Objective:To evaluate the use of cruciate incision, Y-shaped incision and fusiform incision in high perianal abscess patients undergoing incision surgery .Methods:One hundred and sisty-one patients of high perianal abscess treated by drainage surgery at Nanjing Hospital of Traditional Chinese Medicine from Feb to Jun 2024 were randomly divided into shuttle shape incision group , cruciate incision group , and Y-shaped incision group , and the three groups were compared for traumatic granulomatous histopathologic changes, traumatic healing, complications, recurrence, and scar formation on the 2nd, 7th, and 14th postoperative days .Results:On the 14th postoperative day, both the crucifix group and the Y-shaped group had higher trabecular capillary density and plasma cell counts than the shuttle group, while the CD34 and CD138 counts of these two groups were significantly higher than those of the shuttle group, and the differences were statistically significant ( H=12.58, 9.49, P=0.002, 0.009). The wound edema and secretion was more significent in the crucifix group and the least secretion in the incision in the Y-shape group.The wound healing time was shorter than that in the shuttle group in both groups,and the difference was statistically significant [(51.67±7.09) d vs. (48.80±6.75) d vs. (55.41±8.25) d, F=10.622, P=0.001]. The crucifix and Y-shaped groups were superior to the shuttle group in terms of postoperative complications, but the difference was not statistically significant ( P>0.05). The difference between the three type incisions in terms of distant scar severity scores was not statistically significant ( P>0.05). Conclusion:Crucifixion incision and Y-shaped incision are superior to shuttle shape incision in the treatment of high perianal abscess, which can significantly promote the growth of granulation tissue and wound healing.

The Guidelines for Occupational Hazard Assessment and Control of Active Pharmaceutical Ingredient in the Pharmaceutical Industry (T/WSJD 60—2024) is the first guiding standard in the field of health in China that focuses on occupational health protection for active pharmaceutical ingredient (API). It covers the general principles, work procedures, assessment methods, and control strategies for API occupational hazard assessment, providing practical guidance and recommendations for pharmaceutical enterprises to eliminate or reduce occupational health risks associated with API, improve working environment, and enhance refined management practices. This article interpreted and analyzed the background of standard establishment, formulation process, fundamental basis, and main content, to provide scientific and comprehensive technical support for occupational health managers in the pharmaceutical industry to better apply this standard.

Objective:To investigate the pollution status of legionella pneumophila of industrial circulating cooling towers, and explore the factors affecting the positive rate and quantity of legionella pneumophila, in order to provide data support for the risk assessment and hierarchical management of legionella pneumophila in workplaces.Methods:In February, May, August and October 2023, the cooling water samples were collected from a total of 20 industrial circulating cooling towers of 9 enterprises in an industrial park in Shanghai. The water temperature, free residual chlorine, total residual chlorine, turbidity, chroma, pH, conductivity, chemical oxygen consumption, iron content and total plate count in the water samples were detected. Meanwhile, the legionella pneumophila in the water samples were qualitatively and quantitatively analyzed, and the influence of water quality indexes on the positive rate and number of legionella pneumophila detected was analyzed by logistic regression and linear regression respectively.Results:The positive rates of legionella pneumophila in the first to fourth quarters of 20 industrial circulating cooling towers of 9 chemical enterprises were 35% (7/20), 45% (9/20), 45% (9/20), and 85% (17/20). The serotypes of legionella pneumophila detected in the cooling tower were mainly legionella pneumophila type 1 (95.2%, 40/42), and the number of legionella pneumophila ranged from 0.2 to 316.8 cfu/ml. Circulating cooling water temperature ( OR=1.36, 95% CI: 1.12-1.64, P=0.001) and conductivity ( OR=1.02, 95% CI: 1.00-1.03, P=0.026) were independent risk factors affecting the detection of legionella pneumophila. There was a positive correlation between chemical oxygen consumption and the detected amount of legionella pneumophila ( β=8.08, P=0.002) . Conclusion:The positive rate of legionella pneumophila in industrial circulating cooling water system is high, and the detected quantity fluctuates greatly, which may have health risks, suggesting that it is necessary to pay attention to the water quality management such as water temperature, conductivity and chemical oxygen consumption of industrial circulating cooling water and the monitoring and control of legionella pneumophila.

Objective:To explore the early predictive value of the triglyceride-glucose (TyG) index and the controlling nutritional status (CONUT) score for severe acute pancreatitis (SAP).Methods:Clinical data from 1 050 hospitalized patients with acute pancreatitis (AP) at the General Hospital of Central Theater Command between January 2019 and December 2023 were retrospectively analyzed. Patients were categorized into mild acute pancreatitis (MAP) group ( n=606), moderately severe acute pancreatitis (MSAP) group ( n=320), and SAP group ( n=124) based on AP severity. General clinical data, laboratory parameters, modified computed tomography severity index (MCTSI), bedside index for severity in acute pancreatitis (BISAP), TyG index, and CONUT score were compared among the three groups. Spearman correlation analysis was used to evaluate the relationship between TyG index, CONUT score and AP severity. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for AP severity. Receiver operating characteristic curves (ROC) were plotted to calculate the area under the curve (AUC), sensitivity, and specificity for evaluating the predictive efficacy of TyG index, CONUT score, and their combination for SAP. Results:Significant differences on TyG index and CONUT score were observed among AP patients with varying severity (all P value <0.001). Spearman correlation analysis further revealed positive correlations of TyG index ( r=0.174), CONUT score ( r=0.306) with AP severity (both P<0.001). Multivariate logistic regression identified neutrophil count ( OR=1.076, 95% CI 1.027-1.125), MCTSI ( OR=2.565, 95% CI 2.250-2.921), BISAP ( OR=3.522, 95% CI 2.726-4.549), TyG index ( OR=1.859, 95% CI 1.276-2.707), and CONUT score ( OR=1.155, 95% CI 1.035-1.288) as independent risk factors for AP severity. The combined predictive model equation was: -7.342+0.76×TyG+0.439×CONUT. ROC analysis showed that the AUC values of the TyG index, CONUT score, and the combined index (TyG index+CONUT score) were 0.583 (95% CI 0.529-0.637), 0.701 (95% CI 0.652-0.75), and 0.755 (95% CI 0.710-0.801), with sensitivities of 0.706, 0.677, and 0.742, and specificities of 0.884, 0.629, and 0.657, respectively (all P value <0.05). Conclusions:TyG index and CONUT score are positively correlated with AP severity and may serve as reliable predictors for SAP. Their combination could enhance the predictive accuracy for AP.

Objective:To explore the early predictive value of the triglyceride-glucose (TyG) index and the controlling nutritional status (CONUT) score for severe acute pancreatitis (SAP).Methods:Clinical data from 1 050 hospitalized patients with acute pancreatitis (AP) at the General Hospital of Central Theater Command between January 2019 and December 2023 were retrospectively analyzed. Patients were categorized into mild acute pancreatitis (MAP) group ( n=606), moderately severe acute pancreatitis (MSAP) group ( n=320), and SAP group ( n=124) based on AP severity. General clinical data, laboratory parameters, modified computed tomography severity index (MCTSI), bedside index for severity in acute pancreatitis (BISAP), TyG index, and CONUT score were compared among the three groups. Spearman correlation analysis was used to evaluate the relationship between TyG index, CONUT score and AP severity. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for AP severity. Receiver operating characteristic curves (ROC) were plotted to calculate the area under the curve (AUC), sensitivity, and specificity for evaluating the predictive efficacy of TyG index, CONUT score, and their combination for SAP. Results:Significant differences on TyG index and CONUT score were observed among AP patients with varying severity (all P value <0.001). Spearman correlation analysis further revealed positive correlations of TyG index ( r=0.174), CONUT score ( r=0.306) with AP severity (both P<0.001). Multivariate logistic regression identified neutrophil count ( OR=1.076, 95% CI 1.027-1.125), MCTSI ( OR=2.565, 95% CI 2.250-2.921), BISAP ( OR=3.522, 95% CI 2.726-4.549), TyG index ( OR=1.859, 95% CI 1.276-2.707), and CONUT score ( OR=1.155, 95% CI 1.035-1.288) as independent risk factors for AP severity. The combined predictive model equation was: -7.342+0.76×TyG+0.439×CONUT. ROC analysis showed that the AUC values of the TyG index, CONUT score, and the combined index (TyG index+CONUT score) were 0.583 (95% CI 0.529-0.637), 0.701 (95% CI 0.652-0.75), and 0.755 (95% CI 0.710-0.801), with sensitivities of 0.706, 0.677, and 0.742, and specificities of 0.884, 0.629, and 0.657, respectively (all P value <0.05). Conclusions:TyG index and CONUT score are positively correlated with AP severity and may serve as reliable predictors for SAP. Their combination could enhance the predictive accuracy for AP.

Objective:To evaluate the use of cruciate incision, Y-shaped incision and fusiform incision in high perianal abscess patients undergoing incision surgery .Methods:One hundred and sisty-one patients of high perianal abscess treated by drainage surgery at Nanjing Hospital of Traditional Chinese Medicine from Feb to Jun 2024 were randomly divided into shuttle shape incision group , cruciate incision group , and Y-shaped incision group , and the three groups were compared for traumatic granulomatous histopathologic changes, traumatic healing, complications, recurrence, and scar formation on the 2nd, 7th, and 14th postoperative days .Results:On the 14th postoperative day, both the crucifix group and the Y-shaped group had higher trabecular capillary density and plasma cell counts than the shuttle group, while the CD34 and CD138 counts of these two groups were significantly higher than those of the shuttle group, and the differences were statistically significant ( H=12.58, 9.49, P=0.002, 0.009). The wound edema and secretion was more significent in the crucifix group and the least secretion in the incision in the Y-shape group.The wound healing time was shorter than that in the shuttle group in both groups,and the difference was statistically significant [(51.67±7.09) d vs. (48.80±6.75) d vs. (55.41±8.25) d, F=10.622, P=0.001]. The crucifix and Y-shaped groups were superior to the shuttle group in terms of postoperative complications, but the difference was not statistically significant ( P>0.05). The difference between the three type incisions in terms of distant scar severity scores was not statistically significant ( P>0.05). Conclusion:Crucifixion incision and Y-shaped incision are superior to shuttle shape incision in the treatment of high perianal abscess, which can significantly promote the growth of granulation tissue and wound healing.

Objective:To investigate the pollution status of legionella pneumophila of industrial circulating cooling towers, and explore the factors affecting the positive rate and quantity of legionella pneumophila, in order to provide data support for the risk assessment and hierarchical management of legionella pneumophila in workplaces.Methods:In February, May, August and October 2023, the cooling water samples were collected from a total of 20 industrial circulating cooling towers of 9 enterprises in an industrial park in Shanghai. The water temperature, free residual chlorine, total residual chlorine, turbidity, chroma, pH, conductivity, chemical oxygen consumption, iron content and total plate count in the water samples were detected. Meanwhile, the legionella pneumophila in the water samples were qualitatively and quantitatively analyzed, and the influence of water quality indexes on the positive rate and number of legionella pneumophila detected was analyzed by logistic regression and linear regression respectively.Results:The positive rates of legionella pneumophila in the first to fourth quarters of 20 industrial circulating cooling towers of 9 chemical enterprises were 35% (7/20), 45% (9/20), 45% (9/20), and 85% (17/20). The serotypes of legionella pneumophila detected in the cooling tower were mainly legionella pneumophila type 1 (95.2%, 40/42), and the number of legionella pneumophila ranged from 0.2 to 316.8 cfu/ml. Circulating cooling water temperature ( OR=1.36, 95% CI: 1.12-1.64, P=0.001) and conductivity ( OR=1.02, 95% CI: 1.00-1.03, P=0.026) were independent risk factors affecting the detection of legionella pneumophila. There was a positive correlation between chemical oxygen consumption and the detected amount of legionella pneumophila ( β=8.08, P=0.002) . Conclusion:The positive rate of legionella pneumophila in industrial circulating cooling water system is high, and the detected quantity fluctuates greatly, which may have health risks, suggesting that it is necessary to pay attention to the water quality management such as water temperature, conductivity and chemical oxygen consumption of industrial circulating cooling water and the monitoring and control of legionella pneumophila.

Objective:Exploring the clinical characteristics and treatment outcomes of tailgut cysts, and improving the understanding of this disease.Methods:A retrospective analysis of 42 patients with tailgut cyst surgically treated from Jan 2012 to Mar 2024 was conducted.Results:This study included 42 patients (28 females,14 males) with a median age of 51 (23-76)years old. Nineteen cases of perineal/abdominal pain, 13 cases of perianal swelling, 10 cases of perianal abscess, 7 cases of sacrococcygeal sinus, and 4 cases of anal mass were observed. These symptoms often occurred simultaneously. All 42 patients had lesions located behind the rectum, with a relative position to the coccyx (7 above the coccyx, 17 below the coccyx, 11 above and between the coccyx levels, and 7 horizontally).Tailgut cysts were located in the pelvic floor, with 3 cases above the levator ani muscle, 17 cases below the levator ani muscle, and 22 cases between the levator ani muscle levels. Forty-one cases were treated with posterior approach, and 1 case was treated with combined approach. Thirty-two were unilocular and 10 multilocular. Female patients with multiple compartments were significantly more common than males ( P<0.05), while tumor location, tumor size, recurrence, and malignancy were all independent of gender. After surgery, 8 cases (19％) experienced recurrences and 5 cases of malignant transformation patients had a long term multiple relapses. Conclusions:Tailgut cysts are rare,while women were common seen.Non-specific symptoms of pain in the perineum or abdomen, perianal swelling or abscess, are usually observed. In addition, multiple relapses could have malignant transformation. Surgical complete resection is the most reasonable treatment method and the appropriate surgical path should be selected based on the size, location, and relationship with adjacent tissues of the tumor.

Objective:To conduct a scoping review on symptom cluster of hematopoietic stem cell transplantation (HSCT) patients, aiming to provide reference for improving postoperative symptom management in HSCT patients.Methods:The study on postoperative symptom clusters in HSCT patients was searched in PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Database, VIP, and WanFang Data. The search period was from database establishment to July 17, 2023.Results:A total of 10 articles were included, and 9 symptom clusters were extracted. The top three symptom clusters in terms of frequency were fatigue related, gastrointestinal related, and psychological symptom clusters. The influencing factors of symptom cluster mainly included chronic graft-versus-host disease, transplant type, conditioning regimen, gender, depression level and so on. The heterogeneity of HSCT patient symptom cluster assessment tools was relatively high.Conclusions:The dynamic changes of postoperative symptom clusters in HSCT patients are influenced by multiple factors, and specific assessment tools still need to be developed.

Background Workers in printing jobs are exposed to a variety of organic solvents at low levels for a long period of time. Previous studies have focused on the main components in Material Safety Data Sheet or high-risk occupational hazardous agents, but have not been able to comprehensively and accurately identify the volatile organic compounds (VOCs) in printing jobs. Objective To qualitatively analyze the VOCs in ink, detergent, varnish, fountain solution, and other raw and auxiliary materials by headspace gas chromatography-mass spectrometry, and to accurately identify the occupational hazardous agents in printing jobs. Methods Raw and auxiliary materials used in printing jobs in 6 printing enterprises in Shanghai were sampled by headspace sampling, analyzed by gas chromatography-mass spectrometry, identified by National Institute of Standards & Technology ( NIST) Standard Library and retention time, and quantified by peak area percentage. Results A total of 181 VOCs were reported in the headspace of 25 organic solvent samples, with a total detection frequency of 337 items and 13.2±12.3 VOCs per sample. The most frequently detected VOCs category was naphthene, with a total of 69 items detected (22.5%), dominated by cyclohexane. The characteristics of VOCs components in the headspace of different types of samples were different. The largest number of VOCs was detected in the headspace of detergent samples, with an average of 31.5 VOCs detected. The characteristic components in detergent were aromatic hydrocarbons and ester compounds; alcohols were the characteristic components in varnish; and ester compounds were the characteristic components in ink. The results of cluster analysis showed that ethanol, toluene, ethyl acetate, cyclohexane, and acetone were occupational hazardous agents with high levels of exposure in printing jobs. Conclusion Many kinds of organic solvents used in printing process are difficult to identify by traditional methods. Headspace gas chromatography-mass spectrometry can help to accurately identify VOCs in the workplace, so as to more accurately assess the occupational hazards, and to provide a technical basis for guiding occupational health monitoring and implementing corresponding occupational health risk management and control.