ObjectiveTo explore the influencing factors of occupational hand-arm vibration disease (OHAVD) caused by handheld workpiece polishing. Methods A total of 222 OHAVD patients (case group), 275 hand-transmitted vibration-exposed workers (exposed group) and 243 healthy workers without hand-transmitted vibration exposure (control group) in a sports equipment manufacturing enterprise were selected as the study subjects using the convenience sampling method. Worksite survey of occupational health was conducted on these three groups, and the human vibration measurement equipment was used to measure the vibration exposure level of handheld vibration among the study subjects. The 8-hour energy equivalent frequency-weighted vibrating acceleration ［A(8)］ and cumulative vibration exposure level (CVEL) were calculated. Results The prevalence of coldness, numbness, tingling fingers, and vibration-induced white finger was higher in the exposed group and the case group compared with the control group (all P<0.05). The prevalence of the above-mentioned hand symptoms was higher in the case group compared with the exposed group (all P<0.05). The A(8) and CVEL levels of the study subjects in the case group were higher than those in the exposed group (all P<0.05). Binary logistic analysis result showed that age and CVEL were both influencing factors of OHAVD (all P<0.05). According to the restricted cubic spline models, CVEL of the study subjects in the exposed group had a positive nonlinear dose-response relationship with the risk of OHAVD (overall trend P<0.01, nonlinear P<0.01), indicating an increasing risk of OHAVD with increasing CVEL. Conclusion Hand-transmitted vibration exposure is a risk factor for OHAVD. Early intervention should be carried out for hand-transmitted vibration-exposed individuals to reduce vibration-exposed levels and control vibration exposure time.

ObjectiveTo analyze the spectrum distribution characteristics of high-intensity productive noise in key industries in Guangdong Province. Methods A total of 2 806 enterprises in 21 prefecture-level cities in Guangdong Province were selected as the study subjects using the stratified sampling method. On-site investigations were conducted in workplaces. Noise in workplaces and work-sites, and the noise spectrum of the workplaces with sound pressure level ≥85.0 dB(A) were detected. Results The noise of a total of 23 076 workplaces and 20 969 work sites from 30 key industries were monitored. The median (M) and 25th and 75th percentiles (P₂₅, P₇₅) of workplace sound pressure level were 82.3 (78.6, 86.5) dB(A). The rate of the noise exceeded national standard was 30.4%. The sound pressure level M (P₂₅, P₇₅) of work-site was 78.6 (70.0, 83.5) dB(A). The rate of the noise exceeded national standard was 18.0%. Workplace noise and work site noise were positively correlated (Spearman correlation coefficient=0.86, P<0.01). The rate of the noise exceeded national standard was 46.5% in key work sites where the rate of noise exceeded the national standard was ≥25.0%, and corresponding rate of the workplace noise exceeded national standard was 58.1%. The noise spectrum result of 5 636 workplaces sound pressure level>85.0 dB(A) showed that most of the noise source was from grinding machines (441 cases), and the highest average sound pressure level of noise source was from screening machines [93.0 dB(A)]. Cluster analysis results showed that the main noise sources could be divided into three categories, including wideband noise with levels >80.0 dB in all frequency bands except 8 000.0 Hz, medium-high-frequency noise with the highest sound pressure level at 1 000.0, 2 000.0, and 4 000.0 Hz and low frequencies <75.0 dB, and medium-low-frequency noise below 500.0 Hz with sound pressure level >85.0 dB. Conclusion The rate of the noise exceeded national standard in workplace of key industries in Guangdong Province is high, involving a wide range of industries, with high sound pressure levels and obvious spectrum characteristics of corresponding noise sources. Corresponding noise control strategies can be formulated based on different spectrum characteristics and magnitudes.

Head and neck squamous cell carcinoma(HNSCC)is characterized by high recurrence or distant metastases rate and the prognosis is challenging.There is mounting evidence that tumor-infiltrating B cells(TIL-Bs)have a crucial,synergistic role in tumor control.However,little is known about the role TIL-Bs play in immune microenvironment and the way TIL-Bs affect the outcome of immune checkpoint blockade.Using single-cell RNA sequencing(scRNA-seq)data from the Gene Expression Omnibus(GEO)database,the study identified distinct gene expression patterns in TIL-Bs.HNSCC samples were categorized into TIL-Bs inhibition and TIL-Bs activation groups using unsupervised clustering.This classification was further validated with TCGA HNSCC data,correlating with patient prognosis,immune cell infiltration,and response to immunotherapy.We found that the B cells activation group exhibited a better prognosis,higher immune cell infiltration,and distinct immune checkpoint levels,including elevated PD-L1.A prognostic model was also developed and validated,highlighting four genes as potential biomarkers for predicting survival outcomes in HNSCC patients.Overall,this study provides a foundational approach for B cells-based tumor classification in HNSCC,offering insights into targeted treatment and immunotherapy strategies.

Critical care medicine-related treatment is an interdisciplinary and multi-professional process,often leading to secondary or concomitant mental disorders in clinical practice.Currently,there is no consensus on the pharmacological treatment of related mental illnesses in China.The Chinese Society of Psychosomatic Medicine collaborated with the Critical Care Medicine expert group to form a consensus writing expert group.After a systematic review of relevant literature,summarizing published domestic and foreign literature,and extensive discussions,the consensus was developed.The consensus elaborates on the principles and processes of the standardized use of psychotropic drugs in critical care medicine,as well as the clinical indications,precautions,and specific drug selection of various psychiatric medications,providing feasible suggestions and guidance for the clinical application of psychiatric medications in the intensive care unit.

Objective To investigate the level of finger systolic blood pressure (FSBP) in healthy young adults. Methods A total of 28 healthy young adults were selected as the study subjects by convenient sampling method. The FSBP of the study subjects was detected at 30 and 10 ℃, and the FSBP index (F_i) was calculated. Results The FSBP of the study subjects at 30 and 10 ℃ were (102.0±16.5) and (104.4±15.2) mmHg, respectively. The FSBP in male group at 30 and 10 ℃ was (99.6±18.6) and (107.2±17.0) mmHg, respectively. The FSBP in female group at 30 and 10 ℃ was (104.4±13.9) and (101.5±2.8) mmHg, respectively. The results of factorial analysis showed that the interaction between gender and temperature on FSBP was statistically significant (P<0.05). FSBP in male group was higher at 10 than 30 ℃ (P<0.05) and higher than female group at 10 ℃ (P<0.05). There was no statistical significance for the main effect of gender, temperature, finger, or the interaction effect of gender and finger, temperature and finger for FSBP (all P>0.05). The average F_i of the study subjects was (98.0±16.6)%, with males and females having the average F_i of (100.7±20.7) % and (95.2±10.6) % respectively. The results of factorial analysis of variance showed that there was no significant difference on F_i in the main effect gender and fingers or the interaction effect between them(all P>0.05). Conclusion The FSBP test could be used as a detection method for assessing peripheral microcirculation function in Chinese population. However, further research is needed to establish reference ranges and influencing factors.

【Objective】 To explore the action mechanism of vinpocetine in improving learning and memory disorders in depressive rats after modified electroconvulsive therapy (MECT). 【Methods】 The models of depressive rats were constructed by chronic unpredictable mild stress (CUMS) method. A total of 30 rats with depression were randomly divided into depression group, MECT group, and MECT+vinpocetine (10 mg/kg) group, with 10 in each group. A total of 10 untreated healthy rats were enrolled as control group. The learning and memory ability were tested by Morris water maze test and novel object recognition test. The depression state was evaluated by sugar preference test. The brain slices of the hippocampus were prepared for electrophysiological experiments. The density of dendritic spine was detected by Golgi staining. The expressions of endocannabinoids related genes [diacylglycerol lipase (DAGLα), monoacylglycerol lipase (MAGL), and endocannabinoid type-I receptor (CB1R)] were detected by qPCR and Western blotting. The lentivirus was injected to downregulate the expressions of CB1R and DAGLα in the hippocampus. After re-modeling and treatment, behavioral tests were performed. 【Results】 Compared with control group, sugar preference, spatial exploration time, relative discrimination index, long-term potentiation (LTP), density of dendritic spine, expressions of DAGLα and CB1R were decreased, while escape latency and MAGL were increased in depression group (P<0.05). Compared with depression group, sugar preference, escape latency, and MAGL were increased, while spatial exploration time, relative discrimination index, LTP, density of dendritic spine, expressions of DAGLα and CB1R were decreased in MECT group (P<0.05). Compared with depression group, sugar preference, spatial exploration time, relative discrimination index, LTP, density of dendritic spine, expressions of DAGLα and CB1R were increased, while escape latency and MAGL were decreased in MECT+vinpocetine group (P<0.05). Compared with MECT group, sugar preference, spatial exploration time, relative discrimination index, LTP, density of dendritic spine, expressions of DAGLα and CB1R were increased, while escape latency and MAGL were decreased in MECT+vinpocetine group (P<0.05). The down-regulation of DAGLα or CB1R by lentivirus could inhibit the improvement effect of vinpocetine on behavioral performance of depressive rats after MECT. 【Conclusion】 Vinpocetine can significantly improve learning and memory disorders in depressive rats after MECT, which may be related to regulating the expressions of endocannabinoid-related genes and enhancing synaptic plasticity.

Humans ; Aripiprazole/therapeutic use* ; Schizophrenia/drug therapy* ; Antipsychotic Agents/therapeutic use* ; Risperidone ; China ; Treatment Outcome

Objective: To analyze the status of noise hazard in workplace of key industries in Guangdong Province. Methods: A total of 1 061 enterprises from 14 key industries in 21 prefecture-level cities in Guangdong Province were selected as the research subjects using stratified sampling method. The occupational health survey was carried out, and the noise intensity in the workplace was detected. Results: There were 12 606 workplaces and 5 570 work sites involved among 1 061 enterprises. The median and the 0-100th percentile value ［M (P₀-P₁₀₀)］ of noise intensity in workplace were 82.6 (46.5-112.6) dB(A), and 35.03% of the workplace exceeded the national noise intensity standard. The regions and industry with the highest rate of noise exceeded the national noise intensity standard in workplace were in the northern part of Guangdong and the stone processing industry respectively. The M (P₀-P₁₀₀) of noise intensity in the work sites was 83.7 (47.5-106.2) dB(A), and 36.00% of the work sites exceeded the national noise intensity standard. The regions and industry with the highest rate of noise exceeded the national noise intensity standard in work sites were in the Pearl River Delta region and the ferrous metal mining and dressing industry respectively. The rate of noise protection facilities setting was 66.45%, and the validity of personal protection was 61.73%. The occupational medical examination was performed in 73.24% of the research subjects, and 3.25% of the result was abnormal. The industry with the highest occupational medical examination rate was nonferrous metal smelting and rolling processing, and the industry with the highest abnormal rate of occupational medical examination was stone processing industry. Conclusion: Noise hazards in workplaces of key industries in Guangdong Province are relatively severe, necessitating strengthened supervision and management, noise control measures, and efforts to reduce noise exposure levels in workplaces and work sites.

Background Hand arm vibration disease (HAVD) is one of the legal occupational diseases in China, and its pathogenesis is not clear. Operators exposed to electric vibration tools for a long time have an increased risk of HAVD. Objective To conduct a systematic evaluation of the effects of vibration operations on workers' upper limb nerves, blood vessels, and muscles. Methods Relevant studies on the effects of hand-transmitted vibration on HAVD were searched and collected from the China Knowledge Infrastructure, Wanfang, and PubMed databases, and the literature was published from January 1974 to April 2021. The quality of cohort and case-control studies was assessed by the Newcastle-Ottawa Scale (NOS), and the quality of cross-sectional studies was by the evaluation criteria recommended by the Agency for Healthcare Quality and Research (AHRQ). Statistical analyses of outcome indicators (OR) in the included literature were performed using RevMan 5.4.1 software, effect sizes in the literature on vibration-induced white finger and neurosensory impairment were combined using a random-effect model, those that included carpal tunnel syndrome were combined using a fixed-effect model, and subgroup and publication bias analyses were also performed. To explore sources of study heterogeneity, meta-regression was performed using Stata 16.0 software, and sensitivity analyses were performed on the included literature. Results A total of 716 papers were retrieved from the databases, and 18 articles were retrieved by manual searching. A total of 34 papers were included after excluding those not meeting the criteria. Of the papers, 11004, 7270, and 1722 subjects related to vibration-induced white finger, neurosensory impairment, and carpal tunnel syndrome, respectively. The results of meta-analysis showed that compared with the control group, the combined ORs of hand-transmitted vibration exposure were 4.25 (95%CI: 2.72−6.65) for vibration-induced white finger, 4.03 (95%CI: 2.46−6.61) for neurosensory impairment, and 2.44 (95%CI: 1.61−3.71) for carpal tunnel syndrome. Heterogeneity was identified in the original studies related to vibration-induced white finger (I²=81%, P < 0.001) and neurosensory impairment (I²=90%, P < 0.001), except carpal tunnel syndrome (I²=23%, P < 0.001). The results of sensitivity analysis showed that the combined effect sizes (ORs) were stable and reliable. The results of meta-regression showed that the factors contributing to high heterogeneity of combined vibration-induced white finger and neurosensory impairment were time of publication (t=−2.10, P=0.049) and working age (t=−2.40, P=0.032), respectively. Conclusion Hand-transmitted vibration is a risk factor for vibration-induced white finger, neurosensory impairment, and carpal tunnel syndrome in operators.

Background Wearing anti-vibration gloves is a simple and effective way to prevent hand-arm vibration disease. The requirements for vibration damping gloves are varied by types of operations exposed to vibration. Objective To study the vibration attenuation and dexterity of different types of protective gloves, and to provide reference for scientific wearing of vibration damping gloves for people working with vibration exposure. Methods Nine kinds of common protective gloves (A and B were dipping gloves; C, D, and E were rubber gloves; F and G were textile and fabric gloves; H was cotton gloves; I was leather gloves) used by workers exposed to vibration in 28 factories in Guangdong Province were selected as research objects by typical case sampling method, and the basic parameters of included protective gloves were investigated and measured. According to ISO 10819:2013, a glove vibration transmissibility (GVT) test system was used to detect the vibration transmissibility values and analyze vibration attenuation characteristics of the subjects wearing different protective gloves. The dexterity was tested by Minnesota Manual Dexterity Test. Pearson test was used to analyze the correlations among glove thickness, vibration transmissibility, dexterity score, and grip strength score. Results For rubber gloves (C, D, and E), the associated average adjusted vibration transmissibility at middle and low frequencies \begin{document}$ {\overline T _{\text{M}}} $\end{document} and average adjusted vibration transmissibility at high frequency \begin{document}$ {\overline T _{\text{H}}} $\end{document} were lower than those of other gloves (0.89-0.91 and 0.59-0.80 respectively), the vibration transmissibility values of 50-200 Hz frequency band was 0.81-0.97, and the vibration transmissibility values of 315-1250 Hz frequency band decreased with the increase of frequency (the minimum value was 0.13). For other types of gloves (A, B, F, G, H, and I), the \begin{document}$ {\overline T _{\text{M}}} $\end{document} and \begin{document}$ {\overline T _{\text{H}}} $\end{document} were 0.95-0.98 and 1.03-1.11 respectively, the vibration transmissibility values of 50-200 Hz frequency band was 0.96-1.02, and the vibration transmissibility values of 400-1250 Hz frequency band increased (the maximum value was 1.29). The \begin{document}$ {\overline T _{\text{M}}} $\end{document}, \begin{document}$ {\overline T _{\text{H}}} $\end{document}, and vibration transmissibility values of 40-1250 Hz frequency band of rubber gloves with double-layer protective materials (C, D, and E) were significantly lower than those of gloves with single-layer protective materials. But the \begin{document}$ {\overline T _{\text{M}}} $\end{document} and \begin{document}$ {\overline T _{\text{H}}} $\end{document} of gloves of other types with double-layer materials (F, H, and I) were still greater than 0.9 and 1.0 respectively. Compared with single-layer protective materials, the gloves of other types with double-layer materials showed no significant changes in the vibration transmissibility values of 25-200 frequency band (0.91-1.06), and an increase in the vibration transmissibility values of 250-630 Hz frequency band (the maximum value was 1.22). The dexterity scores and grip strength scores of dipping gloves (A and B) were the lowest. Rubber gloves C had the highest dexterity score and grip strength score. The thickness of protective gloves was negatively correlated with the vibration transmissibility values, and positively correlated with the dexterity score and the grip strength score (P < 0.05). The vibration transmissibility value was negatively correlated with the dexterity score and the grip strength score (P < 0.05). Conclusion Among the 9 kinds of gloves, cotton gloves and leather gloves have no damping effect. Rubber gloves have certain vibration reduction effect, and the vibration reduction effect on high frequency band is better than that on low frequency band. The thicker the damping material is, the better the damping effect is, but the less the dexterity is. Appropriate damping gloves should be selected according to actual vibration operations.