Objective To explore the selection of palliate operation styles for unresectable malignant obstructive jaundice diseases. Methods The clinical data of 112 cases of unresectable malignant obstructive jaundice diseases in the last 5 years were analyzed retrospectively. Results The rate of operation mortality was 7.1％ and the incidence rate of post-operative cholangitis was 17.3 ％.The survival time in the Roux-en-Y choledochojejunostomy group was (9.4±1.6) months, and there were no significant differences among laparotomy stent internal drainage group[(9.8±12.5)months]and the PTCD stent internal drainage group [(9.0± 3.1)months]. But survival time in the laparotomy bridge internal drainage group [(6.8±1.7)months]was significantly lower (P＜0.05). The survival times in the ERCP stent drainage group [(3.5±2.2)months]and exploratory laparotomy group [(2.8±2.7)months]were even more significantly lower (P＜0.01).Conclusion As a palliative operation for unresectable malignant obstructive jaundice diseases, Roux-en-Y choledochojejunostomy applies to the middle and distal obstruction,laparotomy stent internal drainage applies to hilar obstruction,ERCP stent drainage only applies to distal obstruction,and PTCD stent internal drainage applies to any part obstruction of the bile duct. The Roux-en-Y choledochojejunostomy, laparotomy stent internal drainage, and PTCD stent internal drainage would improve the life time and life quality of these patients.

Objective To investigate the relationship between occupational noise exposure and glycated hemoglobin (HbA1c) levels, as well as prediabetes diagnosed by HbA1c. Methods A total of 1 181 workers from a cigarette factory were selected as the research subjects using a judgment sampling method. Workers were divided into control, low-level noise exposure and high-level noise exposure groups, consisting of 236, 359, and 586 individuals, respectively. The blood sample was collected for HbA1c test and occupation noise exposure intensity in workplace was detected by an area-sampling method. Results There were no statistical significant differences in HbA1c levels and prediabetes prevalence among the three groups of workers (all P>0.05). After adjusting for potential confounding factors such as years of service, gender, smoking, pack-years of smoking, alcohol consumption, and body mass index, multiple linear regression analysis showed that the high-level noise exposure group had higher HbA1c level than the control group (P<0.05). Multivariable logistic regression analysis results showed that the high-level noise exposure group had higher risk of prediabetes compared with the control group (P<0.05). Conclusion Occupational noise exposure could be a risk factor for the increased HbA1c levels and prediabetes incidence among the occupational population. More attention should be paid to the effects of occupational noise exposure on the HbA1c level in occupational health surveillance.