Objective:To explore the effectiveness, safety and cost between urinary follicle stimulating hormone (uFSH) and recombinant follicle stimulating hormone (rFSH) in controlled ovarian stimulation (COS) in China.Methods:Data were collected from 16 reproductive centers in China covering oocytes collection time from May 1, 2015 to June 30, 2018. Eligible patients were over 18 years old, adopting COS with uFSH (uFSH group) or rFSH (rFSH group) as start gonadotropins (Gn), and using in vitro fertilization (IVF) and (or) intracytoplasmic sperm injection for fertilisation, excluding frozen embryo recovery cycle. Generalised estimating equation was used to address the violation of independency assumption between cycles due to multiple IVF cycles for one person and clustering nature of cycles carried out within one center. Controlling variables included age, body mass index, anti-Müllerian hormone level, cause of infertility, ovulation protocol, type of fertilisation, number of embryos transferred, number of days of Gn use.Results:Totally 102 061 cycles met eligibility criteria and were included in the analyses. In terms of effectiveness, after controlling relevant unbalanced baseline characteristics, compared with rFSH group, the high oocyte retrieval (>15 oocytes was considered high retrieval) rate of uFSH group significantly decreased in gonadotropin-releasing hormone agonist protocol ( OR=0.642, P<0.01) and in gonadotropin-releasing hormone antagonist protocol ( OR=0.556, P=0.001), but the clinical pregnancy rate per transfer cycle and the live birth rate per transfer cycle significantly increased ( OR=1.179, OR=1.169, both P<0.01) in both agonist and antagonist protocols. For safety, multiple analysis result demonstrated that in the agonist protocol, compared with rFSH group, the incidence of moderate to severe ovarian hyperstimulation syndrome of uFSH group significantly decreased ( OR=0.644, P=0.002). The differences in ectopic pregnancy rate and multiple pregnancy rate between the uFSH and rFSH groups were not significant ( P=0.890, P=0.470) in all patients. In terms of cost, compared with rFSH group, the uFSH group had lower total Gn costs for each patient ( P<0.01). Conclusion:For patients who underwent COS, uFSH has better safety, and economic profiles over rFSH in China.

Objective:To study the clinical characteristics of children with adenovirus pneumonia complicated with liver injury and the understanding of clinicians.Methods:The children diagnosed with community-acquired adenovirus pneumonia were enrolled from January 1, 2013 to December 31, 2020. The clinical characteristics of the normal liver function group and the liver injured group were compared, and multivariate regression was applied.Results:Among the 3 294 enrolled children, 1 704 children had elevated alanine aminotransferase and/or aspartate aminotransferase on admission, and the liver function impairment rate was 51.7% (1 704/3 294), of which 1 671 cases were mildly injured (98.06%, 1 671/1 704), 28 cases were moderately injured (1.64%, 28/1 704), and 5 cases were severely injured (0.29%, 5/1 704). Compared with the normal liver function group, the proportion of male children in the liver injured group was higher (68.1% vs. 64.2%, P=0.017), and the age was younger[16(9, 30) months vs. 38(19, 53) months, P<0.001]. Children with liver injury were more likely to have wheezing (32.9% vs. 18.7%, P<0.001), shortness of breath (13.7% vs. 9.1%, P<0.001), and diarrhea (11.0% vs. 4.7%, P<0.001). The white blood cell counts, neutrophil counts and hemoglobin in the liver injured group were lower than those in the normal group, while the lymphocyte counts were higher than those in the normal group. The levels of creatine kinase, cardiac creatine kinase and lactate dehydrogenase were higher. The proportion of severe pneumonia in the liver injured group (26.9% vs. 11.2%, P<0.001) was higher than that in the normal liver function group, and the case fatality rate was significantly higher (1.47% vs. 0.25%, P<0.001). Comparing the probability of liver injury in children with mild and severe adenovirus pneumonia, it was found that the severe pneumonia group had more frequent liver injury (73.0% vs 46.6%, P<0.001), and both moderate and severe liver injury groups were higher than in the mild group. Further multivariate logistic regression analysis did not find a significant factor associated with the incidence of liver injury. Conclusions:The incidence of adenovirus pneumonia in children with liver injury was high, and mild injury is more common. Children with liver injury were younger, had more severe clinical symptoms such as wheezing and shortness of breath, and higher proportion of severe pneumonia and mortality. Among them, children with severe pneumonia had a higher proportion of liver injury, and moderate to severe injury was more common. The monitoring of children with different degrees of liver injury should be strengthened.

This paper reports 3 cases of acute hepatitis of unknown cause in children who met the case definition of WHO. Human adenovirus group C was detected in case 3, and the quantity of viral DNA was relatively high, which may be related to the liver function damage in the patient, but its role in pathogenesis needs further study to confirm.

Objective:To analyze the effects of noise exposure on the hearing at different frequencies in workers from the automobile manufacturing industry.Methods:A total of 4723 noise workers in a large automobile manufacturing company in Guangzhou were chosen as the research object by using judgment sampling method between April and July, 2018, and carried out 0.5, 1.0, 2.0, 3.0, 4.0 and 6.0 kHz pure tone audiometry threshold to analyze the characteristics of the status of hearing loss at different frequencies and its relationship with the noise exposure time.Results:The detection rate of hearing loss in noise-exposed workers was 29.8% (1406/4723) . Among them, the binaural hearing loss was 21.2% (999/4723) , and single unilateral hearing loss accounted for 8.6% (407/4723) . The hearing loss detection rate of right ear was higher than that of the left ear ( P<0.05) , especially in the 6.0 kHz ( P<0.001) . The detection rate of increased speech frequency hearing threshold was 1.9% (90/4723) , and the detection rate of increased high-frequency hearing threshold was 28.9% (1366/4723) . The detection rate of increased threshold in both the left and the right ear increased with the increase of frequency ( P<0.001) , the increased hearing threshold was the highest at the frequency of 6.0 kHz. The auditory threshold of left ear in 0.5 kHz were higher than that of right ear at the same frequency ( P<0.05) . The detection rate of hearing loss increased with the increase of noise exposure time ( P<0.001) , and the increased threshold of 3.0, 4.0 and 6.0 kHz from workers increased with the increase of noise exposure time ( P<0.001) . Conclusion:There is a significant increased threshold in workers exposed to noise frequency of 6.0 kHz, right ear is more easily damaged than left ear, there is a dose-response relationship for the noise exposure time and high-frequency hearing loss.

Objective:To analyze the effects of noise exposure on the hearing at different frequencies in workers from the automobile manufacturing industry.Methods:A total of 4723 noise workers in a large automobile manufacturing company in Guangzhou were chosen as the research object by using judgment sampling method between April and July, 2018, and carried out 0.5, 1.0, 2.0, 3.0, 4.0 and 6.0 kHz pure tone audiometry threshold to analyze the characteristics of the status of hearing loss at different frequencies and its relationship with the noise exposure time.Results:The detection rate of hearing loss in noise-exposed workers was 29.8% (1406/4723) . Among them, the binaural hearing loss was 21.2% (999/4723) , and single unilateral hearing loss accounted for 8.6% (407/4723) . The hearing loss detection rate of right ear was higher than that of the left ear ( P<0.05) , especially in the 6.0 kHz ( P<0.001) . The detection rate of increased speech frequency hearing threshold was 1.9% (90/4723) , and the detection rate of increased high-frequency hearing threshold was 28.9% (1366/4723) . The detection rate of increased threshold in both the left and the right ear increased with the increase of frequency ( P<0.001) , the increased hearing threshold was the highest at the frequency of 6.0 kHz. The auditory threshold of left ear in 0.5 kHz were higher than that of right ear at the same frequency ( P<0.05) . The detection rate of hearing loss increased with the increase of noise exposure time ( P<0.001) , and the increased threshold of 3.0, 4.0 and 6.0 kHz from workers increased with the increase of noise exposure time ( P<0.001) . Conclusion:There is a significant increased threshold in workers exposed to noise frequency of 6.0 kHz, right ear is more easily damaged than left ear, there is a dose-response relationship for the noise exposure time and high-frequency hearing loss.

Objective:To estimate the iodine nutrition level of pregnant women and children in Xinjiang.Methods:Using cluster random sampling method, from March to September in 2018, in the whole district, county (city, district) was treated as a unit to conduct sampling; each county (city, district) was divided into five areas (east, west, south, north, middle), 40 children aged 8 - 10 and 20 pregnant women in each area were randomly selected, salt samples and urine samples were collected to measure iodine content, and B-ultrasound method was used to detect thyroid volume in children.Results:Among 94 counties (cities, districts), 18 859 salt samples were collected from children and 9 070 salt samples from pregnant women. The median salt iodine (interquartile range) for children was 26.65 (23.70, 29.80) mg/kg, and the median salt iodine (interquartile range) for pregnant women was 26.60 (23.80, 29.80) mg/kg. Totally 17 736 qualified iodized salt samples and 109 non-iodized salt samples consumed by children were tested, the coverage rate of iodized salt was 99.42% (18 750/18 859), qualified rate of iodized salt was 94.59% (17 736/18 750), the consumption rate of qualified iodized salt was 94.05% (17 736/18 859), and the non-iodized salt rate was 0.58% (109/18 859). Totally 8 533 qualified iodized salt samples and 57 non-iodized salt samples consumed by pregnant women were tested, the coverage rate of iodized salt was 99.37% (9 013/9 070), the qualified rate of iodized salt was 94.67% (8 533/9 013), the consumption rate of qualified iodized salt was 94.08% (8 533/9 070), and the non-iodized salt rate was 0.63% (57/9 070). Twelve counties (cities, districts) had a consumption rate of qualified iodized salt lower than 90% for children, and 14 counties (cities, districts) had a consumption rate of qualified iodized salt lower than 90% for pregnant women. Totally 18 862 8 - 10 years old children's urine samples were detected, median urinary iodine was 227.0 μg/L, no county (city, district) was found with median urinary iodine < 100 μg/L. A total of 9 070 pregnant women's urine samples were detected, median urinary iodine was 182.0 μg/L, and 23 counties (cities, districts) had a median urinary iodine less than 150 μg/L. B ultrasound was used to detect thyroid volume in 18 787 children aged 8 - 10 years, 231 children had goiter, and the goiter rate was 1.23%, ranged from 0 to 12.05%, and 2 counties (cities, districts) had goiter rate > 5%.Conclusions:There are still some areas in Xinjiang with the consumption rate of qualified iodized salt < 90%. Children's iodine nutrition is greater than the appropriate amount (200 - 299 μg/L), pregnant women's iodine nutrition is appropriate (150 - 249 μg/L), and children's goiter rate generally meets national elimination and control standards (< 5%). Monitoring of iodized salt should be strengthened, and iodine nutrition levels in children and pregnant women should be continuously monitored.

Objective:To investigate the combined effect of noise and hand-transmitted vibration on noise-induced hearing loss (NIHL) in the automobile manufacturing industry.Methods:From September 2018 to January 2019, cluster sampling was used to select 998 workers in an automobile factory as study subjects, among whom 352 workers exposed to noise alone were enrolled as noise group, 342 workers exposed to noise and hand-transmitted vibration were enrolled as combined effect group, and 304 workers without exposure to occupational hazardous factors were enrolled as control group. A questionnaire survey and pure tone audiometry were performed for all study subjects. An analysis of variance was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a ordinal polytomous logistic regression analysis was used to investigate the influencing factors for NIHL (with 0.05 as the inclusion criteria and 0.10 as the exclusion criteria for independent variables) .Results:There was a significant difference in L Aeq, 8 h between groups ( P<0.05) ; the noise group and the combined effect group had a significantly higher L Aeq, 8 h than the control group ( P<0.05) , while there was no significant difference in L Aeq, 8 h between the noise group and the combined effect group ( P>0.05) . The control group had a significantly lower detection rate of hearing loss than the noise group and the combined effect group ( P<0.0125) , and the combined effect group had a significantly higher detection rate of hearing loss than the noise group ( P<0.0125) . The ordinal polytomous logistic regression analysis showed that after adjustment for confounding factors such as age, working years, sex, smoking, and drinking, both noise exposure and exposure to both noise and hand-transmitted vibration had an influence on workers' hearing ( P<0.05) , and the workers exposed to both noise and hand-transmitted vibration had a higher risk of hearing loss than those exposed to noise alone. Conclusion:There may be a combined effect of noise and hand-transmitted vibration in the automobile manufacturing industry, which can increase the risk of NIHL in workers.

Objective:To investigate the combined effect of noise and hand-transmitted vibration on noise-induced hearing loss (NIHL) in the automobile manufacturing industry.Methods:From September 2018 to January 2019, cluster sampling was used to select 998 workers in an automobile factory as study subjects, among whom 352 workers exposed to noise alone were enrolled as noise group, 342 workers exposed to noise and hand-transmitted vibration were enrolled as combined effect group, and 304 workers without exposure to occupational hazardous factors were enrolled as control group. A questionnaire survey and pure tone audiometry were performed for all study subjects. An analysis of variance was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a ordinal polytomous logistic regression analysis was used to investigate the influencing factors for NIHL (with 0.05 as the inclusion criteria and 0.10 as the exclusion criteria for independent variables) .Results:There was a significant difference in L Aeq, 8 h between groups ( P<0.05) ; the noise group and the combined effect group had a significantly higher L Aeq, 8 h than the control group ( P<0.05) , while there was no significant difference in L Aeq, 8 h between the noise group and the combined effect group ( P>0.05) . The control group had a significantly lower detection rate of hearing loss than the noise group and the combined effect group ( P<0.0125) , and the combined effect group had a significantly higher detection rate of hearing loss than the noise group ( P<0.0125) . The ordinal polytomous logistic regression analysis showed that after adjustment for confounding factors such as age, working years, sex, smoking, and drinking, both noise exposure and exposure to both noise and hand-transmitted vibration had an influence on workers' hearing ( P<0.05) , and the workers exposed to both noise and hand-transmitted vibration had a higher risk of hearing loss than those exposed to noise alone. Conclusion:There may be a combined effect of noise and hand-transmitted vibration in the automobile manufacturing industry, which can increase the risk of NIHL in workers.

Objective To investigate iodine nutritional status of key population in Puhui Town,Korla Xinjiang.Methods In 2018,totally 29 samples of factory water,peripheral water and self-prepared well water from centralized water supply in Puhui Town were collected,and urine samples,salt samples and blood samples were collected from 200 children aged 8 to 10 years old and 100 women of childbearing age (including pregnant women)in Puhui Town.Arsenic-cerium catalytic spectrophotometric method was used for determination of iodine in water and urine;the salt iodine was determined using direct titration and the thyroid was examined by ultrasound.The assessment was conducted according to the standard of "Delineation of Water-source Areas and Endemic Areas of High Iodine Goiter" (GB/T 19380-2016).Results In this survey,the median of water iodine in Puhui town (n =29)was 76.1 μg/L,and the median of salt iodine (n =175) was 27.76 mg/kg;the rate of iodized salt was 98.29％ (172/175);the consumption rate of qualified iodized salt was 96.00％ (168/175);the medians of urinary iodine of children aged 8 to 10 years old (n =208),women of childbearing age (n =73),and pregnant women (n =25) were 292.47,248.23,and 246.36 μg/L,respectively.The thyroid enlargement rate was 1.9％ (4/208) in children aged 8-10 years old,no swelling of women of childbearing age and pregnant women.Conclusions Iodine nutrition of pregnant women is in an appropriate state;both the children aged 8 to 10 years old and the women of childbearing aged are in excess of the appropriate level;goiter rate is lower in children.According to the national standards,Puhui Town does not belong to waterborne high iodine area.

OBJECTIVE: To explore the combined effect of noise and other occupational hazards on hearing impairment and electrocardiograph(ECG) of workers in automobile manufacturing enterprises. METHODS: A judgment sampling method was used to select 3 434 workers as study subjects from an automobile manufacture enterprise. According to the exposure to different types of occupational hazardous factors, they were divided into noise series group, noise dust group, noise welding dust group, noise benzene series group, noise nitrogen oxide group and control group, with 716, 693, 1 540, 45, 195 and 245 cases in each group, respectively. The subjects were examined with pure-tone hearing test and ECG. RESULTS: The total rate of high frequency hearing loss was 11.2%(385/3 434), and high frequency hearing loss was the main type of hearing loss among workers in each group. The simple high-frequency hearing loss rates of noise group, noise dust group, noise welding dust group, noise benzene series group, noise nitrogen oxide group and the control group were 10.3%, 11.5%, 12.3%, 26.7%, 10.3% and 4.1% respectively, and the rate of total hearing loss were 13.7%, 14.6%, 14.6%, 31.1%, 16.9% and 6.5% respectively. Compared with the control group, the rate of simple high-frequency hearing loss and total hearing loss were higher in the other 5 groups(P<0.005). The rate of high-frequency hearing loss in noise group was lower than that in noise benzene series group(P<0.005). The rate of arrhythmia was 20.9%(717/3 434). Arrhythmia was the main type of ECG abnormality in all groups. The rates of arrhythmia in noise group, noise dust group, noise welding dust group, noise benzene series group, noise nitrogen oxide group and control group were 16.9%, 16.6%, 27.9%, 17.8%, 13.8% and 6.9%, respectively. The rate of arrhythmia in noise welding dust group was higher than that in noise group(P<0.005). CONCLUSION: The combined effect of noise and benzene series increases the risk of high-frequency hearing loss in workers. The combined effect of noise and welding dust increases the risk of arrhythmia in workers.