Objective To explore the wearing status and actual noise reduction effect of hearing protectors among noise workers in a typical automobile manufacturing enterprise. Methods In April 2024, an occupational hazard factor testing was carried out in an automobile manufacturing industry, and at the same time, the hearing protection fit test was conducted for noise workers. Intervention and guidance were provided to those who did not pass the minimum standard of baseline PAR. The difference in PAR between baseline and post-intervention was compared, and the effectiveness of hearing protector wearing method training was evaluated. Results The exceeding rate of the company's noise operation post was 50.77% (66/130). The baseline PAR of the subjects with working experience of less than 15 years and wearing hearing protectors throughout noisy work was higher, and the differences were statistically significant (P<0.05). Compared with those with 80dB≤L_{EX, 8h}<85dB, more research subjects with L_{EX, 8h}≥85dB failed baseline PAR (39.13%). After intervention, the PAR of the subjects who did not pass the minimum standard of baseline PRA increased from 2.0 (0.0, 5.3) to 17.0 (14.8, 20.0), and the protection level was significantly improved, and the difference was statistically significant (P<0.01). Conclusion The individual fit test of hearing protector is an important means to evaluate the actual noise reduction level of hearing protector and guide the selection of hearing protection models. Corporate training can help improve the PAR of hearing protectors.

Objective To analyze the increase in hearing thresholds in different frequency bands of workers exposed to different characteristic noises and the influencing factors of binaural high-frequency hearing loss, and to provide theoretical support for occupational health monitoring in enterprises. Methods In 2021, noise-exposed workers were selected from typical noise-exposing enterprises as research subjects, and their occupational health examination data were tracked for three consecutive years. According to the on-site detection from 2021 to 2023, the cumulative noise exposure (CNE) was calculated. The chi-square test was used to compare the increase of the hearing threshold of workers exposed to different characteristic noises in different frequency bands. A generalized estimation equation was constructed to explore the influencing factors of high-frequency hearing loss in the research subjects. Results The age of the study subjects was 23-54 years old, with 1.6-20.1 years of working experience, mainly distributed in manufacturing workshops, technical workshops and public works workshops. The median LAeq,8h was 85.90 (84.5, 86.1) dB(A), and the average CNE was 94.3±2.6 dB(A). The number of people with increased hearing thresholds in each frequency band was 0.5kHz>6kHz>4kHz>3kHz>1kHz>2kHz. There were statistically significant differences in the increase of hearing thresholds in each frequency band, binaural speech frequency impairment, and high-frequency hearing loss among subjects with different characteristics (P<0.05). The detection rate of binaural speech frequency hearing loss was the highest in subjects aged>45 years, with a length of service of>15 years, and with a CNE>96dB(A). The detection rate of binaural high-frequency hearing loss was the highest in subjects aged 35-40 years, with a length of service of 5-10 years, and with a CNE>96dB(A).In addition, the detection rate of binaural speech frequency and high-frequency hearing loss increased with the increase of CNE(P<0.05). The GEE model showed that age>40 years and CNE>96dB(A) were risk factors for high-frequency hearing loss in both ears. Conclusion With increasing age and CNE, hearing thresholds rise across all frequency bands, elevating the risk of binaural speech-frequency and high-frequency hearing loss, thereby increasing the likelihood of occupational noise-induced deafness.

Based on the concept of "regulating the five zang organs and harmonizing the spleen and stomach"， globus hystericus is believed to originate from dysfunction of the five zang organs and disharmony of the spleen and stomach. Treatment primarily focuses on regulating the spleen and stomach while also considering other affected organs， with a self-prescribed Anpiwei Jingyan Formula （安脾胃经验方） for harmonizing the spleen and stomach as the foundational treatment. Additionally， syndrome-based modifications are applied according to imbalances in the heart， lung， kidney， or liver. For heart-yang deficiency， modified Linggui Zhugan Decoction （苓桂术甘汤） could be combined； for heart-yin deficiency， modified Tianwang Buxin Pill （天王补心丹） could be combined. For lung failing to disperse and descend and fluid retention， modified Sanao Decoction （三拗汤） could be combined； for lung and stomach yin deficiency， modified Shashen Maidong Decoction （沙参麦冬汤） could be combined. For kidney-yang deficiency with ascending counterflow of cold water， modified Jingui Shensi Pill （金匮肾气丸） could be combined； for kidney-yin deficiency， modified Liuwei Dihuang Pill （六味地黄丸） could be combined. For liver constraint and spleen deficiency， modified Sini Powder （四逆散） could be combined； for liver-yin deficiency or liver stagnation transforming into fire and attacking the stomach， modified Yiguan Decoction （一贯煎） could be combined.

Parkinson’s disease (PD) is a common neurodegenerative disorder with profound impact on patients’ quality of life and long-term health, and early detection and intervention are particularly critical. In recent years, the search for precise and reliable biomarkers has become one of the key strategies to effectively address the clinical challenges of PD. In this paper, we systematically evaluated potential biomarkers, including proteins, metabolites, epigenetic markers, and exosomes, in the peripheral blood of PD patients. Protein markers are one of the main directions of biomarker research in PD. In particular, α‑synuclein and its phosphorylated form play a key role in the pathological process of PD. It has been shown that aggregation of α-synuclein may be associated with pathologic protein deposition in PD and may be a potential marker for early diagnosis of PD. In terms of metabolites, uric acid, as a metabolite, plays an important role in oxidative stress and neuroprotection in PD. It has been found that changes in uric acid levels may be associated with the onset and progression of PD, showing its potential as an early diagnostic marker. Epigenetic markers, such as DNA methylation modifications and miRNAs, have also attracted much attention in Parkinson’s disease research. Changes in these markers may affect the expression of PD-related genes and have an important impact on the onset and progression of the disease, providing new research perspectives for the early diagnosis of PD. In addition, exosomes, as a potential biomarker carrier for PD, are able to carry a variety of biomolecules involved in intercellular communication and pathological regulation. Studies have shown that exosomes may play an important role in the pathogenesis of PD, and their detection in blood may provide a new breakthrough for early diagnosis. It has been shown that exosomes may play an important role in the pathogenesis of PD, and their detection in blood may provide new breakthroughs in early diagnosis. In summary, through in-depth evaluation of biomarkers in the peripheral blood of PD patients, this paper demonstrates the important potential of these markers in the early diagnosis of PD and in the study of pathological mechanisms. Future studies will continue to explore the clinical application value of these biomarkers to promote the early detection of PD and individualized treatment strategies.

Paclitaxel， a highly effective natural antitumor drug， has been demonstrated to be efficacious in the treatment of a variety of cancers， including breast cancer， ovarian cancer， and lung cancer. The traditional paclitaxel injections have been observed to present certain issues， including overt adverse reactions and a decline in the quality of life of patients following treatment. This ultimately leads to an inability to meet the comprehensive needs of patients， thereby limiting the clinical applications of the drugs. Compared with injectable administration， the oral administration can avoid the risk of infection present in the invasive route， is conducive to improving patient compliance and quality of life， and reduces healthcare costs， and has a good application prospect. However， paclitaxel has low solubility， poor permeability， and is susceptible to the exocytosis of P-glycoprotein， which presents a significant challenge in the development of its oral preparations. Novel drug delivery technologies can enhance the solubility of paclitaxel and facilitate its controlled release， which is beneficial for the oral absorption and efficacy. The paper reviews the development history of oral preparations of paclitaxel， and summarizes the delivery technologies such as polymer micelles， nanoparticles， nanoemulsions and nanocrystals， and discusses the application mechanisms， advantages and limitations of these technologies and their adaptability in different cancer treatments. Finally， the challenges faced in the development of oral preparations of paclitaxel are summarized， and future research directions are proposed in order to provide new ideas for the development of oral delivery of paclitaxel.

Paclitaxel， a highly effective natural antitumor drug， has been demonstrated to be efficacious in the treatment of a variety of cancers， including breast cancer， ovarian cancer， and lung cancer. The traditional paclitaxel injections have been observed to present certain issues， including overt adverse reactions and a decline in the quality of life of patients following treatment. This ultimately leads to an inability to meet the comprehensive needs of patients， thereby limiting the clinical applications of the drugs. Compared with injectable administration， the oral administration can avoid the risk of infection present in the invasive route， is conducive to improving patient compliance and quality of life， and reduces healthcare costs， and has a good application prospect. However， paclitaxel has low solubility， poor permeability， and is susceptible to the exocytosis of P-glycoprotein， which presents a significant challenge in the development of its oral preparations. Novel drug delivery technologies can enhance the solubility of paclitaxel and facilitate its controlled release， which is beneficial for the oral absorption and efficacy. The paper reviews the development history of oral preparations of paclitaxel， and summarizes the delivery technologies such as polymer micelles， nanoparticles， nanoemulsions and nanocrystals， and discusses the application mechanisms， advantages and limitations of these technologies and their adaptability in different cancer treatments. Finally， the challenges faced in the development of oral preparations of paclitaxel are summarized， and future research directions are proposed in order to provide new ideas for the development of oral delivery of paclitaxel.

Multiple system atrophy (MSA) is a rare neurodegenerative disease with complex clinical manifestations, presenting substantial challenges in clinical diagnosis and treatment. Its symptoms and the eight extraordinary meridians are potentially correlated; therefore, this article explores the association between MSA symptom clusters and the eight extraordinary meridians based on their circulation and physiological functions, as well as their treatment strategies. The progression from deficiency to damage in the eight extraordinary meridians aligns with the core pathogenesis of MSA, which is characterized by "the continuous accumulation of impacts from the vital qi deficiency leading to eventual damage". Liver and kidney deficiency and the emptiness of the eight extraordinary meridians are required for the onset of MSA; the stagnation of qi deficiency and the gradual damage to the eight extraordinary meridians are the key stages in the prolonged progression of MSA. The disease often begins with the involvement of the yin and yang qiao mai, governor vessel, thoroughfare vessel, and conception vessel before progressing to multiple meridian involvements, ultimately affecting all eight extraordinary meridians simultaneously. The treatment approach emphasizes that "the direct method may be used for joining battle, but indirect method will be needed in order to secure victory" and focuses on "eliminate pathogenic factors and reinforce healthy qi". Distinguishing the extraordinary meridians and focusing on the primary symptoms are pivotal to improving efficacy. Clinical treatment is aimed at the target, and tailored treatment based on careful clinical observation ensures precision in targeting the disease using the eight extraordinary meridians as the framework and core symptoms as the specific focus. Additionally, combining acupuncture, daoyin therapy, and other method may help prolong survival. This article classifies clinical manifestations based on the theory of the eight extraordinary meridians and explores treatment.

OBJECTIVE:To conduct a network Meta-analysis to assess the efficacy of various electromagnetic stimulation programs in managing post-stroke dysphagia and identify the optimal stimulation program.METHODS:A comprehensive search was conducted across multiple databases,including CNKI,VIP,WanFang,the Chinese Biomedical Literature Database,PubMed,Web of Science,Embase,and The Cochrane Library.The search terms included"electric stimulation,""magnetic stimulation,""stroke,"and"deglutition disorders"in Chinese and English.The aim was to collect clinical randomized controlled trials evaluating various electromagnetic stimulation programs for the treatment of post-stroke dysphagia.The control group underwent conventional swallowing training,whereas the experimental group received electromagnetic stimulation in addition to the control treatment.The search was limited to publications from the inception of the databases until May 11,2024.EndNote X9 software was utilized for literature management,and the Cochrane risk of bias assessment tool along with the revised Jadad scale was used to assess the risk of bias and the quality of the included studies.Direct Meta-analysis and network Meta-analysis were performed on the functional oral intake scale score,leakage-aspiration grade score,and swallowing muscle group electromyographic activity score index using RevMan 5.4 software and Stata 17 software.The strength of evidence for the outcome indicators was evaluated in accordance with the GRADE evidence level and recommendation strength grading standards.RESULTS:A total of 59 studies were included in this analysis,comprising 50 high-quality documents and 9 low-quality documents,with a collective sample size of 3 801 patients and encompassing 15 different electromagnetic stimulation programs.(1)In the evaluation of feeding ability,the top five electromagnetic stimulation programs,ranked by the area under the cumulative ranking probability chart(SUCRA),were repetitive transcranial magnetic stimulation combined with repetitive peripheral magnetic stimulation and neuromuscular electrical stimulation(99.4％)＞repetitive peripheral magnetic stimulation and neuromuscular electrical stimulation(80.8％)＞repetitive transcranial magnetic stimulation and neuromuscular electrical stimulation(74.2％)＞repetitive transcranial magnetic stimulation and myoelectric biofeedback electrical stimulation(68.4％)＞transcranial direct current stimulation combined with neuromuscular electrical stimulation(63.2％).(2)In the assessment of anti-aspiration ability,the top five electromagnetic stimulation programs,ranked by the area under the cumulative ranking probability chart(SUCRA),were repetitive transcranial magnetic stimulation combined with repetitive peripheral magnetic stimulation and neuromuscular electrical stimulation(99.25％)＞repetitive transcranial magnetic stimulation combined with myoelectric biofeedback electrical stimulation(87.5％)＞repetitive transcranial magnetic stimulation combined with neuromuscular electrical stimulation(80.6％)＞repetitive pheriphal magnetic stimulation combined with neuromuscular electrical stimulation(66.7％)＞transcranial direct current stimulation combined with neuromuscular electrical stimulation(57.8％).(3)In the assessment of surface electromyographic activity levels in the swallowing muscles,the top five electromagnetic stimulation programs ranked by the area under the cumulative ranking probability chart(SUCRA)were repetitive transcranial magnetic stimulation combined with neuromuscular electrical stimulation(87.1％)＞repetitive transcranial magnetic stimulation combined with transcranial direct current stimulation(86.3％)＞transcranial direct current stimulation combined with neuromuscular electrical stimulation(83.9％)＞myoelectric biofeedback electrical stimulation combined with neuromuscular electrical stimulation(77.8％)＞transcranial direct current stimulation combined with myoelectric biofeedback electrical stimulation(74.4％).CONCLUSION:Electromagnetic stimulation significantly improves swallowing function in patients with post-stroke dysphagia.Combined central and peripheral magnetic stimulation has the best effect on improving oral intale ability and anti-aspiration ability in stroke patients(medium-level evidence),followed by central magnetic stimulation combined with peripheral electrical stimulation(medium-level evidence).

Patients with myeloproliferative neoplasms(MPNs)are at risk of developing solid tumors.Although the connection between MPN and solid tumors has been widely discussed,the cause remains to be explored.Some studies show that the MPN is considered to trigger a second cancer,but others suggest both diseases seem to share the same origin.In recent years,more and more studies have found that genetic susceptibility,drugs,chronic inflammation,immune function abnormalities and clonal hematopoiesis of indeterminate potential are related to the development of second cancers.In this review,we try to summarize the new advances of biological characteristics and pathogenesis of second cancers in MPNs.

Objective To conduct the biomechanical analysis on a new power-assisted knee orthosis.Methods A self-force source power-assisted knee orthosis was used,and four motions(level walking,sitting and standing,ascending and descending stairs)were measured before and after wearing the orthosis.A musculoskeletal multibody dynamic model was adopted to calculate the joint angles and pressures at the knee,patellofemoral and hip joints.The effects of power-assisted knee orthosis on biomechanical changes of lower limbs were investigated by comparing the joint angles and pressures before and after wearing this orthosis.Results The orthosis would reduce the knee angles during level walking,as well as the knee pressures during sitting and standing on the wearing side.Wearing the orthosis did not significantly affect the joint angles during sitting and standing;however,it led to a significant decrease in joint pressures at both bilateral knee joints and patellofemoral joints.During ascending and descending stairs,the knee angle change on the wearing side was opposite to that on the non-wearing side.The increase of the peak knee angle was(14.3±3.6)%on the non-wearing side during ascending stairs.Conclusions The power-assisted knee orthosis can offer a conservative treatment for individuals with various knee diseases by reducing joint angles and pressures in daily motions.