Analysis of dust and noise exposure levels in the mining industry from the national surveillance program in 2019 / 中华劳动卫生职业病杂志

Objective: To understand the exposure level of dust and noise in the mining industry and provide data support for revising policy for the prevention and control of occupational diseases. Methods: In May 2022, Data was collected through the National Surveillance Program for Occupational Hazards in the Workplace. Descriptive analysis was conducted for dust and noise levels by industry type and enterprise size from 7, 679 enterprises in the mining industry among 29 provincial regions nationwide. Results: The enterprises in the mining industry included in the National Surveillance Program for Occupational Hazards in the Workplace are mainly small and micro, accounting for 47.97% (3684/7679) and 30.00% (230/7679) respectively. The industry is mainly compred of employers in the non-metallic ming and beneficiation industry, accounting for 50.25% (3859/7679). Among the enterprises with silica dust, coal dust, and noise hazards, the proportion of enterprises where total dust concentration and noise intensity exceed the standard is higher than 50%. 30% of the posts are with an exposure level of silica dust, coal dust, and noise that exceeds the standard. The exceedance rate and the median of the time-weighted average concentration of total coal dust among large and medium-sized enterprises are higher than those among small and micro-sized enterprises (P<0.05) . Conclusion: The dust and noise hazards in the mining industry are lower than in the past in China, but more than 25% of workers are still at a high risk of occupational pneumoconiosis and noise deafness. Therefore, intervention and surveillance strategies should be strengthened in the future.

Analysis of the status of occupational disease prevention and control of enterprises in mining and manufacturing industries in China in 2019 / 中华劳动卫生职业病杂志

Objective: To analyze the status of prevention and treatment of occupational diseases among mining and manufacturing industries in China in 2019, provide the scientific basis for the formulation and revision of policies and standards of prevention and treatment of occupational diseases. Methods: In May 2022, Collecting data of a project named Surveillance of Occupational Hazards in the Workplace in 2019 through the National Surveillance System for Occupational Hazards in the workplace. Compare the status of prevention and treatment of occupational diseases in 63 563 enterprises of mining and manufacturing industries among different dimensions. Results: The training rate of managers was 76.17% and that of occupational health managers was 76.97%. The rate of reporting of occupational diseases hazardous items was 67.58%, the rate of launching of the detection of occupational hazards was 57.16%, and the rate of launching of occupational health examination was 62.42%. Excluding the distribution rate of dust mask, the installation rate of various occupational prevention facilities and the distribution rate of gas mask and hearing protector were less than 80%. The differences in all the indicators among different areas, enterprise scales, economic types were statistically significant (P<0.05) . Conclusion: There are still some enterprises which are relatively weak in the ability of the prevention and treatment of occupational diseases in China. Measures such as special support, guidance and strengthen supervision should be taken towards those enterprises toimprove the awareness of prevention and treatment of occupational diseases and the level of that.

Study on HBV-related acute-on-chronic liver failure risk factors and novel predictive survival model / 中华肝脏病杂志

Objective: To identify the predisposing factors, clinical characteristics, and risk factors of disease progression to establish a novel predictive survival model and evaluate its application value for hepatitis B virus-related acute-on-chronic liver failure. Methods: 153 cases of HBV-ACLF were selected according to the guidelines for the diagnosis and treatment of liver failure (2018 edition) of the Chinese Medical Association Hepatology Branch. Predisposing factors, the basic liver disease stage, therapeutic drugs, clinical characteristics, and factors affecting survival status were analyzed. Cox proportional hazards regression analysis was used to screen prognostic factors and establish a novel predictive survival model. The receiver operating characteristic curve (ROC) was used to evaluate predictive value with the Model for End-Stage Liver Disease (MELD) and the Chronic Liver Failure Consortium Acute-on-Chronic Liver Failure score (CLIF-C ACLF). Results: 80.39% (123/153) based on hepatitis B cirrhosis had developed ACLF. HBV-ACLF's main inducing factors were the discontinuation of nucleos(t)ide analogues (NAs) and the application of hepatotoxic drugs, including Chinese patent medicine/Chinese herbal medicine, non-steroidal anti-inflammatory drugs, anti-tuberculosis drugs, central nervous system drugs, anti-tumor drugs, etc. 34.64% of cases had an unknown inducement. The most common clinical symptoms at onset were progressive jaundice, poor appetite, and fatigue. The short-term mortality rate was significantly higher in patients complicated with hepatic encephalopathy, upper gastrointestinal hemorrhage, hepatorenal syndrome, and infection (P < 0.05). Lactate dehydrogenase, albumin, the international normalized ratio, the neutrophil-to-lymphocyte ratio, hepatic encephalopathy, and upper gastrointestinal bleeding were the independent predictors for the survival status of patients. The LAINeu model was established. The area under the curve for evaluating the survival of HBV-ACLF was 0.886, which was significantly higher than the MELD and CLIF-C ACLF scores (P < 0.05), and the prognosis was worse when the LAINeu score ≥ -3.75. Conclusion: Discontinuation of NAs and the application of hepatotoxic drugs are common predisposing factors for HBV-ACLF. Hepatic decompensation-related complications and infection accelerate the disease's progression. The LAINeu model can predict patient survival conditions more accurately.

Applied research of ultrasound attenuation parameter in the diagnosis of metabolic dysfunction-associated fatty liver disease / 中华肝脏病杂志

Objective: To evaluate the efficacy, establish a diagnostic model, and value of ultrasound attenuation parameters (UAP) to diagnose hepatic steatosis in metabolic dysfunction-associated fatty liver disease (MAFLD) and its relevant disorders. Methods: 3770 cases were selected from the Health Examination Center of the Third Hospital of Hebei Medical University between October to December 2020. MAFLD diagnosis was based on the Asia-Pacific region MAFLD clinical diagnosis and treatment guidelines. The degree of hepatic steatosis was divided into mild, moderate and severe according to ultrasound imaging. UAP, clinical characteristic indexes, serum biochemical indexes, characteristics of hepatic steatosis and related factors were compared and analyzed in MAFLD patients and healthy controls. Logistic regression method was used to analyze the independent risk factors affecting the progression of hepatic steatosis in MAFLD to establish the diagnostic model. The clinical efficacy of UAP and the new model in diagnosing MAFLD was evaluated by the receiver operating characteristic curve (ROC). One-way ANOVA was used to compare means among multiple groups. Mann-Whitney U test was used to compare non-normally distributed measurement data between the two groups, and rank-sum test was used to compare multiple groups. χ2 test was used to compare count data between groups. Results: Among the 3 770 cases, 650 were MAFLD, with a prevalence rate of 17.24%, and the highest prevalence was 37.23% in the age group of 60-69. The prevalence rate was significantly higher in male than female (30.34% vs. 9.17%). Age-sex analysis showed that the prevalence rate in males aged 30-69 years was 38.26%, and that in females aged over 60 years was 31.94%. UAP was significantly higher in patients with MAFLD than healthy controls (278.55 dB/m vs. 220.90 dB/m, Z=-12.592, P＜0.001), and an increasing trend with increased degree of hepatic steatosis (mild:257.20 dB/m, moderate:286.20 dB/m, and severe: 315.00 dB/m) were observed. The cut-off values of UAP for the diagnosis of mild, moderate and severe hepatic steatosis were 243≤UAP＜258 dB/m, 258≤UAP＜293 dB/m, ≥293 dB/m in MAFLD. The sensitivity and specificity were 67.20%, 93.60%, 95.90%, and 82.10%, 72.00%, and 84.80%, respectively. UAP, alanine aminotransferase and fasting blood glucose were independent risk factors for the progression of hepatic steatosis in MAFLD. The combined MAFLD classification model (UAG model) was established. The AUC of mild, moderate and severe hepatic steatosis in MAFLD were 0.906, 0.907, and 0.946, respectively, and the sensitivity and specificity were 76.50%, 82.10%, 98.00%, and 90.80%, 83.30% and 76.10%, respectively. Conclusion: MAFLD is a common disease in the general population, with a higher incidence in male and elderly female over 30 years of age. UAP can be used as a new noninvasive diagnostic technique to evaluate hepatic steatosis in MAFLD. The UAG model has a good diagnostic efficacy on MAFLD and its relevant disorders, and thus can be used as a guide for evaluating clinical diagnosis and prognosis.

The prediction of baicalin content in the extraction process of Scutellaria baicalensis by near-infrared spectroscopy combined with different variable selection methods / 药学学报

Near-infrared spectroscopy (NIRS) combined with chemometrics can achieve rapid detection in process analysis. After variable selection, the redundant information is effectively removed and the characteristic variables related to the response values are selected. Compared with global model, the complexity is significantly reduced and the prediction accuracy is also improved. In this study, near-infrared spectroscopy analysis combined with different variable selection methods was applied to achieve the rapid detection of baicalin in the extraction process of Scutellaria baicalensis. Data sets were divided based on sample set portioning based on joint x-y distance (SPXY) method. Competitive adaptive weighted resampling method (CARS), random frog (RF) and successive projections algorithm (SPA) were applied to variable selection. Partial least squares (PLS) models were constructed based on above three methods, and the prediction results were compared. After CARS, RF and SPA method, 92, 10 and 17 variables were screened out respectively. According to the performance of the models, CARS method is found to be more effective and suitable than RF and SPA. Furthermore, the characteristic variables selected by CARS method have a better correspondence with the chemical structure of baicalin. The root mean square error (RMSEC) of the calibration set and the root mean square error (RMSEP) of the prediction set are 0.528 2 and 0.720 2 respectively. Compared with the global PLS model, the correlation coefficient of the calibration set (Rc) is increased to 0.979 9 from 0.917 0, and the relative standard errors of prediction (RSEP) is reduced to 5.59% from 10.58%.

Clinical features and prognosis of infective endocarditis patients with acute kidney injury / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical features and treatment of infective endocarditis (IE) patients with acute kidney injury (AKI), and to compare the adverse complications and outcome with IE patients without AKI.@*METHODS@#Clinical data of 100 IE cases in Peking University First Hospital from January 2002 to June 2018 were retrospectively reviewed. The patients were divided into AKI group (n=21) and non-AKI group (n=79) based on the AKI network (AKIN) definition. The clinical data and prognosis were compared between the two groups.@*RESULTS@#The incidence of AKI was 21%. The average age was (43.7±15.7) years, and the ratio of male to female was 3 ∶1. There was no significant difference in age and gender between the two groups. Compared with non-AKI group, the AKI group had more rash and lower limbs edema (P=0.017 and P=0.001), higher urine blood and protein positive rate (both P<0.001). Lower hemoglobin and serum albumin level (both P<0.001), worse clinical cardiac function (NYHA III-IV, P=0.033) were found in AKI group compared with non-AKI group. There was no significant difference in microbiologic positive rate and pathogenic bacteria sorts between the two groups. Nine patients refused surgery, and the other 91 cases underwent cardiac surgery with cardiopulmonary bypass under general anesthesia, including 19 cases of AKI group and 72 cases of non-AKI group. The ventilation time and intensive care unit (ICU) stay time were longer in AKI group than in non-AKI group (P=0.028 and P=0.003). AKI group needed more red blood cell transfusion (P=0.010). Using the last serum creatinine before surgery as basic level, there was more new-onset AKI cases in AKI group than in non-AKI group. During the median follow-up time 42 months, there was no significant difference in perioperative and follow-up mortality between the two groups (P=0.463 and P=0.581).@*CONCLUSION@#More perioperation complications occurred in IE patients with AKI, but no significant difference in in-hospital and follow-up mortality between the AKI and non-AKI groups was observed.

Study on early postoperative nutritional support in elderly patients with gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the optimal postoperative nutritional support in elderly patients with gastric cancer.</p><p><b>METHODS</b>One hundred and twenty elderly patients with gastric cancer undergoing radical gastrectomy were prospectively enrolled from January 2010 to March 2013 and randomly divided into total parenteral nutrition group(TPN, n=40), early total enteral nutrition group (TEN, n=40) and enteral plus parenteral nutrition group(EN+PN, n=40). Clinical charasteristics including treatment tolerance, nutritional indexes, immune indexes, time to first flatus, incidence of postoperative infection and anastomotic leakage, were analyzed and compared.</p><p><b>RESULTS</b>Treatment tolerance in EN+PN group(97.5%, 39/40) was significantly higher than that in TPN group(82.5%, 33/40) and TEN group(80.0%, 32/40)(both P<0.05). The nutritional indices, including prealbumin, albumin, transferrin, body mass index, and the incidence of anastomotic leakage were similar in the 3 groups(P>0.05). The immune indices, including CD3, CD4, CD4/CD8, were significantly reduced after operation in each group. However, they were significantly higher in EN+PN group and TEN group than those in TPN group(both P<0.05). Furthermore, compared to the TPN group, the incidence of postoperative infection(surgical site infection, pulmonary infection, abdominal infection) was significantly lower and time to first flatus was significantly shorter in EN+PN group and TEN group.</p><p><b>CONCLUSIONS</b>Early enteral nutrition after gastric cancer surgery is safe, simple and feasible. EN plus PN is the best way to administer postoperative nutritional support in elderly patients with gastric cancer.</p>

The influence of familial factors on post rabies exposure vaccination in rural habitants / 中华流行病学杂志

Objective To understand the current situation of potential exposure to rabies among the rural habitants in Hunan province,and to study the impact related to familial factors on post rabies exposure vaccination.Methods In total,40 villages from 20 townships of 4 counties were selected by multistage sampling method.Study samples were selected from these villagers and familial basic information and vaccination post rabies exposures were recorded through questionnaires.Data were statistically analyzed by SPSS 17.0.Results Among 3042 villagers from 864 households being surveyed,124 person-time exposures were found from January,2009 to October,2010,with a total exposure rate as 4.08％,and the annual average exposure rate as 2.33％.Data from univariante analysis showed that the rates on post rabies exposure vaccination were statistically correlated with the following four factors:knowledge on the score of rabies prevention (x2 =8.260,P =0.042),whether being involved in the new type of rural cooperative medical care (P =0.035),family disposable cash income in the year of 2009 (x2 =10.831,P =0.031),distance between the households and the health facilities in towns and townships (x2 =9.071,P=0.033).Results from logistic regression analysis indicated that the score of knowledge on rabies prevention (OR=1.420,95％CI:1.055-1.905) and the annual disposable cash income of the family in 2009 (OR=1.480,95％ CI:1.044-2.098) were independent factors that influencing the rabies vaccination.Conclusion Strengthening the education programs on rabies prevention in rural habitants and increasing family income were feasible way to increase the rate of rabies vaccination in rural areas of Hunan province.

Serological survey of pandemic influenza A (H1N1) virus infection among population in Hunan Province / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To understand the infection condition and analytical methods of Influenza A (H1N1) virus in the population of Hunan Province during different periods.</p><p><b>METHODS</b>Quick surveys on the positive rate of Influenza A (H1N1) virus hemagglutination inhibition (HI) test have been conducted for 5 times successively from November 2009 to March 2010 in 14 medical and health institutions of Changsha city, whose results were then compared with those from the sampling surveys of whole Hunan province.</p><p><b>RESULTS</b>2131 subjects were involved in this study; the total population standardized rates of antibody positive investigated for 5 times were 9.32% , 14.62%, 31.08%, 28.43% and 22.80% respectively; the population of 6-17-years-old has the highest rate of antibody positive; only 9.84% of the antibody positive subjects attributed to vaccine inoculation; there was no significant difference in the standardized positive rates between the quick serological surveys and the corresponding sampling survey of Hunan province (P > 0.05).</p><p><b>CONCLUSION</b>The positive rate of A (H1N1) virus antibody reached the peak in late January 2010; quick investigations in small region could be used to evaluate the infection prevalence during pandemic of infectious diseases.</p>

Interaction between exposure to environmental smoke and the family history of chronic bronchitis (CB) on the risk of CB in rural females in Liuyang city, Hunan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the relationships and interaction among the exposure to environmental smoke, family history of chronic bronchitis (CB) and CB, in rural women.</p><p><b>METHODS</b>A population-based case-control study chi(2) was used to analyze the relationship between environmental smoke exposure, CB family history and CB. Additive effects model was used to analyze the interaction.</p><p><b>RESULTS</b>In the first stage, 157 CB patients were screened from 24 268 women residents (prevalence rate is 6.47 per thousand), then 92 patients (case group) and 114 healthy women (control group) were investigated in the second stage. Results showed that: coal/firewood for heating (OR = 36.21) and CB family history (OR = 6.41) might serve as the risk factors of CB in rural women (P < 0.05). Factors as frequent cooking and using coal/firewood for heating had a positive interaction with family history of CB in rural women, CB with S as 5.39 and 9.02, attributable proportions of interaction (API) as 72% and 88%, relative excess risk of interaction (RERI) as 6.50 and 225.99, respectively.</p><p><b>CONCLUSION</b>Using coal/firewood for heating and CB family history might be the risk factors of CB for rural women. A positive interaction between cooking frequently, heating model and CB family history was also seen.</p>

Study on risk factors and predictive model for lumbar intervertebral disc herniation in the rural population / 中华流行病学杂志

Objective To explore the risk factors on the symptoms of lumbar intervertebral disc herniation so as to develop a predictive model for the disease. Methods With a populationbased case-control study, 303 of 50 123 residents were diagnosed as having lumbar intervertebral disc herniation symptoms. 152 cases and 167 healthy controls, matched by gender and age, were randomly chosen as case and control groups. Questionnaires were used to collect information on the exposure to risk factors and logistic predictive model was then established. Results Through non-conditional logistic regression analysis, data showed that the positive family history of lumbar vertebra disorder, lumbar treatment or surgery, mental stress, acute low back injury, permanent work pose, and body mass index ≥23.0 kg/m2 were the risk factors among residents from the countryside. The area under the receiver operator characteristic curve of logistic predictive model was 0.809. When 0.4 was set as the classification cutoff, the total predictive correct rate, sensitivity, and specificity were 74.0%, 73.7%, and 74.3% respectively. Conclusion The occurrence of lumbar disk herniationcan in countryside population was affected by multi-variables including genetic and environmental, and could be predicted with the logistic regression model established by our group.The positive predictive results could be used to alarm the patients and doctors for prevention and treatment of the disease.