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 investigate the influencing factors for vaccination willingness of herpes zoster vaccine (HZV) among the elderly, so as to provide the basis for improving the HZV vaccination strategy for the elderly. Methods: From July 2023 to June 2024, permanent residents aged ≥60 years in Yangzhou City, Jiangsu Province were selected using the multistage random sampling method and probability proportionate to size sampling method. Basic information, disease history, awareness of herpes zoster (HZ) and HZV, vaccination history, and vaccination willingness of HZV were collected through questionnaire surveys. Multivariable logistic regression model was used to analyze the influencing factors for vaccination willingness of HZV among the elderly. Results: Totally 1 209 valid questionnaires were recovered, with an effective recovery rate of 95.95%. The respondents included 657 males (54.34%) and 552 females (45.66%). Among them, 626 (51.78%) individuals were aged 60 -<70 years. There were 113 individuals had vaccination willingness of HZV, with a vaccination willingness rate of 9.35%. The multivariable logistic regression analysis showed that female (OR=2.872, 95%CI: 1.624-5.080), urban (OR=4.909, 95%CI: 2.732-8.818), individual monthly income of 1 000-<2 000 yuan (OR=3.085, 95%CI: 1.602-5.940), accessibility of vaccination clinics (OR=5.717, 95%CI: 1.109-29.462), presence of chronic diseases (OR=2.423, 95%CI: 1.325-4.431), history of varicella infection (OR=2.114, 95%CI: 1.213-3.684), awareness of HZ (OR=2.194, 95%CI: 1.096-4.394), awareness of HZV (OR=3.562, 95%CI: 2.005-6.330), history of influenza vaccine vaccination (OR=7.833, 95%CI: 4.189-14.645), and history of 23-valent pneumococcal vaccine vaccination (OR=2.955, 95%CI: 1.603-5.449) were promoting factors for vaccination willingness of HZV. Conclusion The vaccination willingness rate of HZV among the elderly is relatively low, which is mainly affected by factors such as gender, residence, individual monthly income, accessibility of vaccination clinics, presence of chronic diseases, history of varicella infection, awareness of HZ and HZV, and history of influenza vaccine and 23-valent pneumococcal vaccine vaccination.

OBJECTIVE To establish anticoagulation pharmaceutical service model based on the integrated theory of health behavior change （ITHBC）， and analyze its effects. METHODS Referring to relevant literature and soliciting opinions from 8 experts from departments such as pharmacy， respiratory medicine， and vascular surgery， a anticoagulation pharmaceutical service model based on ITHBC was ultimately formed. VTE inpatients were selected from The First Affiliated Hospital of Shihezi University from December 2023 to June 2024 as the research subjects. They were randomly assigned into intervention group （58 cases） and control group （60 cases） using a random number table method. The intervention group implemented pharmacist-led anticoagulant pharmaceutical service model based on ITHBC， while the control group adopted a conventional anticoagulant pharmaceutical service model. The anticoagulation-related outcomes of two groups were compared after 3 months： anticoagulation compliance rate， the incidence of adverse drug reactions， the score of medication adherence and compliance rate of anticoagulant prescription； economic evaluation was conducted. RESULTS After implementing ITHBC-based anticoagulant pharmaceutical services for 3 months， the intervention group had higher anticoagulation compliance rate， score of medication adherence， and compliance rate of anticoagulant prescription than the control group （P＜0.05）. There was no statistically significant difference in the total incidence of adverse drug reactions between the two groups （P＞0.05）. For every 1% point increase in anticoagulant compliance rate， the hospital needed to invest 4.35 yuan additionally in anticoagulant pharmaceutical service fees. Compared with China’s per capita gross domestic product （GDP， 89 358 yuan） in 2023， the incremental cost-effectiveness ratio value that increased the anticoagulation compliance rate by 50% is far less than one time of per capita GDP. CONCLUSIONS The pharmacist- led anticoagulant pharmaceutical service model based on ITHBC can effectively improve the outcomes of anticoagulant therapy for VTE patients， enhance medication compliance， improve patients’ awareness and recognition of adverse drug reactions to anticoagulants， and has certain economic and social benefits.

Objective:To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province.Methods:Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden.Results:From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women.Conclusions:The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

Objective To explore the value of artificial intelligence(AI)in the diagnosis of pulmonary nodules in terms of consistency and efficiency compared with two radiologists(physician 1 is a chief physician and physician 2 is a deputy chief physician)in the diagnosis of benign and malignant pulmonary nodules using computed tomography(CT).Methods Retrospective analysis of 201 patients with pulmonary nodules confirmed by surgery pathology at Hangzhou Municipal Hospital affiliated to Zhejiang Chinese Medical University from January 2021 to October 2022,including a total of 229 pulmonary nodules,of which 74 were benign and 155 were malignant.The consistency of AI diagnosis with two radiologists was evaluated by weighted Kappa test,and the diagnostic performance of AI with the two radiologists was evaluated by the receiver operating characteristic curve(ROC).Results In the diagnosis of the benign and malignant nature of partial solid nodules,ground-glass nodules,solid nodules,and partial ground-glass and solid plus ground-glass nodules,the consistency between AI and physician 2 was higher than that between AI and physician 1.Additionally,the area under the curve(AUC)of physician 2 was higher than that of AI and physician 1 with statistically significant differences between the AUCs of ground-glass nodules,solid nodules,and partial ground-glass and solid plus ground-glass nodules(P<0.05).In the diagnosis of the benign and malignant nature of partial solid nodules and ground-glass nodules,the AUC of physician 1 was higher than that of AI,but there was no statistically significant difference between the two(P>0.05).In the diagnosis of the benign and malignant nature of solid nodules and partial ground-glass and solid plus ground-glass nodules,the AUC of AI was higher than that of physician 1 with statistically significant differences between the two(P<0.05).In the diagnosis of the benign and malignant nature of ground-glass nodules,solid nodules,and partial ground-glass and solid plus ground-glass nodules,AI's sensitivity(97%,92%,and 94%)was higher than that of physician 1(58%,89%,and 72%)and physician 2(83%,84%,and 85%).Conclusion AI has a certain diagnostic efficacy in the diagnosis of pulmonary nodules malignancy.The overall diagnostic efficacy of the AI system used in this study is between that of physician 1 and physician 2,but its sensitivity is higher than that of the latter two.

Objective:To explore the effect of the course ideology and politics teaching model based on the Context-Content-Course (3C) model in the nursing experimental class of endocrine diseases for nursing undergraduates.Methods:From March 2021 to June 2021,168 undergraduates from Class 1 of Chongqing Medical University in Grade 2018 were selected as the experimental group and 163 undergraduates from Class 3 of Nursing as the control group .Taking the humanistic care ability as the entry point of the course ideology and politics education, the experimental group carried out teaching and implement humanistic care education using course ideology and politics teaching mode based on the 3C model; the control group used traditional methods to carry out humanistic care education. After the course, the humanistic care ability, professional self-efficacy, and emotional intelligence of the two groups were compared.Results:After the implementation of the new teaching model, the total scores of humanistic care ability, occupational self-efficacy, and emotional intelligence of the students in the experimental group were 147.55 ± 15.95, 110.13 ± 9.26, and 76.24 ± 8.78, respectively, while those in the control group were 121.16 ± 18.44, 90.45 ± 9.49, and 61.67 ± 12.33, respectively; and the differences of the scores between two groups were statistically significant ( t=13.73, 18.80, 12.24, all P<0.01). Conclusions:The application of the course ideology and politics teaching model based on the 3C model in the nursing experimental class of endocrine diseases is helpful to improve the humanistic care ability, professional self-efficacy, and emotional intelligence of nursing students′ and is conducive to cultivating the comprehensive humanistic qualities of nursing students. It is ansignificant manifestation of accurate course ideology and politics education.

In order to reveal the mechanism of silicon (Si) fertilizer in improving nitrogen (N) and phosphorus (P) nutrient availability in paddy soil, we designed a series of soil culture experiments by combining application of varying Si fertilizer concentrations with fixed N and P fertilizer concentrations. Following the recommendations of fertilizer manufacturers and local farmers, we applied Si in concentrations of 0, 5.2, 10.4, 15.6, and 20.8 μg/kg. At each concentration of added Si, the availability of soil N and P nutrients, soil microbial activity, numbers of ammonia-oxidizing bacteria and P-decomposing bacteria which means that the organic P is decomposed into inorganic nutrients which can be absorbed and utilized by plants, and urease and phosphatase activity first increased, and then decreased, as Si was added to the soil. These indicators reached their highest levels with a Si application rate of 15.6 μg/kg, showing values respectively 19.78%, 105.09%, 8.34%, 73.12%, 130.36%, 28.12%, and 20.15% higher than those of the controls. Appropriate Si application (10.4 to 15.6 µg/kg) could significantly increase the richness of the soil microbial community involved in cycling of N and P nutrients in the soil. When the Si application rate was 15.6 μg/kg, parameters for characterizing microbial abundance such as sequence numbers, operational taxonomic unit (OTU) number, and correlation indices of microbial community richness such as Chao1 index, the adaptive coherence estimator (ACE) index, Shannon index, and Simpson index all reached maximum values, with amounts increased by 14.46%, 10.01%, 23.80%, 30.54%, 0.18%, and 2.64%, respectively, compared with the control group. There is also a good correlation between N and P mineralization and addition of Si fertilizer. The correlation coefficients between the ratio of available P/total P (AP/TP) and the number of ammonia-oxidizing bacteria, AP/TP and acid phosphatase activity (AcPA), AP/TP and the Shannon index, the ratio of available N/total amount of N (AN/TN) and the number of ammoniated bacteria, and AN/TN and AcPA were 0.9290, 0.9508, 0.9202, 0.9140, and 0.9366, respectively. In summary, these results revealed that enhancement of soil microbial community structure diversity and soil microbial activity by appropriate application of Si is the key ecological mechanism by which application of Si fertilizer improves N and P nutrient availability.

【Objective】 To analyze the data of non-small cell lung cancer (NSCLC) gene chip using the bioinformatics method, screen differential expression genes (DEGs), and explore the biomarkers related to the prognosis of NSCLC so as to provide a new target for the treatment of NSCLC. 【Methods】 The NSCLC gene chip data were downloaded from the GEO database and the common DEGs in the two datasets were screened by GEO2R tool and FunRich3.1.3 software. The DAVID database was used in GO analysis and KEGG analysis of the DEGs. The protein-protein interaction (PPI) network was constructed using the STRING database; Cytoscape 3.8.0 software was used to select the top 20 hub genes. Then Kaplan-Meier plotter was used to analyze the prognosis of the identified hub genes, and multiple external databases were used to verify the expressions of the hub genes and their relationship with prognosis. 【Results】 A total of 159 intersect DEGs were screened from the two datasets. A total of 20 hub genes were identified via PPI network. Survival analysis and validation results from multiple external databases showed that SPP1 was highly expressed in NSCLC tumor tissues and was significantly correlated with the patients’ poor prognosis (P<0.05). The subgroup analysis showed that SPP1 might cause the poor prognosis by affecting lymph node metastasis. 【Conclusion】 SPP1 may be a biomarker for evaluating the prognosis of NSCLC patients, providing a new idea for the targeted therapy of NSCLC.

Objective: To explore the reliability and validity of the Chinese Pediatric Quality of Life Inventory（PedsQL）in influenza children. Methods: From January 2017 to February 2018,we selected laboratory-diagnosed influenza cases and healthy children according to age and gender ratio by stratified random sampling and systematic sampling method. We employed Chinese version of PedsQL 4.0 to investigate their quality of life,used Cronbach's α to evaluate the reliability,and used Pearson correlation coefficient, t-test,confirmatory factor analysis（CFA）and ROC curve to evaluate the validity. Results: Totally 300 influenza cases and 300 healthy children were surveyed,with 294（98.00%）and 295（98.33%）valid questionnaires recovered. The general Cronbach's α was 0.89,and the Cronbach's α of each dimension ranged from 0.79 to 0.84. The Pearson correlation coefficients between the items and their belonged dimension ranged from 0.537 to 0.755,between the items and other dimension ranged from 0.203 to 0.384. The CFA resulted in RMSEA of 0.06,GFI of 0.88,AGFI of 0.90,CFI of 0.91 and NFI of 0.89. The scores in total and in all the dimensions in influenza cases were significantly different with those in healthy children（P<0.05）. Taking the scores in influenza cases as a golden standard,the area under the ROC curve was 0. 985（P<0.05）,the sensitivity was 0.92,and the specificity was 0.95. When the limit score was 82.18,the Youden index was the largest. Conclusion The Chinese version of PedsQL4.0 has good reliability and validity, which can be applied to quality of life assessment in children.

Objective:To provide references for aeromedical rescue system development and rational resource allocation for such services, based on analysis of helicopter emergency medical service(HEMS) cases of Bayannur Hospital in Inner Mongolia.Methods:HEMS cases of Bayannur Hospital from 2018 to 2019 were studied, covering such data as patients′ age, gender, disease type, medical service modes, medical service area, and service time. Measurement data were expressed by ± s, and enumeration data were expressed by case number and ratio, while descriptive approach was used for analysis. Results:From 2018 to 2019, 178 patients in Bayannur used HEMS, respectively 39 cases in 2018 and 139 cases in 2019, including 32 cases(17.98%)of pre-hospital emergency care and 146 cases(82.02%) of inter-hospital transfer. The top 3 diseases of the disease spectrum were 73(41.01%) traumatic diseases, 44(24.72%) cardiovascular diseases, and 23(12.92%) neurological diseases.Conclusions:HEMS of Bayannur Hospital has played an important role in emergency medical service for the people in remote areas, and has become an essential method for constructing the air-ground cooperation emergency medical system in West China.