Analysis on influencing factors on occupational stress of medical staff during major public health emergencies / 中国职业医学

Objective To analyze the current status and influencing factors of occupational stress among medical staff during major public health emergencies. Methods A total of 491 medical staff in Guangzhou City was selected as the research subjects using a convenient sampling method. The Job Content Questionnaire and Effort-Reward Imbalance Questionnaire were used to evaluate the occupational stress level in the job demand-control (JDC) and effort-reward imbalance (ERI) models among the staff. Results Among the research subjects, the detection rates of occupational stress in JDC and ERI models were 50.1% and 52.5%, respectively. There was no significant difference in the detection rates of occupational stress between the two models (P>0.05). The result of multivariate logistic regression analysis showed that individuals with lower monthly income and longer weekly working hours had a higher risk of occupational stress in both JDC and ERI models (all P<0.05). Staff with night shift, daily sleep time less than six hours, and dissatisfaction with the protective measures provided by the hospital had higher risk of occupational stress than those with no night shift, daily sleep time at least six hours, and satisfaction with the protective measures provided by the work place in JDC and ERI models (all P<0.01). The risk of ERI model occupational stress of personnel who had been exposed to COVID-19 cases or suspected cases was higher than that in those who had not been exposed (P<0.05). Conclusion Medical staff experience a certain level of occupational stress, characterized by both JDC and ERI models, during major public health emergencies. The main influencing factors included personal monthly income, weekly working hours, night shift, sleep time, satisfaction with protective measures and occupational exposure.

Analyzing the results of finger systolic blood pressure tests in 28 healthy young adults / 中国职业医学

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 (Fi) 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 Fi of the study subjects was (98.0±16.6)%, with males and females having the average Fi 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 Fi 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.

Vibration attenuation and dexterity of different types of protective gloves / 环境与职业医学

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.

Peripheral circulation and peripheral nerve injury in workers exposed to vibration at two different frequencies / 环境与职业医学

Background Hand-arm vibration disease is harmful to human body, but there are no effective diagnosis and treatment so far, and current occupational exposure limits underestimate the health damage caused by high-frequency vibration exposure. Objective To evaluate and compare the damage to workers' peripheral circulation and peripheral nerve caused by different frequencies of vibration operation. Methods Drilling workers (n=187) from a mining company in Shandong Province and golf club head grinding workers (n=228) from a sports equipment factory in Guangdong Province were selected as study subjects. Hand symptoms were investigated. SV106 vibration meter was used to measure the target operation-associated vibration frequency spectrum. The 8 h energy-equivalent frequency weighted acceleration, cumulative vibration exposure level (CVEL), and the working age related to causing white finger in 10% of an exposed group were calculated. Result The study subjects were all male. More grinding workers reported hand symptoms than the drilling workers, e.g. peripheral circulation injury (52.6% vs 19.3%), peripheral nerve injury (71.5% vs 23.0%), hand stiffness (64.0% vs 7.0%), and deformed fingers (69.7% vs 4.3%) (all P<0.001). The main vibration frequencies of grinding operation (500-800 Hz) were much higher than those of drilling operation (125~160 Hz). CVEL and working age of vibration exposure showed a linear rising relationship with the cumulative prevalence rate of peripheral circulation and peripheral never injury, the fitting lines all showed good fitting effects (R2=0.812-0.988), and the slope of the fitting line of the grinding workers was larger than that of the drilling workers. The working age of vibration exposure associated with 10% cumulative prevalence of white finger was shorter in the grinding workers than in the drilling workers (6.81 years vs 10.27 years). According to the ISO prediction formula, the working age of vibration exposure was associated with 10% white finger prevalence shorter in the drilling workers than in the grinding workers (3.12 years vs 8.23 years). Conclusion Both the vibration exposure level and the prevalence of hand symptoms are high in two groups of workers with different vibration frequencies, and vibration exposure at a higher frequency tends to have severer damage to workers' hands.

Characteristics of noise hazard in a nuclear power station / 中国职业医学

OBJECTIVE: To analyze the characteristics of noise hazard in a nuclear power station. METHODS: The workplaces and working posts which exposed to occupational noise from two 1 000 MW power units in one nuclear power station in Guangdong Province was selected as study subjects using the convenience sampling method. Occupational health survey, noise measurement in the workplace and personal noise dosage measurement were used to monitor noise exposure, and to analyze the characteristics of occupational noise in the nuclear power station. RESULTS: The noise sources of the nuclear power plant were mainly distributed in the nuclear island, conventional island, and peripheral workshops. A total of 237 points of noise intensity were measured in the workplace. The intensity of noise ranged from 66.0 to 99.6 dB(A). The noise intensity in 62.4%(148/237) of points was equal or greater than 80.0 dB(A) and 34.2%(81/237) equal or greater than 85.0 dB(A). The percentage of detection points with noise intensity was equal or greater than 85.0 dB(A) from low to high were nuclear island, conventional island, and peripheral workshops with 22.0%, 37.5% and 53.8% respectively(P<0.01). The personal noise intensity of three positions including inspectors of operation department, preparation and main engine positions of mechanical department exceeded the occupational exposure limit(OEL), and the percentage of positions whose noise intensity exceeded the OEL was 9.7%(3/31). CONCLUSION: High-intensity noise sources of the nuclear power plant are widely distributed in the workshop areas of nuclear island, conventional island, and peripheral workshops. The noise level of some positions exceeded the standards of noise intensity. The prevention and control measures of noise hazards in posts with excessive noise should be strengthened.

Inter-laboratory comparison result analysis of noise measurement in simulated workplace in three years / 中国职业医学

OBJECTIVE: To analyze the influence of noise measuring skills by continuous inter-laboratory comparison among occupational hygiene technical service organizations. METHODS: The results of 68, 55 and 50 occupational hygiene technical service organizations(reference organizations) participating in the inter-laboratory comparison of workplace noise measurement in 2014, 2017 and 2018 respectively were collected. The measurement operation and the calculation of equivalent sound level were evaluated according to the GBZ/T 189.8-2007 Measurement of Physical Agents in Workplace--Part 8: Noise.The measured results were analyzed by z score evaluation method. RESULTS: The results of noise measurement field operation of the reference organizations in the year 2014, 2017 and 2018 show that the accuracy rates of instrument setting was 89.7%, 98.2% and 100.0%, the accuracy rates of measuring position were 52.9%, 81.8% and 94.0%, the accuracy rates of sound level meter holding were 54.4%, 80.0% and 92.0%, the accuracy rates of microphone pointing were 98.5%, 98.2% and 94.0%, and the accuracy rates of noise type recognition were 83.8%, 92.7% and 84.0%, respectively. Among them, the accuracy of instrument setting, measurement position and sound level meter holding showed an increasing trend year by year(P<0.01). The pass rates of measurement results were 91.2%, 94.5% and 88.0% in 2014, 2017 and 2018 respectively. The pass rates of equivalent sound level calculation were 73.5%, 92.7% and 88.0%. The pass rates of comprehensive evaluation were 70.6%, 89.1% and 80.0% respectively. Among them, the pass rates of equivalent sound level calculation and comprehensive evaluation in 2017 were higher than that in 2014(P<0.017). There was no significant difference in the three-year comprehensive assessment total pass rate between private organizations and non-private organizations(84.0 % vs 75.5%, P>0.05). There was no significant difference in the total pass rate of three-year comprehensive evaluation between non-Pearl-River-Delta organizations and Pearl-River-Delta organizations(70.3% vs 81.6%, P>0.05). CONCLUSION: Continuous inter-laboratory comparison in occupational hygiene technical service organizations is beneficial to improve on-site noise measure capability.

Effects of hand-transmitted vibration on subjective symptoms in mine drilling workers / 中国职业医学

OBJECTIVE: To investigate the effect of hand-transmitted vibration on the subjective symptoms of mine drilling workers. METHODS: A total of 117 mine drilling workers exposed to hand-transmitted vibration were selected as the exposure group, and 46 workers without hand-transmitted vibration exposure were selected as control group by judgment sampling method. The Occupational Epidemiology Questionnaire of Mine Drilling Workers was used to investigate their subjective symptoms. RESULTS: The prevalence of tinnitus, hearing loss, cough and sputum in the exposure group was higher than that in the control group(P<0.05). The occurrence rate of numbness, tingling, self-reported white fingers and cold hands in the exposure group was higher than that in the control group(P<0.05). The total rate of symptoms of hand in the exposure group was higher than that in the control group(38.5% vs 21.7%, P<0.05). The multivariate logistic regression analysis results indicated that hand-transmitted vibration exposure and service length were risk factors of abnormal hand symptoms(P<0.05). CONCLUSION: Occupational hand-transmitted vibration exposure can affect the hand subjective symptoms of mine drilling workers, and the length of service is a synergistic influencing factor.

Analysis of inter-laboratory comparison results of noise measuring instruments / 中国职业医学

OBJECTIVE: To evaluate the interlaboratory comparison results of noise measuring instruments in the occupational hygiene technical service institutions. METHODS: The basic performance data, multi-frequency acoustic calibration measurement results and simulated workplace noise at fixed points of 60 noise measuring instruments were collected. The instruments were from 60 occupational health technical service institutions who participate in the inter-laboratory comparison study in noise measuring instruments. The results of the measurements were analyzed using quartile robust statistical technology and z score evaluation method.RESULTS: All 60 participating comparison noise measuring instruments were examined or calibrated, and 58 instruments(96.7%) were used within the term of validity of examination or calibration. The 58 instruments were tested by multi-frequency noise calibration measurement. The comparative passing rate of the instrument accuracy was 94.8%(55/58); and the linearity test passing rate was 87.9%(51/58). There were 59 instruments participated in the simulated workplace noise at fixed points. The z-score pass rate of the two comparison measurement points was 89.8%(53/58). A total of 57 enterprises participated all the instrument performance comparison tests, with a pass rate of 94.7%(54/57). CONCLUSION: Performance of noise measuring instruments from the occupational hygiene technical service institutions is generally good. However, there are a small number of instruments have poor accuracy and linearity, and there are measurement bias that require improvement.

Investigation and analysis on fingertip vibrotactile perception threshold at two frequencies in mine drilling workers / 中国职业医学

OBJECTIVE: To analyze the characteristic change of fingertip vibrotactile perception threshold(VPT) at two different frequencies among mine drilling workers. METHODS: A total of 48 mine drilling workers exposed to hand-transmitted vibration for at least 1.0 year were selected from mines in Hubei Province as the vibration exposure group by using the random number table method, and workers without hand-transmitted vibration exposure were selected as the control group. An HVLab vibrotactile perception meter was used to measure the fingertip VPT at 31.5 and 125.0 Hz in workers of these two groups. RESULTS: None of the workers in these two groups showed any clinical symptoms associated with occupational hand-arm vibration diseases. At 31.5 and 125.0 Hz, the fingertip VPT in the vibration exposure group was higher than that in the control group(P<0.01), the fingertip VPT of the little fingers was higher than that of the index fingers(P<0.01). At 125.0 Hz, the fingertip VPT of the fingers in dominant hands was higher than that in non-dominant hands in workers of the vibration exposure group(P<0.01). CONCLUSION: The mine drilling workers with hand-transmitted vibration exposure had higher fingertip VPT. There were differences of VPT in fingers and dominant hands.

Evaluating the occupational exposure to hand-transmitted vibration in golf ball head grinding positions / 中国职业医学

OBJECTIVE: To evaluate the exposure status of hand-transmitted vibration(HTV)in golf ball head grinding workers.METHODS: The golf ball head grinding positions in a sports equipment factory were selected as the research subjects by the judgement sampling method.The HTV exposure level of the workers in 66 grinding positions was measured,the key control points for HTV hazards were identified,and the damage of HTV was classified.RESULTS: The median(M)of 4 hours energy equivalent frequency-weighted acceleration to vibration[a_(hw(4))]of grinding positions in this sports equipment factory was 4.21 m/s~2,and the a_(hw(4)) over standard rate was 50.0%(33/66).The a_(hw(4)) of rough grinding positions was higher than that of fine grinding positions(M:5.50 v.s 3.94 m/s~2,P<0.05).In both rough grinding positions and fine grinding positions,the a_(hw(4)) of different ball head grinding types from high to low were hollow titanium alloy ball heads, hollow stainless steel ball heads,and solid stainless steel ball heads(rough grinding positions M:7.41 vs4.43 vs 3.11 m/s~2,P<0.01; fine grinding p ositions M:5.24 vs 4.21 vs 2.93 m/s~2,P<0.01).For the hollow titanium alloy ball head grinding positions,the a_(hw(4)) of rough grinding was higher than that of fine grinding(M:7.47 vs 5.24 m/s~2,P<0.01).Rough grinding positions,especially hollow stainless steel ball heads and hollow titanium alloy ball head grinding positions were key control points for HTV hazards.In the 66 grinding positions,the HTV hazards were classified as grade 0,Ⅰ,Ⅱ,and Ⅲ in the grinding positions accounted for 3.0%,47.0%,40.9%,and 9.1%,respectively,and those with grade Ⅱ and above were 50.0%(33/66). CONCLUSION: The exposure level of HTV in golf ball head grinding workers is high,with a trend of exceeding the standard.The golf ball head grinding workers have a high occupational health risk.

Characteristics of nailfold capillaroscopy in fine sanding workers / 中国职业医学

OBJECTIVE: To analyze the effects of hand-transmitted vibration operation on nailfold capillaroscopy( NFC) in fine sanding workers. METHODS: A total of 57 fine sanding workers of one golf ball production enterprise in Guangdong Province were selected as vibration exposure group and 30 workers without exposure to hand-transmitted vibration as control group by a judgement sampling method. NFC examination was carried out in workers of these two groups. RESULTS: The capillary haemorrhage detection rates,percentage of abnormal capillary loops and total capillary width in the vibration exposure group were higher than that in the control group [43. 9% vs 13. 3%,( 56. 6 ± 20. 9) % vs( 41. 2 ± 14. 5) %,( 44. 7 ± 4. 9) vs( 42. 4 ± 4. 9) μm,P < 0. 05]. The capillary density,capillary length and branch diameter in the vibration exposure group were lower than that in the control group [( 7. 7 ± 1. 0) vs( 8. 8 ± 1. 0) per mm,( 185. 1 ± 33. 9) vs( 205. 6 ± 23. 2) μm,( 18. 3 ± 1. 9) vs( 19. 6 ± 2. 6) μm,P < 0. 05]. No significant difference was found in the diameter of apical part and branch of capillaries between the two groups( P > 0. 05). In the vibration exposure group,the percentage of abnormal capillary loops in the left hand was lower than that in the right hand [( 53. 1 ± 20. 6) % vs( 61. 5 ±24. 2) %,P < 0. 01],the capillary length in the left hand of vibration exposure group was longer than that in the right hand [( 187. 2 ± 33. 5) vs( 179. 4 ± 35. 4) μm,P < 0. 05]. No significant difference was found in the capillary density,total capillary width,apical part diameter,output branch diameter and input branch diameter between two hands in the vibration exposure group( P > 0. 05). CONCLUSION: The hand-transmitted vibration can lower the nailfold capillary density,shorten and widen capillary loops, increase percentage of abnormal capillary loops and induce capillary haemorrhage. NFC could be used to assist early detection of microvascular damage induced by hand-transmitted vibration.

Evaluation on occupational exposure to whole body vibration in workers of a hydroelectric power station / 中国职业医学

OBJECTIVE: To examine the level of occupational exposure to whole body vibration( WBV) in a hydroelectric power station,and evaluate its effects on workers' health. METHODS: A hydroelectric power station in Hangzhou City was chosen as study subject by using judgment sampling method. The level of WBV exposure to workers and high vibration level areas were measured,and the vibration frequency was analyzed. The comfort and allowing duration of occupational exposure in WBV exposed workers was evaluated. RESULTS: The median root-mean-square of accelerometer acceleration of WBV exposure in generator floor,turbines-floor,middle-floor,hydraulic floor of the hydroelectric power station were 0. 894,0. 995,1. 095 and 0. 904 m/s~2,respectively. The central frequency of WBV in this station was 1. 25 Hz. Among the 105 monitoring spots,8. 6% of WBV exposed workers of the spots did not perceive or feel uncomfortable,but 91. 4%of them felt uncomfortable or very uncomfortable. Only 12. 4% of the WBV exposed workers tolerated more than 8 hours of WBV occupational exposure. CONCLUSION: There is an occupational hazard of WBV in this hydroelectric power station.The low frequency vibration with central frequency below 1. 25 Hz is the key control point of the WBV of this hydroelectric power station.

Correlation between vascular endothelia injury factors and occupational hand-arm vibration disease / 中国职业医学

OBJECTIVE: To analyze the correlation between vascular endothelia injury factors and occupational hand-arm vibration disease( HAVD). METHODS: A judge sampling method was used to select 23 male patients with HAVD as the HAVD group,61 male workers who exposed to hand-arm vibration without HAVD as the vibration exposure group,64 male workers without hand-arm vibration exposure as the control group. The plasma levels of myosin light chain 2( MLC2),endothelin-1( ET-1) and vinculin( VCL) were detected by enzyme-linked immunosorbent assay. Logistic regression analysis was used to analyze the related indicators of HAVD for building the new multivariable model index Y. The indicators of HAVD were screened and judged by receiver operating characteristic( ROC) curves. RESULTS: There was significant difference in plasma levels of MLC2 among the three groups( P < 0. 05). The levels from high to low was as follows: HAVD group > vibration exposure group > control group. The plasma level of ET-1 in HAVD group was lower than that in the control group( P < 0. 05),but there was no significant difference between vibration exposure group and HAVD group( P > 0. 05). There was no significant difference among the three groups in the plasma level of VCL( P > 0. 05).The logistic regression analysis results showed that after adjusting confounding factors such as age,length of service,smoking,alcohol drinking and subjective symptoms,the higher MLC2 plasma level,the higher risk of HAVD( P < 0. 01),and the lower ET-1 plasma level,the higher risk of HAVD( P < 0. 05). According to ROC curve analysis,the area under the ROC curve( A_Z) value of the plasma levels of MLC2 and ET-1 were 0. 820 and 0. 524,respectively( P < 0. 01). The predictive probability index Y built with MLC2 and ET-1 by logistic regression model was used to judge the A_Z value of HAVD to be 0. 799( P < 0. 01). The A_Z values from high to low was as follows: MLC2 > Y> ET-1( P < 0. 01).CONCLUSION: The plasma levels of MLC2 and ET-1 are correlated with HAVD. The efficacy of MLC2 as a biomarker for screening HAVD is better than that of ET-1. No association was found between VCL and HAVD.

Characteristic changes of finger skin temperature in cold provocation test in workers with vibration white finger / 中国职业医学

OBJECTIVE: To analyze the changes of finger skin temperature in cold provocation test( CPT) in workers with vibration white finger( VWF). METHODS: A total of 245 male workers engaged in hand arm vibration operation was selected as study subjects using random number table method. All subjects were divided into VWF group( 73 persons) and control group( 172 persons). CPT( 10 ℃,10 min) was performed and the skin temperature of 6 fingers( index finger,middle finger and ring finger of both hands) was measured at pre-CPT adaptation period( 0,10,20,30 min) and after CPT period( 0,5,10,15,20,25,30 min). RESULTS: The effect of interaction between grouping and observe time was statistically significant on finger skin temperature( P < 0. 01). In the pre-CPT adaptation period,there was no statistically significant difference on skin temperature between 10 and 30 min time point in the two groups( P > 0. 05). After CPT,the fingers skin temperature of VWF group was lower than that of control group at 5 min time point( P < 0. 05),but there were no statistically significant differences on fingers skin temperature of other time points between the two groups( P > 0. 05).In both groups,the finger skin temperature at 0 min time point after CPT were lower than other time points in the same group( P < 0. 05),and the finger skin temperature increased with time( P < 0. 01). However,the finger skin temperature at 30 min after CPT did not restore to that at 30 min time point of pre-CPT. Except the VWF group,the abnormal rewarming temperature at 5 min time point after CPT of left index finger,the right index finger and the right ring finger were higher than that of the control group( 72. 6% vs 56. 4%,75. 3% vs 57. 6%,86. 3% vs 65. 1%,P < 0. 05),but there were no statistically significant differences on the abnormal rewarming temperature at 10,30 min time points of the six fingers in the two groups( P > 0. 05). There were no statistically significant differences on the detection rate of abnormal rewarming temperature between left index finger and the right index finger,or the right index finger and the right ring finger in the VWF group( 72. 6% vs 75. 3%,75. 3% vs 86. 3%,P > 0. 05). CONCLUSION: When CPT( 10 ℃,10 min) was performed in workers engaged in hand arm vibration operation,it is recommended to measure the finger skin temperature of index finger,and adaptation time before CPT can be adjusted to 10 min.

Correlation between acid-suppressive medications and risk of osteoporosis-related fractures:a meta-analysis / 中国组织工程研究

BACKGROUND:Whether a long-term use of acid-suppressive medication for over 3 years can increase the risk of fractures, remains controversial. OBJECTIVE:To systematical y review the effect of acid-suppressive medication on fracture risk. METHODS:Clinical trials about the relationship of acid-suppressive medication use and risk of osteoporosis-related fractures were searched in MEDLINE, Cochrane Library, EMbase, and CNKI database. We also manual y searched some published and unpublished references. Study selection and assessment, data col ection and analyses were undertaken by two reviewers independently. The Cochrane Col aboration’s RevMan 5.0 software was used for data analyses. RESULTS AND CONCLUSION:After a comprehensive search, 11 original clinical trials were included in this meta-analysis, including 3 nested case-control studies, 5 case-control studies, and 3 cohort studies. Patients with fractures were more likely than controls to have previously received supply of proton pump inhibitors [odds ratio (OR)=1.29, 95%confidence interval (CI) (1.18-1.41), P<0.001]. The meta-analysis did not find a significant difference in the patients who received H2 receptor antagonists [OR=1.10, 95%CI (0.99-1.23), P=0.34]. A long-term use of proton pump inhibitors is associated with an increased risk of fracture in elderly persons already at a risk for osteoporosis.

Diagnostic value of ultrasonography in combination with mammography for breast cancer within 2 cm: a meta-analysis / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the diagnostic value of ultrasonography in combination with mammography for breast cancer within 2 cm.</p><p><b>METHODS</b>The PubMed, the Cochrane Library, CNKI, CBM and Wanfang databases (2003/01/01-2013/04/30) were searched for studies of the diagnostic value of ultrasonography in combination with mammography for breast cancer within 2 cm. The quality of the included studies was evaluated according to QUADAS items. The pooled sensitivity (SEN), pooled specificity (SPE), pooled diagnostic odds ratio (DOR), and area under summary receiver operating characteristic curve (AUC) were calculated using Review Manager 5.2 and Meta-DiSc 1.4 software.</p><p><b>RESULTS</b>Nine articles were included in the final analysis. The pooled SEN of ultrasonography, mammography and their combination were 0.75, 0.66, and 0.92, the pooled SPE 0.75, 0.83, and 0.82, the pooled DOR 7.11, 8.67, and 60.82, and the AUC 0.7902, 0.8120, and 0.9469, respectively.</p><p><b>CONCLUSION</b>The combination of ultrasonography and mammography can increase the diagnostic accuracy for breast cancer within 2 cm.</p>

Prognosis and changes of myocardial intersitium before and after ventricular assist device application / 中华胸心血管外科杂志

Objective To investigate the relation between the changes d myocardial collagen content before and after ventricu-lar assist device (LVAD) application and the prognosis in dilated cardiomyopathy. Methods Patients was divided to two groups ac-cording to the prognosis (weaning or transplantation) after LVAD application. Left ventricular samples were collected from the patients (weaning group n= 10, transplanted group n=8) at the time the LVADs were implanted, and again during cardiac transplantation ( n = 8 ). The content of neutral salt soluble collagen (NSC) and acid soluble collagen (ASC) were measured by Sired collagen assay and total collagen and insoluble collagen (ISC) by quantification of hydroxyproline. Moreover, protein quantification of each collagen fraction was performed simultaneously. Results Before LVAD implantation all collagen fraction and their protein contents were higher in the weaning group than that in the transplanted group ( P <0.05), but the difference in the collagen fraction disappeared after LVAD support. Comparison of the pre- and post-LVAD subgroups of the transplanted group showed an increase of NSC and its protein content and total hydroxyproline after LVAD support (P<0.05). Conclusion The significances of myocardial intersititial remodeling in DCM are not identical. Some myocardial collagen and protein content increases may be related to good prognosis. The mechanism of LVAD improving cardiac function may be related to the changes of myocardial intersitial collagen.