OBJECTIVE: To explore the correlation between the cognition on hearing protection and mental health status of noise-exposed workers. METHODS: A total of 499 noise-exposed workers from 3 enterprises of coal mine, steel and textile in Xinjiang region were selected as study subjects by stratified cluster random sampling method. The cognitive status of hearing protection and mental health status of each group were investigated by the Workplace Health Promotion Pilot Project Questionnaire. RESULTS: A total of 235 workers had abnormal mental health status.The abnormal rate of mental health status was 47.1%(235/499). The results of logistic regression analysis showed that female, age ≤40.0 years, unable to bear current noise hazards, worried about noise-induced-deafness and noise-induced discomfort were the risk factors of abnormality of mental health status(odds ratio values were 1.62, 1.87, 2.42, 2.20, 2.14, P<0.05). Using hearing protectors for ≥3.0 years was the protective factor of abnormality of mental health status(odds ratio value was 0.47, P<0.05). CONCLUSION: The subjective cognition on hearing protection has an impact on the mental health of noise-exposed workers.

Objective: To compare the knowledge and behavior toward hearing protection among workers in different workplaces and investigate its influence factors. Methods: 2 manufacturing companies with obvious noise hazard in workplace were selected into the study. Health management level was distinguished through field investigation and verification. Questionnaire focus on basic knowledge of hearing health, acceptance level of noise hazard, comfort of wearing hearing protectors and atmosphere in workplace was designed and was used to investigate the knowledge and behavior toward hearing protection. Results: Hearing protectors that meet the level of protection are distributed throughout the workplaces. Although company A has a lower noise hazards level, the health management system was poorly executed. The proportion of workers persisting in wearing hearing protectors throughout the work shift in company A was lower than B (P<0.01) . Workers in company A intended to underestimate the noise level (P<0.01) and the health effect of hearing loss (P<0.01) . All the workers were worry about suffering from hearing loss (P>0.05) , but those in company B had more positive attitude toward the protection of hearing protector (P<0.01) and relied on the protector (P<0.01) . The awareness of protection, in turn, help workers adapt attitude and get used to wearing hearing protectors consciously in workplace (P<0.01) . Conclusion Health management performance play a key role in help workers form good knowledge and behavior. To protect workplace health, employers need to creative a healthy supportive environment for workers.

Objective To analyze changes in serum levels of inflammatory factors,galectin-3 (Gal-3),fractalkine(FKN) and interleukin-6 (IL-6),in patients with dilated cardiomyopathy (DCM) or ischemic cardiomyopathy (ICM),and to explore their clinical significance.Methods Seventy-six hospitalized patients with DCM were selected to serve as a DCM group,and 78 patients with ischemic cardiomyopathy were selected into an ICM group from October 2016 to December 2017 at the Department of Cardiology,and patients in the two groups received cardiac function classification.Meanwhile,82 healthy people were included as a control group.Fasting venous blood was collected,and serum levels of Gal-3,FKN,IL-6,and BNP were measured.The correlations of Gal-3,FKN,and IL-6 with DCM or ICM were analyzed.Results Levels of plasma BNP and serum Gal-3,FKN,and IL-6 in the DCM and ICM groups were higher than those in the control group,and their levels in the DCM group were significantly higher than in the ICM group.Levels of plasma BNP and serum Gal-3,FKN,and IL-6 increased as their New York Heart Association(NYHA)classification went higher in both the DCM and ICM groups.For patients classified at the same level,serum levels of Gal-3,FKN,and IL-6 of the DCM group were significantly higher than those of the ICM group(P ＜ 0.05).BNP levels showed no difference between the two groups(P ＞0.05).Spearman correlation analysis indicated positive correlations of NYHA classification with levels of BNP(r =0.30,0.19),Gal-3(r=0.24,0.19),FKN(r =0.63,0.51),and IL-6(r =0.28,0.15)in both the DCM and ICM groups(P ＜ 0.05),and the correlation was stronger in the DCM group.Conclusions Increased expression of plasma BNP,Gal-3,FKN,and IL-6 in patients with DCM and ICM are closely related to the severity of cardiac function impairment.Monitoring changes in levels of plasma BNP and serum inflammatory factors Gal-3,FKN and IL-6 provides important clues for the differential diagnosis between DCM and ICM,the assessment of clinical conditions and treatment-related decisions.

Objective To investigate the distribution and antimicrobial resistance profile of the common pathogens isolated during the period from 2009 to 2015.Methods All the bacterial strains isolated from pediatric inpatients in Beijing Children's Hospital during the period from 2009 to 2015 were analyzed. Antimicrobial susceptibility was determined by disk diffusion method and Phoenix 100 Automated Microbiology System. Results were analyzed according to the guidelines of CLSI (2014) using WHONET 5.6 software.Results The total strains were 26630. The most common gram-positive isolates were Streptococcus pneumoniae,Staphylococcusaureusand coagulase-negative Staphylococcus (CNS), while the most frequently isolated gram-negative microorganisms were Klebsiella spp.,Pseudomonas aeruginosa and Escherichia coli. The prevalence of S. pneumoniae was up to 25.7 % (4101/15973) in all respiratory tract specimens. About 50.2 % of the S. pneumoniae isolates were not susceptible to penicillin. The prevalence of methicillin-resistant strains was 20.6 % in S. aureus (MRSA) and 87.8 % in coagulase negative Staphylococcus (MRCNS) on average. The prevalence of MRSA increased from 11.1 % in 2009 to 29.8 % in 2015. No S. pneumoniae or staphylococcal strains were found resistant to vancomycin or linezolid. The Enterococcus strains were still highly susceptible to vancomycin and linezolid. Overall 0.3 % of the Enterococcus faecium isolates were resistant to vancomycin. The extended-spectrum beta-lactamases (ESBLs) producing strains accounted for 71.4 % -78.1 % of E. coli and 65.1 % - 76.9 % of K. pneumoniae isolates. The carbapenem-resistant E. coli and K. pneumoniae were reported for the first time in 2010, but in 2014, the strains resistant to carbapenems had increased to more than 7 % in E. coli, and higher than 20 % in K. pneumoniae. In 2015, up to 27.7 % and 25.7 % of P. aeruginosa isolates were resistant to imipenem and meropenem, respectively, and 59.9 % of the A. baumannii isolates were resistant to imipenem and meropenem. Beta-lactamase was positive in 46.3 % of the H. influenzae isolates. Conclusions MRSA and the carbapenem-resistant strains of E. coli,K. pneumoniae and A. baumannii are still on the rise in pediatric inpatients, which poses a serious threat to clinical practice and implies the importance of strengthening infection control.

Primary immunodeficiency diseases (PIDs) represent a typical group of rare diseases with high mortality and disability with regard to long-term outcome.Saving life and improving quality of life of the patients with PID remain to be the responsibility of the stakeholders from all aspects of the society.As the central player in the long run of PID campaign,pediatric immunologists should play a critical role in providing key epidemiological data in favor of political decision-making and social resource distribution.

Objective To investigate the feasibility, rationality and efficacy of the autologous dermal-fat composite tissue used as filling materials in the repair of nasal dorsum collapse.Methods The dermal fat composite tissue block (7.0 cm× 1.0 cm × 1.0 cm) was removed from the buttocks or abdoman as filling materials. 13 cases of nasal dorsum and nasal-shaped misfits were treated by using an umbrella graft of the auricular cartilage plus dermal-fat composite tissue graft to reconstruct natual shape of nasal dorsum and tip. Results The nasal dorsum and tip were repaired in 13 patients with collapsed nasal dorsum. The dermal-fat composite tissue survived well, and the incisions were healed in stage Ⅰ and the incision trace was not obvious. After follow-up for one year, the shape of nose was much satisfactory. Conclusion It is a well-accepted and easy-going procedure to repair collapsed nasal dorsum with autologous dermal-fat or a combination of composite ear cartilage tissue graft, with satisfactory effect and no rejection reactions.

Objective To study the impact of preprocedure intravenous urography(IVU)on the outcome of shock wave Iithotripsy(SWL)for the middle and lower ureteral stones.Methods 112 patients with solitary radiopaque the middle and lower ureterat stones on plain radiographs and no severe hydronephrosis on ultrasonographic examination were divided randomly to two treatment groups.IVU group(n=56)had IVU before the start of SwL,whereas patients in the control group(n=56)underwent SWL without IVU.Postoperative success,stone-free rates and complications were evaluated in both groups.Results Eleven patients in the IVU group were excluded from the study.The SUCCESS rate[91.1%(41/45)in IVP group VS 94.6%(53/56)in control group],stone-free rate[88.9%(40/45)vs 89.3%(50/56)],and complication rate[22.2%(10/45)vs 21.4%(12/56)]were similar in two groups(P＞0.05).ConclusionIt is not necessary to obtain an IVU for patients who have solitary radiopaque the middle and lower calculi on plain radiographs with no severe hydronephrosis on ultrasonographic examination before scheduling them for SWL,thus minimizing the cost,avoiding exposure to contrast medium,and reducing radiation exposure.

Objective To evaluate the clinical efficacy of expulsive therapy using alpha 1-selective adrenoblocker and prostaglandin synthetase inhibitor for distal ureteral stones.Methods 94 patients with distal ureteral stone were randomly divided into study group and control group.In study group,47 cases received tamsulosin 0.2mg daily and dielofenac rectal suppositories 50mg 2 times daily,while watchful waiting without tamsulosin and diclofenac suppository in 47 cases of control group.Observation lasted 2 weeks and also stone expelled as end point.Results No severe adverse reactions related to the drugs were noted and no patients withdrew from the study.The stone-free rate was 91.5%(43/47) of the study group and 25.5% (12/47) of the control group (P＜0.01).A mean stone expelling date of the control group was(8.9±4.3)d and that of the study group was(6.4±3.7)d(P＜0.01).Rates of renoureteral colic recurred in the study group and the control group were 4.3%(2/47) and 48.9%(23/47),respectively (P＜0.01).Conclusion Treatment of distal ureteral stones wlth tamsulosin and dielofenac suppository can increase the stone-free rate,shorten mean stone expelling date,decrease rate of renottreteral colic recurred.

BACKGROUND: The role of mechanical stress in the functional regulation of osteoblasts becomes an emphasis in osseous biomechanical researches recently. There are few reports on whether fluid shear stress can induce the expression of core-binding factor α1 (Cbfα1) or not and what is its rule.OBJECTIVE: To investigate the effects of fluid shear stress (FSS) on the gene expression of Cbfα1 in human osteosarcoma cells.DESIGN: A controlled observation experiment.SETTING: Department of Aerospace Biodynamics, Faculty of Aerospace Medicine, Fourth Military Medical University of Chinese PLA.MATERIALS: Subjects were human osteosarcoma cells (MG-63) METHODS: This study was carried out at the Department of Aerospace Biodynamics, Faculty of Aerospace Medicine, Fourth Military Medical University of Chinese PLA from November 2004 to April 2005. ①After cultured for 60 hours, MG-63 were treated with 0.5 Pa (0.5 Pa stress treated group ) or 1.5 Pa (1.5 Pa stress treated group ) FSS in a flow chamber for 15, 30, 60minutes, respectively. Cover glass was put in the Petri dish containing culture medium at the same time, serving as the control group of FSS treated group. ②The total RNA in cells was isolated. Reverse transcription polymerase chain reaction analysis was made to examine the gene expression of Cbfα1 mRNA. The ratio of Cbfα1 mRNA and GAPDH mRNA was calculated.MAIN OUTCOME MEASURES: The mRNA expressions of Cbfα1 at different FSS and different time.RESULTS: ① Compared with control group, Cbfα1 mRNA expression increased significantly at 30 and 60 minutes with the treatment of FSS.Within certain time range (15 to 60 minutes), Cbfα1 mRNA expression was strengthened with the elongation of time and the increase of stress level. ②The Cbfα1 mRNA expression at 30 and 60 minutes were significantly increased in 1.5 Pa stress treated group in comparison with 0.5 Pa stress treated group (P＜0.01).CONCLUSION: FSS can significantly increase the gene expression of Cbfα1 in human osteosarcoma cells.

BACKGROUND: Left ventricular hypertrophy induced by primary hyper tension is a risk factor which has a dependent effect on various cardiovas cular complications. Reversal left ventricular hypertrophy has been a keyobject for treating hypertension currently. Plasma neuropeptide Y has en dothelium-derived contracting blood vessel, and has adjusting effect on va somotor function through endothelial cell to participate in onset and main tenance of hypertension. OBJECTIVE: To investigate effect of yixin jiangya capsule on left ven tricular mass index (LVMI) and content of neuropeptide Y of primary grade2 hypertensive patiepts with left ventricular hypertrophy of hyperactivity ofyang due to yin deficiency blood stasis. DESIGN: Case analysis on the basis of patients. SETTING: Department of Traditional Chinese Medicine, General Hospitalof Jinan Military Area Command of Chinese PLA; Department of InternalMedicine, Affiliated Hospital of Shandong University of Traditional Chi nese Medicine. PARTICIPANTS: Totally 93 primary grade 2 hypertensive patients withleft ventricular hypertrophy of hyperactivity of yang due to yin deficiency blood stasis were selected from General Hospital of Jinan Military AreaCommand of Chinese PLA and Affiliated Hospital of Shandong University of Traditional Chinese Medicine from March 2003 to August 2005. All cases were divided into two groups according to random digital table. There were 62 cases in observational group including 40 males and 22 females aged from 46 to 70 years with mean age of 58.94 years and coursed from 2 to 19 years with mean course of 8.93 years. There were 31 cases in control group including 19 males and 12 females aged from 44 to 69 years with mean age of 59.27 years and coursed from 2.5 to 18 years with mean course of 9.11 years. Another 30 people were regarded as healthy group.METHODS: Patients in both groups were treated with enalaprol orally with 10 mg each time of once a day. Patients in observational group were also treated with yixin jiangya capsule (component: shengrlihuang, shengshouwu, sangjisheng, chuanniuxi, gouteng, shijueming, xiakucao, tianma,mudanpi, chishaoyao, dilong, chuanshanjia, etc. Mixed according to ratio,extracted, concentrated, made of capsule, 0.5 g/pill, 4.65 g/raw drug, provided by Shandong Jinan Hongjitang Pharmacy Limited-liability Company,batch number:. 021214), 5 pills once for 3 times every day. Courses in both groups were 24 weeks respectively. LVMI and content of neuropeptide Y were measured with ultrasonic cardiograph and radio-immunity analysis method before and after treatment. Meanwhile, indexes mentioned above were also measured in healthy group so as to regard as the controls.MAIN OUTCOME MEASURFS: LVMI, content of neuropeptide Y,changes of blood pressure, adverse events and side effects.RESULTS: Totally 93 patients entered the final analysis. ① LVMI and content of neuropeptide Y were increased both observational group and control group before treatment [(147.2±16.9), (146.7±17.2), (101.8±.22.4) g/m2;(135.4±33.2), (133.8±31.1), (78.6±24.5) ng/L.; P ＜ 0.01]. ② LVMI and content of neuropeptide Y were decreased both observational group and control group after 24-week treatment, and those in observational group were superior to those in control group [(103.9±24.6), (122.6±19.9) g/m2;(82.9±25.2), (113.7±26.2) ng/L; P ＜ 0.05-0.01]. ③ LVMI and content of neuropeptide Y in observational group were not significantly different from those in healthy group increased both in observational group and control group after treatment (P.＞ 0.05), and those in control group were higher than those in healthy group (P ＜ 0.01). ④ Descent levels of systolic pressure and diastolic pressure were not significantly different between observational group and control group [(137.4±12.8), (134.2:t:11.9) mm Hg;(80.1±8.3), (81.7±7.4) mm Hg, P ＞ 0.05]. Blood routine and liver-kidney function were not changed obviously both groups before and after treatment, and side effect was not observed during the process.CONCLUSION: LVMI and content of neuropeptide Y of primary grade 2 hypertensive patients with left ventricular hypertrophy of hyperactivity of yang due to yin deficiency blood stasis are higher than those of healthy people. Yixin jiangya capsule can deteriorate left ventricular hypertrophy and decrease the content of neuropeptide Y on the basis of application of enalaprol.