Background Workers engaged in benzene-exposed or benzene-containing solvent-exposed operations in China are predominantly subjected to a low concentration of benzene series compounds, and prolonged exposure to low concentrations of benzene, toluene, and xylene (BTX) may have implications for blood pressure. Objective To investigate the influence of low-concentration BTX exposure on the blood pressure of workers, aiming to provide a basis for enterprises to devise associated health management strategies to mitigate the occurrence of hypertension among workers exposed to low concentrations of BTX. Methods Using a cross-sectional design, 884 workers from a petroleum refining enterprise in Hainan who participated in an occupational health examination in 2022 were selected as the study population, and were divided into an exposure group of 649 workers and a control group of 235 workers based on their reporting of BTX exposure or not. Data on workplace BTX concentrations and health examinations of the study subjects were collected and questionnaires were administered. In addition, S-phenylmercapturic acid (S-PMA), hippuric acid (HA), and methyl hippuric acid (MHA, including the three isomers 2-MHA, 3-MHA, and 4-MHA) were measured in the urine of the workers using high-performance liquid chromatography-tandem triple quadrupole mass spectrometry to assess internal BTX burden. The effects of low-concentration BTX exposure on blood pressure were analyzed. Results In 2022, the concentrations of benzene, toluene, and xylene of all monitoring points did not exceeded the national limits by either time-weighted average (TWA) or short-term exposure limit (STEL), indicating low-concentration BTX exposure. Regarding the internal burden of BTX, the concentrations of benzene metabolite S-PMA, toluene metabolite HA, and xylene metabolites 3-MHA and 4-MHA in the urine samples in the exposure group were higher than those in the control group (P < 0.05). The correlation analysis showed a positive correlation between urinary S-PMA concentration and diastolic blood pressure in the workers (r=0.265, P < 0.05). Differences in systolic and diastolic blood pressure distributions were statistically significant among workers grouped by sex, age, work years, educational levels, monthly income, body mass index (BMI), alcohol use, dietary oil, and types of residential address (P < 0.05). Significant differences in systolic blood pressure distribution were observed among workers by smoking status and levels of labor intensity (P < 0.05). Compared with the control group, the workers in the exposure group exhibited a significant increase in diastolic blood pressure (P < 0.05). The results of multiple linear regression showed that age, sex, and BMI had statistically significant effects on systolic blood pressure (P < 0.05), while age, work years, and BMI had statistically significant effects on diastolic blood pressure (P < 0.05). The systolic blood pressure of age > 35 years, male, overweight and obese workers was significantly higher than that of age ≤ 35 years, female, and underweight workers, and the diastolic blood pressure of age > 35 years, work years > 5 years, and obese workers was higher than age ≤35 years, ≤5 years of service, and underweight workers. Low-concentration BTX exposure was one of the main influencing factors for elevated diastolic blood pressure, and the exposed workers showed a 1.337 mmHg increase in diastolic blood pressure compared to the control group (P < 0.05). Conclusion Low-concentration BTX exposure, work years > 5 years, and obesity may elevate blood pressure among petroleum refininig workers. Regular blood pressure monitoring and enhanced health interventions for this occupational group are warranted.

Objective To analyze the current status and influencing factors of elevated blood pressure among employees in a large petroleum refining enterprise in Hainan Province. Methods A total of 940 workers from a petroleum refining enterprise in Hainan Province was selected as the study subjects using the convenience sampling method. The results of their health status survey, occupational medical examination, and occupational stress measurement were collected. Results The detection rate of elevated blood pressure in the study subjects was 23.9% (225/940), with the detection rate of normal blood pressure and hypertension of 17.7% (166/940) and 6.3% (59/940), respectively. The detection rate of occupational stress was 28.8% (271/940). The result of multivariate logistic regression analysis showed that workers aged 30 -<40, 40 -<50, and ≥50 years had a higher risk of elevated blood pressure than those aged <30 years after controlling for confounding factors such as gender, residential address, length of service, education level, personal monthly income, smoking status, physical exercise, salt intake, oil intake, occupational stress, and high temperature exposure (all P<0.05). Workers in the body mass index (BMI) overweight group and obese group had a higher risk of elevated blood pressure than those in the normal group (all P<0.05). The risk of elevated blood pressure was higher in workers who drinks than those who did not (P<0.05). Workers exposed to noise levels of 85-90 dB(A) had a lower risk of elevated blood pressure compared to those exposed to noise levels >90 dB(A) (P<0.05). Conclusion Age, BMI, drinking status, and noise exposure levels are independent influencing factors for elevated blood pressure among workers in this petroleum refining enterprise. Blood pressure management should be strengthened for workers aged ≥30 years, overweight, obesity, alcohol consumption and with noise exposure intensity > 90 dB(A).

Objective : To investigate the mechanism of sertoli/spermatogenic injury induced by cigarette smoke extract(CSE) based on ROS/NLRP3 signaling pathway. Methods : The sertoli/spermatogenic of rat were cultured in vitro , and they were divided into control group , cigarette Smoke extract (CSE) group and CSE + NLRP3 inflammosome inhibitor MCC950 group. Cell viability was detected by CCK⁃8 assay; Lactate dehydrogenase ( LDH) was used to detect cell membrane damage ; reactive oxygen species ( ROS) production was used to detect oxidative stress level ; Hoechst/PI fluorescent staining was used to detect cell pyroptosis. Real⁃time quantitative PCR ( RT⁃qPCR) was used to determine the mRNA level of NLRP3 , ASC , Caspase⁃1 , GSDMD , IL⁃1β and IL⁃18. Western blot was used to determine the protein level of NLRP3 , ASC , Caspase⁃1 , GSDMD , IL⁃1β and IL⁃18. Results: CCK⁃8 assay showed that cell viability decreased in CSE group (P < 0. 001) , LDH leakage rate (P < 0. 001) and ROS (P < 0. 001) production increased. Compared to the CSE group , cell viability increased (P < 0. 001) , LDH leakage rate (P < 0. 01) and ROS (P < 0. 001) production decreased in CSE + MCC950 group. The number of PI staining cells in CSE group was more than that in control group and CSE + MCC950 group , but staining cells in CSE + MCC950 group was less than that in CSE group. RT⁃qPCR and Western blot results showed that the expression levels of NLRP3 , ASC , Caspase⁃1 , GSDMD , IL⁃1β and IL⁃18 increased in CSE group but decreased in CSE+ MCC950 group. Conclusion The oxidative stress and inflammation of sertoli/spermatogenic induced by ciga⁃ rette smoke may be related to the activation of ROS/NLRP3 signaling pathway.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Background Occupational stress has become one of the main factors affecting people's physical and mental health, and there are many sources of occupational stress in petrochemical enterprises. Objective To evaluate the current situation of occupational stress and its related factors among employees in a petrochemical enterprise, and to provide a scientific basis for reduing the risk of occupational stress among employees in petrochemical enterprises. Methods In June 2022, a cross-sectional questionnaire survey was conducted in a petrochemical enterprise in Hainan, including a general information questionnaire for basic information, the Effort-Reward Imbalance (ERI) for occupational stress, and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. Chi-square test was used to compare differences in positive occupational stress by demographic characteristics, occupational characteristics, behavior, and occupational disease hazards. Logistic regression was employed to evaluate factors associated with occupational stress. Results Of the 1129 questionnaire distributed, a total of 999 valid questionnaire were returned,with a valid recovery rate of 88.5%. The positive rate of occupational stress among employees in the petrochemical enterprise was 29.5%. There were statistically significant differences in the positive rate of occupational stress among the employees grouped by gender, age, marital status, body mass index (BMI), monthly income, length of service, smoking, weekly working hours, type of work, working mode, sleep quality, noise exposure, and high temperature exposure (P<0.05). In terms of positive occupational stress among subcategories: workers being male (vs. female), working ＞40 h per week (vs. ≤40 h per week), regular day shift (vs. shift work), smoking (vs. not smoking), with exposure to noise and heat (vs. without such exposure), and having poor sleep quality (vs. good sleep quality) reported higher positive occupational stress rates (P＜0.05). The results of pairwise comparison showed that the positive rate of occupational stress in divorced (50.0%) or married (32.0%) workers was higher than that in single (27.1%) workers, and higher in operation workers (30.6%) than in other types of work (20.5%) (P＜0.05). The trend chi-square results showed that the positive rate of occupational stress increased linearly with the increase of age, length of service, BMI, or monthly income (P＜0.05). The results of logistic regression analysis after adjustment showed that workers who worked ＞40 h a week had a higher risk of occupational stress than those who worked ≤40 h a week, and the OR (95%CI) was 1.909 (1.135, 3.211); the workers of other types of work had a lower risk of reporting occupational stress than operation workers, and the OR (95%CI) was 0.513 (0.272, 0.968); the workers with noise exposure had a higher risk of occupational stress than the workers without, and the OR (95%CI) was 2.457 (1.070, 5.642). Conclusion The positive rate of occupational stress among employees in this petrochemical enterprise is high. Among them, operators, working hours per week＞40 h, and noise exposure may increase the incidence of occupational stress. The enterprise should actively take measures to reduce the occurrence of occupational stress among employees.

Objective:To clarify the elements of post competency of public health professionals and technical personnel, and construct a post competency index system of public health professionals and technical personnel.Methods:Referring to the Hay Group Competency Dictionary and literature review method, the post competency information elements of public health professional and technical personnel were constructed, and were revised through the expert consultation method. Unit-level stratified sampling was used, and 120 public health professionals were invited to evaluate the importance of the elements. SPSS 26.0 was used for data analysis, the continuous data were expressed in ( x ± s) mode, and Pearson was used to study the degree of correlation of each dimension. Finally, the post competency index system for public health positions was constructed by using the factor analysis method to extract the common factor as the first-level index. Results:The index system contained 7 first-level indicators (43 items), including public health practice skills, clinical practice skills, professional basic subject knowledge, personal professional accomplishment, public health authority and management ability, public health leadership, and public health methodology knowledge. Its weight coefficients (%) were 20.03, 17.48, 15.89, 15.68, 13.98, 12.82 and 4.11, respectively. The elements with the highest materiality scores were personal protection, responsibility and professionalism.Conclusion:Personal protection and other public health practical skills and personal professional qualities such as sense of responsibility and professionalism are the core elements of public health positions, and it is recommended to strengthen the training of public health professionals' public health practical skills in actual work, and pay attention to the cultivation of personal professional qualities, so as to establish a better team of public health talents.

Whether Fanconi anemia (FA) heterozygotes are predisposed to bone marrow failure and hematologic neoplasm is a crucial but unsettled issue in cancer prevention and family consulting. We retrospectively analyzed rare possibly significant variations (PSVs) in the five most obligated FA genes, BRCA2, FANCA, FANCC, FANCD2, and FANCG, in 788 patients with aplastic anemia (AA) and hematologic malignancy. Sixty-eight variants were identified in 66 patients (8.38%). FANCA was the most frequently mutated gene (n = 29), followed by BRCA2 (n = 20). Compared with that of the ExAC East Asian dataset, the overall frequency of rare PSVs was higher in our cohort (P = 0.016). BRCA2 PSVs showed higher frequency in acute lymphocytic leukemia (P = 0.038), and FANCA PSVs were significantly enriched in AA and AML subgroups (P = 0.020; P = 0.008). FA-PSV-positive MDS/AML patients had a higher tumor mutation burden, higher rate of cytogenetic abnormalities, less epigenetic regulation, and fewer spliceosome gene mutations than those of FA-PSV-negative MDS/AML patients (P = 0.024, P = 0.029, P = 0.024, and P = 0.013). The overall PSV enrichment in our cohort suggests that heterozygous mutations of FA genes contribute to hematopoietic failure and leukemogenesis.
Anemia, Aplastic/genetics* ; Epigenesis, Genetic ; Fanconi Anemia/genetics* ; Germ Cells ; Hematologic Neoplasms/genetics* ; Humans ; Leukemia, Myeloid, Acute/genetics* ; Retrospective Studies

OBJECTIVE: To detect fusion gene with pathological significance in a patient with refractory and relapsed acute B cell lymphoblastic leukemia (B-ALL) and to explore its laboratory and clinical characteristics. METHODS: Transcriptome sequencing was used to detect potential fusion transcripts. Other laboratory results and clinical data of the patient were also analyzed. RESULTS: The patient was found to harbor TCF3 exon 17-ZNF384 exon 7 in-frame fusion transcript. The minimal residual disease (MRD) has remained positive after multiple chemotherapy protocols including CD19-, CD22- targeted chimeric antigen receptor T cells immunotherapy. The patient eventually achieved complete remission and sustained MRD negativity after allogeneic hemopoietic stem cell transplantation (allo-HSCT). CONCLUSION Transcriptome sequencing can effectively detect potential fusion genes with clinical significance in leukemia. TCF3-ZNF384 positive B-ALL has unique laboratory and clinical characteristics, may not well respond to chemotherapy and immunotherapy, and is more likely to relapse. Timely allo-HSCT treatment may help such patients to achieve long-term disease-free survival. TCF3-ZNF384 positive B-ALL is not uncommon in pediatric patients but has not been effectively identified.
B-Lymphocytes ; Basic Helix-Loop-Helix Transcription Factors/genetics* ; Child ; Hematopoietic Stem Cell Transplantation ; Humans ; Laboratories ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy* ; Trans-Activators/genetics* ; Transcriptome

Objective: To explore the clinical effect of bone grafting in the injured vertebrae combined with pedicle screw-rod system assisted with drugs in treating lumbar vertebral compression fracture in the elderly. Methods: A retrospective case-control study was carried out to analyze the clinical data of 48 cases of lumbar vertebral compression fracture in the elderly admitted to the Union Hospital between October 2015 and October 2018. There were 34 males and 14 females, aged 60-78 years [(62.8±2.5)years]. Segment of injury was L₁ in 37 cases, L₂ in 7, L₃ in 2, and L₄ in 4. There were 20 cases in bone grafting group involving 15 males and five females, aged from 60 to 78 years [(63.7±2.1)years]. There were 28 cases in non-bone grafting group involving 19 males and nine females, aged from 60 to 75 years [(62.4±2.9)years]. The Frankel scale in bone grafting group was grade D in 15 cases and grade E in 5, and in non-bone grafting group was grade D in 18 cases and grade E in 10. All the cases were treated by pedicle screw fixation combined with antiosteoporosis drugs, and the bone grafting group were treated by bone grafting via the injured vertebrae, but the other group were not. The intraoperative blood loss and operation time for each segmental vertebrae were recorded. The visual analogue scale (VAS) before operation and one year after operation, the bone healing at three months and one year postoperatively were recorded. The compression rate of the injured vertebrae at operation, at one day and one-year postoperatively as well as the height loss of the injured vertebrae at postoperative one year were measured. Spinal cord injury was also evaluated by Frankel scale. Wound healing, lower limb thrombosis, lung infection and ulcer were observed. Results: All the cases were followed up, with duration for 12-25 months [(16.2±3.4)months] in bone grafting group and 15-24 months [(17.5±5.4)months] in non-bone grafting group (P>0.05). The blood loss was (240±70)ml in bone grafting group and (210±65)ml in non-bone grafting group (P>0.05). Screw implantation time for each segment was (38.5±9.6)minutes in bone grafting group and (30.5±5.4)minutes in non-bone grafting group (P<0.05). The VAS was (7.5±1.8)points preoperatively and (1.5±0.7)points at one year postoperatively in bone grafting group, while (7.8±1.4)points and (2.9±1.2)points in non-bone grafting group, with significant difference between the two groups at one year postoperatively (P<0.05). The fracture healing rate was 85% (17/20) and 95% (19/20) at three months and one year postoperatively in bone grafting group, while 64%(18/28) and 86%(24/28) in non-bone grafting group, with no statistical difference between the two groups (P>0.05). No significant difference was found in compression rate of the injured vertebral height between the two groups before and after operation (P>0.05). The height loss rate of the injured vertebrae was 3% (2%, 4%) at one year postoperatively in bone grafting group and 6% (5%, 8%) in non-bone grafting group (P<0.05). The Frankel scale was all Grade E postoperatively. During the follow-up, no lower limb thrombosis, lung infection or ulcer occurred. One case had bone non-union in bone grafting group and four in non-bone grafting group (P>0.05). Conclusion For lumbar vertebral compression fracture in the elderly, bone grafting in the injured vertebrae combined with pedicle screw-rod system assisted with drugs is significantly better in recovering and maintaining the injured vertebrae height, relieving the pain and promoting the bone healing, although the screw implantation time is prolonged.

Objective:To investigate the infection spectrum revealed by metagenomics high-throughput next-generation sequencing (mNGS), and to provide a reference for infection diagnosis after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:A total of 64 patients who developed systemic or local infection symptoms after allo-HSCT in Hebei Yanda Lu Daopei Hospital from January 2018 to November 2018 were enrolled. Gene sequences of pathogenic microorganisms in blood, cerebrospinal fluid and bronchoalveolar fluid specimens were detected by using mNGS. The pathogenic microorganisms or suspected pathogens were determined based on the clinical manifestations of patients.Results:There were 97 samples of mNGS detection for 64 patients who underwent allo-HSCT. The most common gram-positive bacteria were staphylococcus haemolyticus (19 times) and staphylococcus (14 times), and the most common gram-negative bacterium was acinetobacter baumannii (8 times). The most common viruses were cytomegalovirus, EB virus and Torque teno virus (35, 22 and 23 times, respectively), and the most common fungi were malassezia globus (14 times) and candida parapsilosis (8 times). There were 3 mycobacterium tuberculosis complexes detected in 3 patients with acute myeloid leukemia who received allo-HSCT. Mycoplasma orale was detected in one patient's sputum, and none parasite was detected.Conclusion:mNGS can comprehensively reveal the infection spectrum of hematologic diseases after allo-HSCT, especially for pathogenic microorganisms that are rare or difficult to cultivate, and it can effectively help the diagnosis of clinically infectious pathogens.