In this paper, the causes of dimethylacetamide poisoning in a small and micro enterprise were analyzed through on-site occupational health investigation, clinical data summary of poisoned patients and occupational hazard factors detection results. The incident was a group poisoning incident caused by exposure to dimethylacetamide, resulting in different degrees of toxic liver disease in 6 workers. Although the concentration of dimethylacetamide in the air in the workplace was excessive, percutaneous absorption may be the main cause of poisoning. The characteristics of percutaneous absorption of dimethylacetamide need to be paid great attention to, which can be used for reference to prevent similar incidents in the future.

Objective To observe the value of changes of neutrophil-to-lymphocyte ratio(NLR)before and after the first interventional treatment of hepatocellular carcinoma(HCC)for predicting patient's overall survival(OS).Methods Totally 92 HCC patients who underwent the first time TACE or TACE+hepatic artery infusion chemotherapy(HAIC)were retrospectively enrolled.The patients were divided into NLR ratio(NLRR)＜1.29 group(n=54)and≥1.29 group(n=38)based on the ratio of NLR after to before treatment,also ΔNLR＜0.87 group(n=60)and≥0.87 group(n=32)based on the difference of NLR after and before treatment.Clinical data were compared between groups,survival analysis was performed,and the value of NLRR and ΔNLR for predicting OS were analyzed.Results No significant difference of clinical data was found between NLRR＜1.29 and≥1.29 groups,nor between ΔNLR＜0.87 and≥0.87 groups(all P＞0.05).The median OS of 92 patients was 30.90 months,which in NLRR＜1.29 group(55.10 months)was longer than that in NLRR≥1.29 group(22.30 months,P=0.005),while in ΔNLR＜0.87 group(55.10 months)was longer than that in ΔNLR≥0.87 group(14.20 months,P=0.003).Cox regression analysis showed that the maximum diameter of tumor≥5 cm,distant metastasis,ascites,NLRR≥1.29 and ΔNLR≥0.87 were all independent risk factors of OS(all P＜0.05).Taken 1.29 and 0.87 as the best cut-off value,respectively,the area under the curve of NLRR and ΔNLR for predicting OS was 0.620 and 0.610,respectively.Conclusion NLRR and ΔNLR were helpful for predicting OS of HCC patient after the first interventional treatment.

In this paper, the causes of dimethylacetamide poisoning in a small and micro enterprise were analyzed through on-site occupational health investigation, clinical data summary of poisoned patients and occupational hazard factors detection results. The incident was a group poisoning incident caused by exposure to dimethylacetamide, resulting in different degrees of toxic liver disease in 6 workers. Although the concentration of dimethylacetamide in the air in the workplace was excessive, percutaneous absorption may be the main cause of poisoning. The characteristics of percutaneous absorption of dimethylacetamide need to be paid great attention to, which can be used for reference to prevent similar incidents in the future.

OBJECTIVE To investigate the epidemiological characteristics of infections in hemodialysis patients so as to provide bases for prevention and control of the infections in the hemodialysis patients.METHODS The patients who underwent maintenance hemodialysis in blood purification rooms of the Fifth Affiliated Hospital of Zhengzhou University in the first two working days each month from 2018 to 2022 were recruited as the research subjects.The incidence of hemodialysis-related events among the hemodialysis patients,including intravenous use of antibiotics,positive blood culture,exacerbation of pus,redness or swellings emerging at vascular access sites,were prospectively investigated.RESULTS A total of 386 case-times of hemodialysis-related events were moni-tored in 2018-2022,including 20 case-times of bloodstream infections,354 case-times of intravenous use of antibi-otics and 12 case-times of exacerbation of pus,redness or swellings emerging at vascular access sites.The inci-dence of hemodialysis-induced events was 4.19 per 100 patients each month,the average incidence rate of blood-stream infections was 0.22 per 100 patients each month.The patients with tunneled central venous catheter were 40.69 times the risk of bloodstream infections as the patients with intestinal fistula(95％CI:9.725～361.703,P＜0.001).The incidence of bloodstream infections was decreased by 53.85％among the hemodialysis patients in 2022 as compared with that in 2018.Staphylococcus aureus was the predominant species of pathogens causing the bloodstream infections.CONCLUSIONS The hemodialysis patients are the population at high risk of infections.The incidence of bloodstream infections and other infections is higher among the patients with tunneled central venous catheters than among the patients with other types of vascular accesses.The monitoring of hemodi-alysis-related infection events may reduce the incidence of bloodstream infections.

Objective To observe the value of changes of neutrophil-to-lymphocyte ratio(NLR)before and after the first interventional treatment of hepatocellular carcinoma(HCC)for predicting patient's overall survival(OS).Methods Totally 92 HCC patients who underwent the first time TACE or TACE+hepatic artery infusion chemotherapy(HAIC)were retrospectively enrolled.The patients were divided into NLR ratio(NLRR)＜1.29 group(n=54)and≥1.29 group(n=38)based on the ratio of NLR after to before treatment,also ΔNLR＜0.87 group(n=60)and≥0.87 group(n=32)based on the difference of NLR after and before treatment.Clinical data were compared between groups,survival analysis was performed,and the value of NLRR and ΔNLR for predicting OS were analyzed.Results No significant difference of clinical data was found between NLRR＜1.29 and≥1.29 groups,nor between ΔNLR＜0.87 and≥0.87 groups(all P＞0.05).The median OS of 92 patients was 30.90 months,which in NLRR＜1.29 group(55.10 months)was longer than that in NLRR≥1.29 group(22.30 months,P=0.005),while in ΔNLR＜0.87 group(55.10 months)was longer than that in ΔNLR≥0.87 group(14.20 months,P=0.003).Cox regression analysis showed that the maximum diameter of tumor≥5 cm,distant metastasis,ascites,NLRR≥1.29 and ΔNLR≥0.87 were all independent risk factors of OS(all P＜0.05).Taken 1.29 and 0.87 as the best cut-off value,respectively,the area under the curve of NLRR and ΔNLR for predicting OS was 0.620 and 0.610,respectively.Conclusion NLRR and ΔNLR were helpful for predicting OS of HCC patient after the first interventional treatment.

OBJECTIVE To investigate the epidemiological characteristics of infections in hemodialysis patients so as to provide bases for prevention and control of the infections in the hemodialysis patients.METHODS The patients who underwent maintenance hemodialysis in blood purification rooms of the Fifth Affiliated Hospital of Zhengzhou University in the first two working days each month from 2018 to 2022 were recruited as the research subjects.The incidence of hemodialysis-related events among the hemodialysis patients,including intravenous use of antibiotics,positive blood culture,exacerbation of pus,redness or swellings emerging at vascular access sites,were prospectively investigated.RESULTS A total of 386 case-times of hemodialysis-related events were moni-tored in 2018-2022,including 20 case-times of bloodstream infections,354 case-times of intravenous use of antibi-otics and 12 case-times of exacerbation of pus,redness or swellings emerging at vascular access sites.The inci-dence of hemodialysis-induced events was 4.19 per 100 patients each month,the average incidence rate of blood-stream infections was 0.22 per 100 patients each month.The patients with tunneled central venous catheter were 40.69 times the risk of bloodstream infections as the patients with intestinal fistula(95％CI:9.725～361.703,P＜0.001).The incidence of bloodstream infections was decreased by 53.85％among the hemodialysis patients in 2022 as compared with that in 2018.Staphylococcus aureus was the predominant species of pathogens causing the bloodstream infections.CONCLUSIONS The hemodialysis patients are the population at high risk of infections.The incidence of bloodstream infections and other infections is higher among the patients with tunneled central venous catheters than among the patients with other types of vascular accesses.The monitoring of hemodi-alysis-related infection events may reduce the incidence of bloodstream infections.

OBJECTIVE: To explore the role of the Notch signaling pathway in regulating neuronal differentiation and sensorimotor ability in a zebrafish model of fetal alcohol spectrum disorder. METHODS: Zebrafish embryos treated with DMSO or 50 μmol/L DAPT (a Notch signaling pathway inhibitor) were examined for mortality rate, hatching rate, malformation rate, and body length at 15 days post fertilization (dpf). The mRNA expression levels of sox2, neurogenin1 and huc in the treated zebrafish embryos were detected using in situ hybridization and qRT-PCR, and their behavioral responses to strong light and vibration stimulation were observed. The zebrafish embryos were then exposed to DMSO, 1.5% ethanol, DAPT, or both ethanol and DAPT, and the changes in mRNA expression levels of sox2, neurogenin1, huc, and the Notch signaling pathway genes as well as behavioral responses were evaluated. RESULTS: Exposure to 50 μmol/L DAPT significantly increased the mortality rate of 1 dpf zebrafish embryos (P < 0.01), decreased the hatching rate of 2 dpf embryos (P < 0.01), increased the malformation rate of 3 dpf embryos (P < 0.001), and reduced the body length of 15 dpf embryos (P < 0.05). DAPT treatment significantly downregulated sox2 mRNA expression (P < 0.01) and increased neurogenin1 (P < 0.05) and huc (P < 0.01) mRNA expressions in zebrafish embryos. The zebrafish with DAPT treatment exhibited significantly shortened movement distance (P < 0.001) and lowered movement speed (P < 0.05) in response to all the stimulation conditions. Compared with treatment with 1.5% ethanol alone, which obviously upregulated notch1a, her8a and NICD mRNA expressions in zebrafish embryos (P < 0.05), the combined treatment with ethanol and DAPT significantly increased neurogenin1 and huc mRNA expression, decreased sox2 mRNA expression (P < 0.01), and increased the moving distance and moving speed of zebrafish embryos in response to strong light stimulation (P < 0.05). CONCLUSION Ethanol exposure causes upregulation of the Notch signaling pathway and impairs neuronal differentiation and sensorimotor ability of zebrafish embryos, and these detrimental effects can be lessened by inhibiting the Notch signaling pathway.
Animals ; Zebrafish ; Amyloid Precursor Protein Secretases ; Dimethyl Sulfoxide ; Platelet Aggregation Inhibitors ; Antineoplastic Agents ; Ethanol/adverse effects* ; Signal Transduction

Objective:To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) at admission for stroke associated pneumonia (SAP) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to the First Affiliated Hospital of Kunming Medical University from January 2019 to June 2020 were retrospectively included. The demographic information, vascular risk factors, severity of stroke at admission, and NLR data of the patients were collected. Multivariate logistic regression was used to analyze the independent correlation between NLR and SAP. The NLR was divided into quartile groups to further analyze the trend relationship between NLR and SAP. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of NLR for SAP. Results:A total of 316 patients with AIS were enrolled, including 200 males (63.29%) with an age of 63.86±13.78 years. The median baseline Nationanl Institutes of Health Stroke Scale score was 4 (interquartile range, 2-9), and the median NLR was 4.42 (interquartile range, 3.17-6.70). Ninety-three patients (29.43%) experienced SAP. Multivariate logistic regression analysis showed that NLR was an independent risk factor for SAP in patients with AIS (odds ratio 1.189, 95% confidence interval 1.077-1.313; P<0.001). Moreover, SAP risk increases with the increase of NLR ( Ptrend<0.001). Compared to the first quartile, the risk of SAP increased 9.991 times in the fourth quartile (95% confidence interval 2.912-34.279; P<0.001). ROC curve analysis showed that the area under the curve of NLR for SAP prediction was 0.793 (95% confidence interval 0.737-0.850), with an optimal cutoff value of 5.475. The sensitivity and specificity for predicting SAP were 66.67% and 79.82%, respectively. Conclusion:NLR at admission is an independent risk factor for SAP in patients with AIS and has certain predictive value for SAP.

Objective:To investigate the correlation between serum forkhead box protein P1 (FOXP1) and cyclin-dependent kinase2 (CDK2) and bone mineral density in perimenopausal women with osteoporosis (OP) .Methods:A total of 80 perimenopausal women treated in our hospital from Feb. 2021 to Aug. 2022 were selected as study objects. Among them, 38 were in the OP group and 42 were in the control group. The expression levels of FOXP1 and CDK2 in serum were detected by ELISA. BMD expression levels of lumbar spine (L1-L4) and femoral neck were measured by DEXA BMD analyzer. The correlation between serum FOXP1 and CDK2 and bone mineral density in perimenopausal women with osteoporosis was analyzed by Pearson method.Results:Compared with the control group, the contents of FOXP1 and CDK2 in serum of the control group were (42.94±3.37) pg/ml and (102.46±12.247) pg/ml, respectively. Serum FOXP1 and CDK2 contents in OP group were (25.91±4.38) pg/ml and (60.59±10.777) pg/ml, respectively. Compared with the control group, serum FOXP1 and CDK2 expression levels and bone mineral density of lumbar spine (L1-L4) and femoral neck in OP group were significantly decreased. The BMD of lumbar spine (L1-L4) and femoral neck of women in the control group were 0.68±0.28 and 0.43±0.99, respectively. BMD of lumbar spine (L1-L4) and femoral neck of women in the OP group were 0.40±0.10 and 0.21±0.15, respectively. Bone mineral density decreased in the lumbar spine (L1-L4) and femoral neck in the OP group. The differences were statistically significant ( P<0.05). In addition, the correlation analysis results showed that the expression level of FOXP1 in serum was positively correlated with bone mineral density of lumbar spine (L1-L4) and femoral neck ( r=0.546, 0.245, P<0.05), and the expression level of CDK2 was positively correlated with bone mineral density of lumbar spine (L1-L4) ( r=0.600, P<0.05) . Conclusions:In perimenopausal women with osteoporosis, the expression of FOXP1 and CDK2 in serum was significantly decreased, and there was a correlation with bone mineral density. It is suggested that FOXP1 and CDK2 may be used as biological indicators and clinical predictors of osteoporosis in perimenopausal women.

Objective:To compare the clinical efficacy of hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating acute radiation proctitis（ARP），and to statistically analyze their rates of acceptance and satisfaction.Methods:A total of 64 patients with ARP after radiotherapy for cervical cancer treated in Linyi Central Hospital from June 2016 to December 2021 were selected and divided into observation group（ n=32）and control group（ n=32）according to the number table method. The control group was treated with（Smecta and Kangfuxin solution）retention enema combined with hyperbaric oxygen，and the observation group was treated with herbal cake-separated moxibustion on umbilicus combined with hyperbaric oxygen. The degree of rectal injury before and after radiotherapy was evaluated according to the criteria of the Radiation Therapy Oncology Group（RTOG），and the clinical efficacy was analyzed. The symptom score and total score of ARP patients were calculated by international scoring standards for long-term complication of radiotherapy，and the satisfaction rate and acceptance rate of the two groups were analyzed. Results:After four courses of treatment，compared with the same group before treatment，the classifications of clinical symptoms in both the observation group and the control group were significantly improved（ P < 0.01），but there was no significant difference between the observation group and the control group（ P > 0.05）. The acceptance rate and satisfaction rate of patients treated with herbal cake-separated moxibustion on umbilicus in the observation group was significantly higher than that in the control group（ P < 0.01）. Conclusion:Both hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating ARP can achieve good clinical therapeutic effect. As a non-invasive approach，the herbal cake-separated moxibustion on umbilicus can avoid aggravating rectal mucosa and perianal injury caused by repeated drug enema. Meanwhile，the herbal cake-separated moxibustion on umbilicus is simple and easy to operate，with less pain for patients，high rates of acceptability and satisfaction，which can be popularized and applied.