ObjectiveTo investigate the correlation between genetic polymorphism of heat shock proteins 70 (HSP70) and susceptibility to occupational noise-induced hearing loss (ONIHL). Methods A total of 229 ONIHL workers were selected as the case group and 229 healthy workers with similar age, years of noise exposure, and noise exposure levels were selected as the control group using the case-control study method. Occupational health examinations were conducted on both groups, and peripheral blood of individuals was collected for DNA extraction. The genotypes of three single nucleotide polymorphisms of the HSP70 were detected using the MassArray system. Results The allele frequency distribution of HSP70 rs2227956, rs1043618, and rs1061581 in the control group was in Hardy-Weinberg equilibrium (all P>0.05). The genotype and allele frequency distribution of rs2227956 was significantly different between the two groups (all P<0.05), while no significant difference was found for rs1043618 and rs1061581 (all P>0.05). After adjusting for age, years of noise exposure, individual noise exposure level, smoking, and drinking, individuals with AG and AG+GG genotypes of rs2227956 had a higher risk of ONIHL than those with AA genotype (all P<0.05). The risk of ONIHL was higher in individuals with G allele of rs2227956 than in those with A allele (P<0.05). No correlation was found between rs1043618 and rs1061581 polymorphisms and the risk of ONIHL (all P>0.05). Conclusion The rs2227956 polymorphism of the HSP70 gene is correlated with susceptibility to ONIHL in noise-exposed workers, and the G allele is a risk factor for ONIHL in this population.

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R² = 0.033; P = 0.018), followed by acute kidney injury (AKI; R² = 0.032; P = 0.011) and plasma MIP-1β level (R² = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.
Acute Kidney Injury/complications* ; Bacteria/classification* ; Chemokine CCL4/blood* ; Community-Acquired Infections/microbiology* ; Humans ; Lung ; Microbiota/genetics* ; Pneumonia, Bacterial/diagnosis* ; Prognosis ; RNA, Ribosomal, 16S/genetics*

Objective:To study the influence of the choice of main diagnosis on diagnosis-related groups(DRG) grouping and weight change, by taking cerebral infarction as the entry point.Methods:From January 1, 2019 to March 31, 2019, 331 patients in three DRG groups(BR25, BR23, BR21) with cerebral infarction were selected. The original group was used as the control group; the main diagnosis was exchanged with the first other diagnosis, then DRG group was used as the experimental group. The difference of the number of cases and weight between the two groups was analyzed.Results:41.4%(137/331) of the patients in the experimental group were enrolled in BZ11 with other neurological disorders associated with important comorbidities and comorbidities, and 82.5%(273/331) patients′ weight increased after diagnostic conversion.Conclusions:Choosing other diagnosis as the main diagnosis may change the weight of the disease and affect the corresponding disease benefit. In order to prevent downcoding, DRG grouping should be detailed, and DRG payment should consider how to reflect the value of difficult cases; for upcoding behavior, medical insurance center and relevant medical institutions should check the correctness of coding, and monitor in place.

Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease, and may progress to cirrhosis and associated with complications of end-stage liver disease. The immunological characteristic of PBC is the presence of anti-mitochondrial autoantibodies (AMAs), and some anti-nuclear antibodies (ANAs) have high specificity for the diagnosis of PBC. In recent years, it has been found that anti-gp210, anti-sp100 and anti-centromere antibodies are correlated with the severity of PBC, treatment response to ursodeoxycholic acid (UDCA) and poor prognosis. However, correlation between AMAs and disease progression of PBC is still in controversial. This article reviewed the progress in research on the influence of autoantibodies on biochemical response and prognosis of PBC.

OBJECTIVE: To explore whether MRI fusion technology (combined T2-weighted imaging [T2WI] and fat-suppressed T2WI [T2WI-(FS)]) improves signal differences between anal fistulas and surrounding structures. MATERIALS AND METHODS: A total of 32 patients with confirmed diagnoses of anal fistula were retrospectively studied. All available T2WI and T2WI-(FS) images for each patient were used to generate fusion image (T2WI-(Fusion)) based on the addition of gray values obtained from each pixel via an MR post-processing work station. The discriminability of fistula, perianal sphincter, and perianal fat in T2WI, T2WI-(FS), and T2WI-(Fusion) images was quantified with Fisher's scoring algorithm. For subjective visual image assessment by researchers, five-point scale scores were determined using a modified double-stimulus continuous quality-scale test to evaluate T2WI-(FS), T2WI, enhanced axial three-dimensional-volumetric interpolated breath-hold examination (3D-VIBE), and T2WI-(Fusion) sequence images. The differences were subsequently compared. RESULTS: Mean Fisher scores for fistulas vs. sphincters obtained from T2WI-(Fusion) (F(Fusion-fistula) = 6.56) were significantly higher than those from T2WI (F(T2WI-fistula) = 3.35) (p = 0.001). Mean Fisher scores for sphincters vs. fat from T2WI-(Fusion) (F(Fusion-sphincter) = 10.84) were significantly higher than those from T2WI-(FS) (FS(FS-sphincter) = 2.57) (p = 0.001). In human assessment, T2WI-(Fusion) showed the same fistula discriminability as T2WI-(FS), and better sphincter discriminability than T2WI. Overall, T2WI-(Fusion) showed better discriminability than T2WI, T2WI-(FS), and enhanced 3D-VIBE images. CONCLUSION: T2WI and T2WI-(FS) fusion technology improves signal differences between anal fistulas and surrounding structures, and may facilitate better evaluation of anal fistulas and sphincters.
Anal Canal ; Diagnosis ; Fistula ; Humans ; Magnetic Resonance Imaging ; Rectal Fistula ; Retrospective Studies

Objective: To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in male welders in different work areas of shipbuilding industry based on their operational working position and body position characteristics and to analyze the operational positions and ergonomic loads. Methods: In February 2017, 412 male welders from the hull and block work areas of a large ship factory were selected by stratified sampling. The prevalence and effects of WMSDs within a year were investigated using the Nordic Musculoskeletal Disorders Questionnaire, and a rapid exposure checklist was used to obtain the ergonomic load index by comprehensive scoring; the exposure-response relationship between the ergonomic loads and WMSDs symptoms of subjects in the hull and block work areas was evaluated. Results: Among the male welders working in the hull work area of shipbuilding industry, WMSDs occurred more commonly in the neck, lower back/waist, and legs, accounting for 53.16% (126/237) , 51.90% (123/237) , and 41.77% (99/237) , respectively; among those working in the block work area, WMSDs occurred more commonly in the lower back/waist, wrist, and legs, accounting for 52.57% (92/175) , 49.14% (86/175) , and 45.14% (79/175) , respectively. There were significant differences in the distribution of cases of pain within the last 7 days and one month, pain lasting more than one month, or absence from work due to pain within a year in the four positions between the two work areas (P<0.05). In the hull work area, high and extremely high exposure levels were mainly seen in the neck, lower back/waist, and legs, accounting for 76.79%(182/237), 69.20%(164/237), and 59.49%(141/237), respectively; in the block work area, high and extremely high exposure levels were mainly seen in the lower back/waist, wrist, and legs, accounting for 77.71%(136/175), 50.29% (88/175), and 46.29% (81/175), respectively. The detection rates of WMSDs in these four positions significantly increased as the exposure levels rose (P<0.01). Conclusion The WMSDs of male welders working in the hull and block work areas of shipbuilding industry occurs more commonly in the lower back/waist and legs. The risk of WMSDs symptoms increases with the rise of ergonomic load.

The authors described the purpose of the creation, the structure of the basic model, and the changes in the chapters of ICD-11, and analyzed its differences with ICD-10, as well as its unique advantages and current progress. The revision of ICD-11 is closely related to the development of modern medicine. It features more elaborate expression of diseases and informatization of classification tools, making it better fitting the development of medical and health information big data and facilitating the global collection and application of medical information data.

Objective To investigate the effects of narrow-band ultraviolet B (NB-UVB) therapy on the levels of plasmin and CC chemokine ligand 20 (CCL20) in peripheral blood of patients with psoriasis vulgaris.Methods A total of 60 patients with psoriasis vulgaris in progressive stage were treated with NB-UVB radiation thrice a week for 8 weeks.Enzyme-linked immunosorbent assay (ELISA) was performed to detect the levels of plasmin and CCL20 in the peripheral blood of the patients before and after the treatment,as well as in the peripheral blood of 50 healthy controls.Results After the treatment,psoriasis area and severity index (PASI) scores in patients were significantly decreased compared with those before the treatment (2.54 ± 1.64 vs.10.26 ± 3.14,t =17.40,P ＜ 0.05),and the response rate was up to 87％ (52/60).Before the treatment,levels of plasmin and CCL20 were both significantly higher in the patient group than in the control group (plasmin:180.07 ± 40.62 μg/L vs.76.30 ± 26.92 μg/L,t =15.45,P ＜ 0.05;CCL20:422.41 ± 129.87 pg/L vs.205.33 ± 49.89 pg/L,t =11.15,P ＜ 0.05).After the treatment,levels of plasmin (148.22 ± 40.05 μg/L) and CCL20 (329.67 ± 100.73 pg/L) in patients were significantly decreased compared with those before the treatment (t =4.97,6.44,P ＜ 0.05),but still significantly higher than those in controls (t =10.82,7.95,P ＜ 0.05).Before the treatment,the level of plasmin was positively correlated with the level of CCL20 in peripheral blood of the patients (r =0.57,P ＜ 0.05),and the levels of plasmin and CCL20 were both positively correlated with the PASI score (r =0.49,0.62,respectively,both P ＜ 0.05).Conclusion NB-UVB radiation may exert a therapeutic effect on psoriasis vulgaris by reducing levels of plasmin and CCL20 in peripheral blood of patients.

Objective: To investigate the current prevalence and prevention of work-related musculoskeletal disorders (WMSDs) among physicians for internal medical examination, and to provide a theoretical basis for the prevention and treatment of WMSDs in physicians for internal medical examination. Methods: In February 2017, 326 physicians for internal medical examination were randomly selected from 5 general tertiary hospitals and 2 specialized tertiary hospitals in a city of China. A questionnaire was designed according to the Nordic Musculoskeletal Questionnaire and the occupational features of doctors in China to investigate the prevalence of musculoskeletal pain over the past year, the cognitive attitude to WMSDs, the knowledge of WMSDs prevention, and ways to get the knowledge of WMSDs prevention. Results: In the tertiary hospitals of this city, the symptoms of WMSDs were mainly seen in the wrist (75.78%) , neck (67.19%) , and lower back (58.59%) among male physicians, and in the wrist (73.74%) , lower back (70.95%) , and upper back (60.89%) among female physicians. Compared with the female physicians, the male physicians had a significantly increased detection rate of symptoms of WMSDs in the neck (P<0.05) and significantly reduced detection rates of symptoms of WMSDs in the upper and lower back (P<0.05). There were significant differences between the detection rates of symptoms of WMSDs in the neck, wrist, and lower back within the past 12 months, 7 days, and >1 month (P<0.01). The rates of knowledge of the severity and prevention of WMSDs were significantly different between the physicians with different working years and professional titles (P<0.01) . Conclusion Among the physicians for internal medical examination in the tertiary hospitals of this city, WMSDs are mostly seen in the wrist, neck, and waist, and the knowledge of WMSDs prevention varies with different working years and professional titles.

Objective: To establish a TaqMan-MGB probe-based real-time fluorescence RT-PCR assay for avian influenza H5N6 virus used in rapid diagnosis for suspected cases and surveillance for outer environment of live poultry markets. Methods: Based on the conservative sequences of avian influenza H5N6 virus for HA and NA gene published on GenBank, specific primers and TaqMan-MGB probes were designed to develop and optimize for the dual real-time RT-PCR assay. Specificity, sensitivity, repeatability and comparison tests were carried out. Results: This dual real-time RT-PCR detection can be completed within 80 minutes. There was no cross-reaction with other subtypes of influenza virus and common respiratory pathogens. The minimum detection limit could be up to 10 copies/reaction. The correlation coefficient of standard curve for the gene of H5 and N6 were 0.999 and 0.993, and the coefficients of variation for cycle threshold were range from 0.151%-0.549%and 0.213%-0.575%, respectively. The positive and negative coincidence rates of the validation test were 100%. Conclusions This TaqMan-MGB probe-based dual real-time RT-PCR for avian influenza H5N6 virus was rapid, specific and sensitive. It will have a good use in early emergency detection of suspected cases and continuous monitoring of external environment in live poultry trade market.