The Hazardous Drug Exposure Management: Information for Healthcare Settings (2023 Edition) released by the National Institute for Occupational Safety and Health (NIOSH) of US provided detailed protection recommendations for medical personnel to mitigate the risks of occupational exposure to hazardous drugs. This study reviewed the literature in terms of hazard identification, occupational exposure assessment, risk assessment, risk management planning, and waste and spill control. It also explored the precautions for each step of hazardous drug handling, aiming to raise medical personnel's awareness of hazardous drug protection and improve their self-protection skills. The findings provided valuable references for medical institutions to develop hazardous drug disposal plans and reduce employees' exposure to hazardous drugs and occupational injuries.

ObjectiveTo investigate the changes of intestinal flora in children with food allergy and constipation by high-throughput sequencing， and to analyze the function of intestinal flora， to provide a basis for the prevention and treatment of food allergy and constipation in children. MethodsTotally 33 children with food allergy and constipation in Longgang District of Shenzhen were selected as the disease group （CPFA group）， another 59 healthy children of the same age were recruited as the HC group. Stool samples were collected and subjected to high-throughput sequencing of 16SrRNA genes， followed by bioinformatics analysis. Results① The species abundance of HC group was higher than that of CPFA group， and the diversity of intestinal microbial community was different between the two groups； ② At the phylum level， the relative abundance of Bacteroidota， Desulfobacterota in CPFA group was lower than that in HC group， and the relative abundance of Firmicutes， Actinobacteria and Proteobacteria in CPFA group was higher than that in HC Group（P< 0.05）； ③ At the genus level， the relative abundance of Bacteroids， Parabacteroides in the CPFA group was lower than that in the HC group， and the relative abundance of Bifidobacterium， Escherichia-Shigella and Veillonella in the CPFA group was higher than that in the HC group； ④ Functional analysis showed that there were significant differences in functional genes between the two groups. Compared with those in the HC group， the abundance of functional genes in valine， leucine and isoleucine biosynthesis， cysteine and methionine metabolism， fatty acid metabolism and Staphylococcus aureus infection were significantly increased in the CPFA group （P<0.05）. The abundance of functional pathways related to bile acid biosynthesis and retinol metabolism was significantly decreased （P<0.05）. ConclusionThere are differences in intestinal flora and function between children with CPFA and HC， which may help to explore the pathogenesis of food allergy and constipation， and provide a theoretical basis for new therapeutic interventions.

Objective: To analyze the current status of latent tuberculosis infection (LTBI) among freshmen in boarding middle schools in Longgang District, Shenzhen, so as to provide reference for formulating tuberculosis prevention and control strategies in the next stage. Methods: Data for tuberculosis health examination conducted among primary and secondary school students in Longgang District of Shenzhen in September 2022 to May 2023 were utilized to analyze the latent tuberculosis infection rate, and to explore the differences in latent tuberculosis infection rate among different grades, school nature, school categories and school levels. Results: The latent tuberculosis infection rate among freshmen in boarding secondary schools in Longgang District, Shenzhen in 2022 was 2.45%. The infection rate among full middle school (6.45%) and high school (3.37%) were higher than that in boarding junior high school (0.28%), nine year education school (0) and twelve year education school (1.00%) ( P <0.01). Moreover, the infection rate of high school freshmen (2.68%) was higher than that of bording junior high school (0.33%), and the rate of public schools (2.87%) and municipal schools (3.24%) were higher than those of private schools (1.78%) and distric-level schools (2.13%) respectively, with statistical significance observed for all differences( χ 2=43.58, 25.15, 22.69, P <0.01). Conclusions The latent tuberculosis infection rate among new boarding secondary students is relatively low in Longgang District of Shenzhen. However, the infection rate is higher in high school, public and municipal school. School should fully guarantee sports participation of students, enhance students awareness of tuberculosis through health knowledge lectures, and reduce the incidence of tuberculosis among students.

Objective To analyze the problems and differences in workplace on-site sampling and testing skills in external quality assessment in laboratory among occupational health technical service institutions. Methods A total of 108 occupational health technical service institutions nationwide, participated in the external quality assessment in laboratory of the on-site individual sampling operation skills for silica dust (hereinafter refer to as "silica dust sampling assessment") and on-site detection operation skills for carbon monoxide (hereinafter refer to as " carbon monoxide sampling assessment") in 2023, were selected as the research subjects. The result of the assessment was analyzed. Results The qualification rate of the institutions for the silica dust sampling assessment was 98.1%. The unqualified rate of institutions in the Pearl River Delta region was lower than that in non-Pearl River Delta regions (0.0% vs 11.1%, P<0.017). The excellence rate was higher in public institutions than that in private enterprises (73.5% vs 40.0%, P<0.017). The unqualified rate of institutions with permit was lower than that of institutions without permit (0.0% vs 13.3%, P<0.05). The qualification rate of the institutions for the carbon monoxide sampling assessment was 79.4%. The proportion of the institutes, whose results of carbon monoxide standard gas (gas bag) deviation was >±20.0% was higher in private enterprises than that in public institutions (32.8% vs 7.1%, P<0.017). In terms of the normativity of on-site individual sampling for silica dust, the rates of conducting air tightness checks before sampling, correct disassembly and installation and correct placement direction of dust sampling heads, and correct flow for calibration based on the provided dust sampling heads were low, at 53.7%, 33.3%, and 14.8%, respectively. In terms of the normativity of on-site detection of carbon monoxide, the accuracy rate of converting results by on-site detection individuals was low, at only 57.8%. ConclusionIt is necessary to further strengthen the training of theoretical knowledge and practical skills of individuals in occupational health technical service institutions in Guangdong Province, especially to enhance the capacity of occupational health technical services in non-Pearl River Delta regions of the province.

OBJECTIVE: To testify the spatial relationship between the subscapularis muscle splitting window and the axillary nerve in modified arthroscopic Latarjet procedure, which could provide anatomical basis for the modification of the subscapularis muscle splitting. METHODS: A total of 29 adult cadaveric shoulder specimens were dissected layer by layer, and the axillary nerve was finally confirmed to walk on the front surface of the subscapularis muscle. Keeping the shoulder joint in a neutral position, the Kirschner wire was passed through the subscapularis muscle from back to front at the 4 : 00 position of the right glenoid circle (7 : 00 position of the left glenoid circle), and the anterior exit point (point A, the point of splitting subscapularis muscle during Latarjet procedure) was recorded. The vertical and horizontal distances between point A and the axillary nerve were measured respectively. RESULTS: In the neutral position of the shoulder joint, the distance between the point A and the axillary nerve was 27.37 (19.80, 34.55) mm in the horizontal plane and 16.67 (12.85, 20.35) mm in the vertical plane. CONCLUSION In the neutral position of the shoulder joint, the possibility of axillary nerve injury will be relatively reduced when radiofrequency is taken from the 4 : 00 position of the right glenoid (7 : 00 position of the left glenoid circle), passing through the subscapularis muscle posteriorly and anteriorly and splitting outward.
Adult ; Humans ; Shoulder ; Rotator Cuff/surgery* ; Arthroscopy/methods* ; Scapula/surgery* ; Shoulder Joint/surgery* ; Cadaver ; Joint Instability/surgery*

OBJECTIVES: To study the change in regional oxygen saturation (rSO METHODS: The preterm infants with patent ductus arteriosus (PDA) who had gestational age <32 weeks and/or birth weight <1 500 g were prospectively enrolled, who were admitted to the Department of Neonatology, Shenzhen Longgang Central Hospital from October 2017 to October 2020.According to the diagnostic criteria for hsPDA, the preterm infants with patent ductus arteriosus (PDA) were divided into two groups: hsPDA and non-hsPDA. According to closure of the ductus arteriosus after oral administration of ibuprofen, the preterm infants in the hsPDA group were subdivided into two groups: hsPDA closure and hsPDA non-closure. Hemodynamic parameters were measured at diagnosis of PDA and after treatment, and the level of intestinal tissue rSO RESULTS: A total of 241 preterm infants with PDA were enrolled, with 55 infants (22.8%) in the hsPDA group and 186 infants (77.2%) in the non-hsPDA group. There were 36 infants (65%) in the hsPDA closure group and 19 infants (35%) in the hsPDA non-closure group. Compared with the non-hsPDA group, the hsPDA group had a significantly higher left atrial diameter/aortic root diameter ratio and significantly lower left ventricular ejection fraction and fractional shortening ( CONCLUSIONS hsPDA has an impact on intestinal tissue oxygenation in preterm infants, and continuous monitoring of intestinal tissue rSO
Ductus Arteriosus, Patent/diagnostic imaging* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Oxygen ; Prospective Studies ; Spectroscopy, Near-Infrared ; Stroke Volume ; Ventricular Function, Left

OBJECTIVES: To investigate the diversity of peripheral blood T cell receptor (TCR) β chain complementarity-determining region 3 (CDR3) based on immune repertoire sequencing in neonates with sepsis and the possible pathogenesis of neonatal sepsis. METHODS: A total of 12 neonates with sepsis were enrolled as the case group, and 9 healthy full-term infants, matched for gestational age, birth weight, and age, were enrolled as the control group. Omega nucleic acid purification kit (SQ blood DNA Kit II) was used to extract DNA from peripheral blood samples, TCR β chain CDR3 was amplified by multiplex PCR, and then high-throughput sequencing was performed for the products to analyze the diversity of TCR β chain CDR3 and the difference in expression. RESULTS: The length and type of TCR β chain CDR3 were similar between the case and control groups, and Gaussian distribution was observed in both groups. With D50 and Shannon-Wiener index as the evaluation indices for diversity, the case group had a significantly lower diversity of TCR β chain CDR3 than the control group ( CONCLUSIONS There is a significant change in the diversity of TCR β chain CDR3 in the peripheral blood of neonates with sepsis, suggesting that it might be associated with the immune pathogenesis of neonatal sepsis.
Complementarity Determining Regions/genetics* ; High-Throughput Nucleotide Sequencing ; Humans ; Multiplex Polymerase Chain Reaction ; Neonatal Sepsis ; Receptors, Antigen, T-Cell, alpha-beta/genetics*

【Objective】 To verify the key performance parameters of Roche Cobas S201 multiplex NAT for blood donors, so as to provide data for the conformation of multiplex NAT performance and establish a scientific and feasible verification scheme. 【Methods】 Comprehensive performance verification on four key parameters of ROCHE COBAS S201 multiplex NAT system, including the 95% detection limit, compliance rate, anti-interference ability and operator comparison were conducted. The data were compared with the specifications provided by the manufacturer to evaluate the performance of laboratory testing system and ensure the quality of blood testing. 【Results】 2 sets of COBAS S201 multiplex NAT system in our laboratory were used to perform 5 times of the 95% detection limit value declared by the manufacturer for individual tests. The experimental results showed that the target NAT can be detected 100% and the lower limit of determination was verified. Single-virus NAT was performed to detect 5 different HBV DNA concentrations (25 ~400 IU/mL), 5 different HCV RNA concentrations (25 ~400 IU/mL), 5 different HIV RNA Concentration (100~1 000 IU/mL), and 5 negative tubes. The experimental results showed that all detected values of 20 tubes were 100% consistent with the true value, and the performance parameter "coincidence rate" was verified. Samples containing lipoemia, hemolysis, with ALT>50 mL/L and syphilis-positive endogenous interfering substances with 3 times of the 95% detection limit value were tested for 3 times, and results showed both response rate (3/3) and yielding rate reached 100%. In the control group (with none or in the normal range of interfering substances), reactivity was detected in samples with extremely low concentration of 3 times of the 95% detection limit, showing no significant difference (P>0.05). Above results fully showed that the existence of interference substances (lipidemia, hemolysis, ALT ≥ 50 and syphilis positive) in the blood of donors had no significant effect on the yielding of HBV/HCV/HIV virus target nucleic acids. Different operators performed the sample loading tests with same instrument, reagent and specimen showed 100% consistency in the results. It could be preliminarily assessed that there was no difference in the operations between the operators in this verification. 【Conclusion】 The verification scheme of the multiplex NAT system for methodology performance index (95% detection limit, coincidence rate, anti-interference ability, and operator comparison) established in this study, showed simple, flexible, scientific and feasible characteristics and could provide reference and data support for domestic blood transfusion services in acid detection.

Objective:To evaluate the trauma center model in general hospitals for patients with severe trauma.Methods:The data of 1,248 patients with severe trauma (ISS≥16) were retrospectively analyzed who had been admitted to the trauma centers in 6 Chinese general hospitals from January 2019 through June 2020. They were 987 males and 261 females with an age of 50.4 years ± 15.4 years. Their injuries were caused by a traffic accident in 622 cases, falling from a height in 357 cases, a knife in 62 cases, and others (like a heavy object and fall) in 207 cases. Upon admission, their injury severity scores (ISS) were 24.9±8.5 and their Glasgow coma scores (GCS) 12.6±3.6. They were all treated in a scientific and standard manner by a multidisciplinary team at the trauma center of their specific general hospital. Recorded were deaths within 30 days after admission, 30-day mortality and causes of death.Results:All the patients were treated effectively. 101 deaths occurred within 30 days after admission, yielding a 30-day mortality of 8.1%. The main causes of death were severe craniocerebral injury in 56 cases, hemorrhagic shock in 26 cases, multi-organ failure in 11 cases and others in 8 cases.Conclusions:Establishment of trauma centers in China can make up for the disadvantage of over-division of clinical specialties in large general hospitals which has led to insufficient care for patients with severe trauma and multiple injuries. The trauma centers in general hospitals may be a feasible model to be popularized in treatment of patients with severe trauma and multiple injuries.

Objective : To describe a novel workflow for the anterior dental esthetics in immediate implant and immediate aesthetic restoration with digital technique. Methods : Before the implant placement, a intra-oral optical scan(IOS) combined with CBCT was performed to virtually design the 3D implant position and restoration. A surgical guide and an individualized Ti abutment restoration was CAD/CAM-fabricated out of the PMMA-based in a fully digital workflow and seated at the stage of minimal invasive surgery. Results : The technique achieved immediate implant and immediate restoration after tooth extraction. Immediate restoration of temporary crown could be completed immediately in second patient visit after the operation, finally realized the aesthetic implantation with preserved soft tissue contour. Conclusin The fully digital technique changed the conventional workflow which achieves more efficiency and better aesthetic effect.