This article introduces the occupational disease diagnosis of work-related musculoskeletal disorders such as lumbar and spinal injuries in Germany, and focuses on the research and standard values of the maximum pressure tolerance of intervertebral discs. This article mainly introduces the dose model limits and their applications proposed by the Mainz Dortmund Dosis model (MDD), the judgment of the German Social Court (Bundessozialgericht, BSG), and the German Spinal Research Re evaluation (Deutsche Wirbels ulentudieⅡ, DWSⅡ) ; X-ray manifestations and measurements of intervertebral disc injury; Problems in actual cases and diagnosis. In order to provide reference and inspiration for the occupational diseases diagnosis of work related musculoskeletal disorders in China.

This article introduces the occupational disease diagnosis of work-related musculoskeletal disorders such as lumbar and spinal injuries in Germany, and focuses on the research and standard values of the maximum pressure tolerance of intervertebral discs. This article mainly introduces the dose model limits and their applications proposed by the Mainz Dortmund Dosis model (MDD), the judgment of the German Social Court (Bundessozialgericht, BSG), and the German Spinal Research Re evaluation (Deutsche Wirbels ulentudieⅡ, DWSⅡ) ; X-ray manifestations and measurements of intervertebral disc injury; Problems in actual cases and diagnosis. In order to provide reference and inspiration for the occupational diseases diagnosis of work related musculoskeletal disorders in China.

Objective To investigate the effect of lead exposure on blood pressure of lead workers. Methods A total of 665 lead workers from some lead-acid battery enterprises in Wuhan were selected as the lead exposure group, and 708 ordinary workers without lead exposure were selected as the control group. The blood pressure in the workers of both groups was measured. The blood lead concentrations were measured in the lead-exposed group. The independent samples t-test was used to compare the blood pressure between the two groups. Linear regression model was used to analyze the relationship between the blood lead concentration and the blood pressure in the lead-exposed group. Logistic regression analysis was used to analyze the relationship between the risk of hypertension and blood lead concentration in lead-exposed group. Results The mean values of systolic blood pressure, diastolic blood pressure and pulse in the lead exposure group were significantly higher than those in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in pulse pressure difference between the two groups (P>0.05). Linear regression analysis revealed that blood lead concentrations were significantly correlated with both systolic and diastolic blood pressure in the lead exposure group. For each increase of 1μg/L of blood lead concentration in the lead exposure group, the systolic blood pressure of lead workers increased by 0.011 mmHg, and the diastolic blood pressure increased by 0.007 mmHg. Logistic regression analysis found that men in the lead-exposed group had a higher risk of hypertension than women. The older the age and the higher the blood lead concentration, the higher the risk of development of hypertension. Conclusion There is a positive correlation between the blood lead concentration and the systolic and diastolic blood pressure in lead workers. The older the lead worker, the higher the risk of developing high blood pressure. The higher the lead concentration in lead workers, the higher the risk of developing high blood pressure.

Objective: To investigate the thyroid functions and influencing factors among radiation workers in Wuhan City, so as to provide insights into occupational health monitoring among radiation workers. Methods : Radiation workers receiving physical examinations in Wuhan Prevention and Treatment Center for Occupational Diseases from January to October 2022 were enrolled, and participants' gender, age, smoking, alcohol consumption, medical history, medication use, types of occupational radiation and work duration were collected. Triiodothyronine (TT3), thyroxine (TT4), free thyroxine (FT4), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) were measured using a magnetic microparticle-based chemiluminescence immunoassay. Personnel dose equivalent was monitored using thermoluminescent dosimetry, and annual cumulative radiation dose was estimated. Factors affecting thyroid function were identified using a multivariable linear regression model. Results: Totally 978 radiation workers were recruited, with a median age of 32.00 (interquartile range, 10.00) years, and including 782 men (79.96%) and 196 women (20.04%). There were 246 smokers (25.15%), 257 workers with alcohol consumption (26.28%) and 489 with a history of radiation work (50.00%). The median annual cumulative radiation dose was 0.20 (interquartile range, 0.24) mSv. The percentage of abnormal thyroid function was 14.72%. Multivariable logistic regression analysis showed that women (OR=1.925, 95%CI: 1.061-3.490), history of radiation work (OR=2.810, 95%CI: 1.119-7.057) and involving in medical application (OR=1.915, 95%CI: 1.101-3.332) were associated with abnormal thyroid function. Conclusions The percentage of abnormal thyroid function was 14.72% among radiation workers in Wuhan City. History of exposure to ionizing radiation, types of occupational radiation and gender were main factors affecting thyroid function.

Objective To investigate the relationship between occupational noise exposure and glycated hemoglobin (HbA1c) levels, as well as prediabetes diagnosed by HbA1c. Methods A total of 1 181 workers from a cigarette factory were selected as the research subjects using a judgment sampling method. Workers were divided into control, low-level noise exposure and high-level noise exposure groups, consisting of 236, 359, and 586 individuals, respectively. The blood sample was collected for HbA1c test and occupation noise exposure intensity in workplace was detected by an area-sampling method. Results There were no statistical significant differences in HbA1c levels and prediabetes prevalence among the three groups of workers (all P>0.05). After adjusting for potential confounding factors such as years of service, gender, smoking, pack-years of smoking, alcohol consumption, and body mass index, multiple linear regression analysis showed that the high-level noise exposure group had higher HbA1c level than the control group (P<0.05). Multivariable logistic regression analysis results showed that the high-level noise exposure group had higher risk of prediabetes compared with the control group (P<0.05). Conclusion Occupational noise exposure could be a risk factor for the increased HbA1c levels and prediabetes incidence among the occupational population. More attention should be paid to the effects of occupational noise exposure on the HbA1c level in occupational health surveillance.

Objective:To investigation the situation of occupational noise exposure and hearing loss among workers in automobile manufacturing enterprise during 2017-2019 in Wuhan.Methods:Workers in automobile manufacturing who underwent physical examination in Wuhan Hospital for the Prevention and Treatment of Occupational Diseases from 2017 to 2019 were included as subjects in the cross-sectional survey. Questionnaire survey, noise detection and pure tone threshold test were used. Excluding individuals with working time less than 3 years and information deficiency, 3 948 individuals were finally included in the study.Results:Among 3 948 workers, 128 workers had hearing loss and the rate of hearing loss was 3.24%, among which 101 workers had high-frequency hearing loss and 27 workers were diagnosed as occupational noise deafness. The prevalence of hearing loss among workers previously exposed to noise was significantly higher than that without prior exposure (12.10%, 0.96%, P<0.05) . The prevalence of hearing loss among workers with occupational noise exposure <80 dB (A) , 80~<85 dB (A) and ≥85 dB (A) was 1.83%, 2.69% and 5.09%, respectively. The prevalence of high frequency hearing loss was 1.60%, 2.05% and 3.71%, respectively. The prevalence of occupational noise deafness was 0.23%, 0.64% and 1.38%, respectively. The prevalence of hearing loss and high frequency hearing loss among workers exposed to different occupational noise was statistically significant ( P<0.05) , while the prevalence of occupational noise deafness was not statistically significant ( P>0.05) . There were statistically significant differences in the prevalence of hearing loss (2.88%, 4.45%) and occupational noise deafness (0.46%, 1.41%) between those who used protective equipment and those who did not ( P<0.05) . Compared with workers exposed to occupational noise <80 dB (A) , workers exposed to occupational noise ≥85 dB (A) had A 3.16-fold increased risk of hearing loss ( OR=3.16, 95% CI: 1.44~6.95, P<0.05) . Compared to workers using hearing protective equipment, the risk of hearing loss ( OR=1.96, 95% CI: 1.25~3.06, P<0.05) and occupational noise deafness ( OR=3.46, 95% CI: 1.51-7.96, P<0.05) significantly increased among those without using hearing protective equipment. Conclusion:The risk of hearing loss in automobile manufacturing workers is significantly associated with occupational noise exposure and the use of hearing protective equipment. Good hearing protection may reduce the risk of occupational noise-induced hearing loss and occupational noise deafness.

Objective:To investigation the situation of occupational noise exposure and hearing loss among workers in automobile manufacturing enterprise during 2017-2019 in Wuhan.Methods:Workers in automobile manufacturing who underwent physical examination in Wuhan Hospital for the Prevention and Treatment of Occupational Diseases from 2017 to 2019 were included as subjects in the cross-sectional survey. Questionnaire survey, noise detection and pure tone threshold test were used. Excluding individuals with working time less than 3 years and information deficiency, 3 948 individuals were finally included in the study.Results:Among 3 948 workers, 128 workers had hearing loss and the rate of hearing loss was 3.24%, among which 101 workers had high-frequency hearing loss and 27 workers were diagnosed as occupational noise deafness. The prevalence of hearing loss among workers previously exposed to noise was significantly higher than that without prior exposure (12.10%, 0.96%, P<0.05) . The prevalence of hearing loss among workers with occupational noise exposure <80 dB (A) , 80~<85 dB (A) and ≥85 dB (A) was 1.83%, 2.69% and 5.09%, respectively. The prevalence of high frequency hearing loss was 1.60%, 2.05% and 3.71%, respectively. The prevalence of occupational noise deafness was 0.23%, 0.64% and 1.38%, respectively. The prevalence of hearing loss and high frequency hearing loss among workers exposed to different occupational noise was statistically significant ( P<0.05) , while the prevalence of occupational noise deafness was not statistically significant ( P>0.05) . There were statistically significant differences in the prevalence of hearing loss (2.88%, 4.45%) and occupational noise deafness (0.46%, 1.41%) between those who used protective equipment and those who did not ( P<0.05) . Compared with workers exposed to occupational noise <80 dB (A) , workers exposed to occupational noise ≥85 dB (A) had A 3.16-fold increased risk of hearing loss ( OR=3.16, 95% CI: 1.44~6.95, P<0.05) . Compared to workers using hearing protective equipment, the risk of hearing loss ( OR=1.96, 95% CI: 1.25~3.06, P<0.05) and occupational noise deafness ( OR=3.46, 95% CI: 1.51-7.96, P<0.05) significantly increased among those without using hearing protective equipment. Conclusion:The risk of hearing loss in automobile manufacturing workers is significantly associated with occupational noise exposure and the use of hearing protective equipment. Good hearing protection may reduce the risk of occupational noise-induced hearing loss and occupational noise deafness.

Objective: To investigate the effects of two anesthetic modes on cognitive function in elderly patients undergoing laparoscopic cervical cancer resection. Methods: From August 2016 to April 2018, 60 elderly patients undergoing laparoscopic cervical cancer resection in the General Hospital of Armed Police were divided into control groupand observation group according to odd and even of bed number, with 30caese in each group.Intravenous anesthesia was used in the control group, and intravenous anesthesia combined with inhalation anesthesia was used in the observation group.The anesthetic effect, MMSE score, MoCA score and the incidence of cognitive dysfunction were compared between the two groups. Results: The anesthesia effect time, extubation time and recovery time of the observation group were (1.62±0.30)min, (15.68±3.26)min, (8.69±3.68)min, respectively, which were significantly shorter than those of the control group[(4.68±0.91)min, (27.46±4.03)min, (20.36±4.58)min](all P<0.05). There were no statistically significant differences in MMSE score and MoCA score between the two groups before operation (all P<0.05), and there was statistically significant difference in MMSE score between the two groups at 2 h and 6 h after operation (all P<0.05). The MMSE score in the observation group was higher than that in the control group(all P<0.05), but there was no statistically significant difference on the 1st day after operation (P>0.05). At 2 h, 6 h, 1 d after operation, the MoCA scores in the observation group were significantly higher than those in the control group (all P<0.05). The incidence of cognitive dysfunction in the observation group was 6.67%(2/30), which was significantly lower than 26.67%(8/30) in the control group (P<0.05). Conclusion Compared with intravenous anesthesia alone, intravenous anesthesia combined with inhalation anesthesia for elderly patients undergoing laparoscopic cervical cancer resection has a good anesthetic effect and can reduce the incidence of cognitive dysfunction, which is worthy of further application in clinical practice.

Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.ResultsTwo groups at T0, T1 esophageal temperature no significant difference, study group t2-t6 esophageal temperatures were significantly higher than those of the control group (P<0.05), maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference (P<0.05), and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference (P<0.05).ConclusionThe surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.

BACKGROUND: BACKGROUND: Studies have found that surface treatment agents containing 10-methacryloyloxy decyl dihydrogen phosphate may be chemical y bonded to the oxide on the surface of zirconia, thereby notably improving the bonding performance of zirconia. OBJECTIVE: To study the effects of Mondbond N and Single bond Universal Adhesive on microtensile bond strength between zirconia and composite resin. METHODS: Sixty pieces of zirconia were randomized into three groups: in group 1, conventional Bis-GMA resin cement was used to bond zironia and composite resin; in group 2, conventional Bis-GMA resin cement was used to bond zironia and composite resin fol owing Mondbond N treatment; in group 3, conventional Bis-GMA resin cement was used to bond zironia and composite resin fol owing surface treatment with Single Bond Universal Adhesive containing 10-methacryloyloxy decyl dihydrogen phosphate. Microtensile bond strength and microstructure on the bonding interface were compared among three groups. RESULTS AND CONCLUSION: (1) Microtensile bond strength was significantly higher in the groups 2, 3 than group 1 (P < 0.05), and there was no difference between the two former groups. (2) Scanning electron microscope observation of the bonding interface: before microtensile test, there were more fissures on the bonding interface of group 1; in the group 2, there were a few fissures on the bonding interface that was relatively even; in the group 3, the bonding interface was smooth and continuous with few fissures. After microtensile, cohesive failure and bonding interface failure were mainly seen in the three groups, but there was no simple interface failure in the groups 2 and 3. These findings indicate that Monobond N and Single Bond Universal Adhesive can both improve the bonding strength of zirconia with composite resin.