Objective To investigate the effects of combined exposure to benzene series, dust and noise on occupational high-frequency hearing loss (HFHL) in the electronics manufacturing industry. Methods A total of 740 employees from an electronic manufacturing enterprise were selected as the study subjects. According to the detection of occupational hazard factors, they were divided into noise group, noise benzene group, and noise dust group, with 325, 167, and 248 people, respectively. Occupational health examinations were conducted on the study participants to analyze their HFHL detection status and influencing factors. Results Among all participants (n=740), 456 (61.62%) were male, 284 (38.38%) were female, and 123 (15.62%) were detected with HFHL. The detection rate of HFHL increased with age and length of service (P<0.01). According to the exposure factor grouping, the detection rates of HFHL in the noise group, noise benzene group, and noise dust group were 12.00%, 19.16%, and 20.97%, respectively (P<0.05). Multivariate logistic regression analysis showed that workers aged ≥ 40 years, with 10-20 years of work experience, ≥ 20 years of work experience, exposure to noise and benzene series, and exposure to noise and dust had an increased risk of developing HFHL to 1.734, 1.923, 3.071, 1.706, and 1.527, respectively (P<0.05). Conclusion Combined exposure to noise and benzene series, combined exposure to noise and dust, as well as age and extended length of service may increase the risk of HFHL among workers.

Objective:To develop and validate the Pain nursing Competency Evaluation Questionnaire for Nursing Students to provide an effective tool for measuring the pain management competency of nursing students in China.Methods:The questionnaire was constructed through literature review, semi-structured interviews, focus group discussions, Delphi expert consultation, and a pre-survey. From September 2023 to January 2024, a convenience sampling method was used to select 250 nursing students from Hangzhou Normal University and Lishui University in Zhejiang Province for the survey. Reliability and validity of the developed questionnaire were tested. A random sample of 30 nursing students was selected for retesting after two weeks.Results:A total of 10 female experts were consulted through correspondence. The Pain Care Competency Evaluation Questionnaire for nursing students consists of 36 items. Through exploratory factor analysis, five common factors were extracted: pain health education, comprehensive pain assessment, pain screening and assessment, analgesic interventions, and analgesic side effects nursing, which together explained 61.695% of the variance. The content validity of the questionnaire was 0.96, and the item-level content validity index ranged from 0.900 to 1.000. The overall Cronbach′s α coefficient was 0.924, and the Cronbach′s α coefficients for the five dimensions ranged from 0.856 to 0.915. The test-retest reliability was 0.831. Conclusions:The Pain Care Competency Evaluation Questionnaire for nursing students developed in this study has good reliability and validity. It can be used as a tool to assess nursing students′ competency in pain care and provides a reference for the design and optimization of pain care courses and clinical practice programs for nursing students in undergraduate institutions.

Objective: To retrospectively compare the safety and efficacy of ultrasound-guided radiofrequency ablation (RFA) with parotidectomy for superficial pleomorphic adenoma (PA). Materials and Methods: From March 2022 to October 2023, 88 patients diagnosed with superficial parotid PA underwent either RFA (n = 12; mean age, 47.1 years) or parotidectomy (n = 76; mean age, 47.8 years). Patients in the RFA group were matched to those in the surgery group in a 1:1 ratio using propensity scores based on age, sex, tumor volume, diameter, location, and comorbidities. Ultrasound characteristics, cosmetic scores (0–4), numerical rating scale scores (0–10), and complications were assessed before the procedures and at 1-, 3-, and 6-month follow-ups. Outcomes were compared between baseline and follow-up in the RFA group and between the RFA and surgery groups. Results: In the RFA group, significant reductions in tumor volume were observed between baseline (median, 2.02 cm 3 ) and the 1-month follow-up (median, 1.21 cm 3 ; P = 0.015), between the 1-month and 3-month follow-ups (median, 0.53 cm 3 ; P= 0.002), and between the 3- and 6-month follow-ups (median, 0.23 cm 3 ; P = 0.003). The volume reduction ratios at 1, 3, and 6 months were 39.7%, 79.9%, and 88.0%, respectively. The cosmetic score was significantly lower at 3- and 6-month followup compared to baseline (median 1 and 1 vs. 4, P = 0.04). The numerical rating scale scores did not differ significantly from baseline throughout follow-up. In the propensity score-matched analysis (12 patients per group), RFA was associated with a shorter median procedure time (61.5 vs. 253.3 minutes; P < 0.001), shorter hospital stay (0 vs. 4 days; P < 0.001), and lower cost (1859.9 vs. 3512.4 USD; P < 0.001) than parotidectomy, with no significant difference in overall complication rates (33.3% [4/12] vs. 41.7% [5/12]; P = 1.000). Conclusion RFA may be a safe and effective alternative to surgery for superficial parotid PA, offering a shorter median procedure time, shorter hospital stay, and lower costs.

OBJECTIVE: Humans are exposed to complex mixtures of environmental chemicals and other factors that can affect their health. Analysis of these mixture exposures presents several key challenges for environmental epidemiology and risk assessment, including high dimensionality, correlated exposure, and subtle individual effects. METHODS: We proposed a novel statistical approach, the generalized functional linear model (GFLM), to analyze the health effects of exposure mixtures. GFLM treats the effect of mixture exposures as a smooth function by reordering exposures based on specific mechanisms and capturing internal correlations to provide a meaningful estimation and interpretation. The robustness and efficiency was evaluated under various scenarios through extensive simulation studies. RESULTS: We applied the GFLM to two datasets from the National Health and Nutrition Examination Survey (NHANES). In the first application, we examined the effects of 37 nutrients on BMI (2011-2016 cycles). The GFLM identified a significant mixture effect, with fiber and fat emerging as the nutrients with the greatest negative and positive effects on BMI, respectively. For the second application, we investigated the association between four pre- and perfluoroalkyl substances (PFAS) and gout risk (2007-2018 cycles). Unlike traditional methods, the GFLM indicated no significant association, demonstrating its robustness to multicollinearity. CONCLUSION GFLM framework is a powerful tool for mixture exposure analysis, offering improved handling of correlated exposures and interpretable results. It demonstrates robust performance across various scenarios and real-world applications, advancing our understanding of complex environmental exposures and their health impacts on environmental epidemiology and toxicology.
Humans ; Environmental Exposure/analysis* ; Linear Models ; Nutrition Surveys ; Environmental Pollutants ; Body Mass Index

OBJECTIVE To prepare nanoparticle-based targeting preparation loaded with triptolide(TP),and evaluate its quality,targeting ability and cytotoxic effects.METHODS Polymer nanoparticles carrying TP-targeted folic acid(FA)receptor(TP@PLGA-PEG-FA)were fabricated using poly(lactic-co-glycolic acid)/polyethylene glycol/FA(PLGA-PEG-FA)as the carrier by emulsion and volatilization technique.The morphology and distribution were observed,and their particle size,Zeta potential,polydispersity index(PDI),drug loading capacity and encapsulation efficiency were measured.Their stability,blood compatibility,in vitro drug release,uptake by RAW264.7 cells(localization with fluorescent dye Cy3.5),and in vitro cytotoxicity were evaluated.RESULTS TP@PLGA-PEG-FA exhibited spherical shape and uniform distribution,with particle size of(122.60±0.02)nm,Zeta potential of(-17.6±0.6)mV,and PDI of 0.26±0.02;drug loading capacity and encapsulation efficiency of TP were measured to be(7.78±0.05)%and(68.62±0.03)%,respectively.The hemolysis rates of 100,200,300,400 μg/mL TP@PLGA-PEG-FA were 0.77%,0.92%,1.34%and 1.63%,respectively.There were no significant changes in particle size,PDI and Zeta potential when TP@PLGA-PEG-FA were placed in 4℃water for 14 days and in DMEM culture medium containing 10%fetal bovine serum at 37℃for 12 h.The cumulative release rate of TP@PLGA-PEG-FA was(84.83±0.29)%in phosphate buffer at pH5.5 for 72 h,which was significantly higher than the cumulative release rates in phosphate buffer solutions at pH7.4 and 6.5 for 72 h[(42.37±0.35)%and(63.83±0.29)%,respectively](P＜0.05).Activated RAW264.7 cells took up significantly more Cy3.5@PLGA-PEG-FA than they took up Cy3.5@PLGA-PEG-FA+free FA and Cy3.5@PLGA-PEG.When the mass concentration of TP was≥15.63 ng/mL,the survival rates of activated cells in the TP@PLGA-PEG-FA groups were significantly lower than those of the same mass concentration of free TP groups(P＜0.05).CONCLUSIONS The prepared TP@PLGA-PEG-FA has high stability,good blood compatibility,active targeting and cytotoxicity to inflammatory cells.

Spinal cord injury (SCI) is a neurological disorder that occurs after a direct or indirect violent injury to the spinal cord, often resulting in sensory and motor dysfunction below the injury level. Patients with SCI are often paralyzed in bed due to impaired nerve function and there has been no effective treatment for limb paralysis after SCI. As a cutting-edge technology with a multidisciplinary integration of neuroscience, computer science, biological engineering, electronic engineering and psychology, brain-computer interface (BCI) provides a new program for the rehabilitation of SCI patients by changing the traditional brain signal output pathways and realizing the direct connection between the brain and external devices. In order to further understand the application of BCI in SCI rehabilitation, the authors reviewed the classification, basic principles of BCI and the research progress of the application of BCI in SCI rehabilitation, which may provide references for the clinical transformation of BCI.

Objective:To observe the effect of rehabilitative exercise on knee function after anterior cruciate ligament (ACL) reconstruction.Methods:Fifty-eight patients with a reconstructed ACL were divided at random into a control group of 28 and an experimental group of 30. In addition to conventional basic treatment, the control group received routine orthopedic rehabilitation training, while the experimental group underwent exercise-based rehabilitation training 6 days a week for 6 weeks. Before and after the treatment, the efficacy in both groups was evaluated using Lysholm knee scoring (LKSS), numerical pain scoring (NRS), maximum knee flexion angle, and a thigh muscle atrophy index.Results:Both groups had significantly higher LKSS scores, lower NRS scores, larger maximum knee flexion angles, and increased thigh muscle atrophy indices, on average, after their treatments. Compared with the control group, the experimental group tended to have significantly higher LKSS scores, larger maximum knee flexion angles, and lower thigh muscle atrophy indices after the treatment. There was, however, no significant difference between the groups in their average NRS scores.Conclusions:Exercise-based rehabilitation training significantly improves the knee function of patients after ACL reconstruction, and its efficacy is superior to conventional orthopedic rehabilitation training.

Objective To investigate the efficacy of nimodipine combined with donepezil in the treatment of CSVD patients with mild cognitive impairment.Methods A total of 130 CSVD pa-tients admitted to our department from October 2020 to October 2023 were recruited and ran-domly divided into monotherapy group(nimodipine,65 cases)and combined group(nimodipine plus donepezil,65 cases).The clinical efficacy after 3 months of treatment was recorded.The blood-brain barrier function and brain function indicators[serum neuron-specific enolase(NSE),vascular endothelial growth factor(VEGF),central nervous system specific protein(S100β)]were compared between the two groups.Results The clinical efficacy was significantly higher in the combined group than the monotherapy group(92.3％vs 78.5％,P＜0.05).The cerebrospinal fluid albumin and blood-brain barrier index were obviously increased in the two groups after treatment(P＜0.05),and the two indicators were notably lower in the combined group than the monothera-py group(P＜0.01).After treatment,the level of VEGF was remarkably elevated while those of NSE and S100β were marvelously reduced in the two groups when compared with the levels be-fore treatment(P＜0.05).The combined group obtained significantly higher VEGF level but low-er NSE and S100β levels than the monotherapy group after treatment(P＜0.01).Conclusion For CSVD patients with mild cognitive impairment,the combination of nimodipine and donepezil can effectively improve the cognitive impairment,and promote the brain function recovery.

Objective:To explore the clinical application value of convolutional neural network（CNN）based on deep learning in the automatic measurement of dynamic pelvic floor ultrasound video parameters and the diagnosis and classification of cystocele.Methods:A retrospective analysis was conducted on dynamic pelvic floor ultrasound videos from 398 postpartum women who underwent examinations at the First People's Hospital of Foshan between June 2020 and June 2022. The lowest point of the posterior bladder wall（PWB），urethral rotation angle（URA），and retrovesical angle（RVA）were manually measured by a senior radiologist（R1）and a junior radiologist（R2），and cystocele was classified according to the Green standard. The CNN model was employed to automatically extract the above parameters and to diagnose and classify cystocele. Using R1 measurements as a reference，intraclass correlation coefficient（ICC）was used to evaluate the consistency between the CNN model and R1，as well as between R2 and R1. The Kappa value was used to assess the agreement between the CNN model，R2，and R1 in the diagnosis and classification of cystocele. Additionally，the time consumption of the three measurement methods was compared.Results:The CNN model showed good consistency with R1 in measuring PWB and URA（ICC = 0.983，0.894），while its consistency in measuring RVA was moderate（ICC = 0.614）. The ICC between R2 and R1 in measuring PWB，URA，and RVA was 0.979，0.815，and 0.627，respectively. In the measurement of PWB and URA，the consistency between the CNN model and R1 was superior to that between R2 and R1. For cystocele diagnosis，the Kappa value between the CNN model and R1 was 0.924，which was higher than that between R2 and R1（0.904）. In cystocele classification，the Kappa value between the CNN model and R1 was 0.503，also higher than that between R2 and R1（0.426）. The CNN model processed a single video in 2.5（0.6）s，significantly faster than R1［59.9（16.9）s］and R2［56.8（11.2）s］（all P < 0.001）. Conclusions:The CNN model demonstrates high accuracy and efficiency in the measurement，diagnosis，and classification of cystocele，outperforming a junior radiologist and showing potential for clinical application.

Objective:To evaluate the clinical efficacy of proximal femoral reconstruction osteotomy (PFRO) in hip revision arthroplasty.Methods:A retrospective analysis was conducted of the 92 patients (93 hips) who had undergone PFRO in hip revision arthroplasty at Department of Orthopedics, The First Affiliated Hospital, University of Science and Technology of China from January 2019 to December 2023. The cohort included 50 males (51 hips) and 42 females (42 hips), with an age of (64.5±11.7) years and a body mass index of (23.7±2.9) kg/m 2. Surgical procedures were performed under general anesthesia via a posterolateral approach. Biologic prostheses were used in femoral reconstruction, and PFRO fragments repositioned and fixed using cerclage wires. The data collected were operative time, intraoperative blood loss, length of osteotomy fragments, healing at the osteotomy site, intraoperative and follow-up complications, as well as Harris hip score (HHS) and leg length discrepancy (LLD) at the last follow-up. Results:For this cohort, operative time was (174.9±45.6) minutes, intraoperative blood loss (594.6±206.6) mL, and length of osteotomy fragments (12.3±2.3) mm. The 92 patients were followed up for (35.8±12.3) months. For them, HHS improved from preoperative (38.3±8.5) points to (80.5±12.8) points at the last follow-up, and LLD decreased from preoperative (21.2±13.0) mm to 2.0(0.0, 5.0) mm at the last follow-up, showing significant differences ( P<0.05). The osteotomy sites healed in 89 cases (90 hips), with a displacement of the greater trochanter <5 mm; 3 cases (3 hips) experienced nonunion with wire loosening and a displacement of the greater trochanter >10 mm. The osteotomy fragment of the greater trochanter got fractured in 2 patients (2 hips) and a fracture of the medial cortex of the proximal femur occurred in 11 patients (11 hips), but follow-ups observed healing of all the fractures. One patient (1 hip) developed postoperative posterior dislocation of the hip which was treated conservatively. One patient (1 hip) developed postoperative periprosthetic infection which did not recur after twice of debridement followed by prosthetic revision of the proximal femoral tumor. Conclusion:In hip revision arthroplasty, as PFRO demonstrates a low incidence of fragment fractures of the greater trochanter and a high rate of healing at the osteotomy site, its short-term clinical outcomes are satisfactory.