Background Electroplating technology is widely used in the mechanical manufacturing industry. Electroplating workers may be exposed to occupational hazards such as chromium, zinc, cyanides, and sulfuric acid. With the continuous improvement of protective conditions, occupational hazards have been effectively controlled, but there is less focus on the potential acute occupational poisoning that may occur during the electroplating process. Objective To identify causes of an acute chromium poisoning accident occurred during the cleaning process of electroplating tank in a hardware processing plant, and to formulate relevant prevention and control measures to avoid similar poisoning accidents. Methods Occupational history, medical history, and treatment process of the poisoned worker were inquired in detail, his inpatient medical records were consulted , and his blood samples were tested. Occupational health investigation and testing were carried out at the scene of the poisoning accident. Results The air concentration of peak exposure (CPE) and permissible concentration-time weighted average (CTWA) of chromium and its compounds in the workplace were 0.49 mg·m⁻³ and 0.31 mg·m⁻³ respectively. The results of auxiliary test were Serum chromium 4175.85 μg·L⁻¹, serum creatinine 1370.2 μmol·L⁻¹, urea 42.28 mmol·L⁻¹, and urine osmotic pressure 248 mosm·L⁻¹. The final diagnosis was occupational acute severe toxic nephropathy (chromium and its compounds) and occupational chemical skin moderate burn (chromic acid, sulfuric acid). The prescribed treatment included right lower limb expansion skin grafting, hemodialysis and symptomatic support. The patient’s condition was stable and gradually improved after the treatment. Conclusion The main causes of the poisoning accident include weak awareness of the employer of occupational disease prevention and control; failures in fulfilling legal obligations of occupational disease prevention and control, implementing effective occupational disease prevention measures, and providing proper occupational health and safety training and effective personal protective equipment. In order to protect the health of workers, the relevant government departments and employers should attach great importance to the prevention and control of occupational diseases, such as strengthening training and education, increasing the intensity of occupational health supervision, and urging employers to implement occupational disease prevention measures in accordance with the law.

Objective:The aim of this study was to develop and validate a new liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for the quantification of melatonin in human serum.Methods:We describe the performance and validation of melatonin by LC-MS/MS. 182 serum samples from the patients diagnosed with Sleep disturbance who visited the Department of Psychiatry at Zhongshan Hospital affiliated to Fudan University from February 2022 to March 2023(56 males,162 females,mean age [45.51±16.31]years), as well as 182 healthy individuals were included(87 males,95 females,mean age [48.55±11.93]years). The two groups were used to assess the application of serum melatonin levels as a diagnostic indicator for sleep disorders (SDs). The liquid chromatography mass spectrometry (LC-MS) system with an chromatography column (2.1×100 mm, 1.8 μm) was used for separation. The column temperature was set at 35 ℃, as well as the mobile phase consisting of a 0.1% formic acid aqueous solution and pure acetonitrile. The flowing rate was set at 0.4 ml/min for gradient elution. The LC-MS/MS method was validated according to guidance documents, including the following parameters: specificity, selectivity, matrix effect, carryover contamination and reproducibility, lower limit of measuring interval, linearity, precision, recovery rate, dilution consistency, and serum sample stability. Then, it was subsequently employed to profile melatonin changes in Sleep disturbance.Results:The lower limit of quantification for melatonin was 1 pg/ml, and the linear range of detection was 1 pg/ml to 500 pg/ml ( r=0.999). The intra-day and intra-batch precision, expressed as the coefficient of variation ( CV), was within the range from 3.07% to 6.86%, which met the requirement of less than 15%. The recovery rate of the spiked samples ranged from 105.91% to 116.30%. The level of serum melatonin in the sleep disturbance group was significantly lower than that in the healthy control group ([2.00(1.00,3.28)] vs [8.35(4.28,14.80)] pg/ml, P<0.001). Conclusions:The LC-MS/MS method we developed for the quantification of melatonin is clinical practicable.

Objective:To compare 3D-printing-assisted surgery and conventional surgery in the treatment of Schazker type Ⅵ tibial plateau fractures.Methods:A retrospective study was conducted to analyze the clinical data of 50 patients with type Ⅵ tibial plateau fracture who had been treated from January 2019 to December 2021 at the 5 Departments of Orthopedics in The First Affiliated Hospital of Nanchang University, The First People's Hospital of Jiujiang, Pingkuang General Hospital, Ganzhou People's Hospital, and Nanchang Hongdu Hospital of Traditional Chinese Medicine. The patients were divided into 2 groups according to their different treatment methods. In the 3D printing group of 25 cases treated by 3D-printing-assisted surgery, there were 14 males and 11 females, with an age of (42.5±9.1) years; in the conventional group of 25 cases treated by conventional surgery, there were 13 males and 12 females with an age of (42.2±9.3) years. The 2 groups were compared in terms of operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, fracture healing time, postoperative complications, the Rasmussen radiological scores and the American Hospital for Special Surgery (HSS) knee function scores at 6 and 12 months after operation.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The operation time [(125.4±10.6) min], intraoperative blood loss [(206.2±16.3) mL], intraoperative fluoroscopy frequency [(9.2±2.7) times] and fracture healing time [(3.0±0.7) months] in the 3D printing group were all significantly less than those in the conventional group [(168.2±14.1) min, (303.2±20.4) mL, (15.5±3.5) times and (4.1±0.8) months] while the Rasmussen radiological scores (17.6±1.2 and 17.9±0.6) and HSS knee scores (90.8±6.4 and 91.5±5.6) at 6 and 12 months after operation in the 3D printing group were all significantly higher than those in the conventional group (16.2±2.6 and 16.7±2.2; 84.5±9.2 and 87.6±8.0) (all P<0.05). In the 3D printing group, there were 1 case of wound infection and 1 case of wound dehiscence after operation. In the conventional group, there were 2 cases of wound skin necrosis, 3 cases of wound dehiscence, 1 case of traumatic arthritis, 2 cases of wound infection, and 1 case of screw loosening. The incidence of complications in the 3D printing group (8.0%, 2/28) was significantly lower than that in the conventional group (36.0%, 9/25) ( P<0.05). Conclusion:In the treatment of Schatzker type VI tibial plateau fractures, compared with conventional surgery, 3D-printing-assisted surgery can lead to better curative outcomes, because it is conducive to lowering surgical difficulty, reducing postoperative complications, and promoting fracture union and functional recovery of the knee.

Objective:To investigate the relationship between vaccination doses and the duration of positive nucleic acid or antigen tests in Corona Virus Disease 2019 (COVID-19) patients during omicron epidemic.Methods:A cross-sectional study was conducted from December 26 to December 31, 2022 among COVID-19 patients from all community health service centers in 16 districts of Beijing municipality selected by multi-stage stratified cluster quota sampling method. A questionnaire was used to collect the basic information, vaccination doses, results of nucleic acid or antigen tests of all subjects. The subjects were divided into 5 groups according to the doses of COVID-19 vaccination: the non-vaccination group, the 1, 2, 3 and 4 doses vaccination group. The relationship between vaccination doses and the duration of positive nucleic acid or antigen tests was analyzed by univariate and multivariate logistic regression models.Results:A total of 10 506 COVID-19 cases were included in the study with the age of (43.3±13.7) years. The duration of positive nucleic acid or antigen tests was longer than 7 days in 59.4%(276/465), 51.5%(67/130), 50.6%(355/701), 46.1% (3 464/7 520) and 39.2%(662/1 690) of non-vaccination, and 1, 2, 3, 4 dose vaccination groups, respectively ( P<0.001). Multivariate logistic regression analysis showed that compared with non-vaccination patients, the vaccination dose was an independent protective factor for duration of positive nucleic acid or antigen tests>7 days, and the OR values were 0.7 (95% CI 0.5-0.9, P=0.015), 0.6 (95% CI 0.5-0.8, P<0.001) and 0.5 (95% CI 0.4-0.6, P<0.001) for 2, 3 and 4 doses of vaccination, respectively. Conclusion:The vaccination doses are independently related to the duration of positive nucleic acid or antigen tests in COVID-19 patients and the risk is gradually decreases with the increasing vaccination doses.

Since the outbreak of COVID-19 pandemic, a large number of elective or limited operations, including tumor treatment, have been postponed. With the deepening of the understanding of the virus and the change of the prevention policy, the impact of the pandemic is gradually shrinking, and a large number of operations delayed by the pandemic will be rescheduled. However, there is no consensus on the best time to perform surgery for patients infected with SARS-CoV-2, and the consensus on thoracic surgery is more limited. This article reviews the research progress in the timing of surgical operations, especially thoracic surgery, after SARS-CoV-2 infection.

Objective:To explore the effect of gemcitabine-associated thrombocytopenia on the survival time of patients with ad-vanced non-small cell lung cancer (NSCLC).Methods: The data of patients with advanced non-small cell lung cancer treated with gemcitabine from January to December 2011 were retrospectively collected. According to the lowest platelet (PLT) value of the first treatment of gemcitabine,the patients were divided into two groups,PLT higher than 50 × 109·L-1group(43 cases) and PLT lower than 50 × 109·L-1group(24 cases). The survival time was retrieved by referring to the electronic medical records. The relevant in-dices in the two groups were compared and analyzed by COX multiple factors. Results:A total of 67 patients were enrolled in the stud-y. Except for the pathological type,there were no significant differences in gender,age and chemotherapy cycle between the groups(P>0.05). There was significant difference in the survival time between the groups (P<0.05). The median survival time of the pa-tients with PLT higher than 50 × 109·L-1was significantly longer than that of the patients with PLT less than 50 × 109·L-1. Con-clusion:Compared with the patients with mild thrombocytopenia(I/II),gemcitabine induced severe thrombocytopenia(III/IV) in the patients with advanced non-small cell lung cancer(NSCLC) has effect on the survival time of the patients. Therefore,it is necessary to do a good job in the prevention and treatment of thrombocytopenia.

Objective We are going to establish a robust liquid chromatography-tandem mass spectrometric(LC-MS/MS) method for plasma aldosterone assay.Methods 324 healthy individuals were enrolled in Zhongshan Hospital from February to April in 2016 for reference interval survey.The signallinearity,lower limits of quantitation,precision and accuracy of LC-MS/MS have been evaluated.Results from LC-MS/MS and RIA methods were compared.Software SPSS17.0 software was used for statistical analysis.Results The performance characteristics for the method in terms of linearity,lowerlimits of quantitation,precision and accuracy were verified.Linear range of ALD were between 25-2000 pg/ml;the LC-MS/MS assay had a limit of quantitation of 20 pg/ml for ALD;the intra-and inter-assay CV of ALD were ＜10％ and ＜6％,respectively;the recovery of ALD from serum samples ranged between 97.3 and 105.8％ The reference value of ALD in health people ranged between 21-211.6 pg/ml The regression equation by LC-MS/MS (X) and RIA (Y) was:Y =0.271X + 138.900(r=0.43;n=322).Conclusion LC-MS/MS method is robust and reliable for the analysis of aldosterone in plasma and suitable for clinical application.

Objective:To evaluate the efficacy and pharmacoeconomics of rhIL-11(Ⅰ) and rhTPO in the treatment of thrombocy-topenia caused by gemcitabine chemotherapy in lung cancer patients. Methods:A retrospective analysis was used. Totally 58 hospital-ized lung cancer patients who suffered thrombocytopenia caused by gemcitabine chemotherapy and treated with rhIL-11(Ⅰ) or rhTPO from June 2011 to June 2014 were involved in the study, and the efficacy and pharmacoeconomics of rhIL-11(Ⅰ) and rhTPO were e-valuated and compared. Results:The lowest platelet value after the chemotherapy in rhIL-11(Ⅰ) group was higher than that in rhTPO group (P<0. 01), and the platelet decrease time in rhIL-11(Ⅰ) group was shorter than that in rhTPO group (P<0. 01), while the platelet qualified rate of the two groups showed no statistically significant difference (P>0. 05). The results of cost-minimization anal-ysis showed that the average cost of rhIL-11(Ⅰ) group was lower than that of rhTPO group(P<0. 01), furthermore, the average cost of the patients with GP, GC or the other gemcitabine chemotherapy regimens in rhIL-11 (Ⅰ) group was lower than that in rhTPO group. Conclusion:The effect of rhIL-11 (Ⅰ) in the treatment of thrombocytopenia caused by gemcitabine based-chemotherapy in lung cancer patients is not inferior to that of rhTPO, and shows certain advantages in economic cost.

Objective The aim of our study was to develop a robust LC-MS/MS method for determination of MN and NMN in blood plasma.Methods A liquid chromatography -tandem mass spectrometric ( LC-MS/MS) method was used, with signal linearity, lower limits of quantitation, precision and accuracy being evaluated.The study recruited 126 healthy volunteers, and MN and NMN in blood plasma were determined.At the same time samples from 21 patients ( 17 pheochromocytoma, 4 ectopic pheochromocytoma) , a hypertension group of 108 persons, and a control group of 84 persons were analyzed. A paired T test was used to compare the MN and NMN levels between the different groups.Results The performance characteristics for the method in terms of linearity, lower limits of quantitation, precision and accuracy were verified.Significant differences were found between the concentration levels of MN and NMN in the diseased and healthy groups.Conclusion A robust and reliable LC-MS/MS method for the determination of MN and NMN in blood plasma has been developed and was shown to be suitable for clinical application.

Objective To investigate the expression of blood CD +4 CD +25 Treg GITR,CD +4 T cell GITRL in children with asthma,and the role of them in asthmatic inflammation.Methods 50 cases of severe asthma were selected,and were controlled with thirty two healthy children.The venous blood was collected both in the period of acute episode and clinic remission.The mean fluorescence intensity of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL was detected by flow cytometry.Results The expression of CD +4 CD +25 Treg GITR in the asthma acute period group was (24.2 ±8.2)MFI,which was significantly lower than (28.5 ±6.0)MFI in the control group(t =2.5,P <0.05).While there was no significant difference of CD +4 T cell GITRL expression between the asthma acute period group[(5.2 ±3.6)MFI]and the control group[(4.6 ±1.0)MFI](t =1.1,P >0.05).Moreover,the expression of CD +4 CD +25 Treg GITR in the asthma in remission group after treatment was (29.5 ±8.3)MFI,which was significantly higher than that in acute period group before treatment(t =-9.9,P <0.01 ).Whereas,there was no significant difference of CD +4 T cell GITRL expression in asthma group between in remission after treatment[(5.7 ±3.6)MFI] and in acute period before treatment(t =-1.6,P >0.05).Furthermore,there was no significant correlation between levels of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL.Conclusion The level of CD +4 CD +25 Treg GITR in acute period asthmatic patients was decreased,but it was increased in remission,but no changes of CD +4 T cell GITRL expression were observed.GITR/GITRL signal system might be involved in the asthmatic inflammation procession.