Objective:To analyze the effects of rehabilitation nursing under the guidance of electrical impedance tomography (EIT) on mechanical ventilation time and complications in ICU patients with respiratory failure so as to promote the systematic improvement of pulmonary rehabilitation nursing exercise measures.Methods:In the randomized controlled trial, 80 patients with respiratory failure admitted to ICU of Quzhou People′s Hospital were enrolled between July 2021 and July 2022 by convenience sampling method. According to different admission time, patients were divided into control group (40 cases, July-December 2021, routine rehabilitation nursing) and observation group (40 cases, February-July 2022, EIT-guided rehabilitation nursing). The lung function indexes, stay time in ICU, mechanical ventilation time, blood gas indexes and incidence of complications were compared between the two groups.Results:There were 22 males and 18 females in the control group, with an age of (53.54 ± 5.17) years; there were 21 males and 19 females in the observation group, with an age of (52.82 ± 5.21) years.After intervention, forced expiratory volume in the first second (2.82 ± 0.67) L, forced expiratory volume/forced vital capacity in the first second (78.87 ± 4.82) % and forced expiratory volume in the first second as a percentage of the predicted value (74.24 ± 9.65) % in observation group were higher than those in control group [(2.10 ± 0.66) L, (65.59 ± 3.67) %, (60.87 ± 9.66) %], and the differences were statistically significant ( t=4.84, 13.86, 6.19, all P<0.05). The stay time in ICU (10.37 ± 1.34)h and mechanical ventilation time (9.82 ± 1.24) h in observation group were shorter than those in control group (12.19 ± 1.22) h, (11.54 ± 1.37) h, and the differences were statistically significant ( t=6.35, 5.89, both P<0.05). After intervention, arterial oxygen partial pressure (90.76 ± 12.46) mmHg (1mmHg=0.133kPa) and oxygenation index (377.36 ± 54.38) in observation group were higher than those in control group (72.65 ± 11.65), (329.15 ± 42.26) mmHg, and the differences were statistically significant ( t=6.72, 4.43, both P<0.05), while arterial carbon dioxide partial pressure (45.32 ± 4.87) mmHg was lower than that in the control group (52.73 ± 4.27) mmHg, the differences was statistically significant ( t=7.24, P<0.05). The incidence of complications 7.50% (3/40) in observation group was lower than that in control group 25.00% (10/40), the differences was statistically significant ( χ2=4.50, P<0.05). Conclusions:EIT-guided rehabilitation nursing is beneficial to improve blood gas indexes and lung ventilation function, effectively shorten tracheal intubation time and stay time in ICU, and reduce the incidence of related complications in ICU patients with respiratory failure.

Objective To investigate the correlation between 23 metals and metalloids elements in the urine and thyroid function indicators in the blood of traffic police. Methods A cross-sectional study was performed to assess the effects of 23 metals and metalloids elements in the urine on blood thyroid function indicators in 166 traffic policemen (122 field staff and 44 internal staff) in Wuhan, Hubei Province. Each subject received an occupational health examination. Results After multiple corrections for false detection rates, in the polymetallic model, the levels of urinary manganese and urinary uranium were positively correlated with the levels of thyroid peroxidase antibody (TPOAb) in the blood (β = 66.57, 95% CI 2.92-130.22, P = 0.040 and β = 62.43, 95% CI 14.37-110.49, P = 0.011), and the level of urinary uranium was positively correlated with thyroid stimulating hormone (TSH) levels in the blood (β = 6.20, 95% CI 2.68-9.72 , P = 0.001). Urinary uranium level was negatively correlated with free thyroxine level in the blood (FT4) (β = -2.03, 95 % CI (-3.67 )- (-0.39), P = 0.015), and urinary lead level was negatively correlated with blood TSH level (β = -4.59, 95% CI (-8.67) - (-0.51), P = 0.027). Conclusion Manganese exposure is related to the increase of TPOAb level in blood, uranium exposure is related to the increase of TPOAb and TSH levels and the decrease of FT4 level in blood, and lead exposure is related to the decrease of TSH level in blood, suggesting that more attention should be paid to the effects of heavy metals on the thyroid of traffic police.

Objective: To investigate the thyroid functions and influencing factors among radiation workers in Wuhan City, so as to provide insights into occupational health monitoring among radiation workers. Methods : Radiation workers receiving physical examinations in Wuhan Prevention and Treatment Center for Occupational Diseases from January to October 2022 were enrolled, and participants' gender, age, smoking, alcohol consumption, medical history, medication use, types of occupational radiation and work duration were collected. Triiodothyronine (TT3), thyroxine (TT4), free thyroxine (FT4), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) were measured using a magnetic microparticle-based chemiluminescence immunoassay. Personnel dose equivalent was monitored using thermoluminescent dosimetry, and annual cumulative radiation dose was estimated. Factors affecting thyroid function were identified using a multivariable linear regression model. Results: Totally 978 radiation workers were recruited, with a median age of 32.00 (interquartile range, 10.00) years, and including 782 men (79.96%) and 196 women (20.04%). There were 246 smokers (25.15%), 257 workers with alcohol consumption (26.28%) and 489 with a history of radiation work (50.00%). The median annual cumulative radiation dose was 0.20 (interquartile range, 0.24) mSv. The percentage of abnormal thyroid function was 14.72%. Multivariable logistic regression analysis showed that women (OR=1.925, 95%CI: 1.061-3.490), history of radiation work (OR=2.810, 95%CI: 1.119-7.057) and involving in medical application (OR=1.915, 95%CI: 1.101-3.332) were associated with abnormal thyroid function. Conclusions The percentage of abnormal thyroid function was 14.72% among radiation workers in Wuhan City. History of exposure to ionizing radiation, types of occupational radiation and gender were main factors affecting thyroid function.

Objective:To explore effects of health education based on the information-motivation-behavioral skills (IMB) skills model on self-care ability and complication rate in patients with liver cirrhosis.Methods:Using the convenient sampling method, a total of 170 patients with liver cirrhosis who were admitted to Department of Infectious Diseases of the First People's Hospital of Hangzhou Lin'an District from September 2018 to September 2020 were selected as the research objects. According to the random number table method, the patients were divided into the control group and the observation group, with 85 cases in each group. The control group received routine health education intervention, while the observation group received health education intervention combined with the IMB skills model on the basis of the control group. Exercise of Self-Care Agency Scale (ESCA) score, The MOS 36-Item Short Form Survey (SF-36) and the incidence of complications were observed in the two groups.Results:After the intervention and the ESCA scores of the two groups were higher than those before the intervention, and that of the observation group was higher than the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of SF-36 in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The incidence of complications in the observation group was 3.52% (3/85) , lower than 17.65% (15/85) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Health education using the IMB skill model for patients with liver cirrhosis can improve self-care ability and quality of life and the complications are fewer, which is worthy of clinical promotion.

Objective:To systematically review risk factors for prolonged postoperative ileus (PPOI) in colorectal surgery patients.Methods:Researches related to the influencing factors of PPOI in patients undergoing elective colorectal surgery were retrieved by computer in PubMed, Web of Science, Embase, Cochrane Library, Medline, China Biomedical Literature Database, China National Knowledge Infrastructure, WanFang Data and VIP. The retrieval time limit was from the establishment of the database to August 1, 2021. Two researchers screened article, extracted data, and evaluated the quality of the article. Meta-analysis was performed using RevMan 5.3 software.Results:A total of 21 articles were included. Meta-analysis results showed that the influence factors for PPOI in patients with colorectal surgery included gender [ OR=1.70, 95% confidence interval ( CI) : (1.55, 1.87) , P<0.001], smoking history [ OR=1.56, 95% CI: (1.30, 1.86) , P<0.001], chronic obstructive pulmonary disease [ OR=1.60, 95% CI: (1.52, 1.68) , P<0.001], hypertension [ OR=1.64, 95% CI: (1.03, 2.62) , P=0.04], diabetes [ OR=1.27, 95% CI: (1.09, 1.48) , P=0.002], history of abdominal surgery [ OR=2.15, 95% CI: (1.55, 2.98) , P<0.001], surgical site [ OR=1.40, 95% CI: (1.09, 1.81) , P=0.009], surgical method [ OR=0.43, 95% CI: (0.29, 0.62) , P<0.001], surgery time [ OR=1.18, 95% CI: (1.15, 1.22) , P<0.001] and intraoperative blood loss [ OR=1.77, 95% CI: (1.15, 2.71) , P=0.009]. Conclusions:The occurrence of PPOI in patients with colorectal surgery is affected by multiple factors. It is recommended that medical and nursing staff identify the risk factors of PPOI in a timely and accurate manner, and actively take measures to prevent the occurrence of PPOI and reduce the incidence of PPOI in patients.

Objective:To investigation the situation of occupational noise exposure and hearing loss among workers in automobile manufacturing enterprise during 2017-2019 in Wuhan.Methods:Workers in automobile manufacturing who underwent physical examination in Wuhan Hospital for the Prevention and Treatment of Occupational Diseases from 2017 to 2019 were included as subjects in the cross-sectional survey. Questionnaire survey, noise detection and pure tone threshold test were used. Excluding individuals with working time less than 3 years and information deficiency, 3 948 individuals were finally included in the study.Results:Among 3 948 workers, 128 workers had hearing loss and the rate of hearing loss was 3.24%, among which 101 workers had high-frequency hearing loss and 27 workers were diagnosed as occupational noise deafness. The prevalence of hearing loss among workers previously exposed to noise was significantly higher than that without prior exposure (12.10%, 0.96%, P<0.05) . The prevalence of hearing loss among workers with occupational noise exposure <80 dB (A) , 80~<85 dB (A) and ≥85 dB (A) was 1.83%, 2.69% and 5.09%, respectively. The prevalence of high frequency hearing loss was 1.60%, 2.05% and 3.71%, respectively. The prevalence of occupational noise deafness was 0.23%, 0.64% and 1.38%, respectively. The prevalence of hearing loss and high frequency hearing loss among workers exposed to different occupational noise was statistically significant ( P<0.05) , while the prevalence of occupational noise deafness was not statistically significant ( P>0.05) . There were statistically significant differences in the prevalence of hearing loss (2.88%, 4.45%) and occupational noise deafness (0.46%, 1.41%) between those who used protective equipment and those who did not ( P<0.05) . Compared with workers exposed to occupational noise <80 dB (A) , workers exposed to occupational noise ≥85 dB (A) had A 3.16-fold increased risk of hearing loss ( OR=3.16, 95% CI: 1.44~6.95, P<0.05) . Compared to workers using hearing protective equipment, the risk of hearing loss ( OR=1.96, 95% CI: 1.25~3.06, P<0.05) and occupational noise deafness ( OR=3.46, 95% CI: 1.51-7.96, P<0.05) significantly increased among those without using hearing protective equipment. Conclusion:The risk of hearing loss in automobile manufacturing workers is significantly associated with occupational noise exposure and the use of hearing protective equipment. Good hearing protection may reduce the risk of occupational noise-induced hearing loss and occupational noise deafness.

Objective:To investigation the situation of occupational noise exposure and hearing loss among workers in automobile manufacturing enterprise during 2017-2019 in Wuhan.Methods:Workers in automobile manufacturing who underwent physical examination in Wuhan Hospital for the Prevention and Treatment of Occupational Diseases from 2017 to 2019 were included as subjects in the cross-sectional survey. Questionnaire survey, noise detection and pure tone threshold test were used. Excluding individuals with working time less than 3 years and information deficiency, 3 948 individuals were finally included in the study.Results:Among 3 948 workers, 128 workers had hearing loss and the rate of hearing loss was 3.24%, among which 101 workers had high-frequency hearing loss and 27 workers were diagnosed as occupational noise deafness. The prevalence of hearing loss among workers previously exposed to noise was significantly higher than that without prior exposure (12.10%, 0.96%, P<0.05) . The prevalence of hearing loss among workers with occupational noise exposure <80 dB (A) , 80~<85 dB (A) and ≥85 dB (A) was 1.83%, 2.69% and 5.09%, respectively. The prevalence of high frequency hearing loss was 1.60%, 2.05% and 3.71%, respectively. The prevalence of occupational noise deafness was 0.23%, 0.64% and 1.38%, respectively. The prevalence of hearing loss and high frequency hearing loss among workers exposed to different occupational noise was statistically significant ( P<0.05) , while the prevalence of occupational noise deafness was not statistically significant ( P>0.05) . There were statistically significant differences in the prevalence of hearing loss (2.88%, 4.45%) and occupational noise deafness (0.46%, 1.41%) between those who used protective equipment and those who did not ( P<0.05) . Compared with workers exposed to occupational noise <80 dB (A) , workers exposed to occupational noise ≥85 dB (A) had A 3.16-fold increased risk of hearing loss ( OR=3.16, 95% CI: 1.44~6.95, P<0.05) . Compared to workers using hearing protective equipment, the risk of hearing loss ( OR=1.96, 95% CI: 1.25~3.06, P<0.05) and occupational noise deafness ( OR=3.46, 95% CI: 1.51-7.96, P<0.05) significantly increased among those without using hearing protective equipment. Conclusion:The risk of hearing loss in automobile manufacturing workers is significantly associated with occupational noise exposure and the use of hearing protective equipment. Good hearing protection may reduce the risk of occupational noise-induced hearing loss and occupational noise deafness.

Objective To investigate the expression levels of IFN-γ, IL-4, IL-6 in the plasma of HBV chronic patients.To acknowledge the correlation between the immune function of T-cell with chronic hepatitis B virus.Methods The expression levels of IFN-γ, IL-4, IL-6 in the plasma were determined by ELISA in 42 cases of chronic hepatitis B (CHB group), 30 cases of cirrhosis (LC group), 30 cases of primary liver cancer (HCC group) and 30 cases of health control (NC group).Combine with the load of HBV DNA, HBeAg and ALT, the expression levels of IFN-γ, IL-4, IL-6 were re-analysed.Results The expression levels of IFN-γ, IL-4 and IL-6 in the researched groups were statistically significantly different.The expression levels of IFN-γ, IL-4, IL-6 in CHB, LC and HCC groups were higher than NC group with significance.The expression level of IL-4 in the CHB group was higher than LC and HCC groups with significance.The expression level of IL-6 in the HCC group was higher than CHB and LC groups with significance.Compared with the control group, the ratio of IFN-γ/IL-4 in CHB, LC and HCC groups were decreased with significance.There was significantly positive correlation between the expression level of IL-4 with the load of HBV DNA (r=0.757, P＜0.001).The expression level of IFN-γhad negative correlation between the load of HBV DNA (r=-0.786, P＜0.001) with the level of ALT (r=-0.713, P＜0.001) with significance.There was no significant correlation between HBeAg with the cytokines in the serum of patients with chronic HBV.Conclusion The results showed the immune function of T-cell play important role in chronic HBV patients.That would provide a good basis on CHB treatment.The expression levels of IL-6 were higher in HCC group with significance, which provided the direction for the deep study of liver cancer.

Objective: To evaluate adolescents’ self-esteem and explore its influencing factors in order to provide basic evidence for improving self-esteem level and mental health of adolescents. Methods: A total of 5 709 adolescents of different characteristics from both urban and rural areas in six provinces were investigated anonymously with the method of computer-assisted self-interview (CASI). Self-esteem was evaluated by Self-Esteem Scale (SES, scored 10-40 points). Results: The average score of self-esteem was 28.15,28.40, 28.97 and 27.45 point for junior high students, senior high students, college students and out-of-school adolescents, respectively. The difference of the scores among the four groups was statistically significant(F=27.64, 14.41, P<0.01). More than 80% adolescents felt they were people of worth, were able to do things as most other people, took a positive attitude toward themselves and were satisfied with themselves. About 50% of adolescents thought they were no good at all at times. Less than 20% adolescents thought they had enough respect for themselves. About 11.57% to 22.22% of adolescents felt sad about their own gender, about 37.56% to 61.49% of adolescents often or sometimes felt sad about their body image. The multiple linear regression analysis showed that those who had a good overall feeling of family, satisfied with their own gender, and less worried about their body image tended to have a higher self-esteem scores among 4 groups(P<0.01). Other related influencing factors included parental education level, family economic status, only-child or not, birth place and parental preference for gender of their child. Conclusion Adolescents’ self-esteem was fair, and many factors were associated with it. It is necessary to strengthen the education on gender equality among parents and adolescents and to pay more attention to mental health of the adolescents, who were in rural areas, with poor family atmosphere and economic status.

Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.