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Early diagnosis of pulmonary diseases is of great significance for their prevention and treatment. Serum Krebs von den Lungen-6 (KL-6) assay can reflect the damage degree of alveolar epithelium and stromal tissue, and is simple, non-invasive and low-cost. Pervious study showed that the serum KL-6 level was higher in patients with various interstitial lung diseases (e.g. idiopathic pulmonary fibrosis and connective tissue disease, primary Sjögren's syndrome, rheumatoid arthritis, idiopathic inflammatory myopathy and systemic sclerosis combined with interstitial lung disease), non-small cell lung cancer, various pneumonias and chronic obstructive pulmonary disease compared to healthy controls. Therefore, serum KL-6 has good sensitivity and specificity for the early diagnosis of these diseases. Occupational pneumoconiosis is an interstitial lung disease with a well-established etiology. Pervious study has shown that serum KL-6 level was higher in patients with occupational silicosis, occupational asbestosis, and dust-exposed workers compared to healthy controls. However, due to the limited sample size and the inconsistent findings on different studies, further research is needed to study the role of serum KL-6 in the early diagnosis of pneumoconiosis. Future studies should increase the sample size, improve the detection methods for serum KL-6, explore its feasibility as an early diagnostic biomarker for occupational pulmonary diseases, and investigate the efficacy andvalue of its combined application with other biomarkers in the early diagnosis of various pulmonary diseases, including occupational lung diseases, to fully exploit its predictive role in pulmonary diseases.
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Objective: To analyze the status of occupational medical examination (OME) institutions in Guangdong Province and the critical control points affecting their future development. Methods: A total of 211 OME institutions registered in Guangdong Province were selected as the research subjects. Their current statue was investigated, and the risk assessment of their future development was carried out based on hazard analysis and critical control point theory. Results: The OME institutions were mainly concentrated in the Pearl River Delta, accounting for 72.0%. The public and private medical and health institutions accounted for 70.6% and 29.4% respectively. The filing rates of different OME categories from high to low in the order were physical factors, chemical factors, dust, other, radiation factors, biological factors (P<0.01), and the filing rates were 89.6%, 88.6%, 84.8%, 63.0%, 7.1% and 1.0%, respectively. The rates of excellence in the field assessment from high to low in the order were hearing atlas analysis personnel, lung function examination operators, chest film reading personnel, chief examination physician, technical director, quality director (P<0.01), and the rates of excellence were 49.4%, 26.2%, 20.6%, 10.8%, 8.2% and 4.6%, respectively. A total of 37 institutions did not submit OME information, of which 23 institutions did not carry out OME work after filing. The required diagnosis rate and confirmed diagnosis rate of suspected occupational diseases in 2020 were 34.3% and 55.3%, respectively. In 2021, the detection rate of suspected occupational diseases was only 1.1‰. Among the institutions with biological monitoring records, 64.1% did not participate in external quality assessment program in laboratory, and the unqualified rate of 38 participating institutions was 55.3%. The risk assessment results show that the future development of OME institutions needs to focus on private institutions, institutions that have not reported OME information, institutions that have missed diagnosis and missed reporting of suspected occupational diseases, institutions that have not participated in external quality assessment program in laboratory and core personnel such as quality managers, technical leaders, and main inspection physicians. Conclusion: OME institutions in Guangdong Province show the characteristics of centralized filing category, centralized filing region and centralized filing institution nature. Combined with the potential risks of OME institutional capacity building, it is necessary to implement classified management, strengthen information construction, supervision and management, implement post responsibilities, and promote the high-quality development of OME institutions.
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Objective To analyze the distribution features of newly reported cases of occupational welder′s pneumoconiosis (OWP) in Guangdong Province from 2013 to 2022. Methods Data of newly reported cases of OWP from National Occupational Disease Network Direct Reporting System of Guangdong Province from 2013 to 2022 was analyzed using conventional data analyzing Methods. Results A total of 294 cases of OWP were reported in Guangdong Province from 2013 to 2022 with an overall downward trend. The average age at diagnosis for new OWP cases was 44±6 years old, and the median of dust exposure duration was 11 years. Males accounted for 99.3% of the cases, and 94.2% of the cases were phase Ⅰ OWP. Guangzhou City had the highest regional distribution with 74.8% of the cases. The industry distribution was mainly manufacturing, accounting for 86.7% of the cases. The scale of enterprises was most common in small enterprises, followed by large and medium-sized enterprises, accounting for 38.4%, 30.6% and 24.5% of the cases respectively. The economic types of enterprises were mostly private enterprises, followed by state-owned enterprises, accounting for 54.1% and 32.0% of the cases respectively. Conclusion In Guangdong Province, the newly reported OWP cases were clustered in terms of disease stage, regional distribution, industry, enterprise scale and enterprise economic type. There was a tendency of younger age at diagnosis and shorter dust exposure duration.
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Objective To analyze the timeline of occupational disease online reporting and reviewing in Guangdong Province from 2014 to 2022. Methods Data and review information from the Occupational Diseases and Hazards Monitoring Information System under China Disease Prevention and Control Information System were collected to analyze the reporting timeline, review status, and timeline of review of "Occupational Disease Report Cards" for the years 2014 to 2022 in enterprises located in Guangdong Province. Results A total of 9 929 occupational disease report cards were recorded in Guangdong Province from 2014 to 2022, and the timely reporting rate of occupational diseases was 84.10%, with an overall upward trend. There was a statistically significant difference in the reporting time among different years (P<0.05), and the reporting time showed a downward trend. In 2022, the timely reporting rate of all cities reached over 80.00%. The final review rate of occupational disease report cards was 85.02%, and the review rate and timely review rate at the county level showed an increasing trend. The occupational disease report card audit timeliness rate from high to low was provincial, district county and city level (61.26% vs 43.87% vs 36.72%, all P<0.05). Conclusion The timeline of occupational disease reporting in Guangdong Province is relatively high, and the review at all levels is generally good. However, further improvement is needed for timely review at the municipal and county levels.
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Objective To detect and analyze the susceptibility genes of methyl acetate poisoning in patients by whole exome sequencing. Methods Two patients with occupational acute severe methyl acetate poisoning and their first-degree relatives who work in the same occupation and position with similar working hours were selected as the research subjects by judgment sampling method. Peripheral blood was collected for whole exome sequencing. The sequencing data was compared with the public genome database to screen the mutation sites and find out the gene sites related to methyl acetate poisoning. The suspected pathogenic mutation genes were annotated and interpreted. Results The results of whole exome sequencing showed that there were 40 differential genes between the patients with methyl acetate poisoning and their first-degree relatives, including 80 single nucleotide polymorphisms and eight Indel with specific marker sequence index. Among these, the genes with strong correlation were carboxyesterase 1 (CES1) and mucin (MUC) 5B. The CES1 gene loci c.248C>T (p.Ser83Leu) heterozygous mutations, MUC5B gene loci c.6635C>T (p.Thr2212Met) and c.7685C>T (p.Thr2562Met) heterozygous mutations in patients with methyl acetate poisoning were detected. They were missense mutations. By constructing a protein-protein interaction network, a total of 11 pairs of interactions with high levels of evidence were identified, involving genes such as lysine methyltransferase 2C, HECT and RLD domains containing E3 ubiquitin protein ligase 2, neutrophil cytoplasmic factor 1, nicotinamide adenine dinucleotide phosphate oxidase 3, C-terminal binding protein 2, zinc finger protein 717, FSHD region gene 2 family member C, FSHD region gene 1, MUC4, MUC6, MUC5B, and MUC12. Conclusion The polymorphism of CES1 and MUC5B genes may be related to the occurrence and development of methyl acetate poisoning in patients.
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Objective To analyze the epidemiological characteristics of occupational diseases caused by physical factors in Guangdong Province from 2013 to 2022, and to evaluate the key risk points of its incidence. Methods The data of newly diagnosed and suspected occupational diseases caused by physical factors in Guangdong Province from 2013 to 2022 were collected from the Occupational Diseases and Hazards Monitoring Information System under China Disease Prevention and Control Information System, and were analyzed retrospectively. The key risk points of occupational diseases caused by physical factors were evaluated. Results A total of 661 cases of occupational diseases caused by physical factors were reported in Guangdong Province from 2013 to 2022, showing an overall increasing trend, with an average annual growth rate of 29.6%. The major occupational diseases caused by physical factors were occupational hand-arm vibration disease and occupational heat stroke, accounting for 59.5% and 39.6%, respectively. The nine prefecture-level cities of Pearl River Delta region accounted for 98.5% of the new cases. The cases were distributed mainly in the manufacturing industry (77.0% of the cases). A total of 294 enterprises were involved in the analysis of newly diagnosed occupational diseases caused by physical factors. Occupational hand-arm vibration cases appeared to be significantly aggregated in specific enterprises, and other disease cases were mostly sporadic. The types of enterprise registration were mainly Hong Kong-, Macao-, and Taiwan-invested enterprises and domestic-funded enterprises, accounting for 53.1% and 41.4%, respectively. In terms of enterprise size, large-scale and small-scale enterprises accounted for 56.5% and 21.4% of cases, respectively. A total of 27.4% of workers with occupational diseases caused by physical factors were identified as suspected occupational diseases before be diagnosed as occupational diseases, all of which were hand vibration disease and heat stroke In the future, attention should be paid to the risks of mass events of occupational hand-arm vibration disease, outbreaks of occupational heat stroke, and missed diagnosis of suspected occupational hand-arm vibration disease. Conclusion Among all occupational diseases caused by physical factors in Guangdong Province, attention should be paid on occupational hand-arm vibration disease and occupational heat stroke. Occupational hand-arm vibration disease has a high risk of group morbidity. Construction workers and sanitation workers have a high potential risk of occupational heat stroke.
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Objective To explore the beneficial effects and mechanisms of neutrophil elastase (NE) and myeloperoxidase (MPO) on lead-induced hepatic inflammation in mice. Methods The specific pathogen free male C57BL/6 mice were randomly divided into four groups: control group, lead-exposed group, NE inhibitor group, and MPO inhibitor group, with three mice in each group. The mice in lead-exposed group, NE inhibitor group, and MPO inhibitor group were intraperitoneally injected with a dose of 10 mg/kg body mass of lead acetate solution, while the mice of control group received an equal volume of 0.9% saline three times per week for four weeks. In the last seven days, mice in both inhibitor groups were intraperitoneally injected with a dose of 40 mg/kg NE inhibitor sivelestat sodium or MPO inhibitor 4-aminobenzoic acid hydrazide (4-ABAH) once per day. Mouse body weight and liver histopathological changes were observed. The mRNA expression of genes associated with inflammation, such as tumor necrosis factor-α (Tnfa), interleukin-1β (Il1b), interleukin-6 (Il6), and nucleotide-binding oligomerization domain-like receptor protein 3(Nlrp3), apoptosis-associated speck-like protein (Asc) and cysteinyl aspartate specific proteinase (Caspase1) in the mouse liver tissues was detected by real-time quantitative polymerase chain reaction. The protein expression of NLRP3, ASC, and CASPASE-1 was detected using Western blotting. Results The activities of mice in all four groups were generally normal, and there was no significant difference in body weight (P>0.05). The results of hematoxylin-eosin staining showed that the cell size of hepatocytes varied in the lead-exposed mice, with indistinct cell boundaries, indicating early inflammatory responses in liver tissues. After intervention with NE or MPO inhibitors, the early inflammatory responses improved in the liver tissues of the mice in both inhibitor groups, with a better improvement observed in MPO inhibitor group compared with the NE inhibitor group. The mRNA expression of Tnfa, Il1b, Il6, Nlrp3, Asc, and Caspase1, as well as the protein expression of ASC, and CASPASE-1 in the livers of mice in the lead-exposed group was higher compared with those in the control group (all P<0.05). Compared with the lead-exposed group, the relative mRNA expression of Tnfa, Il1b, Il6, Nlrp3 and Asc was decreased in the liver tissues of mice in the NE inhibitor group (all P<0.05), while the relative expression of mRNA of Tnfa, Il1b, Il6, Caspase1 and the protein expression of ASC and CASPASE-1 were decreased in the liver tissues of mice in the MPO inhibitor group (all P<0.05). Conclusion Lead induce hepatic inflammation in mice by activating NLRP3 inflammasome. The inhibition of NE or MPO improve the lead-induced hepatic inflammatory responses in mice by alleviating NLRP3 inflammasome activation.
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OBJECTIVE: To develop a radioactive sewage purification device that can effectively filter the nuclides in low-level nuclide-contaminated wastewater. METHODS: The radioactive sewage purification device was composed of lifting pump, stack filter, multi-medium filter, security filter, tubular ultrafiltration membrane, high-pressure pump and reverse osmotic membrane. The combined process of adsorption-ultrafiltration-reverse osmosis was used to separate radioactive elements from wastewater by reverse osmosis membrane separation system. Through two-stage multi-medium filter circulation system circulation treatment, radioactive sewage was purified. The flow rate of water treatment is 20 L/min. The filtration efficiency and purification efficiency of the device were tested by filtration experiments on elements containing radionuclide and purification experiments on radionuclide.RESULTS: The filtration efficiency on iodine, potassium, strontium and cesium, that are the common elements in radioactive sewage samples were 97.88%, 98.38%, 99.99% and 99.80%, respectively. The single purification efficiency of radionuclide ~(40)K in low-level radioactive sewage was over 90.00%. CONCLUSION: The device has high filtering efficiency for common elements such as iodine, potassium, strontium and cesium in sewage and high removal rate of radioactive activity for sewage containing ~(40)K. It can be further optimized and transformed into a suitable radioactive sewage water purifier.
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OBJECTIVE: To understand the long-term prognosis of patients with occupational medicamentosa-like dermatitis induced by trichloroethylene( OMDT) after recovery. METHODS: A total of 185 patients with OMDT were surveyed through landline and correspondence after recovery. Based on the individual's wishes,19 patients( follow-up examination group)were followed up and arranged for health examination in hospital. RESULTS: Seventy-one cases of OMDT was successfully follow-up. The success rate was 38. 4%( 71/185). Among the 71 cases who were successfully followed up,64. 8%( 46/71)cases complained of physical discomfort. The main complain included skin itching,allergy,upper respiratory tract infection or frequent fever,xerophthalmus,osteonecrosis of femoral head. The 19 cases in the follow-up examination group had different degrees of skin itching,dryness and mild melanosis. The abnormal rates of schirmer I test were 42. 1%( 8/19)and 52. 6%( 10/19) in the left and right eye,respectively. The abnormal rate of tear break-up time in both left and right eyes was 84. 2%( 16/19). The highest positive rate of patch test was chloral hydrate( 100. 0%). There was no abnormality in body temperature,superficial lymph nodes,blood routine,urine routine,liver function and autoimmunity antibody. There was no new rash. CONCLUSION: Different degree of long-term prognosis can occur in OMDT recovery patients. Xerophthalmus and osteonecrosis of femoral head are the major sequelae. Chloral hydrate,which is the main metabolite of trichloroethylene,may be the causative culprit compound for OMDT.
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OBJECTIVE: To analyze the epidemiologic characteristics of occupational medicamentosa-like dermatitis induced by trichloroethylene( OMDT) in Guangdong Province. METHODS: The data of OMDT cases diagnosed by Guangdong occupational disease diagnosis institutions from 1988 to 2016 was collected and analyzed. The data of OMDT come from medical records,the National Occupational Disease Network Reporting System and literature retrieval. RESULTS: A total of 475 cases of OMDT were diagnosed in Guangdong Province during 1988 to 2016. The recovery rate was 91. 4%( 434/475),and the fatality rate was 8. 6%( 41/475). All cases had a clear history of trichloroethylene( TCE) exposure and had not been exposed to TCE prior to the present exposure. The median incubation period was 30 days. The exceeding standard rate of TCE time weighted average concentration was 80. 7%( 171/212),and the exceeding standard rate of urine trichloroacetic acid was 75. 0%( 123/164). The years that have most OMDT cases were from 1999 to 2006,which accounted for 64. 0%( 304/475); but there was no seasonal aggregation. The enterprises of OMDT cases concentrated in the Pearl River Delta Region,with Shenzhen City and Dongguan City accounting for 62. 9%. The median age of onset was22 years old,81. 9% of cases were 30 years old or below. The male-female ratio was 1. 2 ∶ 1. 0; 57. 7%( 274/475) cases were from southern China. Meanwhile,95. 4%( 453/475) of the cases came from the manufacturing industry such as electronics factory,hardware factory,electroplating factory and others. CONCLUSION: The distribution of OMDT cases on area,age of onset,native place and occupation in Guangdong Province showed a certain aggregation.
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OBJECTIVE: To analyze the distribution of network reported suspected occupational diseases( SOD),and the follow-up of confirmed diagnosis of occupational diseases in Guangdong Province from 2014 to 2017. METHODS: In July2018,the SOD cases reported from 2014 to 2017 in the direct network of Guangdong Province were collected as study subjects through the Suspected Occupational Diseases Report Card,Occupational Disease Report Card and Pneumoconiosis Report Card from the subsystem of National Information Surveillance System for Occupational Disease and Occupational Health. And the institutions for occupational disease diagnosis were asked to collect related data of applying for diagnosis and to investigate the final confirmed diagnostic status through the report cards of occupational diseases and pneumoconiosis. RESULTS: A total of 10 155 SOD cases were reported in Guangdong Province from 2014 to 2017,with an average annual growth rate of 62. 2% and an increasing trend year by year. The top three SOD were: suspected occupational otorhinolaryngological oral diseases( 58. 9%), particularly the suspected occupational noise deafness( 99. 9%); suspected occupational chronic chemical poisoning( 24. 6%),particularly suspected occupational chronic benzene poisoning( 88. 4%); and suspected occupational pneumoconiosis( 12. 8%). In total,there were 3 514 SOD cases applying for occupational diseases diagnosis,and the appication rate was 34. 6%. The final confirmed diagnosis rate was 59. 5%( 2 090/3 514). The application rate of occupational otorhinolaryngological oral diseases,occupational chronic chemical poisoning,occupational pneumoconiosis was 33. 8%,31. 3% and 35. 7%,while the final confirmed diagnosis rate was 54. 0%,49. 9% and 89. 5%. The application rate and the final confirmed diagnosis rate were the highest in the occupational disease prevention and treatment institutions, with the rate of 58. 1% and 70. 2% respectively. The application rate and the final confirmed diagnosis rate from occupational health examination were lower than those from occupational disease diagnosis institution,outpatient department and hospitalization( P < 0. 005). CONCLUSION: There is a rapid increasing trend of SOD in Guangdong Province from 2014 to 2017,but the confirmed diagnosis rate is low.
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OBJECTIVE: To screen the allergens of trichloroethylene-induced occupational medicamentosa-like dermatitis( OMDT) by patch test,and explore methods for OMDT auxiliary diagnosis and trichloroethylene( TCE) allergic population screening. METHODS: A total of 20 subjects diagnosed with OMDT were selected as case group,and 22 nonOMDT healthy workers exposed to TCE≥12 weeks were selected as control group. Different concentrations of TCE and its main metabolites such as chloral hydrate( CH),trichloroethanol( TCOH) and trichloroacetic acid( TCA) were used as allergens in a skin patch test in workers of these two groups. Another 20 new workers exposed to TCE < 12 weeks without OMDT were tested as validation group. They were tested with a patch test at a mass fraction of 15. 00% CH and follow-up observations were performed until 12 weeks of TCE exposure. RESULTS: The patch test of TCE,CH,TCOH and TCA were negative in the control group. In the case group,the patch test positive rate for 50. 00% TCE was 10. 00%,the patch tests were negative in 25. 00%,10. 00% and 5. 00% TCE. The CH patch test positive rate was 100. 00% with the CH mass concentrations of 15. 00%,10. 00% and 5. 00%. The TCOH patch test positive rates were 90. 00%,75. 00% and50. 00%,with the corresponding concentration of 5. 00%,0. 50% and 0. 05%. The TCA patch test positive rates were50. 00% and 0. 00% with the TCA concentrations of 5. 00% and 0. 50% respectively. When the mass concentration was5. 00%,the patch test positive rates in case group from high to low were CH,TCOH,TCA and TCE( P < 0. 01). And the patch test positive rates of CH and TCOH showed no statistical significant difference( P > 0. 05). The patch test positive rate of TCOH increased with increase of TCOH mass concentrations( P < 0. 01). The patch test positive rates for 5. 00%TCA was higher than that of 0. 50% TCA( P < 0. 01). The patch test positive rate in 0. 50% TCOH was higher than that of 0. 50% TCA( P < 0. 01). In the validation group,the patch test of 15. 00% CH was negative,and there was no OMDT case found during the follow-up 12 weeks of TCE exposure. CONCLUSION: The metabolites CH and TCOH of TCE may be the main allergens of OMDT after exposure to TCE. The CH and TCOH patch test can be an auxiliary diagnosis method for OMDT. The CH patch test could be used as a method for screening population allergic to TCE.
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OBJECTIVE: To explore the feasibility of using network system to carry out desktop health emergency response exercise for sudden poisoning incidents,and to understand the emergency response capability on sudden poisoning incident in Guangdong Province. METHODS: A chemical poisoning incident caused by drinking polluted water was simulated. Eight questions were designed in 4 sections including the emergency report,response,disposal and strain capacity to the emergency. A total of 10 teams from prefecture-level city in Guangdong Province answered through the desktop network exercise system designed by National Institute of Occupational Health and Poison Control. Meanwhile,the experts judged score using this system. RESULTS: Ten teams were familiar and adapted to the network system in a relatively short period of time. The scores of emergency report,response,disposal and strain capacity on emergency were(14. 9 ± 2. 3),(6. 0 ±2. 2),(20. 7 ± 4. 1) and(13. 2 ± 3. 5),respectively. The score rates of above 4 sections were(74. 5 ± 11. 5) %,(50. 4 ±18. 7) %,(43. 5 ± 8. 5) % and(66. 2 ± 17. 5) %,respectively. The score rate of emergency report was higher than that of response and disposal( P < 0. 05). The score rate of strain was higher than that of disposal( P < 0. 05). The total score of desktop exercises of the 10 teams was(55. 0 ± 8. 0),which was low on the whole. CONCLUSION: The network system can be used for desktop exercise for sudden poisoning incidents. There is a weak link in the health emergency response capacity of sudden poisoning incidents in Guangdong Province and the capability of emergency response and disposal should be strengthened.
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OBJECTIVE: To explore an objective evaluation mode for emergency response capacity on sudden poisoning incidents. METHODS: Based on the health emergency drills and blind design,22 teams in Guangdong Province were recruited to participate in the first round of evaluation,including blind sample analysis,theoretical examination( poisoning medical rescue,detection and investigation) and skills assessment( poisoning medical care,poisoning investigation,personal protection,poisoning detection and emergency decision-making). Then,the top 10 teams in the first round of evaluation were proceeded to desktop exercise in the second round of evaluation. The evaluation results were compared with the local gross domestic product( GDP) from 2011 to 2015 by Spearman rank correlation analysis. RESULTS: The median scores of the 4 sections were as follows: blind sample analysis was 71. 0,theoretical examination was 61. 4,skills assessment was 76. 5,and the desktop exercise was 55. 0. The rates of excellent for assessment of blind sample analysis,theoretical examination and skills assessment were 22. 7%,4. 5% and 0. 0%,while the failure rates were 31. 8%,45. 5% and 4. 5%,respectively. The rates of failure in medical rescue and investigation in theoretical examination were63. 6% and 50. 0%,the rates of failure in medical rescue and investigation in skills assessment were 40. 9% and 31. 8%,respectively. The middle-grade and passing rates of the top 10 teams in the desktop exercise were 10. 0%,and the failure rate was 80. 0%. There was a moderate positive correlation between the emergency response capacity for emergent poisoning and local GDP( Spearman rank correlation coefficient > 0. 700,P < 0. 05). CONCLUSION: The evaluation mode of emergency response capability assessment combined with actual combat and desktop emergency drill is established successfully. It can objectively test the assessment of emergency response capabilities.
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OBJECTIVE: To evaluate the ability of health emergency drill for sudden poisoning incidents in Guangdong Province. METHODS: A double-blinded method was used to organize 22 teams in Guangdong Province to conduct a health emergency drill which contained preliminary and repeated drill. The preliminaries contained blind sample analysis,theoretical examination and skills assessment. The repeated drills was desktop network exercise carried out for the teams ranked top 10 in the preliminaries. RESULTS: In the preliminary round,the median( M) of total score among the 22 teams was 72. 5. Among them,blind sample analysis,theoretical examination and skills assessment were 71. 0,61. 4 and 76. 5,respectively. The total score of skill assessment was higher than that of theoretical assessment( P < 0. 05). The passing rate of 22 teams was 68. 2%(15/22),and the failure rate was 31. 8%(7/22). The failing teams all came from the nonPearl River Delta region. The total preliminary scores,passing rate,the total scores of blind sample analysis and skills assessment of the teams in Pearl River Delta Region were higher than that in the non-Pearl River Delta region( P < 0. 01).In the theoretical examination,the scores of detection and investigation were both higher than that of medical rescue( P <0. 05). For the skills assessment,the scores of decision-making,personal protection and poisoning detection were in the top three,the scores of the medical rescue and investigation were relatively low( P < 0. 05). In the repeated round,the M of desktop exercise was 55. 0,passing rate was 20. 0%,and the failure rate was 80. 0%. CONCLUSION: The health emergency response capacity for sudden poisoning incidents in Guangdong Province needs to be improved. The construction of emergency response capacity for emergency poisoning in the non-Pearl River Delta region should be strengthened,especially the training on strengthening theoretical and practical knowledge of poisoning medical treatment and poisoning investigation.
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OBJECTIVE: To establish the clinical pathway of occupational medicamentosa-like dermatitis due to trichloroethylene(OMDT).METHODS: OMDT was selected as the clinical disease category.The diagnosis and treatment schemes of OMDT were determined and the clinical pathway was developed on the basis of evidence-based medicine,clinical data analysis,and the expert opinion as well as GBZ 185—2006 Diagnostic Criteria of Occupational Medicamentosa-like Dermatitis due to Trichloroethylene.The initial clinical validation was performed.RESULTS: We formulated the clinical pathway of OMDT for medical staffs,including standard hospitalization procedures(including normative use of glucocorticoids),Clinical Path Form,and Informed Consent for Glucocorticoid Therapy.The Clinical Pathway Notification of OMDT for patients or their family members was established.Based on the initial clinical verifications,the clinical pathway was conducive to optimize the medical process,none of the patients suffered from rebounds and complications,and the awareness of OMDT and satisfaction with treatments were improved.CONCLUSION: The clinical pathway for OMDT is scientific and reasonable,which is suitable for use to regulate medical behaviors.
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OBJECTIVE: To explore the retrospective problem of occupational disease diagnostic criteria,and to improve the correct application and the theoretic basis of legal norms of occupational disease diagnosis. METHODS: Based on the related theory and principle of laws retroaction,different retroaction and its advantages and disadvantages of the occupational disease diagnostic criteria were analyzed. The applicable methods of new and old occupational disease diagnostic criteria based on the current occupational disease diagnosis and appraisal system were discussed. RESULTS: The occupational disease diagnostic criteria are updated frequently,but there is a lack of clear specification on the application of the old and new criteria. There is misunderstanding in correct application of old and new occupational disease diagnostic criteria from the society,which could have great influence on occupational disease diagnosis and appraisal. The occupational disease diagnostic criteria are a part of laws and regulations and the essence of its correct application is the retroactive force of law.The non-retrospection of occupational disease diagnostic criteria might be against the reasonable protection of the rights of laborers' health. The retroactivity of occupational disease diagnostic criteria reflects the value orientation of social law,but at the same time it must comply with the provisions of laws,regulations or administration rules. CONCLUSION: Active occupational disease diagnostic criteria should be used in the process of occupational disease diagnosis,and occupational disease appraisal should use the criteria of diagnosis.
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OBJECTIVE: To explore the feasibility of dynamic observation and measurement of living silicosis rat model by using small animal positron emission tomography( PET)-computed tomography( CT). METHODS: Specific pathogens free SD rats were divided into model group and control group. The silicosis rat model was established by one-time endotracheal injection of 30 g/L silica suspension,while the control group rats were injected of isopyknic 0. 9% sodium chloride solution. Six rats from each group were randomly selected for CT scan from 1st,2nd,3rd,4th,6th,8th and 12 th week after silica injection using the small animal PET-CT. CT value and standardized uptake value( SUV) of18F-fluorodeoxyglucose were measured. Lung tissue was collected for pathological sections. The levels of hydroxyproline( HYP) of lung tissue and serum transforming growth factor β1( TGF-β1) and interleukin-1( IL-1) were measured.RESULTS: Pathological sections of rats of model group showed inflammatory exudation,inflammation reduced and fibrosis increased with extended time. The results are identical with findings in PET-CT. Lung SUV of rats in model group in the1st-3rd weeks were higher than that in control group in the same time point( P < 0. 05) and decreased by the increasing time during the 1st-4 th weeks of dust injection( P < 0. 05). Lung CT values of model group in the 1st-12 th weeks were higher than that of control group in the same 7 time points( P < 0. 05) and decreased in the 1st-6th weeks and then increased in the 6th-12th weeks by the increasing time of dust injection( P < 0. 05). Lung coefficients and HYP levels of model group in the 7 time points were higher than that of control group in the same 7 time points( P < 0. 05). Lung coefficients decreased in 1st-4th weeks and lung HYP levels increased in 6th-12th weeks with the increasing time of dust injection( P < 0. 05). Excepted of the 3rd and 4th weeks,serum TGF-β1 levels of model group in other 5 time-points were higher than that of control group in the same 5 time points( P < 0. 05) and decreased in the 1st-4th weeks( P < 0. 05)then increased in the 4th-8th weeks( P < 0. 05) by the increasing time of dust injection. Serum IL-1 levels of model group in the 1st-4th weeks were higher than that of control group in the same 4 time points( P < 0. 05) and decreased by the increasing time of dust injection( P < 0. 05) and decreased by the increasing time of dust injection( P < 0. 05).CONCLUSION: Early inflammation and terminal fibrosis of living silicosis rat model could be observed effectively by small animal PET-CT,which can be used as a new approach for dynamic tracing silicosis in rat models.
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<p><b>OBJECTIVE</b>To investigate the association between single nucleotide polymorphisms (SNPs) in glutathione peroxidase 1 (GPX-1) gene, rs3448, rs1050450, rs1800668, and rs1987628, and the susceptibility to noise-induced hearing loss (NIHL) among Chinese Han population.</p><p><b>METHODS</b>A case-control study was conducted to investigate the threshold shift of the left ear at 3000 Hz among the workers of Chinese Han population who were exposed to the same level of sound pressure. Two hundred and one (10%) of the subjects with the highest level of threshold shift were recruited in susceptible group, while 202 of (10%) of the subjects with the lowest level of threshold shift were recruited in tolerant group. Targeted occupational health survey and questionnaire survey were performed among these people. For each individual, genome DNA was extracted from 5 ml of fasting peripheral venous blood. Four SNPs (GPX-1 rs3448, rs1050450, rs1800668, and rs1987628) were genotyped by the TaqMan SNP genotyping kit. The main effects of SNPs and the association between NIHL susceptibility and SNPs were analyzed by logistic regression.</p><p><b>RESULTS</b>The C allele of rs1987628 was a risk factor for NIHL, with an odds ratio (OR) of 2.531 (95%CI: 1.878-3.411) as compared with the T allele. The CC genotype of rs1987628 was more associated with NIHL than the TT genotype (OR = 3.500, 95% CI: 1.984-6.174; adjusted OR = 3.544, 95% CI: 1.974 ∼ 6.364).</p><p><b>CONCLUSION</b>Among Chinese Han population, GPX-1 SNP rs1987628 may be associated with the susceptibility to NIHL.</p>