Objective To analyze the monitoring status of occupational hazard factors in key industry workplaces in a city of the Pearl River Delta area from 2019 to 2023. Methods A total of 1 548 enterprises in 12 key industries of the city were selected as the research subjects using the judgmental sampling method. Their monitoring data for dust, chemical factors, and noise, along with the occupational health management status of the enterprises were analyzed. Results Among the 1 548 enterprises, large and medium-sized enterprises accounted for 2.7% and 13.4%, while small and micro enterprises accounted for 83.9%. A total of 474 enterprises exceeded the national limit in the detection of occupational hazard factors, with an exceedance rate of 30.6%. The rates of workers exposed to occupational hazard factors, dust, chemical factors, and noise were 29.4%, 6.9%, 21.0%, and 13.0%, respectively, all showing a downward trend year by year (all P<0.05). The training rates for occupational health among enterprise managers, responsible persons, and workers were 84.1%, 84.2%, and 91.2%, respectively. The detection rates for abnormal occupational health examinations among workers exposed to dust, chemical factors, and noise were 0.2%, 0.3%, and 0.5%, respectively. The setting rates of warning signs and warning instructions among enterprises for dust, chemical toxins, and noise were 87.3%, 91.1%, and 89.5%, respectively. The setting rates for dust, toxic chemical, and noise control facilities were 72.4%, 75.4%, and 46.0%, with effectiveness rates of 70.5%, 56.6%, and 55.2%, respectively. The distribution rates of personal protective dust masks, gas masks, and noise earplugs/earmuffs were 91.9%, 83.8%, and 86.4%, with wearing rates of 80.8%, 70.5%, and 76.4%, respectively. The detection rates of exceeding national limits for dust, chemical factors, and noise in the work site of occupational hazard factors were15.2%, 1.0%, and 21.6%, respectively. The detection rates of exceeding national limits for dust, chemical factors, and noise in the workplace of occupational hazard factors were 2.4%, 2.5%, and 12.3%, respectively. The exceedance rate for noise in work site showed an upward trend year by year (P<0.01). Conclusion Occupational disease prevention and control work in the key industries of this city needs strengthening. It is essential to further enhance the regular monitoring and preventive measures of occupational hazard factors in enterprises, improve protective measures, strengthen the use of personal protective equipment, and enhance occupational health training and supervision, to effectively reduce the risk of occupational diseases and protect workers' occupational health rights.

Multimodal analgesia is the gold standard for postoperative pain management,and ultra-sound-guided nerve block as the cornerstone supplemented with fewer opioids and a sufficient amount of non-steroidal anti-inflammatory drugs(NSAIDs)throughout the entire course of the procedure is the most main-stream multimodal analgesic regimen at present.However,ultrasound-guided nerve blocks are limited by the duration of action of local anesthetics and often provide effective analgesia for surgical patients for no more than 8 hours,resulting in a low satisfaction rate of postoperative analgesia in surgical patients.With the con-tinuous research on the concept of rapid rehabilitation,how to extend the duration of action of local anesthet-ics is the focus and hotspot of research.Ultra-long-acting local anesthetics include liposomal bupivacaine and HTX-011,which have been applied in clinical practice,and quaternary ammonium derivatives,which are still in the research stage.In this paper,we will review the existing ultra-long-acting local anesthetics in terms of ultra-long-acting local anesthetics with extended-release systems,new pathways and targets of ultra-long-acting local anesthetics,and the development of ultra-long-acting local anesthetics in the form of brand-new compounds,so as to provide new ideas for the subsequent research and clinical application of ultra-long-acting local anesthetics.

Background: Glycolytic function is obviously related to the proliferation, metastasis and drug resistance of colorectal cancer, and there is still a lacking of corresponding indicators for quantitatively evaluating the level of glycolysis. Aims: To investigate the correlation between

Objective:To study the relationship between the dynamic changes of angiopoietin-2 (Ang-2) and surfactant protein D (SP-D) in pediatric acute respiratory distress syndrome (pARDS) and the severity and prognosis of the disease.Methods:Using nested case-control study method, 80 children with pneumonia complicated with pARDS admitted to PICU at Fujian Maternal and Child Health Hospital from June 2018 to May 2021 were selected as pARDS group, and 19 healthy children with corresponding age were selected as control group.According to the oxygenation, the children in pARDS group were divided into three subgroups: mild group (23 cases), moderate group (32 cases) and severe group (25 cases). According to the prognosis at discharge, the children in pARDS group were divided into survival group (67 cases) and death group (13 cases). Ang-2 and SP-D were detected by enzyme-linked immunosorbent assay.The levels of Ang-2 and SP-D in children with pARDS of different severity on the first day were compared; The changes of Ang-2 and SP-D levels on the 1st, 3rd and 8th day of children in survival group and death group were compared, and the receiver operating characteristic (ROC) curve was plotted to compare the predictive value of Ang-2 and SP-D for pARDS prognosis.Results:(1) The levels of Ang-2 and SP-D on the first day in pARDS group were significantly higher than those in control group( P<0.001). (2) The levels of Ang-2 and SP-D on the first day in children with pARDS of different severity levels were significantly different ( P<0.001), and the levels of Ang-2 and SP-D increased gradually with the increase of disease severity.(3) The levels of Ang-2 and SP-D in death group were significantly higher than those in survival group on the 1st, 3rd and 8th day ( P<0.05). (4) Prognostic efficacy of Ang-2 and SP-D levels in pARDS group at different time points: when the areas under the ROC curve predicted by Ang-2 on the 1st, 3rd and 8th day for inpatient mortality in children with pARDS were 0.808, 0.981 and 0.989, respectively; the optimal cut-off values were 6 000 pg/mL, 6 971 pg/mL and 4 171 pg/mL, respectively; the sensitivity was 84.6%, 92.3% and 92.3%, respectively; and the specificity was 76.1%, 97.0% and 98.5%, respectively.The areas under the ROC curve predicted by SP-D on the 1st, 3rd and 8th day for inpatient mortality in children with pARDS were 0.689, 0.993 and 0.983, respectively; the optimal cut-off values were 13544 pg/mL, 16003 pg/mL and 12294 pg/mL, respectively; the sensitivity was 84.6%, 100.0% and 100.0%, respectively; and the specificity was 46.3%, 98.5% and 97.0%, respectively. Conclusion:Serum Ang-2 and SP-D levels in children with pARDS increase with the aggravation of the disease.The dynamic changes of Ang-2 and SP-D in children with pARDS with different prognosis are different during the course of disease, and monitoring serum Ang-2 and SP-D during the course of disease has a certain predictive value for clinical outcome.

Objective:To evaluate the accuracy of lung ultrasound score (LUSS) in predicting emerging hypoxemia after tracheal extubation in the patients in postanesthesia care unit (PACU).Methods:A total of 333 patients of both sexes, aged 18-89 yr, of American Society of Anesthesiologist physical statusⅠ-Ⅲ, scheduled for elective abdominal surgery, were included in the study.Lung ultrasound examinations were performed before operation (T 0) and on admission to PACU (T 1), and the LUSS were recorded as LUSS 0 and LUSS 1.Arterial blood gas analysis was conducted at 20 min after tracheal extubation, and oxygenation index (PaO 2/FiO 2) were recorded.Patients were divided into 2 groups according to the oxygenation index: PaO 2/FiO 2<300 mmHg group (hypoxemia group), and PaO 2/FiO 2≥300 mmHg group (non-hypoxemia group). Multivariate logistic regression analysis and the receiver operating characteristic curve were used to evaluate the accuracy of LUSS 1 in predicting the emerging hypoxemia after extubation in the patients in PACU. Results:The incidence of emerging hypoxemia in PACU after extubation was 9.0%.Multivariate logistic regression analysis indicated that LUSS 1 and body mass index were independent risk factors for emerging hypoxemia after extubation in the patients in PACU.The area under the ROC curve for LUSS 1 was 0.873 ( P<0.001, 95%CI 0.812-0.935). The patients with LUSS 1<7 had a lower risk of hypoxemia after extubation (LR -=0.15, 95%CI 0.05-0.45), and the patients with LUSS 1>10 had a higher risk of hypoxemia after extubation (LR + =17.25, 95%CI 7.35-40.51). Conclusion:LUS can effectively predict the development of hypoxemia after tracheal extubation in the patients in PACU.

Objective To investigate gait characteristics of both lower limbs in female patients before and after unilateral total knee arthroplasty (TKA). Methods Based on three-dimensional (3D) motion capture system and independent-sample t test, gait parameters of 10 female patients were compared in both lower limbs and compared with those of 10 healthy subjects before and after TKA. Results The preoperative stance phase, peak adduction angle, adduction-abduction range of motion (ROM) and peak flexion moment of the unoperated knee were significantly higher than those of the operated knee (P<0.05), while postoperative gait parameters were similar in both sides. Compared with the control group, the patients had significantly lower speed and stride length, longer double support time before TKA (P<0.05). Moreover, the operated knee demonstrated significantly lower peak extension and adduction angles, adduction-abduction ROM, peak flexion and abduction moments, higher peak adduction moment, and the unoperated knee revealed significantly lower peak extension angle, higher peak flexion and adduction moments than the control group before TKA (P<0.05). The greater differences of peak knee extension angles and adduction moments of both sides still existed in the two groups after TKA (P<0.05). Conclusions Unilateral TKA could ease pain and reduce gait deviations in both lower limbs of patients. However, there were still gait differences compared with the control group. Patients still suffered deficits in joint function, such as muscle strength and proprioception, and revealed pathological gait and posture. It’s advised that patients should enhance muscle strength of the operated limb, and take gait correction exercises. Female patients should also control walking speed to avoid increasing pressure on the knee after TKA.

Objective:To confirm the Sigma N transcription factor activity of a gene product encoded by LA2404 gene of Leptospira interrogans ( L. interrogans) and to identify the target genes of Sigma N signaling system. Methods:L. interrogans LA2404 gene and its regulated target genes were predicted using bioinformatic analysis according to the promoter sequence signature in Sigma N-regulated genes. A LA2404 gene-knockout (ΔLA2404) strain of L. interrogans was constructed based on homologous sequence recombinant of suicide plasmid. Real-time fluorescent quantitative RT-PCR (qRT-PCR) was used to detect the changes in the expression of target genes at mRNA level in the ΔLA2404 mutant. A prokaryotic expression system for LA2404 gene was established and the target recombinant protein rSigma N was extracted by Ni-NTA affinity chromatography. Gel electrophoresis mobility shift assay (EMSA) was used to screen out the target genes regulated by rSigma N. Results:Pathogenic L. interrogans serogroup Icterohaemorrhagiae serovar Lai strain Lai carried one Sigma N gene and 22 Sigma N promoter sequence-containing target genes. Qualitative examination of the ΔLA2404 mutant by microscopy revealed no defect in motility and appearance. Expression of LA1188, LA2306, LA3426, LA1968, LA1313, LA3806 and LA0773 genes at mRNA level in the ΔLA2404 mutant was significantly down-regulated ( P<0.05), but no significant changes in the expression of other target genes at mRNA level were detected. EMSA results confirmed that rSigma N could bind to the promotor sequences of the target genes mentioned above. Conclusions:Sigma N transcription factor was encoded by LA2404 gene. LA1188, LA2306, LA3426, LA1968, LA1313, LA3806 and LA0773 genes contained Sigma N promoter sequence and the expression of them was regulated by Sigma N signaling system.

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 explore the status of occupational stress and its influencing factors in medical radiation workers using two occupational stress measurement models. METHODS: A total of 632 medical radiation workers from Guangdong Province were selected as the study subjects using cluster sampling method. Chinese version of Job Content Questionnaire and Effort Reward Imbalance Questionnaire were used to assess occupational stress with job demand-control( JDC) and effort-reward imbalance( ERI) models. RESULTS: The rate of occupational stress in the study subjects was 43. 8%( 277/632) using the JDC model. The rate of occupational stress was 38. 6%( 244/632) using the ERI model. The multivariate logistic analysis results showed that the risk of JDC occupational stress was higher in workers with more than 8 hours work daily and more than 40 hours weekly( P < 0. 01). The risk of ERI occupational stress was higher in the workers with age of30. 0-40. 0,public medical institutions,daily work more than 8 hours and weekly work more than 40 hours( P < 0. 01).CONCLUSION: Under the two theoretical models,medical radiation workers have a certain degree of occupational stress. The age,medical institution type,daily and weekly work hours are the main factors affecting occupational stress.