Volatile organic compounds from second-hand smoke may increase susceptibility of children through oxidative stress damage.

Although humans are generally exposed to second-hand smoke (SHS), volatile organic compounds (VOCs) exposure derived from SHS and its health hazard to non-smokers are rarely investigated. Thus, we examined the effects of SHS on VOCs exposure and oxidative stress damage via a passive smoking simulation experiment in 6 children and 7 adults. To further validate the studied urinary VOC metabolites as biomarkers for passive smoking, 259 children were recruited. The levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG), malonaldehyde (MDA), trans-3'-hydroxycotinine (OH-Cot) and 31 VOC metabolites in urine were determined. The results showed that the geomean concentrations of 17 VOC metabolites in urine of children were 26.5%-138% higher than those of adults after passive smoking. The levels of urinary 8-OHdG, MDA and OH-Cot increased by 24.6%, 18.8% and 600% in children, but only 1.25%, 10.3% and 116% in adults, respectively. Therefore, children are more vulnerable to SHS than adults. After exposure to SHS, the levels of 8 urinary VOC metabolites of benzene, acrylonitrile, 1-bromopropane, propylene oxide, toluene, methyl methacrylate and cyanide increased by 60.9%-538% within 23 h. These 8 VOC metabolites were also significantly associated with 8-OHdG or MDA in urine (p < 0.01). Therefore, exposure to VOCs caused by SHS increases body oxidative stress damage. OH-Cot level higher than 2.00 µg/g Cr can be used as a threshold of passive smoking. The levels of urinary s-benzylmercapturic acid (BMA) and s-phenylmercapturic acid (PMA) in children increased by 494% and 728% within 6 h after passive smoking, respectively. Population validation study indicated that BMA and PMA levels were significantly elevated in children exposed to SHS. Therefore, in addition to OH-Cot, urinary BMA and PMA are potentially useful short-term biomarkers of passive smoking. Future studies should focus on the differences in VOC metabolism and detoxification mechanisms between children and adults.

Doctor-patient bilateral matching considering diagnosis and treatment perception in the absence of public health resources.

Introduction: The public health crisis is one of the main threats affecting the sustainable development of the economy and strengthening the rational allocation of medical resources is essential for building a strong public health system. Therefore, the study of the doctor-patient bilateral matching has important theoretical and practical significance and perception of diagnosis and treatment is taken as a key consideration in the research. Methods: Based on the current situation of the medical industry and the main contradiction between supply and demand of medical services, an evaluation index of doctor-patient satisfaction is constructed in this paper. Then, based on the different forms of evaluation, calculate the doctor's satisfaction and patient's satisfaction respectively. Taking maximizing the overall satisfaction of doctors and patients, maximizing the number of patients and minimizing the workload difference between doctors as the decision-making objectives, considering the upper limit of doctors' working hours as the constraint condition, a multi-objective decision-making model is constructed and solved by NSGA-II algorithm to realize the matching between doctors and patients. Conclusion: Finally, through the comparison with NSGA-III algorithm in three dimensions: the degree of convergence to the reference set, the propagation range of the solution and the running time of the algorithm, it is proved that NSGA-II algorithm has good performance in solving the matching problem of medical service supply and demand.