Synkinesis in primary and postparalytic hemifacial spasm: Clinical features and therapeutic outcomes of botulinum toxin A treatment.

Facial synkinesis can be present in both primary and postparalytic hemifacial spasm (HFS). The present retrospective study aimed to summarize the clinical features of synkinesis and explore an appropriate botulinum toxin A (BoNT-A) injection strategy to manage the synkinesis accompanying HFS. Video recordings of 234 patients with primary and postparalytic HFSs were analyzed. Improvements in the severity of spasm and synkinesis owing to BoNT-A treatment were monitored and compared among 36 primary and 12 postparalytic HFS patients with synkinesis and completed follow-up records. BoNT-A was injected into the voluntary facial region (VFR), the synkinetic facial region (SFR), or both VFR and SFR, and the efficacy of these strategies was evaluated and analyzed. Oral-ocular synkinesis in the primary group (32.8%) and ocular-oral synkinesis in the postparalytic group (81.0%) showed the highest incidence. Patients in both the primary and postparalytic groups exhibited a tremendous alleviation of spasm (97.2% vs. 91.7%, P > 0.05) following BoNT-A treatment. In both groups, coinjection and SFR injection were commonly used and effective in treatment of ocular and oral synkinesis, while VFR was frequently used but ineffective for frontal synkinesis. In addition, the improper muscle selection surrounding the mouth corner resulted in pattern change and treatment failure of oral synkinesis. Synkinesis mostly affected the ocular and oral regions. BoNT-A, via treatment of SFR, is effective against synkinesis accompanying HFS.

Fitting characteristics of N95 filtering-facepiece respirators used widely in China.

BACKGROUND: Millions of people rely on N95 filtering facepiece respirators to reduce the risk of airborne particles and prevent them from respiratory infections. However, there are no respirator fit testing and training regulations in China. Meanwhile, no study has been conducted to investigate the fit of various respirators. The objective of this study was to investigate whether people obtained adequate fit when wearing N95 filtering facepiece respirators (FFRs) used widely in China. METHODS: Fifty adult participants selected using the Chinese respirator fit test panel donned 10 common models of N95 FFRs. Fit factors (FF) and inward leakage were measured using the TSI PortaCount Plus. Each subject was tested with three replications for each model. A subject was considered to pass the fit test when at least two of the three FFs were greater than 100. Two models were conducted fit tests before and after training to assess the role of training. RESULTS: The geometric mean FFs for each model and trained subjects ranged from <10 to 74.0. The fifth percentile FFs for only two individual respirator models were greater than 10 which is the expected level of performance for FFRs. The passing rates for these two models of FFRs were 44.7% and 20.0%. The passing rates were less than 10.0% for the other eight models. There were 27 (54%) participants who passed none of the 10 FFRs. The geometric mean FFs for both models when the subjects received training (49.7 and 74.0) were significantly larger than those when the same group of subjects did not receive any training (29.0 and 30.9) (P<0.05). CONCLUSIONS: FFRs used widely in China should be improved according to Chinese facial dimensions. Respirator users could benefit from respirator training and fit testing before using respirators.

Trace analysis of persistent toxic substances in the main stream of Jiangsu section of the Yangtze River, China.

BACKGROUND, AIM, AND SCOPE: The Jiangsu section of the Yangtze River is the downstream of the whole river, serving as an important drinking water source. Persistent toxic substances (PTS), from the industries such as automobile, textile, chemical, and electronic production, are not listed in the National Standard yet and not monitored and controlled. However, pollution of PTS can threaten the environment and human health. In order to understand the pollution status of the PTS contamination and recommend future rationalization of countermeasure, the PTS including organochlorine pesticides (OCPs), polyaromatic hydrocarbons (PAHs), polychlorobiphenyls (PCBs), and phthalates (PAEs) were investigated. MATERIALS AND METHODS: Samples were collected at 15 sites from five main stream sections of the Yangtze River in Jiangsu Province. PTS were extracted using solid phase extract method. The analysis of OCPs, PCBs was performed using GC/ECD and PAHs, PAEs was performed by GC/MS. RESULTS AND DISCUSSIONS: The method detection limits are low and the recoveries are from 58.1% to 110.3%. The total concentrations of OCPs, PCBs, PAHs, and PAEs were 0.27∼2.15 ng l(-1), <0.21∼44.4 ng l(-1), 0.012∼3.576 µg l(-1) and 0.178∼1.474 µg l(-1), respectively. γ-HCH, PCB28, PCB101, phenanthrene, anthracene, di-n-butyl phthalate, diethyl phthalate, and di-(2-ethylhexyl) phthalate are the major detected PTS. The concentration of most of the PTS was below the environmental quality standards for surface water of China. CONCLUSIONS: The pollution status of OCPs, PCBs, PAHs, and PAEs were analyzed. PTS contamination levels of the five main stream sections were relatively low.