Objective:To analyze the effect of hyperbaric oxygen therapy on peritoneal dialysis（PD）patients with cognitive impairment and its impact on quality of life.Methods:A total of 120 maintenance PD patients with cognitive impairment admitted to Linyi Central Hospital from December 2019 to December 2020 were divided into observation group and control group according to the random number table method，with 60 cases in each group. Patients in both groups received conventional treatments including PD for end-stage renal disease. The control group received cognitive training，and the observation group received hyperbaric oxygen therapy on the basis of the training of the control group. The changes of cognitive function and quality of life of the patients in the two groups were compared.Results:There was no significant difference in the levels of BUN，Scr，PaO 2，PaCO 2，and pH between the two groups before and after treatment（ P>0.05）. After treatment，Hb levels in the two groups were significantly higher than those before treatment，with statistically significant differences（ P<0.05），while there was no statistically significant difference between the two groups（ P>0.05）. After treatment，the Addenbrooke’s Cognitive Examination-Revised（ACE-R）total score and sub-scale scores of patients in both groups were significantly increased than those before treatment，with statistically significant differences（ P<0.05），and those scores in the observation group were significantly higher than those in the control group，with statistically significant differences（ P<0.05）. The serum BNDF level of the observation group was significantly higher than that before treatment. The serum Hcy and CRP levels of the two groups were significantly lower than those before treatment，with statistically significant differences（ P<0.05），and those two levels of the observation group were significantly lower than those of the control group，with statistically significant differences（ P<0.05）. The indicators of quality of life in the two groups were significantly improved than those before treatment，with statistically significant differences（ P<0.05），and the indicators of the observation group were better than those of the control group，with statistically significant differences（ P<0.05）. There was no statistically significant difference in the incidence of adverse events between the two groups during treatment（ P>0.05）. Conclusion:Hyperbaric oxygen therapy can significantly improve the cognitive function and quality of life of PD patients，and it is safe and reliable，which is worthy of clinical promotion.

Objective:To analyze the effect of hyperbaric oxygen therapy on peritoneal dialysis（PD）patients with cognitive impairment and its impact on quality of life.Methods:A total of 120 maintenance PD patients with cognitive impairment admitted to Linyi Central Hospital from December 2019 to December 2020 were divided into observation group and control group according to the random number table method，with 60 cases in each group. Patients in both groups received conventional treatments including PD for end-stage renal disease. The control group received cognitive training，and the observation group received hyperbaric oxygen therapy on the basis of the training of the control group. The changes of cognitive function and quality of life of the patients in the two groups were compared.Results:There was no significant difference in the levels of BUN，Scr，PaO 2，PaCO 2，and pH between the two groups before and after treatment（ P>0.05）. After treatment，Hb levels in the two groups were significantly higher than those before treatment，with statistically significant differences（ P<0.05），while there was no statistically significant difference between the two groups（ P>0.05）. After treatment，the Addenbrooke’s Cognitive Examination-Revised（ACE-R）total score and sub-scale scores of patients in both groups were significantly increased than those before treatment，with statistically significant differences（ P<0.05），and those scores in the observation group were significantly higher than those in the control group，with statistically significant differences（ P<0.05）. The serum BNDF level of the observation group was significantly higher than that before treatment. The serum Hcy and CRP levels of the two groups were significantly lower than those before treatment，with statistically significant differences（ P<0.05），and those two levels of the observation group were significantly lower than those of the control group，with statistically significant differences（ P<0.05）. The indicators of quality of life in the two groups were significantly improved than those before treatment，with statistically significant differences（ P<0.05），and the indicators of the observation group were better than those of the control group，with statistically significant differences（ P<0.05）. There was no statistically significant difference in the incidence of adverse events between the two groups during treatment（ P>0.05）. Conclusion:Hyperbaric oxygen therapy can significantly improve the cognitive function and quality of life of PD patients，and it is safe and reliable，which is worthy of clinical promotion.

Objective:To investigate the dose-response relationship between serum polycyclic aromatic hydrocarbon adducts and serum complement C3 and C4 levels among children from a city in East China.Methods:In September 2016, two boarding schools in the air pollution exposure area and the control area (beyond the upwind of 30 km in the air pollution exposure area) in a city in East China were selected as the research site, and the eligible school-age children were recruited as the research objects. A total of 273 children were included, including 163 in the exposure group and 110 in the control group. The annual air pollutant data (PM 2.5, PM 10 and NO 2) of the two regions during the study period were collected. The exposure level of tobacco was evaluated by cotinine in urine. The levels of serum complement C3 and C4 were determined by automatic biochemical analyzer. The serum anti-7, 8, -dihydrodiol-9, 10-epoxide benzo[a]pyrene (BPDE)-albumin adduct levels were detected by ELISA. Linear regression model was used to explore the dose-response relationship between BPDE-albumin adducts and serum complement C3 and C4. Results:The age of 273 subjects was (13.67±0.37) years old, including 165 boys (60.4%). The average annual exposure levels of PM 2.5, PM 10 and NO 2 and the level of serum BPDE-albumin adducts in the exposure group were higher than those in the control group ( P<0.05). The results of linear regression model analysis showed that after adjusting age, sex, BMI z-score and urinary cotinine level, when the serum BPDE-albumin adduct level increased by 10%, the serum complement C4 level decreased by 1.2% ( P=0.017). After adjusting age, BMI z-score and urinary cotinine level, for every 10% increase in serum BPDE-albumin adduct level in boys, the serum complement C4 level decreased by 1.68% ( P=0.024). After adjusting age, sex and BMI z-score, the levels of serum complement C3 and C4 decreased by 1.31% and 3.57% respectively for every 10% increase in serum BPDE-albumin adducts among children in the urinary cotinine detection group ( P<0.05). Conclusion:There is a significant dose-response relationship between serum BPDE-albumin adducts and the complement C4 among children.

Objective:To investigate the dose-response relationship between serum polycyclic aromatic hydrocarbon adducts and serum complement C3 and C4 levels among children from a city in East China.Methods:In September 2016, two boarding schools in the air pollution exposure area and the control area (beyond the upwind of 30 km in the air pollution exposure area) in a city in East China were selected as the research site, and the eligible school-age children were recruited as the research objects. A total of 273 children were included, including 163 in the exposure group and 110 in the control group. The annual air pollutant data (PM 2.5, PM 10 and NO 2) of the two regions during the study period were collected. The exposure level of tobacco was evaluated by cotinine in urine. The levels of serum complement C3 and C4 were determined by automatic biochemical analyzer. The serum anti-7, 8, -dihydrodiol-9, 10-epoxide benzo[a]pyrene (BPDE)-albumin adduct levels were detected by ELISA. Linear regression model was used to explore the dose-response relationship between BPDE-albumin adducts and serum complement C3 and C4. Results:The age of 273 subjects was (13.67±0.37) years old, including 165 boys (60.4%). The average annual exposure levels of PM 2.5, PM 10 and NO 2 and the level of serum BPDE-albumin adducts in the exposure group were higher than those in the control group ( P<0.05). The results of linear regression model analysis showed that after adjusting age, sex, BMI z-score and urinary cotinine level, when the serum BPDE-albumin adduct level increased by 10%, the serum complement C4 level decreased by 1.2% ( P=0.017). After adjusting age, BMI z-score and urinary cotinine level, for every 10% increase in serum BPDE-albumin adduct level in boys, the serum complement C4 level decreased by 1.68% ( P=0.024). After adjusting age, sex and BMI z-score, the levels of serum complement C3 and C4 decreased by 1.31% and 3.57% respectively for every 10% increase in serum BPDE-albumin adducts among children in the urinary cotinine detection group ( P<0.05). Conclusion:There is a significant dose-response relationship between serum BPDE-albumin adducts and the complement C4 among children.

Objective: To analyze the exposure level and the geographical distribution trend of toxicological indicators of rural drinking water in Shandong Province. Methods: The drawing method was used to randomly select no less than 60% villages and towns from 137 counties (cities, districts) of 17 cities in Shandong Province in 2015, and then 1-3 rural centralized water supply units were selected according to the circumstance of rural centralized water supply units in each village and town. In total, 735 villages and towns, 1 473 rural centralized water supply units were selected, and 1 473 water samples were collected. The water treatment process, water supply population and other circumstances of the rural centralized water supply units were investigated, the water quality was monitored, the content of toxicological indicators of drinking water in different areas was compared, and the trend surface isogram of excessive toxicological indicators was drawn. Results: The qualified rate of toxicological indicators in 1 473 water samples was 83.64% (n=1 232). The main toxicological indicators that affected the qualified rate of toxicological indicators of drinking water in rural areas in Shandong Province were nitrate and fluoride. The excessive rate of fluoride was 5.70% (n=84) and the exposed population was 1 736 709 (4.22%). The excessive rate of nitrate (as nitrogen) was 12.29% (n=181) and the exposed population was 1 393 612 (3.39%). The P₅0 content of fluoride in the eastern, middle and western regions was 0.24, 0.29 and 0.59 mg/L, respective;which was higher in the western region than in the east and the middle regions (P<0.05). There was no significant difference between the eastern and the middle regions (P>0.05). The P₅₀ content of nitrate (as nitrogen) in the eastern, middle and western regions was 8.00, 7.48, and 2.00 mg/L, which was higher in the eastern and middle regions than in the west region (P<0.05), there was no significant difference between the eastern and the middle regions (P>0.05). The trend surface isogram of nitrate and fluoride content showed that the content of nitrate (as nitrogen) in rural drinking water in the eastern region was significantly higher than that in the western region, especially there was a high peak area in the northeastern region, and this high content distribution extended diagonally to the central region, while the other regions were in a relatively low range. The content of fluoride in rural drinking water in the western region was significantly higher than that in the eastern region, and there were high peaks in the southwest and northwest regions, and the other regions were in a relatively low range. Conclusion The high exposed toxicological indicators in rural drinking water in Shandong Province were nitrate (as nitrogen) and fluoride, and their distribution showed obvious geographical distribution trend.

OBJECTIVE: To study the biological exposure limit of 1,3-butadiene occupational exposure. METHODS: A total of 139 workers who exposed to 1,3-butadiene in a rubber plant was chosen as exposure group,and 45 workers without 1,3-butadiene exposure were chosen as control group by judgment sampling method. Gas chromatography-flame ionization detection method was used to detect the level of 1,3-butadiene in workplace air,and ultra-high performance liquid chromatography-tandem mass spectrometric was used to determine the level of urinary dihydroxybutyl mercapturic acid( DHBMA) in end-of-shift workers. The correlation between 1,3-butadiene level and urinary DHBMA level was analyzed.The biological limit of 1,3-butadiene occupational exposure was assessed. RESULTS: The range of concentration-time weighted average( C_(TWA)) of 1,3-butadiene was from 0. 004 to 7. 609 mg/m~3,the medium was 0. 253 mg/m~3 in the exposure group,while the level of urinary DHBMA was from 0. 171 to 4. 235 mg/g Cr,and the medium was 1. 220 mg/g Cr. The range of C_(TWA)of 1,3-butadiene was below detection limit in the control group. The level of urinary DHBMA was from 0. 157 to 1. 808 mg/g Cr,and the medium was 0. 627 mg/g Cr in the control group. The level of urinary DHBMA in the exposure group was higher than that of the control group( P < 0. 01). The level of urinary DHBMA( y) of workers was related to the level of 1,3-butadiene( x) of the workplace air in the exposure group( y = 0. 349 x + 1. 082,P < 0. 01).CONCLUSION: DHBMA in urine could be used as a biomarker for 1,3-butadiene exposure in workers. The recommended biological exposure limit of DHBMA is 2. 900 mg/g Cr.

Objective To explore and validate suitable risk assessment methods for titanium dioxide though applying three risk assessment tools for nanomaterials based on the control banding (CB) approach.Methods A factory manufacturing titanium dioxide in Jinan city,Shandong province,was assessed using a quantitative exposure method and qualitative risk assessment methods in September,2014.A condensation particle counter equipment was used to monitor the number concentration of particles at packaging workshop and jet milling workshop.We employed three control banding tools,including CB nanotool,Stoffenmanager nano and the Guidance on working safely with nanomaterials and nanoproducts (GWSNN) to evaluate the two workshops,then compared the evaluation results.Results The increases of particle concentrations were generated directly by packaging and jet milling processes,the number concentration from (3.52± 1.46)× 104/cm3 to (14.70±8.86) ×104/cm3 at packaging workshop and from (0.97±0.25) ×104/cm3 to (1.26±0.35) ×104/cm3 at milling workshop (both P＜0.05).The number concentrations at packaging workshop were higher than those at jet milling workshop during both manufacturing and break times (both P＜0.05).The results of CB nanotool showed that the risk level of the packaging workshop was classified as high and the risk level of the jet milling workshop was classified asmedium.The results of Stoffenmanager nano showed that the risk level of the packaging workshop was classified as medium and the risk level of the jet milling workshop was classified as low.The results of GWSNN showed that the risk level of packaging workshop was classified as high and the risk level of jet milling workshop was classified as low.Conclusion The results of evaluation based on the three control banding tools are related and aligned with the results of quantitative monitoring,so they are all suitable to perform occupational health risk assessment on industrial scale production of titanium dioxideto some extent.

Objective To explore and validate suitable risk assessment methods for titanium dioxide though applying three risk assessment tools for nanomaterials based on the control banding (CB) approach.Methods A factory manufacturing titanium dioxide in Jinan city,Shandong province,was assessed using a quantitative exposure method and qualitative risk assessment methods in September,2014.A condensation particle counter equipment was used to monitor the number concentration of particles at packaging workshop and jet milling workshop.We employed three control banding tools,including CB nanotool,Stoffenmanager nano and the Guidance on working safely with nanomaterials and nanoproducts (GWSNN) to evaluate the two workshops,then compared the evaluation results.Results The increases of particle concentrations were generated directly by packaging and jet milling processes,the number concentration from (3.52± 1.46)× 104/cm3 to (14.70±8.86) ×104/cm3 at packaging workshop and from (0.97±0.25) ×104/cm3 to (1.26±0.35) ×104/cm3 at milling workshop (both P＜0.05).The number concentrations at packaging workshop were higher than those at jet milling workshop during both manufacturing and break times (both P＜0.05).The results of CB nanotool showed that the risk level of the packaging workshop was classified as high and the risk level of the jet milling workshop was classified asmedium.The results of Stoffenmanager nano showed that the risk level of the packaging workshop was classified as medium and the risk level of the jet milling workshop was classified as low.The results of GWSNN showed that the risk level of packaging workshop was classified as high and the risk level of jet milling workshop was classified as low.Conclusion The results of evaluation based on the three control banding tools are related and aligned with the results of quantitative monitoring,so they are all suitable to perform occupational health risk assessment on industrial scale production of titanium dioxideto some extent.

OBJECTIVERisk assessment and risk control for occupational exposure to chemical toxicants were performed on an isophorone nitrile device with an annual production of 5,000 tons, based on improved Singaporean semi-quantitative risk assessment method, with consideration of actual situation in China and in the present project.

METHODSWith the use of engineering analysis and identification of occupational hazards in the improved Singaporean semi-quantitative risk assessment method, hazard rating (HR) and risk assessment were performed on chemical toxicants from an isophorone nitrile device with an annual production of 5,000 tons.

RESULTSThe chemical toxicants in the isophorone nitrile device were mainly isophorone, hydrocyanic acid, methanol, phosphoric acid, sodium hydroxide, and sodium cyanide; the HR values were mild hazard (2), extreme hazard (5), mild hazard (2), mild hazard (2), moderate hazard (3), and extreme hazard (5), respectively, and the corresponding exposure rating (ER) values were 2.09, 2.72, 2.76, 1.68, 2.0, and 1.59, respectively. The risk of chemical toxicants in this project was assessed according to the formula Risk = [HR×ER](1/2). Hydrocyanic acid was determined as high risk, sodium hydroxide and sodium cyanide as medium risk, and isophorone, methanol, and phosphoric acid as low risk. Priority in handling of risks was determined by risk rating. The table of risk control measure was established for pre-assessment of occupational hazards.

CONCLUSIONWith risk assessment in this study, we concluded that the isophorone nitrile device with 5,000 ton annual production was a high-occupational hazard device. This device is a project of extreme occupational hazard. The improved Singaporean semi-quantitative risk assessment method is a scientific and applicable method, and is especially suitable for pre-evaluation of on-site project with no analogy.

To provide the human being with safe drinking water is one of the most important issues in public health. In response to the more and more serious pollution of algal toxins, growing concern has been attached to the water bodies contaminated with algal toxins and the effects posed on human health. Drinking water suppliers are confronted with the important problem of how to remove the toxins to the acceptable levels. Conventional water treatment procedures are not efficient in removing toxins. Activated carbon adsorption, membrane filtration, photocatalic process, ozonation and chlorination are effective in removing cyanobacterial toxins, but each has its limitation.