Objective:To investigate the effects of different levels of ophthalmic surgical stimulation on blood glucose in patients with type 2 diabetes mellitus(T2DM).Methods:From Mar to Oct 2021,236 patients with T2DM who underwent ophthalmic surgery in our hospital were enrolled,including 71 cases of secondary surgery,89 cases of tertiary surgery,and 76 cases of quaternary surgery.According to the operation time,the 236 patients were divided into groups A(＜60 min),B(60-120 min)and C(＞120 min).The preoperative and postoperative blood glucose levels were compared in patients with different levels of surgery,and in groups A,B and C.Results:The postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery,and it was higher than that before surgery in quaternary surgery(P＜0.05).The fluctuation value of blood glucose in secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In groups A,B and C,the postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery(P＜0.05).In group A,there was no significant difference in the blood glucose before and after surgery in quaternary surgery(P＞0.05),and in groups B and C,the postoperative blood glucose was higher than that before surgery in quaternary surgery(P＜0.05).In group A,there was no difference in the fluctuation value of blood glucose at different levels of surgery(P＞0.05).In group B,the fluctuation value of blood glucose in patients with secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In group C,the fluctuation value of blood glucose in patients with tertiary and quaternary surgery was higher than that in patients with secondary surgery(P＜0.05).Conclusions:For ophthalmic surgery patients with T2DM,the postoperative blood glucose values of patients undergoing secondary and tertiary surgery generally show a downward trend,while the postoperative blood glucose value of patients undergoing quaternary surgery generally shows an upward trend.It is suggested that clinical workers should actively manage the perioperative blood glucose of patients with high-level surgery.

Background Hand-transmitted vibration is one of the most common occupational hazards and is closely related to symptoms of fingertip terminal nerve damage. Objective To analyze the effects of hand-transmitted vibration on the terminal nerve of fingertips. Methods We systematically searched literature about the effects of hand-transmitted vibration on fingertip terminal nerve at home and abroad. The outcome index was the number (rate) of fingertip terminal nerve symptoms reported by the vibration group and the control group, such as finger numbness and finger tingling, and the search period was from database inception to December 2021. The quality of cross-sectional studies was assessed using the criteria recommended by the Agency for Healthcare Research and Quality (AHRQ), and the quality of cohort studies was assessed by the Newcastle-Ottawa Scale (NOS). NoteExpress 3.2 was used for literature management, and Excel 2003 was used for data collection and extraction. RevMan 5.4.1 software was used for statistical analysis, and random effect model was used to calculate the OR value of pooled effects and to draw forest plots. Subgroup analysis was carried out according to the working years with vibration exposure. At the same time, sensitivity analysis was performed after excluding studies with the largest weight and funnel plots were generated to evaluate publication bias. Results A total of 3619 articles were retrieved, and 39 articles were finally included, including 29 Chinese articles and 10 English articles; 36 cross-sectional studies and 3 cohort studies. In total, 8399 subjects were studied, including 5673 cases in the vibration exposure group and 2726 cases in the control group. Random effect model was used to merge the included literature. The results of meta-analysis showed that compared with the control group, hand-transmitted vibration was significantly associated with the self-reported occurrence of finger numbness (OR=8.29, 95%CI: 5.43-12.66), finger tingling (OR=7.50, 95%CI: 4.78-11.77), finger swelling (OR=8.25, 95%CI: 4.06-16.76), finger stiffness (OR=10.71, 95%CI: 3.60-31.87), finger trembling (OR=5.11, 95%CI: 2.60-10.04), hand weakness (OR=11.05, 95%CI: 3.98-30.68), hand sweating (OR=2.70, 95%CI: 1.64-4.43), hand coldness (OR=3.54, 95%CI: 2.42-5.18) (P<0.01). The subgroup analysis showed that the odds ratios of both finger numbness and finger tingling increased in the early and middle stages of vibration exposure (<5 years and 5-10 years of exposure duration）(finger numbness: OR=11.11, 19.07; finger tingling: OR=4.70, 16.55, respectively)(P<0.01), and decreased in the late stage of vibration exposure (10-15 years and ≥15 years of exposure duration) (finger numbness: OR=9.57, 2.30; finger tingling: OR=5.71, 6.00, respectively) (P<0.01). The results of sensitivity analysis showed a stable pooled effect (OR=13.96, 95%CI: 4.85-40.13, Z=4.89, P<0.01). The funnel plot results showed positive publication bias. Conclusion Occupational exposure to hand-transmitted vibration can cause finger numbness, finger tingling, finger swelling, finger stiffness, finger trembling, hand weakness, hand sweating, and hand coldness.

Hand-transmitted vibration is one of the most common physical harmful factors in the workplace，and the hand-arm vibration syndrome caused by it lacks effective treatment, and seriously affects the physical and mental health of the involved workers. As an important target for hand-transmitted vibration, the nervous system has attracted increasing attention from scholars, and much progress has been made in recent years in studying the effects of hand-transmitted vibration on nervous system function. Based on related literature at home and abroad, this paper introduced the hand-transmitted vibration-associated damage in peripheral, autonomic, and central nervous systems, and then explored the associated influence factors, like vibration frequency, environment temperature, and individual factors. The potential directions for further research were also proposed.