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Objective: To investigate the specificity of endogenous metabolic profile in plasma of patients with occupational acute methyl acetate poisoning using non-targeted metabolomics. Methods: A total of six patients with occupational acute methyl acetate poisoning were selected as the poisoning group, while 10 healthy workers without occupational exposure history of chemical hazards in the same industry were selected as the control group using the judgment sampling method. Metabolites in patient plasma of the two groups were detected using ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry, and non-targeted metabolomics analysis was performed. Principal component analysis and partial least squares discriminant analysis were used to identify differential metabolites and analyze their metabolic pathways. Results: There were significant differences in metabolite profiles in patient plasma between poisoning group and control group. A total of 195 differentially expressed metabolites were screened in plasma of patients in poisoning group, including 119 upregulated and 76 downregulated metabolites. Lipid substances (lipids and lipid-like molecules) accounted for the highest proportion (21.5%). The differential metabolites of poisoning group were related to folate biosynthesis, amino acid metabolism, pyrimidine metabolism, sphingolipid biosynthesis and other metabolic pathways in plasma compared with the control group (all P<0.05). Conclusion: Occupational acute methyl acetate poisoning affects metabolism of the body. The folic acid biosynthesis, amino acid and lipid metabolism and other pathways may be involved in the occurrence and development of poisoning.
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Objective To establish a method for the determination of thallium and its soluble compounds in workplace air using microporous filter membrane sampling and inductively coupled plasma mass spectrometry (ICP-MS). Methods Thallium and its soluble compounds in workplace air were collected using microporous filter membranes, digested with nitric acid, quantified using lutetium internal standard method, and detected by ICP-MS. Results The linear range of thallium was 0.00 to 600.00 μg/L, with the correlation coefficient of 1.000. The detection limit was 0.08 μg/L, and the lower limit of quantification was 0.26 μg/L. The minimum detection concentration and minimum quantitation concentration of thallium of 75.00 L workplace air were 1.0×10-5 and 3.0×10-5 mg/m3, respectively. The minimum detection concentration and minimum quantitation concentration of thallium of 480.00 L workplace air was 2.0×10-6 and 5.0×10-6 mg/m3, respectively. The recovery rate of spiking was 100.82%-103.44%, and the relative standard deviation within- and between-batches was 1.50%-3.32% and 1.32%-3.11%, respectively. The sample could be stored at room temperature for at least 14 days. Conclusion This method can be used for the detection of thallium and its soluble compounds in workplace air.
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OBJECTIVE: To establish a method for testing lithium and its compounds in workplace air by inductively coupled plasma mass spectrometry(ICP-MS). METHODS: Lithium and its compounds in workplace air were collected by microporous filtration membrane. After elution with nitric acid solution in volume fraction of 1.0%, the samples were determined by ICP-MS. RESULTS: The linearity range of lithium mass concentration was 10.00-500.00 μg/L, and the correlation coefficient was 0.999 8. The detection limit was 0.03 g/L and the lower limit of quantitation was 0.10 μg/L. The minimum detection concentration and the minimum quantitative concentration of lithium were 4.0 and 10.0 ng/m~3 respectively. The recovery rate of standard addition was 96.18%-100.91%.The within-run and the between-run relative standard deviation were 1.17%-2.17% and 0.89%-1.54% respectively. Lithium and its compound samples could be stored at room temperature for at least 28 days. CONCLUSION: The method could be used for detection of lithium and its compounds in workplace air.
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OBJECTIVE: To compare the advantages and disadvantages and application range of three methods for detection of urinary mercury. These methods include alkaline stannous chloride cold atomic absorption spectrometry, acid stannous chloride cold atomic absorption spectrometry and atomic fluorescence spectrometry. METHODS: The detection limits, accuracy and precision in these three methods were compared. RESULTS: The alkaline stannous chloride cold atomic absorption method and acidic stannous chloride cold atomic absorption method had a wide linear range(1.000-10.000 μg/L). The detection limit was high(0.265 and 0.556 μg/L, respectively). The atomic fluorescence spectrometry had the narrowest linear range(0.400-2.000 μg/L) and the lowest detection limit(0.048 μg/L). The average spiked recoveries of the above three methods were 95.93%-101.02%, 92.49%-98.72% and 95.96%-99.57%. The relative standard deviations within and between batches of these three methods were less than 5.00%. The addition recovery of organic mercury by alkaline cold chloride atomic absorption method was 80.91%. The recoveries of inorganic mercury and organic mercury by other methods were close to 100.00%. CONCLUSION: All three methods meet the daily needs of detecting urinary mercury. Among them, alkaline stannous chloride cold atomic absorption method is suitable for promotion in primary laboratories as a preliminary screening method. The atomic fluorescence spectrometry is suitable for the detection of microscale and trace amount of urinary mercury.
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OBJECTIVE: To evaluate the technical level and ability of the detection of free silica in dust in occupational health technical service institutions of Guangdong Province through inter-laboratory comparison. METHODS: The interlaboratory detection of free silica in dust in 55,61,58 and 66 occupational health technical service institutions were carried out and compared in 2012-2015. The results were statistically analyzed by four points robust statistical technique,and the relative deviation between the laboratory test results and the Median of them was used as the auxiliary evaluation index of the laboratory's technical ability. RESULTS: The stable coefficient of variation(CV) of samples with free silica content > 20. 00% was less than 5. 00%,and the stable CV of samples with free silica content ≤20. 00% was more than5. 00%. The qualified rate in 2012-2015 were 89. 09%,81. 97%,77. 59% and 81. 82%,respectively. There was no statistical difference(P > 0. 05) in the annual reference between private and non-private institutions compared to the qualified rate in 2012-2015. There was no statistical difference(P > 0. 05) in the qualified rate of the institutions in the Pearl River Delta region and in the non-triangular regions of the Pearl River Delta in 2012-2015. CONCLUSION: Comparison of the detection technology service ability in the detection of free silica in dust should be conducted to improve its technical service quality.
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Objective To study the risk factors of lymph node metastasis in the central neck compartment of thyroid carcinoma,and to explore the reasonable range of lymph node dissection in central neck dissection for clinically node-negative papillary thyroid microcarcinoma patients.Methods From Dec.2015 to Dec.2016,a total of 200 patients with CN0 papillary thyroid carcinoma were randomly divided into two groups according to the registration number:unilateral central neck dissection group and bilateral central neck dissection group in Department of Thyroid Surgery,Fujian Medical University Union Hospital.The risk factors of lymph node metastasis and value of bilateral central neck dissection were analyzed.Results The risk factors of lymph node metastasis in the central papillary thyroid carcinoma were ≥0.7 cm in diameter and older than 45 years in age and gender in male.Further analysis found that contralateral central lymph node metastasis occurred in patients with tumor diameter ≥0.5 cm.The positive rate was 22％.The number of lymph nodes detected in the unilateral and bilateral central areas was 9.53±6.04 and 12.19±7.18,P=0.035,respectively.The positive numbers of lymph nodes were 1.17±1.47 and 2.11±2.75,P=0,022 respectively.Conclusion In patients with tumor diameter ≥0.5 cm,bilateral central neck dissection is conducive to improving the thoroughness of tumor dissection and does not increase the risk of complications.
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The authors reviewed the practice of integrated health care delivery system( IDS) at home and abroad, and based on experiences of collaborations between medical service institutions in Zhejiang province,proposed the strategic positioning,responsibilities and service innovation of urban public hospitals in a regional medical service system. It is held that the direction of China′s health care reform should move towards IDS in the future,and such hospitals should play an active role in the process via integration of its own resource and provide multi-level,diversified services for the regional health care system.
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Objective To investigate the methodology and feasibility of bedside temporary cardiac pacing with balloon-tipped floating catheter by femoral vein approach.Methods 86 patients in this study were treated with bedside temporary cardiac pacing by femoral vein for arrhythmias.A balloon-tipped floating catheter was inserted through the femoral vein in right ventricle,guided by the length of catheter in body and the QRS morphology of pacing electrocardiogram(ECG).After that,the pacing site was identified by X-ray fluoroscopy.Then,the feasibility and successful rate of this bedside temporary cardiac pacing,and the causes for failure were analyzed.Results Guided by the length of catheter and the QRS morphology of pacing ECG,the succesful rate of balloon-tipped floating catheter putted into right ventricle was 98.8%.The most successful pacing sites were located at the right ventricular apex(RVA) and right ventricular out-flow tract(RVOT).The lengths of catheter from the puncture sites to RVA and RVOT were (57.2?3.2)cm and (54.3?3.1)cm,respectively.Incidence of undersensing in RVOT pacing group was significantly higher than that in RVA pacing group(P
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Objective To investigate the effect of combined antiplatelet drugs on clinic and aggregation activity of platelet in patient with aucte myocardial infarction(AMI).Methods Consecutive 97 cases with AMI were redomized to receive clopidogrel plus aspirin(treated group,n=48) or aspirin alone(placebo group,n=49) for 30 days.Before and after treatment,the clinical recurrent angina,improvement of heart function,death,ST segment changes of electrocardiogram and the rate of maximun aggregation of paltelet were tested and analysed.Results Recurrent angina occurred in 10.0%(5 cases) in the treated group and 20%(10 cases) in the placebo group.The total frequency of improvement of heart function occurred in 36.7%(18 cases) in the treated group and 22.4%(11 cases) in the placebo group(?~2=3.638,P=0.045).Death occurred in 4%(2 cases) in the treated group and 8%(4 cases) in the placebo group.ST segment of electrocardiogram decreased from (0.36?0.13)mV to (0.13?0.08)mV,compared with placebo from (0.35?0.14)mV to (0.16?0.90)mV(t=3.012,P=0.04).The rate of maximum aggregation of platelet induced by ADP reduced from (74.54?8.99)% to (34.09?9.23)%,the placebo from (72.30?7.78)% to (56.54?6.92)%(t=13.42,P