Background China is the world's largest producer and consumer of cobalt. Skin exposure to excess cobalt can cause symptoms such as contact dermatitis. At present, there are few studies on skin contact of cobalt and its compounds. Objective To investigate the skin contact characteristics of cobalt and its compounds. Methods A cross-sectional study was conducted in February 2024 involving 70 workers from a hard metal tool manufacturing company and the workers were divided into four groups according to their job positions: powder mixing, sintering, automatic pressing, and grinding processing. General demographic information was collected through questionnaires. Workplace air samples were collected using personal samplers, and cobalt concentrations in workplace air were measured by inductively coupled plasma optical emission spectrometry (ICP-OES). Skin samples were collected from the workers' foreheads using cotton swabs, and urine samples were collected within 30 min after the end of their shift. Urine specific gravity was measured immediately after collection, and disqualified samples were discarded. Cobalt concentrations in the swab extracts and urine were determined by inductively coupled plasma mass spectrometry (ICP-MS). Statistical analysis was performed using Kruskal-Wallis test for multiple group comparisons, Mann-WhitneyU test for pairwise comparisons, Chi-square test for categorical variables, and Spearman's rank correlation analysis to examine the correlations among air, dermal, and urinary cobalt levels. Results The 8 h time-weighted average (TWA) cobalt concentration was (2.30±2.15) μg·m⁻³ (\begin{document}$ \bar{x}\pm s $\end{document}). The median skin exposure level was 53.8 ng·cm⁻², with a range of 4.25 ng·cm⁻² to 1090.2 ng·cm⁻². The median urinary cobalt level was 3.74 µg·L⁻¹, with a range of 0.83 to 382.9 µg·L⁻¹. Statistically significant differences in TWA cobalt concentration, skin exposure levels, and urinary cobalt levels were found between different work positions (H=9.012, P=0.029; H=16.348, P＜0.001; H=11.078, P=0.011). A positive correlation was observed between skin exposure levels and urinary cobalt levels (r=0.537, P＜0.01). Conclusion Skin contact may be one of the main sources of cobalt levels in urine. Therefore, it is essential for workers to improve skin protection and hygiene practices.

Background Coal workers' pneumoconiosis is a serious occupational disease in China. Exhaled volatile organic compounds (VOCs) can serve as the "breath fingerprint" of internal pathological processes, which provides a theoretical basis for exhaled VOCs to be used as potential non-invasive biomarkers for early diagnosis of coal workers' pneumoconiosis. Objective To screen out the characteristic VOCs and important characteristic VOCs of exhaled air in patients with coal workers' pneumoconiosis, and to explore the potential of these VOCs as biomarkers for early non-invasive diagnosis of the disease. Methods In this study, 27 VOCs in the exhaled breath of 22 patients with stage I coal workers' pneumoconiosis, 77 workers exposed to dust, and 92 healthy controls were quantitatively detected by thermal desorption gas chromatography-mass spectrometry (TD-GC-MS). Substances with P<0.05 in univariate analysis and variable importance projection (VIP) >1 in supervised orthogonal partial least squares discriminant analysis (OPLS-DA) model were selected as the characteristic VOCs for early diagnosis of coal workers' pneumoconiosis. Age was included in the LASSO regression model as a covariate to screen out important characteristic VOCs, and the diagnostic performance was evaluated by receiver operating characteristic (ROC) curve. Spearman correlation was further used to explore the correlation between important characteristic VOCs and clinical lung function indicators. Results Through univariate analysis and OPLS-DA modeling, 8 VOCs were selected, including 2-methylpentane, 3-methylpentane, n-hexane, methylcyclopentane, n-heptane, methylcyclohexane, 4-methyl-2-pentanone, and 2-hexanone, in exhaled breath of patients with coal workers' pneumoconiosis. The concentrations of 4 VOCs, including 3-methylpentane, n-hexane, 4-methyl-2-pentanone, and 2-hexanone, showed a decreasing trend with the increase of dust exposure years. By LASSO regression, the important characteristic VOCs of the coal workers' pneumoconiosis group and the dust exposure group were n-hexane, methylcyclohexane and 4-methyl-2-pentanone, and the important characteristic VOCs of the coal workers' pneumoconiosis group and the healthy group were 2-methyl-pentane and 4-methyl-2-pentanone. The ROC analysis showed that the area under the curve (AUC) of n-hexane, methylcyclohexane, and 4-methyl-2-pentanone were 0.969, 0.909, and 0.956, respectively, and the AUC of combined diagnosis was 0.988 and its Youden index was 0.961, suggesting that these results can serve as a valuable reference for further research on early diagnosis. The Correlation analysis found that there was a positive correlation between n-hexane and lung function indicators in the important characteristic VOCs, indicating that it could indirectly reflect the obstruction of lung function ventilation, further proving that important characteristic VOCs have the potential to monitor lung function decline. Conclusion Three important characteristic VOCs selected in this study have the potential to be used as non-invasive biomarkers for early diagnosis and disease monitoring of coal workers' pneumoconiosis, and are worthy of further study and verification.

BACKGROUND:Clinical studies have shown that aerobic exercise is an important supplement to the clinical treatment of patients with pulmonary hypertension,which can alleviate the disease condition,increase exercise tolerance and improve the quality of life.However,it is not clear whether patients at different stages of pulmonary hypertension can benefit equally from exercise training. OBJECTIVE:To compare the intervention effects of early or late aerobic training on right heart failure in rats with pulmonary hypertension and explore its possible mechanism. METHODS:Sixty male Wistar rats were randomly divided into control group,model sedentary group,model early exercise group and model late exercise group,with 15 rats in each group.The model of pulmonary hypertension was established by intraperitoneal injection of monocrotaline(60 mg/kg)in the latter three groups.The model early exercise group was given 8 weeks of treadmill aerobic exercise(60%maximum running speed,60 minutes per day,5 days a week)after modeling,while the model late exercise group was trained for 6 weeks after 2 weeks of modeling.The control and model sedentary groups were fed quietly in the rat cage for 8 weeks.After training,the exercise performance,right ventricular hemodynamics,cardiopulmonary function,cardiopulmonary histopathology,reactive oxygen species level in mitochondria,activity of mitochondrial respiratory chain complex and expressions of myocardial tissue proteins were detected. RESULTS AND CONCLUSION:Compared with the model sedentary group,exercise performance and right ventricular function improved(P<0.05),myocardial collagen content,endothelin-1,tumor necrosis factor-α/interleukin-10 ratio and β-myosin heavy chain/α-myosin heavy chain ratio decreased(P<0.05),vascular endothelial growth factor and sarcoplasmic reticulum calcium-adenosine triphosphate enzyme expression increased(P<0.05),immunofluorescence intensity of mitochondrial reactive oxygen species and the protein expression of 3-nitrotyrosine decreased(P<0.05),the activities of complex I,II,IV and V increased in the model early exercise and model late exercise groups(P<0.05),but there were no significant changes in right ventricular maximum pressure,pulmonary acceleration time and pulmonary artery wall area/total vascular area ratio(P>0.05).Compared with the model late exercise group,the model early exercise group further improved exercise performance and right ventricular function,and downregulated collagen content,brain natriuretic peptide protein expression,tumor necrosis factor-α/interleukin-10 ratio and β-myosin heavy chain/α-myosin heavy chain ratio(P<0.05).To conclude,although pulmonary vascular remodeling and right ventricular overload persist in rats with pulmonary hypertension,exercise training at different stages of the disease has a cardioprotective effect.The mechanism is related to the improvement of cardiac remodeling,neurohormone system imbalance,inflammatory response and mitochondrial oxidative stress.Greater benefit is gained from initiating exercise in the early stage of the disease.

BACKGROUND:Resistance training and weight-bearing exercise are recommended modes for patients with osteoporosis to improve bone health.High-intensity interval training is a high-impact weight-bearing exercise with obvious time-efficient characteristics;however,little attention has been paid to its impact on bones. OBJECTIVE:To observe the effect of high-intensity interval training on the bone health of ovariectomized rat models. METHODS:Thirty-six female Sprague-Dawley rats were randomly divided into sham group,model group and model exercise group(n=12 per group).Bilateral ovariectomy was used to prepare an osteoporosis rat model in the latter two groups.Six weeks after modeling,the model exercise group was subjected to a high-intensity interval training on an electric treadmill at 90%peak running speed for 2 minutes and 50%peak running speed for 1 minute as one session,a total of nine sessions,3 days per week,for 6 weeks.Rats in the sham and model groups were raised quietly in the mouse cage during the same period.The relevant indexes were tested 48-72 hours after the final training. RESULTS AND CONCLUSION:Compared with the sham group,bone mineral density,maximal load,stiffness,elasticity,trabecular volume fraction,and trabecular number decreased(P<0.05),while trabecular separation increased(P<0.05);the level of irisin in the serum,gastrocnemius and femur decreased(P<0.05);the expression of peroxisome proliferator-activated receptor γ coactivator-1α protein and fibronectin type Ⅲ domain-containing protein 5 mRNA and protein in the gastrocnemius muscle decreased(P<0.05);the expression of type I collagen,Osterix,and Runx2 mRNA in the femur decreased(P<0.05);and the expression of anti-tartrate acid phosphatase,receptor activator of nuclear factor κB ligand,and osteoclast-associated receptor mRNA increased in the model group(P<0.05).Compared with the model group,bone mineral density,fracture load,maximal load,stiffness,elasticity,average trabecular thickness,and trabecular number increased(P<0.05),and trabecular separation decreased(P<0.05);the level of irisin in the serum,gastrocnemius and femur increased(P<0.05);the expression of peroxisome proliferator-activated receptor γ coactivator-1α protein and fibronectin type Ⅲ domain-containing protein 5 mRNA and protein in gastrocnemius increased(P<0.05);the expression of type I collagen,Osterix,and Runx2 mRNA in the femur increased(P<0.05);and the expression of anti-tartrate acid phosphatase,receptor activator of nuclear factor κB ligand,and osteoclast-associated receptor mRNA decreased in the model exercise group(P<0.05).To conclude,short-term high-intensity interval training may improve bone health of ovariectomized rats through up-regulating the irisin level.

This article reports the pharmacotherapy process of a clinical pharmacist participating in the treatment of acute liver injury caused by nintedanib in a patient with lung cancer complicated with interstitial pneumonia.Clinical pharmacist analyzed the rapid increase of liver enzymes in patients by excluding their past drug use history,stopping suspicious drugs and searching domestic and foreign literature,and determined that the association with nidanib was very likely according to RUCAM scale.The clinical pharmacies suggesteded stopping nintedanib and taking liver protection treatment actively.The clinician adopted the suggestion,and finally the patient's liver function improved after 20 days of treatment.Clinical pharmacists demonstrate their value by analyzing the causes and characteristics of liver injury in patients,assisting physicians in the timely identification and management of adverse reactions,and participating in clinical practice.This article can provide a reference for the diagnosis and treatment of similar cases of acute liver injury.

Objective To understand the quality status of salt iodine monitoring results at the county level and checking results at the city level from 2017 to 2021 in Suzhou，and to provide a scientific basis for the development of iodine deficiency disease（IDD）prevention and control strategies and measures.  Methods During the past five years, Suzhou CDC randomly selected 15 samples of 300 monitored salt samples from each county/district CDC each year for spot checks. The data were processed by comparative analysis of relative error and grouped data t test.  Results In the conformity of iodized salt and non-iodized salt, the sample monitoring results of some counties/districts were non-iodized salt, while the city-level test results were iodized salt. In the conformity of iodized salt and seaweed iodized salt (or enhanced salt), the sample monitoring results of county/district level were iodized salt, while the test results at the city level were seaweed iodized salt (or enhanced salt). The non-conformity was relatively concentrated in some county/district laboratories, and the total amount of non-conformity tended to increase year by year. The total number of samples with relative error of >20% between the county/district and city-level results was the least in 2021, with 6, and the most in 2018, with 25. The number of samples with relative error of >30% between the county/district and city-level results was the least in 2017 being 0, while there were 12 samples in 2018, fluctuating within a small range in the past three years. The t-test results of grouped data showed that the average value of the checking results at the city level was generally higher than the monitoring results at the county level. There were 21 pairs of data with no statistical significance (P>0.05) and 29 pairs of data with statistical significance (P<0.05) between the results at the county/district level and at the city level. Among them, there were 7 counties/districts whose sample monitoring results were not significantly different from the city-level test results in 2020, while there were 9 counties/districts whose monitoring results were statistically different from the city-level test results in 2021.  Conclusion  The data analysis results show that the monitoring data of iodized salt in Suzhou is basically reliable and accurate, but there still exist some problems. Therefore, in the future work it is necessary to strengthen the monitoring system of IDD, increase training efforts, continuously monitor and check the quality of iodized salt to provide a scientific basis for effective prevention and control of IDD.

Objective:To investigate the protective effect of ulinastatin on sepsis-acute kidney injury (SA-AKI) by NF-κB signaling pathway.Methods:Total of 60 mice were randomly(random number) divided into sham group, cecal ligation puncture group (CLP group) and ulinastatin treatment group (CLP+UTI group). Ulinastatin treatment group was intraperitoneally injected with ulinastatin 50 000 U/kg once a day. 24 hours after operation, five mice were sacrificed, the kidney tissues were collected to observe renal histopathology by HE staining. The macrophage infiltration was observed by immunohistochemistry. The remaining mice in each group were used to calculate the survival rate of 7-day after operation. HK-2 cells were stimulated by LPS to obtain the SA-AKI model, and the cells were divided into control group, LPS group and LPS + UTI group. CCK-8 assay was used to detect cell viability, EdU assay was used to detect cell proliferation, and JC-1 assay was used to detect mitochondrial damage. The phosphorylation degree of NF-κB was detected by western blot. Inflammatory factors concentrations of cellular supernatant were detected by ELISA assay.Results:Compared with the sham group, the kidney tissue of mice in CLP group showed that kidney pathological obvious changed, the infiltration of macrophages increased, and the survival rate of mice decreased. CLP+ UTI group reduced the pathological changes and the infiltration of macrophages, improved the survival rate of mice. Compared with control group, LPS group obviously inhibited the cells activity and proliferation of HK-2 cells, damaged the mitochondrial membrane potential of HK-2 cells. Compared with LPS group, LPS+ UTI group attenuated the phosphorylation of NF-κB, decreased the secretion of inflammatory factors, rescued the activity and proliferation of HK-2 cells, and reduced the damage of HK-2 mitochondrial membrane potential.Conclusions:Ulinastatin can reduce mitochondrial damage, inhibit the secretion of inflammatory factors and improve the function of renal tubular epithelial cells through regulating NF-κB signaling pathway.

Objective:To study the impact of Roux-en-Y reconstruction with isolated pancreatic drainage (RYR) on delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD).Methods:The data of 203 patients who underwent PD at 5 clinical centers from January 2014 to June 2020 were collected. According to the method of reconstruction of the digestive tract, the patients were divided into the RYR group ( n=88) and the conventional loop reconstruction (CLR) group ( n=115). The incidence and severity of DGE were compared between groups. The risk factors of clinically relevant DGE (CR-DGE) after PD were analysed by univariate and multivariate analyses. Results:Of 203 patients, there were 124 males and 79 females, aged (61.6±10.2) years. The overall incidence of DEG was 27.6% (56/203). The incidence of CR-DGE in the RYR group was significantly lower than that in the CLR group [13.6%(12/88) vs 26.1%(30/115), P=0.030]. Patient age of more than 65 years ( OR=2.966, 95% CI: 1.162-8.842, P=0.024), clinically relevant pancreatic fistula ( OR=3.041, 95% CI: 1.122-8.238, P=0.029), ascites and abdominal infection ( OR=10.000, 95% CI: 2.552-39.184, P=0.001), and CLR ( OR=3.206, 95% CI: 1.162-8.842, P=0.024) were identified as independent risk factors for CR-DGE. The duration of hospitalization and hospital expenditure of patients were significantly increased in the CR-DGE group ( P<0.05). Conclusions:Patients over 65 years with clinically relevant pancreatic fistula, with ascites or abdominal infection after operation, had a higher evidence of CR-DGE. Roux-en-Y reconstruction with isolated pancreatic could helped to decrease the incidence of CR-DGE after PD.

OBJECTIVE：To optimize the inclusion technology of volatile oil from Ganmao qingre granules. METHODS ： Guided by the concept of “quality by design ”，taking volatile oil inclusion rate and inclusion complex yield as key quality attribute，comprehensive score of above two indexes after weighting as response value ，inclusion temperature ，inclusion time ，the ratio of β-CD to volatile oil as key technology parameters ，Box-Burman response surface design was adopted to establish the design space of key technology parameters and key quality attributes. The design space was optimized and verified by 95％ confidence interval. The stability of inclusion complex was investigated preliminarily. RESULTS ：The optimal design space ，i. e. the optimal technology parameters rang ，included inclusion temperature 35-40 ℃，inclusion time 1.8-2.0 h，the ratio of β-CD to volatile oil 9.5∶1- 10∶1（g/mL）. The results of 3 validation tests showed that the volatile oil inclusion rates were all over 62％，the yields of inclusion complex were all over 75％，and the comprehensive scores were all over 80 point. The results of preliminary stability showed that the inclusion rate of volatile oil ，the yield of inclusion complex and the comprehensive score did not change significantly. The difference in evaluation indicators within 7 days was within 5％. CONCLUSIONS ：The optimized inclusion technology is feasible ， and the obtained inclusion complex is stable.

A total of 280 patients with varicose veins of lower extremities who were prescribed stretch socks as pressure therapy in the outpatient clinic of Beijing Chaoyang Hospital from September 2019 to November 2019 were included in the study. Among 280 patients 208 were followed up for one year(74.3%), 139 cases (66.8%) gave up wearing stretch socks and 69 cases (33.2%) insisted to wear. The main reasons for giving up wearing were feeling too tight (23.1%), too much troubles (17.7%), symptom improvement (15.1%), poor effect (10.8%) and so on. The compliance of wearing stretch socks as pressure therapy in outpatients with varicose veins of lower extremities is poor with a variety of reasons, the data may provide a reference for improving clinical compliance in the future.