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Hepatocellular carcinoma (HCC) has an insidious onset, and most HCC patients have reached the intermediate-advanced stage when they were diagnosed, which lead to missing the opportunity for radical treatment and suffering a poor prognosis. Conversion therapy is an important tool to improve the prognosis of patients with unresectable HCC by creating resectable opportunities. With the new targeted agents, anti-vascular agents, immune agents and multi-dimensional treatment regimens bringing high objective response rate and long duration of remission in HCC treatment, conversion therapy has emerged as a hot spot in the clinical research of HCC. In the era of targeted therapy combined with immunotherapy, the connotation of conversion therapy for HCC continues to expand, with strategies constantly being updated. As such, conversion therapy for HCC has entered a rapid development period, but still faces many challenges. Combined with clinical experience and the latest research progress, based on the efficacy of systematic therapy with targeted combined immunotherapy as the core and combined local therapy in advanced HCC, the authors summarize the definition and expansion of conversion therapy and the conversion therapy strategies in oncology.
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Background The aging of the labor force has become a global trend, and various occupational activities can affect blood biochemical indexes and increase the risk of metabolic diseases. Elderly workers are the main laborers in the solar greenhouse industry, and their blood biochemical indexes need more attention. Objective The purpose of this study is to explore the alternation of selected blood biochemical indexes and provide clues for conducting management programs of metabolic diseases in the elderly solar greenhouse workers. Methods The research subjects of the greenhouse group and the non-greenhouse group were selected from a vegetable production base in Northwest China. The elderly workers were selected from a recruited subjects pool for an earlier project by means of matching and non-matching respectively. The matching conditions were gender (consistent), age (±2 years old), body mass index (BMI) (±1 kg·m−2), education level (±1 level), smoking (consistent), and drinking (consistent). Routine clinical tests were used to detect serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), fasting blood glucose (GLU), and albumin (ALB), and single-factor and multi-factor analyse were used to identify different indexes in matching and non-matching samples, respectively. The matching and the non-matching samples included 80 pairs of subjects and 327 subjects, respectively. Results In the matching sample set, the greenhouse group's HDLC [(1.61±0.34) mmol·L−1] was lower than the non-greenhouse group's [(2.09±0.37) mmol·L−1] (P<0.05), the level of TG/HDLC in the greenhouse group was (1.17±0.74), higher than that in the non-greenhouse group (0.78±0.47) (P<0.05), and the level of LDLC/HDLC in the greenhouse group was (1.87±0.36), also higher than that in the non-greenhouse group(P<0.05), while there was no statistical difference of the other indexes between the two groups (all Ps>0.05). In the non-matching sample set, the results of multiple linear regression analysis showed that solar greenhouse working correlated with decreased HDLC, and increased TG/HDLC and LDLC/HDLC among the elderly workers (all Ps<0.05). Conclusion Solar greenhouse working may correlate with variations of selected blood biochemical indexes in elderly workers, and the occupational health surveillance of elderly workers should be strengthened.
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Background As a new type of vegetable production method, solar greenhouse has been widely promoted nationwide. The influence of solar greenhouse working on blood lipid cannot be ignored. Objective The aim of the study is to explore the relationship between solar greenhouse working and blood lipid and family clustering. Methods A total of 744 solar greenhouse workers in northwestern China were selected as the greenhouse group, and 231 general open field farmers in the same area were selected as the non-greenhouse group. The levels of serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), and low-density lipoprotein cholesterol (LDLC) in the two groups were detected. Dyslipidemia was determined by a two-classification criteria in the national guideline of 2007. Multiple logistic regression model and multilevel multiple linear regression model were used to explore the relationship of blood lipid with solar greenhouse working, and its family clustering. Results The number of dyslipidemia cases in the greenhouse group and non-greenhouse group was 142 (19.1%) and 43 (18.6%), respectively, and the difference was not statistically significant (P>0.05). The results of multiple logistic regression analysis showed that increasing age (OR=1.019, 95% CI: 1.001-1.038) and increased BMI (OR=1.162, 95% CI: 1.106-1.220) were related to elevated risk of dyslipidemia (all Ps<0.05). The results of multilevel multiple linear regression model showed that the changes of TC, HDLC, and TG/HDLC had family clustering (b=0.238, 95%CI: 0.132-0.430; b=0.044, 95%CI: 0.033-0.065; b=1.003, 95%CI: 0.947-1.059) (all Ps<0.05). Conclusion Solar greenhouse working does not significantly increase the incidence of dyslipidemia, but the levels of TC, HDLC, and TG/HDLC levels in the solar greenhouse workers have family clusters.
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Background Due to long working time and complex and changeable lighting conditions, greenhouse workers' anisometropia is an issue of concern. Objective This study is conducted to evaluate the relationship between solar greenhouse working and anisometropia of workers. Methods Subjects of a solar greenhouse group and a non-greenhouse group in northwest area of China were selected. Questionnaire survey was used to collect general demographicinformation. Standard Logarithmic Visual Acuity Chart (GB 11533—2011) was used to measure naked eye vision before working, the absolute value of binocular visual acuity difference was calculated and converted into classification variables, and both anisometropia absolute value and classification variables of anisometropia were used as indicators to compare the difference of the two groups. A cumulative exposure index that multiplies exposure time and number of greenhouses was further introduced to evaluate cumulative exposure levels of the greenhouse workers and was used to divide them into low, medium, and high cumulative exposure subgroups. Generalized linear model and logistic regression model were used to analyze possible risk factors associated with anisometropia. Results A total of 1002 subjects were enrolled in this study, including 739 workers in the greenhouse group and 263 workers in the non-greenhouse group. The medians (interquartile intervals) of anisometropia of the greenhouse group and non-greenhouse group were 0.1 (0, 0.2) and 0 (0, 0.1) respectively, and the difference was statistically significant (P<0.05). The proportions of anisometropia=0, ≤0.2, and >0.2 in the greenhouse group were 34.2%, 55.2%, and 10.6%, respectively, and those in the non-greenhouse group were 58.2%, 34.6%, and 7.2%, respectively. The difference of anisometropia distribution between the two groups was statistically significant (P<0.05). According to the cumulative exposure index, the greenhouse group was divided into low, medium, and high cumulative exposure subgroups, with 154 (21.0%), 188 (25.6%), and 392 (53.4%) workers, respectively. There was no statistical significance in anisometropia among workers with different cumulative exposure levels (P>0.05). The results of multiple generalized linear analysis showed that greenhouse working was a risk factor of anisometropia (b=0.053, P<0.05), and the results of multiple logistic regression analysis showed that greenhouse working was associated with an increased risk of anisometropia (OR=2.586, 95%CI: 1.473-4.539). The results of multiple generalized linear analysis showed that medium exposure level increased the degree of anisometropia after adjusting age, gender, and other factors (b=0.054, P<0.05). Conclusion Solar greenhouse working may be a risk factor for increasing anisometropia in workers.
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Background In the process of greenhouse working, labor intensity is high and repetitive work involves multiple body parts such as limbs, neck, upper back, and lower back. The prevalence and comorbidity of work-related musculoskeletal disorders (WMSDs) in greenhouse workers are worthy of attention. Objective This study is conducted to investigate the prevalence and comorbidity, as well as potential influencing factors of WMSDs in greenhouse workers. Methods A total of 722 greenhouse workers were selected as the subjects for a cross-sectional epidemiological survey. Through questionnaire survey and physical examination, basic information of the subjects and the prevalence of WMSDs were collected. The participants were divided into low, medium, and high cumulative exposure groups by cumulative exposure index matrix. Chi-square test was used to analyze the difference of prevalence among different cumulative exposure levels, the correlation between the prevalence of WMSDs in paired sites was calculated as prevalence ratio (PR) by using the log-binomial model, the prevalence of multi-site WMSDs in each group was compared by Wilcoxon rank sum test, and the influencing factors of multi-site WMSDs were evaluated by multi-classification logistic regression model. Results The prevalence rate of WMSDs in the greenhouse workers was 78.7% (568/722). The main affected sites of body were lower back, legs, neck, and shoulders, and associated prevalence rates were 47.6%, 46.0%, 27.1%, and 23.8%, respectively. By constructing a cumulative exposure index matrix, the low, medium, and high cumulative exposure groups contained 121, 196, and 405 workers respectively. The prevalence rates of WMSDs in lower back, legs, or shoulders were significantly different among groups with different exposure levels (P<0.05), and the prevalence rates increased with higher cumulative exposure levels (lower back, \begin{document}${χ} _{{{\rm{trend}}}}
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Biomonitoring can be applied to assess internal exposure and environmental exposure by exposure markers with providing internal exposure to biological characterization and individual exposure information, which is a key tool to evaluate the risk exposure to disease by biological alternation information. With the development of high throughput, broad spectrum and high efficiency screening and detection technology, biomonitoring is defined as traditional biological monitoring (targeted monitoring) and non targeted monitoring analysis (exposomic approaches). An exposomic approach differs from traditional biomonitoring in that it can theoretically include all exposures of potential health significance, whether they are derived from exogenous sources. Both traditional and nontraditional biomonitoring methods should be used to understand the complexity of exposures faced throughout the lifespan. Through hybrid approaches, emerging techniques and the integration of bioinformatics, and developing the detection methods for low abundance chemicals, improving the differentiation ability between endogenous and exogenous chemical, the health outcomes and exposures can be widely recognized and characterized, which can finally contribute to improving the precise prevention and intervention for diseases under the new exposomic model.
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<p><b>OBJECTIVE</b>To investigate the characteristics of exposure to iron oxide nanoparticles in workplace.</p><p><b>METHODS</b>The real-time particle number (NC), surface area (SAC), and mass (MC) concentrations of nanoparticles were measured in various locations of a selected workplace manufacturing iron oxide nanoparticles. The collected particles were analyzed for morphology and elemental composition.</p><p><b>RESULTS</b>The average NCs and SACs in milling site (16,566 pt/cm3, 106.082 µm2/cm3), packaging site (12,386 pt/cm3, 89.861 µm2/cm3), shipping site (13,808 pt/cm3, 102.071 µm2/cm3), and product storage room (17,192 pt/cm, 115.044 µm2/cm3) of the yellow powder (α-Fe2O3 . nH2O) were all significantly higher than the workplace background concentrations (11,420 pt/cm3, 85.026 µm2/cm3) (all P<0.05). The NC was highly correlated with the SAC (r= 0.784), while both NC and SAC were loosely correlated with the MC (r1=0.323, r2=0.331). Scanning electron microscopy revealed a spindle-like shape of the iron oxide nanoparticle; the chemical composition of the collected particles contained 19.33 weight percent iron (Fe).</p><p><b>CONCLUSION</b>The milling site and product storage room of the yellow powder are exposed to a higher concentration of nanoparticles, which are mainly composed of iron oxide nanoparticles. The NC is highly correlated with the SAC.</p>
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Compuestos Férricos , Nanopartículas del Metal , Exposición Profesional , Lugar de TrabajoRESUMEN
<p><b>OBJECTIVE</b>To develop a method for determination of 2, 4-dichlorophenoxyacetic acid (2, 4-D) in the air of workplace by high-performance liquid chromatography.</p><p><b>METHODS</b>2, 4-D was collected by ultrafine glass filters, desorbed by methanol, separated by a C18 column, and detected by a UV detector. Identification and quantification of 2, 4-D were performed by retention time and peak areas, respectively.</p><p><b>RESULTS</b>The linear range of the test was 2∼200 µg/ml; the elution efficiency was 94.6%- 95.9%; the limit of detection (S/N = 3) was 0.034 µg/ml (injection volume of 20 µl eluant); the lower limit of quantification (S/N = 10) was 0.11 µg/ml; the minimum detectable concentration was 0.011 mg/m(3); the minimum quantifiable concentration was 0.037 mg/m(3) (with sampled air volume of 45 L).</p><p><b>CONCLUSION</b>This method is convenient and simple in sample collection and preparation, and satisfies all methodological requirements. Therefore, this method is useful for the determination of 2, 4-D in the air of workplace.</p>