Objective To evaluate the role of distortion product otoacoustic emissions (DPOAE) testing in evaluating early hearing loss among noise-exposed workers. Methods A total of 174 noise-exposed workers in a metal shipbuilding enterprise were selected as the research subjects by the convenience sampling method. Pure tone audiometry (PTA), DPOAE and the level of noise exposure were conducted on the workers. The rank correlation analysis was used to analyze the correlation between DPOAE amplitude and PTA threshold. The multilevel model was used to analyze the effects of gender, age, noise exposure intensity, cumulative noise exposure (CNE), hearing loss classification and PTA threshold on DPOAE results. Results At the frequencies of 0.50, 1.00, 2.00, 3.00, 4.00, 6.00 and 8.00 kHz, the DPOAE amplitude was negatively correlated with the PTA threshold (rank correlation coefficients were -0.12, -0.48, -0.47, -0.18, -0.23, -0.44, -0.19, respectively, all P<0.01). At the most frequencies, DPOAE amplitude was negatively correlated with age and CNE (all P<0.05). The results of multilevel model analysis showed that there were significant differences in DPOAE amplitudes at certain frequencies across gender, age, noise intensity, CNE, and hearing loss classification (all P<0.05). Significant differences in DPOAE responses were found among different CNE and hearing loss groups (all P<0.01). Conclusion DPOAE testing can objectively reflect the hearing status of noise-exposed workers and could be considered for inclusion in routine hearing monitoring to facilitate early detection of noise-induced hearing loss.

OBJECTIVE: Lipid oxidation is involved in the pathogenesis of atherosclerosis and may be contribute to the development of Ischemic stroke (IS). However, the lipid profiles associated with IS have been poorly studied. We conducted a pilot study to identify potential IS-related lipid molecules and pathways using lipidomic profiling. METHODS: Serum lipidomic profiling was performed using LC-MS in 20 patients with IS and 20 age- and sex-matched healthy controls. Univariate and multivariate analyses were simultaneously performed to identify the differential lipids. Multiple testing was controlled for using a false discovery rate (FDR) approach. Enrichment analysis was performed using MetaboAnalyst software. RESULTS: Based on the 294 lipids assayed, principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) models were used to distinguish patients with IS from healthy controls. Fifty-six differential lipids were identified with an FDR-adjusted P less than 0.05 and variable influences in projection (VIP) greater than 1.0. These lipids were significantly enriched in glycerophospholipid metabolism (FDR-adjusted P = 0.009, impact score = 0.216). CONCLUSIONS Serum lipid profiles differed significantly between patients with IS and healthy controls. Thus, glycerophospholipid metabolism may be involved in the development of IS. These results provide initial evidence that lipid molecules and their related metabolites may serve as new biomarkers and potential therapeutic targets for IS.
Humans ; Pilot Projects ; Lipidomics ; Male ; Female ; Biomarkers/blood* ; Middle Aged ; Ischemic Stroke/blood* ; Aged ; China ; Lipids/blood* ; Adult ; Case-Control Studies ; East Asian People

The number of patients with eye diseases in China is enormous,and the negative effects of these conditions,such as impaired visual function,psychological burdens,and restricted social participation,are becoming increasingly severe.Due to the limited and unevenly distributed ophthalmic resources,and the significant limitations of traditional diagnostic and therapeutic approaches in terms of accuracy and efficiency,there is an urgent need for more sensitive and efficient modalities.With the rapid advancement of artificial intelligence technology,ophthalmic diagnosis has entered a new stage of intelligent transformation.Facial photos,as a noninvasive and convenient medium,show unique advantages in eye disease diagnosis.Artificial intelligence systems based on facial photo analysis have been applied to the screening and diagnosis of conditions such as myopia,strabismus,ptosis,and thyroid eye disease,showing promising results.This review introduces the workflow of intelligent diagnosis for ocular diseases based on facial photographs,with a focus on recapitulating relevant research findings both domestically and internationally in recent years.It summarizes the innovative features and application advantages of intelligent diagnosis systems for eye diseases based on facial photos,analyzes the current technical bottlenecks and challenges in application,proposes corresponding countermeasures,and discusses future development directions,aiming to provide references and new insights for the intelligent screening and diagnosis of eye diseases.

OBJECTIVE To investigate the current status of prevalence of hand eczema(HE)among the health care workers,explore the influencing factors and analyze the association with hand hygiene.METHODS A questionnaire survey was conducted for the health care workers.The health care workers who had HE were followed up by the dermatology department and were completed the assessment of severity.Logistic regression analysis was per-formed for the influencing factors.RESULTS The questionnaires were distributed to the health care workers of Shanghai First Peoples Hospital in Jul.2024,and 659 valid questionnaires were recycled.The prevalence rate of HE by self-report was 37.03％in recent almost one year.The finger and dorsal hand were the predilection sites of skin damage,with the symptom dominated by itching;dryness,desquamation and vesicles were the primary man-ifestations of skin damage,most of which(64.81％)were moderate.Wearing gloves in work environment and contact with hand sanitizer and disinfectants could make the HE symptoms ever more severe.The use of hand san-itizer/frequent hand washing with soap lye and prolonged glove-wearing were the leading causes of HE.The nurses were dominant among the health care workers with HE(P=0.003),and the proportion of those with allergic his-tory was even higher(P＜0.001).As for the health care workers who washed hands for surgeries,high volume of daily surgical procedures(OR=1.325,95％CI:1.121 to 1.567)and glove-wearing duration more than 120 min(OR=3.177,95％CI:1.087 to 9.281)were the risk factors for HE.As for the common hand-washing health care workers,daily hand washing more than 15 times(OR=3.199,95％CI:1.014 to 10.137),glove-wearing dura-tion more than 120 min(OR=2.216,95％CI:1.117 to 4.391)and use of powdered latex glove(OR=1.591,95％CI:1.058 to 2.390)were the risk factors for HE.CONCLUSION The prevalence rate of HE is high among the health care workers.It is necessary to attach great importance to the hand skin health of the health care work-ers and take comprehensive intervention measures for prevention of HE such as optimization of hand hygiene pro-cedure,enhancement of barrier protection and stress on occupational health education so as to achieve the dual goals of infection control and skin health.

OBJECTIVE To investigate the current status of prevalence of hand eczema(HE)among the health care workers,explore the influencing factors and analyze the association with hand hygiene.METHODS A questionnaire survey was conducted for the health care workers.The health care workers who had HE were followed up by the dermatology department and were completed the assessment of severity.Logistic regression analysis was per-formed for the influencing factors.RESULTS The questionnaires were distributed to the health care workers of Shanghai First Peoples Hospital in Jul.2024,and 659 valid questionnaires were recycled.The prevalence rate of HE by self-report was 37.03％in recent almost one year.The finger and dorsal hand were the predilection sites of skin damage,with the symptom dominated by itching;dryness,desquamation and vesicles were the primary man-ifestations of skin damage,most of which(64.81％)were moderate.Wearing gloves in work environment and contact with hand sanitizer and disinfectants could make the HE symptoms ever more severe.The use of hand san-itizer/frequent hand washing with soap lye and prolonged glove-wearing were the leading causes of HE.The nurses were dominant among the health care workers with HE(P=0.003),and the proportion of those with allergic his-tory was even higher(P＜0.001).As for the health care workers who washed hands for surgeries,high volume of daily surgical procedures(OR=1.325,95％CI:1.121 to 1.567)and glove-wearing duration more than 120 min(OR=3.177,95％CI:1.087 to 9.281)were the risk factors for HE.As for the common hand-washing health care workers,daily hand washing more than 15 times(OR=3.199,95％CI:1.014 to 10.137),glove-wearing dura-tion more than 120 min(OR=2.216,95％CI:1.117 to 4.391)and use of powdered latex glove(OR=1.591,95％CI:1.058 to 2.390)were the risk factors for HE.CONCLUSION The prevalence rate of HE is high among the health care workers.It is necessary to attach great importance to the hand skin health of the health care work-ers and take comprehensive intervention measures for prevention of HE such as optimization of hand hygiene pro-cedure,enhancement of barrier protection and stress on occupational health education so as to achieve the dual goals of infection control and skin health.

The number of patients with eye diseases in China is enormous,and the negative effects of these conditions,such as impaired visual function,psychological burdens,and restricted social participation,are becoming increasingly severe.Due to the limited and unevenly distributed ophthalmic resources,and the significant limitations of traditional diagnostic and therapeutic approaches in terms of accuracy and efficiency,there is an urgent need for more sensitive and efficient modalities.With the rapid advancement of artificial intelligence technology,ophthalmic diagnosis has entered a new stage of intelligent transformation.Facial photos,as a noninvasive and convenient medium,show unique advantages in eye disease diagnosis.Artificial intelligence systems based on facial photo analysis have been applied to the screening and diagnosis of conditions such as myopia,strabismus,ptosis,and thyroid eye disease,showing promising results.This review introduces the workflow of intelligent diagnosis for ocular diseases based on facial photographs,with a focus on recapitulating relevant research findings both domestically and internationally in recent years.It summarizes the innovative features and application advantages of intelligent diagnosis systems for eye diseases based on facial photos,analyzes the current technical bottlenecks and challenges in application,proposes corresponding countermeasures,and discusses future development directions,aiming to provide references and new insights for the intelligent screening and diagnosis of eye diseases.

Objective To observe the clinical efficacy of external application of Liangxue Chushi Zhiyang Powder(composed of Isatidis Folium,Chrysanthemi Flos,Sophorae Flavescentis Radix,Schizonepetae Spica,and Zanthoxyli Pericarpium,etc.)in the treatment of facial dermatitis,and to analyze its effect on skin barrier function of the patients.Methods Seventy-two patients with facial dermatitis were randomly divided into the control group and the observation group,with 36 cases in each group.The control group was treated with Butyl Flufenamic Ointment for external use and Ebastine Tablets orally,while the observation group was given cold and wet compress of Liangxue Chushi Zhiyang Powder on the basis of treatment for the control group.The course of treatment of both groups covered three weeks.Before and after the treatment,the changes of subjective and objective symptom scores as well as skin barrier function indicators of the two groups were observed.After treatment,the clinical efficacy and incidence of adverse reactions of the two groups were assessed.Results(1)After three weeks of treatment,the total effective rate of the observation group was 75.00%(27/36),and that of the control group was 47.22%(17/36);the intergroup comparison showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group(χ2=5.844,P＜0.05).(2)After treatment,the scores of objective symptoms such as erythema,inflammatory papules,desquamation,swelling,and lesion area in the two groups were significantly decreased when compared with those before treatment(P＜0.05),and the decrease of the scores of erythema,inflammatory papules and lesion area in the observation group was significantly superior to that in the control group(P＜0.05).The differences in the scores of desquamation and swelling between the two groups were not statistically significant(P＞0.05).(3)After treatment,the scores of subjective symptoms such as itching,burning,stabbing pain,dryness/tightness of the skin in the two groups were significantly decreased when compared with those before treatment(P＜0.05),and the decrease of the scores of each subjective symptom in the observation group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the skin barrier function indicators such as trans-epidermal water loss(TEWL)and skin pH value of the two groups were significantly lowered(P＜0.05),and stratum corneum hydration(SCH)and sebum(SEB)content were significantly increased when compared with those before treatment(P＜0.05).The decrease of TEWL and pH value as well as the increase of SCH and SEB content in the observation group was significantly superior to that in the control group(P＜0.05).(5)During the treatment,no serious adverse reactions occurred in the two groups of patients.The incidence of adverse reactions in the observation group was 8.33%(3/36),and that in the control group was 5.66%(2/36),and the difference was not statistically significant(χ2=0.215,P＞0.05).Conclusion The cold and wet compress of Liangxue Chushi Zhiyang Powder exerts certain efficacy in the treatment of facial dermatitis,which is effective on markedly relieving the subjective and objective symptoms of the patients,and improving the skin barrier function,with few and mild adverse reaction.

Objective:To detect the level of the circulating cell-free mitochondrial DNA (ccf-mtDNA) in plasma of children with primary carnitine deficiency (PCD)-associated cardiomyopathy and evaluate its clinical significance.Methods:In this prospective case-control study, peripheral blood samples were collected from 7 PCD patients with cardiomyopathy (PCD group), 16 dilated cardiomyopathy (DCM) patients (DCM group), and 50 healthy children (healthy control group) in the Pediatric Cardiovascular Department Ward of First Hospital of Jilin University from July 2017 to June 2022.The ccf-mtDNA levels were measured and compared between groups by the real-time fluorescence quantitative polymerase chain reaction.The correlations between plasma ccf-mtDNA level and blood free carnitine level and cardiac function in the PCD group were analyzed.The changes in the ccf-mtDNA level were monitored after L-carnitine treatment in the PCD group.The Kruskal-Wallis test was used for comparison among the three groups.The Mann-Whitney test was used for comparison between the PCD group and the control group.Changes before and after treatment in the PCD group were analyzed using the paired Wilcoxon rank sum test.The correlation between variables was evaluated by Logistic regression.Results:The plasma ccf-mtDNA levels in the PCD and DCM groups were 3.69×10 6 (1.09×10 6-7.26×10 6) copies/L and 0.99×10 6 (0.25×10 6-4.10×10 6) copies/L, respectively, which were significantly higher than that in the healthy control group[0.09×10 6 (0.01×10 6-0.35×10 6) copies/L]( H=33.34, 24.69; all P<0.01). Besides, the plasma ccf-mtDNA level in the PCD group was higher than that in the DCM group ( H=6.31, P<0.05). In the PCD group, the plasma ccf-mtDNA level was negatively correlated with the blood free carnitine level and left ventricular ejection fraction ( r=-0.85, -0.82, all P<0.05) and positively correlated with the modified Ross score and the N-terminal pro B type natriuretic peptide level ( r=0.81, 0.83, all P<0.05) before L-carnitine treatment.After treatment, the plasma ccf-mtDNA level decreased, and the blood free carnitine level and cardiac function recovered in the PCD group.The plasma ccf-mtDNA level declined sharply from the 3 rd month[0.96×10 6(0.50×10 6-2.27×10 6) copies/L] after treatment ( Z=2.24, P<0.05) and got to 0.27×10 6 (0.18×10 6-0.76×10 6) copies/L, 0.29×10 6(0.19×10 6-0.78×10 6) copies/L, and 0.16×10 6(0.10×10 6-1.06×10 6) copies/L at the 6 th, 9 th, and 12 th months after treatment, respectively, with no statistically significant difference compared to the healthy control group[0.09×10 6(0.01×10 6-0.35×10 6) copies/L] ( Z=1.23, 1.09, 2.12; all P>0.05). Conclusions:Plasma ccf-mtDNA may act as one pathogenic factor of cardiomyopathy in PCD, and monitoring its level is clinically important for heart condition assessment in PCD.

Objective To analyze the efficacy of bevacizumab combined with paclitaxel+carboplatin in the treatment of recurrent/metastatic cervical cancer,and to explore the influence on survival prognosis of patients.Methods Patients with recurrent/metastatic cervical cancer were divided into control group and treatment group according to different treatment methods.The control group received paclitaxel combined with carboplatin chemotherapy regimen(intravenous infusion of 170 mg·m-2 paclitaxel and carboplatin(AUC=5 mg·mL-1·min)for 3 weeks as a course of chemotherapy),and the treatment group was given bevacizumab on the basis of control group,intravenous infusion of 15 mg·kg-1 bevacizumab,once every 3 weeks.Both groups were treated for 3 cycles of treatment by taking 3 weeks as 1 treatment cycle.The clinical efficacy,levels of serum tumor markers,quality of life,survival prognosis and occurrence of drug-related adverse reactions during treatment were compared between the two groups.Results There were 41 cases in treatment group and 48 cases in control group.After treatment,the overall response rate(ORR)of treatment group and control group were 31.71％(13 cases/41 cases)and 14.58％(7 cases/48 cases),with no statistical significance(P＞0.05).After treatment,the disease control rate(DCR)in control group and treatment group were 62.50％(30 cases/48 cases)and 82.93％(34 cases/41 cases);the squamous cell carcinoma antigen(SCCA)levels were(3.58±0.73)and(2.52±0.57)ng·mL-1;carbohydrate antigen 19-9(CA19-9)levels were(23.60±4.29)and(19.19±3.72)U·mL-1;carbohydrate antigen 15-3(CA15-3)levels were(27.13±5.36)and(22.86±3.94)U·mL-1;carbohydrate antigen 125(CA125)levels were(39.24±6.88)and(26.47±5.09)U·mL-1;the overall improvement rates of quality of life were 41.67％(20 cases/48 cases)and 73.17％(30 cases/41 cases),the progression-free survival times were 8.67 months(95％CI:7.82-9.53)and 10.25 months(95％CI:9.68-10.81),the total survival times were 9.96 months(95％CI:9.13-10.79)and 11.47 months(95％CI:11.00-11.93),all with significant difference(all P＜0.05).There were no statistically significant differences in the incidence of nausea and vomiting,leukopenia,thrombocytopenia and liver-kidney function impairment between both groups(all P＞0.05).Conclusion Bevacizumab combined with chemotherapy has significant efficacy in the treatment of recurrent/metastatic cervical cancer,and it can reduce the levels of serum tumor markers,enhance the quality of life,and improve the survival prognosis,and it has good safety.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.