1.Monitoring and occupational health risk assessment of key volatile organic compounds in workplace air based on qualitative monitoring
Xiaoxia XIANG ; Xuejian ZHANG ; Yang LIU ; Liu HE ; Jun LUO
Journal of Environmental and Occupational Medicine 2024;41(11):1246-1250
Background Occupational hazards in the workplace are often determined through on-site investigations and recognized hazards to determine monitoring items, and occupational health risk assessments are rarely carried out on the monitoring results. Objective Based on the qualitative results of volatile organic compounds, to monitor 8 types of volatile organic compounds in workplace air, and conduct occupational health risk assessments for workstations with disqualified results. Methods This study selected 29 enterprises from 12 key industries listed in the Work Plan for Monitoring Occupational Disease Hazards in Workplaces in Chongqing (2023) in 5 districts and counties of Chongqing. A total of 49 key workstations, including spray painting, glue brushing, glue adjustment, adhesion, printing, bonding, packing, oil film, feeding, material preparation,dispersion, and immersion, were selected for air sampling and chemical headspace treatment. The volatile organic compounds in the headspace were separated with a gas chromatography capillary column and sequentially entered into a mass spectrometer for detection. Qualitative analysis of each component was conducted using the National Institute of Technical Standards and Technology standard spectrum library and retention time. Based on the qualitative results, chemical hazards and related workstations were determined, then quantitative evaluation was conducted for key hazards in workplace air, and followed by occupational health risk assessment for the disqualified workstations using semi-quantitative exposure ratio. Results One or more of the 8 key chemical hazards were positive in the 29 enterprises, among which xylene (89.7%) and toluene (86.2%) had the highest positive rates, followed by benzene (34.5%), 1,2-dichloroethane (31.0%), ethylbenzene (20.7%), n-hexane (10.3%), and trichloromethane (6.9%), and trichloroethylene was negative. In the quantitative evaluation for occupational hazards in workplace air, the highest positive rates of chemical hazards were xylene (70.6%) and ethylbenzene (83.3%), and the highest disqualification rate of chemical hazards was 1,2-dichloroethane (50.0%). Out of the 29 enterprises, 8 reported disqualified air key chemical hazards, mainly in the workstations of spray painting and immersion. One spray painting workstation reported 3 disqualified chemical hazards, and one spary painting workstation reported 2 disqualified chemical hazards. The risk level of 1,2-dichloroethane in the spary painting workstations of 3 enterprises was high. The joint risk of 2 enterprises with multiple disqualified chemical hazards was high. Conclusion The positive rates of benzene derivatives and 1,2-dichloroethane in workplace chemicals are high in this study. The risk level of 1,2-dichloroethane in the spary painting workstations of 3 companies is high, and this substance needs special attention in future monitoring.
2.The application value of MR diffusion tensor imaging in assessing the impact of march training on the thigh muscles of recruits
Yu ZHANG ; Xiaogang WANG ; Wei SONG ; Chao WANG ; Zi MO ; Xuejian ZHANG ; Xiangwei LUO
Journal of Practical Radiology 2024;40(12):2017-2020
Objective To explore the value of MR diffusion tensor imaging(DTI)in evaluating the effect of march training on the thigh muscles of recruits.Methods DTI scans of the right thigh were performed three times in forty recruits:before and after the march training and one month after the rest.Fractional anisotropy(FA)was measured on the cross-sectional images of the thigh muscles,including rectus femoris(RF),vastus medialis(VM),vastus lateralis(VL),vastus intermedius(VI),gracilis muscle(GM),sartorius muscle(SM),semitendinosus muscle(STM),semimembranosus muscle(SMM),long head of biceps femoris(LHBF)and short head of biceps femoris(SHBF).The percentage changes in FA values of each muscle after the training and rest were calculated.Paired samplet-tests were used to analyze the differences in FA among the thigh muscles at different time points,and one-way ANOVA was used to analyze the differences in the percentage changes of FA among the thigh muscles after the training and rest.Results Compared to pre-training,the FA values of all thigh muscles significantly decreased after the training,with statistical differences(P<0.05).After the rest,the FA values of all thigh muscles recovered,but statistical differences remained in RF(P<0.001),VM(P<0.001),VL(P=0.001),STM(P=0.046),and LHBF(P=0.013).After the training and rest,the FA values of the recruits'thigh muscles showed a"decreasing first and then increasing"trend.There were statistical differences in the percentage changes of FA after the training and the recovery percentages of FA after the rest among the thigh muscles(P<0.001,P<0.001).Conclusion DTI may reflect the ultra-structure changes in the thigh muscles of recruits after the march training and provide a quantitative and noninvasive assessment of muscle micro-injuries.
3.A clinical study on the treatment of refractory tennis elbow with arc-edge needle therapy based on zaodian theory
Xuejian MA ; Dongzhe ZHANG ; Chaoyang NIU ; Shuaigang DU ; Wuyang WANG ; Shilong CHENG ; Yingyuan XIAO ; Xuechang WANG
The Journal of Practical Medicine 2024;40(15):2161-2165
Objective To explore the clinical efficacy of arc-edge needle therapy based on Zaodian theory in the treatment of refractory tennis elbow.Methods 64 patients with refractory tennis elbow were collected and randomly divided into a control group and an observation group using a random number table method.Among them,32 cases in the control group were treated with local pain point injection.32 patients in the observation group were treated with arc-edge needle therapy once a week,with two treatments per group.The Number rating scale(NRS)Mayo,elbow joint performance score(MEPS)and Disabilities of the arm,shoulder and hand(DASH)score were recorded and compared between the two groups before treatment and at 1,2,4 and 24 weeks of follow-up after treatment,disease efficacy score(WDES)at 24 weeks of follow-up.Results During the treat-ment process,neither group of patients experienced serious adverse reactions.At each stage after treatment,two groups of NRS MEPS,DASH,and WDES at 24 weeks of follow-up all improved compared to before treatment.After one week of treatment,there was no statistically significant difference in NRS scores between the two groups(P>0.05).At follow-up visits at weeks 2,4,and 24,the NRS scores in the observation group were lower than those in the control group.After 1,2,4,and 24 weeks of follow-up after treatment,the DASH score was lower in the observation group than in the control group,and the MEPS score was higher in the observation group than in the control group,with statistically significant differences(P<0.05).After 24 weeks of treatment,the WDES of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Local pain point injection and arc-edge Zaodian release can alleviate pain and improve elbow joint function in the early stage of refractory tennis elbow.However,the long-term effect of local pain point injection treatment is not good,and the treatment effect of the observation group gradually improves.
4.No-touch technique for harvesting saphenous vein in coronary artery bypass grafting and research progress
Wei LI ; Xuejian HOU ; Zhuhui HUANG ; Kui ZHANG ; Ran DONG ; Jubing ZHENG
Chinese Journal of Thoracic and Cardiovascular Surgery 2023;39(7):436-440
The saphenous vein has been one of the most commonly used vascular materials for coronary artery bypass grafting(CABG), but the low long-term patency of the vein grafts limits the surgical benefits of CABG. The traditional method of saphenous vein harvesting is more damaging to the venous structures, which has led to the development of no-touch saphenous vein harvesting techniques. In this paper, we review the clinical progress of no-touch saphenous vein in CABG and the potential mechanisms of this technique, to improve the patency of vein grafts by analyzing the latest literature and research progress at the domestic and international level.
5.Analysis of the Symptoms of Jaundice Formula"Ma-Huang Lian-Yao Chi-Xiao-Dou Tang",Examination of Lian-Yao,and Insight into the Medicinal Value and Research of Forsythiae Fructus
Tao WANG ; Qilei CHEN ; Baifang WANG ; Jiankai TANG ; Xuejian GUO ; Shifei LI ; Hubiao CHEN ; Liwei ZHANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2023;25(9):2909-2913
Ma-huang Lian-yao Chi-xiao-dou Tang is one of the three formulas for typhoid jaundice.But it has not received much attention,and the source of Lian-yao in the formula is unknown and the status and role are difficult to identify.In this paper,we first analyzed the functions of Ephedra and the symptoms of the whole formula.The formula was mainly used to"clear damp-heat"in order to remove jaundice.On this basis,it is proved that Lian-yao is the root of Forsythia,not"Qiao-gen".Today,the use of Forsythia instead of Lian-yao has the same effect.Then,the indispensable and important position of Forsythia in the formula was analyzed.It also pointed out some valuable directions for the medicinal use and research and development of Forsythia based on its wide range of effects but the lack of main symptoms.This paper provides insights for in-depth theoretical and practical research on Forsythiae Fructus.
6.Clinical application of adjustable traction skin stretchers in repair of wounds at the lower leg, foot and ankle
Wenchao SONG ; Xuejian WU ; Juyu TANG ; Jianli WANG ; Bo LIU ; Peng XIAO ; Chong MENG ; Jianzhong GUAN ; Tao SONG ; Guohua NI ; Dehong ZHANG ; Weihong ZHANG
Chinese Journal of Orthopaedic Trauma 2023;25(3):226-232
Objective:To evaluate the clinical effects of adjustable traction skin stretchers used in repair of wounds at the lower leg, foot and ankle.Methods:A retrospective study was performed to analyze the clinical data of 56 patients who had been treated for skin defects at the lower leg, foot and ankle from August 2016 to September 2022 at The First Affiliated Hospital of Zhengzhou University, Honghui Hospital, Affiliated to Xi'an Jiaotong University Medical College, The First Affiliated Hospital of Henan Polytechnic University, and Yunnan Zhongde Orthopedic Hospital. There were 35 males and 21 females, aged (39.9±18.7) years. There were 43 traumatic wounds, 3 burns, 6 inflammatory wounds, 3 relief incisions due to osteofascial compartment syndrome, and 1 scar. The areas of skin defect ranged from 2.5 cm × 2.0 cm to 20.0 cm × 10.0 cm. The duration of wounds was (8.6±7.8) d. All the wounds were repaired with adjustable traction skin stretchers. The row-hook type of skin stretchers was used in 28 cases, the single-rod type in 20 cases, the single-rod type combined with an external fixator in 5 cases, and a combination of the row-hook type and the single-rod type in 3 cases.The time for wound traction closure, color of wound skin margin, skin swelling around the wound, functional recovery of affected limb and complications were recorded.Results:The time from skin stretching to wound closure was (7.8±3.8) d in the 56 patients. The color of wound skin edge after stretching was normal in 16 cases, dark red in 38 cases, and dark in 2 cases; the skin swelling around the wound was degree 1 in 21 cases, degree 2 in 33 cases, and degree 3 in 2 cases. The 56 patients were followed up for (8.9±4.1) months. Primary wound closure was achieved in 48 patients, and secondary wound closure in 8 patients after repair with an autologous skin graft. Partial skin necrosis occurred due to tension blisters after skin stretching in 2 patients, one of whom was repaired with an autologous skin graft and the other of whom by dressing change. Deep bone infection recurred in 2 patients whose wounds healed after their bone defects were repaired using Ilizarov technique of bone transfer. In the 56 patients, the muscle strength of the lower extremity beyond the wound was recovered to normal, and the range of motion of the joints adjacent to the wound also recovered to normal.Conclusion:In repair of wounds at the lower leg, foot and ankle, adjustable traction skin stretchers can lead to fine clinical effects and limited complications, because the stretchers can control the tension of skin digitally and precisely.
7.Characteristic of 12 cases of acute brucellosis of Brucella melitensis in Xinjiang Uygur Autonomous Region
Xuejian ZHANG ; Songsong XIE ; Yuanzhi WANG ; Xiangwei WU
Chinese Journal of Endemiology 2022;41(12):1013-1018
Objective:To identify the biotypes of blood culture positive Brucella in patients with acute brucellosis in Xinjiang Uygur Autonomous Region (hereinafter referred to as Xinjiang), and to learn about the clinical characteristics of these patients. Methods:Among the 30 patients diagnosed with acute brucellosis in First Affiliated Hospital, School of Medicine, Shihezi University from January 2019 to July 2021, the positive strains of blood culture Brucella of 12 patients with acute brucellosis were used to identify the biotype by AMOS-PCR. Then the general and clinical data of the 12 patients were collected, including demographic characteristics, epidemiological characteristics, clinical characteristics, laboratory tests, treatment and prognosis. Results:AMOS-PCR results showed that all 12 strains were Brucella melitensis. Among the 12 patients, 9 were males and 3 were females, all of whom had a clear history of livestock contact, and the onset time was concentrated in April to September. All 12 patients showed fever, followed by headache and dizziness (9/12), weakness (8/12), digestive symptoms (8/12), hyperhidrosis (7/12), lumbago and backache (6/12), and arthralgia (6/12). One patient was complicated with pleural effusion and pericardial effusion. One patient was complicated with pleural effusion, pelvic effusion and ascites. Only ascites occurred in 2 patients. Liver function was abnormal in 3 patients, lactate dehydrogenase increased in 6 patients, and blood creatinine decreased in 9 patients. Among the 12 patients, 10 patients were treated with rifampicin combined with doxycycline. The other 2 patients were treated with levofloxacin and doxycycline, supplemented by symptomatic treatment with hepatoprotective drugs due to impaired liver function. After discharge, the patients received out-of-hospital oral anti-infectious drugs for 1-2 courses (6 weeks each course), and all indicators returned to normal at 6 months and 12 months after discharge. Conclusions:All the 12 patients with acute brucellosis in Xinjiang are infected with Brucella melitensis. In addition to the common clinical features, patients are characterized by decreased creatinine and increased lactate dehydrogenase. The standardized anti- Brucella treatment is still the main treatment strategy.
8.Discovery of thiosemicarbazone derivatives as effective New Delhi metallo-β-lactamase-1 (NDM-1) inhibitors against NDM-1 producing clinical isolates
Bing ZHAO ; Xinhui ZHANG ; Tingting YU ; Ying LIU ; Xiaoling ZHANG ; Yongfang YAO ; Xuejian FENG ; Hongmin LIU ; Dequan YU ; Liying MA ; Shangshang QIN
Acta Pharmaceutica Sinica B 2021;11(1):203-221
New Delhi metallo-β-lactamase-1 (NDM-1) is capable of hydrolyzing nearly all β-lactam antibiotics, posing an emerging threat to public health. There are currently less effective treatment options for treating NDM-1 positive “superbug”, and no promising NDM-1 inhibitors were used in clinical practice. In this study, structure–activity relationship based on thiosemicarbazone derivatives was systematically characterized and their potential activities combined with meropenem (MEM) were evaluated. Compounds 19bg and 19bh exhibited excellent activity against 10 NDM-positive isolate clinical isolates in reversing MEM resistance. Further studies demonstrated compounds 19bg and 19bh were uncompetitive NDM-1 inhibitors with Ki = 0.63 and 0.44 μmol/L, respectively. Molecular docking speculated that compounds 19bg and 19bh were most likely to bind in the allosteric pocket which would affect the catalytic effect of NDM-1 on the substrate meropenem. Toxicity evaluation experiment showed that no hemolysis activities even at concentrations of 1000 mg/mL against red blood cells. In vivo experimental results showed combination of MEM and compound 19bh was markedly effective in treating infections caused by NDM-1 positive strain and prolonging the survival time of sepsis mice. Our finding showed that compound 19bh might be a promising lead in developing new inhibitor to treat NDM-1 producing superbug.
9.Application of a 3D printed trabecular block cage in treatment of patients with basilar invagination and atlantoaxial dislocation
Min ZHANG ; Yao ZHAO ; Yuqiang WANG ; Yilin LIU ; Limin WANG ; Xuejian WU ; Hongjian LIU ; Shuhao ZHANG
Chinese Journal of Orthopaedic Trauma 2021;23(4):343-348
Objective:To explore the short-term outcomes of a 3D printed trabecular block cage to assist posterior internal fixation for the treatment of patients with basilar invagination and atlantoaxial dislocation.Methods:Between June 2017 and February 2019, 12 patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial distraction and posterior internal fixation at Department of Orthopedics, The First Affiliated Hospital to Zhengzhou University. They were 5 males and 7 females, aged from 34 to 62 years (average, 45.6 years). 3D printed cages were inserted intraoperatively between the joints of the atlantoaxial lateral mass. The atlanto-dental interval interval (ADI), cervico-medullary angle (CMA) and distance from tip of the odontoid process to Chamberlain's line (DOCL) and the Japanese Orthopedic Association (JOA) scale were compared between preoperation and 12 months postoperation to observe the fusion of the joints of the atlantoaxial lateral mass.Results:Operation went on uneventfully in all the 12 patients. Operation time averaged 116.5 min (from 85 to 190 min), fluoroscopy frequency 9.4 times (from 6 to 21 times), and intraoperative bleeding 82.3 mL (from 50 to 210 mL). No such postoperative complications occurred as cerebrospinal leak, cerebral infarction, or breakage, displacement or loosening of implants. All patients were followed up for 18 to 42 months (mean, 26.3 months). Their preoperative JOA, ADI, CMA and DOCL [8.33±0.98, (8.66±1.64) mm, 119.63°±4.15° and (9.66±2.15) mm] were significantly improved to 14.17±1.03, (2.63±0.59) mm, 153.76°±7.88° and (2.07±0.69) mm ( P<0.05) at 12 months postoperation. Bony fusion was achieved in all the operative segments. Conclusion:In the treatment of patients with basilar invagination and atlantoaxial dislocation, a 3D-printed trabecular block cage can be used to assist posterior internal fixation to achieve satisfactory reduction and maintain the height of joint space, leading to satisfactory short-term outcomes.
10.Preliminary study of MRI features of cerebral amyloid angiopathy-related inflammation
Jia CHEN ; Jie CHEN ; Qiang FU ; Qing LIU ; Yan ZHANG ; Jie XIE ; Guoheng DING ; Xuejian WANG
Chinese Journal of Radiology 2021;55(6):627-632
Objective:To explore the MRI features of cerebral amyloid angiopathy-related inflammation (CAA-ri).Methods:The clinical and imaging data of 12 patients with CAA-ri diagnosed in Affiliated Guizhou Aviation Industry Cor Ltd No 300 Hospital of Zunyi Medical University (9 cases), Xingyi People′s Hospital (2 cases) and Anshun people′s Hospital (1 case) from June 2013 to June 2020 were analyzed retrospectively. There were 3 females and 9 males, aged from 57 to 89 years old, with an average age of 71±10 years. The twelve patients included 5 cases with probable CAA-ri and 7 cases with possible CAA-ri. The duration of the disease ranged from 30 minutes to 2 years. One patient has ApoE ε4/ε4 gene overexpressed. All the 12 patients underwent MRI, including susceptibility weighted imaging in 12 cases, DWI in 10 cases, contrast enhanced MRI (CE-MRI) in 9 cases, MRS in 3 cases, MRA in 7 cases, and perfusion-weighted imaging in 1 case.Results:Imaging features of CAA-ri included encephalopathic, tumoral, classical cerebral amyloid angiopathy(CAA) manifestations. Twelve cases of encephalopathic manifestations showed patchy white matter hyperintensity (WMH) involving U-shaped fibers on T 2 weighted fluid-attenuated inversion recovery sequence (FLAIR), usually asymmetric,with various degree of mass effect, no diffusion restriction on DWI and no enhancement on CE-MRI. One case showed a single tumoral lesion with irregular enhancement on CE-MRI. The classic CAA findings included hemorrhagic lesions (microhemorrhage in 8 cases, lobar hemorrhage in 6 cases, subarachnoid hemorrhage in 3 cases, iron deposition on the brain surface in 7 cases) and ischemic lesions (microinfarction in 1 case, enlarged perivascular space and interlobar space in 4 cases). Follow-up showed lesions absorption and/or new lesion formation in 5 cases. Conclusions:The MRI features of CAA-ri are mainly patchy WMH involving U-shaped fibers on T 2 FLAIR, usually asymmetric, with wandering and alternating features, and inconsistency with clinical manifestations.

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