Objective To evaluate the role of distortion product otoacoustic emissions (DPOAE) testing in evaluating early hearing loss among noise-exposed workers. Methods A total of 174 noise-exposed workers in a metal shipbuilding enterprise were selected as the research subjects by the convenience sampling method. Pure tone audiometry (PTA), DPOAE and the level of noise exposure were conducted on the workers. The rank correlation analysis was used to analyze the correlation between DPOAE amplitude and PTA threshold. The multilevel model was used to analyze the effects of gender, age, noise exposure intensity, cumulative noise exposure (CNE), hearing loss classification and PTA threshold on DPOAE results. Results At the frequencies of 0.50, 1.00, 2.00, 3.00, 4.00, 6.00 and 8.00 kHz, the DPOAE amplitude was negatively correlated with the PTA threshold (rank correlation coefficients were -0.12, -0.48, -0.47, -0.18, -0.23, -0.44, -0.19, respectively, all P<0.01). At the most frequencies, DPOAE amplitude was negatively correlated with age and CNE (all P<0.05). The results of multilevel model analysis showed that there were significant differences in DPOAE amplitudes at certain frequencies across gender, age, noise intensity, CNE, and hearing loss classification (all P<0.05). Significant differences in DPOAE responses were found among different CNE and hearing loss groups (all P<0.01). Conclusion DPOAE testing can objectively reflect the hearing status of noise-exposed workers and could be considered for inclusion in routine hearing monitoring to facilitate early detection of noise-induced hearing loss.

Objective:To analyze the prognostic outcomes of 1 147 patients who underwent liver transplantation at Qingdao University Affiliated Hospital and to summarize measures to enhance the efficacy of liver transplantation.Methods:A retrospective analysis was conducted on the clinical and follow-up data of 1 147 liver transplant patients at Qingdao University Affiliated Hospital.Results:The overall postoperative 1-, 3-, and 5-year survival rates for the 1 147 liver transplant patients were 87.20%, 73.40%, and 65.60%, respectively. The survival rates for benign disease liver transplant recipients were 88.01%, 84.98%, and 81.39% at 1, 3, and 5 years post-transplant, respectively, compared to recipients transplanted for malignancies of 78.11%, 64.41%, and 60.06% (all P<0.001). Among the mid vs more recent period, patients' 1-year and 3-year postoperative survival rates were 84.20%, 70.80% vs 90.50%, 71.70%, respectively,significantly in favor of recently enrolled patients ( P=0.022). In the complex surgery group, patients' 1-, 3-, and 5-year survival rates were 82.70%, 65.50%, 56.70%, while in less complicated group, it was 89.00%, 76.50%, 69.20% ( P<0.001). The primary causes of death for benign disease recipients were multi-organ failure (4.1%), while in recipients with malignant disease primary cause of death was tumor recurrence (23.7%). Postoperative complications included primary graft dysfunction, delayed graft function recovery, portal vein thrombosis, hepatic artery thrombosis, biliary stricture, post-transplant lymphoproliferative disorder, and graft-versus-host disease, with occurrence rates of 1.05%, 6.89%, 1.92%, 0.44%, 2.00%, 0.61%, and 0.44%, respectively. Conclusions:With the continuous improvement in surgical techniques and perioperative care levels, the 3-year survival rate of recipients at our center has increased. Malignant diseases and complex liver transplantation remain crucial factors affecting recipient prognosis, highlighting the need to further enhance comprehensive treatment capabilities for patients with malignant diseases and complex surgeries.

Objective:To explore the impact of donor cold ischemia time(CIT)on early recovery after liver transplantation(LT).Methods:From January 2016 to December 2020, the relevant clinical data were retrospectively reviewed for 456 LT recipients.According to the value of CIT of donor liver, they were assigned into two groups of CIT >5 h and CIT≤5 h. T, Mann-Whitney U or Chi square test was employed for statistical processing.Intraoperative findings and liver function(LF)parameters of two groups were compared, including operative duration, intraoperative volume of hemorrhage, erythrocyte transfusion and anhepatic phase.LF parameters included alanine aminotransferase(ALT), aspartate aminotransferase(AST)and total bilirubin(TB)within Day 1-7 post-LT.Postoperative recovery was evaluated by postoperative stay of intensive care unit(ICU), normalization time of liver function recovery, length of postoperative hospitalization and incidence of postoperative complications.Results:Among them, 407(89.3%)patients underwent classic orthotopic LT.Median CIT of donor liver was 309 min.In CIT≤5 h and CIT >5 h groups, operative duration was[(446.3+ 76.8)vs.(526.0+ 98.1)min], anhepatic phase time[(51.9+ 13.3)vs.(62.6+ 18.9)min]and intraoperative volume of erythrocyte transfusion[(7.3+ 5.8)vs.(10.0+ 6.87)U]. And the differences were statistically significant( P<0.001, 0.001 & 0.001). Postoperative hospitalization stay was longer[(29.1±15.9)vs.(27.1±13.0)]day.And the incidence of postoperative complications was higher in CIT >5 h group[22.7%(54/238)vs.12.4%(27/218)]. And the difference was statistically significant( P=0.045 & 0.004). As compared with CIT≤5 h group, ALT, AST & TB spiked in CIT >5 h group at Day 1 post-operation and the differences were statistically significant( P=0.002, P<0.001, P=0.001). In CIT >5 h group, ALT rose at Day 2/5/6/7 post-LT( P=0.026, 0.026, 0.015 & 0.011), AST jumped from Days 2-6( P=0.002, 0.004, 0.035, 0.029 and 0.019)and TB increased from Days 2-7 post-LT and the differences were statistically significant( P=0.003, 0.014, 0.030, 0.039, 0.027 & 0.009). LF recovered at CIT≤5 h and CIT>5 h group[(10.0±3.2)vs.(10.7±3.3)day]. There were significantly statistical differences( P=0.044). Conclusions:Non-conducive to patient recovery, prolonged cold ischemic time aggravates early LF injury post-LT.

Abstract The large intestinal flora is interdependent and mutually restricted, and synergistically participates in the physiological metabolism of the body and the digestion of nutrients. The study on intestinal flora and cardiovascular health has become a very important research field. Changes in intestinal flora composition, metabolites and toxins produced by intestinal flora can cause cardiovascular system lesions. Cardiovascular disease(CVD) has become a major health problem due to high morbidity and mortality. The changes in specific intestinal flora have been identified as the key factors in the occurrence and development of CVD. However, the underlying mechanism of how intestinal flora and metabolites produce and affect CVD remains unclear. In this paper, the latest research progress of intestinal flora in regulating CVD through the intestinal cardiac axis are reviewed, focusing on the complex interaction between intestinal microorganisms and their metabolites and the occurrence and development of CVD, as well as the effect of changes in intestinal flora imbalance on the occurrence of cardiovascular events, to discuss a causal link between intestinal flora and the pathogenesis of CVD.

Objective:To explore the advantages and disadvantages of frozen section versus rapid paraffin section in the evaluations of donor organ.Methods:Five cases of donor liver and 8 cases of discarded donor kidney were collected from 2017 to 2021.Tissues were harvested and prepared by frozen section, rapid paraffin section and normal paraffin section.After hematoxylin-eosin (H&E) staining, the specimens of donor kidney/liver were evaluated by differential histopathological structures and donor quality scoring system.Results:Rapid paraffin section was similar to normal paraffin section in reflecting the proportion of glomerulosclerosis (18.6%±22.3%), arteriolar hyaline degeneration (43.7%±23.8%) and arteriolar stenosis (47.9%±29%). The proportion of glomerulosclerosis (0.8%±2.2%), arteriolar hyaline degeneration (4.9%±7.4%) and arteriolar stenosis (5.3%±7.5%) were lower in frozen sections than those in rapid paraffin sections.The diagnoses of hydropic degeneration and necrosis in donor liver were more accurate in rapid paraffin section.Conclusions:Rapid paraffin section is superior to frozen section in observing histopathological changes under microscope.Scoring of donor organ is more precise according to rapid paraffin section.

OBJECTIVE: To determine the prevalence and influencing factors of work-related musculoskeletal disorders(WMSDs) among workers in a shipyard. METHODS: A total of 496 workers in a large shipyard in Guangdong Province were selected as research subjects using the convenient sampling method. The Questionnaire of Musculoskeletal Disorders was used to investigate the prevalence of WMSDs in various regions of the body in the past year.Multivariate logistic regression was used to analyze the potential influencing factors of WMSDs in the frequently affected body parts. RESULTS: The prevalence of WMSDs was 70.2%(348/496). The prevalence rates of WMSDs in different body regions were: lower back/waist(43.1%), neck(29.4%), shoulder(29.0%), hand/wrist(25.4%), knee(22.4%), hip/leg(14.3%), ankle/foot(12.1%), upper back(11.3%) and elbow(9.3%). Multivariate logistic regression analysis results showed that increased risk of lower back/waist WMSDs occurred in workers who carry heavy objects>5.0 kg, who work in uncomfortable positions, who repeatedly perform the same work every day, and who repeatedly perform the same action using the lower limbs and ankles(P<0.05). Employees working ≤8 hours or more than 8 hours per day had higher risk of developing lower back/waist WMSDs compared with workers working 8-10 hours per day(P<0.05). CONCLUSION: The prevalence of WMSDs among workers in the shipyard is high.The lower back/waist WMSD is the most common one. The influencing factors include work organization and adverse ergonomic factors.

The procurement, preservation and transportation of the donor organs directly affect the clinical prognosis of the recipients. The establishment of process optimization and quality control standards of organ procurement, preservation and transportation contributes to improving the quality and utilization rate of donor organs and reducing the medical risk. According to Guide to the Quality and Safety of Organs for Transplantation (6th edition) proposed by European Union, the 11th chapter of organ procurement, preservation and transportation was interpreted and summarized in this article.

Objective:To explore the effects of apatinib combined with chemotherapy on tumor markers, angiogenesis and bone marrow suppression in patients with stage Ⅲ B-Ⅳ colorectal cancer. Methods:A total of 60 patients with stage Ⅲ B-Ⅳ colorectal cancer who were treated in Yizheng People's Hospital of Jiangsu Province from March 2018 to May 2019 were selected, they were divided into the observation group (30 cases) and control group (30 cases) according to the random number table method. The control group was treated with conventional intravenous chemotherapy, while the observation group was treated with apatinib on the basis treatment of the control group. The remission rate and incidence of bone marrow suppression were compared between the two groups, and the expressions of carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), carbohydrate antigen 242 (CA242), vascular endothelial growth factor (VEGF) and microvessel density (MVD) before and after treatment were also compared. Results:The remission rate in the observation group was higher than that in the control group [86.7% (26/30) vs. 63.3% (19/30)], and the difference was statistically significant ( χ2 = 4.356, P = 0.037). After treatment, the levels of CEA, CA199 and CA242 in the observation group [(3.1±0.8) ng/ml, (112±17) U/ml and (27±6) U/ml] were significantly lower than those in the control group [(6.6±1.1) ng/ml, (169±22) U/ml and (39±7) U/ml], and the differences were statistically significant (t values were -14.209, -11.102 and -7.384, all P < 0.01). After treatment, the levels of VEGF and MVD in the observation group [(41±5) ng/ml and 18±3] were significantly lower than those in the control group [(80±7) ng/ml and 33±5], and the differences were statistically significant (t values were -23.161 and -13.529, both P < 0.01). The incidence of bone marrow suppression was 10.0% (3/30) in the observation group and 6.7% (2/30) in the control group, and there was no statistical difference between the two groups ( P = 1.000). Conclusion:Apatinib combined with chemotherapy for treatment of patients with stage Ⅲ B-Ⅳ colorectal cancer can further improve the short-term efficacy, reduce the level of tumor markers, inhibit angiogenesis, and do not increase the incidence of bone marrow suppression.

Objective To examine the impact of person-organization fit ( P-O fit) on turnover intention of medical staff and examine the mediating role of job involvement between P-O fit and turnover intention of medical staff.Methods The basic research hypothesis was obtained by combing the relationship among three variables of P-O fit, job involvement and turnover intention of medical staff. A questionnaire survey was conducted among 408 medical staff at 9 general public hospitals in the Pearl River Delta from July to August 2018. The contents of survey were as follows: the match between such factors as medical staff values, culture, personal ability and hospital, as well as turnover intention and job involvement of medical staff.The structural equation model was constructed by Amos 20.0, and the relationship between variables was analyzed.Results The path coefficients between the three variables were 0.436(P<0.001),-0.281 (P<0.05),-0.544(P<0.001), respectively.The total effect value and intermediate effect value were-0.470,- 0.082, respectively. P-O fit was positively related to job involvement. P-O fit and job involvement were negatively related to turnover intention of medical staff.Job involvement partially mediated the relationship between P-O fit and turnover intention. Conclusions In order to reduce the turnover intention of medical staff, hospitals must pay attention to the match of values, culture and personal ability between medical staff and hospitals, establish a match evaluation mechanism between medical staff and hospitals, create good working conditions and atmosphere for medical staff, and encourage medical staff to work harder.

Objective: To investigate the changes of internal fixation stress under different angles of interior fracture line and different screw placement modes in the case of A-type distal femoral fracture. Methods: A 24-year-old healthy male volunteer was recruited to collect the right femur data. CATIA V5R21 software produced a 10 mm fracture gap at the external side of the femur 6.5 cm proximal to the joint line and different angle fracture lines were generated on the internal of the femur at the same height. Based on the actual measured dimensions, the three-dimensional (3D) model of the locking plate and screw was reconstructed using CATIA V5R21 software, ignoring the screw surface threads and then the assembly of the internal fixation of the titanium plate, screws and femur was done. All models were meshed using Hypermesh 13.0 software. The assembled 3D model was input into ABAQUS 6.14 to generate a finite element model. Preliminary finite element biomechanical analysis was performed using the four medial fracture line angles and the stress distribution of the internal fixation under the three screw placement modes, and then the analysis was continued after the optimal screw placement method was re-determined. Results: Under an axial loading of 700 N, with the increase of the angle of the fracture line, the stress of the lateral internal fixation gradually increased, and the displacement of the proximal end of the fracture gradually increased. The sequential screw placement method was superior to the leaping screw placement method. The placement of the first screw at the proximal end of the fracture was critical to the distribution of the internal fixation stress. Conclusions The operation plan of the type A of distal femoral fracture needs to be confirmed according to the internal and external fracture′s condition. When the fracture line is at a excessive positive angle or a negative angle, a simple lateral fixation may not provide a stable fracture fixation so that other fixation methods are needed.