Background Noise energy has been well-established to increase the risk of occupational noise-induced hearing loss (NIHL). However, the role of noise temporal structure (expressed by kurtosis) or its combination with energy metrics (e.g., kurtosis-adjusted cumulative noise exposure, adj-CNE) in occupational NIHL was still unclear. Methods A cross-sectional survey of 867 Chinese workers, including 678 metal manufacturing workers and 189 workers exposed to Gaussian noise, was conducted. Noise energy metrics, including L Aeq,8h and CNE, kurtosis (β), and adj-CNE were used to quantify noise exposure levels. Noise-induced permanent threshold shift at frequencies 3, 4, and 6 kHz (NIPTS 346 ) and the prevalence of high-frequency NIHL (HFNIHL%) were calculated for each participant. The dose–response relationship between kurtosis or adj-CNE and occupational NIHL was observed. Results Among 867 workers, different types of work had specific and independent noise energy and kurtosis values ( p > 0.05). HFNIHL% increased with an increase in exposure duration (ED), L Aeq,8h , CNE, or kurtosis ( p < 0.01), and there were strong linear relationships between HFNIHL% and ED (coefficient of determination [ R 2 ] = 0.963), CNE ( R 2 = 0.976), or kurtosis ( R 2 = 0.938, when CNE < 100 dB(A)∙year). The “V” shape notching extent in NIPTS became deeper with increasing kurtosis when CNE < 100 dB(A)∙year and reached the notching bottom at the frequency of 4 or 6 kHz. The workers exposed to complex noise (β ≥ 10) had a higher risk of NIHL than those exposed to Gaussian noise (β < 10) at the frequencies of 3, 4, 6, and 8 kHz (OR > 2, p < 0.01). Moreover, HFNIHL% increased with adj-CNE ( p < 0.001). There were strong linear relationships between NIHL and adj-CNE or CNE when β ≥ 10 ( R 2 adj-CNE > R 2 CNE ). After CNE was adjusted by kurtosis, average differences in NIPTS 346 or HFNIHL% between the complex and Gaussian noise group were significantly reduced ( p < 0.05). Conclusion Kurtosis was a key factor influencing occupational NIHL among metal manufacturing workers, and its combination with energy metrics could assess the risk of NIHL more effectively than CNE alone.

Objective To explore the interaction between abnormal prepregnancy body mass index(pBMI)and high blood lipid level during pregnancy on the risk of gestational diabetes mellitus(GDM). Methods A total of 235 patients with GDM and no blood lipid-related diseases before pregnancy were selected from Hangzhou Women's Hospital during March 2017 to July 2018 as the GDM group.At a ratio of 1∶3,a total of 705 individual age-matched pregnant women with normal glucose metabolism during prenatal examination from the same hospital were selected as the control group.The generalized multifactor dimension reduction(GMDR)method was employed to characterize the possible interaction between pBMI-blood lipid and GDM.The cross-validation consistency,equilibrium test accuracy,and P value were calculated to evaluate the interaction of each model. Results GMDR model analysis showed that the second-order model including pBMI and gestational blood lipid level had the best performance(P=0.001),with the cross-validation consistency of 10/10 and the equilibrium test accuracy of 64.48%,suggesting that there was a potential interaction between pBMI and gestational high blood lipid level.After adjustment of confounding factors,the model demonstrated that overweight/obesity patients with high triglyceride(TG) level had the highest risk of developing GDM(OR=14.349,95%CI=6.449-31.924,P<0.001).Stratified analysis showed that overweight/obesity patients under high TG level group had a higher risk of developing GDM than normal weight individuals(OR=2.243,95%CI=1.173-4.290,P=0.015). Conclusions Abnormal pBMI and high blood lipid level during pregnancy are the risk factors of GDM and have an interaction between each other.Overweight/obese pregnant women with high TG levels are more likely to develop GDM.

目的 运用Meta分析的方法评价CDH23基因rs1227049、rs1227051、rs3802711和Exon7多态性与噪声性听力损失(noise-induced hearing lose,NIHL)的相关性.方法 检索PubMed、Embase、Web of Science、中国知网、维普、万方数据库,收集有关CDH23基因rs1227049、rs1227051、rs3802711和Exon7多态性与NIHL相关性的研究,检索时限均为建库至2020年5月13日,采用RevMan5.3软件进行Meta分析.结果 共纳入6篇病例对照研究,病例组合计798例,对照组1112例.Meta分析结果表明,CDH23-rs3802711多态性与NIHL具有相关性(等位基因模型:OR=0.75,95％CI:0.55～1.01,P=0.06;显性模型:OR=1.08,95％CI:1.38,P=0.52;隐性模型:OR=2.94,95％CI:1.12～7.71,P=0.03;加性基因模型:OR=2.24,95％CI.0.97～5.14,P=0.06);CDH23-Exon7多态性与NIHL具有相关性(等位基因模型:OR =3.38,95％CI.1.84～6.22,P＜0.01;显性模型:OR=1.77,95％CI:0.79～3.97,P=0.17;隐性模型:OR =9.59,95％CI:28.20,P＜0.01;加性基因模型:OR=6.95,95％CI:2.86～16.86,P＜0.01);CDH23-rs1227049和rs1227051多态性与NIHL无相关性(P＞0.05).结论 CDH23-rs380271和Exon7多态性与NIHL的发病风险有显著相关性,但未发现rs1227049和rs1227051多态性与NIHL易感性有关.

BackgroundOccupational noise-induced hearing loss (NIHL) is one of the most prevalent occupational diseases in the world. With the development of industry, noise sources in the workplace have become increasingly complex.ObjectiveTo apply kurtosis-adjusted cumulative noise exposure (CNE) to assess the occupational hearing loss among furniture manufacturing workers, and to provide a basis for revising noise measurement methods and occupational exposure limits in China.MethodsA cross-sectional survey was conducted to select 694 manufacturing workers, including 542 furniture manufacturing workers exposed to non-Gaussian noise, and 152 textile manufacturing workers and paper manufacturing workers exposed to Gaussian noise. The job titles involving non-Gaussian noise were gunning and nailing, and woodworking, while those involving Gaussian noise were weaving, spinning, and pulping. High frequency noise-induced hearing loss (HFNIHL) and noise exposure data were collected for each study subject. Noise energy metrics included eight-hour equivalent continuous A-weighted sound pressure level (LAeq,8 h) and CNE. Kurtosis was a noise temporal structure metric. Kurtosis-adjusted CNE was a combined indicator of noise energy and temporal structure.ResultsThe age of the study subjects was (35.64±10.35) years, the exposure duration was (6.71±6.44) years, and the proportion of males was 75.50%. The LAeq,8 h was (89.43±6.01) dB(A). About 81.42% of the study subjects were exposed to noise levels above 85 dB(A), the CNE was (95.85±7.32) dB(A)·year, with a kurtosis of 99.34 ± 139.19, and the prevalence rate of HFNIHL was 35.59%. The mean kurtosis of the non-Gaussian noise group was higher than that of the Gaussian noise group (125.33±147.17 vs. 5.86±1.94, t=−21.04, P<0.05). The results of binary logistic regression analysis showed that kurtosis was an influential factor of workers' HFNIHL after correcting for age, exposure duration, and LAeq,8 h (OR=1.49, P<0.05). The results of multiple linear regression analysis showed that the effects of age, exposure duration, LAeq,8 h, and kurtosis on noise-induced permanent threshold shift at frequencies of 3, 4, and 6 kHz of the poor hearing ear were statistically significant (all P<0.05). The results of chi-square trend analysis showed that when CNE ≥ 90 dB(A)·year, the HFNIHL prevalence rate elevated with increasing kurtosis (P<0.05). The mean HFNIHL prevalence rate was higher in the non-Gaussian noise group than in the Gaussian noise group (31.7% vs. 22.0%, P<0.05). After applying kurtosis-adjusted CNE, the linear equation between CNE and HFNIHL prevalence rate for the non-Gaussian noise group almost overlapped with that for the Gaussian noise group, and the mean difference in HFNIHL prevalence rate between the two groups decreased from 9.7% to 1.4% (P<0.05). ConclusionNoise kurtosis is an effective metric for NIHL evaluation. Kurtosis-adjusted CNE can effectively evaluate occupational hearing loss due to non-Gaussian noise exposure in furniture manufacturing workers, and is expected to be a new indicator of non-Gaussian noise measurement and assessment.

人体血液维生素E主要有8种形式,即α-生育酚、β-生育酚、γ-生育酚、δ-生育酚、α-三烯生育酚、β-三烯生育酚、γ-三烯生育酚和δ-三烯生育酚.α-生育酚是人体分布最广泛、含量最丰富、活性最高的形式,是国内外公认判定人体维生素E营养状况的指标.不同形式的维生素E具有不同的生物活性,实现人体血液维生素E不同形式之间的分离检测有利于进一步探索维生素E与疾病的关系.本文从样本前处理技术和分离检测技术2个方面介绍人体血液维生素E检测技术的研究进展,样本前处理技术包括固相萃取、液液萃取、分散液相微萃取、固相支撑液液萃取和直接蛋白沉淀法,分离检测技术包括自动生化分析法、酶联免疫吸附法、气相色谱法、液相色谱法和超高效超临界流体色谱法.本文对上述检测方法的特点和适用范围进行综述,为检验技术人员选择合适的方法提供参考.

目的 调查制造业三个子行业工人职业性噪声暴露特征及其分布状况.方法 于2020年5月选取来自浙江省的232名稳态噪声暴露工人(包括170名纺织工人和62名造纸工人)和416名复杂噪声暴露的家具制造工人,对工作场所噪声的波形、8小时等效 A 声级(eight-hour continuous equivalent a-weighted sound level,LAeq,8h)、累积噪声暴露量(cumulative noise exposure,CNE)和平均峰度(mean β,反映波形时域结构)进行分析.结果 除纺织业外,造纸业和家具制造业以男性青壮年为主(分别为33.53％、59.68％和88.46％).造纸业和纺织业的峰度均＜10,为稳态噪声;家具制造业的峰度均＞10,为复杂噪声,不同行业的峰度分布差异有统计学意义(U=446.26,P＜O.05).每个工种拥有唯一波形,复杂噪声波形与稳态噪声波形具有显著差异.纺织业和造纸业LAeq,8h的超标率分别为92.35％和93.55％,家具制造业的超标率为78.13％.CNE指标在不同行业之间差异有统计学意义(F=95.80,P＜0.05),纺织业和造纸业 CNE 分别为(101.09±6.82)dB(A)·年、(99.63±4.94)dB(A)·年,家具制造业CNE为(93.66±6.172)dB(A)·年.结论 纺织业和造纸业工人噪声暴露的类型为稳态噪声,家具制造业工人噪声暴露类型为复杂噪声.能量指标(LAeq,8h和CNE)和结构指标在复杂噪声和稳态噪声中的分布差异显著,联合应用能量指标和峰度能更加全面评估噪声接触导致的损害.

In this paper, we built a method of verifying the 4 retinols of vitamin A and 8 tocopherol isomers of vitamin E in the food industry based on RP-HPLC-PDA-FLR. The effect of laboratory light conditions on the target components was considered for the first time, and it was found that the loss rate of the target components was the smallest in the case of a white laboratory bench with red or LED light in the dark room. There was no finding of extraction recoveries of the target components with a significant difference under different saponification conditions. Meanwhile, it was found that using ethyl acetate/n-hexane mixed solvent as the extraction solvent could ensure the effective extraction of the target components. Finally, baseline separation of 12 components was achieved within 45 min using the C30 column. With the help of methodological verification, we found that the recovery rate ranged from 76.45% to 93.52%, and RSD was between 0.19% and 12.99%; the Limit of Detection minimum value was 0.01 mg/100 g and the Limit of Quantitation minimum value was 0.03 mg/100 g. The detection method was successfully applied to the distribution detection of 4 kinds of retinols and 8 kinds of vitamin E in egg and dairy products and provided technical support for the accurate nutritional evaluation of vitamin A and vitamin E.

目的 探讨制造业工人噪声暴露特征与高频听力损失的关系.方法 采用典型抽样法,选择浙江省5家制造业工厂755名噪声作业工人为研究对象,测量其接触的8 h等效声级(LEX,8h)并记录噪声波形,计算累积噪声暴露量(CNE)和峰度;测试双耳纯音气导听阈.结果 研究对象的高频听力损失患病率(HFHL％)为19.3％(146/755),且HFHL％均随着CNE和峰度的增加而升高(P值均＜0.01).研究对象高频噪声诱发永久性听阈位移中位数为23.0 dB,其与CNE、LEX.8h和峰度均呈正相关(相关系数分别为0.24、0.19、0.17,P值均＜0.01).多因素Logistic回归分析结果显示,在排除性别和年龄等混杂因素的影响后,CNE、峰度均可导致罹患高频听力损失的风险增加[比值比及其95％可信区间分别为2.59(1.84～3.65)、1.53(1.20～1.95),P值均＜0.01].结论 制造业工人噪声暴露特征与其高频听力损失呈剂量-反应关系;除能量指标LEX,8h和CNE外,峰度也是影响高频听力损失的关键因素.

OBJECTIVE:The effects of interactions between genetic and environmental factors on the noise-induced hearing loss (NIHL) are still unclear. This study aimed to assess interactions among gene polymorphisms, noise metrics, and lifestyles on the risk of NIHL.METHODS:A case-control study was conducted using 307 patients with NIHL and 307 matched healthy individuals from five manufacturing industries. General demographic data, lifestyle details, and noise exposure levels were recorded. The Kompetitive allele-specific polymerase chain reaction (KASP) was used to analyze the genotypes of 18 SNPs.RESULTS:GMDR model demonstrated a relevant interaction between NRN1 rs3805789 and CAT rs7943316 (P = 0.0107). Subjects with T allele of rs3805789 or T allele of rs7943316 had higher risks of NIHL than those with the SNP pair of rs3805789-CC and rs7943316-AA (P < 0.05). There was an interaction among rs3805789, rs7943316, and kurtosis (P = 0.0010). Subjects exposed to complex noise and carrying both rs3805789-CT and rs7943316-TT or rs3805789-CT/TT and rs7943316-AA had higher risks of NIHL than those exposed to steady noise and carrying both rs3805789-CC and rs7943316-AA (P < 0.05). The best six-locus model involving NRN1 rs3805789, CAT rs7943316, smoking, video volume, physical exercise, and working pressure for the risk of NIHL was found to be the interaction (P = 0.0010). An interaction was also found among smoking, video volume, physical exercise, working pressure, and kurtosis (P = 0.0107).CONCLUSION:Concurrence of NRN1 and CAT constitutes a genetic risk factor for NIHL. Complex noise exposure significantly increases the risk of NIHL in subjects with a high genetic risk score. Interactions between genes and lifestyles as well as noise metrics and lifestyles affect the risk of NIHL.

近年来,大量研究致力于鉴定可能与噪声性听力损失(noise-induced hearing loss,NIHL)易感性相关的候选基因单核苷酸多态性(single nucleotide polymorphisms,SNPs)的探讨,但尚未见对该领域研究成果的归纳总结.通过全面系统的检索,本文汇总了与NIHL相关的SNPs,并对NIHL易感基因多态性的研究现状进行综述,以期为该领域的研究方向提供科学的指导.

Objective: To explore the effect of gene polymorphism on workers suffering from noise induced hearing loss (NIHL) . Methods: In May 2019, a case-control study was conducted to select noise exposed workers in five factories in Zhejiang Province from 2017 to 2018. The average hearing threshold of binaural high frequency (3, 4, 6 kHz) was >25 dB (A) as the NIHL group, and the hearing threshold of any language frequency (0.5, 1, 2 kHz) was ≤25 dB (A) as the non NIHL group, with 307 people in each group. The general demographic data, occupational history, pure tone audiometry results and oral swab mucosal samples of noise exposed workers were collected, and the DNA of oral mucosal cells was extracted. The relationship between genetic risk score (GRS) and NIHL was analyzed, single nucleotide polymorphisms (SNP) were genotyped, the relationship between genotype and NIHL was analyzed by logistic regression, and the relationship between haplotype and NIHL was analyzed by R language. Results: After adjusting for gender, age, education and working years, the risk of NIHL among workers carrying cysteine-aspartic acid protease 3 gene (CASP3) rs1049216 recessive model GG genotype, rs6948 recessive model TT genotype, NADPH oxidase 3 gene (NOX3) rs12195525 additive model GT genotype and dominant model TT+GT genotype decreased (P<0.05) , the risk of disease was higher in workers with AA genotype carrying cysteine-aspartic acid protease 7 gene (CASP7) rs12415607 additive model (P<0.05) . There was a strong linkage disequilibrium (LD) relationship between rs1049216 and rs6948 (D'>0.8) . Haplotype AT and GG composed of rs1049216-rs6948 increased the risk of NIHL (P<0.05) . The risk of NIHL increased with the increase of GRS (OR=2.69, P<0.05) . Conclusion: Genotype polymorphisms at rs1049216 and rs6948 (CASP3) , rs12195525 (NOX3) , rs12415607 (CASP7) may be associated with susceptibility to NIHL.

带有脉冲或冲击性质的复杂噪声普遍存在于工作场所中;在等效声级的条件下,其对听觉系统的损害大于稳态噪声.目前国际上广泛采用的噪声接触测量和评估指标主要包括等效连续声级和累积噪声接触量,均基于等能量假设而制定.该假设仅考虑噪声能量对听觉系统的损害,忽略噪声的时域结构特性,低估复杂噪声所致的听力损失程度.本文首先介绍国内外有关噪声接触评估标准的不足,进一步介绍时域峰度的定义及其相关能量指标(例如累积噪声暴露量和等效声级)的计算方法,并总结时域峰值作为衡量噪声能量的辅助参数在评估复杂噪声所致听力损失风险中的有效性,为补充现有噪声评估标准提供依据.

Objective: To investigate the distribution of noise exposure between non-steady state noise and steady-state noise for metal processing workers, which will provide scientific basis for the prevention and treatment of noise hazards in metal processing industry. Methods: The cross-section method was used to investigate the noise exposure of 737 workers from three metal processing industries in Zhejiang Province from October to December 2017. The general demographic information and occupational history were collected by questionnaire. The noise was recorded by individual noise meters, and the noise exposure intensity (equivalent continuous A-weighted noise exposure level normalized to an 8 h-working-day, L(Aeq, 8 h)) and kurtosis were calculated. Results: Workers exposed to noise in the metal processing industry were mainly 18-40 years old (527 workers, 71.51%) , men (570 workers, 77.34%) , and junior high school education background (416 workers, 56.45%) . There were 572 workers (77.61%) with noise exposure intensity (L(Aeq, 8 h)) greater than 85 dB (A) , 558 workers (75.71%) exposed to non-steady state noise (kurtosis ≥4) , and 634 workers (86.02%) with exposure duration less than 8 years. Among the 30 work types investigated, the work types with noise intensity reaching 100% were the stamping, welding and others from a children's car manufacturing factory in Ningbo, operating, chamfering, tapping, and thread rolling from an automobile parts manufacturing factory in Ningbo; The work types with a rate of 100% exposed to non-steady state noise were the grinding from a children's car manufacturing factory in Ningbo, assembling, assembly operating and others from an automobile brake manufacturing factory in Wenzhou, and polishing from an automobile parts manufacturing factory in Ningbo. Conclusion: Metal processing workers have a high rate of over-standard exposed to high noise intensity and a high proportion exposed to non-steady state noise. It is necessary to take sound insulation and noise reduction engineering control, and strengthen personal protection and occupational health management measures to prevent and control the noise hazards.

30 Background: Multiple genetic and environmental factors influence the severity of NIHL. However, 31 few studies have reported interactions among such factors in modulating the risk of NIHL. This 32 study aimed to assess for interactions among gene polymorphisms, noise metrics, and lifestyles on 33 the risk of NIHL. Methods: A case-control study was conducted using 307 patients with NIHL and 307 matched 35 healthy individuals from five manufacturing industries. General demographic data, lifestyle details, 36 and noise exposure levels were recorded. The kompetitive allele-specific polymerase chain reaction 37 (KASP) was used to analyze the genotypes of 18 single nucleotide polymorphisms (SNPs). The 38 generalized multifactor dimensionality reduction (GMDR) method was used to examine the effects 39 of all possible interactions. 40 Results: The proportion of people with complex noise exposure, high CNE, high adj-CNE, smoking, 41 propensity to watch loud videos, or sedentary lifestyle was significantly greater in the NIHL group 42 than in the healthy group ( P < 0.05). The GMDR model demonstrated a relevant interaction between 43 NRN1 rs3805789 and CAT rs7943316. Subjects with the SNP pair of NRN1 rs3805789-CC and CAT 44 rs7943316-AT, NRN1 rs3805789-CT and CAT rs7943316-AA, NRN1 rs3805789-CT and CAT 45 rs7943316-TT, NRN1 rs3805789-CT/TT and CAT rs7943316-AA, or NRN1 rs3805789-CC and 46 CAT rs7943316-AT/TT had higher risks of NIHL than those with NRN1 rs3805789-CC and CAT 47 rs7943316-AA ( P < 0.05). There was an interaction among NRN1 rs3805789, CAT rs7943316, and 48 kurtosis. Subjects exposed to complex noise and carrying both NRN1 rs3805789-CT and CAT 49 rs7943316-TT or NRN1 < 0.05). The best six‐locus model involving NRN1 rs3805789, CAT rs7943316, smoking, video 52 volume, physical exercise, and working pressure for the risk of NIHL was found to be the interaction 53 ( P = 0.0010). An interaction was also found among smoking, video volume, physical exercise, 54 working pressure, and kurtosis ( P = 0.0107). 55 Conclusions: Complex noise, high CNE, high adj-CNE, smoking, high video volume, and 56 sedentary lifestyle are environmental risk factors for NIHL. Concurrence of NRN1 rs3805789 and 57 CAT rs7943316 constitutes a genetic risk factor for NIHL. Complex noise exposure significantly 58 increases the risk of NIHL in subjects with a high genetic risk score. Interactions between genes and 59 lifestyle as well as noise metrics and lifestyle affect the risk of NIHL. These results provide a 60 theoretical basis for screening genetic and environmental risk factors to prevent NIHL. 61 multi-locus 18 in 7 the validated results illustrated that NRN1 higher risks than interactions while investigating the effects of noise-metric– lifestyle-factor interactions on NIHL. We observed a cross-reaction involving NRN1 rs3805789,