic level, these patterns of rearrangement likely contribute to the reproductive versatility of higher plants.

The effect of toll-like receptor 4 in the aqueous humor of endotoxin-induced uveitis.

In our previous study, we found that acute anterior uveitis (AAU) could be induced in wild-type mice (C3H/HeN), but it could not be induced in TLR4 gene-deficient mice (C3H/HeJ), we concluded that the translocation of transcription factor nuclear factor-κB (NF-κB) may play an important role. In this study, we examined the concentration of different cytokines in the aqueous humor of C3H/HeN mice and C3H/HeJ mice with the aim of exploring the role of different cytokines in the lipopolysaccharide (LPS) and TLR4-mediated signal transduction in the development of AAU.

Heterogeneous effect of GHG emissions and fossil energy on well-being and income in emerging economies: a critical appraisal of the role of environmental stringency and green energy.

The new Agenda 2030 for sustainable development call for initiatives to bridge the gap between environmental protection and socio-economic development. To provide insight on the relationship between socio-economics, and ecology, the current study examines the effectiveness of environmental stringency and green energy to mitigate the effects of fossil energy and greenhouse gas emissions on human well-being and income for 12 emerging economies. The outcomes from dynamic heterogeneous panel estimators of cross-sectional-based auto regressive distributed lag and cross-sectional-augmented distributed lag indicate that: (i) green energy consumption and electricity consumption have a substantial positive effect on well-being and per capita income. (ii) The stringent environmental policy is found to decrease per capita income, but it increases well-being, while the square of environmental stringency is found to increase per capita income. (iii) Fossil energy consumption and greenhouse gas emissions have a negative effect on well-being but a positive impact on income. The outcome of U-test confirmed the presence of a U-shaped curve with a turning point (0.433) between per capita income and environmental policy stringency. This study yielded consistent results from the panel Granger causality test. Based on our findings, we may argue that it is necessary to prioritize human well-being over economic growth, and suggest several policy implications to achieve sustainable development goals.

Trade openness and environment: a panel data analysis for 88 selected BRI countries.

In 2013, the Chinese government officially announced the Belt and Road Initiative (BRI). Since then, environmentalists have raised concerns regarding the environmental impact of trade between China and BRI countries. Therefore, the current study aims to analyze the environmental impact of the two aspects of BRI countries' trade: First, it examines the environmental impact of trade openness between China and BRI countries. Second, it examines the environmental impact of trade openness among BRI countries. For this purpose, the current study employs the two-step system GMM model with a panel dataset for the period 2001-2018. The results obtained for the whole sample of 88 selected BRI countries suggest that the trade openness between China and BRI countries significantly reduces CO2 emissions. However, the trade openness among BRI countries has no significant effect on CO2 emissions. In addition, BRI countries' exports to China do not have a significant effect on CO2 emissions. However, BRI countries' imports from China significantly reduce CO2 emissions in these countries. The results obtained for the subsamples of BRI countries suggest that the trade openness between China and BRI countries, BRI countries' exports to China, and BRI countries' imports from China have no significant effect on CO2 emissions in both low-income and high-income BRI countries. Moreover, the trade openness among BRI countries significantly increases CO2 emissions in low-income BRI countries only.

How does green technology innovation affect urbanization? An empirical study from provinces of China.

The construction of new-type urbanization with the theme of innovation, green, and smart development is becoming the endogenous driving force of China's economic transformation and upgrading, and green technological innovation is a key factor in cracking the problems of development motivation and environmental constraints in urbanization construction. This paper investigates the impact of green technology innovation on urbanization based on a panel dataset covering 30 provinces in China from 2005 to 2019. First, we use the entropy method and the super-efficiency DEA method to measure the level of urbanization and green technology innovation, respectively. Moreover, on this basis, we use panel regression model and FGLS model to estimate the direct impact of green technological innovation on urbanization and its three dimensions-population urbanization, industrial urbanization, and ecological urbanization. Then, the mediating effect model is used to further study the indirect impact of green technological innovation on urbanization. The results indicate that green technological innovation is the most effective way to promote the development of new urbanization currently. In addition, green technology innovation can indirectly affect urbanization through the effects of foreign capital, energy consumption and information development, while the effect of industrial structure optimization effects is not significant. Finally, some policy suggestions are discussed to better promote the development of urbanization in China.

Evaluating China's pilot carbon Emission Trading Scheme: collaborative reduction of carbon and air pollutants.

Collaborative reduction of carbon and air pollutants can more efficiently achieve green technological change, industrial low-carbon transition, and high-quality economic and social development. As a typical environmental policy in China, the pilot carbon Emission Trading Scheme (ETS) has obvious advantages in achieving the collaborative reduction of carbon and air pollutants. Therefore, an evaluation of China's pilot carbon ETS from the perspective of collaborative reduction of carbon and air pollutants is performed in this paper. Compared with previous studies, first, this study innovatively uses the coupled coordination degree (CCD) model to measure the collaborative reduction level of carbon and air pollutants under different scenarios based on the panel data of China's 30 provincial-level regions during 2004-2018. Second, this study uses the DID method to evaluate the impact of China's pilot carbon ETS on the collaborative reduction of carbon and air pollutants and conducts some robustness checks and regional heterogeneity regressions. Third, this study uses the synthetic control method (SCM) further to examine the policy outcomes of the pilot carbon ETS. Scenario analysis shows that attaching importance to reducing air pollution will improve the collaborative reduction effect of carbon and air pollutants. Furthermore, the implementation of China's pilot carbon ETS exerts an effect of roughly 24.7% on reducing carbon, roughly 10.1% on reducing air pollutants, and roughly 22.0% on the collaborative reduction of carbon and air pollutants, ceteris paribus. Regional heterogeneity analysis shows that the impacts of the pilot carbon ETS are significant in all regions, except that the impact on reducing air pollutants in the central region is not significant. In addition, results from SCM indicate that the impacts of the pilot carbon ETS on the collaborative reduction of carbon and air pollutants are significantly efficient in Beijing, Tianjin, Shanghai, Hubei, and Chongqing, while not much efficient in Guangdong and Fujian. The main policy implications include strengthening the top-level design of the ETS in the collaborative reduction of carbon and air pollutants, attaching importance to the governance of air pollution, making the regional governance more targeted, and improving energy efficiency.