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.

Objective To assess the risk of hearing loss caused by occupational noise exposure in workers in an automobile manufacturing plant in Tianjin, China, and to perform risk management. Methods Occupational health field investigation and noise exposure measurements were conducted from July to December 2023, and physical examination data were collected. ISO 1999:2013(E) Acoustics-Estimation of Noise-Induced Hearing Loss and WS/T 754-2016 ^“Guidelines for Risk Management of Occupational Disease Hazards Caused by Noise^” were used to predict the risk of high-frequency hearing loss and occupational noise induced deafness for operational workers and make a risk classification. Results The noise intensity of each workshop was 79.4 to 95.5 dB(A), and the maximum noise intensity of welding and stamping exceeded the standard. The results of the assessment showed that the noise level remained unchanged, and the risk of HFHL and ONID in workers increased as the predicted age and length of service increased. It was predicted that after the age of 40, the maximum risk of hearing loss in welding workers would be high risk, and the risk of stamping workers would be at higher risk, suggesting that welding and stamping were the key control posts of noise hazards in the enterprise. The N50 prediction values of permanent hearing threshold displacement caused by potential noise at all frequencies for final assembly and painting workers were lower than the measured values. Conclusion The consequences of hearing loss for workers in the welding and stamping shop noise operations at this automobile manufacturing plant are relatively serious and require risk management.

Objective To investigate the relationship between the expression of platelet autophagy related factors and peritoneal metastasis of gastric cancer.Methods The data of 360 patients with gastric cancer who underwent surgery in Hunan Provincial People's Hospital from January 2021 to May 2023 were reviewed.Patients were divided into non-peritoneal metastasis group(n=322)and peritoneal metastasis group(n=38)according to whether peritoneal metastasis occurred or not.The following information was collected:patient's personal information(i.e.age,sex,body mass index)and tumor characteristics(i.e.location,size,pathological type,histopathological differentiation,lymphatic infiltration).Platelets were collected from all subjects,and the levels of autophagy-associated protein 7(ATG7),benzalkonium chloride 1(BECN1),microtubule-associated protein 1 light chain 3(LC3)and sequestosome 1(p62)were measured by enzyme-linked immunosorbent assay(ELISA).Results Among the 360 patients included,peritoneal metastasis was detected in 38 cases.Compared with the non-peritoneal metastasis group,the peritoneal metastasis group exhibited decreased BMI(P<0.05),while the tumor size,non-ulcerative tumor,number of lymph node metastasis,infiltration depth,number of cases of lymphatic invasion,platelet count,platelet LC3-Ⅱ level,platelet ATG7 level and CEA level were increased(P<0.05).Multivariate logistic regression analysis showed that BMI(OR=1.094),lymphatic invasion(OR=2.658),and LC3-Ⅱ(OR=3.793)and ATG7(OR=2.010)were independent influencing factors for peritoneal metastasis in patients with gastric cancer(P<0.05).LC3-Ⅱ>2.59ng/ml had the highest ability to predict peritoneal metastasis in patients with gastric cancer(AUC=0.932),followed by ATG7(AUC=0.916).Conclusions Elevated levels of platelet LC3-Ⅱ and ATG7 are independently related to peritoneal metastasis in patients with gastric cancer,and can be used to predict the occurrence of peritoneal metastasis,which is helpful to guide individualized treatment.

Objective:To analyze the risk factors of cardiac arrest during pre-hospital emergency treatment,and to construct the corresponding nomogram model.Methods:A retrospective analysis was performed on 159 patients who were dispatched by our center and received pre-hospital emergency treatment from Jan 2021 to Jan 2023.As the modeling group,these patients were divided into the occurrence group(n=54)and the non-occurrence group(n=105)according to whether they had cardiac arrest.According to the ratio of modeling group∶validation group=1.2∶1.0,132 patients who were dispatched and received pre-hospital emergency treatment by our center from Feb 2023 to Oct 2024 were selected as the validation group.They were divided into the occurrence group(n=45)and the non-occurrence group(n=87).Multivariable Logistic regression analysis was employed to investigate the factors influencing pre-hospital cardiac arrest and to construct a predictive model.The value of the predictive model was evaluated using receiver operating characteristic(ROC)curve,calibration curve,and decision curve.Results:Multivariate Logistic regression analysis showed that age＞59 years old(OR=0.658,95%CI:0.559-0.773),rescue arrival time＞10 min(OR=7.699,95%CI:3.013-19.675)and non-standard pre-hospital emergency measures(OR=2.807,95%CI:1.150-6.853)were independent risk factors for pre-hospital emergency cardiac arrest(P＜0.05).The nomogram model constructed according to the above factors was verified,and the C-index of the modeling group and verification group model was 0.798(95%CI:0.749-0.847)and 0.794(95%CI:0.740-0.848),respectively,which proved that the prediction efficiency of this model was good,and the decision curve showed good clinical benefit.Conclusion:Age＞59 years old,rescue arrival time＞10 min,and non-standard pre-hospital emergency measures are independent risk factors for pre-hospital emergency cardiac arrest,and the constructed prediction model has good clinical application.

Objective:To analyze the risk factors of cardiac arrest during pre-hospital emergency treatment,and to construct the corresponding nomogram model.Methods:A retrospective analysis was performed on 159 patients who were dispatched by our center and received pre-hospital emergency treatment from Jan 2021 to Jan 2023.As the modeling group,these patients were divided into the occurrence group(n=54)and the non-occurrence group(n=105)according to whether they had cardiac arrest.According to the ratio of modeling group∶validation group=1.2∶1.0,132 patients who were dispatched and received pre-hospital emergency treatment by our center from Feb 2023 to Oct 2024 were selected as the validation group.They were divided into the occurrence group(n=45)and the non-occurrence group(n=87).Multivariable Logistic regression analysis was employed to investigate the factors influencing pre-hospital cardiac arrest and to construct a predictive model.The value of the predictive model was evaluated using receiver operating characteristic(ROC)curve,calibration curve,and decision curve.Results:Multivariate Logistic regression analysis showed that age＞59 years old(OR=0.658,95%CI:0.559-0.773),rescue arrival time＞10 min(OR=7.699,95%CI:3.013-19.675)and non-standard pre-hospital emergency measures(OR=2.807,95%CI:1.150-6.853)were independent risk factors for pre-hospital emergency cardiac arrest(P＜0.05).The nomogram model constructed according to the above factors was verified,and the C-index of the modeling group and verification group model was 0.798(95%CI:0.749-0.847)and 0.794(95%CI:0.740-0.848),respectively,which proved that the prediction efficiency of this model was good,and the decision curve showed good clinical benefit.Conclusion:Age＞59 years old,rescue arrival time＞10 min,and non-standard pre-hospital emergency measures are independent risk factors for pre-hospital emergency cardiac arrest,and the constructed prediction model has good clinical application.

Objective:Three occupational health risk assessment methods were used to assess the occupational health risk of noise exposed posts in an automobile manufacturing enterprise. According to the results, the selection of risk assessment methods and risk management of such occupational noise enterprises were provided.Methods:Form April to November 2021, The occupational health field survey was carried out in an automobile manufacturing industry in Tianjin. The occupational health MES risk assessment method, occupational health risk index risk assessment method and Australian occupational hazard risk assessment method were used to evaluate the occupational health risk of noise-exposed posts in this enterprise, and the evaluation results of different methods were analyzed and compared.Results:The average value of LAeq, 8 h in the four workshops of automobile manufacturing industry was 82.95 dB (A) , and the noise detection exceeding rate was 22.41% (26/116) . The LAeq, 8h and exceeding rate noise of welding workshop were higher than those of other workshops (χ 2=23.56, 32.94, P<0.01) . The three occupational health risk assessment methods have the same risk assessment results for the four major workshops. The assembly and painting workshops are level 4 risk (possible risk) , and the stamping and welding workshops are level 3 risk (significant risk) . Conclusion:Occupational noise has certain potential hazards to workers in automobile manufacturing enterprises. Therefore, in the future work, corresponding organizational management measures should be taken to improve the working environment and reduce the actual exposure level of workers in order to protect the health of occupational workers.

Objective To evaluate effectiveness of evidence-based nursing practice of postoperative delirium management during cardiac surgery under cardiopulmonary bypass.Methods The best evidence was selected for the prevention and management of delirium after cardiac surgery under cardiopulmonary bypass.From May 2022 to April 2023,the evidence-based nursing practice was developed and applied into the Department of Cardiovascular and Macro-vascular Surgery of a tertiary A general hospital in Wuhan.The nurses'knowledge,belief and practice of postoperative delirium,incidence of postoperative delirium and subdelirium syndrome,the implementation rate of examination indicators were compared before and after the application of evidence.Results A total of 27 articles were finally included.Based on this,23 pieces of the best evidence were selected,and 27 review indicators were constructed.Through evidence-based practice,the scores of nurses'knowledge,belief and practice questionnaire were significantly increased from(100.81±13.92)to(105.51±10.35)(P＜0.05).The implementation rate of 24 indicators was significantly higher compared with baseline review(P＜0.05).The incidence of delirium decreased from 43.5％ to 34.7％(P=0.120).The incidence of postoperative subdelirium syndrome decreased from 55.1％ to 40.1％(P=0.010).The duration of postoperative delirium and sub delirium significantly decreased,respectively(P＜0.05).Conclusion Evidence-based practice can reduce the incidence of subdelirium syndrome,and it can reduce postoperative delirium and the duration of subdelirium syndrome.It can improve nurses'knowledge and practice of postoperative delirium care.

Objective:Three occupational health risk assessment methods were used to assess the occupational health risk of noise exposed posts in an automobile manufacturing enterprise. According to the results, the selection of risk assessment methods and risk management of such occupational noise enterprises were provided.Methods:Form April to November 2021, The occupational health field survey was carried out in an automobile manufacturing industry in Tianjin. The occupational health MES risk assessment method, occupational health risk index risk assessment method and Australian occupational hazard risk assessment method were used to evaluate the occupational health risk of noise-exposed posts in this enterprise, and the evaluation results of different methods were analyzed and compared.Results:The average value of LAeq, 8 h in the four workshops of automobile manufacturing industry was 82.95 dB (A) , and the noise detection exceeding rate was 22.41% (26/116) . The LAeq, 8h and exceeding rate noise of welding workshop were higher than those of other workshops (χ 2=23.56, 32.94, P<0.01) . The three occupational health risk assessment methods have the same risk assessment results for the four major workshops. The assembly and painting workshops are level 4 risk (possible risk) , and the stamping and welding workshops are level 3 risk (significant risk) . Conclusion:Occupational noise has certain potential hazards to workers in automobile manufacturing enterprises. Therefore, in the future work, corresponding organizational management measures should be taken to improve the working environment and reduce the actual exposure level of workers in order to protect the health of occupational workers.

Objective:To explore the effect of adult growth hormone deficiency on cognitive function in adults.Methods:A total of 19 hypophyseal or craniopharyngioma patients who underwent surgical treatment and were diagnosed with adult growth hormone deficiency in Department of Endocrinolog, the Second Affiliated Hospital, School of Medicine, Zhejiang University from June 2017 to June 2018 were selected as the case group, and 19 normal people were included as the control group. All the members were assessed with the cognitive function scale and brain functional magnetic resonance examination, data between the groups were analyzed.Results:The body weight within a year of case group was significantly increased than that of the control group( P=0.017). Compared with the control group, the case group was relatively inattentive and had decreased memory(Time of stroop color words test-a, test-c, and trail-making test-A, P values were 0.009, 0.018, 0.020 respectively; Auditory word learning test N6, P=0.008). The executive function and language ability of the case group were weakened compared with the control group(Raven′s matrices score E1-E12, P=0.022; Time cost and the number of arrivals in 1 min of connection test B, P values were 0.023, 0.004; Symbol digit modalities test, P=0.037; The number of words spoken in 46-60 s and total number in 0-60 s of the case group was less than the control, P values were 0.030, 0.006). The general mental state of the case group was worse than the control group( P=0.018). The accuracy of the 2-back task of the case group was significantly lower and the activation signal of the left frontal lobe in the case group was significantly weaker( P<0.005). Conclusions:Adult growth hormone deficiency may increase obesity risk and have a detrimental influence on patients′ overall mental health, resulting in varying degrees of cognitive impairment. Working memory impairments associated with adult growth hormone deficiency may be a result of decreased frontal lobe brain activity.