ObjectiveTo explore the impact of the interaction between occupational and non-occupational noise exposure on the risk of high-frequency hearing loss (HFHL) in noise-exposed workers. Methods A total of 602 male workers with normal hearing, engaged in an automobile manufacturing company between 2016 and 2018, were selected as the study subjects using the retrospective cohort study method. Pure-tone audiometry and questionnaire surveys were conducted on the workers. The Kaplan-Meier survival analysis and multivariate Cox proportional hazards regression model were used to analyze the interaction between occupational and non-occupational noise exposure and the risk of HFHL in these workers. Results The prevalence of HFHL of the workers was 34.1% in 2020, without any cases of speech frequency hearing loss. Kaplan-Meier survival analysis result showed that the risk of HFHL increased in workers with excessive national occupational noise exposure intensity, self-reported noisy living environments, and both excessive national occupational noise exposure intensity and self-reported noisy living environments (all P<0.01). The results of the Cox proportional hazards model showed that the combined effect of excessive national occupational noise exposure intensity and self-reported noisy living environments [relative risk (RR)=2.40, P<0.01] was higher than the individual effects of excessive national occupational noise exposure intensity (RR=2.09, P<0.01) and self-reported noisy living environments (RR=2.39, P<0.01). There was an antagonistic effect between excessive national occupational noise exposure intensity and self-reported noisy living environments (interaction index <1.00). Conclusion Both occupational and non-occupational noise exposure can increase the risk of HFHL in noise-exposed workers, and there is an interaction between them.

Objective:To investigate the effect of intensive care unit (ICU) admission model on acute kidney injury (AKI) development and the prognosis in patients with sepsis.Methods:Patients with sepsis admitted to the ICU of Xinjiang Uygur Autonomous Region People's Hospital from January 2019 to July 2020 were retrospectively analyzed. According to the ICU admission model, the patients were divided into emergency group (first admission or emergency transfer from relevant surgical departments) and delayed group (transferred from the general ward due to disease evolution). Patients were divided into AKI group and non-AKI group according to whether AKI was accompanied. The gender, age, underlying diseases, surgical history, heart rate, laboratory test indicators, acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), organ failure and acute complications were collected. The incidence of AKI, 28-day mortality and length of ICU stay were recorded. Univariate and multivariate Logistic regression was used to analyze the risk factors of AKI in patients with sepsis.Results:A total of 185 patients with sepsis were enrolled, including 96 cases in the emergency group and 89 cases in the delayed group. 119 cases of AKI occurred while 66 cases without AKI development. The incidence of AKI within 7 days and the 28-day mortality of patients in the delayed group were significantly higher than those in the emergency group [AKI incidence rate: 77.53% (69/89) vs. 52.08% (50/96), 28-day mortality: 24.72% (22/89) vs. 10.42% (10/96), both P < 0.05], and the length of ICU stay was significantly longer than that of the emergency group (days: 18.70±7.29 vs. 14.56±4.75, P < 0.05). Univariate Logistic analysis showed that there were significant differences in age, diabetes, hypertension, organ failure, heart failure, APACHEⅡscore, SOFA score, white blood cell count (WBC), absolute neutrophil value, platelet count (PLT), blood lactate, total bilirubin, and ICU transferred from general wards between AKI group and non-AKI group. Multivariate Logistic regression analysis showed that transfer from general ward to ICU due to disease evolution was an independent risk factor for AKI in ICU sepsis patients [odds ratio ( OR) = 5.165, 95% confidence interval (95% CI) was 3.911-6.823, P < 0.001]. Conclusion:Septic patients transferred from general ward to ICU due to disease evolution are more likely to develop AKI, and also had a higher mortality and longer ICU stay. It may be an independent risk factor for AKI complicated by patients with sepsis in ICU.

Objective:To compare the therapeutic effect of polysaccharide iron complex capsule and Shengxuening tablet on renal anemia in maintenance hemodialysis (MHD) patients.Methods:Patients who received MHD treatment from April to June 2016 in our dialysis center and met the criteria for iron deficiency anemia were block-randomly divided into two groups: the polysaccharide-iron complex group and the Shengxuening group. Blood routine, iron metabolism biomarkers and biochemical exams were measured before treatment and at the 1st, 2nd and 3rd months after treatment, and the incidence of adverse reactions were recorded. The compliance rate of the two groups was observed and compared, and the block-randomized-statistical methods were used to compare the clinical data of the two groups before and after treatment, and cost-benefit analysis was also conducted.Results:Thirty patients in each group completed follow-up. After three months of treatment, the blood routine and iron metabolism indicators of the two groups were improved. Compared with the Shengxuening group, the polysaccharide iron complex group had higher therapeutic efficiency, and the levels of hemoglobin, transferrin saturation and serum ferritin were higher, and lower use of recombinant human erythropoietin ( P<0.05). The other indexes such as red blood cell (RBC), hematocrit (HCT) levels and the effective rate of anemia correction, the effective rate of iron therapy, the effective rate of iron therapy between the two groups were similar. Cost-benefit analysis suggested that the use of polysaccharide iron complexes to treat anemia has lower costs and higher benefits ( P<0.05). Conclusions:Polysaccharide iron complex capsule can better correct anemia and improve iron metabolism, and has low cost-effectiveness, which can effectively reduce medical insurance expenditure. It is a good iron supplementing method in addition to intravenous iron supplement.

Objective: To analyze the association between polycyclic aromatic hydrocarbons(PAHs)exposure and rheumatoid arthritis(RA)based on large sample data. Methods: The RA patients(RA group)and non-RA patients(non-RA group)with complete data were selected from the National Health and Nutrition Survey Database in the United States(NHANES)(2005—2014). The logistic regression model was used to analyze the association between 8 monohydroxylated(OH-)PAH metabolites in the urine and RA. Results: A total of 357 RA patients and 5, 256 non-RA participants were included.After adjusting the confounding factors by logistic analysis, the level of OH-PAHs mixture at the highest quartile(Q4)was associated with increased risk of RA compared with that at the lowest quartile(Q1)(OR=1.60, 95%CI: 1.16-2.23). For a single kind of OH-PAHs, the Q4 levels of 1-hydroxynaphthalene(OR=1.59, 95%CI: 1.14-2.23), 2-hydroxynaphthalene(OR=1.66, 95%CI: 1.19-2.32), 2-hydroxyfluorene(OR=1.61, 95%CI: 1.17-2.22), 3-hydroxyfluorene(OR=1.64, 95%CI: 1.18-2.27)and 1-hydroxyphenanthrene(OR=1.38, 95%CI: 1.00-1.94)were all associated with significantly increased risk of RA compared with the Q1 level(all P<0.05). However, the Q2 level of 1-hydroxypyrene(OR=0.60, 95%CI: 0.43-0.83)was related to a decreased incidence of RA(P<0.01). Conclusions OH-PAHs mixed exposure is a risk factor for RA.The association between the level of individual OH-PAH and the rate of RA is bidirectional and is depended on the type and concentration of OH-PAHs.

Objective To investigate the clinical features,pathogenesis,diagnosis and treatment of neonatal cerebral infarction(NCI)in order to have a further understanding of its clinical features,to enhance therapeutic effica﹣cy and to improve prognosis. Methods The clinical history,head magnetic resonance imaging( MRI)+ diffusion Weighted imaging(DWI)data and folloW－up results of 39 neonates With NCI admitted into the Department of Neonato﹣logy,Gaozhou People＇s Hospital and the Second Affiliated Hospital of Shantou University Medical College from January 2013 to March 2018 Were retrospectively analyzed. Results All the 39 children Were diagnosed as NCI by MRI +DWI,among Which 30 cases(76. 92%)Were full－term infants,and 9 cases(23. 08%)Were premature infants,in Which 61. 54%(24／39 cases)Were males,and 17 cases(43. 59%)Were performed With emergency cesarean section because of umbilical cord around neck,intrauterine distress or maternal pregnancy hypertension respectively. TWenty－five patients(64. 10%)had the history of perinatal hypoxia. The presentation of MRI shoWed 32 cases(82. 10%)of ischemic cerebral infarction and 7 cases(17. 90%)of hemorrhagic cerebral infarction,While middle cerebral artery and its branches Were more susceptible to NCI With a left hemisphere predominance. Sixteen patients(41. 03%)developed convulsions. TWo patients died of purulent meningoencephalitis associated With NCI. One patient gave up treatment in the neonatal period and died 2 days after discharge. One patient died of cerebral palsy and pneumonia at the age of 11 months. Nine cases(31. 03%)developed cerebral palsy,and 2 patients developed speech disturbance so they could not express complex sentences. Conclusions Perinatal hypoxia and emergency cesarean section may be closely related to the incidence of NCI. NCI resulting from purulent meningoencephalitis is more severe and has a Worse prognosis. Considering the facts that NCI usually does not have specific clinical manifestations in the early stage,MRI +DWI,as the gold standard for the diagnosis of NCI,could be performed to facilitate early diagnosis and intervention.

According to the literature and expert experience, a comprehensive index system of subjective and objective was established, including the patient's condition, the treatment information for the same kind of patients, technical level of the medical team, and the medical conditions. Secondly, in the light of the heterogeneous evaluation information, the comprehensive index weight was computed by combining subjective weight and objective entropy weight. Furthermore, the VIKOR method was applied to deal with heterogeneous evaluation information and obtain the priority of potential surgical treatments. Taking a rectal cancer patient in a general hospital in Hunan Province as an example, the optimal surgical treatment obtained by this method was consistent with the actual treatment. The reliability and effectiveness of the heterogeneous VIKOR method based on probabilistic linguistic term sets are verified by an experimental example of rectal cancer, and the method can be used to help doctors, patients and family members to select the surgical treatments for rectal cancer effectively.
Body Weight ; Humans ; Rectal Neoplasms ; surgery ; Reproducibility of Results

Objective To investigate the correlation and clinical significance between the serum 25-hydrovitamin D3[25-(OH)D3] level and bronchiolitis in children. Methods Sixty-one children with bronchiolitis diagnosed by Xiamen Children′s Hospital between September 2016 and June 2017 were enrolled in the study. Forty-one healthy children were used as the healthy control group. All the children were tested by enzyme-linked immunosorbent assay for serum 25-(OH)D3levels and serum IgE,IgG,IgA and IgM content. The clinical data of children with bronchiolitis group were recorded in the meanwhile. Results (1) Com-paredwiththehealthycontrolgroup,theserumlevelsof25-(OH)D3[(59.47±23.66)nmol/Lvs.(69.94± 25.19)nmol/L],IgM[(1.27±0.49)g/Lvs.(1.56±0.43)g/L]andIgA[(1.38±0.83)g/Lvs.(1.71± 0. 61)g/L] were significantly lower in children with bronchiolitis;while the serum IgE[(106. 59 ± 67. 74) IU/L vs. (75. 95 ± 35. 27)IU/L] was significantly higher(P<0. 05). (2)The serum levels of IgE,IgG and IgA in children diagnosed bronchiolitis with vitamin D deficiency [( 177. 37 ± 82. 72 ) IU/L, ( 5. 46 ± 1. 95)g/L and(0. 68 ± 0. 24) g/L] were obviously different from those of children diagnosed bronchiolitis with vitamin D inadequate[(94.21 ±44.21)IU/L,(7.14 ±2.82)g/L and(1.35 ±0.72)g/L] and vitamin D normal group[(79. 60 ± 44. 30)IU/L,(8. 03 ± 2. 49)g/L and(1. 57 ± 0. 78)g/L](P<0. 05). There was no significant difference about serum levels of IgE,IgG,IgA and IgM between vitamin D inadequate and vita- min D normal group(P>0. 05). (3)The wheeze time was higher in bronchiolitis children with vitamin D deficiency[(3. 97 ± 1. 01) d] than those of patients with vitamin D inadequate[(2. 41 ± 0. 79) d] and vitamin D normal group[(2. 27 ± 0. 88)d](P<0. 05). The level of venous glucocorticoid utilization was higher in bronchiolitis children with vitamin D deficiency than that of patients with vitamin D normal group (58. 82% vs. 29. 03%)(P<0. 05). There was no significant difference about clinical data between vitamin D inadequate and vitamin D normal group(P>0. 05). Conclusion The serum 25-(OH)D3levels are lower in children with bronchiolitis than those in healthy children. The lower the level of vitamin D,the more severe the children with bronchiolitis. Vitamin D deficiency is an important cause of bronchiolitis in children,which may be related to immune dysfunction effected by vitamin D deficiency.

In this article we analyzed the current development of moxibustion treating rheumatoid arthritis from the usefulness, advancement, synergistic effect as well as the variance between different kind of moxibustion. We concluded that moxibustion was an effective intervention for treating RA, and the methods used in moxibustion were searched in clinic. But the clinical tralls has a long way to go, we should pay more attention to the critical issues while in the use of moxibustion.

Objective To investigate the expression and change of cytoglobin(Cygb)gene on hypoxicischemic brain damage(HIBD).Methods Fifty SD rats of 7days old were divided into four study groups and one control group.The brain tissues were taken at 4hours,12hours,24hours and 48hours after the onset of HIBD.Cygb mRNA was determined by the reverse transcription PCR.One-way method of GraphPad Prism was used for statistics.Results The fragment length of PCR products was identical with experimental design.The expression level of Cygb gene increased at 4h after ischemia,and peaked at 24h.48h after HIBD,the Cygb gene level began to decrease.Conclusion The expression of Cygb in brain tissue increased rapidly after HIBD of newborn rats,suggesting that Cygb may have important function in the protection process of HIBD.