Background Hypertension is one of the chronic diseases with the highest prevalence in China, and a history of hypertension may potentially exacerbate hearing loss. Investigating the association between long-term blood pressure trends and hearing thresholds could contribute to hearing protection efforts for occupationally noise-exposed populations. Objective By investigating hearing thresholds and blood pressure levels among occupationally noise-exposed workers in an urban rail transit enterprise, and conducting a comprehensive analysis of the association between long-term blood pressure changes and hearing thresholds, to provide data references for health management strategies targeting occupationally noise-exposed workers. Methods Workers exposed to occupational noise at a rail transit enterprise were enrolled as study subjects and underwent pure-tone audiometry. Group-based trajectory modeling was employed to identify blood pressure trajectories. Categorical data were compared using chi-square tests, while normally distributed continuous variables were analyzed via t-tests and analysis of variance (ANOVA). Generalized linear mixed models (GLMMs) were subsequently applied toexamine associations between these trajectory groups and high-frequency hearing thresholds. Results Among 2 002 occupationally noise-exposed workers, the median (P₂₅, P₇₅) age was 32 (28, 35) years, with a median (P₂₅, P₇₅) working tenure of 7 (3, 10) years. In 2019, the positive hypertension rate was 9.04%, with a mean systolic blood pressure (SBP) of (122.97±11.60) mmHg and a mean diastolic blood pressure (DBP) of (76.37±9.02) mmHg. The hearing loss prevalence was 10.1%, showing bilateral high-frequency average hearing thresholds of (17.18±8.71) dB and speech-frequency average thresholds of (13.79±3.46) dB. Three distinct trajectory groups were identified for both SBP and DBP. Compared with other trajectory groups, the high-stable DBP group exhibited significantly higher hearing loss prevalence (χ²=6.34, P=0.042) and elevated high-frequency hearing thresholds (all Ps<0.05). Specifically, within the 30-39 age subgroup, the moderate-stable DBP group demonstrated 1.96 dB lower high-frequency thresholds than the high-stable group [β(95%CI): −1.96 (−3.61, −0.32), P=0.020]. Conclusion Among occupationally noise-exposed workers in a municipal rail transit enterprise, DBP trajectories demonstrated a positive association with high-frequency hearing thresholds. Notably, in young and middle-aged occupationally noise-exposed populations, DBP may exert a more critical influence than SBP on the progression of hearing loss.

Objective:To explore the adaptability of health resources allocation and the economic development level in Sichuan Province and its influencing factors,so as to provide reference and suggestions for optimizing health resources allocation.Methods:Based on the panel data of 21 cities(states)in Sichuan Province,it analyzes the adaptability of health resources allocation and economic development in Sichuan Province from 2017 to 2021 and its influencing factors through entropy method,coupling coordination model and grey relational model.Results:From 2017 to 2021,the allocation level of health resources in most areas of Sichuan Province showed a gradual upward trend,but the rising speed was obviously lower than the growth rate of economic development;In 2021,the adaptability between the allocation of health resources and the level of economic development in most parts of Sichuan Province is still in a low coordination stage.Conclusion:Different regions should adopt differentiated development strategies based on their actual geographical conditions,optimize the allocation of health resources according to local conditions,and promote the coordinated development of health resource allocation and economic level.

Objective:To analyze the epidemiological characteristics and influencing factors of single-cigarette use and dual cigarette-cigar use in China.Methods:This study was a cross-sectional study that selected 85 638 urban and rural residents who met the inclusion criteria from the 2018 China Health Literacy Survey as research subjects. An analysis was conducted on 21 849 users of cigarettes and cigars among them. Due to the small number of individuals who exclusively used cigars (247 cases), the research subjects were divided into two categories: exclusive cigarette users and dual users of cigarettes and cigars. The groups were categorized by age (18-34 years, 35-54 years, ≥55 years), gender (male, female), education level (primary school and below, junior high school and high school, university and above) and annual household income (<20 000 yuan, 20 000-<80 000 yuan, ≥80 000 yuan) to compare the tobacco usage rate and conduct subgroup analyses for each subgroup. Multivariate logistic regression analysis was employed, incorporating general demographic characteristic information to explore the influencing factors of exclusive cigarette use and dual use of cigarettes and cigars, respectively.Results:The rate of exclusive cigarette use in our country was 24.3%, while the dual use rate of cigarettes and cigars was 0.9%. The exclusive cigarette use rate and the dual use rate of cigarettes and cigars among males were significantly higher than those among females (48.25% vs 2.48%, and 1.84% vs 0.06%) (both P<0.001). For males, the high-risk factors for exclusive cigarette use included living in urban areas ( OR: 1.37, 95% CI: 1.23-1.54), being Han ethnicity ( OR: 1.73, 95% CI: 1.51-1.98), and having an annual household income ≥20 000 yuan ( OR: 1.54, 95% CI: 1.38-1.82) while having a junior high school education or higher was a protective factor ( OR: 0.68, 95% CI: 0.52-0.90). Age≥35 years ( OR: 3.36, 95% CI: 2.62-4.32) and having a junior high school education or higher ( OR: 1.30, 95% CI: 1.02-1.67) were risk factors for dual use of cigarettes and cigars in males. Among females, living in urban areas ( OR: 1.53, 95% CI: 1.19-1.97) and being Han ethnicity ( OR: 5.96, 95% CI: 4.47-7.96) were risk factors for exclusive cigarette use, while having a university education or higher was a protective factor ( OR: 0.28, 95% CI: 0.18-0.42). However, for female dual use of cigarettes and cigars, no significant effects were observed for any demographic characteristics. Conclusions:The use rate of cigarettes alone in China is significantly higher than that of cigarette-cigar dual use, and the rates of cigarette use alone and cigarette-cigar dual use in men are significantly higher than those in women. Tobacco use is being affected by sociodemographic factors, among which place of residence, ethnicity and education level are the main influencing factors of cigarette use alone, and gender, age and education level are the main influencing factors of cigarette-cigar dual use.

Objective:To investigate the association between different socioeconomic status (SES) levels and the incidence of sensory impairment (SI) in the Chinese population.Methods:This study adopted a prospective cohort design, utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) collected in July or August 2011. Participants who met the inclusion and exclusion criteria were followed up every 2-3 years until the onset of SI or the end of the follow-up period (August 2018). Based on educational attainment and annual per capita household expenditure, participants were classified into four SES groups: low, lower-middle, upper-middle, and high SES. Logistic regression was employed to analyze the relationship between different SES levels and the incidence of SI.Results:A total of 7 415 participants were included in the study, with a mean follow-up duration of 4.9 years. A total of 3 644 cases of incident SI were recorded (49.1%). Compared with the high SES group, the risk of developing SI was progressively higher in the upper-middle SES group ( OR=1.42, 95% CI: 1.03-1.96), lower-middle SES group ( OR=1.83, 95% CI: 1.29-2.60), and low SES group ( OR=2.04, 95% CI: 1.42-2.94) ( P for trend<0.001). Conclusions:SES is closely associated with new-onset SI. Enhancing SES may help reduce the risk of developing SI.

Objective:To explore the adaptability of health resources allocation and the economic development level in Sichuan Province and its influencing factors,so as to provide reference and suggestions for optimizing health resources allocation.Methods:Based on the panel data of 21 cities(states)in Sichuan Province,it analyzes the adaptability of health resources allocation and economic development in Sichuan Province from 2017 to 2021 and its influencing factors through entropy method,coupling coordination model and grey relational model.Results:From 2017 to 2021,the allocation level of health resources in most areas of Sichuan Province showed a gradual upward trend,but the rising speed was obviously lower than the growth rate of economic development;In 2021,the adaptability between the allocation of health resources and the level of economic development in most parts of Sichuan Province is still in a low coordination stage.Conclusion:Different regions should adopt differentiated development strategies based on their actual geographical conditions,optimize the allocation of health resources according to local conditions,and promote the coordinated development of health resource allocation and economic level.

Objective:To analyze the epidemiological characteristics and influencing factors of single-cigarette use and dual cigarette-cigar use in China.Methods:This study was a cross-sectional study that selected 85 638 urban and rural residents who met the inclusion criteria from the 2018 China Health Literacy Survey as research subjects. An analysis was conducted on 21 849 users of cigarettes and cigars among them. Due to the small number of individuals who exclusively used cigars (247 cases), the research subjects were divided into two categories: exclusive cigarette users and dual users of cigarettes and cigars. The groups were categorized by age (18-34 years, 35-54 years, ≥55 years), gender (male, female), education level (primary school and below, junior high school and high school, university and above) and annual household income (<20 000 yuan, 20 000-<80 000 yuan, ≥80 000 yuan) to compare the tobacco usage rate and conduct subgroup analyses for each subgroup. Multivariate logistic regression analysis was employed, incorporating general demographic characteristic information to explore the influencing factors of exclusive cigarette use and dual use of cigarettes and cigars, respectively.Results:The rate of exclusive cigarette use in our country was 24.3%, while the dual use rate of cigarettes and cigars was 0.9%. The exclusive cigarette use rate and the dual use rate of cigarettes and cigars among males were significantly higher than those among females (48.25% vs 2.48%, and 1.84% vs 0.06%) (both P<0.001). For males, the high-risk factors for exclusive cigarette use included living in urban areas ( OR: 1.37, 95% CI: 1.23-1.54), being Han ethnicity ( OR: 1.73, 95% CI: 1.51-1.98), and having an annual household income ≥20 000 yuan ( OR: 1.54, 95% CI: 1.38-1.82) while having a junior high school education or higher was a protective factor ( OR: 0.68, 95% CI: 0.52-0.90). Age≥35 years ( OR: 3.36, 95% CI: 2.62-4.32) and having a junior high school education or higher ( OR: 1.30, 95% CI: 1.02-1.67) were risk factors for dual use of cigarettes and cigars in males. Among females, living in urban areas ( OR: 1.53, 95% CI: 1.19-1.97) and being Han ethnicity ( OR: 5.96, 95% CI: 4.47-7.96) were risk factors for exclusive cigarette use, while having a university education or higher was a protective factor ( OR: 0.28, 95% CI: 0.18-0.42). However, for female dual use of cigarettes and cigars, no significant effects were observed for any demographic characteristics. Conclusions:The use rate of cigarettes alone in China is significantly higher than that of cigarette-cigar dual use, and the rates of cigarette use alone and cigarette-cigar dual use in men are significantly higher than those in women. Tobacco use is being affected by sociodemographic factors, among which place of residence, ethnicity and education level are the main influencing factors of cigarette use alone, and gender, age and education level are the main influencing factors of cigarette-cigar dual use.

Objective:To investigate the association between different socioeconomic status (SES) levels and the incidence of sensory impairment (SI) in the Chinese population.Methods:This study adopted a prospective cohort design, utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) collected in July or August 2011. Participants who met the inclusion and exclusion criteria were followed up every 2-3 years until the onset of SI or the end of the follow-up period (August 2018). Based on educational attainment and annual per capita household expenditure, participants were classified into four SES groups: low, lower-middle, upper-middle, and high SES. Logistic regression was employed to analyze the relationship between different SES levels and the incidence of SI.Results:A total of 7 415 participants were included in the study, with a mean follow-up duration of 4.9 years. A total of 3 644 cases of incident SI were recorded (49.1%). Compared with the high SES group, the risk of developing SI was progressively higher in the upper-middle SES group ( OR=1.42, 95% CI: 1.03-1.96), lower-middle SES group ( OR=1.83, 95% CI: 1.29-2.60), and low SES group ( OR=2.04, 95% CI: 1.42-2.94) ( P for trend<0.001). Conclusions:SES is closely associated with new-onset SI. Enhancing SES may help reduce the risk of developing SI.

Objective To investigate the characteristics of ST segment changes in middle-aged and elderly people in Fuzhou through cardiopulmonary exercise test and to analyze its possible influencing factors, in order to provide theoretical guidance for cardiovascular prevention. Methods A total of 987 individuals undergoing health examination at the physical examination center of 900TH Hospital of Joint Logistics Support Force from 2017 to 2023 were collected as study subjects, and cardiopulmonary exercise tests were performed, and the exercise maximum heart rate (/min), resting systolic blood pressure (mm Hg), resting diastolic blood pressure (mm Hg), peak systolic blood pressure (mm Hg),，carbon dioxide ventilation equivalent (%) ，Borg score (score) and other index data were collected, using Logistic regression to analyze the influencing factors of ST segment anomalies. Results A total of 234 ST-segment abnormalities occurred, and the abnormal rate was 23.72%. Among them, 148 cases (14.99%) were depressed in ST segment, 52 cases (5.27%) were elevated in ST segment, 13 cases (1.32%)was extended in ST segment , and 21 cases (2.14%) was shortened in ST segment . The ST-segment abnormal group had higher exercise maximum heart rate (/min), resting systolic blood pressure (mm Hg), resting diastolic blood pressure (mm Hg), peak systolic blood pressure (mm Hg), peak diastolic blood pressure (mm Hg), carbon dioxide ventilation equivalent (%) and Borg score (score) than the normal group, and the differences were statistically significant. The results of multivariate regression analysis showed that peak systolic blood pressure (mm Hg), carbon dioxide ventilation equivalent (%) and Borg score (score) were the influencing factors in the ST segment depression ; the peak systolic blood pressure (mm Hg) and Borg score (score) were the influencing factors in the ST segment elevation(OR>1). Conclusion Peak systolic blood pressure (mm Hg), carbon dioxide ventilation equivalent (%) and Borg score (score) are the influencing factors of ST segment abnormalities in cardiopulmonary exercise test in middle-aged and elderly people , and their measurement is of great significance for cardiovascular health evaluation and treatment.

Objective To explore whether adiponectin receptor 1/2(AdipoR1/R2)mediates berberine to alleviate renal lipid toxicity in mice with diabetic kidney disease.Methods C57BLKS/J db/db mice and db/m mice were selected and divided into 4 groups,with 8 in each group.db/db mice and db/m mice were given berberine(150 mg·kg-1·d-)or placebo by gavage for 12 weeks,respectively.After intervention,blood glucose,blood lipids,urinary microalbumin/creatinine ratio and urinary albumin excretion rate were determined.Kidney tissues were taken for pathological examination,and oil red O staining,immunohistochemistry,ELISA and Western blotting were used to examine lipid deposition,AdipoRl/R2 expression and fibrosis markers expressions,etc.,respectively.The human glomerular endothelial cell line(HGEC)was used to verify the role of AdipoR1/R2 in berberine alleviating renal lipid toxicity.Results After berberine intervention,the body weight,blood glucose,lipids,proteinuria,renal lipid deposition,and renal pathological changes decreased in db/db mice(P＜0.05);the expressions of AdipoR1 and AdipoR2 increased,expressions of TGF-β1 and Col-Ⅳ decreased,and the expressions of PPAR-α and p-AMPK increased in kidney tissue of db/db mice(P＜0.05).In high-fat cultured HGEC cells treated with berberine-treated db/db mouse serum,the expressions of TGF-β1 and Col-Ⅳ decreased,while the expressions of PPAR-α and p-AMPK increased(P＜0.05);after AdipoR1/R2 on HGEC cells were silenced,the expressions of TGF-β1 and Col-Ⅳ increased,while the expressions of PPAR-α and p-AMPK decreased(P＜0.05).Conclusions Berberine can reduce renal lipid toxicity in diabetic nephropathy mice,and adiponectin receptor may mediate this effect of berberine.

BACKGROUND:Reducing the rate of abnormal fertilization is an effective approach to improving the efficacy of in vitro fertilization and reducing patients'financial strain.However,the current research on abnormal fertilization has focused on exploring the types of prokaryotic nuclei and their generation mechanisms,as well as analyzing embryos formed by abnormal fertilization,chromosomal ploidy and utilization value.There is a lack of clinical prediction models for abnormal fertilization based on retrospective studies. OBJECTIVE:To construct a nomogram model to predict abnormal female factors in in vitro fertilization. METHODS:A total of 5 075 patients undergoing treatment for conventional in vitro fertilization at Nanxishan Hospital of Guangxi Zhuang Autonomous Region from March 2017 to March 2022 were retrospectively analyzed.The male confounders were calibrated on a 1:1 propensity score with a match tolerance of 0.02,and 1 672 cases were successfully matched.According to the Vienna Consensus,patients with≥60%normal fertilization capacity were included in the normal fertilization group(n=836)and those with<60%normal fertilization capacity were included in the abnormal fertilization group(n=836).The model and validation groups were obtained by random sampling at a ratio of 7:3.Factors related to the occurrence of abnormal fertilization following conventional in vitro fertilization in the model group were screened using univariate analysis and the best matching factors were selected using the Least Absolute Shrinkage and Selection Operator(LASSO)and included in a multifactorial forward stepwise Logistic regression to identify their independent influencing factors and plot a nomogram.Finally,the prediction model was validated for discrimination,accuracy and clinical application efficacy using receiver operating characteristic curves,calibration curves,clinical decision curves and clinical impact curves. RESULTS AND CONCLUSION:The univariate analysis indicated the factors influencing the occurrence of abnormal fertilization were age,controlled ovarian hyperstimulation protocol,number of assisted pregnancies,years of infertility,infertility factors,anti-mullerian hormone,sinus follicle count,basal luteinizing hormone,luteinizing hormone concentration on the human chorionic gonadotropin day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).LASSO regression further identified the best matching factors,including age,microstimulation protocol,number of assisted pregnancies,years of infertility,anti-mullerian hormone,luteinizing hormone level on human chorionic gonadotropin injection day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).Multifactorial forward stepwise Logistic regression results showed that age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day were independent influencing factors for the occurrence of abnormal fertilization following conventional in vitro fertilization.The receiver operating characteristic curves showed an area under the curve of 0.761(0.746,0.777)for the model group and 0.767(0.733,0.801)for the validation group,indicating that the model has good discrimination.The mean absolute error of the calibration curve was 0.044,and the Hosmer-Lemeshow test indicated that there was no significant difference between the predicted probability of abnormal fertilization and the actual probability of abnormal fertilization(P>0.05),indicating the prediction model has good consistency and accuracy.The clinical decision curves and clinical impact curves showed that the model and validation groups had the maximum net clinical benefit at valve probability values of 0.00-0.52 and 0.00-0.48,respectively,and there was a good clinical application efficacy in this valve probability range.To conclude,the nomogram model has good discrimination and accuracy as well as clinical application efficacy for predicting the occurrence of abnormal fertilization in women undergoing conventional in vitro fertilization based on age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day.