OBJECTIVE To analyze the clinical characteristics and influential factors of drug-induced liver injury （DILI） in children caused by intravenous azithromycin. METHODS Clinical data of 157 DILI pediatric cases caused by intravenous azithromycin， reported by the Hengshui Adverse Drug Reaction Monitoring Center from January 2015 to January 2025， were collected as the observation group. Clinical data of pediatric patients who received intravenous azithromycin but did not develop DILI during the same period at Hengshui People’s Hospital were collected in a 1∶1 ratio to serve as the control group. The clinical classification， severity and prognosis of DILI in pediatric patients from the observation group were analyzed. Univariate and multivariate Logistic regression analyses were used to screen the independent risk factors for DILI in children caused by intravenous azithromycin. RESULTS Among 157 DILI cases， 92 cases （58.60%） had hepatocellular injury-type， 51 cases （32.48%） had cholestatic-type， and 14 cases （8.92%） had mixed-type. DILI severity was grade 1 in 117 cases （74.52%）， grade 2 in 33 cases （21.02%）， and grade 3 in 7 cases （4.46%）. Liver function had all recovered after stopping medication and symptomatic treatment. Combined with acetaminophen [OR＝3.769， 95%CI （1.615， 8.235）， P＝0.021]， daily dose of azithromycin＞10 mg/kg [OR＝ 2.237， 95%CI （1.075， 4.655）， P＝0.034] were independent risk factors for DILI in children caused by intravenous azithromycin. CONCLUSIONS Hepatocellular injury-type and cholestatic-type are relatively common in children with DILI caused by intravenous azithromycin， with mild severity being predominant and showing a favorable prognosis. Combination with acetaminophen and daily dose＞10 mg/kg are independent risk factors for azithromycin-induced DILI in children.

ObjectiveTo investigate the therapeutic effect of Baihe Wuyaotang （BWT） on non-alcoholic fatty liver disease （NAFLD） and elucidate its underlying mechanism. MethodC57BL/6J mice were randomly assigned to six groups： normal control， model， positive drug （pioglitazone hydrochloride 1.95×10^-3 g·kg^-1）， and low-， medium-， and high-dose BWT （1.3，2.5 and 5.1 g·kg^-1）. Following a 12-week high-fat diet （HFD） inducement， the mice underwent six weeks of therapeutic intervention with twice-daily drug administration. Body weight was monitored weekly throughout the treatment period. At the fifth week， glucose tolerance （GTT） and insulin tolerance （ITT） tests were conducted. Subsequently， the mice were euthanized for the collection of liver tissue and serum， and the subcutaneous adipose tissue （iWAT） and epididymal adipose tissue （eWAT） were weighed. Serum levels of total triglycerides （TG） and liver function indicators，such as alanine aminotransferase （ALT） and aspartate aminotransferase （AST）， were determined. Histological examinations， including oil red O staining， hematoxylin-eosin （HE） staining， Masson staining， and transmission electron microscopy， were performed to evaluate hepatic lipid deposition， pathological morphology， and ultrastructural changes， respectively. Meanwhile， Western blot and real-time quantitative polymerase chain reaction （Real-time PCR） were employed to analyze alterations， at both gene and protein levels， the insulin signaling pathway molecules， including insulin receptor substrate 1/2/protein kinase B/forkhead box gene O1 （IRS1/2/Akt/FoxO1）， glycogen synthesis enzymes phosphoenolpyruvate carboxy kinase （Pepck） and glucose-6-phosphatase （G6Pase）， lipid metabolism-related genes stearoyl-coA desaturase-1 （SCD-1） and carnitine palmitoyltransferase-1 （CPT-1）， fibrosis-associated molecules α-smooth muscle actin （α-SMA）， type Ⅰ collagen （CollagenⅠ）， and the fibrosis canonical signaling pathway transforming growth factor-β₁/drosophila mothers against decapentaplegic protein2/3（TGF-β₁/p-Smad/Smad2/3）， inflammatory factors such as interleukin（IL）-6， IL-8， IL-11， and IL-1β， autophagy markers LC3B Ⅱ/Ⅰ and p62/SQSTM1， and the expression of mammalian target of rapamycin （mTOR）. ResultCompared with the model group， BWT reduced the body weight and liver weight of NAFLD mice（P<0.05， P<0.01）， inhibited liver lipid accumulation， and reduced the weight of white fat： it reduced the weight of eWAT and iWAT（P<0.05， P<0.01） as well as the serum TG content（P<0.05， P<0.01）. BWT improved the liver function as reflected by the reduced ALT and AST content（P<0.05， P<0.01）. It improved liver insulin resistance by upregulating IRS2， p-Akt/Akt， p-FoxO1/FoxO1 expressions（P<0.05）. Besides， it improved glucose and lipid metabolism disorders： it reduced fasting blood glucose and postprandial blood glucose（P<0.05， P<0.01）， improved GTT and ITT（P<0.05， P<0.01）， reduced the expression of Pepck， G6Pase， and SCD-1（P<0.01）， and increased the expression of CPT-1（P<0.01）. The expressions of α-SMA， Collagen1， and TGF-β₁ proteins were down-regulated（P<0.05， P<0.01）， while the expression of p-Smad/Smad2/3 was downregulated（P<0.05）， suggesting BWT reduced liver fibrosis. BWT inhibited inflammation-related factors as it reduced the gene expression of IL-6， IL-8， IL-11 and IL-1β（P<0.01） and it enhanced autophagy by upregulating LC3B Ⅱ/Ⅰ expression（P<0.05）while downregulating the expression of p62/SQSTM1 and mTOR（P<0.05）. ConclusionBWT ameliorates NAFLD by multifaceted improvements， including improving IR and glucose and lipid metabolism， anti-inflammation， anti-fibrosis， and enhancing autophagy. In particular， BWT may enhance liver autophagy by inhibiting the mTOR-mediated signaling pathway.

Objective To investigate the effect of subchronic inhalation of toluene diisocyanate (TDI) on oxidative stress damage in rat lung tissue. Methods SPF-grade Sprague-Dawley male rats were randomly divided into 4 groups,the rats were placed in a HOPE-MED 8050A movable poison cabinet in a cage.To observe the ultrastructural and histopathology changes of lung tissue in rats.The levels of reduced glutathione (GSH), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) in lung tissue were detected. The ultrastructural and histopathological changes were examined. The expression levels of HO-1 mRNA and protein were detected by Real-time PCR and Western Blot, respectively. Results The body mass, lung tissue mass, and lung organ coefficient of rats in each dose group were lower than those in the control group (P<0.05), and the body mass of rats in each group increased with the increase of exposure time (P<0.05); The results of lung histopathological examination showed that after TDI exposure,in the high-dose group, pulmonary alveolar wall hyperemia and edema were observed in the lung tissue of rats, alveolar wall thickening was observed, alveolar septa widening, and a large number of red blood cells were seen in the alveolar cavity. The results of ultrastructural examination of lung tissue showed that after TDI exposure, while in the high-dose group, the number of alveolar cells decreased, with unclear cell boundaries and irregular morphology. The levels of MDA in the lung tissue of rats exposed to TDI at various doses were higher than those in the control group (P<0.05), while the levels of GSH, GSH-Px, SOD, and CAT were lower than those in the control group (P<0.05); There was no significant difference in HO-1 gene and protein levels among rats in each group (P>0.05). Conclusion Subchronic inhalation of TDI can cause changes in the pathology and ultrastructure of rat lung tissue, leading to abnormal levels of metabolic enzymes in lung function, thereby inducing oxidative stress damage to the lungs. However, but HO-1 is involved in oxidative stress damage in the lungs induced by TDI.

Objective To analyze the applicability of different risk assessment methods in assessing laboratory benzenes exposure. Methods The work positions exposed to benzenes (benzene, toluene, xylenes) of a chemical catalyst research and development company were selected as the research subjects. An occupational health field survey was conducted, and the benzenes exposure levels of the lab personnel were measured. Qualitative assessment method, comprehensive index method, quantitative assessment method, and occupational hazards classification method were used to evaluate the occupational health risk on benzenes exposure in the laboratory personnel. The applicability of different assessment methods was compared. Results The occupational health engineering protection measures and management system of the company need to be further implemented. The benzene exposure level of benzene hydrogenation laboratory personnel exceeded the national standard, with the exposure concentration of time weighted average (C_TWA) of 5.00 mg/m³ and short term exposure concentration (C_STE) of 10.50 mg/m³. The C_TWA and C_STE of toluene and xylenes exposure were both lower than the minimum quantitative concentrations. The results of different risk assessment methods varied. The qualitative assessment method indicated higher level of occupational health risk of benzenes, while the comprehensive index and hazard classification methods indicated consistent result on lower level of benzenes. For occupational health risk of benzene, the standardized risk ratio (RR) levels corresponding to the qualitative and quantitative assessment methods were both extremely high risk. The RR levels of benzene exposure assessment using the comprehensive index method and the occupational hazards classification method were high, while the corresponding RR levels of exposure to toluene and xylenes were both low. Conclusion Attention should be paid on the health risks of benzene exposure to benzene hydrogenation laboratory personnel. When benzene exposure level is below the national occupational exposure limit, occupational hazards classification method is not recommended for health risk assessment for benzenes. The comprehensive index method is preferable when more comprehensive occupational health information is available, as it provides a more objective and comprehensive evaluation on occupational health risks of benzenes.

Purpose/Significance To analyze the network security risk events monitored by the situational awareness platform of large hospitals,to find out the causes,and to put forward solutions and suggestions for improvement.Method/Process Taking the First Affiliated Hospital of Zhengzhou University as an example,the paper analyzes risk events on the situational awareness platform,screens the risky ter-minals on the hospital intranet,carries out rectification and reinforcement,analyzes the department distribution and causes of risky termi-nals,and puts forward suggestions for improvement.Result/Conclusion The number of risky terminals in medical and technical depart-ments is large,mainly due to the lack of management and the lack of full coverage of antivirus software.Through the rectification and rein-forcement of risky terminals,the number of network security risk events has been significantly reduced.Strengthening the hospital terminal security management,enhancing staff awareness of network security,and strengthening network security protection in different areas can ef-fectively reduce the incidence of hospital network security risk events and improve the hospital network security protection capability.

Objective To investigate the clinical efficacy of endovascular intervention in the treatment of acute ischemic stroke caused by carotid stump syndrome(CSS).Methods A retrospective analysis was performed for the patients with anterior circulation acute ischemic stroke who underwent endovascular intervention in The First Hospital of Jilin University from August 2018 to October 2022,among whom the patients with acute ischemic stroke caused by CSS were identified,and related data were collected for these patients,including demographic information,risk factors,surgery-related characteristics,and prognosis.Results A total of 23 patients met the diagnostic criteria for CSS,among whom 19 patients achieved successful revascularization and 7 achieved extended Thrombolysis in Cerebral Infarction(eTICI)grade 3.Fourteen patients received concurrent carotid artery stenting.Twelve patients experienced intracranial hemorrhage after surgery,among whom 1 patient experienced symptomatic intracranial hemorrhage(sICH)leading to in-hospital death.On day 90 after onset,8 patients achieved functional independence,with a modified Rankin Scale score of≤2,while 4 patients died within 90 days.Conclusion CSS is a clinical syndrome caused by embolization from the occluded distal portion of the internal carotid artery.Endovascular intervention is an effective method for the treatment of CSS.

Objective To analyze the diagnosis cases of occupational benzene poisoning in gas station industry, and to explore the application of GC-MS technology in occupational disease diagnosis.   Methods The epidemiological method was used to describe and analyze the occupational disease diagnosis of 15 gas station workers , and qualitative screening of occupational hazard factors was performed by GC-MS.   Results All the 15 workers had more than one year's occupation history of oil refueling and unloading.  The clinical manifestations were consistent with the characteristics of chronic benzene poisoning in diagnosis of occupational benzene poisoning.  However, due to lack of evidence of occupational exposure to benzene and incomplete diagnostic data, occupational chronic benzene poisoning was not diagnosed. GC-MS technology was used to screen the occupational hazard factors in the gas station workplace, and benzene, n-pentane, n-hexane and so on were found.  Conclusion GC-MS is recommended for qualitative screening of organic solvents such as benzene when diagnosing occupational diseases for gas station workers , so as to accurately identify occupational hazard factors in workplaces and provide reliable basis for diagnosis of occupational diseases.

Objective To understand the occurrence characteristics of occupational chemical incidents in China by media surveillance, to provide scientific evidences for formulating effective prevention and control strategies, and to provide new ideas for public surveillance and early warning of chemical incidents. Methods Occupational chemical incidents were collected and sorted through the Internet every day. The statistical analysis was conducted from time, region, industry, and causes of the collected incidents. Results A total of 99 occupational chemical incidents were collected in 2021, involving 356 peoples and 186 deaths. April to July was the high incidence period of events, mainly limited space poisoning and asphyxiation events. Majority of the incidents were general grade events, mainly occurring in small and medium enterprises. Guangdong Province had the most incident reporting areas. Incidents mainly occurred in chemical raw material and chemical product manufacturing industry as well as in water production and supply industry, mainly in manufacturing, cleaning and maintenance positions. The main types of poisons were asphyxiating gases and organic solvents, mainly involving hydrogen sulfide and benzene. The incidents could have been caused by lack of safety awareness, leakage of equipment, and lack of protective measures. Conclusion Occupational chemical incidents still occur frequently and cause serious harm. It is suggested that the relevant departments and employers should strengthen supervision and management, effectively manage and control operational risks, and increase supervision of key industries and positions, to ensure the health and safety of workers.

ObjectiveTo observe the effect of comprehensive intervention on the incidence of lactation galactostasis in communities from the perspective of preventive medicine， so as to prevent the occurrence of the mammary ducts obstruction disease. MethodsA total of 400 women in the early stage of pregnancy were selected from four communities. Those in two communities were set up as the intervention group. Comprehensive intervention for the prevention and treatment of mammary ducts obstruction disease during pregnancy and "Six-step recanalization manual therapy" practical guidance were conducted on the intervention group. The pregnant women from the other two communities were the control group， who received no intervention or guidance training. The two groups were followed up at 1 month， 3 months and 5 months postpartum， and the occurrence of mammary ducts obstruction disease was investigated and interventions were carried out. ResultsThe incidence of galactostasis in the intervention group was 26.0%， 10.6% and 5.1%， respectively at 1， 3 and 5 months after delivery， and the incidence of galactostasis in the control group was 38.0%， 22.2% and 8.3%， respectively. The incidence of galactostasis at 1 month and3 months after delivery was statistically different （P<0.05）， while the incidence of galactostasis 5 months after delivery was not statistically different （P>0.05）. The protection rates of comprehensive intervention on galactostasis were 31.58%， 52.25% and 38.55%， respectively. ConclusionPublicity and education work of prevention and control of the mammary ducts obstruction disease and "Six-step recanalization manual therapy" practical guidance can effectively reduce the occurrence of plugged mammary ducts， and therefore should be promoted.

Objective To understand the occupational health status of gas station workers, to analyze the characteristics of early health damage, and to provide a reference for the occupational health monitoring of workers in this industry. Methods The gas station workers who underwent occupational health examination in an occupational health examination institution in Tianjin in 2021were selected as the research subjects. The examination results were statistically analyzed. Results A total of 381 gas station workers were included in this study, with a sex ratio of male to female of 1.40:1. The top three tests with abnormal results from high to low were abdominal color Doppler ultrasound (39.63%), urine routine (29.13%), and blood pressure (23.62%). The detected fatty liver accounted for 74.83% of abnormal abdominal color Doppler ultrasound. Analysis of abnormal results of different genders showed that the detection rate of abnormal blood pressure, fatty liver and liver function in males was higher than that in females (χ²=16.40, 25.40, 15.98，P＜0.05), the detection rate of high GGT in males was significantly higher than that in females (χ²=16.04，P＜0.05）. The detection rate of abnormal urine routine in females was higher than that in males (χ²=12.85，P＜0.05), and the positive rate of urine white blood cells and blood in urine were significantly higher I women than those in men (χ² =16.80, 11.66，P＜0.05). The abnormal detection rate of electrocardiogram of gas station workers increased with age (χ²=28.02，P＜0.05), and the abnormality of high blood pressure showed an increasing trend with age and working years（χ²=25.00, 15.26，P＜0.05). Conclusion The long-term exposure of gas station workers to chemical toxic substances such as organic solvents and benzene series and physical factors such as high temperature in summer and low temperature in winter will have a certain impact on health. It is suggested that employers should reasonably arrange their work systems and carry out occupational health monitoring in a targeted manner.