Objective To evaluate the effect of prone ventilation in children with severe pneumonia at high altitude.Methods By convenience sampling method,80 children with severe pneumonia hospitalized in intensive care department of a tertiary A children's hospital in Xining,Qinghai Province from June 2021 to June 2023 were selected as the study subjects,and the regional randomization group method was used to divide into a test group and a control group with 40 cases in each group.On the basis of routine care,the test group received prone ventilation once a day for 6 to 12 h;the control group received supine ventilation.Respiratory mechanical parameters(oxygenation index,oxygen saturation,arterial oxygen partial pressure,arterial CO2 partial pressure),mechanical ventilation duration and safety parameters(incidence of unplanned extubation,stress injury)at 6 h and 12 h of mechanical ventilation were compared.Results There were no shedding cases.The interaction between oxygenation index,blood oxygen saturation and arterial oxygen partial pressure(P＜0.05)in the 2 groups was compared(P＞0.05).The results of simple effect analysis showed that at 6 h,the oxygen saturation and oxygenation index in the test group were higher than those in the control group,and the difference was statistically significant(P＜0.05).At 12 h of mechanical ventilation,the oxygenation index,blood oxygen saturation and arterial oxygen partial pressure in the test group were higher than those in the control group,and the difference was statistically significant(P＜0.05).The time of mechanical ventilation in the test group was102.00(60.00,153.00)h and 126.00(108.00,156.00)h in the control group,and the difference was statistically significant(P=0.013).The incidence of unplanned extubation and pressure injury were compared,and the differences in 2 groups were not significant(P＞0.05).Conclusion Prone ventilation in children with severe pneumonia at high altitude is safe and feasible,which is helpful to improve the respiratory function and shorten the time of mechanical ventilation.

OBJECTIVE: To investigate the relationship between the sleep duration on peak melatonin secretion and renal function injury in steel workers. METHODS: A judgment sampling method was used to select 7 655 steel workers in a steel production department for health examination and questionnaire survey, and the relationship between renal function injury and non-peak sleep time(equivalent to the reduction of sleep duration on peak melatonin secretion) was analyzed using restriction cubic spline(RCS) model and multi-factor logistic regression. RESULTS: The detection rate of renal injury in the study subjects was 14.5%(1 110/7 655). RCS model analysis results showed that there was a linear dose-response relationship between non-peak sleep time and renal injury(overall correlation test χ~2=16.85, P<0.01, nonlinear test χ~2=3.70, P>0.05). Multivariate logistic regression analysis results showed that the workers of non-peak sleep time more than or equal to 4 515-day had higher risk of renal function injury than the workers of non-peak sleep time less than 4 515-day(P<0.05), with odds ratio and 95% confidence interval of 1.4(1.2-1.7), after adjustment for the potential influencing factors such as individual factors and occupational factors. CONCLUSION: Reduction of peak melatonin secretion sleep duration is correlated with renal function injury in steel workers.

OBJECTIVE: To explore the effects of cumulative noise exposure(CNE) on the intima-media thickness(IMT) of carotid artery in steel workers. METHODS: A cluster random sampling method was used to select 1 437 noise exposed workers in a steel company as study subjects. The CNE was calculated according to the noise intensity of the workplace, and the occupational health check was carried out to construct the structural equation model of noise to IMT. RESULTS: The detection rate of carotid atherosclerosis(CAS) in these 1 437 subjects was 38.3%. The CAS detection rates of steel workers increased with the increasing CNE(P<0.01). The structural equation model had good fitting effect. Path analysis showed CNE can indirectly affect IMT through blood pressure, triglycerides, fasting blood glucose, homocysteine, high-density lipoprotein & apolipoprotein A, low-density lipoprotein & apolipoprotein B. The total effects were-0.375, 0.337, 0.248, 0.117, 0.056, 0.056 and 0.018 respectively. CONCLUSION: CNE can indirectly increase the IMT of steel workers by acting on the proximal cause.