Objective: To develop an individual noise exposure dose estimation model based on spatial distribution of noise in order to provide reference for occupational health management and hearing loss risk assessment caused by noise in workplace. Methods: From July 2018 to October 2019, 10 noise-exposed positions and 48 employees in 3 high-noise workplaces of a manufacturing enterprise in Sichuan Province were selected as the research objects. Occupational health survey, fixed-point measurement of workplace noise and individual noise measurement were used to obtain noise intensity and employee exposure information. The mean noise intensity and the corresponding exposure time were weighted to estimate the individual noise exposure dose estimation model based on the spatial distribution of workplace noise, and the paired t-test was used to evaluate the accuracy of the individual noise exposure dose estimate (8 h equivalent sound level, L(EX, 8h)) based on the spatial distribution of workplace noise and the measured value of individual noise exposure dose. And the least square regression model was used to correct it. Results: The daily noise exposure dose of 44 (91.7%) of 48 workers in 10 types of work in 3 sites of the manufacturing enterprise exceeded the standard, and the maximum noise exposure intensity was up to 108.3 dB (A). The measured value of individual noise exposure dose was higher than L(EX, 8h), and the difference was statistically significant (P<0.001). The noise difference distribution was mostly positive and symmetrical (P=0.958). The measured noise exposure dose of 6 out of 10 work types in 3 sites was higher than L(EX, 8h) (all P<0.05), and there was a linear correlation between the measured dose and L(EX, 8h) (r=0.373, P<0.05). Considering the influence of systematic error and the construction, diagnosis and screening of adaptive assessment model, an individual noise exposure dose estimation model based on the spatial distribution of workplace noise was finally obtained: y=0.574x+45.250, where y was the measured value of individual noise exposure dose, x was L(EX, 8h) value. Conclusion: The high noise hazard in manufacturing industry is more serious, and the noise exposure assessment of single fixed-point detection is relatively rough. The individual noise exposure dose estimation model based on the spatial distribution of workplace noise has a certain role in the occupational health management of workplace noise hazard in manufacturing industry.
Objective To observe the clinical efficacy of thread-embedding at the combined lower he-sea and front-mu points for functional constipation with intestinal excess heat.Methods A total of 80 patients with functional constipation of intestinal excess heat were randomly divided into a thread-embedding group(40 cases,2 cases dropped out)and a Chinese patent medication group(40 cases,1 case dropped out).Based on the theory of combined lower he-sea and front-mu points for diseases of fu organs,Zhongwan(CV12),Guanyuan(CV4)and bilateral Zusanli(ST36),Shangjuxu(ST37),Tianshu(ST25),Xiajuxu(ST39)were selected and thread-embedding therapy was delivered in the thread-embedding group,once a week.Maren Runchang pill was given orally in the Chinese patent medication group,6-12 g each time,twice a day.Both groups were treated for 4 weeks.Before and after treatment,the scores of constipation assessment scale(CAS),Bristol stool form scale(BSFS),patient-assessment of constipation quality of life(PAC-QOL)and TCM syndrome were observed,and the clinical efficacy was evaluated after treatment in the two groups.Results After treatment,the CAS scores and the TCM syndrome scores were decreased compared with those before treatment(P＜0.05),while the BSFS scores were increased compared with those before treatment(P＜0.05)in the two groups;the total scores,as well as the physical discomfort and psychosocial discomfort scores of PAC-QOL were decreased compared with those before treatment(P＜0.05)in the two groups,the worry and anxiety,and the satisfaction scores of PAC-QOL were decreased compared with those before treatment(P＜0.05)in the thread-embedding group.After treatment,the CAS score,the total score and item-scores of PAC-QOL,as well as the TCM syndrome score in the thread-embedding group were lower than those in the Chinese patent medication group(P＜0.05).The total effective rate was 78.9％(30/38)in the thread-embedding group,which was higher than 56.4％(22/39)in the Chinese patent medication group(P＜0.05).Conclusion Thread-embedding at the combined lower he-sea and front-mu points can effectively treat functional constipation with intestinal excess heat and improve quality of life.
Objective: To investigate the effects and mechanisms of the hydrogen sulfide donor GYY4137 on acute lung injury in sepsis. Methods: An acute lung injury model was established using the method of cecal ligation and puncture(CLP). Mice received an intraperitoneal injection of GYY4137 (50 mg/kg) or saline 30 minutes after surgery. C57BL/6J mice were divided into four groups: the sham operation group (Sham), the sham operation with GYY4137 group (GYY4137), the sepsis group (CLP), and the sepsis with GYY4137 group (CLP+GYY4137). Respiratory parameters (minute ventilation volume and expiratory flow 50) were measured using a whole-body plethysmography system. Lung tissue was evaluated by hematoxylin and eosin (H&E) staining, and inflammatory cells were identified by immunofluorescence. mRNA expression of inflammatory factors (interleukin-1β, interleukin-6) and adhesion molecules (vascular endothelial cadherin, intercellular cell adhesion molecule-1, vascular cell adhesion molecule-1) were quantified by real-time quantitative polymerase chain reaction (RT-PCR). Levels of NLRP3, Pro-IL-1β, IL-1β, and the cyclic guanosine monophosphate synthase (cGAS)/stimulator of interferon genes (Sting)/NF-κB signaling proteins were analyzed by Western blotting. In vitro, murine pulmonary microvascular endothelial cells were cultured and exposed to lipopolysaccharide (LPS, 1 μg/ml) and GYY4137 (25 μmol/L) to simulate sepsis-induced damage and to study the mechanism of hydrogen sulfide action. Levels of inflammatory factors and adhesion molecules in cells were quantified by RT-PCR. Data were analyzed for normal distribution using Shapiro-Wilk test, then variance homogeneity by Brown-Forsythe test. P-value<0.05 was set as statistical significance for all analyses. Results: (1) MV and EF50 values were significantly lower in the CLP group [(36.32±3.91)ml/min and (1.43±0.26)ml/s, respectively] compared to the Sham group [(50.14±6.07)ml/min and (2.70±0.46)ml/s, respectively]. These parameters were higher in the CLP+GYY4137 group [(45.83±2.33)ml/min and (2.02±0.16)ml/s, respectively] compared to the CLP group (P<0.05). (2) Severe lung tissue damage, alveolar collapse, increased septal thickening and exudation were observed in the CLP group and significantly reduced in the CLP+GYY4137 group (P<0.05). (3) Infiltration of inflammatory cells and mRNA levels of inflammatory factors and adhesion molecules were increased in the CLP group compared to the Sham group (P<0.05), and decreased in the CLP+GYY4137 group compared to the CLP group (P<0.05). (4) Protein levels of NLRP3, Pro-IL-1β, IL-1β, cGAS, Sting, and NF-κB were higher in the CLP group compared to the Sham group (P<0.05) and were reduced in the CLP+GYY4137 group compared to the CLP group (P<0.05). (5) LPS induced higher levels of inflammatory factors and adhesion molecules in pulmonary endothelial cells compared to the control, which were reduced in cells co-treated with GYY4137 and LPS (P<0.05). Conclusion: The hydrogen sulfide donor GYY4137 effectively modulates acute lung injury in septic mice by inhibiting NLRP3 inflammasome activation via the cGAS/Sting/NF-κB signaling pathway.
Objective: To explore the clinical characteristics and prognostic value in hereditary transthyretin amyloidosis cardiomyopathy (hATTR-CM) patients based on cluster analysis, and to explore the risk factors for cardiovascular composite events. Methods: This retrospective cohort study included hATTR-CM patients who were admitted to Peking Union Medical College Hospital from January 2000 to January 2024. These patients were divided into two clusters using cluster analysis, based on genetic information, demographic information and clinical information. During the follow-up period, cardiovascular composite events were defined as all-cause death and hospitalization for heart failure. Both cardiovascular composite events and all-cause death were the endpoints. Kaplan-Meier survival curves and log-rank method were used to compare the prognostic significance of cluster analysis subgroups. Univariate and multivariate Cox proportional hazard regression models were used to analyze the risk factors affecting the incidence of cardiovascular composite events. Results: A total of 43 patients were included in this study, 30 were male (69.8%). In cluster 1 (n=27), whose age of onset was (49.9±13.9) years old, 24(88.9%) of them started with neuropathy or gastrointestinal symptoms, and all clinical phenotypes were mixed type (neurological and cardiac). In cluster 2 (n=16), whose age of onset was (59.0±10.6) years old, 15(93.8%) of them started with heart failure symptoms, and 13(81.3%) were pure cardiomyopathy. During the median follow-up time of 2.6 years, a total of 16 patients (37.2%) experienced composite cardiovascular events, and a total of 12 patients (27.9%) died. Kaplan-Meier survival curves showed a significantly lower cumulative survival rate for cardiovascular composite endpoint events (log-rank P=0.04) and all-cause death (log-rank P=0.04) in cluster 2 than in cluster 1. Univariate Cox proportional hazard regression model analysis showed that hATTR-CM patients with reduced estimated glomerular filtration rate, left ventricular ejection fraction≤40%, and moderate to severe mitral regurgitation were risk factors for vascular composite events (all P<0.05). Multivariate Cox proportional hazard regression analysis showed that left ventricular ejection fraction≤40% was an independent risk factor (P<0.01). Conclusions: Cluster analysis is a valuable prediction tool on the prognostic stratification of hATTR-CM. Cluster 2, which is late-onset with onset of heart failure symptoms has a worse prognosis during follow-up period. The occurrence of composite cardiovascular events in hATTR-CM is related to left ventricular ejection fraction≤40%. Cluster analysis is helpful for clinical identification of high-risk groups.
OBJECTIVE:To observe the clinical efficacy of auricular point sticking therapy combined with antibiotics for pediatric bacterial pneumonia of wind-heat accumulating in lung. METHODS:Ninety-four children with bacterial pneumonia were divided into an observation group (47 cases, 3 cases dropped out) and a control group (47 cases, with 4 cases terminated). The patients in the control group were treated with intravenous drip of latamoxef sodium injection, twice daily for 7 days. The patients in the observation group were treated with auricular point sticking therapy in addition to the treatment given to the control group. Acupoints selected included Fei (CO14), Qiguan (CO16), Jiaogan (AH6a), Shenshangxian (TG2P), and Shenmen (TF4), with treatment applied once daily, alternating ears, for 7 days. The TCM syndrome scores, Canadian acute respiratory illness and flu scale (CARIFS) scores, and levels of white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT) were compared before and after treatment between the two groups, along with clinical efficacy. RESULTS:Compared before treatment, both groups showed a reduction in TCM syndrome scores, CARIFS scores, and levels of WBC, CRP, and PCT after treatment (P<0.05). Compared with the control group, the observation group had lower TCM syndrome scores in fever, cough, expectoration, lung auscultation, sneezing, runny nose, sleep, and bowel symptoms, as well as lower CARIFS scores in fever, cough, nasal congestion and runny nose, and irritability (P<0.05). The curative and remarkably effective rate was 70.5% (31/44) in the observation group, which was higher than 44.2% (19/43) in the control group (P<0.05). CONCLUSION:Auricular point sticking therapy combined with antibiotics is more effective in improving symptoms such as fever, cough, and runny nose in children with bacterial pneumonia of wind-heat accumulating in lung.
