Objective:To study the effects of combined occupational exposure of benzene, toluene, and xylene on human metabolism at an overall level, and to screen biomarkers related to the combined occupational exposure of benzene, toluene, and xylene, and to explore the mechanism of early health effects preliminarily caused by combined occupational exposure of benzene, toluene, and xylene by identification of biomarkers and retrieval of metabolic pathways.Methods:A shoe-making company was selected as the research site. Twenty subjects for the exposed group and the control group were selected separately, and urine of the subjects was collected. The metabolic profiles of the samples were collected by liquid chromatography time-of-flight mass spectrometry, and professional metabolomics and multivariate statistical analysis software were used to establish PCA and OPLS-DA analysis models to screen potential biomarkers and identify biomarkers. Finally, based on the dynamic changes and trends of potential biomarkers between groups, the mechanism of body damage caused by benzene, toluene, and xylene was initially explored.Results:Urine metabolomics analysis showed that the metabolic profile of urine samples of the benzene, toluene, and xylene combined exposure group was different from that of the control group. 27 potential biomarkers that were closely related to the combined exposure of benzene, toluene, and xylene were screened and identified. These potential biomarkers were enriched in 16 metabolic pathways, of which 3 pathways were significantly enriched ( P<0.05) , respectively, lysine metabolism, amino sugar metabolism, and nucleotide sugar metabolism. Conclusion:The metabonomics method can well reflect the changes in the metabolome of urine samples in the occupational population after the combined exposure of benzene, toluene, and xylene, which will help us better evaluate the risk of combined exposure of benzene, toluene, and xylene and prevent and control their health risks.

Objective:To investigate the effects of titanium dioxide nanoparticles (TiO 2 NPs) on urine metabolites in occupationally exposure people based on metabolomics technology, and to explore the mechanism of early health effects of TiO 2 NPs on occupational exposure. Methods:In October 2019, the TiO 2 NPs occupational exposure population was selected as the research object, of which 64 people were in the exposure group who had been engaged in TiO 2 NPs exposure positions for more than 1 year; the control group was 62 people, who were logistics administrative staff of the same company. The urine of the research subjects before class was collected, using the ultra-high performance liquid chromatography time-of-flight mass spectrometer to collect the metabolism data of the urine, Progenesis QI software for data preprocessing and metabolite identification, SIMCA-P software for the principal component analysis of the data and potential biomarkers screening, MetaboAnalyst 4.0 software for metabolic pathway enrichment analysis. Results:The urine metabolism profile of workers in the exposure group was different from the control group, and 44 potential biomarkers were screened and identified. These potential biomarkers were significantly enriched in three pathways ( P<0.05) , namely D-arginine and D-ornithine metabolism pathway, nitrogen metabolism pathway and D-glutamine and D-glutamate metabolism pathways. Conclusion:The occupational exposure of TiO 2 NPs can affect the concentration of metabolites in people urine and metabolic pathways, which provides a direction for the study of occupational hazard mechanisms of TiO 2 NPs and the monitoring of health risks.

Objective:To study the effects of combined occupational exposure of benzene, toluene, and xylene on human metabolism at an overall level, and to screen biomarkers related to the combined occupational exposure of benzene, toluene, and xylene, and to explore the mechanism of early health effects preliminarily caused by combined occupational exposure of benzene, toluene, and xylene by identification of biomarkers and retrieval of metabolic pathways.Methods:A shoe-making company was selected as the research site. Twenty subjects for the exposed group and the control group were selected separately, and urine of the subjects was collected. The metabolic profiles of the samples were collected by liquid chromatography time-of-flight mass spectrometry, and professional metabolomics and multivariate statistical analysis software were used to establish PCA and OPLS-DA analysis models to screen potential biomarkers and identify biomarkers. Finally, based on the dynamic changes and trends of potential biomarkers between groups, the mechanism of body damage caused by benzene, toluene, and xylene was initially explored.Results:Urine metabolomics analysis showed that the metabolic profile of urine samples of the benzene, toluene, and xylene combined exposure group was different from that of the control group. 27 potential biomarkers that were closely related to the combined exposure of benzene, toluene, and xylene were screened and identified. These potential biomarkers were enriched in 16 metabolic pathways, of which 3 pathways were significantly enriched ( P<0.05) , respectively, lysine metabolism, amino sugar metabolism, and nucleotide sugar metabolism. Conclusion:The metabonomics method can well reflect the changes in the metabolome of urine samples in the occupational population after the combined exposure of benzene, toluene, and xylene, which will help us better evaluate the risk of combined exposure of benzene, toluene, and xylene and prevent and control their health risks.

Objective:To investigate the effects of titanium dioxide nanoparticles (TiO 2 NPs) on urine metabolites in occupationally exposure people based on metabolomics technology, and to explore the mechanism of early health effects of TiO 2 NPs on occupational exposure. Methods:In October 2019, the TiO 2 NPs occupational exposure population was selected as the research object, of which 64 people were in the exposure group who had been engaged in TiO 2 NPs exposure positions for more than 1 year; the control group was 62 people, who were logistics administrative staff of the same company. The urine of the research subjects before class was collected, using the ultra-high performance liquid chromatography time-of-flight mass spectrometer to collect the metabolism data of the urine, Progenesis QI software for data preprocessing and metabolite identification, SIMCA-P software for the principal component analysis of the data and potential biomarkers screening, MetaboAnalyst 4.0 software for metabolic pathway enrichment analysis. Results:The urine metabolism profile of workers in the exposure group was different from the control group, and 44 potential biomarkers were screened and identified. These potential biomarkers were significantly enriched in three pathways ( P<0.05) , namely D-arginine and D-ornithine metabolism pathway, nitrogen metabolism pathway and D-glutamine and D-glutamate metabolism pathways. Conclusion:The occupational exposure of TiO 2 NPs can affect the concentration of metabolites in people urine and metabolic pathways, which provides a direction for the study of occupational hazard mechanisms of TiO 2 NPs and the monitoring of health risks.

Objective: To establish a liquid chromatography tandem mass spectrometry method to determine the cortisol in saliva. Methods: Take 0.5 ml saliva sample into a 2 ml centrifuge tube, add excess sodium chloride and 1ml acetonitrile to it, then vortex for 3 min, centrifuge for 10 min at 15 000 r/min, and take 800 μl of the upper layer to another centrifuge tube. Finally, the sample was concentrated by a vacuum concentrator and brought to 200 μl with the initial mobile phase. Then, the sample was analyzed by liquid chromatography tandem mass spectrometry. The target compound was quantified by external standard curve method. Results: The linear range of the method was 0.02-5.00 ng/ml, r=0.999 9, the method limit of the detection was 0.002 ng/ml, the method limit of quantitative was 0.02 ng/ml, and the spiked recoveries were 89.60%-98.60%. The intra-assay precision was 1.90%-3.30%, and the inter-assay precision was 4.20%-9.00%; samples could be stored at -20 °C for at least 14 days. The determination of cortisol could not be interfered by other endogenous substances in the sample. Conclusion The method is simple in pretreatment, high sensitivity, good reproducibility and good recovery, and it is suitable for the quantitative analysis of cortisol in saliva for normal and occupationally stressed populations.

Objective: To develop a method using ultra-high performance liquid chromatography-triple quadrupole mass spectrometry to determine the urinary metabolites of benzene, toluene and xylene. The selected metabolites are S-phenylmercapturic acid (S-PMA) , trans, trans-muconic acid (t, t-MA) , 8-hydroxy-2 deoxyguanosine (8-OHdG) , hippuric acid (HA) , 2-methylhippuric acid (2-MHA) , 3-methylhippuric acid (3-MHA) and 4-methylhippuric acid (4-MHA) . Methods: The urine sample was pretreated using methanol to precipitate the proteins. HSS T3 chromatographic column was used to separate the metabolites. The mass spectrometric acquisition was carried out using multiple reaction monitoring (MRM) after ionization with ESI source. External standard method was used for quantification. Results: All the standard curves showed good linear relation, and r of the seven metabolites was all above 0.999. The detection limits and quantitative limits of the seven metabolites were 0.01-500 ng/ml and 0.02-1 000 ng/ml (based on the actual dilution ratio) , respectively. The average spiked recoveries of four loadings ranged from 85.8% to 109.9%. The intra-day and inter-day precisions were 0.2%-4.5% and 0.6%-9.5%, respectively. The samples can be kept for at least 14 days at both 4 ℃ and -20 ℃. Conclusion This method is simple, rapid and highly sensitive with low cost, and its accuracy, precision and stability can meet the daily test requirements. It can be applied for the determination of urinary S-PMA, t, t-MA, 8-OHdG, HA, 2-MHA, 3-MHA and 4-MHA for the occupational population exposed to benzene, toluene and xylene.

Objective To investigate the value of evaluation of pelvic floor ultrasound in the transvaginal modified patch repair and sacrospinous ligament fixation in uterine prolapse patients. Methods Thirty-two patients with uterine prolapse were included in the retrospective study from March 2016 to January 2017 in Hangzhou maternity and child health care hospital. All patients were detected by pelvic floor ultrasound before operation and cured by vaginal patch bilateral sacral spine ligament fixation treatment after. Of them, 8 cases were complicated with cystocele and 3 cases with anorectal prolapse, and all the complications were treated at the same time. The observations of the change of position, shape and activity of the implant by transvaginal at rest, on maxium Valsalva and contraction, and the transperineal pelvic ultrasound were performed to evaluate the change of pelvic floor function and compare the distance from the lowest point of the bladder, uterus and the rectal ampulla to reference line (the horizontal line at the lower margin of the pubic bone), area of levator hiatus and the thickness of the puborectalis muscle before and after operation. Results The patches were observed 2D and 3D postoperatively by pelvic ultrasound. The U-shaped hyperecho could be clearly shown around the cervix and activity of patches were clearly shown. The observation of 32 cases of patients with pelvic viscera situation by the transperineal 2D and 4D pelvic ultrasound: the distance from the lowest point of the bladder, uterus and the rectal ampulla to reference line and the thickness of the puborectalis muscle enlarged after operation (0.65±1.85 vs 0.15±1.85, 2.80±1.10 vs -1.00±1.50, 0.60±1.90 vs-0.55±1.55,0.51±0.24 vs 0.37±0.19)onmaxium valsalva,the area of levator hiatus decreased after operation (20.15±7.20 vs 29.00±9.50).The differences were both statistically significant (all P < 0.05). Uterine prolapse were not found after operation. In the 8 cases with cystocele, 5 cases were cured and 3 cases were improved. And all the 3 cases of patients with anorectal prolapse were all cured. Conclusion Combined application of transvaginal and transperineal pelvic ultrasound can clearly show the suspension of the patch after the treatment of modified patch repair and Sacrospinous ligament fixation, which provide valuable imaging information in the evaluation of preoperative pelvic functionand postoperative therapeutic effect.

Objective:To investigate the types of non-tumor diseases in patients with cancer, and to explore the effects of those dis-eases on the diagnosis and treatment of cancer patients. Methods:We collected the medical records of cancer patients from January 2013 to December 2017 in Peking University Cancer Hospital, and screened for non-tumor diseases. The clinical records of the patients in this group were analyzed retrospectively, and the effects of those diseases on the diagnosis and treatment of tumors were dis-cussed. Results:Of the 1,323 cases of inter-hospital consultation, 1,153 cases of non-tumor disease (87.2％) were selected. There were 773 men (67.0％) and 380 women (33.0％) included. The median age was 62 (14-90) years. The primary tumor types included lung can-cer, gastric cancer, lymphoma, colorectal cancer, esophageal cancer, breast cancer, malignant melanoma, liver cancer, cholangiocarci-noma/gallbladder cancer, pancreatic cancer, and other tumors. Non-neoplastic diseases included cardiovascular disease in 356 cases (30.9％), respiratory system disease (17.0％) in 196 cases, digestive system disease in 107 cases (9.3％), skin and venereal diseases in 81 cases (7.0％), nervous system lesions (6.4％) in 74 cases, urinary system disease in 72 cases (6.2％), blood disease in 70 cases (6.1％), en-docrine and metabolic diseases in 47 cases (4.1％), autoimmune disease in 23 cases (2.0％), and other diseases (11.0％) in 127 cases. Impact on tumor diagnosis and treatment was as follows:direct, 771 cases (66.9％);no influence, 313 cases (27.1％);and uncertain, 69 cases (6.0％). Conclusions:Cardiovascular disease is a major non-tumor disease associated with cancer. Non-neoplastic diseases are important factors affecting the diagnosis and treatment plans of cancer.

Objective To study the reasons of seroma formation and long-term existence after modified radi-cal mastectomy ( MRM) .Methods The structure of fibrous lamina for seroma postoperative breast cancer was ana-lyzed by pathological methods;the composition of drainage fluids after MRM in the different postoperative time peri-ods was determined;and the structure of fibrous lamina following an experimental mastectomy model created in rats was investigated,which the process of fibrous lamina formation was imitated.Results There were three layer struc-tures in fibrous lamina,including fibrous leakage,capillaries and fiber lay.Hematology test results supported seroma for exudate.Animal model showed that with the extension of time,fibrous lamina thickened gradually.Conclusion It is capillaries in fibrous lamina that seroma long-standing histological basis.Maybe excising or destructing the structure of subcutaneous fibrous lamina,making the procedure of wound healing to begin again as soon as possible,which is a kind of effective method to solve the problem of seroma long-term existence after MRM.

ABSTRACT:Objective To investigate the effect of PDCA nursing model in children with mycoplasma pneumonia.Methods 120 children with mycoplasma pneumonia treated with Tanre-qing combined with azithromycin were randomly divided into the observation group (PDCA nursing model)and the control group (usual care)with 60 cases in each group.Clinical compliance,effica-cy,clinical symptoms,hospitalization time and adverse reactions were compared in two groups.Re-sults The clinical compliance in the observation group was higher than that in the control group(P<0.05).The effective rate in the observation group was 98.33%,which was significantly higher than that in the control group(88.33%)(P <0.05).Cooling time observation group,cough time, rales disappeared time,tonsils congestion disappear time and length of hospital stay in the observa-tion group were significantly less than those in the control group (P <0.05).Incidence of adverse reactions in the observation group was 15.00%,which was significantly lower than that in the con-trol group(31.67%)(P <0.05).Conclusion PDCA nursing model significantly improves compli-ance and clinical efficacy in children with mycoplasma pneumonia,and shortens the time of clinical symptoms and hospitalization and reduces adverse side effects.