Objectives To investigate the recurrence risk factors and the protective factors of aortic dissection (AD) DeBakey type Ⅲ. Methods 43 patients with AD DeBakey type Ⅲ who were in Guangdong General Hospital from May 2014 to September 2014, were enrolled as the case group, while 27 volunteers exclude AD as the control group. Blood chemistries and other information obtained immediately after admissions , χ2 test or T test was used for univariate analysis of independent samples. Multivariate Logistic regression analysis was used to screen patients with recurrence risk factors or protective factors. Results The prevalence of hypertension (93.02%vs. 18.52%, P = 0.000) and proportion of smokers (34.88% vs. 11.11%, P = 0.027) were significantly higher in case group than control group. Logistic regression analysis showed that hypertension (OR=5.148, 95%CI= [2.209~13.058], P=0.001) and albumin level (OR=0.709, 95%CI = [0.541~0.929], P=0.013) were significantly associated with recurrence of aortic dissection DeBakey type Ⅲ. Conclusion Hypertension is an independent risk factor for recurrence of aortic dissection DeBakey type Ⅲ, and albumin level is a protective factor.

Objective To investigate the clinical effect of different detection methods in the detection of allergens in allergic skin diseases .Methods Choose 74 cases of allergic skin disease patients in our hospital from March 2014 to March 2015 as the research object ,they were divided into two groups by random number method ,immunoblotting group and skin prick test group ,detected al-lergens of the two groups by immunoblotting and skin prick test before treatment .Results The positive rate was 70 .3% in immu-noblotting group ,and the positive rate was 56 .8% in skin prick test group .For allergens detection ,the positive rate was higher by using immunoblotting ,the differences between the two had significant difference(P<0 .05) .Conclusion Immunoblotting is better than the skin prick test for allergen detection in allergic skin diseases .

Objective Toexplore the expressions of interleukin-16 (IL-16), interferon-γ (IFN-γ), CXC chemokine receptor 3 (CXCR3), and CRP and their clinical significance in acute exacerbation chronic obstructive pulmonary disease by observing the changes in these factors in patients with AECOPD. Methods 103 patients with AECOPD and 20 healthy controls were collected. According to the 2013 GOLD guideline, all the patients with AECOPD were divided into4 groups(group A of 21 patients, B of 30, C of 27, andD of 25). Results As compared withthe control group, plasma concentrations of IL-16, IFN-γ, CXCR3. and CRP were significantly increased in the patients with AECOPD (P < 0.01), and as the severity of the disease was elevating, these expression levels were significantly increased.While the expression levels of IL-16, IFN-γ, CXCR3, and CRP levels were significantly reduced after treatment, but they were still higherthan those in the control group (P < 0.05). The expression levels of serum IL-16, IFN-γ, CXCR3, and CRP were significantly correlated in patients with AECOPD. Conclusions Expressions of IL-16, IFN-γ and CXCR3 are significantly increased in AECOPD, which is correlated with disease severity and decreased after treatment, suggesting that these three factors may be associated with the occurrence and development of COPD.

OBJECTIVETo investigate the relationship between work in shifts and occupational stress.

METHODSA total of 5338 employees from 13 companies were investigated by cluster sampling, and occupational stress measuring tools, job content questionnaire, and effort-reward imbalance questionnaire were used to investigate occupational stress factors, stress reaction, and the condition of work in shifts.

RESULTSThe employees who worked in shifts accounted for 46.6%. The condition of work in shifts varied significantly across different companies, employees with different individual features (including sex, job title, degree of education, age, working years, smoking, and drinking), and employees with different weekly working times(P<0.01 or P<0.05); health status was associated with work in shifts(P<0.01); compared with the employees who did not work in shifts, those who worked in shifts had significantly lower scores of technology utilization, work control level, psychological need, reward, social support, and job satisfaction(P<0.01 or P<0.05), as well as significantly higher scores of physical demands, effort, depressive symptoms, and negative affectivity(P<0.01).

CONCLUSIONWork in shifts can affect health status, and is associated with occupational stress.

Depression ; Health Status ; Humans ; Job Satisfaction ; Occupational Diseases ; epidemiology ; Smoking ; Social Support ; Stress, Psychological ; Surveys and Questionnaires ; Work Schedule Tolerance

Objective To investigate insulin resistance in type 1 diabetes(T1DM)with euglycemic-hyperinsulinemic clamp.Methods Eight cases of newly diagnosed T1DM and 8 cases of newly diagnosed type 2 diabetes(T2DM)were selected.Their insulin sensitivity index(ISI)was evaluated with euglycemic-hyperinsulinemic clamp after 2 week insulin intensive treatment and compared with that of 10 heMthy volunteers(normal control group,NC group).Results Age,BMI,fasting insulin(Fins),fasting C-peptide in the TI DM group were significantly lower than those in the NC group.while waist-to-hip ratio (WHR),systolic blood pressure(SBP),diastolic blood pressure(DBP),TC,TG,LDL-C,HDL-C were not significantly different between the T1DM and NC groups.Age,BMI,WHR,Fins,fasting C-peptide,SBP,TC,TG in the T1DM group were significantly lower than those in the T2DM group.The ISI of the NC,TlDM and T2DM groups were 12.83±1.09,9.95±0.50,3.80±0.20,respectively.There was significant difference among the three groups(P＜0.05).Conclusion The ISI in T1DM Was significantly lower than that in NC group,but higher than that in T2DM.

Objective:To investigate association between genetic polymorphism in the grainyhead-like 2 gene (GRHL2)and noise-induced hearing loss (NIHL)in the Chinese population.Methods:A matched case-control association study was employed,In which,3 790 workers exposed to continuous and steady-state occupational noise in a steel factory participated.The questionnaires were adopted to col-lect individual features and audiometry tests performed.In the sstudy,286 subjects were diagnosed as ca-ses,Which were each designated on the basis of the matched criterion,and 286 paired samples were se-lected finally.Noise intensity was measured according to the standards given in ‘Measurement of Noise in the Workplace’(Occupational Health Standard of the People’s Republic of China,GBZ /T1 89.8 -2007).Cumulative noise exposure (CNE)was calculated,according to monitoring data on A-weighed sound pressure level and employment time.Genomic DNA was obtained from peripheral blood samples using 2 mL DNA extraction Kit following the manufacturer’s protocol.Five single nucleotide polymor-phisms (SNPs)of GRHL2 were genotyped by multiplex SNP genotyping kit.The continuous variables and categorical variables were analyzed by t-test and chi-square test respectively.Multivariate Logistic re-gression was used to test the association between genetic frequency and disease status,with adjustments for the possible confounding variables.The haplotypes were established and their frequencies in the two groups were assessed by haploview and phase softwares.Results:All the five SNPs (rs373571 3, rs3824090,rs373571 4,rs373571 5 and rs61 1 41 9)were in Hardy-Weinberg equilibrium (HWE)(P >0.05).The subjects carrying rs373571 5 GG genotype had a higher NIHL risk than those carrying the GA genotype under the co-dominant model (OR =0.644,95% CI:0.442 -0.939,P =0.022)after ad-justment for height,blood pressure,drinking status and smoking status.After being stratified by CNE,in the CNE ≥ 98 dB (A)group,rs373571 5 polymorphism was associated with the NIHL under the co-dominant model (OR =0.509,95% CI:0.281 -0.923,P =0.026)after adjustment for height,blood pressure,drinking status and smoking status as well.However,no statistical significant difference was found in variant genotypes of the other SNPs between the case and control subjects.Four-locus (rs373571 3,rs3824090,rs373571 4 and rs373571 5)haplotypes were constructed,and no risk or protec-tive haplotypes was identified.Conclusion:It is suggested that GRHL2 polymorphisms may be associated with development of NIHL.

OBJECTIVETo explore depressive symptoms and influencing factors in employees from 13 enterprises.

METHODSA total of 6711 workers from 13 enterprises were investigated by cluster sampling, and data were collected anonymously between November 2008 and June 2009. Job satisfaction, occupational stressors, strains, coping strategy, and social support were measured using occupational stress instruments, job content questionnaire, and effort-reward imbalance questionnaire.

RESULTSMedian and P25~P75 values of depression score were 14 and 9~21, respectively. The depression score of male workers (16.31 ± 10.12) was significantly higher than that of female workers(14.50 ± 9.08) (Z=4.09, P<0.01). The depression score of managers was lowest (12.89 ± 8.70), and the front-line workers scored highest (16.02 ± 9.94), with a significant difference between the two groups (χ² =9.90, P<0.01). The depression score of shift workers (16.79 ± 9.974) was significantly higher than that of non-shift workers (14.81 ± 9.63) (Z=53.43, P<0.01). The depression scores of workers with weekly job times of ≤ 40 h, ~50 h, ~59 h, and ≥ 60 h were (14.70 ± 9.94), (15.76 ± 9.84), (15.46 ± 9.91), and (19.70 ± 10.67), respectively (χ² = 31.79, P <0.01). Correlation analysis revealed that depression score was negatively correlated with the scores of job control (r=-0.236, P <0.01), reward (r=-0.443, P<0.01), job satisfaction (r=-0.418, P<0.01), positive affectivity (r=-0.307, P <0.01), superior support (r=-0.287, P<0.01), colleague support (r=-0.235, P<0.01), and coping strategy (r=-0.208, P<0.01), but positively correlated with the scores of external effort (r=0.225, P<0.01), inherent effort (r=0.248, P<0.01), psychological demands (r = 0.246, P <0.01), physical demands (r=0.246, P<0.01), and negative affectivity (r=0.525, P<0.01). Multivariate logistic regression analysis revealed that the risk of depressive symptoms in workers with high negative affectivity was about four times as high as that in workers with low negative affectivity. The risks of depressive symptoms in workers with low reward, having disease in the past six months, and with high inherent effort were 1.62, 1.50, and 1.48 times, respectively, as high as those for their counterparts.

CONCLUSIONOccupational stress, individual factors, health status, and shift work affect the depressive symptoms of workers. Reducing negative affectivity and increasing rewards are main measures to relieve depressive symptoms.

Adaptation, Psychological ; Depression ; epidemiology ; Female ; Health Status ; Humans ; Job Satisfaction ; Male ; Occupational Health ; Social Support ; Stress, Psychological ; Surveys and Questionnaires ; Work Schedule Tolerance

Objective: To investigate the influencing factors for job satisfaction in train drivers. Methods: In March 2012, cluster sampling was used to conduct a cross-sectional survey in 1413 male train drivers (including 301 passenger train drivers, 683 freight train drivers, 350 passenger shunting train drivers, and 79 high-speed train drivers) from a locomotive depot of a railway bureau. The occupational stress instruments, job content questionnaire, and effort-reward imbalance questionnaire were used to analyze job satisfaction, occupational stress factors, stress reaction, individual characteristics, coping strategies, and social support. Results: There were significant differences in job satisfaction score between the drivers with different posts, working years, ages, smoking status, and drinking status (P<0.01). The correlation analysis revealed that job satisfaction score was positively correlated with reward, working stability, promotion opportunity, positive emotion, social support, self-esteem, and coping strategy scores (P<0.01) and negatively correlated with sleep disorders, effort, role conflict, intergroup conflict, responsibility for persons, responsibility for things, psychological needs, physiological needs, daily stress, negative emotion, and depressive symptom scores (P< 0.01). The analysis of variance showed that compared with the moderate and low job satisfaction groups, the high job satisfaction group had significantly higher reward, positive emotion, promotion opportunity, and role ambiguity scores (P<0.01) , as well as significantly lower scores of responsibility for persons and responsibility for things (P<0.01). Compared with the moderate and high job satisfaction groups the low job satisfaction group had significantly higher scores of psychological needs, effort, role conflict, sleep disorders, daily stress, depressive symptom, negative emotion, drug use, intragroup conflict, and social support (P<0.01) , and the moderate job satisfaction group had a significantly higher score of self-esteem than the other two groups (P<0.05). The logistic regression analysis showed that the risk of job dissatisfaction in the drivers with low so-cial support and high daily stress was more than 2 times that in those with high social support and low daily stress (OR=2.176 and 2.171) , and sleep disorders, effort, depressive symptom, low self-esteem, and role conflict were risk factors for job dissatisfaction (OR=1.48-1.625). Conclusion Occupational stress, stress re-sponse, emotion, individual characteristics, and social support have great influence on job satisfaction. Im-proving social support, increasing positive emotion, and reducing occupational stress are main measures for increasing job satisfaction in train drivers.

Objective: To investigate sleep quality status of train drivers. Methods: By using cluster sampling method, a cross-sectional study was conducted in 1413 train drivers (including passenger train drivers 301, freight train drivers 683, passenger shunting train drivers 350, and high speed train drivers 79) from a railway bureau. The occupational stressors, strains, personalities and sleep quality were measured using occupational stress instruments and effort-reward imbalance questionnaire. Results: The train drivers of poor sleep quality was 48.34%. Sleep quality scores among different among different job category (job title) , exercise, smoking and drinking were statistical significance (P<0.01) . Differences of sleep quality among different educational level, marry status, age, length of service groups weren’t statistical significance (P>0.05) . Correlation analysis revealed that sleep quality score was related negatively to job satisfaction, reward, working stability, promotion opportunities, positive affectivity, esteem and self-esteem scores (r: -0.454, -0.207, -0.329,-0.170, -0.291, -0.103, -0.139, P<0.01 or P<0.05) , positively to social support, effort, role conflict, conflict between groups, conflict in groups, responsibility for person, responsibility for thing, psychological needs, physiological needs, daily stress, negative affectivity, depressive symptoms scores (r: 0.338, 0.524, 0.226, 0.094, 0.182, 0.210, 0.247, 0.190, 0.615, 0.550, 0.345, 0.570, P<0.01) . Nonparametric test found that train drivers of group with high sleep quality score reported higher scores for physiological need, psychological need, effort, role conflict, conflict between groups, social support, daily stress, depressive symptoms, responsibility for person, responsibility for thing, negative affectivity and coping scores than the group of lower sleep quality score (P<0.01) . But reword, job satisfaction, positive affectivity, self-esteem working stability and Promotion opportunities scores were lower than the group of lower sleep quality score (P<0.01) . Multivariate logistic regression analysis revealed the risk for more physiological needs, more effort, more depressive symptoms and more daily stress for drivers occured the risk of poor sleep quality were more than two times as high as that of drivers with less physiological needs, less effort, less depressive symptoms and less daily stress (OR=2.905~2.005) . Conclusions Different types of locomotive drivers get different level of sleep quality. Sleep quality was affected by occupational stress largely. Reducing the occupational stress may contribute to improve the sleep quality of train drivers.

Objective: To investigate self-esteem status of train drivers. Methods: By using cluster sampling method, a cross-sectional study was conducted in 1 413 train drivers (including passenger train drivers 301, freight train drivers683, passenger shunting train drivers350, and high speed train drivers79) from a railway bureau. The occupational stressors, strains, self-esteem and personalities were measured using occupational stress instruments and effort-reward imbalance questionnaire. Results: The level of self-esteem is medium ofthe train drivers. Sself-esteem scores among different among different job category (job title) , marry status, age, length of service groups were statistical significance (P<0.01) . Differences of self-esteem among different educational level, exercise, smoking and drinking groups weren’t statistical significance (P>0.05) . Correlation analysis revealed that self-esteem score was related positively to job satisfaction (r=0.300) , reward (r=0.842) , working stability (r=0.243) , promotion opportunities (r=0.493) , positive affectivity (r=0.216) , responsibility for human beings (r=0.112) and responsibility for things scores (r=0.108) (P<0.01) , negatively to sleep quality (r=-0.103) , social support (r=-0.212) , role conflict (r=-0.007) , role ambiguity (r=-0.169) , physiological needs (r=-0.115) , daily stress (r=-0.150) , negative affectivity (r=-0.252) , depressive symptoms scores (r=-0.215) (P<0.01) . Nonparametric test found that train drivers of group with low self-esteem score reported higher scores for physiological need, role conflict, role ambiguity, social sleep quality, depressive symptoms, negative affectivity, social support and daily stress scores than the medium and higher groups (P<0.01 or<0.05) . But reword, job satisfaction, positive affectivity, copping stratgy, working stability and promotion opportunities scores were lower than the group of medium and higher groups (P<0.01) . Inter-group conflict scores were insignificance (P>0.05) . Multivariate logistic regression analysis revealed that low low self-esteem for drivers occured the risk of job dissatisfaction about 1.5 times as high as that of drivers with higher self-esteem (OR=1.476) Conclusion Different types of locomotive drivers get different level of self-esteem. Self-esteem was affected by occupational stress largely.