OBJECTIVE To investigate the influence of noise on the hearing of the workers with noise exposureand explore the relationship between the hearing damage and the length of noise exposure.METHODS 120 workers who exposed to noise were recruited. Their physical examination including audiometry was done in our hospital from year 2012 to 2014. Hearing loss and the length of noise exposure were detected in all subjects after 2-year's follow-up.The rate of hearing loss between workers with different length of noise exposure was analyzed statistically. RESULTS There were 22 workers who were exposed to noise for 2 years, 43 workers for 3-5 years and 55 workers for 6-10 years. After 2-year's follow up, there were significant differences between the rate of hearing loss and the length of noise exposure at 3,4 and 6 kHz. And the rate of hearing loss at different sound frequency were significantly different statistically. CONCLUSION The relevance ratio of hearing loss in long noise-exposed group was significantly higher than short groups. The hearing damages at 4 KHz were more frequent than other sound frequency.

Autism spectrum disorder(ASD) comprises neurodevelopmental disorders characterized by core symptoms of social communication disorders, restricted interests, and repetitive behaviors.With increasing incidence year by year, ASD may persist throughout life.The current clinical treatment is mainly behavioral intervention, occasionally supplemented with medication to treat the accompanying symptoms, such as irritability, paresthesia, sleep disorders, and gastrointestinal diseases, but there is still a lack of specific drugs targeting the core symptoms of ASD.Bumetanide, an U. S.Food and Drug Administration-approved diuretic, has been proposed as a candidate to treat the core symptoms of ASD.This article mainly reviews the latest research progress on Bumetanide treatment of core symptoms in children with ASD, providing a theoretical basis for the research and application of Bumetanide.

Objective:To explore the clinical application of transumbilical single-port laparoscopy with self-made approach in common gynecological operations.Methods:105 cases of transumbilical single-port laparoscopic surgery with self-made approach successfully (single-port laparoscopic group) carried out in Karamay Central Hospital from January 2018 to September 2020 were retrospectively collected, and 105 cases of multi-port laparoscopic surgery (multi-port laparoscopic group) with matching conditions were selected. The operation time, intraoperative blood loss, postoperative first exhaust time, postoperative first out of bed activity time, postoperative 24-h pain score, postoperative satisfaction score of patients 3 months after operation, incision cosmetic score of doctors 3 months after operation, postoperative hospital stay, intraoperative surgeon′s feeling score and intraoperative and postoperative complications were compared between the two groups.Results:All operations were successfully completed under laparoscopy, without conversion to laparotomy, without auxiliary holes, and no obvious complications occurred during the operation. The operation time and intraoperative blood loss in the single-port laparoscopic group were greater than those in the multi-port laparoscopic group (all P<0.05). The incision cosmetic score of single-port laparoscopic group was significantly better than that of multi-port laparoscopic group ( P<0.05). The intraoperative surgeon′s feeling score in multi-port laparoscopic group was better than that in single-port laparoscopic group ( P<0.05). There was no significant difference between the two groups in the first postoperative exhaust time, the first postoperative out of bed activity time, 24-hour postoperative pain score, surgical satisfaction score and postoperative hospital stay (all P>0.05). The operation time and intraoperative blood loss of ovarian cyst stripping, hysteromyomectomy and total hysterectomy in the multi-port laparoscopic group were less than those in the single-port laparoscopic group (all P<0.05). There was no significant difference between the two groups in the operation time and intraoperative blood loss of salpingectomy and adnexectomy (all P<0.05). The feeling of doctors in multi-port laparoscopic group was better than that in single-port laparoscopic group (all P<0.05). Conclusions:Under the condition of appropriate case selection, laparoendosopic single-port surgery with self-made approach is feasible in common gynecological operations. The prominent advantage of laparoendosopic single-port surgery is postoperative cosmetic effect.

OBJECTIVE To investigate the impact of noise exposure in metallurgical manufacturing on hearing.METHODS 245 workers exposed to noise in an enterprise and 51 administrative staff were tested for air conduction hearing threshold of pure tones at 0.5-8 kHz in both ears,and the equivalent sound level of workplace noise was measured for 8 hours.The hearing threshold of workers in different jobs was statistically analyzed.RESULTS The hearing threshold of workers exposed to noise at 0.5-8 kHz was significantly higher than that of administrative staff;hearing loss mainly occurred at 4 kHz and 6 kHz;the hearing threshold was positively correlated with working age and age,and the hearing threshold of workers over 40 years old and with working age of more than 6 years were higher than 40 dB HL at both ears at 4 kHz and 6 kHz.CONCLUSION The hearing loss of 4 kHz and 6 kHz is most obvious in noise-exposed workers,and age,working age,and noise exposure intensity were risk factors for hearing loss.It is necessary to strengthen the control of noise sources,attach importance to protective measures such as earplugs,and reduce noise exposure time.

OBJECTIVE To explore the clinical practice differences based on GBZ 49-2007 and GBZ 49-2014 diagnostic criteria for occupational noise induced hearing loss.METHODS Two hundred and sixty-five noise workers who applied for occupational noise induced hearing loss diagnosis in Hangzhou Occupational Disease Prevention and Treatment Center from January 2016 to November 2023 were selected and diagnosed according to the diagnostic criteria of GBZ 49-2007 and GBZ 49-2014 for noise induced hearing loss.RESULTS The diagnostic rate of occupational noise induced hearing loss in GBZ 49-2014 standard was 53.58%,which was significantly higher than the 42.64%in GBZ 49-2007 standard(P<0.05).The κ value of the diagnostic consistency between the GBZ 49-2014 standard and the GBZ 49-2007 standard for occupational noise induced hearing loss was 0.761,P<0.05,indicating good diagnostic consistency with a diagnostic consistency rate was 86.04%.The diagnostic rate of occupational noise induced hearing loss(GBZ 49-2007)among workers with work experience≥10 years was 59.05%,which was higher than that of workers with work experience<10 years(P<0.05).The diagnostic rate of occupational noise induced deafness in workers with work experience≥10 years(GBZ 49-2014)was 72.38%,which is higher than that of workers with work experience<10 years(P<0.05).According to the diagnosis of occupational noise induced hearing loss in GBZ 49-2007 and GBZ 49-2014,patients with work experience≥10 years had a higher severity of occupational noise induced hearing loss than those with work experience<10 years(P<0.05).CONCLUSION Compared to the GBZ 49-2007 standard,the GBZ 49-2014 standard will increase the diagnostic cases of occupational noise induced hearing loss;Under the GBZ 49-2007 and GBZ 49-2014 standards,the diagnosis and severity of occupational noise induced hearing loss are related to length of service.

ObjectiveTo observe the effects of Wendantang on the expression of inflammatory cytokines， autophagy markers， and key molecules of phosphatidylinositol-3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR） signaling pathway in the adipocytes of the rat model of obesity （syndrome of phlegm-dampness） and to explore the material basis of inflammation in obesity （syndrome of phlegm-dampness） and the underlying mechanism of Wendantang intervention. MethodA total of 126 SD rats were randomized into 2 groups： 16 rats in the blank group and 110 rats in the modeling group. The blank group was fed with a basic diet while the modeling group with a high-fat diet to establish the animal model of obesity （syndrome of phlegm-dampness） for 8 weeks. After successful modeling， 48 obese rats were selected according to their body mass and randomized into a model control group， an orlistat （ORLI， 32.40 mg·kg^-1） group， a rapamycin （RAPA， 2 mg·kg^-1） group， and low-， medium-， and high-dose （4.45， 8.90， 17.80 g·kg^-1， respectively） Wendantang groups， with 8 rats in each group. In addition， 8 rats were randomly selected from the blank group to be set as the normal control group. The corresponding agents in each group were administrated by gavage and the model and control groups were administrated with equal amounts of distilled water once daily for 6 weeks. The body mass， Lee's index， body fat ratio， and obesity rate were measured or calculated. The expression of UNC51-like kinase-1 （ULK1）， Beclin1， human autophagy-related protein 5 （Atg5）， p62， and microtubule-associated protein 1 light chain 3 （LC3） Ⅰ/Ⅱ （markers of autophagy in adipocytes） was detected by the immunohistochemical two-step method. Enzyme-linked immunosorbent assay （ELISA） was employed to determine the expression of tumor necrosis factor （TNF）-α， interleukin-6 （IL-6）， IL-1β， monocyte chemotactic protein-1 （MCP-1）， IL-4， IL-10， IL-13， and transforming growth factor （TGF）-β in adipocytes. Western blot was employed to measure the protein levels of classⅠ-PI3K， phosphatidylinositol triphosphate （PIP3）， Akt， mTORC1， ULK1， TSC1， and TSC2 in adipocytes. ResultCompared with the blank group， the modeling group showed increased body mass and Lee's index （P<0.01）， the obesity rate >20%， and phlegm-dampness syndrome manifestations such as physical obesity， decreased mobility， decreased appetite， lusterless and tight fur， loose stools， decreased responsiveness to the outside world， and decreased water intake. Compared with the normal control group， the model control group showed increased body mass， Lee's index， body fat ratio， adipocyte autophagy marker expression， pro- and anti-inflammatory cytokine levels （P<0.05， P<0.01）， down-regulated protein levels of classⅠ-PI3K， PIP3， Akt， mTORC1， TSC1， and TSC2 （P<0.01）， and up-regulated protein level of ULK1 （P<0.01）. The intervention groups showed lower body mass， body fat ratio， adipocyte autophagy marker protein expression， and protein levels of TNF-α， IL-6， IL-1β， MCP-1， IL-4， and IL-13 than the model control group （P<0.05， P<0.01）. Moreover， the RAPA and Wendantang （medium and high dose） groups showed lowered levels of IL-10 and TGF-β （P<0.01）， and the ORLI group showed down-regulated expression of TGF-β （P<0.01）. The expression of key molecules of the signaling pathway was up-regulated （P<0.05， P<0.01） while that of ULK1 was down-regulated （P<0.01） in all the intervention groups. Compared with the RAPA group， the Wendantang groups showed up-regulated expression of all autophagy marker proteins in adipocytes （P<0.01）. In addition， the low-dose Wendantang group showed elevated levels of inflammatory cytokines （except TNF-α） （P<0.05， P<0.01） and down-regulated expression of all key molecules of the signaling pathway （P<0.05， P<0.01）. The levels of inflammatory cytokines （except IL-16， MCP-1， and IL-10） were elevated in the medium-dose Wendantang group （P<0.05， P<0.01）. The expression of key molecules except PI3K of the signaling pathway was down-regulated in the medium- and high-dose Wendantang groups （P<0.05， P<0.01）. Compared with the ORLI group， low- and medium-dose Wendantang groups showed up-regulated expression of autophagy markers in adipocytes （P<0.01）， and the low-dose group showed elevated levels of inflammatory cytokines （IL-6， IL-4， and TGF-β） （P<0.01） and down-regulated expression of all key molecules of the signaling pathway （P<0.01）. The medium-dose Wendantang group showed up-regulated expression of IL-4 （P<0.01） and down-regulated expression of key molecules except PI3K of the signaling pathway （P<0.05， P<0.01）. The high-dose Wendantang group showed increased body mass， up-regulated expression levels of autophagy markers （ULK1， LC3 Ⅰ/Ⅱ） （P<0.05， P<0.01）， down-regulated expression of PIP3， mTORC1， and TSC1 （P<0.05， P<0.01）， and lowered levels of Beclin1， Atg5， TNF-α， and IL-13 （P<0.05， P<0.01）. ConclusionThe inflammation in obesity （syndrome of phlegm-dampness） is closely associated with the PI3K/Akt/mTOR pathway-mediated adipocyte autophagy. Wendantang can treat the chronic inflammation in obese rats with the syndrome of phlegm-dampness by regulating this signaling pathway and thus improve adipocyte autophagy.

BACKGROUND: Given the general unavailability, common adverse effects, and complicated administration of tetracycline, the clinical application of classic bismuth quadruple therapy (BQT) is greatly limited. Whether minocycline can replace tetracycline for Helicobacter pylori ( H . pylori ) eradication is unknown. We aimed to compare the eradication rate, safety, and compliance between minocycline- and tetracycline-containing BQT as first-line regimens. METHODS: This randomized controlled trial was conducted on 434 naïve patients with H . pylori infection. The participants were randomly assigned to 14-day minocycline-containing BQT group (bismuth potassium citrate 110 mg q.i.d., esomeprazole 20 mg b.i.d., metronidazole 400 mg q.i.d., and minocycline 100 mg b.i.d.) and tetracycline-containing BQT group (bismuth potassium citrate/esomeprazole/metronidazole with doses same as above and tetracycline 500 mg q.i.d.). Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed at 4-8 weeks after eradication to evaluate outcome. We used a noninferiority test to compare the eradication rates of the two groups. The intergroup differences were evaluated using Pearson chi-squared or Fisher's exact test for categorical variables and Student's t -test for continuous variables. RESULTS: As for the eradication rates of minocycline- and tetracycline-containing BQT, the results of both intention-to-treat (ITT) and per-protocol (PP) analyses showed that the difference rate of lower limit of 95% confidence interval (CI) was >-10.0% (ITT analysis: 181/217 [83.4%] vs . 180/217 [82.9%], with a rate difference of 0.5% [-6.9% to 7.9%]; PP analysis: 177/193 [91.7%] vs . 176/191 [92.1%], with a rate difference of -0.4% [-5.6% to 6.4%]). Except for dizziness more common (35/215 [16.3%] vs . 13/214 [6.1%], P = 0.001) in minocycline-containing therapy groups, the incidences of adverse events (75/215 [34.9%] vs . 88/214 [41.1%]) and compliance (195/215 [90.7%] vs . 192/214 [89.7%]) were similar between the two groups. CONCLUSION: The eradication efficacy of minocycline-containing BQT was noninferior to tetracycline-containing BQT as first-line regimen for H . pylori eradication with similar safety and compliance. TRIAL REGISTRATION ClinicalTrials.gov, ChiCTR 1900023646.
Humans ; Bismuth/therapeutic use* ; Metronidazole/therapeutic use* ; Esomeprazole/pharmacology* ; Minocycline/pharmacology* ; Helicobacter pylori ; Potassium Citrate/therapeutic use* ; Anti-Bacterial Agents ; Tetracycline/adverse effects* ; Helicobacter Infections/drug therapy* ; Drug Therapy, Combination ; Amoxicillin