Simvastatin,a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor,is widely prescribed to patients with hypercholesteremia and its muscular toxicity has been widely reported.The metabolism of simvastatin depends on the enzymic activity of cytochrome P450 3A4 (CYP3A4) and inhibitors of CYP3A4 can result in clinical events by interacting with simvastatin.Diltiazem is a moderate inhibitor of CYP3A4,which is known to increase the serum concentration of simvastatin.Here we report a patient with unrecognized hypothyroidism who had been stable for more than one year on low-dose simvastatin therapy of hypercholesteremia and rhabdomyolysis occurred with the addition of diltiazem.This is one of scanty reports of rhabdomyolysis induced by simvastatindiltiazem drug interaction,especially in hypothyroid patient.This case reminds the clinicians that although diltiazem as a moderate CYP3A4 inhibitor can be used cautiously with small doses of CYP3A4-dependent statius (eg,simvastatin),these two commonly used drugs should be avoided in hypothyroid patient.

Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.

OBJECTIVETo provide data for the occupational health supervision by analyzing the occupational health status in manufacturing industry in Guangzhou, China.

METHODSThe occupational health investigation was performed in 280 enterprises randomly selected from 8 industries based on industry stratification. According to the occupational health standards, 198 out of the 280 enterprises were supervised and monitored. Sample testing was performed in 3~5 workplaces where workers were exposed to the highest concentration/intensity of occupational hazard for the longest time. Comparative analyses of the overproof rates of hazard were performed among enterprises, workplaces, and testing items from different industries.

RESULTSThe concentrations of occupational hazard in 42.93% (85/198) of enterprises and 22.96% (200/871) of workplaces were above the limit concentration. The most severe hazards were the noises in shipbuilding and wooden furniture industries and the welding fumes in shipbuilding industry. Less than 30% of enterprises were able to provide occupational health examination and periodic test reports of occupational hazard in workplaces. The rate of the workers with abnormal occupational health examination results and the need for reexamination reached 6.63% (832/12 549), and they were mostly from shipbuilding, wooden furniture, and chemical industries.

CONCLUSIONThe occupational health supervision should be strengthened in enterprises, and hazard from noises and dusts should be selectively controlled or reduced. The publication of relevant data and information of occupational health in enterprises should be promoted to enhance social supervision.

Chemical Industry ; China ; Dust ; Humans ; Interior Design and Furnishings ; Manufacturing Industry ; statistics & numerical data ; Noise, Occupational ; Occupational Exposure ; statistics & numerical data ; Occupational Health ; statistics & numerical data ; Welding ; Workplace