Objective:To understand the current status of the actual protective effect of respiratory protective equipment (RPE) for workers exposed to trichloroethylene (TCE), and to explore the factors affecting the actual protective effect.Methods:From July to December 2023, a total of 75 workers occupationally exposed to TCE from 21 hardware and electronics manufacturing facilities in a province were selected as research objects by convenient sampling method. Workplace protection factor (WPF) was used as an index to evaluate the actual protective effect of workers' RPE. The concentration of TCE inside and outside the RPE was detected to calculate WPE, and the temperature, humidity and wind speed near the working place were measured, as well as the forced vital capacity, respiratory rate, heart rate and other indicators of the worker were measured. The log-transformed WPF value (lgWPF) followed a normal distribution. One-sample t-test was used to compare the difference between the mean lgWPF and the log value of the assigned protection factor (APF) of the half mask (lgAPF=1). Multiple linear regression model was used to investigate the influencing factors of lgWPF. Results:The lgWPF of 75 TCE-exposed workers ranged from 0.40 to 1.32 (0.84±0.22). The mean of lgWPF was lower than that of lgAPF, and the difference was statistically significant ( t=-6.37, P<0.001). After adjusting for confounding factors, the results of multiple linear regression showed that humidity, forced vital capacity and respiratory rate were negatively correlated with lgWPF ( β=-0.008, -0.079, -0.021, P<0.05) . Conclusion:The actual protective efficacy of RPE among workers exposed to TCE is suboptimal. High humidity, elevated forced vital capacity, and increased respiratory rate may be contributing factors to the diminished protective performance of RPE.

This article aims to summarize the nursing experience of a patient with Hashimoto's encephalopathy accompanied by cerebral edema and epileptic seizures.The key nursing points:to strengthen nursing care for cerebral edema and intracranial hypertension to reduce brain injury;to comprehensively manage epileptic seizures to prevent and control serious complications;to carry out personalized Double Filtration Plasmapheresis nursing to optimize treatment effectiveness;to take proactive nursing measures to reduce the risk of infection;to implement multiple forms of psychological care to alleviate negative emotions of the patient and his families;to provide health guidance and regular follow-up to enhance the disease management capabilities of patients and his families.After 27 days of active treatment and meticulous care,the patient recovered and was discharged,with a good recovery during follow-up.

Objective:To investigate the use of earplugs among noise-exposed workers (Homo sapiens) in Bao'an District, Shenzhen, measure the personal attenuation rating (PAR) of earplugs when wearing earplugs, (Homo sapiens), analyze factors influencing the protective effect of earplugs, and evaluate the role of targeted wearing interventions in improving protective efficacy.Methods:From December 2022 to January 2023, 220 workers in noise-exposed positions from 3 enterprises in Bao'an District, Shenzhen were selected as subjects using the convenience sampling method. The Personal Attenuation Rating (PAR) values of workers wearing earplugs were measured using a fit testing system. Combined with the results of a questionnaire survey, the individual differences in workers' baseline PAR were described. A multivariate logistic regression model was used to analyze the influencing factors for earplugs to achieve the protective effect. One-on-one wearing interventions were implemented for workers who failed to achieve the protective effect, and repeated PAR tests were conducted. The changes in PAR of 120 workers before and after the intervention were compared.Results:The median baseline PAR for 220 workers was 7 (0, 14) dB, and the intervention rate was 54.55% (120/220). There were differences in the baseline PAR of workers with different length of service, earplugs wearing time and experience, daily noise exposure time and intensity, training and the comfort of earplug use ( P<0.05). The results of multivariate regression analysis showed that workers The comfort with earplugs wearing ( OR=2.81, 95% CI: 1.49~5.33, P<0.01) and training ( OR=6.60, 95% CI: 1.70~25.63, P<0.05) were the influencing factors of achieving the protective requirement. The median PAR was increased to 13 (11, 16) dB after intervention. Conclusion:The baseline protective effect of earplugs worn by workers is significantly influenced by comfort and enterprise training. One-on-one interventions can effectively improve the protective efficacy of those who fail to meet the requirements.

Objective:To investigate the use of earplugs among noise-exposed workers (Homo sapiens) in Bao'an District, Shenzhen, measure the personal attenuation rating (PAR) of earplugs when wearing earplugs, (Homo sapiens), analyze factors influencing the protective effect of earplugs, and evaluate the role of targeted wearing interventions in improving protective efficacy.Methods:From December 2022 to January 2023, 220 workers in noise-exposed positions from 3 enterprises in Bao'an District, Shenzhen were selected as subjects using the convenience sampling method. The Personal Attenuation Rating (PAR) values of workers wearing earplugs were measured using a fit testing system. Combined with the results of a questionnaire survey, the individual differences in workers' baseline PAR were described. A multivariate logistic regression model was used to analyze the influencing factors for earplugs to achieve the protective effect. One-on-one wearing interventions were implemented for workers who failed to achieve the protective effect, and repeated PAR tests were conducted. The changes in PAR of 120 workers before and after the intervention were compared.Results:The median baseline PAR for 220 workers was 7 (0, 14) dB, and the intervention rate was 54.55% (120/220). There were differences in the baseline PAR of workers with different length of service, earplugs wearing time and experience, daily noise exposure time and intensity, training and the comfort of earplug use ( P<0.05). The results of multivariate regression analysis showed that workers The comfort with earplugs wearing ( OR=2.81, 95% CI: 1.49~5.33, P<0.01) and training ( OR=6.60, 95% CI: 1.70~25.63, P<0.05) were the influencing factors of achieving the protective requirement. The median PAR was increased to 13 (11, 16) dB after intervention. Conclusion:The baseline protective effect of earplugs worn by workers is significantly influenced by comfort and enterprise training. One-on-one interventions can effectively improve the protective efficacy of those who fail to meet the requirements.

This article aims to summarize the nursing experience of a patient with Hashimoto's encephalopathy accompanied by cerebral edema and epileptic seizures.The key nursing points:to strengthen nursing care for cerebral edema and intracranial hypertension to reduce brain injury;to comprehensively manage epileptic seizures to prevent and control serious complications;to carry out personalized Double Filtration Plasmapheresis nursing to optimize treatment effectiveness;to take proactive nursing measures to reduce the risk of infection;to implement multiple forms of psychological care to alleviate negative emotions of the patient and his families;to provide health guidance and regular follow-up to enhance the disease management capabilities of patients and his families.After 27 days of active treatment and meticulous care,the patient recovered and was discharged,with a good recovery during follow-up.

Objective:To understand the current status of the actual protective effect of respiratory protective equipment (RPE) for workers exposed to trichloroethylene (TCE), and to explore the factors affecting the actual protective effect.Methods:From July to December 2023, a total of 75 workers occupationally exposed to TCE from 21 hardware and electronics manufacturing facilities in a province were selected as research objects by convenient sampling method. Workplace protection factor (WPF) was used as an index to evaluate the actual protective effect of workers' RPE. The concentration of TCE inside and outside the RPE was detected to calculate WPE, and the temperature, humidity and wind speed near the working place were measured, as well as the forced vital capacity, respiratory rate, heart rate and other indicators of the worker were measured. The log-transformed WPF value (lgWPF) followed a normal distribution. One-sample t-test was used to compare the difference between the mean lgWPF and the log value of the assigned protection factor (APF) of the half mask (lgAPF=1). Multiple linear regression model was used to investigate the influencing factors of lgWPF. Results:The lgWPF of 75 TCE-exposed workers ranged from 0.40 to 1.32 (0.84±0.22). The mean of lgWPF was lower than that of lgAPF, and the difference was statistically significant ( t=-6.37, P<0.001). After adjusting for confounding factors, the results of multiple linear regression showed that humidity, forced vital capacity and respiratory rate were negatively correlated with lgWPF ( β=-0.008, -0.079, -0.021, P<0.05) . Conclusion:The actual protective efficacy of RPE among workers exposed to TCE is suboptimal. High humidity, elevated forced vital capacity, and increased respiratory rate may be contributing factors to the diminished protective performance of RPE.

Objective To evaluate the intraoperative identification of ectopic parathyroid tissue in the central neck region using autofluorescence point-spectral analysis(AFPSA)combined with immune colloidal gold technique(ICGT),for guiding total parathyroidectomy(TPTX)or clean parathyroidectomy(CPTX)in the management of secondary hyperparathyroidism(SHPT).Methods Retrospectively collected and compared the clinical data of 64 patients with SHPT from October 2019 to June 2023.In the observation group,TPTX was performed as the initial procedure in 36 cases,followed by sampling of suspicious targets using AFPSA in the central neck area and subsequent detection through ICGT.CPTX was then conducted if a positive result was obtained.On the other hand,the control group consisted of 28 cases where only TPTX was performed without any additional tests during surgery.The surgical data,parathyroid hormone(PTH)levels,blood calcium levels,blood phosphorus levels,alkaline phosphatase(ALP)levels,regression of clinical symptoms,changes in parathyroid function and occurrence of hypocalcemia were compared between these two groups.Results In the observation group,there were 9 cases of AFPSA-ICGT positivity,including 2 left-sided cases,4 right-sided cases,and 3 thymic cases;among these posi-tive cases,there were a total of 10 locations with mildly hyperplastic or nonhyperplastic microscopic parathyroid tissue.The difference in the number of total parathyroid glands removed(including ectopic)between the two groups was statistically significant(P<0.05).At both 3 and 6 months postoperatively,ALP levels in the observation group were significantly lower than those in the control group(P<0.01 and P<0.001 respectively);at 6 months postoperatively,differences in PTH and blood phosphorus levels between the two groups were also statistically significant(P<0.05 and P<0.001 respectively).Joint bone pain and skin itching recurred in some patients within the control group at six months after surgery(P<0.05),whereas recurrence of SHPT was less frequent within the observation group compared to controls(P<0.05);however,no statistically significant differences were observed regarding postoperative hypoparathyroidism or hyperparathyroidism as well as hypocalcemia between either groups.Conclusion The AFPSA-ICGT intraoperative test can be utilized to guide surgery for SHPT,enabling accurate and efficient identification as well as safe targeting of parathyroid tissues that may not exhibit obvious hyperplasia in the central cervical region.

Objective To explore the value of coronary fat attenuation index(FAI)combined with laboratory indicators in predicting the risk of acute coronary syndrome(ACS)in patients with coronary heart disease(CHD).Methods A retrospective analysis was conducted on 454 patients who were diagnosed with CHD in Guangdong Provincial People's Hospital SCAD group(n=233)and an ACS group(n=221).Univariate and multivariate Logistic regression analyses were performed on the FAI values of the main coronary branches[right coronary artery(RCA),left anterior descending branch(LAD),left circumflex branch(LCX)],laboratory indicators,and clinical data,to identify independent risk factors for ACS in CHD patients.Receiver operating characteristic curves were constructed,and area under the curve(AUC)was calculated to evaluate the predictive performance of the independent risk factors and their combinations.Results LAD-FAI,RCA-FAI,and high-sensitivity C-reactive protein(hs-CRP)were independent influencing factors for ACS in CHD patients.The AUC for the prediction of ACS occurrence in CHD patients based on LAD-FAI,RCA-FAI,and elevated hs-CRP values alone were 0.568,0.703,and 0.749,respectively.When these three factors were analyzed in combination,the AUC was 0.815.Conclusion The combined analysis of LAD-FAI,RCA-FAI,and hs-CRP has good predictive performance for assessing the risk of ACS in CHD patients.

Objective To explore the muscle force characteristics of the knee joint during a Taekwondo roundhouse kick in Korea.Methods Kinematic and dynamic data from twelve elite Taekwondo athletes were collected using the DaeDo electronic scoring system,Vicon optical motion capture system,Kistler three-dimensional force plates.The OpenSim software was used to simulate these movements and calculate the muscle forces,joint torques,joint stiffness,and muscle coordination patterns of the knee.Results During the knee-lifting and striking phases,the coronal torque of the knee joint in the attacking leg was significant,and the sagittal torque peaked during the strike.For the supporting leg,the highest coronal torque of the knee joint occurred during knee lifting,with the sagittal torque reaching its peak during strike.In terms of muscle activity,the semimembranosus and long head of the biceps femoris in the attacking leg exerted greater force during the striking phase,whereas the semimembranosus and medial head of the gastrocnemius in the supporting leg were more active during the recovery phase.Five muscle synergy patterns were observed during the Taekwondo roundhouse kick.Conclusions Significant differences were found in the muscle forces and knee joint torques of the attacking and supporting legs when athletes performed the roundhouse kick,and there was a complex muscle synergy.

Objective To develop a nomogram for predicting the risks of early anastomotic recurrence(EAR)after primary bowel resection in patients with Crohn's disease(CD).Methods The patients with CD under-going preoperative magnetic resonance enterography(MRE)and primary bowel resection were enrolled in this retrospective study and divided into an EAR group(18 patients)and EAR-free group(12 patients).The EAR group included the patients having an endoscopic Rutgeerts score of≥I2 month or the need for anastomotic resection within 12 months after surgery.All the 38 indexes including preoperative demographic characteristics,laboratory examina-tions,multi-parameter MRE features of the resected intestine and its adjacent mesentery,histological findings,and postoperative pharmacotherapy were analyzed.Least absolute shrinkage and selection operator(LASSO)regression and multivariate binary logistic regression analysis were performed to identify independent risk factors to be incorpo-rated into the nomogram for predicting the risks of early anastomotic recurrence and the prediction performance was evaluated.Results Mesenteric creeping fat index on MRE and comb sign were independent risks of EAR,with a concordance index of 0.882(95%CI:0.764～1).The calibration plot revealed a strong relationship between actual observation and predicted probability of EAR.Conclusions The preoperative MRE-based nomogram may be a potential tool for predicting EAR following surgery in patients with CD,which is beneficial to individual management in those patients.It provides reference for the formulation of early postoperative individualized drug adjuvant therapy in patients at high risk of EAR.