Objective To analyze the development trends and hot topics in the field of phosgene poisoning research in China. Methods The China National Knowledge Infrastructure was used as the retrieval source to search for academic literature on phosgene poisoning published in Chinese journals from the database's inception to December 31, 2023. CiteSpace 6.2.R6 software was used for bibliometric analysis and visualization. Results A total of 334 articles were included for analysis. The earliest literature was published in 1982, with publication peaks occurring in 2004-2005 and 2011, followed by a gradual decline in publications after 2013. Authors from 221 research institutions published related literature in 133 kinds of Chinese journals. There were 19 core authors with three or more publications, and some of these core authors formed relatively stable research teams. Grants were covered 32.0% of the literature, and case reports and articles accounted for 89.2% of the literature, with “pulmonary edema” being the earliest and most prominent keyword. Conclusion The field of phosgene poisoning research in China has achieved some progress, particularly in studies related to the mechanisms of pulmonary edema and lung injury. However, there is a need to enhance collaboration among research institutions, deepen research efforts, and improve the quality of scientific research outcomes.

Hazardous drugs represented by antineoplastic drugs have clear health hazards to occupational exposed populations, and this issue has received widespread attention all over the world in recent years. This article reviewed the laws, regulations, guidelines, and industry guidance documents for the prevention and control of occupational exposure to hazardous drugs issued by relevant departments and associations in the United States. It could provide a reference basis for the development of occupational environmental health standards and protection guidelines, with the aim of reducing the risk of occupational exposure to hazardous drugs and promoting the healthy development of healthcare services in China.

Objective:To explore the influencing factors of abnormal blood pressure and electrocardiogram (ECG) in occupational motor vehicle drivers.Methods:In January 2024, a cluster sampling method was used to study 606 occupational motor vehicle drivers from a transportation service enterprise in Beijing who completed occupational health examination in 2023 in Peking University Third Hospital as observation group and 596 non-occupational motor vehicle drivers as control group. The data of personal history, occupational history, blood pressure and ECG were collected, and the effects of occupational motor vehicle driving on hypertension and ECG were analyzed by multivariate logistic regression.Results:The age of workers in the observation group was (34.1±7.8) years old, and the length of service was (7.0±7.1) years. The age of the control group was (33.8±7.6) years old, and the working age was (7.7±6.5) years. There was no significant difference in age and length of service between the two groups ( t=0.62, -1.90, P=0.538, 0.057). Systolic blood pressure (133.0±14.7) mmHg, diastolic blood pressure (83.7±11.6) mmHg, hypertension detection rate of 33.0% (200/606), ECG abnormality detection rate of 39.9% (242/606). They were significantly higher than those in the control group [ (127.8±14.4) mmHg, (77.5±11.0) mmHg, 24.7% (147/596), 31.0% (185/596) ], and the differences were statistically significant ( P<0.05). Multivariate logistic regression analysis showed that occupational motor vehicle driving were risk factors for hypertension and abnormal ECG ( OR= 1.210, 1.578; 95% CI: 1.145-1.231, 1.237-2.012; P<0.001) . Conclusion:Occupational motor vehicle driving may increase the risk of hypertension and abnormal ECG in workers.

Hazardous drugs represented by antineoplastic drugs have clear health hazards to occupational exposed populations, and this issue has received widespread attention all over the world in recent years. This article reviewed the laws, regulations, guidelines, and industry guidance documents for the prevention and control of occupational exposure to hazardous drugs issued by relevant departments and associations in the United States. It could provide a reference basis for the development of occupational environmental health standards and protection guidelines, with the aim of reducing the risk of occupational exposure to hazardous drugs and promoting the healthy development of healthcare services in China.

Objective:To explore the influencing factors of abnormal blood pressure and electrocardiogram (ECG) in occupational motor vehicle drivers.Methods:In January 2024, a cluster sampling method was used to study 606 occupational motor vehicle drivers from a transportation service enterprise in Beijing who completed occupational health examination in 2023 in Peking University Third Hospital as observation group and 596 non-occupational motor vehicle drivers as control group. The data of personal history, occupational history, blood pressure and ECG were collected, and the effects of occupational motor vehicle driving on hypertension and ECG were analyzed by multivariate logistic regression.Results:The age of workers in the observation group was (34.1±7.8) years old, and the length of service was (7.0±7.1) years. The age of the control group was (33.8±7.6) years old, and the working age was (7.7±6.5) years. There was no significant difference in age and length of service between the two groups ( t=0.62, -1.90, P=0.538, 0.057). Systolic blood pressure (133.0±14.7) mmHg, diastolic blood pressure (83.7±11.6) mmHg, hypertension detection rate of 33.0% (200/606), ECG abnormality detection rate of 39.9% (242/606). They were significantly higher than those in the control group [ (127.8±14.4) mmHg, (77.5±11.0) mmHg, 24.7% (147/596), 31.0% (185/596) ], and the differences were statistically significant ( P<0.05). Multivariate logistic regression analysis showed that occupational motor vehicle driving were risk factors for hypertension and abnormal ECG ( OR= 1.210, 1.578; 95% CI: 1.145-1.231, 1.237-2.012; P<0.001) . Conclusion:Occupational motor vehicle driving may increase the risk of hypertension and abnormal ECG in workers.

Objective To investigate the role of histone H4 in the polarization of alveolar macrophages (AM) in lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) in mice. Methods i) The specific pathogen free male C57BL/6 mice were randomly divided into control group and 2, 4, 6 and 8 mg/kg LPS groups, with six mice in each group. The mice in the LPS groups were intratracheally administered LPS according to their respective doses, while the mice in the control group received an equivalent volume of 0.9% saline. After 12 hours, the arterial blood gas was analyzed, and the pulmonary edema and histopathological changes in lung tissues of mice in each group were observed. The level of histone H4 in bronchoalveolar lavage fluid (BALF) of mice was detected using enzyme-linked immunosorbent assay , and mice AMs of the five group were isolated using adherent method. ii) AMs from normal mice were isolated using adherent method and randomly divided into control group, histone H4 injury group, BALF injury group and anti-histone H4 antibody (anti-H4) intervention group. In the histone H4 injury group, AMs were treated with histone H4 at a final concentration of 20 mg/L. In the BALF injury group and anti-H4 intervention group, AMs were treated with 200 μL BALF supernatant from mice intratracheally administered 6 mg/kg body weight LPS, with the latter group treated with 25 mg/L anti-H4 antibody. The control group AMs were treated with phosphate-buffered saline. iii) After 12 hours of stimulation, the cells were collected, and the relative expression of tumor necrosis factor-α (Tnfa), interleukin-1β (Il1b), differentiation antigen 206 (Cd206) and arginase 1 (Arg1) in AMs was detected using real-time quantitative polymerase chain reaction. Results i) Compared with the control group, mice in all four LPS groups exhibited rapid breathing, inflammatory reaction and lung edema in lung tissues, which were aggravated in a dose-dependent manner. The ratio of partial pressure of arterial oxygen to fraction of inspired oxygen in mice decreased with the increase of LPS dose (P<0.05). The wet/dry weight ratio of lung, the level of histone H4 in BALF and the relative expression of Tnfa and Il1b mRNA in AMs increased with the increase of LPS dose (all P<0.05). The mice in the 6 and 8 mg/kg LPS groups developed ARDS. The level of histone H4 in BALF and the relative expression of Tnfa and Il1b mRNA in AMs of mice in 6 and 8 mg/kg LPS groups were higher than those in the other three groups (all P<0.05). ii) The relative expression of Tnfa and Il1b mRNA increased (both P<0.05), and the relative expression of Cd206 and Arg1 mRNA decreased (both P<0.05) in AMs of histone H4 injury group and BALF injury group compared with the control group. Compared with BALF injury group, the relative mRNA expression of Tnfa and Il1b in AMs of anti-H4 intervention group decreased (both P<0.05), while the relative expression of Arg1 mRNA increased (P<0.05). Conclusion LPS can induce a dose-dependent increase in histone H4 levels in BALF in mice. Histone H4 drives the development of ARDS by activating AMs to M1 polarization. Antagonizing histone H4 to interfere with AM polarization to M1 could be a target for the treatment of ARDS.

Objective:To improve the differential awareness of lead porsoning.Methods:A case with stomachache, anemia, myasthenia, and abnormal urine color was described. The diagnosis and treatment were analyzed and discussed.Results:A middle-aged female was admitted with a 9-month medical history, compalnied with rash, stomachache. She also had evidence of hemolytic anemia,nervous system and kidneys imvolvement, and Lab test showed a significantly elevated blood lead level. It was considered to be in line with multiple organ system damage caused by lead poisoning.Conclusion:Lead poisoning can mimic the clinical presentations of rheumatic diseases, resulting in multiple system ivolvement. When the patient's clinical manifestation cannot be fully explained, some special situations should be considered, such as toxic testing.

Objective:To analyze the audiology and occupational health data of applicants diagnosed of occupational noise deafness, and to explore the influencing factors in the diagnosis of suspected occupational noise deafness.Methods:In May 2022, the information of patients diagnosed with occupational noise deafness in Peking University Third Hospital from January 2018 to December 2021 was collected, and the occupational health data of their working environment, clinical audiological examination results and diagnosis basis of occupational noise deafness were collected and analyzed. Multi-factor unconditional logistic regression analysis was used to analyze independent risk factors for the diagnosis of occupational noise deafness.Results:A total of 129 subjects were included, all of which were suspected cases of occupational noise deafness found in various occupational health examination institutions. Eight cases (6.20%) were diagnosed as occupational noise deafness, and 121 cases (93.80%) were non-occupational noise deafness. After hearing examination, only 27.27% (24/88) of the patients' audiological changes were consistent with the starting point of occupational noise deafness diagnosis. Further analysis of the noise intensity in the workplace showed that 16 patients were identified as non-occupational noise deafness because the noise intensity of the working environment was less than 85 dB. Logistic regression analysis showed that the working hours were more than 8 hours ( OR=9.274, 95% CI: 1.388-61.950, P=0.022) and the noise intensity of the working environment ( OR=1.189, 95% CI: 1.059-1.334, P=0.003) were independent risk factors for the diagnosis of occupational noise deafness. Conclusion:The exclusion rate of suspected occupational noise deafness found in occupational health examination is higher after adequate rest. The test results of working environment noise intensity provided by the employer can help to determine occupational noise deafness.

Objective:To analyze the audiology and occupational health data of applicants diagnosed of occupational noise deafness, and to explore the influencing factors in the diagnosis of suspected occupational noise deafness.Methods:In May 2022, the information of patients diagnosed with occupational noise deafness in Peking University Third Hospital from January 2018 to December 2021 was collected, and the occupational health data of their working environment, clinical audiological examination results and diagnosis basis of occupational noise deafness were collected and analyzed. Multi-factor unconditional logistic regression analysis was used to analyze independent risk factors for the diagnosis of occupational noise deafness.Results:A total of 129 subjects were included, all of which were suspected cases of occupational noise deafness found in various occupational health examination institutions. Eight cases (6.20%) were diagnosed as occupational noise deafness, and 121 cases (93.80%) were non-occupational noise deafness. After hearing examination, only 27.27% (24/88) of the patients' audiological changes were consistent with the starting point of occupational noise deafness diagnosis. Further analysis of the noise intensity in the workplace showed that 16 patients were identified as non-occupational noise deafness because the noise intensity of the working environment was less than 85 dB. Logistic regression analysis showed that the working hours were more than 8 hours ( OR=9.274, 95% CI: 1.388-61.950, P=0.022) and the noise intensity of the working environment ( OR=1.189, 95% CI: 1.059-1.334, P=0.003) were independent risk factors for the diagnosis of occupational noise deafness. Conclusion:The exclusion rate of suspected occupational noise deafness found in occupational health examination is higher after adequate rest. The test results of working environment noise intensity provided by the employer can help to determine occupational noise deafness.

Objective:To investigate the changes in kidney and its mechanism during the development of acute phosgene exposure in rats.Methods:Rats were randomized into 2 groups: control and phosgene group (including 1, 3, 6, 12 and 24 h after exposed to phosgene) , 6 rats in each group. Rats in control group were exposed to air for 5 min, while rats in phosgene group were exposed to 8.33 mg/L phosgene for 5 min. The blood samples were collected at 1, 3, 6, 12 and 24 h after phosgene exposure. The blood creatinine (Cr) , urea nitrogen (BUN) and blood gas analysis were detected. HE staining and immunohistochemical staining were performed to observe the expression levels of 8-hydroxy deoxyguanosine and myeloperoxidase.Results:The arterial partial pressure of oxygen and oxygenation index of rats in the phosgene group were significantly lower than those in the control group at 3, 6 and 12 h after exposure ( P<0.01) . The lowest points were reached at 6 h, which were (58.67±7.89) mmHg and (202.30±27.20) mmHg, respectively. The Cr and BUN of rats in the phosgene group were significantly higher than those in the control group at 3, 6, 12, and 24 h, and the renal organ coefficients were significantly higher than those in the control group at 3, 6 and 12 h ( P<0.01) . HE staining showed that there were more erythrocytes in the glomeruli of rats in the phosgene group, the volume of renal tubular epithelial cells increased, and the cytoplasm was loose and lightly stained. The damage was most obvious at 6 h. The results of immunohistochemical staining showed that the positive expressions of 8-hydroxy deoxyguanosine and myeloperoxidase in the kidney tissue of the phosgene group increased. Conclusion:Hypoxemia and oxidative stress caused by phosgene poisoning may be the cause of renal damage in rats.