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OBJECTIVE: To establish an effective clinical pathway of hospitalization process for occupational chronic mild lead poisoning within the framework of project time; to formulate a rational and effective management model for the diagnosis and treatment. METHODS: Occupational chronic mild lead poisoning was selected as a disease for pilot study based on GBZ 37-2015 Diagnosis of Occupational Chronic Lead Poisoning. According to evidence-based medicine criteria,the clinical procedure was developed,preliminary used and evaluated in clinical practice in several hospitals,with the best treatment scheme of the disease. The principal methods used are literature research,case analysis and expert consultation.RESULTS: Standardized documents relevant to clinical pathway for occupational chronic mild lead poisoning have been formulated,including standardized in-hospital treatment process,Clinical Pathway Forms for medical staff and Consent Documents of Clinical Pathway for Patients. Preliminary clinical research showed that this clinical pathway is conducive to standardizing medical process,improving medical quality,shortening the time in hospital,reducing medical cost and the waste on medical resources. CONCLUSION: The results confirm that the clinical pathway for occupational chronic mild lead poisoning is scientific,rational,normative and practical. It will surely contribute to promote the management of disease diagnosis and treatment.
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OBJECTIVE: To evaluate the efficacy and safety of sodium dimercaptopropane sulfonate( DMPS) in the treatment of patients with increased urinary mercury. METHODS: By random sampling method,68 patients with elevated urinary mercury were chosen as study subjects. Among them,61 cases were observation subjects working with mercury and 7 cases were chronic occupational mild mercury poisoning. DMPS was used to eliminate mercury by intramuscular injection. The changes of urinary mercury level were observed before and after treatment,and the curative effect was analyzed. RESULTS: The median( the 25 th and 75 th percentiles) of natural voiding urinary mercury was 36. 6( 28. 4,55. 6) μmol / mol creatinine and 24 hours total urine mercury amount was 1 074. 7( 608. 0,1 646. 3) μg / d in the first course of treatment.After 1 to 8 courses of mercury expulsion,the 24 hours total urine mercury amount in 68 patients were lower than the normal reference level( 45. 0 μg / d). The median( the 25 th and 75 th percentiles) of one-time morning urinary mercury level before hospital discharge was 2. 7( 1. 8,4. 0) μmol / mol creatinin,which was lower than the level of natural voiding urinary mercury( P < 0. 05). The first and second course of treatment resulted in the highest decline in urinary mercury,followed by a gradually decreased in urinary mercury in later courses. The number of treatment courses in observation subjects working with mercury was less than that in patients with chronic mild mercury poisoning [( 4. 0 ± 1. 3) vs( 5. 6 ±1. 1) times,P < 0. 05]. There was a positive correlation between the number of treatment courses and the level of natural voiding urinary mercury or 24 hours total urine mercury amount in the first course of treatment( P < 0. 01). The number of courses of mercury expulsion was not related to gender,length of service and age( P > 0. 05). One patient had dizziness and pale after intramuscular injection of DMPS,the symptom was disappeared with symptomatic treatment; 68 patients after treatment have no other adverse reactions. CONCLUSION: Using DMPS as mercury displacement treatment was effective and relatively safe. The change of urinary mercury after DMPS treatment can be used as a basis for establishing clinical standard for patients with increased urinary mercury.
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OBJECTIVE: To evaluate the therapeutic effects between comprehensive therapy and routine therapy in treatment of occupational chronic n-hexane poisoning. METHODS: By randomized controlled trial,116 cases with occupational chronic n-hexane poisoning were divided into two groups: the control group( n = 58) and the treatment group( n = 58). Subjects in the control group were given vitamin B_(12) and vitamin B_1 for neural nutrition; and Danshen and deproteinized calf blood extractive injection for activating blood circulation to dissipate blood stasis. Subjects in the treatment group were treated with comprehensive treatment including traditional Chinese and Western medicine,which including mouse nerve growth factor,acupuncture,physical therapy( infraredtherapy,microwave irradiation therapy),Chinese medicine steamingwashing and comprehensive rehabilitation therapy for a period of 12 weeks in addition to the conventional treatment. The curative effect and adverse reactions of both groups were observed after 12 weeks,and the treatment results and hospital stay were followed up. RESULTS: Before treatment,no significant differences( P > 0. 05) were noted in both groups in scores of neurological symptoms,signs,activities of daily living and neurogenic damage indexes of electroneuromyography[including motor digital latency( MDL),motor nerve conduction velocity( MCV),sense nerve conduction velocity( SCV) of median nerve,ulnar nerve,sural nerve or common peroneal nerve; and the detection of lengthen MDL,shorten MCV and SCV]. After treatment,patients in both groups got better in terms of the above indicators( P < 0. 05),with larger extend of improvement noted in the treatment group than in the control group( P < 0. 05). No obvious adverse reactions were noted in the 2 groups. Hospital stay of patients in the treatment group was about 2 months shorter than that in the control group( P < 0. 05). CONCLUSION: The therapeutic effects of comprehensive therapy on occupational chronic n-hexane poisoning are obviously better than routine therapy,which is an effective and safe therapeutic method.
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OBJECTIVE: To analyze the usage of glucocorticoid in patients who were treated with occupational medicamentose-like dermatitis due to trichloroethylene( OMDT),in order to provide a reference for regulating the glucocorticoid treatment of the disease. METHODS: Using a retrospective survey method,144 OMDT cases of patients who were diagnosed and cured by Guangdong Province Hospital for Occupational Disease Prevention and Treatment from 2001 to2013 were selected. The general information,clinical data and the use of glucocorticoid were collected and analyzed.RESULTS: i) The usage of glucocorticoid. The median and the 0th to 100 th percentile [M( P_0-P_(100)) ] of first dose of methylprednisolone was 100. 00( 40. 00-1 000. 00) mg / d; 58 patients( 40. 3%) using the first dose of treatment were ineffective. The dosage of glucocorticoid was increased one week after admission,the M( P_0-P_(100)) to an initial dose of120. 00( 40. 00-1 000. 00) mg / d; The M( P_0-P_(100)) of maintenance time of initial dose was 5. 5( 1. 0-14. 0) days. After treating effectively,should the decrement to stop using gradually the first glucocorticoid. The dose was gradually cut down to 20-50 mg every 1 to 3 days if the glucocorticoid dose was more than 100 mg / d; it was cut down to 10 mg every 2 to 3days if the glucocorticoid dose was less than 100 mg / d. The M( P_0-P_(100)) of glucocorticoid using time was 66. 0( 22. 0-229. 0) days. The M( P_0-P_(100)) of total amount of glucocorticoid was 3 510. 0( 420. 0 ~ 27 336. 3) mg. ii) The first dose of glucocorticoid in patients of erythema multiforme group were less than those of exfoliative dermatitis group and bullous epidermal necrolysis group( P < 0. 05),the initial dose and total amount of glucocorticoid were less than the other 3 types of rash( P < 0. 05). iii) Compared with the patients with severe impaired liver function,the first dose,the initial dose and the total amount of glucocorticoid were significantly higher than those in mild impaired liver function( P < 0. 05),and the time of using glucocorticoid was longer than that in mild impaired liver function( P < 0. 05). iv) The first dose and the initial dose of glucocorticoid in patients were positively correlated with the total amount of glucocorticoid [Spearmen correlation coefficient( r_S) were 0. 73 and 0. 78 respectively,P < 0. 01). The maintenance time of the initial dose of glucocorticoid was not correlation with the time of patients who were out of contact with trichloroethylene or the urinary level of trichloroacetic acid at admission( r_Swere- 0. 14 and 0. 10 respectively,P > 0. 05). v) Binary Logistic regression analysis showed that,if the patients who had no erythema multiforme,the more severe the degree of liver dysfunction or the white blood cell count higher than 9. 5 × 10~9/ L,the first dose of glucocorticoid used should be more than 120 mg / d( P <0. 05). CONCLUSION: Liver function and type of rash are important factors that affect the usage of glucocorticoid in patients with OMDT. Glucocorticoid therapy should be prescribed in reference to the liver function and skin lesion of patients with OMDT.
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OBJECTIVE: To establish the clinical pathway of chronic mild occupational cadmium poisoning,and to promote the application of clinical pathway in the treatment of occupational diseases. METHODS: Chronic mild occupational cadmium poisoning was selected as a disease for a pilot study based on GBZ 17-2015 Diagnosis of Occupational Cadmium Poisoning. The diagnosis and treatment scheme and the clinical pathway were developed based on the theory of evidencebased medicine and expert consultation. It was then used and evaluated in clinical practice in several hospitals. RESULTS: The content of clinical pathway of chronic mild occupational cadmium poisoning included the standard in-hospital treatment process protocol,the clinical pathway forms and the consent document for patients. The clinical application of the pathway significantly improved the outcome of treatment,shortened hospital stays and effectively control hospitalization expenses.CONCLUSION: The clinical pathway for chronic mild occupational cadmium poisoning is rational and feasible. The result confirms that the clinical pathway may have good application prospect for the treatment of occupational diseases.
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OBJECTIVE: To evaluate the major influence factors affecting the quality and accuracy of measuring instruments for power frequency electromagnetic fields in occupational hygiene technical service organizations by developing interlaboratory comparison in workplaces. METHODS: Six measuring instruments for power electromagnetic fields from 6occupational hygiene technical service organizations in Guangdong Province were selected by typical sampling method. A high-voltage substation was selected as a standard source. We set measurement sites underneath it as inter-laboratory comparison spots for power frequency electromagnetic fields. The stability of the standard source was evaluated by pairedsamples t-test and measure results were analyzed by z-score evaluation method based on quartile robust statistical technology. RESULTS: During and after the inter-laboratory comparison,the intensity of electric field and magnetic field of the standard source showed no significant difference [( 555. 03 ± 2. 94) vs( 555. 68 ± 3. 20) V / m,( 2. 30 ± 0. 06) vs( 2. 29 ± 0. 07) μT,P > 0. 05],which met the demand of stability of inter-laboratory comparison. The data of electric field measured by 2 measuring instruments without remote-reading system were found to be high because of proximity effect from its handheld status. The z-score of inter-laboratory( zB) of other 4 measuring instruments with remote-reading system ranged from- 0. 52 to 1. 10,while the z-score of within-laboratory( zW) ranged from- 1. 28 to 0. 37,and both results of| zB| and | zW| were satisfactory( < 2. 00). The zBof power frequency magnetic field measured by the 6 measuring instruments ranged from- 0. 67 to 1. 26,while zWranged from- 0. 59 to 0. 90,and both | zB| and | zW| were also satisfactory( < 2. 00). CONCLUSION: It is feasible that the inter-laboratory comparison of measuring instruments of power frequency electromagnetic fields could be implemented by a high-voltage substation as a standard source. The measuring instruments without remote-reading system could be used to measure the intensity of magnetic field but not the electric field. The measuring instruments with remote-reading system could be used to measure the intensity of either the electric field or the magnetic field,and the measurement results are satisfactory.
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OBJECTIVE: To explore the effect and significance of tumor necrosis factor-α( TNF-α) in serum and bronchoalveolar lavage fluid( BALF) of coal workers' pneumoconiosis( CWP). METHODS: Twenty-eight cases of CWP were selected by purposive sampling method and divided into 3 groups based on different stages of pneumoconiosis. There were 7 cases in stage Ⅰ,10 cases in stage Ⅱ,and 11 cases in stage Ⅲ. The venous blood and BALF were collected.TNF-α in the serum and BALF were detected by chemiluminescence assay. The lung function was determined. RESULTS: In the serum,the TNF-α level of CWP patients was positively correlated with the CWP stage [Spearman correlation coefficient( rS) = 0. 843,P < 0. 01],and negatively correlated with the forced expiratory volume in one second/forced vital capacity( FEV1/ FVC)( rS=- 0. 503,P < 0. 01). In BALF,the TNF-α level of CWP patients was negatively correlated with the CWP stage( rS=- 0. 654,P < 0. 01),and positively correlated with the FEV1/ FVC( rS= 0. 432,P <0. 05). The TNF-α level in the serum was negatively correlated with the TNF-α level in BALF( rS=- 0. 561,P < 0. 01).CONCLUSION: With the development of pneumoconiosis,the levels of TNF-α in the serum and BALF showed different variation,and were correlated with the changes of FEV1/ FVC. The level of TNF-α could be used as a reference index for evaluating the severity of CWP.
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OBJECTIVE: To observe whether bone marrow mesenchymal stem cell( BMMSC) could be induced by alveolar epithelial cell( AEC) of rats exposed to silica dust or not. METHODS: BMMSCs were isolated and cultivated from 6specific pathogen free healthy male SD rats through bone marrow adherent method. The AECs from other 6 rats randomly selected from the same batch were cultivated by immune adherent purification method. Three rats were treated with 1. 0 m L( 40 g/L mass concentration) of silicosis dust suspension by one time intratracheal injection as silicosis dust exposure model,and the other 3 rats were given 0. 9% sodium chloride solution as normal. Experimental group was the co-culture of BMMSCs and AECs from silicosis dust exposure rats. Control group A was the co-culture of BMMSCs and AECs from normal rats. Control group B was the culture of BMMSCs alone. The morphology changes were observed by the inverted phase contrast microscope at the time points of the 4th and the 8th day. Double immunofluorescence staining using aquaporin 5( AQP5) and surfactant protein C( SP-C) was performed on the treated BMMSCs. The fluorescence staining was observed using the inverted fluorescence microscope( IFM) and laser scanning confocal microscope( LSCM). Integral optical density( IOD) analysis was conducted on fluorescence of 2 kinds of proteins by Image-pro plus 6. 0 graphic analysis software. RESULTS: After the co-culture,the BMMSCs in experimental group and control group A changed from long spindle shape to cubic and polygonal shape,the variation of morphology on day 8 was more obvious than that on day 4,and the change in control group A was less obvious than that of experimental group. There was no obvious morphology change in BMMSCs of control group B. By IFM and LSCM,on day 4 and day 8,the expression of green fluorescence AQP5 and red fluorescence SP-C were all observed in BMMSCs of experimental group and control group A. The BMMSCs of control group B only showed a little green fluorescence expression of AQP5,no expression of red SP-C fluorescence was seen. Both by IFM and LSCM,on day 4 and day 8,the 2 kinds of IOD of BMMSCs in experiment group were higher than those of control group A and B at the same time points( P < 0. 01); the IOD of control group A was higher than that of control group B at the same time point( P < 0. 01). The IOD of experiment group and control group A on day 8 were higher than those on day4 in the same group( P < 0. 01). CONCLUSION: AEC of rats exposed to silica dust can effectively induce BMMSC to be differentiated into AEC.
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<p><b>OBJECTIVE</b>To measure and assess the levels of occupational exposure to power frequency electromagnetic fields in workers of power grid.</p><p><b>METHODS</b>PMM8053 electromagnetic fields measuring system with EHP-50 probe was used to measure the levels of electromagnetic fields at working place. Personal dosimeters (EMDEX LITE) were utilized to measure the individual exposure levels of power frequency magnetic field. The results were evaluated with the limitation criteria of GBZ2.2 and ICNIRP.</p><p><b>RESULTS</b>In the 500 kV ultra high voltage substation, the intensity at 90% measure points of power electric field was more than 5 kV/m. The magnetic field intensity in the areas nearby reactors and capacitors was often higher than 100 µT, even several hundreds µT. The mean daily exposure levels of workers in power grid were between 0.04 and 5.0 µT, and the exposure levels of 70% workers were higher than 0.4 µT.</p><p><b>CONCLUSION</b>In the areas of ultra high voltage and nearby the reactors and capacitors are the key control points for occupational health in power grid. There is acute health risk of workers exposed to high accumulative exposure levels.</p>
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Humans , Electricity , Electromagnetic Fields , Occupational Exposure , WorkplaceABSTRACT
<p><b>OBJECTIVE</b>To evaluate the chromium (Cr) levels in blood and urine among general population in China between 2009 and 2010, and thereby to analyze its prevalent features.</p><p><b>METHODS</b>From year 2009 to 2010, a total of 11 983 subjects of general population aged between 6 and 60 year-old were recruited from 24 districts in 8 provinces in eastern, central and western China mainland, by cluster random sampling method. The information about their living environment and health status were collected by questionnaire, and 11 983 blood samples and 11 853 urine samples were also collected. Inductively coupled plasma mass spectrometry (ICP-MS) was applied to test the Cr level both in blood and urine; and the Cr distribution in blood and urine among groups of population in different ages, genders and districts, were then analyzed.</p><p><b>RESULTS</b>Among general population in China, the geometric mean (GM) of Cr concentration in blood was 1.19 µg/L, with median at 1.74 µg /L and 95% percentile at 5.59 µg/L. The Cr concentration in blood among males and females were separately 1.18 µg/L and 1.20 µg/L(P > 0.05); while its GM in the groups of population aged 6 - 12, 12 - 16, 16 - 20, 20 - 30, 30 - 45 and 45 - 60 years old were 1.00, 1.22, 1.01, 1.40, 1.27 and 1.30 µg/L (P < 0.01), respectively; and the figures in populations from eastern, central and western China were 1.00, 1.70 and 1.98 µg/L (P < 0.01), respectively. Among general population, the GM of Cr concentration in urine was 0.53 µg/L, with median was lower than 0.42 µg/L and 95% percentile at 3.53 µg/L. The Cr concentration in urine among males and females were separately 0.52 µg/L and 0.53 µg/L (P > 0.05);while its GM in the groups of population aged 6 - 12, 12 - 16, 16 - 20, 20 - 30, 30 - 45 and 45 - 60 years old were 0.56, 0.60, 0.52, 0.50, 0.52 and 0.46 µg/L (P < 0.01), respectively;and the figures in populations from eastern, central and western China were 0.58, < 0.42 and 0.60 µg/L (P < 0.01), respectively.</p><p><b>CONCLUSION</b>The study reported the Cr levels in blood and urine among general population in China, and thereby provided basic data evidence for the following Cr biological monitoring studies in near future.</p>
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Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , China , Chromium , Blood , Urine , Population SurveillanceABSTRACT
<p><b>OBJECTIVE</b>To observe the changes of brain oxygen metabolism and neuroelectrophysiology after severe brain injury, and the effects of hypothermia on severe brain injury.</p><p><b>METHODS</b>148 patients with severe brain injury (GCS 3 - 8, admitted within 10 hours from injury) were selected for this study. Patients were divided into 3 groups, Group GCS 7 - 8, Group GCS 5 - 6 and Group GCS 3 - 4. Every group were also randomly assigned to normothermia and hypothermia subgroup. Patients in the hypothermia group were cooled to 32 approximately 34 degrees C. SLSEP, BAEP, P(br)O(2) and rSaO(2) were recorded in each group at the same time.</p><p><b>RESULTS</b>In the Group GCS 7 - 8, N20 in SLSEP, I/V in BAEP and rSaO(2) were improved significantly after mild hypothermia treatment, and P(br)O(2) was decreased by hypothermia; In the Group GCS 5 - 6, N20 in SLSEP, I/V in BAEP and rSaO(2) were improved by hypothermia, and P(br)O(2) was decreased in hypothermia subgroup; In the Group GCS 3 - 4, no significant difference was found.</p><p><b>CONCLUSION</b>Mild hypothermia has a significant effect on patients of GCS 7 - 8 and a doubt effect on patients of GCS 5 - 6. It seem no effect on patients of GCS 3 - 4. Brain oxygen metabolism and neuroelectrophysiology are important to value the therapeutic effect on severe brain injury.</p>
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Brain , Metabolism , Craniocerebral Trauma , Metabolism , Therapeutics , Evoked Potentials, Auditory, Brain Stem , Evoked Potentials, Somatosensory , Follow-Up Studies , Hypothermia, Induced , Oxygen , Metabolism , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To establish the association between genetic polymorphisms of HLA-DMA and HLA-DMB and risk of developing trichloroethylene-induced medicamentosa-like dermatitis (TIMLD).</p><p><b>METHODS</b>Sixty-one cases were medically confirmed to have been affected with TIMLD and 60 controls were selected from exposed workers who were free from TIMLD. The TIMLD cases and controls were similar in terms of age, sex, and duration of exposure. DNA was extracted both from the TIMLD cases and controls, HLA-DMA and HLA-DMB loci were amplified by using Touchdown PCR, and the alleles and genotypes were confirmed by restriction fragment length polymorphism (RFLP) and direct sequencing. Finally, the frequencies of HLA-DMA and HLA-DMB variants were compared between the two groups.</p><p><b>RESULTS</b>The results showed that the frequency of HLA-DMA*0101 and HLA-DMB*0103 alleles was significantly increased in TIMLD patients than in controls (71.3% vs. 55.0% for HLA-DMA*0101; P<0.05) (11.5% vs. 3.3% for HLA-DMB*0103; P<0.05). In addition, the frequency of HLA-DMA*0102-*0102 homozygous genotype was also significantly higher in the controls than in the patients (25.0% vs. 8.2%, P<0.05), whereas the frequency of heterozygous HLA-DMB *0101-*0102 genotype was lower in the patients in comparison with the controls. Conclusion The polymorphisms of HLA-DM may be associated with the susceptibility to TIMLD.</p>
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Humans , Alleles , Dermatitis, Contact , Genetics , Genetic Predisposition to Disease , HLA-D Antigens , Genetics , Polymorphism, Genetic , Polymorphism, Restriction Fragment Length , Trichloroethylene , ToxicityABSTRACT
<p><b>OBJECTIVE</b>To investigate the association between genetic polymorphisms of human leukocyte antigen-DQ (HLA-DQ) and susceptibility to trichloroethylene (TCE)-induced severe generalized dermatitis.</p><p><b>METHODS</b>A case-control study was conducted which included 112 patients with TCE-induced severe generalized dermatitis and 142 healthy controls exposed to TCE in the same workshop. The DNA sequences in exon2 of HLA-DQA1 and HLA-DQB1 were performed by direct sequencing of polymerase chain reaction (PCR) products. The frequencies distribution of allelic genotypes and codon polymorphisms were compared.</p><p><b>RESULTS</b>The frequencies of DQA1*0201 and 060101/0602 in cases [7.6% (17/224) and 16.1% (36/224)] were significantly higher than those of the exposed controls [3.5% (10/284) and 7.0% (20/284)], while frequencies of DQA1*0103 and 050101/0503/0505 in cases [5.8% (13/224) and 8.9% (20/224)] were significantly lower than those of exposed controls [10.9% (31/284) and 17.3% (49/284)]. In terms of codon polymorphisms, there were 5 codons of DQA1 (25, 41, 52, 54 and 69) showing significant differences between cases and controls. There were no significant differences in the frequencies of allelic genotypes of HLA-DQB1 between cases and exposed controls.</p><p><b>CONCLUSION</b>The genetic polymorphisms of HLA-DQA1 might be one of the factors influencing the individual susceptibility to TCE-induced severe generalized dermatitis.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Alleles , Drug Eruptions , Genetics , Gene Frequency , Genetic Predisposition to Disease , Genotype , HLA-DQ Antigens , Genetics , Occupational Exposure , Polymorphism, Genetic , Trichloroethylene , ToxicityABSTRACT
<p><b>OBJECTIVE</b>To investigate the susceptibility of trichloroethylene-induced medicamentosa like dermatitis by comparing the frequency of HLA-DMA and HLA-DMB in patients with trichloroethylene-induced medicamentosa like dermatitis and in normal controls.</p><p><b>METHODS</b>The DNA of lymphocytes in 61 patients with trichloroethylene-induced medicamentosa like dermatitis and in 60 people as the normal control were abstracted by using touchdown PCR amplification of HLA-DMA and HLA-DMB. Then through restriction fragment length polymorphism (RFLP) and sequence base typing, the alleles and genotypes were confirmed. The frequency of HLA-DMA and HLA-DMB in the two groups was compared.</p><p><b>RESULTS</b>The HLA-DMA*0101 allele frequency in patients with trichloroethylene-induced medicamentosa like dermatitis was significantly higher than in the control group (71.3% vs 55.0%, P < 0.05). The allele frequency of HLA-DMA*0103 was significantly higher in the patient group than in the control group (11.5% vs 3.3%, P < 0.05). The ratio of *0102 homozygotes of HLA-DMA*0102 in the patient group was significantly higher than in the control group (25.0% vs 8.2%, P < 0.05). The ratio of *0102 heterozygotes of HLA-DMB*0101 in the patient group was lower than in the control group (P < 0.05).</p><p><b>CONCLUSION</b>The polymorphisms of DMA may be related to the susceptibility of the patients with trichloroethylene-induced medicamentosa like dermatitis.</p>
Subject(s)
Humans , Alleles , Dermatitis, Occupational , Genetics , Gene Frequency , Genetic Predisposition to Disease , Genotype , HLA-D Antigens , Genetics , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , TrichloroethyleneABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical manifestations, complications and treatment of medicament-like dermatitis due to trichloroethylene (TCE), so as to provide basis for studying its etiology and mechanism.</p><p><b>METHODS</b>Fifty patients with dermatitis due to TCE from 1997 to 2000 were analysed retrospectively.</p><p><b>RESULTS</b>The occurrence of the dermatitis was not parallel to TCE exposure levels, without significant dose-effect relationship. This disease could be caused by both inhalation and skin exposure. The latency period of TCE dermatitis ranged from 5 to 66 days, and the average was 31.5 d (Medium). The major clinical manifestations included skin lesions, fever, superficial lymph node swelling and liver dysfunction. Infection was the major complication. Glucocorticoid was effective for treatment of this disease.</p><p><b>CONCLUSION</b>The clinical manifestations due to TCE exposure were similar to dermatitis medicamentosa. The major clinical types of TCE dermatitis included exfoliative dermatitis and erythema multiforme. The dermatitis is considered to be mediated by delayed-type (IV) hypersensitivity. The key factors to treat this disease successfully included the use of glucocorticoid in time with sufficient dose and full course, professional skin care, active treatment to protect the liver and to avoid infection.</p>