Objective:To investigate the interaction of workplace noise, body mass index (BMI) and systemic inflammatory response on hypertension.Methods:In January 2019, 1124 male workers from an automobile factory in Wuhan were selected by cluster random sampling method. The study population was divided into normal body weight group (BMI<24 kg/m 2) and overweight group (BMI≥24 kg/m 2) according to BMI, and were followed up for 3 years. The occupational health examination of the workers was carried out every year, blood routine and blood biochemical indexes were collected, and the information of the workers' age, BMI, type of work and age of exposure to injury were collected through field questionnaires. The noise intensity of the workplace of the enterprise was measured for 3 consecutive years, and the equivalent sound level was calculated according to the working time. Normal and skewness measurements were described by Mean±SD and [ M ( Q1, Q3) ], respectively. t-test or Wilcoxon rank sum test was used for inter-group comparisons. Categorical variables were expressed by frequency and percentage (%), and Chi-square test was used for inter-group comparisons. Mixed effects models and generalized estimation equations were fitted to analyze the relationship between occupational noise, systemic inflammation, and their interaction terms with blood pressure and hypertension risk. Results:Univariate analysis revealed that the white blood cell counts, neutrophil counts, lymphocyte counts and eosinophil counts were positively associated with systolic blood pressure and diastolic blood pressure in overweight group ( n=467), respectively ( P<0.05). The participants with white blood cell counts≥5.94×10 9/L, neutrophil counts≥3.31×10 9/L, lymphocyte counts ≥2.03×10 9/L, and eosinophil counts ≥0.12×10 9/L had increased risk of hypertension by 52% ( RR=1.52, 95% CI: 1.11-2.05), 37% ( RR=1.37, 95% CI: 1.01-1.83), 58% ( RR=1.58, 95% CI: 1.18-2.09), and 52% ( RR=1.52, 95% CI: 1.12-2.06), respectively (all P<0.05). Multivariate analysis found a positive association between BMI and the risk of hypertension in the overweight group ( P<0.05), the participants with lymphocyte counts≥2.03×10 9/L and eosinophil counts≥0.12×10 9/L had increased risk of hypertension by 39% ( RR=1.39, 95% CI: 1.01-1.89) and 46% ( RR=1.46, 95% CI: 1.06-1.98), respectively (all P<0.05). There was no correlation between BMI and the risk of hypertension in normal weight group ( P>0.05). The multiplicative interaction of occupational noise (≥80 dB) with white blood cell counts (≥5.94×10 9/L) and lymphocyte counts (≥2.03×10 9/L) increased the risk of hypertension by 100% ( RR=2.00, 95% CI: 1.06-3.55) and 89% ( RR=1.89, 95% CI: 1.01-3.32) (all P<0.05) in overweight group, respectively. Additionally, a significant additive interaction was observed between noise exposure (≥80 dB) and basophil counts (≥0.03×10 9/L) on hypertension risk in the overweight group (RERI=0.49, 95% CI: 0.02-0.96, P<0.05) . Conclusion:The combined exposure of occupational noise and systemic inflammation may increase the risk of hypertension in overweight workers in automobile manufacturing plants, and the two have additive and multiplicative interactions.

In order to study the effects of prostaglandin D2(PGD2)on cow bone marrow-derived macrophages induced by E.coli,cultured cow bone marrow-derived macrophages were taken as the research object.The effects of endogenous and exogenous PGD2 on the secretion and phagocytosis of E.coli induced proinflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages were ana-lyzed.The results showed that the synthesis of PGD2 in macrophages induced by E.coli is depend-ent on the natural pattern recognition receptors TLR2,TLR4 and NLRP3.Inhibition of endogenous PGD2can down-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in E.coli induced macrophages(P＜0.001),and inhibition of endogenous PGD2 can enhance the kill-ing function of macrophages to a certain extent(P＜0.01).In addition,exogenous PGD2 could up-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages af-ter E.coli stimulation(P＜0.01),and exogenous PGD2 could weaken the killing function of mac-rophages within a certain concentration range(P＜0.01).Results indicated that PGD2 had certain effects on the secretion of cytokines and phagocytosis and killing function of macrophages induced by E.coli.

In order to study the effects of prostaglandin D2(PGD2)on cow bone marrow-derived macrophages induced by E.coli,cultured cow bone marrow-derived macrophages were taken as the research object.The effects of endogenous and exogenous PGD2 on the secretion and phagocytosis of E.coli induced proinflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages were ana-lyzed.The results showed that the synthesis of PGD2 in macrophages induced by E.coli is depend-ent on the natural pattern recognition receptors TLR2,TLR4 and NLRP3.Inhibition of endogenous PGD2can down-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in E.coli induced macrophages(P＜0.001),and inhibition of endogenous PGD2 can enhance the kill-ing function of macrophages to a certain extent(P＜0.01).In addition,exogenous PGD2 could up-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages af-ter E.coli stimulation(P＜0.01),and exogenous PGD2 could weaken the killing function of mac-rophages within a certain concentration range(P＜0.01).Results indicated that PGD2 had certain effects on the secretion of cytokines and phagocytosis and killing function of macrophages induced by E.coli.

Objective:To investigate the interaction of workplace noise, body mass index (BMI) and systemic inflammatory response on hypertension.Methods:In January 2019, 1124 male workers from an automobile factory in Wuhan were selected by cluster random sampling method. The study population was divided into normal body weight group (BMI<24 kg/m 2) and overweight group (BMI≥24 kg/m 2) according to BMI, and were followed up for 3 years. The occupational health examination of the workers was carried out every year, blood routine and blood biochemical indexes were collected, and the information of the workers' age, BMI, type of work and age of exposure to injury were collected through field questionnaires. The noise intensity of the workplace of the enterprise was measured for 3 consecutive years, and the equivalent sound level was calculated according to the working time. Normal and skewness measurements were described by Mean±SD and [ M ( Q1, Q3) ], respectively. t-test or Wilcoxon rank sum test was used for inter-group comparisons. Categorical variables were expressed by frequency and percentage (%), and Chi-square test was used for inter-group comparisons. Mixed effects models and generalized estimation equations were fitted to analyze the relationship between occupational noise, systemic inflammation, and their interaction terms with blood pressure and hypertension risk. Results:Univariate analysis revealed that the white blood cell counts, neutrophil counts, lymphocyte counts and eosinophil counts were positively associated with systolic blood pressure and diastolic blood pressure in overweight group ( n=467), respectively ( P<0.05). The participants with white blood cell counts≥5.94×10 9/L, neutrophil counts≥3.31×10 9/L, lymphocyte counts ≥2.03×10 9/L, and eosinophil counts ≥0.12×10 9/L had increased risk of hypertension by 52% ( RR=1.52, 95% CI: 1.11-2.05), 37% ( RR=1.37, 95% CI: 1.01-1.83), 58% ( RR=1.58, 95% CI: 1.18-2.09), and 52% ( RR=1.52, 95% CI: 1.12-2.06), respectively (all P<0.05). Multivariate analysis found a positive association between BMI and the risk of hypertension in the overweight group ( P<0.05), the participants with lymphocyte counts≥2.03×10 9/L and eosinophil counts≥0.12×10 9/L had increased risk of hypertension by 39% ( RR=1.39, 95% CI: 1.01-1.89) and 46% ( RR=1.46, 95% CI: 1.06-1.98), respectively (all P<0.05). There was no correlation between BMI and the risk of hypertension in normal weight group ( P>0.05). The multiplicative interaction of occupational noise (≥80 dB) with white blood cell counts (≥5.94×10 9/L) and lymphocyte counts (≥2.03×10 9/L) increased the risk of hypertension by 100% ( RR=2.00, 95% CI: 1.06-3.55) and 89% ( RR=1.89, 95% CI: 1.01-3.32) (all P<0.05) in overweight group, respectively. Additionally, a significant additive interaction was observed between noise exposure (≥80 dB) and basophil counts (≥0.03×10 9/L) on hypertension risk in the overweight group (RERI=0.49, 95% CI: 0.02-0.96, P<0.05) . Conclusion:The combined exposure of occupational noise and systemic inflammation may increase the risk of hypertension in overweight workers in automobile manufacturing plants, and the two have additive and multiplicative interactions.

Objective:To explore the application effects of the mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice" in the teaching of spinal surgery.Methods:A total of 64 eight-year program clinical medical students who practiced in Peking Union Medical College Hospital in 2021 were taken as research objects and randomly divided into experimental group ( n=33) and control group ( n=31). The experimental group received the new teaching mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice", and the control group received regular teaching mode. At the end of teaching, the teaching effects were evaluated from several aspects, including the scores of theoretical examinations, anatomical marks identification tests, and anonymous questionnaires. SPSS 22.0 software was used for paired t-test and two independent-samples t-test. Results:The theoretical test scores [(51.25±6.99) points] and anatomical structure identification scores [(37.56±1.83) points] of the experimental group were higher than those of the control group [(42.46±6.13) points and (30.37±3.46) points], and the differences were statistically significant ( P<0.001). The effective recovery rate of the questionnaire was 100%. The results of the questionnaire showed that the experimental group was significantly higher than the control group in terms of teaching attractiveness, attention, learning interest, learning efficiency, anatomical identification ability, problem-finding and problem-solving ability and overall teaching method satisfaction ( P<0.05). Conclusion:The teaching mode of "Multidisciplinary integration, Doctors & patients co-teaching, Simulated practice" can effectively improve students' theoretical knowledge, learning interest, learning efficiency, operation proficiency and problem-finding and problem-solving ability, which is worth promoting.

Objective To establish an ELISA for quantitative determination of decoy receptor 3 (DcR3) in human plasma.Methods A solid phase double antibody sandwich method was established for quantitative determination of DcR3.The anti-DcR3 antibody was immobilized onto ELISA plate.DcR3 in samples was captured by anti-DcR3 on ELISA plate and then detected by biotin-anti-DcR3 and subsequent peroxidase-labeled streptavidin,and the color was developed by adding substrate.The standard DcR3 samples on the same plate were detected simultaneously to calculate the DcR3 concentrations in unknown samples.The sensitivity,specificity,precision,recovery,linearity and DcR3 range in normal human adults were assessed.Results The sensitivity of the developed assay was 0.051 ng/mL.The intra-coefficient of variation (CV) was less than 10％ and inter-CV was less than 15％.The average recovery rate was 90.50％.When 2-fold amount of anti-TNF-α was added into the coated antibodies,10-fold amount of biotin-labeled anti-LIGHT,antiFAS or anti-TNF-α was added into the detection antibodies,or 10 fold amount of purified LIGHT protein was added into the standard DcR3 samples as competitor,no disturbing effects on standard curve were found.The linear range of the assay was from 0.25 to 16 ng/mL (r≥0.98).The concentration of DcR3 tested in 128 plasma samples from healthy adults was (0.21 ± 0.05) ng/mL with 95％ CI ranged from 0.14 to 0.28 ng/mL and no difference of age and sex was found.Conclusion The established ELiSA for determining plasma DcR3 exhibited high specificity,sensitivity,precision,fine linearity and wide detecting range.This method could be used for quantification of DcR3 in plasma.

Objective To explore the effect of multi-channel minimally invasive percutaneous nephrolithotomy in the treatment of patients with complex renal calculi in Ⅰ stage.Methods Totally 80 patients with complex renal calculi were divided into two groups according to different treatment methods.Control group was treated with single-channel minimally invasive percutaneous nephrolithotomy,while observation group was treated with multi-channel minimally invasive percutaneous nephrolithotomy.Intra-operative related conditions,postoperative comfort,pain degree and postoperative complications were compared between the two groups.Results Compared with the control group,the observation group had shorter operative time,less intra-operative blood loss,shorter postoperative hospital stay,and higher stone clearance rate in Ⅰ stage (P ＜ 0.05).There was no significant differences in the degree of pain and comfort between the two groups at 12 and 48 h after operation (P ＞ 0.05).The total incidence rate of complications in the observation group was 5 ％,which was significantly lower than 25％ of the control group (P ＜ 0.05).Conclusion For the patients with complex renal calculi,multi-channel minimally invasive percutaneous nephrolithotomy can improve the clearance rate of calculus and reduce the incidence of postoperative complications.

Objective To explore the effect of multi-channel minimally invasive percutaneous nephrolithotomy in the treatment of patients with complex renal calculi in Ⅰ stage.Methods Totally 80 patients with complex renal calculi were divided into two groups according to different treatment methods.Control group was treated with single-channel minimally invasive percutaneous nephrolithotomy,while observation group was treated with multi-channel minimally invasive percutaneous nephrolithotomy.Intra-operative related conditions,postoperative comfort,pain degree and postoperative complications were compared between the two groups.Results Compared with the control group,the observation group had shorter operative time,less intra-operative blood loss,shorter postoperative hospital stay,and higher stone clearance rate in Ⅰ stage (P ＜ 0.05).There was no significant differences in the degree of pain and comfort between the two groups at 12 and 48 h after operation (P ＞ 0.05).The total incidence rate of complications in the observation group was 5 ％,which was significantly lower than 25％ of the control group (P ＜ 0.05).Conclusion For the patients with complex renal calculi,multi-channel minimally invasive percutaneous nephrolithotomy can improve the clearance rate of calculus and reduce the incidence of postoperative complications.

Objective The aim of this study was to determine the effect of a new method of cardiac assistant therapy with an extra-aortic balloon pump on the experimental dogs in which myocardial ischemia or infarction were induced, and to ob serve its effectiveness and feasibility. Methods Twelve animal models of myocardia 1 infarction were established with the method of left anterior descending coronary artery ligation. They were divided randomly into two groups, six in the experimental group and six in the untreated group. The end points observed were the differences between the two groups in the blood pressure, cardiac function, myocardial enzymes, infarction size and routine blood variables before procedure, 1,2, 3, 4, 5 and 6 hours after myocardial infarction. Results All six dogs in the experimental group were survived, with a mortality rate of 0.The number of death in the control group was three, with a mortality rate of 50%. Measurements such as mean blood pressure,cardiac output, cardiac index in the experimental group were better than those in the control group ( P ＜ 0.05 ). Mean heart rate before myocardial infarction in the experimental group was 156 beats per minute, as compared with 148 beats per minute in the control group, and was 128 vs. 67 beats per minute respectively six hours after myocardial infarction. The cardiac output was 3.48 vs. 4.98 liters per minute before myocardial infarction and was 6.10 vs. 0.85 liters per minute six hours after myocardial infarction. The average pressure was 94 mm Hg vs. 99 mm Hg before myocardial infarction and was 70 mm Hg vs. 33 mm Hg six hours after myocardial infarction. Conclusion The extra-aortic balloon pump significantly improved the hemodynamic variables of the experimental animals after myocardial infarction and reduced mortality. Injury to the blood cells may be the potential disadvantage.