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1.
China Occupational Medicine ; (6): 705-710, 2020.
Article in Chinese | WPRIM | ID: wpr-881958

ABSTRACT

OBJECTIVE: To analysis the dynamic change of cytokines in patients with occupational trichloroethylene-induced medicamentosa-like dermatitis(OMDT) at the initial stage of treatment. METHODS: Twenty-two cases of early onset OMDT with no glucocorticoid treatment history were selected as the research subjects by judgment sampling method. Blood samples were collected on the 1 st, 2 nd, 3 rd, 4 th and 5 th weeks after admission and on the day of hospital discharge. The levels of tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ), interleukin(IL)-5, IL-6 and IL-10 in plasma samples were measured by the enzyme linked immunosorbent assay. RESULTS: The five cytokines in patients with exfoliative dermatitis showed an increasing trend at the initial stage of treatment. Among them, the levels of TNF-α, IL-5 and IL-10 reached a peak and then dropped rapidly to form a plateau, and the levels of IFN-γ and IL-6 were slightly increased and the duration of increase was shorter than that of other cytokines. The levels of TNF-α, IFN-γ, IL-5 and IL-6 in patients with erythema multiforme remained within the detection limits in the detection process. Only a few patients showed a short-term increase, the IL-10 level showed a slight increase at the initial stage and then decreased to the plateau stage. The levels of TNF-α, IFN-γ and IL-6 in patients with bullous epidermal necrolysis increased rapidly at the initial detection stage for a short period of time, and then decreased sharply. The level of IL-5 remained at the detection limit, and the IL-10 level showed alternative rising and falling pattern. Part of the dynamic change of cytokines in patients with exfoliative dermatitis and bullous epidermal necrolysis was similar. CONCLUSION: The levels of TNF-α, IFN-γ, IL-5, IL-6, and IL-10 in OMDT patients changed with the progression of the disease at the early treatment stage, and the degree of change was related to the type of rash. Among them, the levels of TNF-α and IL-10 showed dynamic changes due to the progression of the disease, which could be considered as effect biomarkers to evaluate the severity and progression of the disease, and provide a reference for the rational treatment of patients.

2.
China Occupational Medicine ; (6): 162-167, 2020.
Article in Chinese | WPRIM | ID: wpr-881879

ABSTRACT

OBJECTIVE: To investigate the correlation between plasma cytokine levels and liver functions in patients with occupational medicamentosa-like dermatitis due to trichloroethylene(OMDT). METHODS: A total of 22 OMDT patients were selected as research subjects using judgment sampling method. Blood samples were collected from patients on the 1 st, 2 nd, 3 rd, 4 th, and 5 th week of admission and the day of hospital discharge. The automatic biochemical instrument was used for detecting the index of serum liver function. The levels of cytokines including tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ), interleukin(IL)-5, IL-6, and IL-10 in plasma were measured by enzyme-linked immunosorbent assay. The Spearman correlation analysis was performed to analyze the correlation between cytokines and liver function in 15 patients with exfoliative dermatitis. RESULTS: The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL), direct bilirubin(DBIL), glutamyl transpeptidase(GGT), and total bile acid(TBA) of OMDT patients on the 1 st week of admission increased(P<0.05), while total protein(TP) and albumin(ALB) decreased(P<0.05) compared with the results at discharge(a stage of recovery). The correlation analysis results of patients with exfoliative dermatitis showed that: the levels of TNF-α, IFN-γ and IL-6 were negatively correlated with the levels of TP and ALB respectively(P<0.05), the level of IL-5 was negatively correlated with TBIL(P<0.05), and the level of IL-10 was negatively correlated with ALB(P<0.05) in the 1 st week. The level of IL-6 was positively correlated with ALT(P<0.05) in the 2 nd week. The level of TNF-α was positively correlated with TBIL(P<0.05), the level of IL-10 was positively correlated with AST(P<0.05) in the 3 rd week. The levels of TNF-α and IL-10 were positively correlated with AST and ALT respectively(P<0.05), the level of IFN-γ was positively correlated with AST(P<0.05) in the 4 th week. The levels of IL-6 and IL-10 were positively correlated with ALT and GGT(P<0.05), and the levels of TNF-α and IFN-γ were positively correlated with AST(P<0.05) in the 5 th week. The level of TNF-α was negatively correlated with DBIL(P<0.05) and was positively correlated with TBA(P<0.05) at discharge.CONCLUSION:s Patients with OMDT are frequently accompanied with severe liver function damage at the early stage. The level of plasma cytokines(TNF-α, IFN-γ, IL-6 and IL-10) might correlate with the severity of liver dysfunction.

3.
China Occupational Medicine ; (6): 678-683, 2019.
Article in Chinese | WPRIM | ID: wpr-881842

ABSTRACT

OBJECTIVE: To summarize and analyze the diagnostic ideas of new occupational lung tumors in Guangdong Province.METHODS: According to the Law of the People′s Republic of China on the Prevention and Control of Occupational Disease and the GBZ 94-2002 Diagnostic Criteria of Occupational Cancer, the key diagnostic points of 6 new occupational lung tumors diagnosed in Guangdong Province from 2010 to 2011 were analyzed. RESULTS: There were 9 cases of 6 new kinds of new occupational tumors were diagnosed in Guangdong Province in 2010-2011. The cases included 3 occupational lung cancer of coke oven workers, 2 occupational lung cancer caused by asbestos, 1 occupational mesothelioma caused by asbestos, 1 occupational lung cancer caused by arsenate, 1 occupational lung cancer caused by chromate salt, and 1 occupational lung cancer caused by asphalt. During the process, the diagnosis was based on the principles of the comprehensive analysis and the attribution diagnosis, combined with occupational history, occupational disease hazard exposure history, clinical data and auxiliary examination results. If the patients were diagnosed with a primary tumor, the patients′ exposure history to occupational carcinogens should be tracked, traced and confirmed, and the diagnosis should be confirmed by referring to the list of occupational carcinogens and literature reports of the International Labor Organization, and not limited to only the personnel in a particular industry. CONCLUSION: During the diagnostic process of occupational tumors, attention should be paid to confirm the exposure history of occupational carcinogen. The key is to determine the exposure of corresponding occupational carcinogen, the route and the time of exposure and the incubation period.

4.
China Occupational Medicine ; (6): 354-358, 2019.
Article in Chinese | WPRIM | ID: wpr-881805

ABSTRACT

OBJECTIVE: To understand the long-term prognosis of patients with occupational medicamentosa-like dermatitis induced by trichloroethylene( OMDT) after recovery. METHODS: A total of 185 patients with OMDT were surveyed through landline and correspondence after recovery. Based on the individual's wishes,19 patients( follow-up examination group)were followed up and arranged for health examination in hospital. RESULTS: Seventy-one cases of OMDT was successfully follow-up. The success rate was 38. 4%( 71/185). Among the 71 cases who were successfully followed up,64. 8%( 46/71)cases complained of physical discomfort. The main complain included skin itching,allergy,upper respiratory tract infection or frequent fever,xerophthalmus,osteonecrosis of femoral head. The 19 cases in the follow-up examination group had different degrees of skin itching,dryness and mild melanosis. The abnormal rates of schirmer I test were 42. 1%( 8/19)and 52. 6%( 10/19) in the left and right eye,respectively. The abnormal rate of tear break-up time in both left and right eyes was 84. 2%( 16/19). The highest positive rate of patch test was chloral hydrate( 100. 0%). There was no abnormality in body temperature,superficial lymph nodes,blood routine,urine routine,liver function and autoimmunity antibody. There was no new rash. CONCLUSION: Different degree of long-term prognosis can occur in OMDT recovery patients. Xerophthalmus and osteonecrosis of femoral head are the major sequelae. Chloral hydrate,which is the main metabolite of trichloroethylene,may be the causative culprit compound for OMDT.

5.
China Occupational Medicine ; (6): 302-306, 2019.
Article in Chinese | WPRIM | ID: wpr-881794

ABSTRACT

OBJECTIVE: To analyze the epidemiologic characteristics of occupational medicamentosa-like dermatitis induced by trichloroethylene( OMDT) in Guangdong Province. METHODS: The data of OMDT cases diagnosed by Guangdong occupational disease diagnosis institutions from 1988 to 2016 was collected and analyzed. The data of OMDT come from medical records,the National Occupational Disease Network Reporting System and literature retrieval. RESULTS: A total of 475 cases of OMDT were diagnosed in Guangdong Province during 1988 to 2016. The recovery rate was 91. 4%( 434/475),and the fatality rate was 8. 6%( 41/475). All cases had a clear history of trichloroethylene( TCE) exposure and had not been exposed to TCE prior to the present exposure. The median incubation period was 30 days. The exceeding standard rate of TCE time weighted average concentration was 80. 7%( 171/212),and the exceeding standard rate of urine trichloroacetic acid was 75. 0%( 123/164). The years that have most OMDT cases were from 1999 to 2006,which accounted for 64. 0%( 304/475); but there was no seasonal aggregation. The enterprises of OMDT cases concentrated in the Pearl River Delta Region,with Shenzhen City and Dongguan City accounting for 62. 9%. The median age of onset was22 years old,81. 9% of cases were 30 years old or below. The male-female ratio was 1. 2 ∶ 1. 0; 57. 7%( 274/475) cases were from southern China. Meanwhile,95. 4%( 453/475) of the cases came from the manufacturing industry such as electronics factory,hardware factory,electroplating factory and others. CONCLUSION: The distribution of OMDT cases on area,age of onset,native place and occupation in Guangdong Province showed a certain aggregation.

6.
China Occupational Medicine ; (6): 669-674, 2018.
Article in Chinese | WPRIM | ID: wpr-881731

ABSTRACT

OBJECTIVE: To screen the allergens of trichloroethylene-induced occupational medicamentosa-like dermatitis( OMDT) by patch test,and explore methods for OMDT auxiliary diagnosis and trichloroethylene( TCE) allergic population screening. METHODS: A total of 20 subjects diagnosed with OMDT were selected as case group,and 22 nonOMDT healthy workers exposed to TCE≥12 weeks were selected as control group. Different concentrations of TCE and its main metabolites such as chloral hydrate( CH),trichloroethanol( TCOH) and trichloroacetic acid( TCA) were used as allergens in a skin patch test in workers of these two groups. Another 20 new workers exposed to TCE < 12 weeks without OMDT were tested as validation group. They were tested with a patch test at a mass fraction of 15. 00% CH and follow-up observations were performed until 12 weeks of TCE exposure. RESULTS: The patch test of TCE,CH,TCOH and TCA were negative in the control group. In the case group,the patch test positive rate for 50. 00% TCE was 10. 00%,the patch tests were negative in 25. 00%,10. 00% and 5. 00% TCE. The CH patch test positive rate was 100. 00% with the CH mass concentrations of 15. 00%,10. 00% and 5. 00%. The TCOH patch test positive rates were 90. 00%,75. 00% and50. 00%,with the corresponding concentration of 5. 00%,0. 50% and 0. 05%. The TCA patch test positive rates were50. 00% and 0. 00% with the TCA concentrations of 5. 00% and 0. 50% respectively. When the mass concentration was5. 00%,the patch test positive rates in case group from high to low were CH,TCOH,TCA and TCE( P < 0. 01). And the patch test positive rates of CH and TCOH showed no statistical significant difference( P > 0. 05). The patch test positive rate of TCOH increased with increase of TCOH mass concentrations( P < 0. 01). The patch test positive rates for 5. 00%TCA was higher than that of 0. 50% TCA( P < 0. 01). The patch test positive rate in 0. 50% TCOH was higher than that of 0. 50% TCA( P < 0. 01). In the validation group,the patch test of 15. 00% CH was negative,and there was no OMDT case found during the follow-up 12 weeks of TCE exposure. CONCLUSION: The metabolites CH and TCOH of TCE may be the main allergens of OMDT after exposure to TCE. The CH and TCOH patch test can be an auxiliary diagnosis method for OMDT. The CH patch test could be used as a method for screening population allergic to TCE.

7.
China Occupational Medicine ; (6): 420-429, 2017.
Article in Chinese | WPRIM | ID: wpr-881624

ABSTRACT

OBJECTIVE: To establish the clinical pathway of occupational medicamentosa-like dermatitis due to trichloroethylene(OMDT).METHODS: OMDT was selected as the clinical disease category.The diagnosis and treatment schemes of OMDT were determined and the clinical pathway was developed on the basis of evidence-based medicine,clinical data analysis,and the expert opinion as well as GBZ 185—2006 Diagnostic Criteria of Occupational Medicamentosa-like Dermatitis due to Trichloroethylene.The initial clinical validation was performed.RESULTS: We formulated the clinical pathway of OMDT for medical staffs,including standard hospitalization procedures(including normative use of glucocorticoids),Clinical Path Form,and Informed Consent for Glucocorticoid Therapy.The Clinical Pathway Notification of OMDT for patients or their family members was established.Based on the initial clinical verifications,the clinical pathway was conducive to optimize the medical process,none of the patients suffered from rebounds and complications,and the awareness of OMDT and satisfaction with treatments were improved.CONCLUSION: The clinical pathway for OMDT is scientific and reasonable,which is suitable for use to regulate medical behaviors.

8.
China Occupational Medicine ; (6): 285-289, 2017.
Article in Chinese | WPRIM | ID: wpr-881609

ABSTRACT

OBJECTIVE: To explore the retrospective problem of occupational disease diagnostic criteria,and to improve the correct application and the theoretic basis of legal norms of occupational disease diagnosis. METHODS: Based on the related theory and principle of laws retroaction,different retroaction and its advantages and disadvantages of the occupational disease diagnostic criteria were analyzed. The applicable methods of new and old occupational disease diagnostic criteria based on the current occupational disease diagnosis and appraisal system were discussed. RESULTS: The occupational disease diagnostic criteria are updated frequently,but there is a lack of clear specification on the application of the old and new criteria. There is misunderstanding in correct application of old and new occupational disease diagnostic criteria from the society,which could have great influence on occupational disease diagnosis and appraisal. The occupational disease diagnostic criteria are a part of laws and regulations and the essence of its correct application is the retroactive force of law.The non-retrospection of occupational disease diagnostic criteria might be against the reasonable protection of the rights of laborers' health. The retroactivity of occupational disease diagnostic criteria reflects the value orientation of social law,but at the same time it must comply with the provisions of laws,regulations or administration rules. CONCLUSION: Active occupational disease diagnostic criteria should be used in the process of occupational disease diagnosis,and occupational disease appraisal should use the criteria of diagnosis.

9.
China Occupational Medicine ; (6): 121-126, 2017.
Article in Chinese | WPRIM | ID: wpr-881585

ABSTRACT

OBJECTIVE: To explore the intervening effects of bone marrow-derived mesenchymal stem cells(BMMSCs) for pulmonary fibrosis of rats exposed to silica dust at different stages. METHODS: Specific pathogen free SD rats were randomly divided into model group,2-week group,4-week group and control group with 6 rats in each group(half males and half females). Rats of the first three groups were one-time endotracheally injected with 0. 5 mL aseptic silica suspension at 30 g/L mass concentration. Rats of control group were injected with 0. 5 mL 0. 90% sodium chloride solution. Rats of 2-week group and 4-week group were injected with 0. 5 mL BMMSCs suspension with cell density was 5 × 10~9/L at 2 weeks and 4 weeks respectively after silica dust exposure,while model group and control group were injected with aseptic 0. 90% sodium chloride solution in the same volume. After that all rats were examined by lung computed tomography(CT) scan,pathological sections were observed,lung coefficient were measured,lung tissue hydroxyproline(HYP) content and serum transforming growth factor β1(TGF-β1) concentration were investigated at the 12 th week after silica dust exposure. RESULTS: Lung CT image showed clean lung field and clear pulmonary parenchyma in control group.Multiple and diffused high density granular shadows of different size and streak/reticular fiber shadows in model group;diffused distribution of very small granular shadows in 2-week group; granular shadows and local reticular fiber shadows in 4-week group,and either the size or the area of granular shadows was smaller than model group. The lung CT value,lung coefficient,lung tissue HYP content and serum TGF-β1 concentration of model group,2-week group and 4-week group were higher than those of control group(P < 0. 05). The lung CT value,lung tissue HYP content and serum TGF-β1 concentration of control group,2-week group,4-week group and model group were elevated in turn(P < 0. 05),while the lung coefficient of model group and 4-week group was higher than that of 2-week group respectively(P < 0. 05).CONCLUSION: BMMSCs could delay pulmonary fibrosis caused by silica dust,and the protective effect is better at early stage than later stage of fibrosis.

10.
Modern Clinical Nursing ; (6): 43-46, 2014.
Article in Chinese | WPRIM | ID: wpr-444896

ABSTRACT

Objective To study the curative effect of mesenchymal stem cells(MSC)transplantation on occupational chronic benzene poisoning and summarize the nursing measures.Methods The clinical data of 5 patients with occupational chronic benzene poisoning treated with MSC transplantation for 48 times totally were retrospectively reviewed for the purpose of investigating the curative effects and summing up the nursing measures.Results After transplantation,the levels of white blood cells,hemoglobin and neutrophil,platelet were all increased significantly.The differences in white blood cells and neutrophil were significant between pre-and post-transplantation(P<0.05).Bone marrow hyperplasia was active after treatment.No adverse reactions were observed in all of the patients.Conclusion MSC is safe and effective in treating occupational chronic benzene poisoning.Observing patient’s conditions closely,implementing protective isolation and psychological nursing strictly and doing predictive nursing measures are of significance for success of MSC transplantation and improvement of the curative effect.

11.
Article in Chinese | WPRIM | ID: wpr-436706

ABSTRACT

Objective To investigate the clinical efficacy of biological dressing A covering bandage of Ⅲ° burn wounds given comprehensive treatment including dermabrasion.Methods For patients of non Ⅲ° ° burn wounds (deep Ⅱ ° and partial superficial Ⅲ ° wounds),28 cases in the treatment group,were given improved dermabrasion with tangential excision plus thin layer of skin graft from the body,the wounds were covered with biological dressing A bandage.21 patients in the control group were treated by traditional tangential excision,escharectomy and self-skin grafting.The clinical treatment effect was observed and compared between the two groups.Results The wounds were healed 2 ~ 3 weeks after surgery in treatment group,the cure rate of burns in patients with a total area of 40% ~ 50% TBSA was 99%,and after treatment the scar formation significantly reduced,self-donated skin significantly reduced,the hospital stay and postoperative recovery time of the patients were significantly shorter,patients were easier to accept.In the control group,the operation time was longer,the blood loss was more,the wounds had more scar healing wounds.The wound healing time of the treatment group was (14.8 ± 1.8) d,which was significantly shorter than (19.4 ± 3.0) d of the control group (P < 0.05).Conclusion The improved grinding A scab plus biological dressings covering bandage has the advantages of simple operation,light damage,less complications,need less skin,to maximize retention of healthy tissue,wound healing speed up,healing scar lessened.

12.
Article in Chinese | WPRIM | ID: wpr-428264

ABSTRACT

ObjectiveTo compare the capability of optimized acellular(OA) allograft and xenograft reparing rat sciatic nerve defect by observing the immunological rejection, early functional recovery and nerve regeneration in the adult rats, which had been made a 1.0cm long gap in the continuity of the sciatic nerve.MethodsThe right sciatic nerve of adult Sprague-Dawley(SD) rats were exposed and 1.0cm long segment of the nerves were removed and repaired by fresh rabbit nerve and autofrafts, OA rat and rabbit nerve. After 1 and 3 months respectively,sciatic functional index (SFI),electrophysiological and histology studies were detected to evaluate immunological rejection,early functional recovery and nerve regeneration. ResultsThe immunological rejection, functional recovery and nerve regeneration in OA xenografts were compared with that in OA allografts, autografts and fresh allografts. One month after the surgery, the levels of CD8+ T cells and macrophages that infiltrated the grafts,the SFI and the axon density at the midpoints of them were similar within OA grafts and autografts(P > 0.05),but all statistically distinguishable from fresh allografts(P < 0.05).And better results were got after 2 months(P < 0.05).ConclusionsThe results imply that OA xenografts is as good as OA allografts,which can be immunologically tolerated and that the removal of cellular material and preservation of the matrix are beneficial for promoting regeneration and functional recovery through an OA procedure.And this gives another promising option to repair peripheral nerve defect.

13.
Article in Chinese | WPRIM | ID: wpr-395732

ABSTRACT

Objective To investigate the clinical application value of three-dimensional ultrasonic inspection in prenatal diagnosis.Methods 90 cases of fetal formations were Tetrospecthely analysed,which were diagnosed by two-dimensionul associtated with three-dimensional ultrasonic inspection.We compared the ultrasonic inspection with the clinical diagnosis.Results The all coincidence rate was 100%by combining the two measures,three-dimensional ultrasonic inspection can make up the defect of two-dimemional ultrasonic inspection.Conclusion Two-dimensional combined with three-dimensional ultrasonic inspection can accurately diagnose fetal formations,and increase the detection rate.

14.
Article in Chinese | WPRIM | ID: wpr-340077

ABSTRACT

<p><b>OBJECTIVE</b>To observe the effect of fluoroacetamide on cardiomyocytes of rat and the antidotal effect of acetamide.</p><p><b>METHODS</b>4 groups of SD rats were treated with various dosages of fluoroacetamid(p.o.) and 2 groups of them were treated with acetamide(i.p.). The changes of cardiomyocytes and serum AST, LDH, CK, CK-MB and HBDH were measured at different intervals after poisoning.</p><p><b>RESULTS</b>In the group treated with fluoroacetamid 8 mg/kg. bw, serum AST[(589.58 +/- 821.72) U/L], CK[(916.78 +/- 343.55) U/L], HBDH[(504.47 +/- 148.88) U/L] raised obviously compared with control[(187.70 +/- 46.87), (755.65 +/- 498.90), (347.25 +/- 228.40) U/L respectively] (P < 0.01), and the pathological findings such as degeneration, liquefactive necrosis and filtration of inflammatory cells in cardiac muscles were observed 24 hours later, while all the male dead within 3 days. In the group treated with fluoroacetamid 4 mg/kg. bw, serum LDH and HBDH rose significantly compared with control(P < 0.01) 5 day later. On the day of 10, myocardial enzymes restored in all experiment groups with some interstitial fibroblastic proliferation. The pathological changes were reduced in the group treated with acetamide synchronously (100 mg/kg. bw).</p><p><b>CONCLUSION</b>Acute intoxication of fluoroacetamide could damage cardiomyocytes while acetamide could reduce the injury of them, but the injury was reversible. The levels of serum myocardial enzymes could be a usable index for early diagnosis.</p>


Subject(s)
Acetamides , Pharmacology , Alanine Transaminase , Blood , Animals , Antidotes , Pharmacology , Creatine Kinase, MB Form , Blood , Fluoroacetates , Toxicity , L-Lactate Dehydrogenase , Blood , Myocytes, Cardiac , Pathology , Rats , Rats, Sprague-Dawley
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