Establishment of high-throughput liquid chromatography tandem mass spectrometry method for determination of 53 per- and polyfluoroalkyl substances in serum / 环境与职业医学

Background Per- and polyfluoroalkyl substances (PFAS) are a class of persistent organic pollutants that possess potential toxicity to the human body. The production and utilization of diverse emerging PFAS have resulted in widespread human exposure. Therefore, it is imperative to establish a quantitative methodology encompassing a wide range of PFAS for a comprehensive assessment of human exposure to these compounds. Objective To establish a high-throughput quantitative method for the simultaneous determination of 53 PFAS in human serum based on ultra-high-performance liquid chromatography-Q Exactive high resolution mass spectrometry (UPLC-Q Exactive HRMS). Methods The extraction recoveries of hydrophilic-lipophilic balance (HLB) column, weak anionexchange (WAX) column, and 96-well WAX μElution plate were compared to select the SPE column with the highest recovery. The retention time and peak shape of the target compounds were compared between ACQUITY UPLC BEH C18 column and Accucore aQ column, and the more cost-effective column was chosen. The effects of adding different levels of ammonium formate (0, 2, 5 and 10 mmol·L−1) in mobile phase on peak shape and target response were compared to determine the optimal buffer salt concentration. The optimal spray voltage was obtained by comparing −2 kV and −4 kV. The proposed method was validated from the aspects of selectivity, standard curve, limits of detection, precision, accuracy, and matrix effect. The method was applied to 142 umbilical serum samples. Results The best recovery rate (64%-118%) was achieved by using 96-well WAX μElution plate. The optimal separation and peak shape were obtained by utilizing Accucore aQ column with H2O-methanol (containing 5 mmol·L−1 ammonium formate) as the mobile phase. Less in-source collision and better target response were observed when the spray voltage was set to −2 kV. All target analytes had a good linearity, with R2 > 0.99. The limits of detection ranged from 0.01 to 0.50 μg·L−1, and the recovery ranged from 69% to 127% with the precision less than 26%. A total of 31 PFAS were detected in the 142 actual samples, among which 14 PFAS had a detection frequency over 50%. Perfluorooctanoic acid showed the highest median concentration of 4.16 μg·L−1, followed by 6:2 chlorinated polyfluorinated ether sulfonate and perfluorooctane sulfonates (3.50 μg·L−1 and 1.59 μg·L−1, respectively). Conclusion In this study, we establish a UPLC-Q Excative HRMS method for simutanious determination of 53 PFAS concentrations in serum. This method has the advantages of wide coverage of PFAS, good selectivity, and easy operation, and is suitable for biological detection with a large sample size.

Construction of an assessment tool for the effectiveness of internal performance management in public hospitals / 中华医院管理杂志

Objective:To design a set of assessment tool for the effectiveness of internal performance management in public hospitals, so as to provide reference for optimization hospital internal systems and multi-institutional comparison.Methods:From September 2022 to April 2023, literature review and expert group discussion were used to initially construct an index system for evaluating the effectiveness of performance management in public hospitals, based on the " structure-process-outcome" model. Index quantitative scoring rules and standardized staff questionnaire for supporting use were developed by drawing on the World Management Survey Hospital Edition and Chinese Hospital Management Survey. Two rounds of Delphi consultation were made to rate the importance and measurement feasibility of each index. The analytic hierarchy process was used to determine the relative importance of the finalized indexes. Results:The effective recovery rate of expert consultation questionnaire was 100%, and the authority coefficient was 0.882. The index system consisted of 3 first-level indexes (structure, process, and result), 9 second-level indexes, and 27 third-level indexes. The weights of structure, process and result were 0.307, 0.406 and 0.287, respectively. The second-level indexes with the highest weight were internal effectiveness, informationization, and performance tracking and evaluation, with values of 0.180, 0.156 and 0.115, respectively. The third-level indexes with the highest weight were the construction level of performance management information integration platform, the incentive degree of hospital performance management system to employees, and the scope of performance tracking and evaluation, with values of 0.156, 0.075 and 0.073. The third-level index quantitative scoring rules covered the management activity points that were easy to collect via investigation. Among them, the feasibility of 22 scoring rules were recognized by all the 15 experts, 5 rules were recognized by 14 experts, and 2 rules were recognized by 13 experts. A standardized survey questionnaire covering 25 questions was established based on four third-level indexes: the level of understanding, recognition, satisfaction, and motivation of employees towards the hospital performance management system. The importance scores of each question ranged from 7.43 to 8.71.Conclusions:This study developed a comprehensive suite of assessment instruments, including an index system, a set of quantitative scoring rules, and a standardized staff questionnaire, which could provide reference for hospitals to upgrade their internal performance management levels.

Associations between urinary paraben levels and obesity of 10-year-old children / 环境与职业医学

Background Parabens, a widely used class of preservatives, are suspected to be potential obesogens as emerging endocrine disrupting chemicals with reproductive and developmental toxicity. Objective To analyze five urinary parabens (PBs) and estimate the associations of exposure to PBs with adiposity measures in 10-year-old school-age children. Methods A total of 471 school-age children aged 10 years from the Sheyang Mini Birth Cohort were enrolled in this study. A questionnaire survey was conducted to collect socio-demographic information, physical activity, and dietary intake. Weight, height, and waist circumference of children were measured, and age- and sex-adjusted body mass index (BMI-Z score) was calculated. Spot urine samples were collected during the follow-up visits. Urinary concentrations of five PBs including methyl-paraben (MeP), ethyl-paraben (EtP), propyl-paraben (PrP), butyl-paraben (BuP), and benzyl-paraben (BzP) were detected by gas chromatography-tandem mass spectrometry (GC-MS/MS). Generalized linear models (GLMs) and Bayesian kernel machine regression (BKMR) models were applied to estimate associations of individual/overall urinary PBs concentrations with BMI Z-score and waist circumference. Results The positive rates of selected five urinary PBs were in the range from 78.98% to 98.94%. The urinary PBs concentrations (geometric mean) were in the range of 0.31-5.43 μg·L−1. The children's BMI Z-score and waist circumference (mean ± standard deviation) were (0.56±1.40) and (67.62±10.07) cm respectively. The GLMs results showed that the urinary BzP concentration was negatively associated with waist circumference (b=−0.08, 95%CI: −0.14, −0.02; P=0.01). In sex-stratified analysis, the urinary concentration of BzP was negatively associated with BMI-Z score (b=−0.59, 95%CI: −0.88, −0.30; P<0.001) and waist circumference (b=−0.80, 95%CI: −1.23, −0.37; P<0.001) in boys, but not in girls. The BKMR results also found significant negative correlations of urinary BzP concentrations with BMI-Z score and waist circumference, which were consistent with the GLM results. Conclusion The selected 10-year-old children are extensively exposed to PBs in the study area. Furthermore, childhood PBs exposure may have potential impacts on childhood adiposity measures with sex-specific effects.

The mediating effect of depression and anxiety between objective cognitive function and subjective memory in patients with epilepsy / 中华行为医学与脑科学杂志

Objective:To explore the relationship between objective cognitive function and subjective memory in patients with epilepsy and the mediating effect of depression and anxiety.Methods:A total of 123 patients with epilepsy were included, and their basic information and clinical data were collected. The quality of life in epilepsy inventory-89 memory subscale, Beck depression inventory Ⅱ, Beck anxiety scale and repeatable battery for the assessment of neuropsychological status were used to evaluate the subjective memory, depression, anxiety and objective cognitive function of patients with epilepsy. SPSS 25.0 software was used for bivariate correlation analysis and multiple regression analysis, and PROCESS V3.5 macro program was used for Bootstrap mediating effect test.Results:(1)Correlation analysis showed that the objective cognitive function score of patients with epilepsy was negatively correlated with depression score ( r=-0.392, P<0.01) and anxiety score ( r=-0.310, P<0.01), while positively correlated with subjective memory score ( r=0.388, P<0.01). Subjective memory score was significantly negatively correlated with depression score ( r=-0.436, P<0.01) and anxiety score ( r=-0.395, P<0.01). (2)The mediating effects analysis showed that objective cognitive function of patients with epilepsy could affect the subjective memory through the mediating effects of depression and anxiety indirectly. The mediating effect accounted for 33.87% and 17.93% of the total effects respectively. Conclusion:Objective cognitive function, depression and anxiety are closely related to subjective memory in patients with epilepsy. Depression and anxiety play a mediating role between objective cognitive function and subjective memory in patients with epilepsy.

Delayed central nervous system damage caused by chlorfenapyr-indoxacarb poisoning: a case report / 中华神经科杂志

Chlorfenapyr and indenocarb are two new insecticides widely used in the world. In recent years, there have been a few cases of human being being poisoned by chlorfenapyr or indenocarb respectively at home and abroad, but no cases of poisoning caused by chlorfenapyr or indenocarb have been reported. A case of delayed central nervous system damage after chlorfenapyr and indoxacarb poisoning was reported for clinical reference.

Establishment of a vimentin knockout and HIV-1 gp120 transgenic mouse model / 南方医科大学学报

OBJECTIVE@#To construct a HIV-1 gp120 transgenic mice (gp120 Tg) with vimentin (VIM) gene knockout.@*METHODS@#Female HIV-1 gp120 Tg mice were mated to VIM heterozygote mice (F0). All the offspring mice were derived from these original founders so that both genotypes had the same mixed genetic background. The F1 mice were bred to generate of VIM, VIM, VIM/gp120 Tg and VIM/gp120 Tg mice. PCR was performed for genotyping of the mice, and the expressions of VIM and gp120 in the brain tissues were examined using immunoblotting.@*RESULTS@#The results of PCR showed the presence of the target bands in VIM, VIM, VIM/gp120 Tg and VIM/gp120 Tg mice. In VIM/gp120 Tg mice, gp120 expression was detected throughout the brain regions while no VIM expression was detected.@*CONCLUSIONS@#We generated gp120 transgenic mouse models with VIM gene knockout, which facilitate the exploration of the role of VIM in gp120-induced neurotoxicity.

Oxidative stress and apoptosis of VX2 hepatocarcinoma after transcatheter arterial embolization in rabbit / 中国介入影像与治疗学

Objective: To observe the oxidative stress and apoptosis of paracancerous liver tissue after transcatheter arterial embolization (TAE) in rabbit models with VX2 hepatocarcinoma, in order to investigate the role of oxidative stress and apoptosis in liver tissue injury. Methods: Twenty-five rabbit VX2 hepatocarcinoma models were established and randomly divided into TAE group (n=13) and control group (n=12). TAE group was treated with TAE, while no treatment was performed on control group. Peripheral blood indexes, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBI), serum albumin (ALB) and prothrombin time (PT) were detected three days after operation in TAE group and the same time in control group. Then the experimental animals were killed, and the samples of tumor tissues and paracancerous liver tissues were obtained for histopathological examination, bioenzyme detection and apoptosis detection. The levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), Catalase (CAT) were detected by biochemical enzymatic assay. The apoptosis of hepatocytes was detected by using TUNEL method, and the apoptotic index (AI) was calculated. Results Compared with control group, ALT, AST and TBI increased, ALB decreased and PT prolonged, while SOD, GSH-PX, CAT decreased in TAE group (all P<0.001). Mild steatosis and inflammatory cell infiltration were observed in paracancerous liver tissue of TAE group, while only mild steatosis was observed in control group. AI of TAE group was significantly higher than that of control group ([64.20±2.77]% vs [2.20±1.90]%; t=-112.30, P<0.001). Conclusion: The decrease of liver function after TAE in rabbit VX2 hepatocarcinoma models maybe associate with the decrease of antioxidant activity and the oxidative stress which eventually lead to the increase of hepatocyte apoptosis.

Benign paroxysmal positional vertigo with multiple canal involvement / 中国耳鼻咽喉头颈外科

OBJECTIVE To describe the type, clinical features and curative effect of benign paroxysmal positional vertigo with multiple canal involvement. METHODS Retrospective analysis was performed on 1502 patients diagnosed with BPPV. Multiple canal BPPV was diagnosed by Dix-Hallpike and roll test, which showed combination of typical nystagmus during the examination, and was treated by means of canalith repositioning manoeuvre. RESULTS Among the 1502 patients, multiple canal BPPV was diagnosed in 162 patients(10.8％), 74 patients(45.7％) had horizontal and posterior canal, 48 patients(29.6％) had bilateral posterior canal, 20 patients (12.3％) had posterior and anterior canal, 10 patients(6.2％) had bilateral horizontal canal, 6 patients(3.7％) had horizontal and anterior canal, 4 patients(2.5％) had bilateral anterior canal. Multiple canal BPPV was more associated with head trauma, a longer duration of treatment and more repositioning times were required in multiple canal BPPV compared with single canal BPPV. CONCLUSION The horizontal and posterior canal was the most common in the multi-canal BPPV, the treatment of multi-canal BPPV can be effective by repositioning maneuver.

Comparison of PG-SGA, NRS 2002 and BIA in nutritional assessment and screening of patients with gynecologic cancers / 肠外与肠内营养

Objective:To evaluate the application of PG-SGA,NRS 2002 and BIA in nutritional assessment and screening of patients with gynecologic cancers.Methods:118 patients were randomly selected.Nutritional status were evaluated by PG-SGA,NRS 2002 and BIA,and consistency between each tools were compared.Results:The prevalence of malnutrition or nutritional risk of patients were 64.4％ (PG-SGA),57.6％ (NRS 2002),and 33.9％ (BIA) respectively.In all patients,the consistency of PG-SGA and NRS 2002 was high (P ＜ 0.001),while there were not significantly consistent between BIA and PG-SGA,or between BIA and NRS 2002 (P ＜ 0.001).Conclusion:According to the evaluation of PG-SGA or NRS 2002 in gynecologic patients,the prevalence of malnutrition or nutritional risk is high,and these two scales are suitable for nutritional assessment and screening of gynecologic cancer patients,especially in ovarian cancer patients.In addition,BIA may be a promising tool to evaluate cervical cancer patients' nutritional status.