Objective To explore the regulation and effect factors of arsenic expose and arsenic methylation level, then to provide a reference for study the function of arsenic metabolism in a arsenic poisoning process. Methods A meta-analysis was performed by two researchers. Twenty-five papers satisfying our priori eligibility criteria were included by searching Cochrane library, Pubmed, Springer, Embase and China National Knowledge Infrastructure. Based on the results of heterogeneity, a random or fixed effects model was chosen for the meta-analysis. Results The results showed that the following arsenic metabolites increased (all P<0.01) following arsenic exposure: inorganic arsenic [iAs; standardized mean difference (SMD): 1.07; 95% confidence interval (CI):0.61 - 1.53)], monomethyl arsenic (MMA; SMD: 1.10; 95% CI: 0.81 - 1.40), dimethyl arsenic (DMA; SMD: 2.50;95%CI:1.50-3.69), and total arsenic (TAs, SMD:3.10;95%CI:2.13-4.07). Additionally, the percentages of iAs (iAs%; SMD: 1.00; 95% CI: 0.60 - 1.40) and MMA (MMA%; SMD: 0.49; 95% CI: 0.21 - 0.77) also increased, while the percentage of DMA (DMA%; SMD: - 0.55; 95% CI: - 0.80 - - 0.31) decreased (P<0.01). The primary methylation index (PMI; SMD: - 0.57; 95% CI: - 0.94 - - 0.20), and secondary methylation index (SMI;SMD: - 0.27; 95% CI: - 0.46 - - 0.09) decreased (all P< 0.01). Compared to female, male had higher MMA%(SMD:0.44;95%CI:0.35-0.52), lower DMA%(SMD:-0.33;95%CI:-0.38--0.28) and SMI (SMD:-0.36;95%CI:-0.53--0.19). The smoker had higher MMA%(SMD: 0.22; 95%CI: 0.07 - 0.37) and lower DMA%(SMD:-0.16;95%CI: - 0.26 - - 0.05). The drinker had higher MMA% (SMD: 0.17; 95% CI: 0.07 - 0.27) and lower DMA%(SMD:-0.24;95%CI:-0.39--0.10). The older people had higher MMA%(SMD:-0.23;95%CI:-0.40--0.06). In addition, the body mass index may influence the percentages of MMA (SMD: - 0.18; 95% CI: - 0.31 - - 0.04, P < 0.01). Conclusion Arsenic exposure, smoking, drinking, and older age can reduce the capacity of arsenic methylation. Arsenic methylation is more efficient in women than in men.

Objective To analyze the influencing factors of unplanned extubation(UE)occurrence of peripherally inserted central catheter(PICC)in the patients with hematological diseases.Methods A retro-spective cohort study method was adopted.The data of 7 298 patients with hematological diseases implanted with PICC catheter and followed up to its removal from January 1,2016 to December 31,2020 in the Hematol-ogy Hospital of Chinese Academy of Medical Sciences were collected,including the demographic information,catheterization records,maintenance and extubation records.According to whether UE occurring,they were divided into the UE group(n=262)and normal extubation group(n=7 036).The general data were com-pared between the two groups.The COX regression was used to analyze the influencing factors of UE in pa-tients with hematological diseases.The dose-effect relationship between age and PICC UE occurrence risk was studied by the restrictive cubic spline method.Results The incidence rate of UE was 3.6％(262/7 298).The COX regression analysis results showed that the gender,disease diagnosis,fibrinogen,prothrombin time,PLT,catheter material,number of punctures during catheterization,positioning method of catheter tip,num-ber of catheter-related complications occurrence were related to PICC UE occurrence in the patients with he-matological diseases(P＜0.05).The results of restricted cubic spline showed that there was a"U"-type non-linear relationship between age and UE risk(X2=17.710,P＜0.05),and the risk of UE was the lowest when the age was 30 years old.Conclusion In PICC,the emphasis should be paid to the male patients with hemato-logical malignancies who have repeated punctures during catheterization,no intracardiac electrocardiographic positioning during catheterization,bleeding tendency,indwelling polyurethane catheters and repeated catheter-related complications in order to decrease the UC occurrence probability.

Objective To investigate the status of application of the central venous access in the departments of hematology to develop targeted administrative strategies and provide evidence for management.Methods A self-de-signed questionnaire was applied and convenience sampling was adopted in 93 hematology departments from 48 hospitals in 19 provinces(autonomous regions,municipalities).Results A total of 91 valid questionnaires were col-lected,with a valid questionnaire response rate of 97.85％.Among the 91 hematology departments,91(100％),73(80.22％),and 68(74.73％)carried out PICC,central venous catheter,and totally implantable access port catheteriza-tion,respectively.In the evaluation of blood test indicators before central venous access,the items with a higher e-valuation proportion were platelet count(100％)and D-dimer concentration(87.91％),while the evaluation proportion of other items was＜85％.When PICC catheterization,97.80％of hematology departments prefer basilic vein;83.52％of hematology departments used zone insertion method;95.60％of hematology departments had a skin disinfection range of ≥20 cm;98.90％of hematology departments had catheterization under ultrasound guidance;67.03％and 96.70％of hematology departments used the intracardiac electrocardiogram method or ultrasound assisted localiza-tion,postoperative X-ray localization;12.09％and 53.85％of hematology departments carried out tunnel catheteriza-tion and blunt separation expansion techniques,respectively.In terms of maintenance of central venous access de-vices,82.42％of hematology departments used disposable specialized maintenance kits;61.54％of hematology de-partments used transparent patches to fix PICC;45.21％of hematology departments used suture to fix central venous catheters;24.18％of hematology departments used cotton swabs to disinfect infusion joints;60.44％of hematology departments did not use disposable infusion joint disinfection cap;74.73％of hematology departments used gauze compression to prevent puncture site bleeding;only 6.59％hematology departments used antibacterial dressings con-taining chlorhexidine to prevent puncture site infections.In terms of quality management of central venous access devices,94.51％and 86.81％of hematology departments regularly conducted quality inspections of central venous access,and collected,calculated and analyzed relevant data.50.55％of hematology departments conducted complica-tion risk assessments,and 10.99％of hematology departments had established information management systems for venous therapy.Conclusion The implementation rate of PICC catheterization in the hematology department was relatively high,and the insertion operation basically meets the standard requirements.The evaluation before central venous access catheterization was relatively completed,and the maintenance and management are relatively stan-dardized.However,the evaluation of blood test indicators before the placement of central venous access urgently needs to be standardized and unified.When PICC catheterization,attention should be paid to the application of new technologies,and the information management of venous therapy needs to be improved.

OBJECTIVES: Idiopathic intracranial hypertension (IIH) is a syndrome that excludes secondary causes such as intracranial space-occupying lesion, hydrocephalus, cerebrovascular disease, and hypoxic ischemic encephalopathy. If not be treated promptly and effectively, IIH can cause severe, permanent vision disability and intractable, disabling headache. This study aims to explore the clinical and image features for IIH, to help clinicians to understand this disease, increase the diagnose rate, and improve the outcomes of patients. METHODS: We retrospectively analyzed 15 cases of IIH that were admitted to Xiangya Hospital, Central South University, during January 2015 to September 2020. The diagnosis of IIH was based on the updated modified Dandy criteria. We analyzed clinical data of patients and did statistical analysis, including age, gender, height, weight, medical history, physical examination, auxiliary examination, treatment and outcome. RESULTS: There were 10 females and 5 males. Female patients were 22 to 42 years old with median age of 39.5. Male patients were 27 to 52 years old with the median age of 44.0. The BMI was 24.14-34.17 (28.71±2.97) kg/m CONCLUSIONS IIH primarily affects women of childbearing age who are overweight. The major hazard of IIH is the severe and permanent visual loss. Typical image signs have high specificity in IIH diagnosis. Prompt diagnosis and effective treatment are significantly important to improve the outcomes of patients.
Adult ; Anemia, Iron-Deficiency ; Female ; Humans ; Intracranial Hypertension ; Male ; Middle Aged ; Pseudotumor Cerebri/diagnostic imaging* ; Retrospective Studies ; Ventriculoperitoneal Shunt ; Young Adult