Objective: To explore the related influencing factors of high frequency hearing loss (HFHL) in workers exposed to noise and establish a prediction nomogram for HFHL. Methods: A total of 822 workers exposed to noise from 46 enterprises were included. A questionnaire survey and a pure-tone hearing test were conducted for the workers. The data of noise level of the workers exposed was also collected. After single factor analysis of related influencing factors, the multivariate Logistic regression analysis was performed to identify the final independent influencing factors of HFHL. Finally, a nomogram model was established by R software to achieve individual prediction of HFHL. Results: Among the 822 workers exposed to noise, 166 (20.2%) workers had HFHL. In multivariate Logistic regression analysis, increasing age, men, increasing wearing earphone time, less wearing earplugs, and high noise level were the independent risk factors for HFHL. The C-index of the nomogram model for predicting HFHL was 0.834 (95%CI: 0.748~0.903) . The area under the predictive power curve of nomogram model was 0.834 (95%CI: 0.799~0.869, P<0.001) . Conclusion Age, sex, wearing earphone time, wearing earplugs, and noise level are independent influence factors for HFHL. The nomogram model is successfully established as a accurate and visible tool for individually predicting the HFHL risk in workers exposed to noise.

Objective:To investigate the expression, prognostic value of acylphosphatase 1 (ACYP1) and its relationship with hepatocellular carcinoma (HCC) immune cell infiltration.Methods:The expression of ACYP1 in 374 cases of HCC was analyzed by using The Cancer Genome Atlas (TCGA) database. According to the median expression level of ACYP1 in HCC, the patients were divided into high expression (187 cases) and low expression group (187 cases). Fifty normal liver tissue were used as negative control. The differential expression, Kaplan-Meier survival analysis, univariate and multivariate Cox analysis were performed to evaluate the role of ACYP1 in the diagnosis and prognosis of HCC. The relationship between the expression level of ACYP1 and immune cell infiltration and immune checkpoint were analyzed through the TIMER database.Results:The expression level of ACYP1 in HCC (2.18±0.69) was higher than that in normal liver tissue (1.02±0.31), and the difference was statistically significant ( t=11.76, P<0.001). The survival of HCC patients with high ACYP1 was shorter than those HCC patients with low ACYP1 expression, and high expression of ACYP1 was an independent risk factor for poor prognosis of HCC patients ( HR=2.402, 95% CI: 1.483-3.891, P<0.05). The area under the curve of ACYP1 expression level in diagnosis of HCC was 0.965. The expression level of ACYP1 was significantly positively correlated with immune cell infiltration and immune checkpoints programmed cell death protein 1( r=0.288, P<0.001) and cytotoxic T lymphocyte-associated antigen 4 ( r=0.311, P<0.001). Conclusion:ACYP1 is a potential biomarker for HCC diagnosis and prognosis , as well as a potential therapeutic target.

With the development of digital technology， an increasing number of artificial intelligence （AI） technologies are being applied in the field of public health， significantly improving the efficiency of healthcare systems. However， such technological advancement also introduces a series of ethical risks. In this article， we conducted a systematic review by searching nine domestic and international databases and analyzing the ethical issues related to AI in public health， ultimately including 158 articles. Based on the analysis of the included literature， ethical risks were categorized into four aspects： data， algorithms， rights and responsibilities， and social impact. A total of 15 key issues were identified， among which privacy and confidentiality， informed consent， data security， and fairness， justice and inclusion emerged as the most prominent issues. The ethical challenges posed by AI in the field of public health cannot be ignored， and it is necessary to formulate ethical guidelines and practical recommendations for AI in this field， establish sound regulatory and review mechanisms， thereby ensuring the healthy development of AI research in public health.

Sepsis is characterized by a severe and life-threatening host immune response to polymicrobial infection accompanied by organ dysfunction.Studies on the therapeutic effect and mechanism of immunomod-ulatory drugs on the sepsis-induced hyperinflammatory or immunosuppression states of various im-mune cells remain limited.This study aimed to investigate the protective effects and underlying mechanism of artesunate(ART)on the splenic microenvironment of cecal ligation and puncture-induced sepsis model mice using single-cell RNA sequencing(scRNA-seq)and experimental validations.The scRNA-seq analysis revealed that ART inhibited the activation of pro-inflammatory macrophages recruited during sepsis.ART could restore neutrophils'chemotaxis and immune function in the septic spleen.It inhibited the activation of T regulatory cells but promoted the cytotoxic function of natural killer cells during sepsis.ART also promoted the differentiation and activity of splenic B cells in mice with sepsis.These results indicated that ART could alleviate the inflammatory and/or immunosuppressive states of various immune cells involved in sepsis to balance the immune homeostasis within the host.Overall,this study provided a comprehensive investigation of the regulatory effect of ART on the splenic microenvironment in sepsis,thus contributing to the application of ART as adjunctive therapy for the clinical treatment of sepsis.

Xiang thinking is the key way of thinking to construct the life model of human body in traditional Chinese medicine （TCM）， and the theory of ascending and descending of qi movement is an important manifestation of xiang thinking in the theory of TCM. Based on the theory of qi movement， this paper interpreted the mechanism of ischemic stroke through the perspective of xiang thinking "earth weakness - wood constraint - fire hyperactivity"， as "earth weakness in the central and dampness accumulated to phlegm" "wood constraint and stirring wind led to blood stasis" and "fire hyperactivity and fire toxin showed flaming upward" due to disorder of qi movement. Combined with the "xiang of medicinal properties and therapy methods" to discuss the treatment and prescriptions of ischaemic stroke， applying wind medicinals to elevate ji-earth （己土） and yi-wood （乙木）， so that phlegm and stasis can be eliminated， and cold medicinals to descend jia-wood （甲木） and wu-earth （戊土） so that fire toxin can be cleared， with a view to restore ascending and descending of qi movement for ischaemic stroke.

ObjectiveTo discuss the thought of treatment of orifices in the Chinese herbal classics in the past dynasties based on the correspondence between drugs and symptoms to guide the clinical treatment based on syndrome differentiation. MethodAll the literature data of Chinese herbal classics were retrieved from the database of the Chinese Medical Dictionary， involving 76 works of Chinese herbal classics and covering representative works from the Han dynasty to the Ming and Qing dynasties. The information on Chines herbal drugs for the treatment of orifices was collected and sorted out. According to Chinese Materia Medica （11^th Edition） and Pharmacopoeia of the People's Republic of China （2020 Edition）， the nature， flavor， and meridian tropism of the selected Chinese herbal drugs were statistically analyzed. The pathogenesis elements in the treatment of orifices were classified and counted， and the contents of syndrome differentiation and treatment in various Chinese herbal classics were extracted. ResultIn 76 Chinese herbal classics in the past dynasties， 93 Chinese herbal drugs for the treatment of orifices were selected. The nature of drugs was mainly warm， followed by cold and mild. The flavor was mainly pungent， followed by bitter and sweet. In terms of meridian tropism， drugs mainly acted on the lung meridian， followed by stomach， heart， liver， spleen， and kidney meridians. The pathogenesis elements of orifices could be divided into six categories， i.e.， wind invasion， turbid obstruction and Qi stagnation， water and dampness stagnation， blood stasis and collaterals blockage， heat and toxin damage， deficiency of vital Qi and cold coagulation. ConclusionOrifices are mainly treated with drugs effective in dispelling wind and pathogenic factors， resolving turbidity and removing stagnation， inducing diuresis and eliminating dampness， promoting blood circulation and dredging collaterals， clearing heat and purging fire， tonifying deficiency and dispelling cold， which are used in combination. Eliminating pathogenic factors and dredging， tonifying deficiency and purging excess are the main characteristics of treatment of orifices based on syndrome differentiation， which is in line with the physiological dysfunction state of orifices in losing the function， evil Qi blockage and healthy Qi deficiency.