Objective To investigate and analyze a group occupational acute dimethylacetamide (DMA) poisoning incident occurred during the post-fire cleaning operation in a spandex manufacturing enterprise. Methods This study focused on the involved enterprise, employing units, poisoning patients, and workers with similar occupational exposure history from a group occupational acute chemical poisoning incident in Guangdong Province in 2023. Occupational health on-site investigation data, clinical records of poisoned patients, and occupational disease diagnostic data were collected to determine the cause of the poisoning. Results The incident occurred at a spandex manufacturing enterprise during the cleaning of polymerization reaction vessels after a fire, resulting in poisoning of six cleaning workers. The clinical symptoms of patients included varying degrees of liver function abnormalities and skin damage. All six patients wore long-tube air-supplied full-face masks during work. The patients were in a confined work space with poor ventilation, and worked more than 8 hours per day. Patients felt unwell after 5-13 days of work. Post-incident investigation revealed that the DMA exposure concentration of short term near the reaction vessels was 36.06 mg/m³. DMA accounted 13.74% to 30.09% of the volatile organic compounds in the raw and auxiliary materials and waste in the vessel. N-methylacetamide was detected in the urine of these six patients, with levels up to 1 639.78 mg/g creatinine, exceeding the occupational exposure limit (20.00 mg/g creatinine). All six patients were diagnosed as occupational acute DMA poisoning. Conclusion Occupational acute DMA poisoning mainly causes liver damage, has a latent onset, and poses a risk of group occurrence. The main causes of group poisoning are confined work space, inadequate management, insufficient protective measures, and excessive working hours.

Objective To study the clinical features and risk factors of acute pulmonary reperfusion injury after operation in neonates with severe pulmonary stenosis or pulmonary atresia.Method From February 2014 to February 2018,a retrospective analysis was performed in patients with critical pulmonary stenosis or pulmonary atresia who received percutaneous balloon pulmonary valvuloplasty (PBPV) in the neonatal intensive care unit of our hospital.Clinical characteristics,perioperative cardiac structure,hemodynamic data and biochemical results were collected.The neonates were assigned into injury group if they had acute lung reperfusion injury,and non-injury group if not.The risk factors of acute lung reperfusion injury were analyzed using multi-variate Logistic regression model.Result A total of 32 patients (24 prenatal diagnosis and 8 postnatal diagnosis) with severe pulmonary stenosis or pulmonary atresia with intact ventricular septum were enrolled.The main manifestations were dyspnea and cyanosis.Intravenous prostaglandin E was administered to keep the ductus arteriosus open.The age of operation ranged from 1 to 52 days and the median age was 7.5 days.Postoperative acute lung reperfusion injury occurred in 7 cases (21.9％).Preoperative and intraoperative pulmonary valve annulus diameter,balloon diameter,preoperative hemoglobin,hematocrit and blood albumin were significantly lower in the injury group.The operation duration,total length of hospital stay and postoperative duration were longer than in the non-injury group,the differences were statistically significant (P ＜ 0.05).Multi-variate Logistic regression analysis showed that the diameter of pulmonary valve annulus (OR =5.814,95％CI 1.106 ～30.568),preoperative blood albumin (OR =1.361,95％ CI 1.063 ～ 1.742),and hematocrit (OR =1.173,95％ CI 1.010 ～ 1.363) were risk factors of acute lung reperfusion injury,with statistically significant differences (P ＜ 0.05).Conclusion Acute lung reperfusion injury is one of the common complications after the operation of severe pulmonary stenosis or pulmonary atresia.The severity of pulmonary valve annulus stenosis,preoperative hematocrit and blood albumin level may be the risk factors of postoperative acute lung reperfusion injury.

The Choledochal cyst is an extremely rare congenital anomaly of the bile duct. Early cyst resection and Roux-en-Y hepatojejunostomy are the primary surgical methods for treating choledochal cyst. With the emergence of enhanced recovery after surgery, laparoscopic surgery has effectively reduced the incidence of biliary complications and wound infections, but it still does not meet people's requirements for minimally invasive surgery. Robotic surgery system has the potential to enhance surgical precision and the maneuverability of surgeons due to clear surgical visualization and flexible mechanical arms. The authors review the relevant literatures and conduct a Meta-analysis to evaluate the efficacy of robot-assisted surgery and laparoscopic surgery for choledochal cyst.

Objective To investigate the potential dose-response relationship between PCDD/Fs inhalational exposure and oxidative damage to DNA and lipid in foundry workers.Methods The participants were divided into three groups,including exposure group,administrator group and control group.The concentrations of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in air environment were determined by isotope dilution high resolution capillary column gas chromatography/high resolution mass spectrometry (HRGC-HRMS).The inhalational dose of PCDD/Fs were evaluated by Houmen's model.Urinary 8OHdG was analyzed by high performance liquid chromatography-electrochemical detector (HPLC-ECD).Urinary 8-iso-PGF2a were determined by ELISA.Results The PCDD/Fs environmental concentrations of three groups (pg· TEQ/m) were 0.21 +0.08,0.03 ±0.01,0.0012 ±0.0007 (P＜0.05),respectively.The inhalational dose of exposure group (92.54 (32.90～264.49) fg· TEQ/kg· d) was 5.4 folds higher than the administrator group,and was 201 times more than control group.The levels of urinary 8-OHdG(nmol/L crea) of three groups were 3.25 (1.07～15.36),2.72(0.75～16.07),2.17(0.38～17.07) (P＜0.05) and the levels of urinary 8-iso-PGF2n (nmol/L crea)were 19.11(9.33～76.50),20.95(8.40～79.31),11.48(4.85～37.80)(P＜0.05),respectively.The multiple linear regression analysis revealed that there were significantly increased trend for levels of urinary 8-OHdG and 8-iso-PGF2a as PCDD/Fs exposure levels increased,after adjustment for age,sex,smoking statue,alcohol use and BMI (P＜0.01).Conclusion There was a dose-response relationship between PCDD/Fs inhalational exposure and oxidative damage in foundry workers.

Objective To investigate the potential dose-response relationship between PCDD/Fs inhalational exposure and oxidative damage to DNA and lipid in foundry workers.Methods The participants were divided into three groups,including exposure group,administrator group and control group.The concentrations of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in air environment were determined by isotope dilution high resolution capillary column gas chromatography/high resolution mass spectrometry (HRGC-HRMS).The inhalational dose of PCDD/Fs were evaluated by Houmen's model.Urinary 8OHdG was analyzed by high performance liquid chromatography-electrochemical detector (HPLC-ECD).Urinary 8-iso-PGF2a were determined by ELISA.Results The PCDD/Fs environmental concentrations of three groups (pg· TEQ/m) were 0.21 +0.08,0.03 ±0.01,0.0012 ±0.0007 (P＜0.05),respectively.The inhalational dose of exposure group (92.54 (32.90～264.49) fg· TEQ/kg· d) was 5.4 folds higher than the administrator group,and was 201 times more than control group.The levels of urinary 8-OHdG(nmol/L crea) of three groups were 3.25 (1.07～15.36),2.72(0.75～16.07),2.17(0.38～17.07) (P＜0.05) and the levels of urinary 8-iso-PGF2n (nmol/L crea)were 19.11(9.33～76.50),20.95(8.40～79.31),11.48(4.85～37.80)(P＜0.05),respectively.The multiple linear regression analysis revealed that there were significantly increased trend for levels of urinary 8-OHdG and 8-iso-PGF2a as PCDD/Fs exposure levels increased,after adjustment for age,sex,smoking statue,alcohol use and BMI (P＜0.01).Conclusion There was a dose-response relationship between PCDD/Fs inhalational exposure and oxidative damage in foundry workers.

OBJECTIVETo compare the determination methods of fiber number concentration between China and WHO.

METHODSIndividual fiber samplings were conducted at a RCF manufacturing enterprise for 40 types of work. Flow rate was set as 2 L/min and lasted 2 to 4 hours. We used acetone-triacetin to prepare samples. The rules of two methods were used to count fibers for each sample respectively. The differences between the results of two methods were compared using the sign-rank test, and the correlation between the two methods' counting results were evaluated by the Spearsman rank correlation analysis.

RESULTSThe results of WHO counting rule were higher than those of Chinese counting rule for the same sample. The ratios of WHO method to Chinese method ranged from 1.88 to 3.70. Paired sign-rank test found the statistically significant differences of the results between the two methods (P<0.01). The rank correlation coefficient of the results by two rules counting ranged between 0.621 to 0.975, suggested positive correlation (P<0.01). The possible reasons of the difference between the two methods included the difference between the shapes of asbestos fiber and man-made mineral fiber, and counting rules of two methods.

CONCLUSIONThe results of WHO counting method is higher than those of Chinese counting method. High correlations between the results of the two methods were observed.

Asbestos ; analysis ; Chemistry Techniques, Analytical ; methods ; China ; Humans ; Mineral Fibers ; analysis ; Specimen Handling ; World Health Organization