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1.
Article in Chinese | WPRIM | ID: wpr-869869

ABSTRACT

Objective:To evaluate the effect of patient-controlled intravenous analgesia (PCIA) with dexmedetomidine mixed with subanesthetic dose of ketamine on anxiety and depression in the patients with advanced cancer pain.Methods:Sixty patients of either gender with advanced cancer pain, aged 24-82 yr, with poor analgesic effect or obvious adverse reactions after three-step analgesic treatment, were selected and randomly divided into 2 groups ( n=30 each) using a random number table method: routine treatment group (group R) and dexmedetomidine mixed with ketamine group (group DK). The initial dose of morphine for PCIA was 1/3 of the oral dose in group R. In group DK, ketamine 5.4 mg/kg (90 μg·kg -1·h -1) and dexmedetomidine 6 μg/kg (0.1 μg·kg -1·h -1) were added on the basis of group R. Tropisetron 8 mg was added to analgesics and diluted to 200 ml with normal saline in both groups.The analgesic pump was programmed to deliver 4 ml with an initial dose of 4 ml, lockout interval of 15 min and background infusion at 4 ml/h.The numerical rating scale score, Ramsay sedation score, Chinese version of State-Trait Anxiety Inventory score and Beck Depression Inventory-Ⅱ score were recorded before PCIA and at 4, 12, 24 and 48 h of PCIA.The development of effective analgesia and satisfactory sedation, occurrence and degree of depression, score for patient's quality of life and satisfaction score, consumption of morphine and adverse reactions such as constipation, nausea and vomiting, agitation and respiratory depression were recorded within 48 h of PCIA. Results:Compared with group R, the NRS score was significantly decreased, the rate of effective analgesia was increased, Beck Depression Inventory-Ⅱscore and Chinese version of State-Trait Anxiety Inventory score were decreased, the incidence and degree of depression were decreased, incidence of nausea and vomiting and constipation, consumption of morphine and pressing times of PCIA pump were decreased, and the score for patient's quality of life and satisfaction score were increased in group DK ( P<0.05). Conclusion:PCIA with dexmedetomidine mixed with subanesthetic dose of ketamine can significantly enhance the analgesic effect, improve anxiety and depression, and raise the quality of life when used for the patients with advanced cancer pain.

2.
Article in Chinese | WPRIM | ID: wpr-865131

ABSTRACT

Objective:To investigate the surgical indications of gallbladder polyps.Methods:The retrospective case-control study was conducted. The clinicopathological data of 2 272 patients with gallbladder polyps who underwent cholecystectomy in 11 medical centers from January 2015 to December 2019 were collected, including 585 in the First Affiliated Hospital of Xi′an Jiaotong University, 352 in No. 215 Hospital of Shaanxi Nuclear Industry, 332 in the First People′s Hospital of Xianyang, 233 in Shaanxi Provincial People′s Hospital, 152 in the Second Affiliated Hospital of Xi′an Jiaotong University, 138 in Xianyang Hospital of Yan′an University, 137 in People′s Hospital of Baoji, 125 in Hanzhong Central Hospital, 95 in Baoji Central Hospital, 72 in Ankang Central Hospital, 51 in Yulin No.2 Hospital. There were 887 males and 1 385 females, aged (48±12)years, with a range from 12 to 86 years. Observation indicators: (1) surgical treatment, pathological examination and hospitalization; (2) follow-up and complications; (3) comparison of clinicopathological data between patients with non-neoplastic polyps and neoplastic polyps; (4) comparison of clinicopathological data among patients who had gallbladder polyp diameter of 7 to 9 mm, 10 to 12 mm, or ≥13 mm without cholecystolithiasis; (5) analysis of influence factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis; (6) construction and evaluation of nomogram prediction model for neoplastic polyps of patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis. Follow-up using outpatient examination or telephone interview was conducted to detect complications and survival of patients up to April 2020. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the rank-sum test. Ordinal data was analyzed using the rank-sum test of multi-samples. Analysis of influence factors for the incidence of neoplastic polyps was conducted after excluding missing data of CEA and CA19-9. Univariate analysis was conducted using the chi-square test or rank-sum test of multi-samples, and multivariate analysis was conducted using Logistic regression model. Based on Logistic regression model multivariate analysis, the nomogram prediction model was constructed using the R 3.6.0 version software. Results:(1) Surgical treatment, pathological examination and hospitalization: of the 2 272 patients, 2 199 cases underwent laparoscopic cholecystectomy, 43 cases underwent open cholecystectomy, 28 cases underwent radical resection for gallbladder carcinoma, and 2 cases underwent laparoscopic gallbladder preservation and polypectomy. There were 1 050 of the 2 272 patients undergoing intraoperative frozen section examination. Results of pathological examination showed that 1 953 of the 2 272 patients had non-neoplastic polyps including 1 681 cases with cholesterol polyps and 272 cases with inflammatory polyps; 319 cases had neoplastic polyps including 274 with benign polyps (93 cases with adenoma, 66 cases with adenomyoma, 81 cases with adenoma-like hyperplasia, 34 cases with adenoma combined with intraepithelial neoplasia); and 45 cases had malignant polyps including 43 cases with adenocarcinoma, 1 case with adenosquamous carcinoma and 1 case with sarcomatoid carcinoma. The duration of postoperative hospital stay of 2 272 patients was 3 days(range, 1 to 27 days). (2) Follow-up and complications: of the 2 272 patients, 1 932 were followed up for 3.5 to 63.5 months, with a median follow-up time of 31.0 months. During the follow-up, 180 patients had short-term complications and 170 patients had long-term complications. (3) Comparison of clinicopathological data between patients with non-neoplastic polyps and neoplastic polyps: cases with age ≤50 years or >50 years, cases with time from first discovery of polyp to operation <1 year, 1-3 years, >3 years and ≤5 years or >5 years, CEA, CA19-9, CA125, cases with single or multiple polyps in preoperative ultrasonography examination, cases with diameter of polyps in preoperative ultrasonography examination as 1-6 mm, 7-9 mm, 10-12 mm or ≥13 mm, cases with pedicled or broad based polyp wall in preoperative ultrasonography examination, cases with polyp morphology in preoperative ultrasono-graphy examination as nodular, papillary, globular or mulberry-like, cases undergoing or not undergoing intraoperative frozen section examination, cases with diameter of polyps in postoperative pathological examination as 1-6 mm, 7-9 mm, 10-12 mm or ≥13 mm, cases with gallbladder wall thickness in postoperative pathological examination as ≤4 mm or >4 mm of the 1 953 patients with non-neoplastic polyps were 1 118, 835, 1 027, 422, 230, 274, 2.0 mg/L(range, 0.2-8.6 mg/L), 14.5 U/mL(range, 2.6-116.4 U/mL), 10.5 U/mL(range, 1.2-58.7 U/mL), 658, 1 295, 674, 741, 413, 125, 1 389, 564, 407, 1 119, 292, 135, 832, 1 121, 698, 774, 385, 96, 1 719, 234, respectively. The above indicators of the 319 patients with neoplastic polyps were 160, 159, 204, 55, 26, 34, 2.9 mg/L(range, 0.2-28.8 mg/L), 19.7 U/mL(range, 3.5-437.1 U/mL), 15.0 U/mL(range, 1.0-945.0 U/mL), 203, 116, 49, 59, 100, 111, 154, 165, 92, 153, 49, 25, 218, 101, 53, 85, 90, 91, 263, 56, respectively. There were significant differences in the above indicators between the non-neoplastic polyps and neoplastic polyps patients ( χ2=5.599, Z=-3.668, -2.407, -3.023, -3.403, χ2=104.474, Z=-13.367, χ2=65.676, 12.622, 73.075, Z=-11.874, χ2=7.649, P<0.05). (4) Comparison of clinicopathological data among patients who had gallbladder polyp diameter of 7 to 9 mm, 10 to 12 mm, or ≥13 mm without cholecystolithiasis: after excluding 311 of the 2 272 patients with cholecystolithiasis, there were 706 cases with gallbladder polyp diameter of 7 to 9 mm, 459 cases with gallbladder polyp diameter of 10 to 12 mm, and 205 cases with gallbladder polyp diameter ≥13 mm, respectively. Cases with time from first discovery of polyp to operation <1 year, 1-3 years, >3 years and ≤5 years or >5 years, CEA, CA19-9, cases with single or multiple polyps in preoperative ultrasonography examination, cases with pedicled or broad based polyp wall in preoperative ultrasonography examination, cases with polyp morphology in preoperative ultrasonography examination as nodular, papillary, globular or mulberry-like, cases with echo intensity of preoperative ultrasonography examination as slightly strong, medium or weak, cases undergoing or not undergoing intraoperative frozen section examination, and cases with pathological types of polyps as non-neoplastic polyps, benign polyps or malignant polyps of the 706 patients with gallbladder polyp diameter of 7 to 9 mm were 291, 170, 107, 138, 2.2 mg/L(range, 0.5-8.6 mg/L), 21.0 U/mL(range, 2.8-116.4 U/mL), 207, 499, 620, 86, 118, 463, 75, 50, 252, 410, 44, 379, 327, 657, 49, 0, respectively. The above indicators of the 459 patients with gallbladder polyp diameter of 10 to 12 mm were 267, 85, 43, 64, 1.6 mg/L(range, 0.4-9.3 mg/L), 10.4 U/mL(range, 3.3-354.0 U/mL), 205, 254, 237, 222, 158, 223, 51, 27, 222, 213, 24, 263, 196, 373, 79, 7, respectively. The above indicators of the 205 patients with gallbladder polyp diameter ≥13 mm were 128, 38, 20, 19, 2.1 mg/L(range, 0.6-28.8 mg/L), 10.2 U/mL(range, 3.6-307.0 U/mL), 120, 85, 75, 130, 68, 97, 22, 18, 98, 95, 12, 148, 57, 113, 71, 21, respectively. There were significant differences in the above indicators among patients who had gallbladder polyp diameter of 7 to 9 mm, 10 to 12 mm, or ≥ 13 mm ( χ2=46.482, 8.093, 39.504, 66.971, 277.043, 60.945, 19.672, 22.340, 197.854, P<0.05). (5) Analysis of influence factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis: of the 459 patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis, there were 373 cases with non-neoplastic polyps, and 86 cases with neoplastic polyps, respectively. Results of univariate analysis showed that CEA, CA19-9, the number of polyps in preoperative ultrasonography examination, diameter of polyps in preoperative ultrasonography examination, polyp wall in preoperative ultrasonography examination were influence factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis ( χ2=10.342, 5.616, 20.009, Z=-4.352, χ2=6.203, P<0.05). Results of multivariate analysis showed that CEA>5.0 mg/L, CA19-9>39.0 U/mL, single polyp in preoperative ultrasonography examination, polyp diameter of 11 mm in preoperative ultrasonography examination, polyps of broad base in preoperative ultrasonography examination were independent risk factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis ( odds ratio=8.423, 0.082, 0.337, 3.694, 2.318, 95% confidence interval: 1.547-45.843, 0.015-0.443, 0.198-0.575, 1.987-6.866, 1.372-3.916, P<0.05). (6) Construction and evaluation of nomogram prediction model for neoplastic polyps of patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis: CEA, CA19-9, the number of polyps in preoperative ultrasonography examination, diameter of polyps in preoperative ultrasonography examination, polyp wall in preoperative ultrasonography examination were imported into R 3.6.0 version software to establish the nomogram prediction model for neoplastic polyps. The results showed the score for CEA>5.0 mg/L, CA19-9>39.0 U/mL, cases with single polyp in preoperative ultrasonography examination, cases with polyp diameter of 10 mm in preoperative ultrasonography examination, cases with polyp diameter of 11 mm in preoperative ultrasonography examination, cases with polyp diameter of 12 mm in preoperative ultrasonography examination, polyps of broad base in preoperative ultrasonography examination were 25, 27, 100, 0, 26, 72, 98 in the nomogram prediction model, respectively. The C-index of nomogram prediction model was 0.768. Result of nomogram prediction model showed that the incidence of tumor polyps was 0, 6% and 10% in patients with multiple and pedicled gallbladder polyps with diameter of 10, 11, 12 mm and with CEA ≤5.0 mg/L and CA19-9 ≤39.0 U/mL, the incidence of tumor polyps was 43%, 53% and 70% in patients with single and broad base gallbladder polyps with diameter of 10, 11, 12 mm. The calibration curve showed that the probability of the nomogram prediction model predicting neoplastic polyps was nearly consistent with the actual probability. Conclusions:CEA>5.0 mg/L, CA19-9>39.0 U/mL, single polyp in preoperative ultrasonography examination, polyp diameter of 11 mm in preoperative ultrasonography examination, polyps of broad base in preoperative ultrasonography examination are independent risk factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis. Cholecystectomy should be performed in time for patients with single and broad based gallbladder polyps with diameter of 10, 11, 12 mm.

3.
China Occupational Medicine ; (6): 81-85, 2020.
Article in Chinese | WPRIM | ID: wpr-881870

ABSTRACT

OBJECTIVE: To explore the detection of small airway dysfunction in occupational populations and its influencing factors. METHODS: A convenient sampling method was adopted, and 15 490 occupational health workers who were tested for pulmonary ventilation function in 2018 were selected as study subjects. The results of pulmonary ventilation function examination and chest direct digital radiography(DR) were collected and analyzed. RESULTS: Among the study subjects, 2 083 were detected to have abnormal pulmonary ventilation function, the abnormal detection rate was 13.4%; 3 089 subjects were detected to have small airway dysfunction, and the abnormal detection rate was 19.9%. The two-class logistic regression analysis results suggested that female, exposure to organic dusts during work, exposure to asthmogenic during work, chest DR abnormalities and abnormal pulmonary ventilation function were risk factors for abnormal small airway function(P<0.05). CONCLUSION: The abnormal small airway function in occupational populations is related to various factors such as gender and occupational exposure to allergens. The screening of small airway function in this group may help advance the prevention and treatment of respiratory diseases.

4.
Article in Chinese | WPRIM | ID: wpr-798632

ABSTRACT

Objective@#To detect the prevalence of sleep disorders among metro staff and to analyze influencing effects of effort reward imbalance (ERI) on it.@*Methods@#In January 2015, subway driver, dispatcher and station operator from Guangzhou subway were selected as the research object in the whole group sampling method. A total of 1200 questionnaires were distributed and 1124 were valid questionnaires, and the effective questionnaire recovery rate was 93.7%. Based on the effort reward imbalance questionnaire and the self-administered sleep questionnaire, the data of the general demographic characteristics, life satisfaction, occupational stress and sleep status of the respondents were collected. Epi.data3.1 and spss19.0 were used for analyzing.@*Results@#A total of 1124 subway employees were surveyed, with an average age of (28±5) years; the working age was (4.5±3.6) years. ERI occupied 24.7% (278/1124) of the study population and sleep disorders as 42.2% (474/1124) . Single factor analysis showed that marital status, educational level, work position, life satisfaction and ERI could significantly influence sleep disorders of metro staff (P<0.05) . Logistic regression showed that higher effort (adjusted OR=2.56, 95%CI: 1.79-3.68) , lower reward (adjusted OR=1.90, 95%CI: 1.34-2.68) and ERI (adjusted OR=2.33, 95%CI: 1.69-3.22) could increase the risk of sleep disorders after the confounding factors were controlled. ERI (adjusted OR=2.89, 95% CI: 1.80-4.64) , and over commitment (adjusted OR=4.64, 95%CI: 2.81-7.68) could influence the risk of sleep disorders independently when over commitment was evaluated as a moderating variable.@*Conclusion@#Occupational stress as ERI could influence the risk of sleep disorders among metro staff. The situation should not be neglected for occupational health of metro staff.

5.
Article in Chinese | WPRIM | ID: wpr-800814

ABSTRACT

Objective@#To choose various occupational health risk assessment of the mature methods at home and abroad respectively occupational health risk assessment was carried out on the 4s stores, to explore different risk assessment methods on the 4 s shop the applicability of the occupational health risk assessment.@*Methods@#Chemical was applied on the harmful factors of occupational health risk assessment technology guideline in the composite index method, quantitative cancer risk assessment method using the guidelines for the harmful factors of occupational health risk assessment of chemical technology of composite index method, quantitative cancer risk assessment method, international commission on mining and metals (ICMM) occupational health risk assessment quantitative method and the occupational-disease-inductive operation classification to evaluate chemical factors in 4S store, Combined with on-site occupational health investigation to compare with the result of risk assessment and analysis of international mining and metals (ICMM) committee occupational health risk assessment quantitative method and the occupational-disease-inductive operation classification of 4S store to evaluate chemical factors, combined with on-site occupational health investigation comparison and analysis the result of the risk assessment.@*Results@#Except for 6 times, the results of ICMM matrix method and comprehensive index method were consistent, which were all higher than job classification. The other results were job classification of >of ICMM matrix method >comprehensive index method or job classification of >of ICMM matrix method.@*Conclusion@#When the concentration of occupational-disease-inductive factors is lower than 1/2 limit, the risk assessment results tend to be ICMM quantitative >composite index method >operation classification. When the occupational-disease-inductive factors were involved with triphenyl, the quantitative non-carcinogenic risk assessment method was more likely to reach the conclusion that the occupational health risk was unacceptable.

6.
Article in Chinese | WPRIM | ID: wpr-755092

ABSTRACT

Objective In order to investigate the clinical features and influence factors for incidence in patients with radiation-induced external auditory canal carcinoma (RIEACC).Methods The nasopharyngeal carcinoma (NPC) 16 patients who were diagnosised RIEACC after radiotherapy in the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from January 1990 to December 2017 were retrospectively analysis.The influence factors analysis were used Logistic regression analysis.Results Univariate analysis showed that age,somking history,family history of cancer and NPC stage were the influencing factors.Multi-factor logistic regression analysis showed that age,family history of cancer and NPC stage were independent risk factors.Conclusions RIEACC is rare complication of NPC patients received radiotherapy,which is also a multifactorial outcome.Age,family history of cancer and NPC stage is preliminary the main influencing factor.Although RIEACC has a low incidence,its malignancy should be highly vigilant.

7.
Article in Chinese | WPRIM | ID: wpr-805589

ABSTRACT

Objective@#To explore the impact of welding operations on the health status of workers with low working age, and provide a basis for occupational health risk assessment for workers of low working age.@*Methods@#Used the method of cluster sampling to randomly selected workers from an automobile manufacturing plant in Guangzhou as research subjects: 982 workers with welding posts of 1 year ≤working age ≤5 years were welding groups, 707 workers with simple exposure noise of 1 year ≤working age ≤5 years were assembly groups, and 717 workers in pre-job medical examinations were pre-job groups from June 2017 to September 2018. Then conducted occupational health checks on all subjects, investigated and detected the occupational hazards in welding posts and assembly posts.@*Results@#There was no statistical difference between the noise over-standard rate of welding posts' (59.3%, 16/27) and the assembly posts' (47.4%, 9/19) (P>0.05) . The over-standard rate of welding fume, manganese and its inorganic compounds in welding posts was 11.11% (3/27) . The results of occupational health examination showed that the detection rate of disease or abnormal of the welding group was 78.4% (770/982) higher than 70.2% (496/707) in the assembly group and 53.0% (380/717) in the pre-job group (the value of 2 were 14.92 and 122.37, respectively, P<0.05) . The rate of hearing loss of the assembly group and the welding group were 14.7% (104/707) and 19.3% (190/982) , respectively, which was higher than that of the pre-job group (10.5%, 75/717) , and the hearing loss rate gradually increased with the increase of working age (the value of linear-by-linear association were 12.04 and 44.67, respectively, P<0.01) . Compared with the hearing loss rate of each working age of the assembly group, the hearing loss rate of each working age of the welding group was higher, and when the working age was 3 years, the risk of hearing loss in the welding group was 2.70 times that of the assembly group (P<0.01) . The rate of pulmonary dysfunction in the welding group was 19.2% (189/982) higher than that in the pre-job group (12.6%, 90/717) , and it increased with the increase of working age (the value of linear-by-linear association was 15.97, P<0.01) .@*Conclusion@#Welding work seriously damages the health of workers with low working age, increases the hearing loss of workers and the occurrence of pulmonary dysfunction; manganese and its compounds increases noise-induced damage to the hearing system.

8.
Article in Chinese | WPRIM | ID: wpr-805355

ABSTRACT

Objective@#To explore the applicability of Singapore semi-quantitative assessment method and international committee on mining and metals occupational health risk assessment method in occupational health risk assessment of ceramic enterprises.@*Methods@#From March 2017 to May 2018, A ceramic enterprise was selected for the investigation and testing of occupational health, and the risk assessment of the occupational-disease-inductive factors in the workplace was conducted by the semi-quantitative assessment method of Singapore and the occupational health risk assessment method of the international committee on mining and metals.@*Results@#The occupational-disease-inductive factors in the production process of this ceramic enterprise mainly include silicon dust, noise, high temperature, carbon monoxide, carbon dioxide and so on. The two risk assessment methods were applied to assess the risk of occupational-disease-inductive factors in the workplace, and the results showed that the high risk level was 16.67%, the medium risk level was 63.33%, and the low risk level was 20.00%. The risk level of silicon dust is from low risk to high risk.@*Conclusion@#The semi-quantitative assessment method and the occupational health risk assessment method of the International Commission on Mining and Metals are simple to operate and practical, and are suitable for the assessment of occupational hazards in ceramic enterprises.

9.
Article in Chinese | WPRIM | ID: wpr-805354

ABSTRACT

An accident of mixed acute gas poisoning accident happened in a place in GuangDong in March 2018. To investigates three poisoning workers and related clinical data were summarized., we tested the field air and analyzed the accident reasons. This event due to the staff lack of occupational protection awareness and illegal operation. The working environment must be ventilated before limited space operation, and must be sure that the limited space is safe by toxic gas monitoring. In case of occupational acute gas poisoning, rescuers should help the persons who are poisoned reasonably and meanwhile their own safety.

10.
Article in Chinese | WPRIM | ID: wpr-805121

ABSTRACT

Objective@#To explore the applicability of semi-quantitative risk assessment methods in wood furniture manufacturing companies.@*Methods@#Two medium-sized wooden furniture manufactures were randomly selected as research objects, namely A company and B company. Used the Semi-Quantitative risk assessment method (the ratio method, the index method and the comprehensive method) in the "Guidelines for occupational health risk assessment of chemicals in the workplace" (GBZ/T 298-2017) to conduct occupational hygiene survey, occupational hazard factor testing and occupational health risk assessments for two wood furniture manufacturers from January to October 2018, and compared and analyzed the applicability of these three semi-quantitative risk assessment methods in wooden furniture manufacturing enterprises.@*Results@#The occupational health status of A enterprises was worse than that of B enterprises, and the occupational health risk level was higher than that of B enterprises, and the risk level of A enterprise is 3~4, and the risk level of B enterprise is 2~3. The occupational health risk level obtained by the index method was consistent with the comprehensive method, while the risk level of some occupational disease hazards used the ratio method was inconsistent with the results of the index method and the comprehensive method. Compared with the index method and the comprehensive method, when E/OEL<0.5 or E/OEL≥2, there might be a certain fluctuation in the occupational health risk level obtained by the ratio method.@*Conclusion@#The semi-quantitative risk assessment is more objective, comprehensive and flexible in the application of occupational health risk assessment, and can assess the occupational health risk level of chemical poisons in wood furniture manufacturing enterprises.

11.
Article in Chinese | WPRIM | ID: wpr-804934

ABSTRACT

Objective@#To analyze 8 cases of paraquat lung transplantation in the world, and to explore the timing of lung transplantation and the factors affecting prognosis.@*Methods@#An analysis of the clinical data of a paraquat poisoning lung transplant patient completed by The 12th People's Hospital of Guangzhou Medical University and The First People's Hospital affiliated to Guangzhou Medical University in August 2017 and literature review.@*Results@#A 26 years old female patient was admitted to the hospital ingested 20% paraquat solution 20ml. On the 58th day of poisoning, she underwent double lung transplantation under general anesthesia. The operation was successful. Excised lungs show extensive lung fibrosis in both lungs, which was consistent with paraquat poisoning. Used tacrolimus and corticosteroids and mycophenolate antirejection, the patient discharged 46 days after surgery. 7 articles were retrieved through the search tool, and a total of 8 articles included this case were reported. Five patients who underwent lung transplantation within 1 month after poisoning all died, And 3 patients conducted lung transplantation for more than 1 month after poisoning survived; Pathogenic bacteria were isolated from the sputum in 3 of the 8 cases, all containing Pseudomonas, 2 of which died, and our case survived.@*Conclusion@#Appropriate transplantation time window is very important for the prognosis of paraquat poisoning after lung transplantation. Active treatment of the sputum pathogens, improving the donor receptor matching, and exhausting the various means to remove the paraquat from the storage pool which may improve success rate of lung transplantation.

12.
Article in Chinese | WPRIM | ID: wpr-804930

ABSTRACT

Objective@#To learn about the cardiovascular health effects of workers expose to benzene-toluene-xylene and noise in painting workshop of automobile manufacturing enterprises, and to provide intervention measures and strategies for the health of workers.@*Methods@#The effects of noise exposure, benzene-toluene-xylene exposure and combined exposure on workers' blood pressure and electrocardiogram were analyzed through epidemiological investigation, workplace monitoring and occupational health examination in several automobile enterprises which had carried out occupational hazard factors monitoring and occupational health examination in our hospital from April to October 2017.@*Results@#There were differences in age, sex, working years, smoking, drinking and physical exercise among workers in different exposure groups (P<0.05) . The systolic blood pressure level of workers in benzene-toluene-xylene exposure group and combined exposure group was significantly different comparing with control group (P< 0.05) , After the factors of age and working years were adjusted. The abnormity rate of electrocardiogram in workers were not statistically significant in all groups (P>0.05) .@*Conclusion@#The benzene-toluene-xylene exposure and noise combined with benzene-toluene-xylene exposure in painting workshop of automobile manufacturing enterprises has positive influence on the systolic blood pressure of workers. Regular physical examination and health intervention measures should be strengthened to improve health.

13.
Article in Chinese | WPRIM | ID: wpr-804799

ABSTRACT

Objective@#To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in male welders in different work areas of shipbuilding industry based on their operational working position and body position characteristics and to analyze the operational positions and ergonomic loads.@*Methods@#In February 2017, 412 male welders from the hull and block work areas of a large ship factory were selected by stratified sampling. The prevalence and effects of WMSDs within a year were investigated using the Nordic Musculoskeletal Disorders Questionnaire, and a rapid exposure checklist was used to obtain the ergonomic load index by comprehensive scoring; the exposure-response relationship between the ergonomic loads and WMSDs symptoms of subjects in the hull and block work areas was evaluated.@*Results@#Among the male welders working in the hull work area of shipbuilding industry, WMSDs occurred more commonly in the neck, lower back/waist, and legs, accounting for 53.16% (126/237) , 51.90% (123/237) , and 41.77% (99/237) , respectively; among those working in the block work area, WMSDs occurred more commonly in the lower back/waist, wrist, and legs, accounting for 52.57% (92/175) , 49.14% (86/175) , and 45.14% (79/175) , respectively. There were significant differences in the distribution of cases of pain within the last 7 days and one month, pain lasting more than one month, or absence from work due to pain within a year in the four positions between the two work areas (P<0.05). In the hull work area, high and extremely high exposure levels were mainly seen in the neck, lower back/waist, and legs, accounting for 76.79%(182/237), 69.20%(164/237), and 59.49%(141/237), respectively; in the block work area, high and extremely high exposure levels were mainly seen in the lower back/waist, wrist, and legs, accounting for 77.71%(136/175), 50.29% (88/175), and 46.29% (81/175), respectively. The detection rates of WMSDs in these four positions significantly increased as the exposure levels rose (P<0.01).@*Conclusion@#The WMSDs of male welders working in the hull and block work areas of shipbuilding industry occurs more commonly in the lower back/waist and legs. The risk of WMSDs symptoms increases with the rise of ergonomic load.

14.
Article in Chinese | WPRIM | ID: wpr-804685

ABSTRACT

Objective@#To investigated the effect of long-term low-concentration mixed benzene exposure on peripheral blood of male workers.@*Methods@#A case-control study was conducted to select 452 male workers exposed to mixed benzene (benzene, toluene, xylene) for five consecutive years from January 2012 to December 2016 in an automobile manufacturer as case group, and 438 male administrative and logistic managers who underwent physical examination during the same period as control group. The peripheral blood of the two groups was tested and compared, and the occupational hazards in the workplace were detected.@*Results@#There were low dose exposure to mixed benzene in the enterprise, but the test results met the occupational exposure limit requirements. During the five years from 2010 to 2016, between the two groups of workers, the mean values of WBC, NEUT, RBC and Hb were statistically different (P<0.05). There was no statistical difference (P>0.05) in the mean value of PLT. The abnormal rate of main peripheral blood indexes in the control group was higher than that in the exposed group. There were significant differences in NEUT, RBC and Hb (P< 0.05), but no significant differences in WBC and PLT (P>0.05).@*Conclusion@#It can not be concluded that long-term low-concentration mixed benzene exposure can cause the change of peripheral blood index.

15.
China Occupational Medicine ; (6): 700-704, 2019.
Article in Chinese | WPRIM | ID: wpr-881846

ABSTRACT

OBJECTIVE: To explore the combined effect of noise and other occupational hazards on hearing impairment and electrocardiograph(ECG) of workers in automobile manufacturing enterprises. METHODS: A judgment sampling method was used to select 3 434 workers as study subjects from an automobile manufacture enterprise. According to the exposure to different types of occupational hazardous factors, they were divided into noise series group, noise dust group, noise welding dust group, noise benzene series group, noise nitrogen oxide group and control group, with 716, 693, 1 540, 45, 195 and 245 cases in each group, respectively. The subjects were examined with pure-tone hearing test and ECG. RESULTS: The total rate of high frequency hearing loss was 11.2%(385/3 434), and high frequency hearing loss was the main type of hearing loss among workers in each group. The simple high-frequency hearing loss rates of noise group, noise dust group, noise welding dust group, noise benzene series group, noise nitrogen oxide group and the control group were 10.3%, 11.5%, 12.3%, 26.7%, 10.3% and 4.1% respectively, and the rate of total hearing loss were 13.7%, 14.6%, 14.6%, 31.1%, 16.9% and 6.5% respectively. Compared with the control group, the rate of simple high-frequency hearing loss and total hearing loss were higher in the other 5 groups(P<0.005). The rate of high-frequency hearing loss in noise group was lower than that in noise benzene series group(P<0.005). The rate of arrhythmia was 20.9%(717/3 434). Arrhythmia was the main type of ECG abnormality in all groups. The rates of arrhythmia in noise group, noise dust group, noise welding dust group, noise benzene series group, noise nitrogen oxide group and control group were 16.9%, 16.6%, 27.9%, 17.8%, 13.8% and 6.9%, respectively. The rate of arrhythmia in noise welding dust group was higher than that in noise group(P<0.005). CONCLUSION: The combined effect of noise and benzene series increases the risk of high-frequency hearing loss in workers. The combined effect of noise and welding dust increases the risk of arrhythmia in workers.

16.
China Occupational Medicine ; (6): 412-416, 2019.
Article in Chinese | WPRIM | ID: wpr-881810

ABSTRACT

OBJECTIVE: To explore the effect of wearing earphone to listen to music on the high-frequency noise-induced hearing loss(NIHL) in noise-exposure workers. METHODS: A total of 651 male noise-exposure workers in an automobile manufacturer were selected as study subjects by using judgment sampling method. The level of noise exposure in the individuals and the pure tone hearing threshold were tested. According to the frequency of wearing earphone to listen to music after work, the subjects were divided into low-, medium-and high-frequency earphone-using groups, with 60, 436 and 155 workers in each group, respectively. The effects of wearing earphone to listen to music combined with occupational noise exposure on high-frequency NIHL were analyzed. RESULTS: The high-frequency NIHL detection rate of the study subjects was 31.3%(204/651). The detection rate of high-frequency NIHL in these three groups from low to high was low-, medium-and high-frequency earphone-using groups(P<0.01). The detection rate of high-frequency NIHL in the high-frequency earphone-using group was higher than that of the low-and medium-frequency earphone-using groups(43.2% vs 25.0%, 43.2% vs 28.0%, P<0.01). Multivariate logistic regression analysis showed that wearing earphones to listen to music was a risk factor for high-frequency NIHL in noise-exposure workers(P<0.01) after eliminating the influence of confounding factors such as age, length and level of noise-exposure, and wearing anti-noise ear plugs. The higher frequency of wearing earphone to listen to music, the higher risk of high-frequency NIHL. CONCLUSION: Wearing earphone to listen to music after work and occupational noise exposure had a synergistic effect on high-frequency NIHL in noise-exposure workers.

17.
China Occupational Medicine ; (6): 345-348, 2019.
Article in Chinese | WPRIM | ID: wpr-881803

ABSTRACT

OBJECTIVE: To explore the 2014 edition of the diagnostic criteria of occupational noise-induced deafness on the assessment of hearing loss in occupational health examination. METHODS: A total of 835 noise-exposed workers were selected as study subjects by cluster sampling method. The hearing threshold results were compared through two different editions of criteria: GBZ 49-2007 Diagnostic Criteria of Occupational Noise-induced Deafness( GBZ 49-2007) and GBZ 49-2014 Diagnosis of Occupational Boise-induced Deafness( GBZ 49-2014). RESULTS: The binaural high frequency threshold average calculated by GBZ 49-2007 was lower than that of GBZ 49-2014 [( 46. 8 ± 8. 1) vs( 49. 2 ± 8. 0) d B,P < 0. 01].The speech frequency threshold average of the good ear calculated by GBZ 49-2007 was lower than the monaural threshold of weighted value of the good ear of GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 22. 0 ± 3. 3),P < 0. 01]. The speech frequency threshold average of the good ear and the monaural threshold of weighted value of the good ear calculated after age and sex correction using GBZ 49-2007 were lower than that calculated by using GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 19. 4 ± 3. 6),( 21. 5 ±3. 4) vs( 22.0 ±3.3),P <0.05]. The detection rate of suspected occupational noise-induced deafness GBZ 49-2014 was higher than that of GBZ 49-2007( 6. 35% vs 2. 87%,P < 0. 01). CONCLUSION: In occupational health examination,the diagnostic criteria of GBZ 49-2014 can diagnose patients as suspected occupational noise-induced deafness easier than that of GBZ 49-2007.

18.
China Occupational Medicine ; (6): 203-207, 2019.
Article in Chinese | WPRIM | ID: wpr-881779

ABSTRACT

OBJECTIVE: To analyze the clinical features, diagnosis and treatment of acute poisoning caused by colchicine. METHODS: The clinical data of 3 cases of acute colchicine poisoning were retrospectively analyzed. RESULTS: All the 3 cases had a clear history of colchicine overdose, at the doses of 30.0, 50.0 and 58.5 mg. These 3 cases had different degree of gastrointestinal symptoms, bone marrow restrain, rhabdomyolysis, myocardial damage and liver damage. After treatment, case 1 and case 2 were discharged. Case 3 had a long history of oral intake of colchicine. Severe metabolic acidosis and abnormal coagulation function occurred in the early stage, and the condition was dangerous. Despite active rescue treatments including blood purification, glucocorticoid, coagulation factors, liver pretection, heart protection and water electrolyte correction, death could not be prevented after taking colchicine 89 hours later.CONCLUSION: There is no specific antidote for colchicine poisoning. The prognosis is poor if there is severe metabolic acidosis and abnormal blood coagulation in early stage.

19.
China Occupational Medicine ; (6): 28-33, 2019.
Article in Chinese | WPRIM | ID: wpr-881751

ABSTRACT

OBJECTIVE: To establish the occupational exposure limits for methyl t-butyl ether(MTBE) in the air of workplace in China. METHODS: According to the GBZ/T 210.1-2008 Guide for Establishing Occupational Health Standards--Part 1: Occupational Exposure Limits for Airborne Chemicals in the Workplace, we collected and analyzed data on physical and chemical properties, toxicology, occupational epidemiology and foreign occupational exposure limits related to MTBE by literature search. A total of 180 occupational workers exposed to MTBE were selected as exposure group, and 155 workers and administrative logistics personnel without exposure to MTBE were selected as the control group. Occupational hygiene investigation and occupational physical examination were carried out. We deduced the occupational exposure limits for MTBE in workplace air in China by combining literature data. RESULTS: The time-weighted average(TWA) of MTBE in the workplace air developed by the United States of America and Britain is 180.00 mg/m~3. The short-term exposure limit(STEL) of MTBE in the workplace air developed by Australia and New Zealand is 270.00 mg/m~3. The concentration of TWA(C_(TWA)) of MTBE in the exposure group was less than 0.08-4.90 mg/m~3. The concentration of short term exposure was less than 0.10-14.28 mg/m~3, and the C_(TWA) was less than 0.02-83.66 mg/m~3, in parts of workplaces. There was no statistically significant difference on the self-conscious discomfort and the abnormality in physical examination between these two groups(P>0.05). CONCLUSION: It's recommended that the permissible concentration-TWA of MTBE should be set at 180.00 mg/m~3, and the permissible concentration-STEL should be set at 270.00 mg/m~3 in China.

20.
China Occupational Medicine ; (6): 22-33, 2019.
Article in Chinese | WPRIM | ID: wpr-881750

ABSTRACT

OBJECTIVE: To observe the status of protein kinase B(Akt) signaling pathway in Akt phosphorylation induced by free silica(SiO_2) in mouse monocyte macrophage cell RAW264.7, and the role of Akt signaling pathway in early inflammatory response of silicosis. METHODS: i) RAW264.7 cells were routinely cultured and divided into SiO_2 stimulation groups at 5 different time points, and were stimulated for 15, 30, 60, 120 and 240 minutes with SiO_2 suspension with a final concentration of 100 mg/L, and a control group without SiO_2 treatment. At the end of treatment, the cells were collected and the expression of phospho-(Ser/Thr) Akt(p-Akt) was detected by Western blotting to select the optimal time of treatment. ii) RAW264.7 cells were divided into control group(no treatment), SiO_2 exposure group(previous concentration of 100 mg/L SiO_2 suspension) and intervention group(pre-treated with Akt activation inhibitor deguelin for one hour and then treated with 100 mg/L SiO_2 suspension), samples were collected after incubation for 60 minutes. The p-Akt expression and distribution in cells were detected by cellular immunofluorescence assay, the relative expression of p-Akt in cells was detected by Western blotting, and the levels of tumor necrosis factor-α(TNF-α) and transforming growth factor-β1(TGF-β1) in the supernatant of cells were detected by enzyme-linked immunosorbent assay. RESULTS: i) The optimal treatment time of RAW264.7 cells for SiO_2 exposure model was 60 minutes in vitro. ii) The results of cellular immunofluorescence assay showed that Akt phosphorylation was activated in RAW264.7 cells after stimulant with SiO_2, and the fluorescence of p-Akt was enhanced in the SiO_2 exposure group than the control group, and in the intervention group it was relatively weaker than the SiO_2 exposure group. The relative expression of p-Akt as well as the levels of TNF-α and TGF-β1 in the SiO_2 exposure group and the intervention group were higher than that in the control group(P<0.05), and the above three idexes in the intervention group were lower than the SiO_2 exposure group(P<0.05). CONCLUSION: Akt signaling pathway is involved in the process of SiO_2-induced macrophages phosphorylation, and participates in the early inflammatory response of silicosis.

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