Objective:To explore the relationship between polycyclic aromatic hydrocarbons (PAHs) exposure and sleep quality in workers from a coking plant.Methods:From April to June 2019. Selected 632 employed workers in the coking plant of a large state-owned enterprise in Shanxi Province as the exposed group, and 477 employed workers in the water-pump plant belonged to the same enterprise as the control group. We used self-designed questionnaires to collect the basic information of subjects. We measured the concentrations of 12 PAHs in the peripheral blood of workers using gas chromatography-mass spectrometry (GC-MS) ; Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of workers; The relationship between plasma PAHs concentration and sleep quality was analyzed using multiple linear regression model, restricted cubic spline (RCS) regression and logistic regression.Results:The concentration of 12 polycyclic aromatic hydrocarbons in the peripheral blood of the exposure group was (2.36±1.46) ng/ml, which was significantly higher than that of the control group (2.19±1.21) ng/ml. The detection rate of sleep disorder in the exposure group (18.0%) was higher than that in the control group (16.8%) , which was manifested by the significantly increased scores in subjective sleep quality, sleep latency, sleep disorders, daytime dysfunction, and PSQI. Multiple linear regression analysis showed that the PSQI score of workers in the high exposure group decreased by 0.80 (95% CI: -1.40~-0.19) points compared with the low exposure group, with a statistically significant difference ( P<0.05) . RCS analysis showed a non-linear dose-response relationship of PSQI score with PAHs cumulative exposure (plasma PAHs concentration multiplied by length of service) . The results of logistic regression showed that compared with the low level group, the risk of somnipathy in the middle level group of PAHs cumulative exposure decreased by 44%, among which the risk of sleep disorder in the drinkers decreased by 40%, while the risk of somnipathy in the high level group increased by 96% compared with the low level group. Stratified analysis of alcohol drinking habit showed non-significant difference in PSQI score with low, medium, and high levels of PAHs cumulative exposure in non-drinkers ( P>0.05) , and that the PSQI score was significantly increased in alcohol drinkers with high level of PAHs cumulative exposure compared to those with low and medium levels of PAHs cumulative exposure. Conclusion:The workers in the coking plant had high levels of PAHs in plasma and poor sleep quality, Higher level of PAHs cumulative exposure (>1396.56ng/ml) is a risk factor of poor sleep quality.

Objective:To explore the relationship between polycyclic aromatic hydrocarbons (PAHs) exposure and sleep quality in workers from a coking plant.Methods:From April to June 2019. Selected 632 employed workers in the coking plant of a large state-owned enterprise in Shanxi Province as the exposed group, and 477 employed workers in the water-pump plant belonged to the same enterprise as the control group. We used self-designed questionnaires to collect the basic information of subjects. We measured the concentrations of 12 PAHs in the peripheral blood of workers using gas chromatography-mass spectrometry (GC-MS) ; Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of workers; The relationship between plasma PAHs concentration and sleep quality was analyzed using multiple linear regression model, restricted cubic spline (RCS) regression and logistic regression.Results:The concentration of 12 polycyclic aromatic hydrocarbons in the peripheral blood of the exposure group was (2.36±1.46) ng/ml, which was significantly higher than that of the control group (2.19±1.21) ng/ml. The detection rate of sleep disorder in the exposure group (18.0%) was higher than that in the control group (16.8%) , which was manifested by the significantly increased scores in subjective sleep quality, sleep latency, sleep disorders, daytime dysfunction, and PSQI. Multiple linear regression analysis showed that the PSQI score of workers in the high exposure group decreased by 0.80 (95% CI: -1.40~-0.19) points compared with the low exposure group, with a statistically significant difference ( P<0.05) . RCS analysis showed a non-linear dose-response relationship of PSQI score with PAHs cumulative exposure (plasma PAHs concentration multiplied by length of service) . The results of logistic regression showed that compared with the low level group, the risk of somnipathy in the middle level group of PAHs cumulative exposure decreased by 44%, among which the risk of sleep disorder in the drinkers decreased by 40%, while the risk of somnipathy in the high level group increased by 96% compared with the low level group. Stratified analysis of alcohol drinking habit showed non-significant difference in PSQI score with low, medium, and high levels of PAHs cumulative exposure in non-drinkers ( P>0.05) , and that the PSQI score was significantly increased in alcohol drinkers with high level of PAHs cumulative exposure compared to those with low and medium levels of PAHs cumulative exposure. Conclusion:The workers in the coking plant had high levels of PAHs in plasma and poor sleep quality, Higher level of PAHs cumulative exposure (>1396.56ng/ml) is a risk factor of poor sleep quality.

Objective:To evaluate the effect of sufentanil on activation of Schwann cells after peripheral nerve injury in mice.Methods:Eighty healthy pathogen-free male Balb/c mice, aged 6-8 weeks, weighing 18-22 g, were divided into 4 groups ( n=20 each) using a random number table method: peripheral nerve injury group (group PNI), high dose sufentanil group (group H), medium dose sufentanil group (group M) and low dose sufentanil group (group L). The model of unilateral sciatic nerve transaction was established in ketamine-anesthetized mice.Immediately after establishment of the model, sufentanil 10, 5 and 2.5 μg/kg was injected intraperitoneally once a day for 3 consecutive days in H, M and L groups, respectively, while the equal volume of normal saline was given instead in group PNI.Sciatic function index (SFI) was calculated at 4, 8 and 12 weeks after establishment of the model.At 2, 4, 8 and 12 weeks, 5 mice in each group were sacrificed, and segments of the injuried ipsilateral sciatic nerve were removed for examination of the ultrastructure of the sciatic nerve (with a transmission electron microscope) and for detection of the expression of glial fibrillary acidic protein (GFAP) of sciatic nerve (by immunohistochemistry). Results:Compared with group PNI, SFI was significantly increased, and the expression of GFAP was up-regluated at each time point after establishment of the model in H and M groups ( P<0.05) and no significant change was found in SFI and GFAP expression after establishment of the model in group L ( P>0.05). Compared with group L, SFI was significantly increased, and GFAP expression was up-regluated in H and M groups ( P<0.05). There was no significant difference in SFI and GFAP expression between group H and group M ( P>0.05). The thickness of myelin lamellae was dense, and the proliferation of Schwann cells was not marked in H and M groups.The thickness of myelin lamellae was thin, and the proliferation of Schwann cells was marked in L and MO groups. Conclusion:The mechanism by which sufentanil improves repair after peripheral nerve injury may be related to promoting activation of Schwann cells in mice.

Background Sleep is a crucial physiological activity for the human body, and research has shown that air pollution can affect sleep quality. However, the association between polycyclic aromatic hydrocarbons (PAHs) exposure, neurotoxic compounds in air pollutants, and sleep quality remains uncertain. Objective To evaluate the association of PAHs exposure with sleep quality, and to provide evidence for improving sleep quality. Methods This study used a cross-sectional design. We selected 632 workers from a coking plant of a large state-owned enterprise as the exposure group, and 477 workers from the energy and power plant of the same enterprise as the control group. All workers worked in three shifts. A questionnaire survey was conducted to collect basic information including gender, years of service, age, educational level, smoking, alcohol consumption, consumption of fried foods, cooking frequency, types of cooking fuels. Worker's post-shift morning midstream urine was sampled to determine the concentrations of eight PAHs metabolites (OH-PAHs) using gas chromatography-tandem mass spectrometry (GC-MS). Worker's sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI). A higher PSQI score indicated a lower sleep quality. Associations of urinary OH-PAHs levels with sleep quality in the workers were analyzed using linear regression, Bayesian kernel-machine regression (BKMR), and quantile g-computation. Results The median (P₂₅, P₇₅) concentration of total OH-PAHs in the exposure group [88.84 (46.27, 151.96) μg·L⁻¹] was higher than that in the control group [54.33 (24.86, 97.97) μg·L⁻¹]. Additionally, the PSQI score (\begin{document}$ \overline{x}\pm {s} $\end{document}) in the exposure group (5.16±3.84) was higher than that in the control group (4.60±3.17). The multiple linear regression revealed that an increase in the sum of the concentrations of eight OH-PAHs after natural logarithmic transformation (lnΣ₈OH-PAHs) was associated with an increase of 0.3646 (95%CI: 0.1337, 0.5955) in PSQI score, and an increase in lnΣlow-ring OH-PAHs was associated with an increase of 0.2954 (95%CI: 0.0941, 0.4967) in PSQI score. The BKMR analysis demonstrated that PSQI score was gradually increased as the increasing of lnΣ₈OH-PAHs concentration. The quantile g-computation analysis indicated that a quantile increase in lnΣ₈OH-PAHs concentration was associated with an increase of 0.4062% (95%CI: 0.1176%, 0.6949%) in PSQI score. Conclusion Compared to the controls, the coking workers show a higher concentration of urinary OH-PAHs and report worse sleep quality. The concentration of OH-PAHs is significantly negatively associated with sleep quality.

Background Long-term occupational polycyclic aromatic hydrocarbons (PAHs) exposure is an important risk factor for cognitive impairment. At the same time, it can also cause a decrease of brain-derived neurotrophic factor (BDNF). However, it is not clear whether BDNF plays a key role in the cognitive impairment of workers caused by occupational PAHs exposure. Objective To analyze the correlation between the levels of PAHs in the plasma of coke oven workers and cognitive impairment, and to explore the possible mediating effect of plasma BDNF level on the relationship between PAHs and cognitive impairment. Methods A cross-sectional survey was carried out to select 138 pairs of workers from a coking plant (exposure group) and an energy plant (control group) in a large enterprise in Taiyuan, and the matching variables included age, education level and smoking status. The basic data of the workers were collected by questionnaire. The cognitive function of the workers was assessed by the Montreal Cognitive Assessment (MoCA) scale. Fasting elbow venous blood was collected, the plasma concentrations of 16 PAHs were determined by high performance gas chromatography-mass spectrometry (GC-MS), and the plasma concentration of BDNF was detected by enzyme-linked immunosorbent assay (ELISA). Multiple linear regression model was used to analyze the relationship between 12 PAHs levels in plasma and MoCA scores, and Bootstrap method was used to analyze the mediating effect of BDNF in the relationship between these two indicators. Results The average (\begin{document}$\bar x \pm s $\end{document}) age of workers in the two groups was (48.46±5.04) years, the length of service was (21.45±9.78) years, and 58.7% of the participants reported their education level at secondary vocational school, high school, and above. The median level (25th and 75th percentiles) [M(P₂₅, P₇₅)] of plasma Σ₁₂PAHs concentration of workers in the exposure group [20.937 (9.454, 38.387) μg·L⁻¹] was significantly higher than that of the control group [9.997 (4.952, 23.770)μg·L⁻¹] and the MoCA score (22.82±2.38) of the exposure group was significantly lower than that of the control group (24.60±5.67) (P<0.05). The plasma BDNF showed no significant difference between the exposure group [(29.99±9.80) μg·L⁻¹] and the control group [(31.48±9.09) μg·L⁻¹](P>0.05). Taking plasma PAHs as independent variable and MoCA score as dependent variable, after adjusting selected covariates, the results of multiple linear regression model showed that the MoCA score changed by −0.020 (95%CI: −0.035 - −0.005) for every 1 μg·L⁻¹ increase of plasma Σ₁₂PAHs. Low (<P₃₃), medium ( P₃₃~P₆₆) and high (>P₆₆) dummy variables were set according to the intertertile boundaries (8.31, 23.76) μg·L⁻¹ of the plasma level of Σ₁₂PAH of the workers. The change of MoCA score in the high concentration group versus the low concentration group was −1.167 (95%CI: −1.866 - −0.467). The MoCA score changed by 0.066 (95%CI: 0.012 - 0.119) for each 1 μg·L⁻¹ increase in plasma BDNF level. The results of dichotomous logistic regression analysis showed that the risk of cognitive impairment in the high concentration group was 2.635 (95% CI: 1.085 - 6.398) times higher than that in the low concentration group. The results of mediating effect analysis showed that plasma BDNF level was an intermediate variable between PAHs and cognitive impairment, and 45.50% of PAHs-induced cognitive impairment risk was mediated by reduced BDNF level. Conclusion The level of plasma PAHs in coke oven workers is negatively correlated with MoCA score, and PAHs may mediate cognitive impairment by reducing plasma BDNF level.

Objective: To investigate the application of the axillary central venous catheterization (CVC) based on Nickalls' landmarks in treating adult multiple injury patients. Methods: A retrospective case control study was conducted to analyze the clinical data of 83 adult multiple injury patients treated in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from August 2017 to August 2018. There were 48 males and 35 females, aged 21-84 years [(56.5±14.3)years]. The body mass index ranged from 19.8 to 43.1 kg/m² [(27.6±6.5)kg/m²]. There were 26 patients with mainly craniocerebral injury, 15 with mainly thoracic injury, 28 with mainly abdominal injury, eight with mainly spinal injury and six with mainly pelvic fracture. The injury severity score (ISS) ranged from 24 to 66 points [(41.8±18.1)points]. All the patients received the axillary CVC based on Nickalls' landmarks. The left axillary vein was used as the puncture vein in 16 patients (left group), and the right axillary vein was used as the puncture vein in 67 patients (right group). A total of 36 patients were combined with the clavicle and/or 1-3 rib fractures at the same side as the puncture site (adjacent fracture group), while 47 patients were not combined with the clavicle and/or 1-3 rib fractures at the same side as the puncture site (non-adjacent fracture group). The success rate of catheterization, pneumothorax, hematoma or artery injury, catheter ectopia, catheter-related infection and catheter-related thrombosis were recorded. Results: A total of 80 patients were successfully intubated, with a success rate of 96%. Subgroup analysis showed that the success rate of right group was [97% (65/67)], slightly higher than that of the left group [94%(15/16)] , but the difference was not statistically significant (P>0.05). And the success rate of adjacent fracture group [94%(34/36)] was similar to that of non-adjacent fracture group [98%(46/47)], and the difference was not statistically significant (P>0.05). Complication incidences were as follows: hematoma or arterial injury [5%(4/83)], pneumothorax 2%(2/83), catheter-related thrombosis [12%(10/83)], and catheter ectopia [1%(1/83)]. No catheter-related infection was observed. Subgroup analysis showed that the incidence of various complications was similar between the left group and the right group (hematoma or arterial injury: 6% vs. 4%, pneumothorax: 0% vs. 3%; catheter ectopic: 0% vs. 1%; catheter-related thrombosis: 13% vs. 12%), and the difference was not statistically significant (P>0.05). The incidence of various complications was also similar between the adjacent fracture group and the non-adjacent fracture group (hematoma or arterial injury: 3% vs. 6%; pneumothorax: 3% vs. 2%; catheter ectopic: 0% vs. 2%; catheter-related thrombosis: 17% vs. 9%), and the difference was not statistically significant (P>0.05). Conclusions Axillary CVC based on Nickalls' landmark has a relatively high catheterization success rate and low complication incidence in adult multiple trauma patients. It is applicable to both left and right sides of axillary vein and suitable for patients with adjacent fracture. However, there still exists a high risk of catheter-related thrombosis, requiring enhanced anticoagulation and regular monitoring of thrombosis during catheterization.