Objective To investigate the effects of glutathiones-transferase (GST) T1, GSTM1 and epoxide hydrolase (EPHX1) genes on skin injury in workers exposed to coal tar pitch. Methods Workers from a carbon manufacturing company involved in coal tar pitch production and use were selected as the study subjects using a judgment sampling method. Workers with skin injury after exposed to coal tar were selected as the case group (55 cases), and those with the same workshop and type of work but without skin abnormalities were selected as the control group (197 cases). Urine and blood samples were collected from the workers, and levels of polycyclic aromatic hydrocarbon metabolites, including 1-pyrenol (1-OH-P), 1-naphthol (1-OH-N) and 2-naphthol (2-OH-N), in urine were measured using ultra high-performance liquid chromatography tandem mass spectrometry. The GSTT1, GSTM1 and EPHX1 genes in blood were detected by polymerase chain reaction. Results In the case group, all 55 workers reported skin stinging, 25 workers reported itching and flaking, and 15 workers reported blackheads and pigmentation. Urinary levels of 1-OH-N and 2-OH-N were lower in the worker in the case group than that in the control group (all P<0.05). However, there was no significant difference in the level of 1-OH-P between the two groups (P>0.05). There were significant differences in the number of workers with GSTT1, GSTM1 and EPHX1(His139His) genes between the two groups (all P<0.01). The GSTT1 and GSTM1 genes were positively correlated with post-shift urinary levels of 1-OH-N, 1-OH-P, and 2-OH-N (all P<0.01). The EPHX1 (139Arg locus) gene was positively correlated with post-shift 2-OH-N levels (P=0.03). The GSTT1, GSTM1, and EPHX1 (139Arg locus) genes were associated with reduced skin damage among coal tar workers (all P<0.01), after controlling for age, length of service, gender, smoking, and alcohol consumption. Conclusion Exposure to coal tar pitch can cause skin injury in workers, and the GSTT1, GSTM1, and EPHX1 (139Arg locus) genes are protective factors against skin injury in those workers.

Humans ; SARS-CoV-2 ; COVID-19 ; Antibodies ; Antibodies, Viral/therapeutic use* ; Antibodies, Neutralizing/therapeutic use*

The development of multi-campus is an effective way to expand and enlarge high-quality medical resources for public hospitals. In view of the problems in the relationship between power, responsibility and benefit, functional positioning, discipline layout, homogenization of medical quality and service, and management of human and financial resources in multi-campus, the authors introduced the integrated management system built by the Second Affiliated Hospital Zhejiang University School of Medicine in the process of multi-campus construction. The system included a standard-oriented quality system, a demand-oriented service system, a position-oriented personnel system, an efficiency-oriented financial system, a sharing-oriented information system and a mutual integration-oriented culture system, and formed an integrated management mode of " hospital-area synergy, differential positioning, and homogeneous development" , which significantly improved the management efficiency, service capacity and operational efficiency of the hospital, and could provide an effective reference for public hospital managers.

Objective:To analyze the risk factors and etiological characteristics of multidrug-resistant organism (MDRO) infection after traumatic brain injury, and to explore its nursing countermeasures.Methods:From January 2019 to January 2021, convenience sampling was used to select 478 patients with post-traumatic infection in the First Affiliated Hospital of Zhengzhou University as the research object. The patients' gender, age, underlying diseases, and infection types were collected, and the patients were divided into MDRO infection group ( n=69) and non-MDRO infection group ( n=409) according to whether the pathogen was MDRO. Binary Logistic regression was used to analyze the risk factors of MDRO infection. Results:Logistic regression analysis showed that cerebrovascular disease, malnutrition, history of shock, invasive operation, and combined use of antibiotics were independent risk factors for MDRO infection, and the difference was statistical ( P<0.05) . A total of 516 strains of pathogenic bacteria were detected in the infected samples of 478 patients, of which 386 were target strains, involving 73 strains of MDRO (18.91%) , including 22 strains of Staphylococcus aureus (30.14%) , 14 strains of Pseudomonas aeruginosa (19.18%) , 13 strains of Klebsiella pneumoniae (17.81%) , 11 strains of Escherichia coli (15.07%) , 10 strains of Acinetobacter baumannii (13.70%) , 3 strains of Enterococcus faecalis (4.11%) . The lower respiratory tract was the main site of infection, followed by the urinary tract, wound and upper respiratory tract. Conclusions:Combination of underlying diseases, invasive operation, and combined use of antibiotics all increase the risk of postoperative MDRO infection in patients with traumatic brain injury. Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae are common MDROs. Clinical nurses should strengthen the monitoring of the condition of patients with traumatic brain injury, do a good job of isolation protection, to prevent the occurrence of respiratory system, urinary system and wound infection in patients.

Objective To explore the DNA expression of human cytomegalovirus (HCMV) in glioma and the association between HCMV infection and prognosis of glioma patients.Methods Used for this study were 89 specimens of glioma which had been surgically ablated and pathologically confirmed from the patients between January 2007 and December 2016 at Department of Neurosurgery,The First Affiliated Hospital of Zhengzhou University,and Department of Neurosurgery,The First Hospital of China Medical University.Of them,32 belonged to WHO grade Ⅱ,31 to WHO grade Ⅲ and 26 to WHO grade Ⅳ.Ten specimens of normal brain tissue were excised as controls from the contemporary patients receiving resection for essential epilepsy.Nested PCR was used to analyze the DNA expression of HCMV in the glioma tissue and normal brain tissue,and in the peripheral blood from the glioma and control patients.Prognosis of the glioma patients was evaluated using the Kaplan-Meier survival analysis.Results The DNA expression of HCMV was positive in 46 of the 89 specimens of glioma,involving 14 cases of WHO grade Ⅱ,16 ones of WHO grade Ⅲ and 16 ones of WHO grade Ⅳ.The DNA expression of HCMV was negative in all the 10 specimens of normal brain tissue.There was a significant difference in the DNA expression of HCMV between the glioma tissue and normal brain tissue (P=0.002).The HCMV DNA was measured in the peripheral blood from 26 glioma patients,involving 10 cases of WHO grade Ⅱ,8 ones of WHO grade Ⅲ and 8 ones of WHO grade Ⅳ.No HCMV DNA was detected in the peripheral blood from the 10 control patients.There was a significant difference between the brain glioma and control groups in gene expression of HCMV in peripheral blood (P=0.048).There were no significant differences in the survival rate between the patients with positive or negative DNA expression of HCMV in the glioma tissue or in the peripheral blood from the glioma and control patients (x2=1.849,P=0.174;x2=0.082,2=0.774).Conclusion HCMV infection may play an active role in pathogenesis and development of glioma.

Objective To investigate the effects of Caprini risk assessment model on the prevention and control of lower extremity deep venous thrombosis after craniocerebral operation. Methods Patients with traumatic brain injury who had undergone brain surgeries in the First Affiliated Hospital of Zhengzhou University from June 2011 to May 2015 were enrolled in the research. A total of 188 patients who were treated from June 2011 to May 2013 were recruited to control group, and given routine antithrombotic intervention. A total of 192 patients from June 2013 to May 2015 were selected as the observation group, and evaluated with the Caprini risk assessment model.The incidence of lower limb swelling, the incidence of deep vein thrombosis and the incidence of pulmonary embolism were compared between the two groups 7 days after surgery. Results The proportion of high risk and extremely high risk of thrombosis was 45.38% and 19.79% in the observation group, and 46.28% and 19.15% in the control group respectively. There was no statistical significant difference between the two groups (χ2=2.695,P> 0.05). The proportion of patients' occurrence of lower limb swelling and lower extremity deep vein thrombosis 7 days after surgery in the observation group was 2.08% and 1.04% respectively, and both lower than the control group with statistical significance (χ2=18.245,13.099;P< 0.01). There was 1 cases of pulmonary embolism in the observation group, and 2 cases in the control group, and there was no statistical significance (P> 0.05). Conclusions Using Caprini risk assessment model to assess the risk of thrombosis in patients with brain surgery can effectively reduce the incidence of lower limb swelling and deep venous thrombosis.

Objective To investigate the risk factors of acute kidney injury (AKI) in patients undergoing cardiac valve surgery with cardiopulmonary bypass (CPB).Methods A retrospective cohort database study was conducted, involving 1 349 patients undergoing heart valve surgery with CPB technique.Logistic regression was used to screen out the risk factors of AKI after the surgery.Results Of the 1 349 patients, the incidence of AKI in valve surgery was 28.4%.One year older (OR=1.05, 95%CI 1.03-1.06, P<0.001), diabetes (OR=2.11, 95%CI 1.22-3.68, P=0.008), anemia (OR=1.50, 95%CI 1.05-2.21, P=0.026), each additional basic serum creatinine of 1 mg/dl (OR=1.01, 95%CI 1.01-1.02, P=0.001), each additional operation time of 1 hour (OR=1.28, 95%CI 1.15-1.41, P<0.001), plasma transfusion during surgery (OR=1.50, 95%CI 1.14-1.97, P=0.004) were the independent risk factors for AKI in multivariate logistic regression model.Conclusion AKI is a common and serious complication following cardiac valve surgery.More attention should be paid to the patients with elder age, anemia, prolonged operation time, diabetes, increased basic serum creatinine and requirement of plasma transfusion during surgery.

Objective To evaluate the effects of ischemic time factors on reduction of myocardial ischemia-reperfusion injury by sulfentanil postconditioning in rats .Methods Healthy adult male Sprague-Dawley rats ,weighing 230-250 g ,were heparinized and anesthetized with intraperitoneal 5% chloral hydrate 8 ml/kg .The hearts were excised and perfused in a Langendorff apparatus with K-H solution .After 30 min of stabilization ,48 isolated rat hearts were randomly assigned into 6 groups (n=8 each) using a random number table .In I/R1-3 groups ,the hearts were subjected to 30 ,45 ,and 60 min of myocardial ischemia ,respectively ,followed by 90 min of reperfusion . In SP1-3 groups , the hearts were subjected to 30 , 45 , and 60 min of myocardial ischemia , respectively ,followed by 90 min of reperfusion ,and sulfentanil 100 nmol/L was added to K-H solution at 15 min of reperfusion for postconditioning . Left ventricular end-diastolic pressure (LVEDP ) , left ventricular developed pressure (LVDP) ,+dp/dtmax ,-dp/dtmax ,HR and coronary flow (CF) were measured at the end of equilibration and 15 ,30 ,60 and 90 min of reperfusion .Creatine kinase (CK) and lactate dehydrogenase (LDH) activities in coronary effluent were measured at 5 min of reperfusion .Myocardial infarct size was determined in 5 hearts chosen randomly at 90 min of reperfusion .Results LVEDP was significantly higher ,and LVDP , ± dp/dtmax and CF were lower at each time point of reperfusion than at the end of equilibration in I/R1-3 groups ( P<0.05) .Compared with I/R1 and I/R2 groups ,LVEDP was significantly increased ,and LVDP and ± dp/dtmax were decreased at 30 ,60 and 90 min of reperfusion ,HR and CF were decreased ,and CK and LDH activities in coronary effluent and infarct size were increased at 15 and 30 min of reperfusion in group I/R3 ,and LVEDP was significantly decreased ,LVDP , ± dp/dtmax and CF were increased ,CK and LDH activities in coronary effluent and infarct size were decreased at 30 , 60 and 90 min of reperfusion in groups SP1 and SP2 ( P< 0.05 ) . Compared with group I/R3 , LVDP was significantly decreased at 30 ,60 and 90 min of reperfusion ( P<0.05) ,and no significant change was found in CK and LDH activities in coronary effluent and infarct size in group SP3 ( P>0.05 ) .Conclusion Sulfentanil postconditioning can attenuate myocardial ischemia-reperfusion injury when the rats are subjected to 30 or 45 min of ischemia ,however ,it provides no myocardial protection when the rats are subjected to 60 min of ischemia .

Objective To explore the preliminary experience of a one-stage hybrid operating room (OR) in cerebrovascular surgery.Methods A total of 23 patients [9 male,mean age:(40.0±11.2) years] underwent one-stage hybrid approach in a hybrid OR from September 2012 to December 2013,were chosen in our study.Craniotomy and percutaneous intervention of these patients were performed in a single session.Their clinical data were retrospectively analyzed.Results Thirty-one times of digital subtraction angiography (DSA) was performed in all patients,and 15 patients were diagnosed as having intracranial aneurysms and 8 arteriovenous malformations (AVMs).In one patient,a reposition of the clip was needed due to neck remnant after clipping.Residual nidus resection was done in 2 patients with AVMs.Temporary balloon occlusion happened in 5 patients,parent artery occlusion in 3,and 8 accepted emergency surgery under DSA confirming cerebrovascular diseases and removing hematoma.No procedural complications was observed.Conclusion A combined endovascular and surgical approach conducted in a one-stage hybrid OR provides a new strategy for the treatment of complex and emergency cerebrovascular diseases.

Objective To evaluate the efficacy of midazolam premedication for prevention of emergence agitation (EA) after sevoflurane anesthesia in children undergoing minor surgery.Methods One hundred and twenty ASA physical status Ⅰ or Ⅱ paediatric patients,aged 3-9 yr,weighing 15-35 kg,scheduled for elective tonsillectomy and adenoidectomy,were randomly divided into 4 groups (n =30 each):control group (group C) and midazolam 0.25,0.50 and 0.75 mg/kg groups (groups M1-3).The 10 ml mixture of midazolam 0.25,0.50 and 0.75 mg/kg and 10％ glucose was taken orally at 30 min before anesthesia in M1-3 groups,respectively,while 10 ml of 10％ glucose was taken orally in group C.Anesthesia was induced with inhalation of sevoflurane and maintained with iv infusion of remifentanil and inhalation of sevoflurane.EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.Results Compared with group C,the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 (P ＜ 0.05),and no significant change was found in group M1 (P ＞ 0.05).Compared with group M1,the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 (P ＜ 0.05).There was no significant difference in the PAED scores and incidence of EA between groups M3 and M2 (P ＞ 0.05).Conclusion Premedication with oral midazolam can prevent EA following sevoflurane anesthesia in children undergoing minor surgery and the optimum dose is 0.50 mg/kg.