Objective To investigate the effects of noise from the subway cars on the preferred listening volumes using different kinds of earphones.Methods A total of 75 subjects with normal hearing were investigated to listen the same song wearing 4 kinds of earphones: insert earphones, intra-concha earphones, supra-concha earphones, and circumaural earphones, in the semi-anechoic background and inside the Line 7 subway-cars of the Beijing subway (the mean of LAeq,1s is 80.3 dB A and then selected personally preferred listening volumes.The effects of noise in the subway cars and earphone types on the preferred listening volumes were then analyzed.Results Inside subway-cars, the preferred listening levels using insert earphones, intra-concha earphones, supra-concha earphones, circumaural earphones were 76.6±4.7, 84.3±5.0, 82.3±4.2, and 80.8±4.2 dB A, respectively.The levels were respectively 65.5±6.8, 71.9±7.1, 69.5±7.5, 67.9±7.3 dB A for those in the semi-anechoic background.The preferred listening levels increase more than 10 dB averagely when stepped into noisy subway-cars background from silent background.According to the threshold levels stipulated in the WHO, to avoid hearing impairment, the daily noise exposure duration should not exceed 134 mins when exposed to subway-cars noise and the duration should not exceed 315, 54, 85, and 120 mins respectively when wearing those 4 kinds of earphones in subway-cars.Conclusion The noise and earphones types have great effects on the preferred listening volumes.The noise exposure levels in the ear canal wearing earphones with good sound insulation and listening at highly increased volume may be lower than that without earphones.

Blood transfusion is an important resuscitation method for combat casualties with severe hemorrhagic shock.The optimal resuscitation plan directly influences the treatment effect of the wounded.Whole blood,once the main resuscitation fluid,was replaced by blood components for various reasons and became a supplement when there was insufficient blood components supply.With the latest evidence of whole blood application in combat casualties,the development of blood transfusion technology and the deepened clinical and basic research,we realize that the obstacles in the use of whole blood are not insurmountable and that whole blood has the advantages that blood components do not have in the treatment of combat casualties.Therefore,whole blood has once again become a research hotspot in the field of combat casualties treatment.This article reviews the development history,advantages and disadvantages of whole blood application in the resuscitation of hemorrhagic shock after combat casualties,with a view to provide reference for further clinical and basic research.

Objective: To understand junior high school students’ sexual knowledge, sexual attitudes, sexual behaviors,as well as acess to sexual knowledge and related influencing factors, so as to provide reference for the practice of sexuality education. Methods: Using stratified cluster sampling method, 7 341 junior high school students were selected from Anhui, Fujian, Gansu, Guangxi, Henan, Xinjiang, Yunnan, Zhejiang and Beijing, and self-compiled questionnaires were used. Results: Junior high school students scored (61.71±18.79) in sexual knowledge, with pass rate and excellent rate being 59.02% and 18.53%. The attitudes towards LGBT was (65.44±20.01), the attitudes towards sexual and healthy behaviors was (67.04±49.23), and the attitudes towards sexual relations and behaviors was (70.75±10.46). Students had intimacy needs and sexual behaviors (18.70%), and some had such behaviors as kissing (13.80%), touching sensitive parts (6.70%) and sexual intercourse (2.20%). The results of multivariate Logistic regression analysis showed that students’ sexual knowledge was related to region, grade and school-based sexuality education (OR=2.11,P<0.05). Conclusion Junior high school students have sexual needs and behaviors, but their sexual knowledge is not sufficient; there are differences in sexual knowledge and attitudes of junior high school students across region,grade and gender; schools should promote school-based sexuality education for junior high school students’ sexual health.

Objective:To propose the application of recognizing bone species by touching blindly (ARBTB) and verify its application effect in human anatomy experimental courses.Methods:The study included experiment 1 and experiment 2, and the research objects were 60 students majoring in clinical medicine in Batch 2019 and 60 students majoring in preventive medicine in Batch 2018, respectively. The research objects in each experiment were randomized into mainstream teaching method group and ARBTB group, with 30 students in each group. In experiment 1, after students studying for the same hours, both of two groups carried out the same test, and then the average scores of the two groups were compared. In experiment 2, the average time spent by the two groups of students in osteology learning was compared.Results:In experiment 1, ARBTB group's average score of the test was significantly higher than that of the mainstream teaching group ( P<0.001). In experiment 2, the ARBTB group took much less time in osteology learning than the mainstream teaching group ( P<0.001). Conclusion:Compared with the mainstream teaching method, ARBTB is more effective in osteology learning, which is worth popularizing.

Objective:To investigate the clinical effect of homemade adjustable mirabilite vest in patients with severe acute pancreatitis and supply reference for clinical nursing.Methods:This was a randomized controlled study. One hundred patients with acute severe pancreatitis admitted to Putuo Hospital, Shanghai University of Traditional Chinese Medicine from January 2021 to June 2022 were selected, and were divided into the pocket group and the vest group according to the order of admission with 50 cases in each group. The pocket group used traditional mirabilite bag for external application, the vest group used adjustable mirabilite vest for external application. The other treatment measures were the same for both two group. The comfort degree, itching severity and average length of hospital stay of these two groups were compared.Results:The basic data of the two groups were homogeneous. The difference were not statistically significant( P>0.05). After intervention, the comfort degree of the pocket group was (65.90 ± 7.95) points while the comfort degree of the vest group was (77.04 ± 5.96) points. The difference was statistically significant ( t = 7.93, P<0.01). The degree of pruritus was (12.72 ± 3.95) points in the pocket group and (8.00 ± 1.20) points in the vest group.The difference was statistically significant ( t = 8.08, P<0.05). The mean length of hospital stay in the pocket group was (15.86 ± 5.83) days and (11.02 ± 3.38) days in the vest group. The difference was statistically significant ( t = 5.08, P<0.01). Conclusions:When using topical mirabilite for patients with acute severe pancreatitis, the use of adjustable mirabilite vest can significantly improve patients′ comfort, reduce itching, and reduce the number of hospital days, which has the value of promotion and use.