To analyze the influencing factors of hearing loss among workers in different workshop noise operations in a certain automobile manufacturing enterprise, and propose corresponding protective suggestions.

A stratified cluster sampling method was employed, and on-site questionnaire surveys were conducted to collect basic information, personal history, occupational history, and exposure status of the study subjects. Physical examinations were performed to obtain their hearing results. The study subjects were divided into four groups based on different workshops: the stamping workshop, the assembly workshop, the painting workshop, and the welding workshop. They were also categorized into two groups based on hearing: the normal hearing group and the hearing loss group. The relationship between various exposure characteristics and hearing loss was analyzed for 1 411 noise-exposed workers who met the inclusion and exclusion criteria, categorized by different workshops and hearing groups.

The detection rate of hearing loss in the research subjects was 20.13% (284/1 411), with the highest detection rate in the assembly workshop (25.00%). There was a statistically significant difference in the detection rate of hearing loss among different workshops (P<0.05). The differences in noise exposure levels and noise exposure duration among the four workshops were statistically significant (P<0.05); The detection rate of hearing loss in noise combined with organic solvent exposure was the highest (34.55%), significantly higher than that in noise combined with dust (21.69%), noise combined with other factors (20.00%), and noise alone (15.47%), with statistically significant differences between the groups (P<0.01). The detection rate of hearing loss in the noise combined with organic solvent exposure group was the highest in the final assembly and welding workshops, and the differences between different exposure groups in the two workshops were statistically significant (P<0.05). Logistic regression showed that workers exposed to noise combined with organic solvents and noise combined with dust had 2.67 times (P<0.01) and 1.43 times (P<0.05) higher risk of hearing loss, respectively, compared to those exposed to noise alone.

The exposure of noise combined with organic solvents and noise combined with dust in automobile manufacturing enterprises is the main influencing factor of hearing loss among workers. The detection rate of hearing loss in the final assembly workshop is the highest. Therefore, it is necessary to strengthen noise control and health protection in the workplace, and implement occupational health monitoring.

To investigate the potential role of ferroptosis in the neurotoxicity induced by deltamethrin (DM) exposure.

Mice hippocampal neuronal cells HT22 cells were treated with DM at different doses (1, 2, 5, 10, 20, 50, 100, 200, and 400 μmol/L) for 24 h, cell survival rate was detected by MTT method to determine the optimal dose (2, 10, and 50 μmol/L). The cell morphology was observed by microscope. The level of lipid peroxidation was detected by flow cytometry. The level of glutathione (GSH) and the content of ferrous ion (Fe²⁺) were detected by the kit. The levels of ferritin heavy chain (FTH), light chain (FTL) protein and glutathione peroxidase 4 (GPX4) were detected by Western Blotting.

With the increase of DM dose, the number of HT22 cells gradually decreased, the morphology changed and the tentacles antennae broke. Compared with the control group, the survival rate of DM infected groups were significantly decreased (F=349.8, P<0.01), and the level of intracellular lipid peroxidation was significantly increased (F=14.86, P<0.01). With the increase of dose, GSH level in HT22 cells in 2, 10 and 50 μmol/L DM groups was significantly lower than that in control group (F=11.56, P<0.01), and Fe²⁺ level in 10 and 50 μmol/L DM groups was significantly higher than that in control group (F=17.67, P<0.01). Compared with the control group, GPX4 and FTL protein expressions in the 50 μmol/L DM group were significantly decreased with the increase of dose (F_GPX4=3.313, P<0.05; F_FTL=2.003, P<0.05), and FTH protein expressions in the 2, 10, 50 μmol/L DM groups were significantly increased with the increase of dose (F=16.95, P<0.01). Pretreatment with Fer-1, an ferroptosis inhibitor, for 2 h significantly reversed GSH, lipid peroxidation and Fe²⁺ levels in 50 μmol/L DM group (F_GSH=215.5, P<0.01; F_{lipid p eroxide}=17.97, P<0.01; F_Fe²⁺=23.26, P<0.01).

DM exposure induces ferroptosis in HT22 cells of mice hippocampal neurons leading to neurotoxicity, the mechanism of which may be related to intracellular lipid peroxidation and iron metabolism disorder.

To explore the impact of standardized clinical pathway management on the cost changes of anterior cruciate ligament injury of the knee and its value in medical practice, with the intention of providing experience for the reform of clinical pathways for disease types and medical insurance payment systems in the context of the DRG payment system.

The study selected a tertiary general hospital in City L as the research object and utilized the interrupted time series analysis method to compare the data before and after the implementation of clinical pathway management.

After the implementation, the average cost per case of this disease type significantly decreased, and the cost structure was optimized. The main cost items such as drug fees, examination fees, and treatment fees all showed a downward trend. The optimization of hospitalization frequency was limited, and the control of consumable costs still needed to be strengthened.

Although clinical pathway management has achieved certain results, it also faces challenges. During the implementation, it is necessary to be vigilant against the decomposition of hospitalizations, strengthen medical insurance supervision and technical monitoring, and optimize hospital management processes. Emphasis should be placed on the value of medical labor and the adjustment of salary systems. Continuous control of consumables is needed to control costs and optimize resource utilization. In the future, the system should be continuously improved to enhance service quality and efficiency, promote the high-quality development of public hospitals, and advance the reform of medical insurance payment systems.

To investigate the protective effect of folic acid on the epithelial-mesenchymal transition (EMT) induced by N-methyl-N ’-nitro-n-nitroguanidine (MNNG) and its signaling mechanism.

SD rats were randomly divided into blank group, model group, low-dose, medium-dose and high-dose folate groups (1.25, 2.5, 5 mg/kg), control group was given 10 mL/kg normal saline, and other groups were given 25 mg/kg MNNG.All were administered with free drinking water once a day for 12 weeks. After 12 weeks, the expression of E-cadherin and N-cadherin protein was observed by immunohistochemistry. The expressions of E-cadherin, ZO-1, N-cadherin and Vimentin were detected by Western blot. In vitro (0.1, 0.2, 0.4 μg/mL), the concentration of folic acid was treated with 20 μmol/L MNNG for 24 h, and the mRNA transcription levels of E-cadherin, ZO-1, N-cadherin, Vimentin, TGF-β, Wnt/β-catenin, JAK/STAT 3 signaling pathways were detected by RT-qPCR. The expressions of E-cadherin, ZO-1, N-cadherin and Vimentin were detected by Western blot.

Compared with the model group, folic acid could improve the precancerous lesions caused by MNNG, up-regulate the expression of E-cadherin (F=90.3，P<0.001) and ZO-1 protein (F=188.9，P<0.001), and down-regulate the expression of N-cadherin (F=68.9，P<0.001) and Vimentin protein (F=82.6，P<0.001). The results of cell Western blot showed that compared with the control group, the expression levels of E-cadherin and ZO-1 were decreased, decreasing to 63.7% (95%CI: 0.589-0.675, P<0.001) and 57.1% (95%CI: 0.494-0.706, P<0.001) of the control group. Cell RT-qPCR results showed that compared with the model group, E-cadherin mRNA levels were increased (F=8.5, P=0.007), the expression of ZO-1 mRNA increased (F=31.5, P<0001), N-cadherin mRNA levels were decreased (F=34.1, P<0.001), and the expression of Vimentin mRNA decreased (F=17.8, P<0.001).Cell RT-qPCR confirmed that MNNG can promote the transcription of key mRNA in TGF-β signaling pathway, Wnt/β-Catenin signaling pathway, and JAK/STAT 3 signaling pathway. The downstream transcription factors snail and ZEB1 mRNA transcription were activated, while folic acid could antagonize the process.

Folic acid has certain protective ability against MNNG induced esophageal epithelial-mesenchymal transformation, which may be related to inhibiting the activation of JAK/ STAT3 signaling pathway.

To analyze the correlation between the Geriatric Nutritional Risk Index (GNRI) and the risk of all-cause and cardiovascular disease (CVD) mortality in elderly populations, and to investigate whether the Cardiovascular-Kidney-Metabolic Syndrome (CKM) modulates this association.

This study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cohort data from 2014 to 2018. The baseline was set in 2014, and participants were prospectively followed for 4 years until the follow-up ended in 2018. Participants were divided into two groups according to the Geriatric Nutritional Risk Index (GNRI): the nutritionally normal group (GNRI ≥ 98) and the malnutrition group (GNRI < 98). Kaplan-Meier analysis and log-rank tests were used to assess differences in survival rates between the groups. Restricted cubic spline (RCS) analysis was employed to explore the non-linear relationship between GNRI and survival risk. Cox proportional hazards models were used to evaluate the associations of GNRI and CKM stratifications with survival risk and to investigate the interaction effect of CKM staging.

A total of 1 725 elderly participants were included, and during the 4-year follow-up, 530 cases of all-cause mortality and 160 cases of CVD mortality were recorded. Significant differences in survival probabilities of all-cause and CVD mortality were observed among different GNRI groups (both P<0.001). GNRI showed a linear negative correlation with both all-cause and CVD mortality risks (P<0.001, P for non-linearity>0.05). After adjusting for confounding factors, compared to the nutritionally normal group, the elderly in the poor nutrition group had a 63% higher risk of all-cause mortality (HR=1.63, 95%CI: 1.34 - 1.97) and a 45% higher risk of CVD mortality (HR=1.45, 95%CI: 1.01 - 2.07). Additionally, CKM staging had a significant modulating effect on the association between GNRI and all-cause mortality risk (P for interaction < 0.05), but it did not have a significant modulating effect on the association between GNRI and CVD mortality risk (P for interaction > 0.05).

GNRI is an independent predictor of all-cause and CVD mortality risk in elderly populations, and its protective effect against all-cause mortality risk is more pronounced in patients with earlier CKM staging.

To investigate the association between dietary oxidative balance score (DOBS) and the risk of sarcopenia in patients with hypertension.

Patients with hypertension aged 20 years and above who participated in four survey cycles of the National Health and Nutrition Examination Survey (NHANES), 2011-2018. Weighted logistic regression and restricted cubic spline were used to analyze the association between DOBS and the risk of sarcopenia in patients with hypertension, and subgroups analysis was performed according to gender and age.

A total of 2 775 patients with hypertension were included, with 349 (12.6%) diagnosed with sarcopenia. After adjusting for multiple covariates, higher DOBS were significantly associated with decreased risk of sarcopenia in patients with hypertension. For each one-point increase in DOBS, the risk of sarcopenia in patients with hypertension was reduced by 11.4% (OR=0.886, 95%CI: 0.842-0.933). As a categorical variable, the OR of DOBS Q3 group was 0.331 (95%CI: 0.116-0.941) and the OR of Q4 group was 0.124 (95%CI: 0.051-0.301) compared with Q1. A restricted cubic spline model indicated a linear negative dose-response association between DOBS and sarcopenia in patients with hypertension (P _non-linear=0.148). Subgroup analysis indicated no significant interaction of gender and age on the association of DOBS and sarcopenia in patients with hypertension (P _interaction > 0.05).

Higher DOBS is significantly associated with a lower risk of sarcopenia in patients with hypertension.

To evaluate the quality of life of the urban older adults with comorbidity from a multi-dimensional perspective, and to verify the influencing factors of the quality of life of the urban older adults with comorbidity by combining the theory of social embeddedness mechanisms.

The questionnaire data of 465 urban older adults with comorbidity were selected as the study sample. One-way ANOVA and independent samples t-test analysis were used to test the differences of different demographic characteristics in the quality of life of the urban older adults with comorbidity, and AMOS 28.0 was used to construct a social embedding structure model of the quality of life of the urban older adults with comorbidity.

The perceived quality of life among urban older adults with comorbidity was rated at a moderate level. In addition, there were significant differences in the quality of life of urban older adults with comorbidity with different genders, ages, marital status, education level, work status, and retirement status. Social support (β=0.10, P<0.001) and social resources (β=0.20, P<0.001) demonstrated positive effects on the quality of life of urban older adults with comorbidity.

Self-reported quality of life are generally higher among urban older adults with comorbidity. Social scenario has a positive effect on social support, and the quality of life of the urban older adults with comorbidity is indirectly improved by strengthening social support. At the same time, social resources not only directly contribute to the quality of life, but also indirectly have a positive impact through social support paths.

To understand the current status of varicella vaccination among age-eligible children in Chuxiong Prefecture and its influencing factors, in order to provide a reference basis for improving the varicella vaccination rate among age-eligible children throughout the prefecture.

Using multi-stage stratified random sampling, a questionnaire survey was conducted from May to August 2023 among guardians of children aged 1-14 years in three counties and cities of Chuxiong Prefecture, which included basic information, varicella vaccination information, varicella, and knowledge of varicella vaccine. To analyze the influencing factors of varicella vaccination in age-eligible children.

A total of 1 924 questionnaires were collected and 1 921 questionnaires were valid, with a validity rate of 99.84%. 1 918 study participants were finally included in the analysis, with a varicella vaccination rate of 35.82% among children and an overall knowledge rate of varicella and varicella vaccine among guardians of 58.33%. The results of multifactorial analysis showed that living in the city (OR=2.00, 95%CI: 1.62-2.48), per capita monthly family income >10 000 (vs. per capita monthly family income <2 000, OR=2.47, 95%CI: 1.33-4.59), and parental occupation of medical personnel or retired (vs. occupation of housework and inactive work, OR=1.63, and 95%CI: 1.03-2.58), and future willingness to be vaccinated against varicella (OR=5.06, 95%CI: 3.39-7.56) had higher varicella vaccination rates among age-eligible children.

The varicella vaccination rate is low among age-eligible children in Chuxiong Prefecture, and publicity and education on vaccination should be strengthened to increase the willingness of parents of age-eligible children to receive the vaccine, thereby increasing the varicella vaccination rate.

To explore the mediating role of depression symptoms in the relationship between bullying and suicide risk, and to analyze the moderating effect of emotional intelligence.

A stratified cluster sampling method was employed to select 16 388 students from 20 primary and secondary schools in the Pidu District of Chengdu, who completed self-administered questionnaires. Structural equation modeling was established to test the mediating and moderated mediating effects.

Among the participants, 28.5% were involved in bullying, and 29.2% exhibited a high risk of suicide. The direct effect between bullying and suicide risk was 0.154 (95%CI: 0.136-0.173, P < 0.001), while the mediating effect of depression symptoms was 0.164 (95%CI: 0.153-0.175, P < 0.001). Emotional intelligence negatively moderated the mediating pathway: at low levels of emotional intelligence, the mediating effect (bullying → depression symptoms → suicide risk) was 0.157 (95%CI: 0.144-0.169),whereas at high levels of emotional intelligence, the mediating effect was 0.114 (95%CI: 0.103-0.126).

There is a positive association between bullying and suicide risk among children and adolescents, with bullying indirectly influencing suicide risk through depression symptoms. Additionally, emotional intelligence negatively moderates the mediating effect of depression symptoms. Interventions aimed at alleviating depression symptoms and enhancing emotional intelligence may be effective strategies to mitigate the adverse effects of bullying on the psychological and behavioral health of children and adolescents.

To explore the comorbidity patterns in middle-aged and older adults and their relationship with subjective life expectancy, as well as to investigate the mediating role of depression.

Using data from the 2020 CHARLS, latent class analysis (LCA) was employed to identify comorbidity patterns in individuals aged 45 and older. Ordered logistic regression was used to analyze the association between comorbidity patterns and subjective life expectancy, while stepwise regression and the KHB method were utilized to assess the mediating effect of depression.

A total of 13 815 middle-aged and older participants were included, with a comorbidity rate of 48.17%. LCA identified four comorbidity patterns: relatively healthy, gastrointestinal-arthritis, cardiovascular-metabolic, and respiratory system. The gastrointestinal-arthritis (OR=0.652, 95%CI: 0.592 to 0.717), cardiovascular-metabolic (OR=0.727, 95%CI: 0.669 to 0.791), and respiratory system (OR=0.518, 95%CI: 0.592-0.717) patterns were negatively associated with subjective life expectancy. Depression acted as a mediator, with heterogeneity in the mediating effect across different comorbidity patterns; the strongest effect was observed in the gastrointestinal-arthritis group, with an indirect effect value of -0.110 (-0.144 to -0.076), accounting for 27.72% of the mediating effect, followed by the cardiovascular-metabolic group (18.05%).

Compared to the relatively healthy group, the other three comorbidity patterns were associated with more negative subjective life expectancy, with depression mediating the relationship between comorbidity patterns and subjective life expectancy.