Comparison analysis on remedy condition of acute chemical intoxication in emergency departments and occupational departments of general hospitals / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the current situation of treatment for acute chemical poisoning in the emergency departments and occupational disease departments of some general hospitals and to provide a basis for improving the ability of general hospital to deal with acute chemical poisoning.</p><p><b>METHODS</b>Four hospitals from Shandong Province, Beijing City, and Shanxi Province, China were selected in the study. They included two first-class hospitals located in the downtown, where the patients with acute chemical poisoning from urban and suburban areas were admitted to the occupational disease departments, and two second-class hospitals located in the suburban area or county, where the patients with acute chemical poisoning from the suburban area were admitted to the emergency departments. A questionnaire survey was conducted in 141 medical workers (51 persons in the emergence department group and 90 persons in the occupational disease department group) that were engaged in the treatment of acute chemical poisoning in the four hospitals; 1999 medical records were analyzed. Individual in-depth interviews, questionnaire investigation, and field observation were used to compare the emergency department group and occupational disease department group in terms of the ability to deal with acute chemical poisoning and the training on treatment for acute chemical poisoning.</p><p><b>RESULTS</b>The emergency department group had significantly higher proportion of pesticide poisoning cases than the occupational disease department group (P<0.01). Thirty-seven of the patients in occupational disease department group died, with a fatality rate of 2.7%, and 14 of the patients in emergence department group died,with a fatality rate of 2.2%, so there was no significant difference between the two groups in this regard (P>0.05). There were significantly more cases treated without emergency plan in the emergency department group than in the occupational disease department group ( 37.3% vs. 10.0%, P <0.0 1). The occupational disease department group had significantly higher score of knowledge about the treatment for acute chemical poisoning than the emergence department group (7.2±1.3 vs. 5.2±0.9, P<0.01 ). There were significantly lower proportions of medical staff who had received training on the knowledge about acute chemical poisoning and on the emergency disposal of acute chemical poisoning in the emergency department group than in the occupational disease department group (P<0.05).</p><p><b>CONCLUSION</b>There is a lack of the knowledge about treatment for acute chemical poisoning and protective measures during treatment among the medical staff in general hospitals, and related training and emergency plan are needed.</p>

Expression of serum cytokines in patients with pneumoconiosis by antibody chip / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the changes in expression of serum cytokines in patients with pneumoconiosis using cytokine antibody chips (CACs).</p><p><b>METHODS</b>The CAC technology was applied to measure the serum levels of 60 cytokines in 12 patients with pneumoconiosis and 3 normal controls.</p><p><b>RESULTS</b>In the patients with pneumoconiosis, the highly expressed serum cytokines included interleukin (IL)-1α, IL-1β, IL-2, ILs 4-16, macrophage colony-stimulating factor, interferon-γ, tumor necrosis factor (TNF)-α, TNF-β, human bone morphogenetic protein-6, fibroblast growth factor-7, neurotrophin-3, and stem cell factor, and the lowly expressed serum cytokines included recombinant human I-309, monocyte chemoattractant protein (MCP)-1, MCP-2, MCP-3, MCP-4, macrophage inflammatory protein (MIP)-1-δ, and MIP-3-α.</p><p><b>CONCLUSION</b>Patients with pneumoconiosis have changes in the expression of most serum cytokines.</p>

Determination method for 17 pesticides in common in whole blood by gas chromatography coupled to mass spectrometry with solid-phase extraction sample cleanup / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish a method for simultaneous determination of 17 common pesticides in whole blood by solid phase extraction-gas chromatography-mass spectrometry (SPE-GC-MS).</p><p><b>METHODS</b>Whole blood samples were treated by extraction with acetonitrile, and the obtained extract was cleaned up using an Oasis HLB SPE cartridge; pesticides were separated by GC and quantitatively analyzed by MS with selected ion monitoring.</p><p><b>RESULTS</b>The concentrations of 17 pesticides in whole blood were 1.0-5.0 mg/L, and the recovery rate was 41.3-102.1%, with a relative standard deviation of less than 10%in most pesticides. The 17 pesticides showed a good linear relationship between concentration and peak area within 0.5-5.0 mg/L, with a correlation coefficient of 0.9945-0.9994. The limit of detection and limit of quantification were 0.02-0.05 mg/L and 0.05-0.09 mg/L, respectively.</p><p><b>CONCLUSION</b>With this method, 17 pesticides in whole blood can be well separated and determined. This method has high sensitivity, accuracy, and precision and can be used for identification and quantification of multiple pesticides in blood samples.</p>

Determination of lead and isotope ratios in whole blood by inductively coupled plasma mass spectrometry / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish a method to determine lead and Isotope Ratios in whole blood by inductively coupled plasma mass spectrometry (ICP-MS).</p><p><b>METHODS</b>The whole blood samples was removed protein by 5% nitric acid , Online join thallium (Tl) as internal standard substance, used lyophilized bovine blood lead and cadmium standard material (GBW09139h and GBW09140h) for quality control of blood lead concentrations. Lead isotope standard substances (GBW04426) is used to determine the correction factor, lead isotope ratios will lead isotope standard reference material NIST SRM981 by icp-ms with samples for testing.</p><p><b>RESULTS</b>Optimize the detection method, detection of blood lead and lead isotope, and the method of linear range r >0.9999, GBW09139h and GBW09140h test results are within the scope of quality control. NIST SRM981 isotope determination precision RSD<1%, NIST SRM981 test results and the certificate of value close to.</p><p><b>CONCLUSION</b>The method is simple and convenient data is reliable, can meet the total lead (pb) in blood and former isotope simultaneous determination.</p>

Application of auditory brainstem response (ABR) and 40 Hz auditory event related potential (40 Hz AERP) to the diagnosis of occupational noise-induced hearing impairment / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the application of auditory brainstem response (ABR) and 40 Hz auditory event related potential (40 Hz AERP) to the diagnosis of occupational noise-induced hearing impairment and to provide the evidence for diagnosis of occupational deafness.</p><p><b>METHODS</b>Pure tone audiometry, ABR and 40 Hz AERP were performed in 54 workers occupationally exposed to noise. The thresholds of higher frequency band, 3 kHz and 4 kHz were compared with the threshold of ABR. The thresholds of auditory frequency ban and 0.5 kHz were compared with the threshold of 40 Hz AERP.</p><p><b>RESULTS</b>A better correlation was found between thresholds of ABR and higher frequency pure tone audiometry. There was a significant difference of thresholds between 40 kHz AERP and pure tone audiometry. The correction values of thresholds between 40 kHz AERP and pure tone audiometry in the light noise-induced hearing impairment group and the moderate noise-induced hearing impairment group were (16.43 ± 1.08) and (11.80 ± 1.12) dBn HL, respectively.</p><p><b>CONCLUSION</b>In diagnosis of occupational noise-induced hearing impairment, the threshold of ABR can be used to estimate the hearing threshold of pure noise higher frequency. Because there is the significant difference of the thresholds between pure tone audiometry and 40 Hz AERP, the response threshold can not be served as the audiometry threshold, and the behavioral hearing thresholds can only be obtained by adjusting the response threshold with respective correction value.</p>

The rescue modalities and etiology of acute organic solvent poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the rescue modalities and etiology of acute organic solvent poisoning.</p><p><b>METHODS</b>A total of 776 cases of acute organic solvent poisoning were analyzed retrospectively. The kinds of organic solvents, the modes of exposure, the characteristics of poisoning and the methods of treatment were analyzed.</p><p><b>RESULTS</b>Poisoning was due to occupational exposure to organic solvents in 87.4%, the other was exposed in daily life. The total number of organic solvents harming the patients was 55. The most common three of the organic solvent poisoning were halogenated hydrocarbons poisoning, hydrocarbons poisoning, amino- and nitro-hydrocarbons poisoning. The accidents of mass poisoning were increasing in numbers recently, especially the acute halogenated hydrocarbons poisoning.</p><p><b>CONCLUSION</b>To know the numerous poisonings responsible for acute solvent poisoning is essential for enhancing the pre-hospital care, emergency treatment and following treatment. Also, extensive clinical knowledge and numerous biologic laboratory tests are needed to improve the diagnosis and rescue of acute solving poisoning. Effect of therapeutic plasma exchange treatment on sever acute poisoning is with a positive attitude.</p>

Measurement of 16 elements in blood by inductively coupled plasma mass spectrometry / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish a method of determining more elements in whole blood by inductively coupled plasma mass spectrometry (ICP-MS).</p><p><b>METHODS</b>The whole blood samples were treated by 5% nitric acid to remove the proteins, then were centrifuged. Sixteen elements (Be, Al, Mn, V, Cr, Co, Ni, As, Mo, Ag, Cd, Sb, Ba,Tl, Pb and U) in the supernatant were directly measured by ICP-MS.</p><p><b>RESULTS</b>The detection limits of 16 elements were 0.01 ∼ 6.51 µg/L. The linear correlation coefficient was ≥ 0.999. The relative standard deviations were below 5 %. The recovery rates were 105% ∼ 115%. Seronorm Trace Elements SerumL-1 LOT 0903106 and GBW09139g or GBW09140g were used in the quality control, the detected results corresponded with the standard values.</p><p><b>CONCLUSION</b>ICP-MS technique is a simple, rapid, accurate and reliable method, which can be used to measure several trace elements in whole blood samples.</p>

Evaluation of different oxygen therapies on therapeutic effects in rats with acute carbon dioxide poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study therapeutic effects by using different oxygen therapies in rats with acute carbon dioxide poisoning, to select the best oxygen therapy technology for patients with acute carbon dioxide poisoning on the spot.</p><p><b>METHODS</b>Sixty healthy male Sprague-Dawley rats were randomized into normal control group, carbon dioxide exposure group, hyperbaric oxygen treatment group (pressure 2 ATA, FiO(2)100%), high concentration of atmospheric oxygen treatment group (FiO(2)50%), low concentration of atmospheric oxygen treatment group (FiO(2)33%). After treated with different oxygen in rats with acute carbon dioxide poisoning, arterial pH, PO2 and PCO2 of rats were detected, in addition observe pathological changes of lung tissue and brain tissue.</p><p><b>RESULTS</b>The arterial pH (7.31 ± 0.06) and PO2 [(68.50 ± 15.02) mm Hg] of carbon dioxide exposure group were lower than those of control group [pH (7.42 ± 0.02) and PO2 (92.83 ± 8.27) mm Hg], PCO2 [(71.66 ± 12.10) mm Hg] was higher than that of control group [(48.25 ± 2.59) mm Hg] (P < 0.05); the arterial pH (hyperbaric oxygen treatment group 7.37 ± 0.02, high concentration of atmospheric oxygen treatment group 7.39 ± 0.03, low concentration of atmospheric oxygen treatment group 7.38 ± 0.02) and PO2 of oxygen treatment groups [hyperbaric oxygen treatment group, high concentration of atmospheric oxygen treatment group, low concentration of atmospheric oxygen treatment group were (82.25 ± 12.98), (84.75 ± 11.24), (83.75 ± 16.77) mm Hg, respectively] were higher than that of carbon dioxide exposure group, PCO2 [hyperbaric oxygen treatment group, high concentration of atmospheric oxygen treatment group, low concentration of atmospheric oxygen treatment group were (52.25 ± 4.95), (51.75 ± 4.82), (52.66 ± 5.61) mm Hg, respectively] was lower than that of carbon dioxide exposure group (P < 0.05); there was no significant difference of the arterial pH, PO2 and PCO2 between oxygen treatment groups and control group (P > 0.05); there was no significant difference of the arterial pH, PO2 and PCO2 among oxygen treatment groups (P > 0.05). There was large area of bleeding of lungs in rats with carbon dioxide poisoning, the bleeding of lungs in rats with high concentration of atmospheric oxygen treatment and low concentration of atmospheric oxygen treatment was better than the rats with carbon dioxide poisoning, there was no abnormal appearance of lungs in rats with hyperbaric oxygen treatment. The light microscope observation showed that there were diffuse bleeding and exudation of lungs in rats with carbon dioxide poisoning, the bleeding and exudation of lungs in rats with high concentration of atmospheric oxygen treatment and low concentration of atmospheric oxygen treatment were better than the rats with carbon dioxide poisoning, there were only minor bleeding and exudation of lungs in rats with hyperbaric oxygen treatment. There was no difference of brain in anatomy and microscopy among all groups, there were no significant bleeding, edema, cell degeneration and necrosis.</p><p><b>CONCLUSIONS</b>Lung pathology in acute carbon dioxide poisoning rats with hyperbaric oxygen treatment is better than the rats with high concentration of atmospheric oxygen treatment and low concentration of atmospheric oxygen treatment, there is no significant difference of effect between high concentration of atmospheric oxygen treatment group and low concentration of atmospheric oxygen treatment group, however, the results of blood gas analysis and lung pathology than the exposure group improved, so qualified medical unit for hyperbaric oxygen therapy as soon as possible, hyperbaric oxygen treatment facilities in the absence of circumstances, the emergency treatment of early oxygen is also a good measure.</p>

Effect of oxygen therapy on the morphology of cardiac muscle, lung and liver in rats with acute hydrogen sulfide intoxication / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the effects of different oxygen therapy technique (different concentrations of normobaric oxygen and the hyperbaric oxygen) on the ultrastructure of cardiac muscle, lung and liver in rats with acute hydrogen sulfide intoxication.</p><p><b>METHODS</b>One hundred healthy male Wistar rats were randomly divided into five groups: normal control group (A), poisoned group (B), oxygen therapy group (C), oxygen therapy group (D) and oxygen therapy group (E). After the exposure to 300 ppm H2S for 60 min in a static exposure tank (1 m3), the rats were treated with oxygen therapy, C, D and E groups were given 33% oxygen, 50% oxygen of atmospheric oxygen and hyperbaric oxygen therapy for 100 min, respectively. The rats in normal control group inhaled air under the same environment. After exposure and therapy, the tissues of lung, heart and liver were observed under light microscope and electron microscope.</p><p><b>RESULTS</b>The results of light microscope examination showed that the broken and not well aligned cardiac myofilaments, cytoplasmic edema and pyknosis could be seen in group B. The well aligned and clear cardiac myofilaments appeared in group C, D and E. The alveolar hemorrhage, edema and inflammatory cells exudation could not be seen in group A. Alveolar epithelial cell edema, unsmooth alveolar edge and alveolar inflammatory cells exudation could be found in group B. The unsmooth alveolar septal borders and pulmonary edema could be seen occasionally in group C and D, the alveolar inflammatory cells exudation could not be seen in group E. The regular hepatic boards and the uniform hepatic cellular nuclei were found in group A. The disordered hepatic boards, widened cellular gaps and cytoplasmic edema could be seen occasionally in group B. The irregular hepatic boards and ballooning degeneration could be seen in group C and D. The regular hepatic boards and uniform cytoplasm could be found in group E. The results of electron microscope examination indicated that the mitochondrial swelling, autolyzing, fuzzy and breakage of myocardial cells were observed in group B; the clear mitochondrial structure appeared in group E. The apoptosis and organelle vacuole of alveolar epithelial cells could be observed in group B. The relatively normal nuclei of alveolar epithelial cells could be seen in group E. The lax cytoplast structure of hepatocytes, unclear nuclear membrane, lumped chromatin, slightly swelled mitochondria and phagosomes were observed in group B. However, no improved change was observed in group C, D and E.</p><p><b>CONCLUSION</b>Hydrogen sulfide could induce the extensive and severe damage of myocardial mitochondria, alveolar epithelial cells and hepatocytes, the oxygen therapy in good time could reduce significantly the myocardial injury, and improve the lung injury to some extent. High-pressure oxygen therapy is better than the normobaric oxygen therapy.</p>

Evaluating the effects of different oxygen therapies on the rats with acute nitrogen asphyxia / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To Evaluate the effects of different oxygen therapies on the rats with acute nitrogen asphyxia and to study the best oxygen therapic protocol for patients with acute nitrogen asphyxia on the spot.</p><p><b>METHODS</b>Sixty healthy male Wistar rats were divided into 5 groups: control, exposure to nitrogen, 33% oxygen treatment, 50% oxygen treatment and hyperbaric oxygen treatment groups. The behavioral performance, arterial oxygen pressure (PO2), carbon dioxide partial pressure (PCO2) and oxygen saturation (SPO2), biochemical changes in liver and kidney function and myocardial enzymes in 5 groups were measured.</p><p><b>RESULTS</b>The rats exposed to nitrogen firstly were excited then inactive symptoms, but consciousness was recovered after oxygen therapy. The PO2 and SPO2 in nitrogen exposure group were (79.67 +/- 9.12) and (94.92 +/- 2.78) mm Hg, respectively, which were significantly lower than those in control group (P<0.01). The PO2 and SPO2 of 3 oxygen treatment groups were (94.75 +/- 7.24), (94.92 +/- 8.98), (104.58 +/- 7.12)mm Hg and (97.17 +/- 0.83), (96.92 +/- 1.16), (97.42 +/- 0.67)mm Hg, respectively, which were significantly higher than those in nitrogen exposure group (P<0.05). The PO2 in hyperbaric oxygen treatment group was significantly higher than those in other 2 oxygen treatment groups (P<0.05). The SPO2 in hyperbaric oxygen treatment group was (51.42 +/- 6.60) mm Hg which was significantly higher than that [(44.58 +/- 3.42)mm Hg] in 50% oxygen treatment groups (P< 0.05). AST [(270.50 +/- 49.05 )U/L], ALT [(122.67 +/- 55.44 )U/L], BUN [(7.31 +/- 0.93 )mmol/L], Cr[(28.32 +/- 4.35) micromol/L], CK [(1808.42 +/- 582.05)U/L] and CtnI [(22.52 +/- 14.29 )ng/ml] in nitrogen exposure group were significantly higher than those in control group (P<0.05). AST [(165.25 +/- 30.87) U/L], HBDH [(350.83 +/- 103.00)U/L] and CtnI [(11.23 +/- 5.38) ng/ml] in hyperbaric oxygen treatment group were significantly lower than those in other 2 oxygen treatment groups (P<0.05).</p><p><b>CONCLUSION</b>Timely and effective oxygen therapy can significantly increase arterial pressure of oxygen and oxygen saturation in the rats with acute nitrogen asphyxia, and can improve liver function and cardiac damage. The hyperbaric oxygen chamber can significantly increase the therapeutic effects on rats with acute nitrogen asphyxiation.</p>

Clinical study on pneumoconiosis with pulmonary thromboembolism / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To probe into the clinical features and the rescue of pneumoconiosis with pulmonary thromboembolism (PTE).</p><p><b>METHODS</b>26 patients with pneumoconiosis and PTE, male 16, female 10, were collected from June 2002 to June 2006 and 42 patients only with pneumoconiosis served as control. Tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), thrombomodulin (TM), plasma protein S, C (Ps, Pc), homocysteine (Hcy) were measured by the methods of ILISA, and antithrombin (AT-III) by chromo substrate method before and after the treatment of heparin.</p><p><b>RESULTS</b>The average age of patients with pneumoconiosis and PTE was 66.0 +/- 11.9 years old. The number of patients with pneumoconiosis of degree 1, 2, 3 was 3, 16 and 7 respectively. After anticoagulant therapy of heparin, 23 were well improved, and 3 died of acute respiratory failure. Dyspnea, chest pain, hemoptysis, syncope were the conspicuous symptoms. The levels of D-Dimer (0.63 +/- 0.14 mg/L), TM (5.02 +/- 1.24 microg/L) were significantly higher than those of the control (P < 0.05), and significantly lower again after the treatment (P < 0.05). The level of AT-III (96.68 +/- 7.23%) was significantly lower than that of the control, and higher again after the treatment (P < 0.05).</p><p><b>CONCLUSION</b>PTE is often developed in the elder patients with high degree of pneumoconiosis (> or = 2 degree). Clinical features are complicated and non-specific, with the high negative ratio of D-Dimer (7/26), high mortality and high complications of anticoagulant therapy.</p>