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.

Caregivers for chronic disease patients of caregiver activation emphasizes the subjective initiative and preparedness of caregivers in managing patients' health conditions and medical needs.Caregivers with high activation levels can participate more effectively in disease management,significantly improve the quality of care,and have a positive impact on their own mental health and quality of life.This article reviews the concept,assessment tools,current situation,influencing factors,and intervention strategies of caregiver activation,and proposes future research directions,aiming to provide references for conducting research and practical exploration related to caregiver activation.

Caregivers for chronic disease patients of caregiver activation emphasizes the subjective initiative and preparedness of caregivers in managing patients' health conditions and medical needs.Caregivers with high activation levels can participate more effectively in disease management,significantly improve the quality of care,and have a positive impact on their own mental health and quality of life.This article reviews the concept,assessment tools,current situation,influencing factors,and intervention strategies of caregiver activation,and proposes future research directions,aiming to provide references for conducting research and practical exploration related to caregiver activation.

Objective:To explore the association between sleep duration, sleep quality and the prevalence of hypertension in the elderly aged 65 years and above.Methods:This study was conducted among the elderly in communities in Yiwu, China from April to July, 2019, and participants were recruited through physical examination in the hospital. Face-to-face interview was performed to obtain basic information. Sleep duration and sleep quality were evaluated by Pittsburgh Sleep Quality Index (PSQI). Associations between sleep duration, sleep quality and hypertension were evaluated by multivariate logistic regression analysis.Results:A total of 3 169 elderly persons, aged ≥65 years old, were included in the study. The overall prevalence of hypertension was 50.8%. The elderly with very poor sleep quality and short sleep duration accounted for 22.4% and 28.5%, respectively. After adjusting for demographic characteristics, socioeconomic status, lifestyle and health status, the OR of hypertension for the elderly with very poor sleep quality was 1.42 (95% CI: 1.12-1.80) compared with those with very good sleep quality. Compared with the elderly with sleep duration of 6-7 h a night, the OR of hypertension for those with sleep duration <6 h was 1.37 (95% CI: 1.15-1.65). As the sleep quality decreased, the risk for hypertension increased. An U-shaped association was found between sleep duration and risk of hypertension. Subgroup analyses showed that this association existed in both men and women, but only significant in the elderly aged <75 years. Conclusion:Poor sleep quality and short sleep duration were associated with risk for hypertension in the elderly.

Objective To compare the effect of three kinds of reverse trendelenburg position angle in block plane of prone position after subarachnoid anesthesia, in order to acquire the conformable reverse trendelenburg position angle of prolapse and hemorrhoids (PPH). Methods Sixty patients having underwent the selective PPH were divided into 10° group, 20° group and 30° group by random digits table method with 20 cases each. Subarachnoid puncture was performed in the L3 - 4 processus spinosus gap, then 0.5%heavy density ropivacaine 2 ml was injected. After anesthesia, the operation bed was adjusted to reverse trendelenburg position 10° (10° group), 20° (20° group) and 30° (30° group). At the same time the patients changed to prone position, and the operation bed was changed to horizontal position before operation. The patients changed to jackknife position 10 min after drug injection of subarachnoid anesthesia. The sensory blockade after drug infusion, circulation function change, anesthetic effect and perioperative adverse reaction were observed. Results There were no statistical differences in operation start time and fixed time of anesthesia plane among 3 groups (P>0.05). The upper bound of sensory nerve block before horizontal position, upper bound of sensory nerve block before jackknife position, highest plane of sensory nerve block in 10° group were significantly higher than those in 20° group and 30° group: T(10.47 ± 0.65) vs. T(12.36 ± 0.72) and T(12.50 ± 0.54), T(10.12 ± 0.56) vs. T(11.82 ± 0.66) and T(11.99 ± 0.72), T(9.53 ± 0.71) vs. T(11.32 ± 0.78) and T(11.54 ± 0.83), and there were statistical differences (P<0.05); but there were no statistical difference between 20° group and 30° group (P>0.05). The systolic blood pressure and diastolic blood pressure levels 15 and 20 min after drug infusion in 10° group were significantly lower than those in 20° group and 30° group, systolic blood pressure:(120.40 ± 7.38) mmHg (1 mmHg=0.133 kPa) vs. (131.82 ± 7.88) and (130.47 ± 7.57) mmHg, (119.55 ± 7.65) mmHg vs. (131.25 ± 9.67) and (130.23 ± 8.69) mmHg, diastolic blood pressure: (63.74 ± 6.54) mmHg vs. (71.36 ± 8.49) and (74.32 ± 7.54) mmHg, (61.59 ± 6.23) mmHg vs. (72.98 ± 7.39) and (73.75 ± 6.34) mmHg, and there were statistical differences (P<0.05);but there were no statistical difference between 20° group and 30° group (P>0.05). No patients′ anesthesia effect was poor in 3 groups, but 4 cases in 30° group were good. Hypotension and tachycardia occurred in 2 cases in 10° group, respectively. Conclusions Immediately prone position after subarachnoid anesthesia can be adjusted by reverse trendelenburg position angle to get the appropriate level of anesthesia, and conformable reverse trendelenburg position angle of PPH is 20°.

BACKGROUND: Stable reliable experimental animal models are needed urgently in scar research.OBJECTIVE: Scar animal models of nude mice are evaluated with histological method to define optimal opportunity for using.DESIGN: Randomizly controlled and repetitively measured design.SETTING: Department of Burn, First Affiliated Hospital, Sun Yat-sen University.MATERIALS: The experiment was conducted at the Center for Animal Experiment, Medical College, Sun Yat-sen University between January 2004 and March 2004. Fifteen nude mice aged 4-6 weeks were provided by Center for Animal Experiment, Medical College, Sun Yat-sen University (of either gender with body mass of 15-25 g). Hyperplastic scar was gained from samples of exairesis in patients with burn after healing which is hyperplastic scar for half a year.METHODS: Human hyperplastic scar was grafted at dorsa of nude mice to establish scar animal models. After graft for four weeks, 5 experimental animals were killed every week, and grafts were gained. 100 g/L formalin was used to fix samples for 3 weeks. Picric-sirius red polarized light method was used to detect the graft and clinical materials, and histological feature was observed.MAIN OUTCOME MEASURES: ①Results of film reading of picric-sirius red polarized light method. ②Analytic result of computer image.RESULTS: ①Results of film reading of picric-sirius red polarized light method: The grafts showed the same feature of diffused distribution of mainly yellow and red thick fiber with thin-mesh green fiber under polarized light in every time segment group. ②Analytic result of computer image: In clinicopathological hyperplastic scar, type Ⅰ collagen was about 74%; type Ⅲ collagen accounted for about 26%. In the graft from 4-6 weeks, the contents of type Ⅰ collagen were (74.52 ±0.47)% , (74.43 ±0.53)% ,(74.69±0.63)%, respectively; The contents of type Ⅲ were (25.48±0.47)%, (25.57±0.53)%, (25.31±0.63)%, respectively, which had insignificant difference (P ＞ 0.05 ).CONCLUSION: In the time segment designed by experiment, the feature of graft and clinical material is coincident, which is accorded with the characteristics of hyperplastic scar. The detection of collagen of scar tissue with picric-sirius red polarized light method is a simple effective method for assessing the tissue of hyperplastic scar. Establishing scar models with nude mice is effective and stable.