Objective:To discuss the association between occupational acid fog exposure and accelerated biological aging of the workers,and to clarify its related risk factors.Methods:A total of 341 male workers exposed to occupational acid fog and 201 male workers without occupational exposure were selected as the study subjects,and they were divided into exposure group and control group,respectively.The general informations of the subjects in two groups were collected through questionnaires and physical examinations.The levels of red blood cell count(RBC),platelet count(PLT),albumin(ALB),urea(Urea),creatinine(CR),triglycerides(TG),total cholesterol(TC),glycated hemoglobin(HBA1c),and high-sensitivity C-reactive protein(Hs-CRP)in serum of the subjects in two groups were detected.The Klemera-Doubal method(KDM)was used to construct the composite aging measure,KDM-biological age(BA)(KDM-BA).The model parameters were trained using samples from the 2009 China Health and Nutrition Survey(CHNS)Database to calculate the BA acceleration of the subjects in two groups;stratified analysis based on the population characteristics was conducted to analyze the BA of the subjects in two groups with different population characteristics;generalized linear model was used to analyze the factors influencing BA acceleration due to acid fog exposure.Results:The model parameters were trained using samples from the 2009 CHNS Database,including 8 133 cases aged 20-79 years,of which 3 788 were male.The levels of Urea,CR,HBA1c,ALB,and TC,as well as systolic blood pressure(SBP),total working years,sleep duration,and body mass index(BMI)of the subjects between two groups had significant differences(P<0.05).Compared with control group,the BA acceleration of the subjects in exposure group was significantly increased(P<0.05).In entire population and exposure group,the BA acceleration in the smokers was significantly higher than that in the non-smokers(P<0.05).In entire population,control group,and exposure group,the BA accelerations of the subjects in different BMI groups were significantly decreased with the increase of BMI(P<0.05).Compared with control group,the BA acceleration of the subjects in exposure group was significantly increased(P<0.05),including those under 40 years old,with total working years of 4-7 years,Han nationality,unmarried,smokers,and sleep duration 6-7 h,and with overweight.Acid fog exposure,smoking,and BMI were associated with the BA acceleration(β=0.72,95%CI:0.24-1.21;β=0.59,95%CI:0.11-1.06;β=-0.29,95%CI:-0.35—-0.22).Conclusion:Occupational acid fog exposure may accelerate the biological aging in the workers,and acid fog is a risk factor to accelerate the biological aging of the body.

Objective To investigate the effect of different doses of esketamine combined with hydromorphone postoperative patient-controlled intravenous analgesia(PCIA)on depression in elderly pa-tients undergoing total knee arthroplasty.Methods A total of 180 elderly patients,44 males and 136 fe-males,aged 65-80 years,BMI 18.5-35.0 kg/m2,ASA physical status Ⅱ or Ⅲ,undergoing total knee arthroplasty(TKA)under elective general anesthesia combined with adductor block from J uly 2023 to Sep-tember 2023.Patients were divided into three groups by random number table method;control group(group C),esketamine 0.5 mg/kg group(group E1),and esketamine 1.0 mg/kg group(group E2),60 patients in each group.After operation,groups C,E1 and E2 were given hydromorphone 0.2 mg/kg,esketamine 0.5 mg/kg combined with hydromorphone 0.2 mg/kg,and esketamine 1.0 mg/kg combined with hydromor-phone 0.2 mg/kg to receive PCIA,respectively,and the three groups were diluted to 100 ml with normal saline.Parameters were set as follows.The background infusion rate was 1.5 ml/h,and the single press dose was 1.5 ml,and the locking time was 15 minutes.If the VAS pain score at rest was greater than or equal to 4 points and the analgesic effect of pressing the PCIA pump was not effective,then intramuscular injection of tramadol 0.1 g was used for remedial analgesia.Hamilton depression scale(HAMD)score was performed 1 day,3 and 7 days after surgery.Depressive state was classified as having HAMD score ≥ 8 points.VAS pain scores at rest were performed 1 day,3 and 7 days after surgery.The number of depression within 7 days after surgery,the number of effective(D1)and total(D2)pump compressions and D1/D2 within 3 days after surgery,the number of rescue analgesia,the occurrence of adverse reactions such as tra-madol dosage,dizziness,headache,multiple dreams,hallucinations,nausea and vomiting were recorded.Results Twenty-one patients(35％)in group C experienced depression,7 patients(12％)in group E1,and 8 patients(13％)in group E2 during 3 days after surgery.Eight patients(13％)in group C experi-enced depression,1 patients(2％)in group E1,and 2 patients(3％)in group E2 during 7 days after sur-gery.Compared with group C,the incidence of depression 3 and 7 days after surgery,rescue analgesia rate in group E1 were significantly decreased,the incidence of depression 3 and 7 days after surgery,dizziness,headache,and dreaminess within 3 days after surgery in group E2 were significantly decreased(P＜0.05).There were no significant differences in the incidence of depression and VAS pain scores between group El and group E2 at 1,3,and 7 days after surgery.Conclusion Esketamine 0.5 and 1.0 mg/kg for PCIA in elderly patients after TKA can improve postoperative depression,while esketamine 1.0 mg/kg can reduce the incidence of postoperative dizziness,headache,and multiple dreams.

Objective:To evaluate the effect of esketamine on extremity ischemia-reperfusion-induced lung injury in elderly patients undergoing total knee replacement.Methods:Sixty elderly patients of both sexes, aged 65-80 yr, with body mass index <35 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective unilateral total knee replacement under neuraxial anesthesia, were divided into 2 groups according to the random number table method: control group (C group) and esketamine group (S group), with 30 cases in each group. Esketamine 0.3 mg/kg was intravenously infused before tourniquet inflation in group S. Immediately after the end of operation, the two groups received adductor block with 0.5% ropivacaine 15 ml under ultrasound guidance. And then patient-controlled intravenous analgesia was performed, patient-controlled intravenous analgesia solution included sufentanil 1.5 μg/kg in 100 ml of normal saline in group C and sufentanil 1.5 μg/kg and esketamine 0.75 mg/kg in 100 ml of normal saline in group S. The background infusion rate was 1.5 ml/h, the patient-controlled analgesia dose was 1.5 ml, and the lockout interval was 15 min in the two groups. When the visual analogue scale score at rest≥ 4 points within 3 days after surgery, ketorolac tromethamine 30 mg was intravenously injected for rescue analgesia. Blood samples from the radial artery were collected for blood gas analysis at 30 min before tourniquet inflation(T 0), 30 min after tourniquet inflation(T 1), and 3 min, 30 min and 24 h (T 4) after tourniquet release (T 2-4), and PaO 2 and PaCO 2 were recorded. The alveola-arterial oxygen partial pressure difference, oxygenation index and respiratory index were calculated. Peripheral venous blood samples were collected at T 0, T 3 and T 4 for determination of serum endothelin-1 and malondialdehyde by enzyme-linked immunosorbent assay. The requirement for rescue analgesia and occurrence of dizziness, hallucinations and pulmonary complications within 3 days after surgery were recorded. Results:Compared with group C, alveola-arterial oxygen partial pressure difference was significantly decreased at T 1-3, respiratory index was decreased, oxygenation index was increased at T 2, 3, and serum endothelin-1 and malondialdehyde concentrations were decreased at T 3, 4, and the rate of postoperative rescue analgesia was decreased in group S( P<0.05). There was no significant difference in the incidence of postoperative dizziness, hallucinations, and pulmonary complications between the two groups ( P>0.05). Conclusions:Esketamine can reduce extremity ischemia-reperfusion-induced lung injury in elderly patients undergoing total knee replacement, and the mechanism may be related to regulating vascular endothelial function and reducing lipid peroxidation.

Objective:To evaluate the relationship between postoperative delirium(POD) and preoperative frailty in elderly patients undergoing spinal surgery.Methods:Two hundred and twenty patients of both sexes, aged ≥65 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ-Ⅳ, undergoing elective posterior lumbar decompression, bone grafting and internal fixation under general anesthesia, were selected. Frailty was measured using the FRAIL (fatigue, resistance, ambulation, illness, and loss of weight) scale on 1 day before surgery. POD was assessed twice a day within 3 days by Confusion Assessment Method. Patients were divided into POD group and non-POD group according to whether POD occurred within 3 days after surgery. Multivariate logistic regression analysis was used to identify the risk factors for POD in elderly patients undergoing spinal surgery, and the value of preoperative frailty in predicting POD was analyzed using the receiver operating characteristic curve.Results:A total of 190 patients were finally enrolled, among which 55 patients presented with frailty before surgery, and the incidence was 29.0%. Forty-six patients developed POD, and the incidence was 24.2%. Multivariate logistic regression analysis showed that aging ( OR=1.15, 95% confidence interval [ CI] 1.03-1.29, P=0.017), preoperative frailty ( OR=2.35, 95% CI 1.24-4.43, P=0.009), increase in surgical segments ( OR=4.14, 95% CI 1.71-10.05, P=0.002) and increase in postoperative 24-h pain VAS score ( OR=1.38, 95% CI 1.07-1.78, P=0.013) were independent risk factors for POD in elderly patients undergoing spinal surgery. The area under receiver operating characteristic curve of preoperative frailty in predicting POD was 0.702 (95% CI 0.608-0.796, P<0.001). Conclusions:Preoperative frailty is an independent risk factor for POD in elderly patients undergoing spinal surgery. Preoperative frailty can predict the occurrence of POD in elderly patients undergoing spinal surgery to some extent.

Objective:To explore the applicability of different exposure assessment methods in occupational health risk assessment of trichloroethylene (TCE) occupation posts in electroplating enterprise.Methods:In November 2018, the occupational health risk assessments are conducted in trichloroethylene (TCE) occupation posts of 6 metal plating enterprises in a street in Shenzhen by using the qualitative risk assessment, semi-quantitative risk assessment (including contact ratio method, contact index method and synthesis index method) and quantitative risk assessment method (including non-carcinogenic and carcinogenic risk assessment methods) , and the results of different methods are compared.Results:The results of qualitative assessment method are all level 4 (high risk) ; the results of contact ratio method show that the risk level is level 5 (very high risk) ; the results of contact index method and Synthesis index method show that the risk level is level 3 and level 4, 66.7% and 33.3% respectively; Non-carcinogenic risk assessment results show that TCE jobs are "unacceptable"; carcinogenic risk assessment results in carcinogenic inhalation excess risk of 50% each being "unacceptable" and "acceptable". The results of the six risk assessment methods showed that there were 3 "substantially consistent", 1 "partially consistent", and 2 "inconsistent" among the 6 companies.Conclusion:Synthesis index method and the carcinogenic risk assessment method are more suitable for occupational health risks of TCE occupation posts.

Objective:To explore the applicability of different exposure assessment methods in occupational health risk assessment of trichloroethylene (TCE) occupation posts in electroplating enterprise.Methods:In November 2018, the occupational health risk assessments are conducted in trichloroethylene (TCE) occupation posts of 6 metal plating enterprises in a street in Shenzhen by using the qualitative risk assessment, semi-quantitative risk assessment (including contact ratio method, contact index method and synthesis index method) and quantitative risk assessment method (including non-carcinogenic and carcinogenic risk assessment methods) , and the results of different methods are compared.Results:The results of qualitative assessment method are all level 4 (high risk) ; the results of contact ratio method show that the risk level is level 5 (very high risk) ; the results of contact index method and Synthesis index method show that the risk level is level 3 and level 4, 66.7% and 33.3% respectively; Non-carcinogenic risk assessment results show that TCE jobs are "unacceptable"; carcinogenic risk assessment results in carcinogenic inhalation excess risk of 50% each being "unacceptable" and "acceptable". The results of the six risk assessment methods showed that there were 3 "substantially consistent", 1 "partially consistent", and 2 "inconsistent" among the 6 companies.Conclusion:Synthesis index method and the carcinogenic risk assessment method are more suitable for occupational health risks of TCE occupation posts.

Objective:To study the effects of hyaluronic acid(HA) and TGF-β1 on the growth of mandibular condylar cartilage and the hyperthophic differentiation of the condylar chondrocyts.Methods:60 condyle samples from newborn mice were in vitro cultured and treated with HA(0.5 mg/ml),TGF-beta 1 (5 ng/ml) and without additional agent(the control) respectively.The Morphological observation,Alizarin Red Staining,Alkaline phosphatase staining and condylar cartilage surface area measurement were conducted after 1,2,4,6 and 8 weeks of culture respectively.Results:High-density photoresist area was observed in the condylar cartilage of the control group after 4 weeks of culture.Alizarin Red Staining and Alkaline phosphatase staining showed condylar cartilage matrix production and calcification.The HA group showed no high-density photoresist area at all time points,however,the cartilage area was significantly increased (P ＜ 0.05);the TGF-beta 1 group showed high-density photoresist area after 2 weeks of culture.but the cartilage area were not significantly changed(P ＞ 0.05).Conclusion:HA can promote the growth of condylar cartilage in vitro,but have an inhibitory effect on chondrocyte differentiation.TGF-β1 plays a role in mandibular condylar chondrocyte hypertrophic differentiation in the early days of in vitro culture.

Benzene ; poisoning ; Chronic Disease ; Humans ; Occupational Diseases ; chemically induced ; Occupational Exposure ; adverse effects

Objective:To study the difference of the development between mandibular condylar cartilage and femoral head cartilage in vitro.Methods:Mandibular condyles and femoral heads were sampled from 1 2 neonatal mice and cultured in vitro.The samples before culture and after 6-week culture were examined by gross observation,HE staining,Alizarin Red staining and PCNA immunohistochem-istry respectively.Results:After in vitro culture,abnormal changes were observed in condyle cartilage,but the surface area of condyle cartilage was not changed(P >0.05).HE staining showed partial cartilage layer structure disappearance and the Alizarin Red staining confirmed calcification in the cartilage matrix.However,calcification was not found in femoral head cartilage,and the surface area of femoral head cartilage increased(P <0.05).HE staining showed the hypertrophied layer was thicker after culture than before and the Alizarin Red staining showed there was no calcification in the femoral cartilage matrix.The immunohistochemistry displayed PCNA posi-tive expression in both cartilage after culture.Conclusion:In vitro,the mandibular condylar cartilage matrix can be spontaneously cal-cificated.

Objective To investigate the effects of Erlong Zuoci Pills on AQP4 expression in cochlear tissue of mice with elderly kidney deficiency deafness;To discuss the action mechanism. Methods Intraperitoneal injection of hydrocortisone method was used to duplicate mice models with kidney deficiency except the normal control group. After the models were established, mice were divided into model group and TCM group, 16 mice in each group. TCM group was gavaged by Erlong Zuoci Pills, model group and normal control group were gavaged by normal saline for 22 d. Cochlear stretched preparation technology was used to observe morphological changes in cochlear inner and outer hair cells, and supporting cells. Immunohistochemistry and Western bolt were used to detect protein expression of AQP4. Results Compared with normal control group, mice in model group missed inner and outer hair cells and supporting cells of the cochlea. Compared with model group, arrangement of cochlear inner and outer hair cells and supporting cells was neat and boundary was clear in TCM group. Compared with model group, protein expression of AQP4 in cochlear tissues in TCM group increased (P<0.01). There was no difference between TCM group and normal control group. Conclusion Erlong Zuoci Pills have significant therapeutic effect for elderly kidney deficiency deafness, and the treatment is related to the upregulation of protein expression of AQP4 in cochlear tissues.