Occupational health risk assessment of n-hexane based on four risk assessment models / 环境与职业医学

Background N-hexane has been a widely used solvent in industrial production, but it is volatile at room temperature and can be accumulated in the body, and its prolonged occupational exposure may lead to serious chronic diseases in workers. Objective To use four risk assessment models to evaluate the health risk levels of n-hexane-exposed workers, discuss the applicability of the four models in the health risk assessment of n-hexane exposure, and make an important supplement to the health risk assessment of n-hexane in China. Methods In 2022, a total of 167 jobs (1724 workers) exposed to n-hexane in 85 manufacturing enterprises in Jiangsu Province were selected, and a cross-sectional study was conducted and included questionnaire surveys and evaluation of on-site air n-hexane of each job. Subsequently, the China’s classification standards of occupational hazards at workplaces (China model), U.S. Environmental Protection Agency (EPA) model, Singapore semi-quantitative risk assessment model (Singapore model), and the International Council on Mining and Metals (ICMM) model were applied to the quantitative, semi-quantitative, and qualitative assessments of the occupational health risk level of n-hexane-exposed workers. Results All job’s 8-h time-weighted average concentrations (CTWA) of n-hexane were within the national occupational exposure limits (OELs). The results of the China model graded all jobs as relatively harmless. The Singapore model graded all jobs as low risk, except that two monitoring sites of adhesive jobs were assessed as medium risk. The ICMM quantitative model evaluated all jobs as intolerable for n-hexane airborne exposure, while the matrix method evaluated all jobs as low risk. The U.S. EPA model identified five sites involving painting, printing, and adhesive jobs as high risk and the other jobs as low risk. Conclusion Inconsistent grading results are observed by using the four models for the occupational health risk assessment of n-hexane exposure, that is, harmless for all jobs by China model, while medium and high risks by Singapore model and U.S. EPA model. Therefore, we recommend to combine the Singapore model and the U.S. EPA model with the China model to assess the occupational risk of n-hexane-exposed workers by considering actual concentrations of exposure.

Routine blood test, C-reactive protein and blood culture for predicting necrotizing enterocolitis in preterm infants with late-onset sepsis / 中华围产医学杂志

Objective:To explore the value of blood routine indexes, C-reactive protein(CRP), and blood culture in predicting the occurrence of neonatal necrotizing enterocolitis (NEC) secondary to late-onset sepsis (LOS) in preterm infants.Methods:This study retrospectively enrolled 80 premature infants with LOS admitted to the First Hospital Affiliated to Army Medical University from January 1, 2015 to January 1, 2020. Based on whether complicated by NEC or not, all the subjects were assigned into the NEC group ( n=11) and non-NEC group ( n=69). Laboratory data for perinatal conditions, complete blood cell count, CRP, and blood culture in the early stage of LOS were recorded, and the decreased value of the hemoglobin concentration before and at early stage of LOS was calculated. Mann-Whitney U test, Chi-square test or Fisher exact probability method was used to compare the differences in perinatal conditions, blood routine, CRP and blood culture results between different groups. Binomial stepwise logistic regression analysis and the receiver operating characteristic (ROC) curve were used to evaluate the risk factors and their predictive value for NEC secondary to LOS, respectively. Results:(1) There was no significant difference in gestational age, birth weight or other perinatal factors between the NEC group and non-NEC group (all P>0.05). (2) Mean platelet volume (MPV), CRP, and the hemoglobin decreased value in NEC group were greater than those in non-NEC group [11.7 fl (10.9-12.6 fl) vs 10.7 fl (10.3-11.6 fl), Z=－2.773; 33.3 mg/L (21.3-92.9 mg/L) vs 13.5 mg/L (4.7-27.3 mg/L), Z=－2.662; 25.0 g/L (18.0 -36.0 g/L) vs 13.0 g/L (1.0-19.0 g/L), Z=－3.803; all P<0.01]. (3) Binomial stepwise logistic regression analysis suggested that higher MPV at early stage of LOS ( OR=3.213, 95% CI: 1.104-9.354, P=0.032) and the decreased hemoglobin ( OR=1.153, 95% CI: 1.057-1.257, P=0.001) were independent risk factors for NEC secondary to LOS in preterm infants. (4) The cut-off values of MPV combined with the decreased value of hemoglobin for predicting NEC in premature infants with LOS were 11.2 fl and 14.0 g/L, respectively, with a sensitivity of 1.00 and specificity of 0.71. Conclusions:MPV combined with the decreased value of hemoglobin may help to predict NEC in the early stage of LOS for preterm infants.

Newborn screening and genetic analysis of methylmalonic acidemia in Shaanxi province / 中华围产医学杂志

Objective:To analyze the incidence, biochemical and molecular characteristics, and gene mutation spectrum of neonatal methylmalonic acidemia (MMA) in Shaanxi province.Methods:This study involved 146 152 newborns undergoing neonatal screening for methylmalonic acidemia by tandem mass spectrometry in Northwest Women's and Children's Hospital from January 2014 and December 2019. Clinical manifestations and follow-up data of newborns diagnosed with MMA and their acylcarnitine profiles and gene mutations were analyzed. According to whether they had elevated homocysteine or not, these patients were divided into two groups, the complicated group and the isolated MMA group. The control neonates were those excluded from having methylmalonic acid by re-examination. Kruskal-Wallis and Mann-Whitney U test was conducted for statistical analysis. Results:(1) Twenty-one cases of MMA were confirmed with an incidence of 1/6 960, including 11 cases (52.4%) of isolated MMA (isolated MMA group) and 10 (47.6%) complicated by elevated homocysteine (complicated group). Eight patients in the isolated group had symptoms within one month after birth, mainly feeding difficulties, vomiting, drowsiness, poor response and infection, and five died. Patients in the complicated group were all diagnosed before developing typical clinical symptoms, and no developmental abnormalities were reported during follow-up. (2) Blood propionyl carnitine and its ratios to acetylcarnitine and free carnitine in the isolated MMA and complicated groups were higher than those in the control group [ M (min-max), 9.26 (3.70-37.78) μmol/L and 7.27 μmol/L (3.58-13.62 μmol/L) vs 4.51 μmol/L (1.48-8.69 μmol/L), H=23.239; 1.12 (0.32-2.43) and 0.74 (0.36-1.90) vs 0.25 (0.09-0.45), H=47.061; 0.94 (0.12-1.92) and 0.56 (0.18-1.03) vs 0.17 (0.06-0.38), H=36.868; all P<0.001]. The blood methionine level in the complicated group was significantly lower than that in the isolated MMA group [7.64 μmol/L (3.40-19.25 μmol/L) vs 24.22 μmol/L (10.73-56.55 μmol/L), U=3.000, P<0.001]. (3) All 21 patients carried complex heterozygous mutations or homozygous mutations in pathogenic genes, including 15 distinct MMUT mutations and 13 distinct MMACHC mutations. In the isolated MMA group, the most common mutation was c.323G>A (p.Arg108His) in the MMUT gene with a positive rate of 13.6%, and an unreported mutation, c.1676+11A>G, with unidentified clinical significance, was also found. The most common mutations in the complicated group were c.609G>A (p.Trp203Ter) and c.567dupT (p.Ile190fs) in the MMACHC gene, and the positive rates were both 20.0%. Moreover, two unreported variants, c.430-2A>C and c.648_650delAGA (p.216_217delSEinsS), were detected and suspected to be pathogenic. Conclusions:MMA is not uncommon in Shaanxi province. Children with isolated MMA tend to be more severe clinically. The identification of hotspot mutations, including c.609G>A (p.Trp203Ter) and c.567dupT (p.Ile190fs) in MMACHC gene and c.323G>A (p.Arg108His) in MMUT gene, provides a foundation for further genetic screening, counseling, and prenatal diagnosis, and is conducive to reduce the mortality and disability rate of neonatal MMA.

Prevalence of Human T-Cell Lymphotropic Virus Type 1 and 2 among Blood Donors in Jiangsu from 2016 to 2019 / 中国实验血液学杂志

OBJECTIVE@#To investigate the prevalence of human T-cell lymphotropic virus (HTLV) type-I/II infection among voluntary blood donors in Jiangsu (Nanjing, Suzhou, Xuzhou).@*METHODS@#From 2016 to 2019, 408 262 samples of voluntary blood donors from four blood stations in Jiangsu Province (Jiangsu Province Blood Center, Nanjing Red Cross Blood Center, Suzhou Central Blood Station, and Xuzhou Central Blood Station) were screened for HTLV-I/II antibody by ELISA. The positive samples were sent to National Center for Clinical Laboratories for confirmation by RT-PCR and Western blot.@*RESULTS@#The positive rate of HTLV-I/II screened by ELISA was 0.20‰ (82/408 262), and three HTLV-I positive samples were confirmed. The prevalence of HTLV-1 infection was 0.74 per 100 000 (3/408 262). All three donors were female repeated blood donors of childbearing ages.@*CONCLUSION@#Jiangsu is a low prevalence area of HTLV, and a reasonable blood screening strategy for HTLV can further reduce the risk of transfusion-transmitted virus infection.

[UPLC quantitative fingerprint research on Gardeniae Fructus based on chemical pattern recognition technology].

Twenty-six batches of Gardeniae Fructus from different producing area were collected for the development of the fingerprint, and the main components of Gardeniae Fructus were identified by liquid chromatography-mass spectrometry. The producing areas of Gardeniae Fructus were distinguished by chemical pattern recognition technology, and the index components of Gardeniae Fructus were quantitated. An UPLC wavelength switching method was adopted, and the separation was carried out on a Waters Acquity UPLC HASS C_(18)(2.1 mm×100 mm, 1.7 µm) column using the mobile phase of acetonitrile-0.5% formic acid water for gradient elution. Principal component analysis(PCA) and orthogonal partial least square discriminant analysis(OPLS-DA) were used for the data ana-lysis. The results showed that the similarity of 26 batches of Gardeniae Fructus was more than 0.89, and ten common peaks were defined. Sixteen compounds including monoterpenes, iridoids and diterpenoids were identified by reference identification, literature comparison and high-resolution mass spectrometry data analysis. The distinguishment of origin of Gardeniae Fructus was realized by PCA and OPLS-DA analysis, and two quality differential markers were screened as geniposide and crocin Ⅰ. The contents of crocin Ⅰ, crocin Ⅱ and geniposide in Gardeniae Fructus from different places were different. These results will provide reference for the geographical origin traceability of Gardeniae Fructus.

Exploratory research on Wiguide needle guidance ultrasound technology for radial artery puncture / 中华超声影像学杂志

Objective To investigate the clinical significance of Wiguide needle guidance ultrasound technology in radial artery puncture . Methods One hundred and thirty‐five patients who would receive elective surgery requiring radial artery puncture and catheterization to monitor invasive blood pressure were randomly divided into 3 groups( n ＝45) :blind puncture group( group A ) ,ultrasound puncture group( group B) and Wiguide needle guidance ultrasound puncture group ( group C ) . T he diameter and depth of radial artery ,blood return time ,puncture time for the process and the puncture success rate were recorded and compared . Results T here was significant diffeence in the blood return time among three groups ( P ＝0 .039) ,the blood return time in group B was higher than in group A and C ( P ＝ 0 .029 ,0 .027 ) . T he difference was statistically significant in the puncture time among three groups ( P ＝0 .002) ,the puncture time in group B was higher than in group A and C ( P ＝0 .009 ,0 .001) . T he puncture success rate in group A was 71 .11% ,the puncture success rate were 100% in both group B and C . Conclusions Wiguide needle guidance ultrasound technology could effectively improve the skill of vascular puncture ,which shortens the puncture time and improves the success rate of puncture . Wiguide needle guidance ultrasound technology provides benefits to master the ultrasound‐guided vascular puncture for clinical work .

Analysis on serotypes and antibiotic resistance characteristics of food-borne Salmonella strains in Guizhou Province from 2016 to 2018 / 中华微生物学和免疫学杂志

Objective To analyze the serotype distribution and antibiotic resistance characteristics of food-borne Salmonella strains isolated from food and patients with gastroenteritis in Guizhou Province from 2016 to 2018. Methods Serotypes of the strains were characterised using slid agglutination method with Salmonella antisera. Minimal inhibitory concentrations (MIC) of antibiotics were determined by the broth microdilution method. Microsoft Excel 2007 and SPSS18. 0 were used for statistical analysis. Results A to-tal of 170 strains of food-borne Salmonella were detected in food and patients with gastroenteritis in Guizhou Province from 2016 to 2018. Thirty-five serotypes were identified and 6 were found in both food and pa-tients. The main serotypes in food were Salmonella Typhimurium ( 16. 67％ ) and Salmonella Stanley (8. 33％ ), and the predominant serotypes in patients were Salmonella Typhimurium (41. 79％ ), Salmonel-la Enteritidis (16. 42％ ) and Salmonella London (8. 96％ ). The rate of resistance to ampicillin, chloram-phenicol, tetracycline, ciprofloxacin, nalidixic and trimeth-sulfame were 27. 78％ -33. 33％ among the iso-lates from food, and 22. 22％ -25. 00％ to gentamicin, cefocime and ampicillin/ sulbatan. Among the isolates from patients, the highest resistance was to ampicillin ( 55. 97％ ), followed by that to tetracycline (49. 25％ ), ampicillin/ sulbatan (44. 03％ ), nalidixic acid (41. 04％ ) and cefazolin (37. 31％ ), and 20. 90％ -30. 60％ strains were resistant to chloramphenicol, ciprofloxacin, gentamicin, cefotaxime and am-picillin/ sulbatan. There were 25. 00％ isolates from food and 25. 37％ isolates from patients resistant to at least 6 antibiotics, and the main multi-resistant pattern was ampicillin-tetracyline-nalidixic-cephalosporin an-tibiotics (partial). Conclusions There were many kinds of serotypes of food-borne Salmonella in Guizhou Province from 2016 to 2018 and the predominant types were Salmonella Typhimurium, Salmonella Enteritidis and Salmonella London. Drug resistance was common in the strars and some multidrug resistant strains were detected.

Types of fluid intake during spring among college students in Hebei Province / 中国学校卫生

Objective@#To investigate the total amount and types of fluid intake among college students in Hebei Province during spring and to provide scientific basis for fluid-intake education.@*Methods@#A simple random sampling method was used to select 156 college students from a college in Hebei Province. The information on amount and type of fluid intake was recorded using the 7-day 24-hour recording method. A separate analysis was performed on people who consumed beverages during the 7 days.@*Results@#The median intake of plain water, milk, sugar-sweetened beverages and other beverages was 866 mL, 43 mL, 43 mL and 2 mL, respectively. The median of plain water, milk, sugar-sweetened beverages and other beverages by the beverage-consumers was 845 mL, 36 mL, 63 mL and 11 mL, respectively. The intake of plain water and sugar-sweetened beverages in male students was significantly higher(Z=2.31, 3.03; 2.31, 2.11, P<0.05), and milk consumption was lower than female students of these two groups of people(Z=-2.73, -2.23, P<0.05). The intake of other beverages in male students was higher than that of female students, but only significant among beverage-consumers(Z=3.31, P<0.01). There was no significant difference in the total amount of different fluid types among different BMI(P>0.05).@*Conclusion@#College students in Hebei Province mainly drink plain water. Sex difference is observed in the types of fluid intake.

Analysis on serotypes and antibiotic resistance characteristics of food-borne Salmonella strains in Guizhou Province from 2016 to 2018 / 中华微生物学和免疫学杂志

Objective@#To analyze the serotype distribution and antibiotic resistance characteristics of food-borne Salmonella strains isolated from food and patients with gastroenteritis in Guizhou Province from 2016 to 2018.@*Methods@#Serotypes of the strains were characterised using slid agglutination method with Salmonella antisera. Minimal inhibitory concentrations (MIC) of antibiotics were determined by the broth microdilution method. Microsoft Excel 2007 and SPSS18.0 were used for statistical analysis.@*Results@#A total of 170 strains of food-borne Salmonella were detected in food and patients with gastroenteritis in Guizhou Province from 2016 to 2018. Thirty-five serotypes were identified and 6 were found in both food and patients. The main serotypes in food were Salmonella Typhimurium (16.67%) and Salmonella Stanley (8.33%), and the predominant serotypes in patients were Salmonella Typhimurium (41.79%), Salmonella Enteritidis (16.42%) and Salmonella London (8.96%). The rate of resistance to ampicillin, chloramphenicol, tetracycline, ciprofloxacin, nalidixic and trimeth-sulfame were 27.78%-33.33% among the isolates from food, and 22.22%-25.00% to gentamicin, cefocime and ampicillin/sulbatan. Among the isolates from patients, the highest resistance was to ampicillin (55.97%), followed by that to tetracycline (49.25%), ampicillin/sulbatan (44.03%), nalidixic acid (41.04%) and cefazolin (37.31%), and 20.90%-30.60% strains were resistant to chloramphenicol, ciprofloxacin, gentamicin, cefotaxime and ampicillin/sulbatan. There were 25.00% isolates from food and 25.37% isolates from patients resistant to at least 6 antibiotics, and the main multi-resistant pattern was ampicillin-tetracyline-nalidixic-cephalosporin antibiotics (partial).@*Conclusions@#There were many kinds of serotypes of food-borne Salmonella in Guizhou Province from 2016 to 2018 and the predominant types were Salmonella Typhimurium, Salmonella Enteritidis and Salmonella London. Drug resistance was common in the strars and some multidrug resistant strains were detected.

Exploratory research on Wiguide needle guidance ultrasound technology for radial artery puncture / 中华超声影像学杂志

Objective@#To investigate the clinical significance of Wiguide needle guidance ultrasound technology in radial artery puncture.@*Methods@#One hundred and thirty-five patients who would receive elective surgery requiring radial artery puncture and catheterization to monitor invasive blood pressure were randomly divided into 3 groups(n=45): blind puncture group(group A), ultrasound puncture group(group B) and Wiguide needle guidance ultrasound puncture group(group C). The diameter and depth of radial artery, blood return time, puncture time for the process and the puncture success rate were recorded and compared.@*Results@#There was significant diffeence in the blood return time among three groups (P=0.039), the blood return time in group B was higher than in group A and C (P=0.029, 0.027). The difference was statistically significant in the puncture time among three groups (P=0.002), the puncture time in group B was higher than in group A and C (P=0.009, 0.001). The puncture success rate in group A was 71.11%, the puncture success rate were 100% in both group B and C.@*Conclusions@#Wiguide needle guidance ultrasound technology could effectively improve the skill of vascular puncture, which shortens the puncture time and improves the success rate of puncture. Wiguide needle guidance ultrasound technology provides benefits to master the ultrasound-guided vascular puncture for clinical work.