Objective To analyze the current situation of the knowledge-attitude-practice among noise-exposed workers at an airport apron. Methods A total of 494 noise-exposed workers from an airport apron were selected as the study subjects using the judgmental sampling method. A self-designed "Occupational Protection Knowledge, Attitudes, and Practices Questionnaire" was used to assess the current situation of knowledge-attitude-practice on occupational protection. Results Regarding the awareness of noise hazards among the study subjects, the awareness rates of noise-induced impairment on digestive function and reproductive system were the lowest (44.9% and 37.7%, respectively). The awareness rate of noise-induced negative emotions increased with length of service (P<0.01). Regarding the occupational protection knowledge for noise, the awareness rate of occupational noise-induced deafness was “incurable” was the lowest (39.1%). The support rate for five kinds of occupational protection attitudes for noise was generally >85.0%, while only 58.3% of the study subjects consistently or frequently wearing earplugs during work. The most common source of noise hazard and protection knowledge was pre-employment training (76.9%), followed by occupational disease prevention and control campaigns (76.1%). Conclusion Noise-exposed workers in this airport apron have incomplete awareness of non-auditory system hazards caused by noise, and the awareness of knowledge of some occupational protection is relatively low. Although their attitudes toward occupational protection are positive, many workers still fail to consistently wear personal protective equipment at work.

In recent years， the incidence of pulmonary nodules has kept rising. To give full play to the advantages of traditional Chinese medicine （TCM） in the treatment of pulmonary nodules and identify the breakthrough points of integrating TCM with Western medicine， the China Association of Chinese Medicine organized medical experts in TCM and western medicine to carry out in-depth discussion regarding this disease. The discussion encompassed the modern medical advances， TCM theories of etiology and pathogenesis， the role and advantages of TCM in the whole course management of pulmonary nodules， contents and methods of research on pulmonary nodules， and science popularization work， aiming to provide a reference for clinical practice and scientific research. After discussion， the experts concluded that the occurrence of pulmonary nodules was rooted in the deficiency of the lung and spleen and triggered by phlegm dampness， blood stasis， and Qi stagnation. TCM can treat pulmonary nodules by controlling and reducing nodules， improving physical constitution， ameliorating multi-system nodular diseases， reducing anxiety and avoiding excessive diagnosis and treatment， and serving as an alternative for patients who are unwilling or unfit for surgical treatment. At present， the optimal diagnosis and treatment strategy for pulmonary nodules has not been formed， which needs to be further studied from multiple perspectives such as clinical epidemiology， biology， and evidence-based medicine. The primary task of current research is to find out the advantages， effective prescriptions， and target populations and determine the effective outcomes of TCM in the treatment of pulmonary nodules. At the same time， basic research should be carried out to explore the etiology and biological behaviors of pulmonary nodules. The expert consensus on the diagnosis and treatment of pulmonary nodules with integrated TCM and Western medicine needs to be continuously revised to guide clinicians to conduct standardized， scientific， and accurate effective diagnosis and treatment.

Background N-hexane has been a widely used solvent in industrial production, but it is volatile at room temperature and can be accumulated in the body, and its prolonged occupational exposure may lead to serious chronic diseases in workers. Objective To use four risk assessment models to evaluate the health risk levels of n-hexane-exposed workers, discuss the applicability of the four models in the health risk assessment of n-hexane exposure, and make an important supplement to the health risk assessment of n-hexane in China. Methods In 2022, a total of 167 jobs (1724 workers) exposed to n-hexane in 85 manufacturing enterprises in Jiangsu Province were selected, and a cross-sectional study was conducted and included questionnaire surveys and evaluation of on-site air n-hexane of each job. Subsequently, the China’s classification standards of occupational hazards at workplaces (China model), U.S. Environmental Protection Agency (EPA) model, Singapore semi-quantitative risk assessment model (Singapore model), and the International Council on Mining and Metals (ICMM) model were applied to the quantitative, semi-quantitative, and qualitative assessments of the occupational health risk level of n-hexane-exposed workers. Results All job’s 8-h time-weighted average concentrations (C_TWA) of n-hexane were within the national occupational exposure limits (OELs). The results of the China model graded all jobs as relatively harmless. The Singapore model graded all jobs as low risk, except that two monitoring sites of adhesive jobs were assessed as medium risk. The ICMM quantitative model evaluated all jobs as intolerable for n-hexane airborne exposure, while the matrix method evaluated all jobs as low risk. The U.S. EPA model identified five sites involving painting, printing, and adhesive jobs as high risk and the other jobs as low risk. Conclusion Inconsistent grading results are observed by using the four models for the occupational health risk assessment of n-hexane exposure, that is, harmless for all jobs by China model, while medium and high risks by Singapore model and U.S. EPA model. Therefore, we recommend to combine the Singapore model and the U.S. EPA model with the China model to assess the occupational risk of n-hexane-exposed workers by considering actual concentrations of exposure.

Backgroud At present, there is no unified standard for the detection of glufosinate ammonium and three metabolites in urine, which affects the accurate assessment of occupational exposure risk to a certain extent. It is of great significance to establish a rapid and effective inspection method to ensure occupational safety and public health. Objective To establish an ultra performance liquid chromatography-tandem mass spectrometry for simultaneous determination of glufosinate ammonium and three metabolites in urine. Methods The effects of dilution solvents and dilution ratios on the response values of glufosinate ammonium and three metabolites were compared, and the retention capacities of solid phase extraction columns for targets as well as the effects of chromatographic columns and mobile phase systems on chromatographic peaks were analyzed. Samples were quantified by matrix effect matching external standard method. Accuracy of the method was evaluated by recovery rate of standard addition, and precision of the method was evaluated by relative standard deviation of intra-day and inter-day measurements. Urine samples of 30 health individuals were collected to evaluate the application of the method. Results The urine samples were diluted with 0.2 mL water and 0.6 mL acetonitrile, purified by HLB solid phase extraction columns, and separated by Dikma Polyamino HILIC columns, and gradient elution was carried out with 0.5 mmol·L⁻¹ ammonium acetate and 0.1% ammonia water as mobile phase, which achieved a good peak shape and mass spectrum response. The linearities of the four target compounds were good in the range of 0.5-50 ng·mL⁻¹, and the correlation coefficients (r) were all greater than 0.998. The detection limits were 0.56-2.86 μg·L⁻¹, the quantification limits were 1.87-29.54 μg·L⁻¹, and the recovery rates of standard addition ranged from 75.0% to 103.6%, The relative standard deviations of intra-batch and inter-batch were from 2.5% to 8.1% and from 4.3% to 9.3% respectively. The method was applied to detect 30 urine samples of subjects, and no target was detected. Conclusion The method is simple, rapid, sensitive, and accurate. It is suitable for the determination of glufosinate ammonium and its metabolites in human urine without derivatization.

Objective To investigate the incidence of anemia and evaluate the immune status among newly reported HIV/AIDS patients in Jiangsu Province in 2021, and to identify the risk factors of anemia among patients living with HIV infections. Methods Newly reported HIV/AIDS patients in Jiangsu Province from January 1 to December 31, 2021 that were registered in China’s National AIDS Comprehensive Control Information Management System were enrolled. Subjects’ fresh whole blood samples were collected, and hemoglobin levels, CD4 and CD8 cell counts and HIV viral loads were measured. Anemia was defined according to hemoglobin levels, and the immunological parameters and HIV viral loads were compared between HIV-infected patients with and without anemia. The risk factors of anemia were identified among individuals living with HIV infections using univariate analysis and multivariate logistic regression analysis. In addition, subjects’ CD4 cell counts one year following antiretroviral therapy (ART) were retrieved from China’s National AIDS Comprehensive Control Information Management System, and compared between subjects with and without anemia. Results A total of 635 newly diagnosed HIV/AIDS patients were reported in Jiangsu Province in 2021, including 544 males (85.67%) and 91 females (14.33%), and with ages of 15 to 83 years, and the overall incidence of anemia was 5.51% (35/635) among the study subjects. Men, individuals at ages of 45 years and lower and workers had relatively higher hemoglobin levels, with median hemoglobin levels of 156 (interquartile range, 22), 154 (interquartile range, 23) g/L and 162 (interquartile range, 19) g/L, respectively. The median baseline HIV viral load was 40 500.00 (interquartile range, 119 735.00) copies/mL among HIV-infected individuals with anemia and 29 754.00 (69 183.00) copies/mL among those without anemia (Z = -0.91, P = 0.31), and the median baseline CD4 and CD8 cell counts were significantly lower among HIV-infected individuals with anemia [166 (interquartile range, 143) cells/μL and 755 (653) cells/μL] than those without anemia [308 (253) cells/μL and 892 (638) cells/μL] (Z = -4.36 and -2.37, both P values < 0.05). The median CD4 cell counts remained lower among HIV-infected individuals with anemia than those without anemia [296 (interquartile range, 229) cells/μL vs. 457 (interquartile range, 313) cells/μL; Z = -3.71, P < 0.05] one year following ART, and the proportions of moderate and severe immunosuppression were significantly higher among HIV-infected individuals with anemia (40.00% and 17.14%) than those without anemia (21.00% and 9.33%) (χ² = 10.37 and 8.79, both P values < 0.01). Univariate analysis showed a higher detection rate of anemia among female HIV-infected individuals than among males [odds ratio (OR) = 4.528, 95% confidence interval (CI): (3.811, 5.245), P < 0.001], a higher rate among HIV-infected individuals at ages of 45 to < 60 years [OR = 3.415, 95% CI: (1.191, 9.788), P = 0.022] and 60 years and older [OR = 5.820, 95% CI: (2.013, 16.826), P < 0.001] than among those at ages of 15 to < 30 years, a higher rate among HIV-infected individuals through heterosexual transmission than among those through homogeneous transmission [OR = 3.015, 95% CI: (1.423, 6.387), P = 0.004], a lower rate among HIV-infected individuals with an educational level of college and above than among those with an educational level of primary school [OR = 0.103, 95% CI: (0.028, 0.386), P < 0.001], a higher rate among HIV-infected individuals with baseline CD4 cell counts of < 200 cells/μL than among those with baseline CD4 cell counts of 200 cells/μL and higher [OR = 4.340, 95% CI: (2.165, 8.702), P < 0.001], and lower detection rates among HIV-infected individuals with CD4/CD8 cell ratios of 0.208 to < 0.326 [OR = 0.232, 95% CI: (0.076, 0.711), P = 0.011] and 0.516 and higher [OR = 0.292, 95% CI: (0.104, 0.818), P = 0.019] than among those with CD4/CD8 cell ratios of < 0.208. Multivariate logistic regression analysis identified woman [OR = 4.945, 95% CI: (3.944, 5.946), P = 0.002], and CD4 cell counts of < 200 cells/μL [OR = 3.597, 95% CI: (1.448, 8.937), P = 0.006] as risk factors of anemia among newly reported HIV/AIDS patients. Conclusions The incidence of anemia was low among newly reported HIV/AIDS patients in Jiangsu Province in 2021, and the immune status was poorer among HIV-infected individuals with anemia than those without anemia at baseline and one year following ART. Female and CD4 cell counts of < 200 cells/μL are risk factors of anemia among individuals living with HIV infections, and intensified surveillance, follow-up and precision interventions are recommended targeting female HIV-infected individuals and HIV-infected individuals with low CD4 cell counts.

Objective To explore the value of peripheral blood circulating DNA in predicting the efficacy and prognosis of immunotherapy for advanced non-small cell lung cancer.Method A retrospective study was conducted on 78 NSCLC patients who were admitted to the Respiratory and Critical Care Medicine Department of the First Affiliated Hospital of Hebei North University and were treated with tirelizumab for advanced driver gene negativity from January 2021 to December 2021.After 2 cycles of immunotherapy,the efficacy was evaluated according to the Solid Tumor Efficacy Evaluation Criteria(RECIST 1.1),including complete remission,partial remission,disease stability,and disease progression.CR and PR patients were defined as the experimental group(n=48)Other patients were defined as the control group(n=30),and the ctDNA levels in peripheral blood were measured before and after treatment in both groups.ROC curves were used to analyze the predictive value of periph-eral blood ctDNA levels for achieving objective remission after immunotherapy.All patients were followed up and their progression free survival were calcutated.Using univariate and multivariate regression analysis identified the factors affecting the prognosis of patients after immunotherapy.Using Spearman correlation coefficient analyzed the correlation between ctDNA levels and PFS.Kalplan Meier survival curve were used for survival analysis.Result The peripheral blood ctDNA levels before and after treatment in the experimental group were(4.47±1.21)ng/μL and(2.65±1.14)ng/μL,respectively(t=7.559,P<0.001),while those in the control group were(4.54±1.15)ng/mL and(4.29±1.57)ng/μL,respectively(t=0.699,P=0.487).There was no statistically significant difference in peripheral blood ctDNA levels between the two groups before treatment(t=-0.25,P=0.801).The peripheral blood ctDNA levels in the experimental group decreased compared to the control group after treatment(t=-5.35,P<0.001).The ROC curve analysis showed that the area under the curve for predicting objective remission after immunotherapy based on peripheral blood ctDNA levels was 0.819,with a sensitivity of 81.3%and specificity of 80%.Peripheral blood ctDNA levels were negatively correlated with progression free survival(r=-0.784,P=0.000).Single factor COX regression was used to analyze the clinical and pathological characteristics and ctDNA levels of enrolled patients,and the results showed that the maximum tumor diameter was greater than 5 cm(HR=0.501,95%CI:6.731～35.567)Tumor stage IV(HR=0.392,95%CI:0.227～0.677),treatment approach(HR=15.473,95%CI:6.731～35.567),and ctDNA levels(HR=4.657,95%CI:3.182～6.555)are all influencing factors for PFS in advanced NSCLC patients after immunotherapy.Multiple factor analysis was conducted on the appeal indicators with statistical differences,and the results showed that treatment approach(HR=2.981,95%CI:1.019～8.722)and peripheral blood ctDNA levels(HR=3.918,95%CI:2.619～5.861)It is an independent influencing factor of PFS in advanced NSCLC patients.The Kalplan Meier survival curve was used for analysis,and the results showed that the median PFS of the treatment effective group was 8.4 months,while the median PFS of the control group was 5.4 months.(χ2=49.277,P=0.000).Conclusion Immunotherapy combined with chemotherapy can enhance the ability to kill tumor cells,and peripheral blood ctDNA levels can evaluate the efficacy and prognosis of immunotherapy,which can be used to guide immunotherapy in advanced NSCLC patients.

The discussion and research on the clinical dominant diseases of traditional Chinese medicine （TCM） have attracted increasing attention. Through approaches including modern technology， evidence-based medical methods， and multi-disciplinary treatment， we should construct a sound TCM inheritance and innovation system， establish a collaborative innovation mechanism， and integrate major research projects， striving to make breakthroughs in TCM theory， methodology， standards， and regulation system， promoting the scientific and technological progress of TCM， and thereby improving its curative effect. The China Association of Chinese Medicine （CACM） carried out a series of youth salon seminars for clinical dominant diseases in TCM， discussing and sorting out the advantages of the dominant diseases in clinical diagnosis and treatment of TCM and integrated traditional Chinese and western medicine in specific diseases or fields. Authoritative experts in the industry were invited to give comment and guidance to form a report. Centering on clinical research of dominant diseases， thematic research was carried out in the aspects of practice， human experience-based evidence， and transformation path. Through the systematic study of the dominant diseases， the advantages of TCM in different stages of disease treatment were excavated to constantly improve the prevention and treatment ability of TCM and carry forward the advancement of TCM theory and practice. At the same time， the communication and understanding between traditional Chinese and western medicine were improved， laying the foundation for the further formation of industry guidelines or consensus and comprehensive promotion. These seminars are expected to provide references for the development of policy planning， clinical diagnosis and treatment， health economy， and social services in TCM and lay the foundation for the formation of a new modern diagnosis and treatment system with Chinese characteristics.

OBJECTIVES: The aims of this study were to update the latest data on the prevalence of hypertension (HTN) in the elderly Chinese population and to assess relationships between new anthropometric indices and HTN. METHODS: Data were obtained from the Basic Public Health Service (BPHS) survey for Jiangsu Province, China. A total of 944,760 people aged 65 years and older were included in this study. Blood pressure was measured by trained investigators. Body weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), conicity index (COI), body roundness index (BRI), and a body shape index (ABSI) were included in the analysis as anthropometric indices. Logistic regression analysis and restricted cubic splines were used to evaluate the association of anthropometric indices with HTN. RESULTS: The prevalence of HTN among elderly residents of Jiangsu Province was 64.7% (95% confidence interval, 64.6 to 64.8). After adjusting for multiple covariates, all anthropometric indices except ABSI showed significant non-linear positive dose-response associations with HTN across sex (pnonlinear<0.001). Among participants with BMI <28 kg/m2, abnormal weight, WC, WtHR, BRI, COI, and ABSI were positively associated with HTN. CONCLUSIONS The prevalence of HTN in the elderly in Jiangsu Province is gradually increasing. It is necessary to consider the combination of ABSI and COI with BMI for screening elderly individuals for HTN in follow-up prospective studies.

Objective:To investigate the effect of laparoscopic ovarian cystectomy on anti-Mullerian hormone (AMH) level, ovarian response to gonadotropin stimulation and pregnancy rate for in vitro fertilization (IVF) patients with benign ovarian cysts.Methods:Patients with benign ovarian cysts who were admitted for cystectomy and had undergone IVF treatment were enrolled in the study. There were 373 participants with ovarian cysts underwent laparoscopic ovarian cystectomy in the experimental group. According to duration of post-surgery, there were four sub-groups: 1 year post-surgery (1Y POST), 2 years post-surgery (2Y POST), 4 years post-surgery (4Y POST) and ≥5 years post-surgery (≥5Y POST) in the experimental group. According to histopathologic types of ovarian cysts, there were two sub-groups: ovarian endometriotic cysts and ovarian non-endometriotic cysts. Two hundreds and three patients with no history of ovarian cysts and ovarian surgery were in the control group. The level of AMH and basic concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P), estradiol (E 2) were measured. Antral follicle counts (AFC) were calculated. There were other study variables: total dose of gonadotropins, duration of ovarian stimulation, the number of oocyte retrieved, the number of embryo obtained, blastocyst transfer rate and pregnancy rate. Results:The control group was matched as closely as possible to the experimental group, including age, body mass index and menstrual cycle (all P>0.05). Compared to the women in control group, the women in ovarian endometriotic cystectomy sub-group had significantly higher levels of basal FSH and basal P, lower level of AMH (all P<0.05); the women in ovarian endometriotic cysts sub-group had significantly higher dose of gonadotropins (all P<0.05); the women in ovarian endometriotic cysts ≥5Y POST sub-group had significantly lower number of oocyte retrieved, lower number of embryo obtained, lower blastocyst transfer rate, and lower pregnancy rate (all P<0.05). Compared to the women in control group, the women in ovarian non-endometriotic cysts sub-group had a significantly higher level of basal FSH and basal P (all P<0.05). The women in ovarian non-endometriotic cysts sub-group had lower level of AMH, higher dose of gonadotropins, lower number of oocyte retrieved, lower number of embryo obtained, lower rate of blastocyst transfer and lower rate of pregnancy than the control group but there were no statistically significant differences among them (all P>0.05). The women with unilateral ovarian endometriotic cysts had significantly lower number of oocyte retrieved on the side of surgery than another side ( P<0.05). Conclusions:In short term laparoscopic ovarian cystectomy has no significant effect on ovarian reserve. But with long-term follow-up ovarian reserve, ovarian response to gonadotropin stimulation and pregnancy rate are decreased. The effect of laparoscopic ovarian cystectomy in benign cysts on ovarian is associated with whether or not it is the surgical side.

Objective To analyze the hepatitis B virus infection with extreme reduction of cholinesterase(CHE)not caused by liver synthesis dysfunction,and to explore its clinical significance.Methods The clinical data of 2 rare cases hospitalized in the 3rd people's hospital of Kunming in July 2021 and February 2022,including liver function,coagulation function,hepatitis B markers,hepatitis B virus volume,and whole exon sequencing,were collected and analyzed,and literature was reviewed.Results CHE was extremely reduced in 2 patients with HBV infection,liver synthesis function was good,and whole exon sequencing showed the presence of butyrylcholinesterase(BCHE)gene mutation.Conclusion The extremely low CHE in this case is not due to liver function disorder.Exon sequencing detected mutations in the BCHE gene in two patients.Screening for BCHE mutations may be necessary in patients with extremely low cholinesterase levels not due to liver dysfunction.