OBJECTIVETo develop the knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for occupational groups, and to provide a convenient and effective tool for the survey of knowledge, attitude, and behavior on the prevention and control of occupational diseases in occupational groups and the evaluation of intervention effect.

METHODSThe initial questionnaire which was evaluated by the experts was used to carry out a pre-survey in Guangzhou, China. The survey results were statistically analyzed by t test, identification index method, correlation analysis, and Cronbach's a coefficient method. And then the questionnaire was further modified, and the content of the questionnaire was determined finally.

RESULTSAfter modification, there were 18 items on knowledge, 16 items on attitude, and 12 items on behavior in the "Knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for enterprise managers"; there were 19 items on knowledge, 10 items on attitude, and 11 items on behavior in the "Knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for workers".

CONCLUSIONThe knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for occupational groups is developed successfully, and it is a convenient and effective tool for the survey of knowledge, attitude, and behavior on the prevention and control of occupational diseases in occupational groups and the evaluation of intervention effect.

Objective To observe the therapeutic effect and mechanism of the aqueous extract of ephedra sinica on brain damage after subarachnoid hemorrhage(SAH)in rats.Methods Totally 50 rats of Sprague-Dawley were randomly divided into control group,model group and three groups treated with different concentrations(4,12,36 mg/kg).The changes of the cerebral water content,malondialdehyde(MDA),glutathione peroxidase(GSH-Px)and hydroxy radical of brain tissue were recorded,and he-matoxylin-eosin(HE)staining was used to test the subarachnoid haemorrhagia and oedema,and immunohistochemistry and western blot were carried out to assay the expression of complement C3 in brains of different animal in different group 3d after operation. Results On the postoperative 3 days,compared with the model group,the content of MDA、GSH-Px activity and hydroxyl radical of 12、36 mg/kg treatment groups significantly reduced(P <0.01 ),the content of MDA of 4 mg/kg treatment group not change (P >0.05),but GSH-Px activity and inhibition of hydroxyl radical significantly reduced(P <0.01),and the cerebral water content of 12,36 mg/kg groups were obviously lower compared with model group.The expression of complement C3 was significantly lower on 36 mg/kg treatment group and edema reduced.Conclusion The aqueous extract of ephedra could significantly inhibit the activity of complement C3,prevent the production of MDA、GSH-Px and hydroxyl radical,reduce the severity of cerebral edema and the in-flammatory response,which has a better therapeutic effect SAH animals.

Hepatic encephalopathy (HE) is an important indicator of decompensated cirrhosis and is one of the most common causes of death. With the development of research on gut microbiota in patients with liver cirrhosis in recent years, the role of gut microbiota in the pathogenesis of HE has attracted wide attention. At present, next-generation sequencing has deepened the understanding of the composition and function of gut microbiota among researchers, and HE treatment targeting gut microbiota has achieved remarkable results. The research on gut microbiota helps to further clarify the pathogenesis of HE and may provide more treatment methods for patients with HE.

Objective: A solvent desorption-gas chromatography method for determination of ethylal in workplace air has been established. Methods: Ethylal in workplace air was collected by activated carbon tube and desorbed with carbon disulfide, and the desorption solutions were analysed by capillary column GC with FID detector. Results: The method presented a good linearity in the range of 0.87~34 800.00 mg/L of ethylal in the standard solution, with the correlation coefficient being r=0.999 7. The limit of detection and the limit of quantification of this method were respectively 0.20 mg/L and 0.80 mg/L, and the minimum detectable concentration and the minimum quantification concentration of this method were respectively 0.17 mg/m³ and 0.60 mg/m³ per 1.50 L of air.The within-run precision of the method was 2.93%-6.20%, and the between-run precision 3.67%-6.44%. The desorption efficiency between 94.22%-97.27%. Ethylal in activated carbon tube could be kept at least 7 days at room temperature without significant loss. Conclusion The method could be used for determination of ethylal in workplace air.

ObjectiveTo investigate the changes in gut microbiota after transjugular intrahepatic portosystemic shunt (TIPS) in cirrhotic patients with mild hepatic encephalopathy (MHE) in different prognosis groups. MethodsA total of 28 MHE cirrhotic patients who were hospitalized and underwent TIPS in Xijing Hospital of Digestive Diseases from July 2016 to July 2017 were enrolled. Fecal samples and related clinical data were collected on days 1-3 before surgery and at 1 month after surgery. According to the prognosis after surgery, the patients were divided into none-hepatic encephalopathy (HE) group with 8 patients, MHE group with 12 patients, and overt hepatic encephalopathy (OHE) group with 8 patients. Fecal samples were analyzed by 16S rRNA sequencing to obtain the relative abundance of gut microbiota, and SPSS and R packages were used to analyze the biodiversity, postoperative changes, and differences in such changes of gut microbiota at the genus level between groups. The chi-square test was used for comparison of categorical data between groups; the Kruskal-Wallis H test was used for comparison of continuous data between three groups; the Bonferroni method was used for multiple comparisons of multiple samples; the Wilcoxon signed-rank test was used for comparison before and after surgery within each group. For microbiome beta-diversity analyses, a principal coordinate analysis (PCoA) was performed based on Bray-Curtis distance matrix, and the Adonis method (PerMANOVA) was used for comparison between groups. ResultsPCoA based on Bray-Curtis distance matrix showed that only the MHE group had a significant change in beta diversity after surgery (F=2.71, P=0.049). After surgery, the non-HE group had significant increases in the abundance of the native flora Dialister, Coprococcus, Ruminococcaceae_uncultured, Flavonifractor, and Clostridium_sensu_stricto_1 (Z=2.521, 2.1, 2.1, 2.1, and 1.96, all P＜0.05); the MHE group had significant reductions in the abundance of the harmful flora Granulicatella（Z=2.521,P=0.012）, Enterococcus（Z=2.51,P=0.012）, Streptococcus（Z=2.432,P=0.015）, and Rothia（Z=2.001,P=0.045） and significant increases in the abundance of Veillonella（Z=2.353,P=0.019） and Megasphaera（Z=1.955,P=0.05）; the OHE group only had a significant increase in the abundance of Veillonella after surgery (Z=2.38, P=0.017). There was a significant difference in the change in gut microbiota (postoperative abundance/preoperative abundance) between the non-HE group, the MHE group, and the OHE group ［2.00 (1.11-91.61) vs 1.21 (0.26-679) vs 0.09 (0.01-0.92), χ2=6.249, P=0.043］. ConclusionThere is a significant difference in the change in gut microbiota after TIPS between patients with different prognoses, and the increase in the abundance of native flora may have a certain influence on the remission of MHE.

Objective To investigate the clinicopathological features and key points of diagnosis and treatment of malignant perivascular epithelioid cell tumor(PEComa)to increase awareness of the disease.Methods The clinicopathological data of 2 patients with malignant PEComa treated in our hospital were retrospectively analyzed,and relevant literatures were reviewed.Results Both patients were male,aged 53 and 16 years,respectively.The sites of occurrence were in the retroperitoneum and pelvis,respectively.Both tumors were resected surgically,and the diagnosis was confirmed with postoperative pathology.Under the microscope,the tumor tissue of one patient was mainly composed of smooth muscle-like cells,and that of the other patient was composed of epithelioid cells,both showing pathological mitotic images and expressing HMB45,Melan-A,SMA and CD34,no tumor recurrence or metastasis was observed during the follow-up.The literatures collected involved 15 patients with retroperitoneal or pelvic PEComa,including 3 males and 12 females,of which 9 were malignant.The clinical manifestations were abdominal pain,bloating,or lower back pain.Some cases were detected during physical examinations.Conclusion Malignant PEComa is difficult to be diagnosed before surgery and easy to be misdiagnosed.The confirmed diagnosis depends on the postoperative pathological results.The preferred treatment is complete resection of tumor.Long-term follow-up is needed.

OBJECTIVE: To explore the applicability of Singapore Ministry of Manpower( MOM) risk model and MES model in risk assessment of occupational health hazard caused by chemical poisons in shoemaking enterprises. METHODS: A medium-sized shoemaking enterprise in Guangzhou City was selected as the research object to carry out on-the-spot investigation of occupational health,measure the level of chemical hazards in the air of the workplace. Occupational health risk assessment of chemical toxins in the workplace was conducted using the MOM model and the MES model,and the results of the two evaluations were compared. RESULTS: The occupational chemical hazards in workplace of the shoemaking enterprise mainly included the toluene,xylene,ethyl acetate,butyl acetate,n-hexane,and 1,2-dichloroethan( 1,2-DCE). The concentration-time weighted average( CTWA) of 1,2-DCE at the stitching post,methylbenzene at the brush coating post and ethyl acetate at the cleaning post exceeded occupational exposure limits. The MOM model assessment results showed that methylbenzene was of high risk and 1,2-DCE was of medium risk in brush coating post. n-Hexane and1,2-DCE were of medium risk in stitching post. Ethyl acetate and 1,2-DCE was of medium risk in cleaning post. The results of the MES model evaluation showed that the risk level of n-hexane and 1,2-DCE used in sticking,brush coating and cleaning posts was extremely high and the remaining chemicals were highly dangerous. CONCLUSION: Both MOM model and MES model can easily predict and assess the occupational health risk of various posts in shoemaking enterprises to some extent. The assessment result of MES model is more practical than that of MOM model.

Objective:To analyze the costs and effectiveness of five common screening modes and genetic screening for thalassemia in China in order to find the optimal way and provide evidence for the implementation of thalassemia prevention and control projects in Hunan Province.Methods:From June 2020 to April 2021, 12 971 couples from 14 cities and autonomous prefectures in Hunan Province were selected as the study population. The diagnosis of thalassemia was based on the results of genetic testing. Results of routine blood test and hemoglobin electrophoresis were collected and analyzed. The efficacy of five screening modes, at the cut-off value of <80 fl or 82 fl for the mean corpuscular volume (MCV), was analyzed by positive predictive value, negative predictive value, Jorden index and cost-effectiveness ratio. Sensitivity analysis was used to assess the feasibility of genetic screening at different costs after fixing the costs of routine blood and hemoglobin electrophoresis. The five thalassemia screening models are as follows: Mode 1: The woman had a blood routine test first. If the result was positive, the spouse required a blood routine test. If both results were positive, a thalassemia gene test should be offered to the couple. Mode 2: Both husband and wife were screened by blood routine and hemoglobin electrophoresis. If one or both of them were positive, both would be tested for thalassemia gene. Mode 3: The couple received blood routine tests initially. If either was positive, both should receive hemoglobin electrophoresis testing. If either was positive, both parties will conduct thalassemia gene testing. Mode 4: The woman was screened by blood routine and hemoglobin electrophoresis. If any one of them was positive, the woman would be tested for thalassemia gene. If the gene test result was positive, the spouse should receive thalassemia gene. Mode 5: Both spouses conducted a blood routine test. If either was positive, both would conduct hemoglobin electrophoresis test. If both were positive, both spouses should receive thalassemia gene testing. Gene testing mode: The woman would be tested for thalassemia, and her spouse would have thalassemia test too if her result was positive.Results:When using MCV<80 fl as the cut-off for diagnosing thalassemia, the Youden indices of the five prenatal screening modes in Hunan Province were 0.551, 0.639, 0.898, 0.555 and 0.356, while when using MCV<82 fl as the cut-off, the Youden indices were 0.549, 0.629, 0.851, 0.548 and 0.356. When the MCV cut-off value was <80 fl, the missed diagnosis rates of the five screening modes were 44.44%, 0.00, 0.00, 18.52% and 62.96%, and the cost-effectiveness ratios were 21 709, 250 939, 76 870, 138 463 and 92 860 yuan (RMB)/couple, respectively. When the price of genetic testing was lower than 55 yuan (RMB), the cost-effectiveness ratio of genetic screening was lower than that of Mode 3.Conclusions:MCV<80 fl can be considered as the positive criteria in blood routine screening for thalassemia in Hunan Province, and the cost-effectiveness ratio of Mode 3 (the couple received blood routine tests initially. If either was positive, both should receive hemoglobin electrophoresis testing. If either was positive, both parties will conduct thalassemia gene testing) is the best. Genetic screening has certain advantages with the decreasing price.

Objective: To explore the applicability of semi-quantitative risk assessment methods in wood furniture manufacturing companies. Methods: Two medium-sized wooden furniture manufactures were randomly selected as research objects, namely A company and B company. Used the Semi-Quantitative risk assessment method (the ratio method, the index method and the comprehensive method) in the "Guidelines for occupational health risk assessment of chemicals in the workplace" (GBZ/T 298-2017) to conduct occupational hygiene survey, occupational hazard factor testing and occupational health risk assessments for two wood furniture manufacturers from January to October 2018, and compared and analyzed the applicability of these three semi-quantitative risk assessment methods in wooden furniture manufacturing enterprises. Results: The occupational health status of A enterprises was worse than that of B enterprises, and the occupational health risk level was higher than that of B enterprises, and the risk level of A enterprise is 3~4, and the risk level of B enterprise is 2~3. The occupational health risk level obtained by the index method was consistent with the comprehensive method, while the risk level of some occupational disease hazards used the ratio method was inconsistent with the results of the index method and the comprehensive method. Compared with the index method and the comprehensive method, when E/OEL<0.5 or E/OEL≥2, there might be a certain fluctuation in the occupational health risk level obtained by the ratio method. Conclusion The semi-quantitative risk assessment is more objective, comprehensive and flexible in the application of occupational health risk assessment, and can assess the occupational health risk level of chemical poisons in wood furniture manufacturing enterprises.

Objective: To explore the applicability of Singapore semi-quantitative assessment method and international committee on mining and metals occupational health risk assessment method in occupational health risk assessment of ceramic enterprises. Methods: From March 2017 to May 2018, A ceramic enterprise was selected for the investigation and testing of occupational health, and the risk assessment of the occupational-disease-inductive factors in the workplace was conducted by the semi-quantitative assessment method of Singapore and the occupational health risk assessment method of the international committee on mining and metals. Results: The occupational-disease-inductive factors in the production process of this ceramic enterprise mainly include silicon dust, noise, high temperature, carbon monoxide, carbon dioxide and so on. The two risk assessment methods were applied to assess the risk of occupational-disease-inductive factors in the workplace, and the results showed that the high risk level was 16.67%, the medium risk level was 63.33%, and the low risk level was 20.00%. The risk level of silicon dust is from low risk to high risk. Conclusion The semi-quantitative assessment method and the occupational health risk assessment method of the International Commission on Mining and Metals are simple to operate and practical, and are suitable for the assessment of occupational hazards in ceramic enterprises.