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.

Objective:To observe the clinical efficacy and safety of Tongren Niuhuang Qingxin Pills combined with telmisartan tablets in the treatment of hypertensive vertigo syndrome of phlegm-heat disturbance.Methods:Randomized controlled trial was conducted. Totally 80 patients with hypertension vertigo and phlegm-heat disturbance syndrome were selected from March 2021 to August 2022 at Beijing Tongrentang Hospital of Traditional Chinese Medicine as the observation objects. They were randomly divided into two groups using a random number table method, with 40 cases in each group. The control group received oral telmisartan tablets, while the experimental group received Tongren Niuhuang Qingxin Pills in addition to the control group. Both groups were treated for 28 days and followed up for 1 month. The patients' room blood pressure before and after treatment was measured, and TCM syndrome scores were evaluated. The dizziness assessment rating scale (DARS) was used to evaluate the severity of dizziness, adverse reactions during treatment were recorded, drug safety was observed, and clinical efficacy was evaluated.Results:The total effective rate of the experimental group was 85.0% (34/40), and that of the control group was 7.5% (3/40), with statistical significance between the two groups ( χ2=48.32, P<0.001). Compared with before treatment, the experimental group had SBP [(136.63 ± 6.01) mmHg vs. (159.30 ± 9.01) mmHg, t=-21.00] and DBP [(84.48 ± 4.36) mmHg vs. (95.30 ± 3.75) mmHg, t=-13.80] after treatment; after treatment, SBP [(137.34 ± 6.39) mmHg vs. (158.00 ± 10.06) mmHg, t=-5.28] and DBP [(86.08 ± 4.43) mmHg vs. (95.18 ± 6.61) mmHg, t=-8.09] decreased in the control group ( P<0.01), but there was no statistical significance between the two groups after treatment ( P>0.05). After treatment, the TCM syndrome scores in the experimental group (8.68 ± 3.39 vs. 15.12 ± 3.03, Z=-6.61) were lower than those in the control group ( P<0.001), and DARS score [(8.53 ± 3.93) vs. (12.20 ± 3.95), Z=-3.63] was lower than that in the control group ( P<0.001). After treatment, the therapeutic effect index of TCM syndromes in the experimental group improved compared to before treatment in the same group. The therapeutic effect index of each symptom, from high to low, was as follows: rotation of oneself or visual objects>numbness of limbs>dry stool>dizziness and dizziness>liking cold drinks>bitter and dry mouth>red urine>red tongue, yellow coating, and greasy tongue>vomiting sticky and turbid phlegm>tinnitus>smooth pulse. There were no significant adverse reactions during the treatment of the two groups. Conclusion:Tongren Niuhuang Qingxin Pills combined with telmisartan can reduce the blood pressure of patients with hypertensive vertigo syndrome of phlegm-heat disturbance, improve the vertigo symptoms and TCM syndromes of patients, and the efficacy evaluation is superior to that of telmisartan alone.

Objective:To examine the expression of human leukocyte antigen G (HLA-G) in the peripheral blood and cancerous tissues of patients with papillary thyroid carcinoma (PTC) .Methods:The expression of soluble HLA-G (sHLA-G) in the peripheral blood of 50 individuals with PTC (PTC group) , 25 patients with benign thyroid tumors (BTT group) from Department of Thyroid and Breast Surgery, Beilun branch of the First Affiliated Hospital of Zhejiang University and 20 healthy controls (healthy control group) from physical examination center was assessed by ELISA. Immunohistochemical examination of HLA-G levels was also performed on tissue specimens from patients in the PTC and BTT groups, and their correlation with clinicopathological features of thyroid cancer was analyzed. SPSS 19.0 was used for statistical analysis. The measurement data of normal distribution were tested by two independent samples t test. Chi square test was used to compare the rates between the two groups. Results:The sHLA-G expression in peripheral blood was 21.33 (±5.54) , 22.73 (±4.99) , and 18.29 (±4.43) ng/mL in the preoperative PTC, BTT, and healthy control groups, respectively. Compared to the healthy group, sHLA-G levels were considerably higher in the PTC and BTT groups, with statistically significant differences (totally P < 0.05) . There was no significant difference in statistically sHLA-G levels between the BTT and PTC groups ( P > 0.05) . The positive HLA-G expression rate in PTC tissues was 78% (39/50) . There was no evidence of HLA-G expression in common tissues adjacent to PTC. HLA-G was not expressed in benign tumors. HLA-G was linked with the PTC tumor diameter, and the rate of positive expression was considerably greater with tumor diameters >1 cm than with those ≤1 cm ( P<0.05) . The rate of HLA-G positive expression was not significantly correlated with sex, age, multiple foci, extra-glandular invasion, metastasis of lymph nodes, or the TNM stage in PTC individuals ( P > 0.05) . Conclusions:HLA-G is significantly expressed at high levels in PTC tissues, is correlated with the tumor diameter, and may probably have a significant role in this disease. Peripheral blood sHLA-G may be associated with thyroid tumorigenesis, and its value in PTC requires further verification.

Objective: To investigated the effect of long-term low-concentration mixed benzene exposure on peripheral blood of male workers. Methods: A case-control study was conducted to select 452 male workers exposed to mixed benzene (benzene, toluene, xylene) for five consecutive years from January 2012 to December 2016 in an automobile manufacturer as case group, and 438 male administrative and logistic managers who underwent physical examination during the same period as control group. The peripheral blood of the two groups was tested and compared, and the occupational hazards in the workplace were detected. Results: There were low dose exposure to mixed benzene in the enterprise, but the test results met the occupational exposure limit requirements. During the five years from 2010 to 2016, between the two groups of workers, the mean values of WBC, NEUT, RBC and Hb were statistically different (P<0.05). There was no statistical difference (P>0.05) in the mean value of PLT. The abnormal rate of main peripheral blood indexes in the control group was higher than that in the exposed group. There were significant differences in NEUT, RBC and Hb (P< 0.05), but no significant differences in WBC and PLT (P>0.05). Conclusion It can not be concluded that long-term low-concentration mixed benzene exposure can cause the change of peripheral blood index.

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.

Objective: To understand the prevalence of gynecologic diseases among married female workers. Methods: The data of married female workers who underwent occupational health examination in a physical examination center from January to December 2017 were collected. The relationship between the detection of common gynecological diseases, age and occupational types examined by gynecological routine, TCT, breast B-mode ultrasound, uterus and appendix B-mode ultrasound were analyzed. Results: Among the 1142 female workers, the total detection rate of reproductive tract infections was 67.25% (768/1142), the total detection rate of breast-related diseases was 75.22% (859/1142) ; the total detection rate of gynecological tumors and benign lesions was 14.71% (168/1142). The detection rate of breast hyperplasia was the highest 67.08% (766/1142), followed by vaginitis 51.66% (590/1142). Among the abnormalities detected in breast-related diseases, gynecological tumors and benign lesions, the highest detection rate was found in public institutions (85.66% and 27.13%), and the lowest was found in factory workers (70.24% and 7.89%). With the increase of age, the detection rate of breastrelated diseases (breast hyperplasia, breast cyst), gynecological tumors, benign lesions (uterine myoma), and Nessler's cyst abnormalities in married female workers increased (χ²_trend=7.647、21.653、107.411、53.802, P<0.05), while the detection rate of columnar epithelium of cervix decreased (χ²_trend=7.404, P<0.05). There was no significant difference in the total detection rate of reproductive tract infectious diseases (vaginitis, cervical polyps, cervical hypertrophy) among married famale workers of different ages (P<0.05) . Conclusion The common gynecological diseases of married female workers are affected by many factors such as age and occupation. Health examination and health education should be carried out regularly to reduce the incidence of gynecological diseases among female workers according to different ages and occupations.

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 observe the expression of wnt1 in patients with oral submucous fibrosis(OSF) before and after treatment.Methods:40 patients with OSF were treated with triamcinolone acetonide combined with salvia miltiorrhiza,Before and after 4 weeks treatment,pain score of VAS and mouth opening(MO) were examined.wnt1 protein in saliva and gingival crevicular fluid(GCF) was examined by ELISA,wnt1 mRNA expression in buccal mucosa tissue was examined by real-time fluorescent quantitative PCR.20 healthy subjects were served as the controls.Results:The expression of wnt1 in OSF group[buccal tissue RT-PCR (36.89 ± 10.40) × 10-5,saliva ELISA (61.61 ± 4.45) ng/L,GCF ELISA (56.20 ± 3.65) ng/L] were significantly higher than that of control group [buccal tissue RT-PCR (4.63 ± 1.53) × 10-5,saliva ELISA (40.26 ± 3.00) ng/L,GCF ELISA (53.45 ± 1.74) ng/L)] (P ＜ 0.01).In OSF group,after treatment VAS was decreased(P ＜0.01),MO increased(P ＜0.01)),Buccal mucosa wnt1 mRNA level was positively correlated with wnt1 protein in saliva and GCF,negativity with MO (P ＜ 0.05),saliva wnt1 was positively correlated with VAS and GCF wnt1,negitively with MO(P ＜ 0.05).Conclusion:Wnt1 might take part in the occurrence and development of OSF.The detection of wnt1 in saliva and GCF might be a noninvasive method for the evaluation of OSF treatment.

[Abstratc ] Objective To analyze whether there are differences in the efficacy and clinical outcomes to first-line tyrosine kinase inhibitors ( TKI) therapy in Chinese patients with metastatic non-small-cell lung cancer ( NSCLC) harboring different subtypes of epidermal growth factor receptor ( EGFR ) mutations.Methods A retrospective analysis was made on the clinical data of stage ⅢB or Ⅳ NSCLC patients who were diagnosed by histology and received EGFR mutation test, in order to confirm if there is any difference between the therapeutic effects of TKIs as first-line therapy and the prognosis.Results A total of 165 patients harboring EGFR exon 19 deletion (19del, n=71), exon 21 L858R mutation (L858R, n=80) or uncommon sensitive mutation ( n =14 ) were treated with EGFR-TKIs for first-line treatment.The comparison among different groups of common types of sensitive mutations revealed that the objective response rate ( ORR) of group 19del and group L858R were 57.8%and 45.0%, respectively ( P=0.113) . The disease control rate ( DCR) was 93.0%and 93.8%, respectively ( P=0.158) .However, the ORR and DCR of uncommon sensitive mutation were 35.7%and 78.6%, which were significantly lower than that of the group 19del (P=0.035) and group L858R (P=00.20 ).The median progression-free survival (PFS) of group 19del, group L858R and uncommon sensitive mutation were 14.0 months, 7.8 months and 5.1 months, respectively ( P=0.001) .The median PFS of the group 19del was significantly longer than that of the group L858R (P=0.009).The median overall survival (OS) of these three groups had significant difference (22.8, 15.2 and 10.0 months) ( P=0.048) .But those of group 19del and group L858R were similar ( P=0.152) . The multivariate analysis indicated that ECOG-PS (P=0.030), cigarette smoking (P=0.013) and EGFR mutation types (P=0.034) are independent prognostic factors of OS.Conclusions For Chinese NSCLC patients with different types of sensitive mutation, there are differences between their efficacy and prognosis of EGFR-TKIs as first-line treatment.The PFS of group 19del is obviously longer than that of other types of sensitive mutations, but have no significant differences in OS.The PFS and OS of patients with common types of sensitive mutation are better than those with uncommon sensitive mutation.

Objective To study the clinical significance and prognostic value of combined detection of urinary N?terminal telopeptide of type Ⅰ collagen ( NTx ) and serum C?terminal telopeptide of type Ⅰcollagen (ICTP) in breast cancer patients with bone metastases. Methods Serum and urine samples from 68 women with advanced breast cancer who received the treatment in Jilin Cancer Hospital between October 2012 and October 2008 were collected before and 2 months after treatment. Among them, 35 patients had bone metastases ( group A) , including 12 cases with single bone metastasis and 23 cases with multiple bone metastases. 33 out of the 68 patients had other organ metastases ( group B ) . 30 healthy females were included as the control group ( group C) . The levels of urine NTX and serum ICTP were measured by ELISA. Results The levels of NTx and ICTP of group A were significantly higher than those of groups B and C [NTx:(7.17±1.11) nmol/L vs. (2.08±0.22) nmol/L and (2.09±0.24) nmol/L, respectively, (P<0.05);ICTP:(7.75±1.14) ng/ml vs. (2.15±0.34) ng/ml and (2.22±0.31) ng/ml, respectively, (P<0.05) ] , while no significant difference was found between the groups B and C. Compared with the patients with single bone metastasis, the patients with ≥2 bone metastases had significantly higher NTx and ICTP levels [NTx:(7.69±0.93) nmol/L vs. (6.16±0.62) nmol/L, P<0.05; ICTP: (8.21±1.00) ng/ml) vs. (6.88±0.81) ng/ml (P<0.05)].At two months after treatment, 40.0%(14/35) of patients with bone metastasis had partial remission (PR), 42.9%(15/35) of patients had stable disease (SD), and 6 patients with progressive disease (PD). Both urinary NTx and serum ICTP of the patients with PR and SD were significantly decreased compared with those before treatment (P<0.05). 10 cases of patients (28.6%) with bone metastases had skeletal?related events (SREs) during the treatment, including one PR patient (1/14, 7.1%) , 5 SD patients ( 5/15, 33. 3%) and 4 PD patients ( 4/6, 66. 7%) . Conclusion The combined detection of urinary NTx and serum ICTP is of important significance for early diagnosis and efficacy evaluation and to control skeletal?related adverse events in breast cancer patients with bone metastases.