中华劳动卫生职业病杂志最新文献

Objective: To investigate the effect of microRNA-204-5p (miR-204-5P) on silica (SiO(2)) -induced inflammatory response in macrophages and its mechanism. Methods: In September 2023, SiO(2)-induced mouse macrophage (RAW264.7) model in vitro was constructed. The experiment was divided into blank control group, SiO(2) treatment group, SiO(2)(+) mimic transfection control group and SiO(2)(+) mimic transfection group. RAW264.7 cells were evenly seeded into 6-well plates and cultured for 24 hours prior to transfection. The SiO(2)+mimic control group and SiO(2)+mimic group were transfected with miR-204-5P mimic control and miR-204-5P mimic, respectively. After 6 hours of transfection, except for the blank control group, the other three groups were treated with SiO(2) suspension, while the blank control group received an equal volume of PBS for 24 hours of stimulation.Cell viability was detected by CCK-8 assay. RT-qPCR was used to detect the mRNA expression levels of miR-204-5P and dishevelled 3 (DVL-3) in cells. Western blot was used to detect Wnt/β-catenin pathway related proteins DVL-3, β-catenin, T cell factor 4 (TCF4) and matrix metalloproteinase 9 (MMP-9) . JAK2/STAT3 pathway related proteins Janus kinase 2 (JAK2) , signal transducer and activator of transcription 3 (STAT3) , phosphorylated JAK2 (p-JAK2) , phosphorylated STAT3 (p-STAT3) ; Inducible nitric oxide synthase (iNOS) expression level. ELISA was used to detect the expression levels of inflammatory factors interleukin-6 (IL-6) , tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) in cell supernatant. The t test was used to compare the differences between the two groups, and the one-way analysis of variance was used to compare the differences among multiple groups. Results: Compared with SiO(2)+ mimic transfection control group, the cell viability of SiO(2)+ mimic transfection group had no significant change. The mRNA and protein levels of DVL-3 were significantly decreased (P<0.05) . The protein expression levels of β-catenin, TCF4 and MMP-9 were significantly decreased (P<0.05) . The protein expression levels of p-JAK2 and p-STAT3 decreased. The levels of inflammatory factors IL-6, TNF-α, and TGF-β(1) and the expression level of protein iNOS were significantly decreased (P<0.05) . Conclusion: miR-204-5P alleviates SiO(2)(-) induced macrophage inflammation by regulating the wnt/β-catenin pathway and JAK2/STAT3 pathway.

This article briefly introduces the new concept of burnout and the new burnout assessment tool BAT. In the past, the most famous burnout definition was proposed by Maslach and Leiter. The Maslach Burnout Inventory (MBI) developed by Maslach has also been the gold standard for evaluating burnout. With the development of burnout research, the concept of burnout has a certain defect. MBI has also been criticized in conceptual, practical and psychological measurement. It may hinder new research, and urgently needs to improve the concept and evaluation of burnout. Therefore, Schaufeli redefined the concept of burnout, and developed a new burnout assessment tool for groups and individuals based on the new concept of burnout-Burnout Assessment Tool (BAT) . This paper systematically reviews the proposal of the new concept of burnout, the development of the BAT scale and its application at home and abroad, and analyzes the advantages and application prospects of the BAT scale.

This article analyzes the treatment process of a patient with respiratory failure caused by occupational acute acetonitrile poisoning. Due to operational errors, the patient's body was sprayed with a large amount of acetonitrile liquid, leading to the absorption of acetonitrile through the skin and resulting in acute poisoning. The clinical manifestations were nervous system and respiratory system damage, accompanied by severe lactic acidosis. After active comprehensive treatments such as tracheal intubation, mechanical ventilation, continuous renal replacement therapy (CRRT) , and glucocorticoids, the patient basically recovered. The treatment process of this patient indicates that early identification and correct first aid of acetonitrile poisoning are the keys to improving prognosis and can provide a reference for the handling of similar clinical cases.

Objective: To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in right-hand ultrasound physicians and identify contributing factors for carpal tunnel syndrome (CTS) . Methods: From May 2023 to February 2025, 188 ultrasound physicians from 15 hospitals in Heilongjiang Province were surveyed using questionnaires to assess their prevalence of wrist-specific mechanical strain disorders (WMSDs) over the past year. Neurophysiological tests were conducted, and logistic regression analysis was performed to identify factors affecting the right carpal tunnel syndrome (CTS) . Results: The prevalence of wrist WMSDs among ultrasound physicians was 48.4% (91/188) . Multivariate logistic regression analysis revealed that age and frequent probe pressure application were associated with 2.14-fold and 4.04-fold increased CTS risk, respectively. Conclusion: Enhance society's attention to the health of noise-exposed physiciansand providing a foundation for implementing targeted interventions.

Pulmonary siderosis caused by iron and its compound dust is prone to misdiagnosis and underdiagnosis due to its insidious exposure pathways and non-specific imaging manifestations. This study analyzes the occupational histories and clinical data of six patients with occupational pulmonary siderosis diagnosed at Qingdao Central Hospital between January 2017 and December 2023, summarizes its characteristics, and evaluates the value of AI-assisted diagnosis. All six patients were male, with five being welders. The median dust exposure duration was 9.4 years, and the median latency period was 8.4 years. The main symptoms were chest tightness, cough, and shortness of breath. High-kilovolt chest radiographs were negative in four cases and showed thickened bronchovascular markings in two cases. High-resolution computed tomography (HRCT) revealed centrilobular nodules and tree-in-bud opacities in all cases. Pulmonary siderosis caused by iron and its compound dust is characterized by mild symptoms and a favorable prognosis. Comprehensive assessment and HRCT are crucial for early diagnosis. The development of AI models could enhance diagnostic recognition efficiency and promote precision diagnosis in the future.

Objective: To establish a method for the determination of 2-amino-5-chloro-N, 3-dimethylbenzamide in blood by ultra-performance liquid chromatography-quadrupole-orbitrap high resolution mass spectrometry (UPLC-Q-Orbitrap HRMS) . Methods: In October 2022, 200 μl of blood samples were taken and 800 μl of acetonitrile was added. The samples were centrifuged at 3500 r/min (with a centrifugation radius of 6.6 cm) for 15 minutes. The supernatant was detected in the positive ion target tandem mass spectrometry (Target MS(2)) mode and quantified by the external standard method. Methodological validation was also carried out for the established method. Results: The working curve of 2-amino-5-chloro-N, 3-dimethylbenzamide showed good linearity in the concentration range of 2.07-165.44 μg/L, with a correlation coefficient (r) of 0.9994. The intra-day and inter-day relative standard deviations (RSD) for the detection of 2-amino-5-chloro-N, 3-dimethylbenzamide were 2.6%-3.0% and 3.1%-3.5%, respectively. Analytical accuracy of 2-amino-5-chloro-N, 3-dimethylbenzamide quantification ranged from 101.0 % to 108.4 %, and the limit of detection and limit of quantification were 0.11 μg/L and 0.36 μg/L, respectively. The blood samples were able to be stored at -20 ℃ for at least 7 days. Conclusion: The UPLC-Q-Orbitrap HRMS determination method is sensitive, efficient and accurate, and can be used for the determination of 2-amino-5-chloro-N, 3-dimethylbenzamide in blood.

Objective: To investigate the characteristics, influencing factors, consequences, coping strategies, and preventive measures of workplace violence in medical consortiums. Methods: Medical professionals from a specialized hospital in South China and its consortium members (2 primary-level, 1 secondary-level, and 1 tertiary-level hospitals) were surveyed in December 2022 and July 2023. Quantitative research included 1013 participants, while qualitative research involved 35 participants. Workplace violence was assessed using the "National Case Study Tool for Workplace Violence in Healthcare Institutions-Survey Questionnaire", with qualitative analysis conducted through semi-structured interviews. Inter-group comparisons employed chi-square tests or Fisher's exact probability test, with logistic regression models for bivariate analysis. Results: The overall incidence rates of violence, psychological violence, and physical violence in this medical consortium were 31.7% (321/1, 013) , 30.6% (310/1, 013) , and 3.3% (33/1, 013) , respectively. Specifically, the overall violence rates in Level 1, Level 2, and Level 3 hospitals were 22.7% (41/181) , 27.4% (43/157) , and 35.1% (237/675) . The physical violence rates were 1.1% (2/181) , 10.2% (16/157) , and 2.2% (15/675) , respectively. The psychological violence rates stood at 22.7% (41/181) , 24.8% (39/157) , and 34.1% (230/675) . The total violence in tertiary hospitals was significantly higher than that in tertiary hospitals (F=10.10, P=0.002) , and the incidence of psychological violence in tertiary hospitals was significantly higher than that in tertiary hospitals (F(level 1 vs level 3)=8.61, P=0.003; F(level 2 vs level 3)=4.96, P=0.026) , incidence of verbal insults (F(level 1 vs level 3)=8.25, P=0.004; F(level 2 vs level 3)=6.36, P= 0.012) was significantly higher than that of level 1 and level 2 hospitals. The incidence of physical violence in secondary hospitals was significantly higher than that of other two-level hospitals (P<0.001) . Compared with other types of violence, the incidence of verbal insults is highest in hospitals at all levels. Higher anxiety about violence was a risk factor for psychological violence in hospitals at all levels (F(level1 hospital)=15.44, P=0.004; F(level2 hospital)=22.87, P<0.001; F(level3 hospital)=84.12, P<0.001) . Health workers in all three levels of hospitals has a high level of approval of existing workplace violence interventions. The main causes of workplace violence were poor communication between doctors and patients (13.2%) , service attitude problems (12.5%) and patient illness (16.9%) . Conclusion: Workplace violence remains prevalent within this medical consortium. Targeted measures should be implemented based on hospital size, functions, and patient demographics.

Objective: To study investigates the current healthcare-seeking status of patients with pneumoconiosis at grassroots rehabilitation stations in Henan Province, analyzes their healthcare-seeking behaviors and influencing factors, and provides references for formulating relevant rehabilitation treatment and health management policies. Methods: In July 2024, a total of 492 cases of pneumoconiosis patients registered at 7 grassroots pneumoconiosis rehabilitation stations from July to December 2021 were selected. The "Healthcare-Seeking Behavior and Influencing Factors of Pneumoconiosis Patients" questionnaire was used to collect information through a combination of rehabilitation station consultations and household interviews. Data on medical insurance type, whether the employer had purchased work-related injury insurance, patient condition characteristics (years of dust exposure, pneumoconiosis stage, patient condition score) , and reasons for not visiting rehabilitation stations were gathered and statistically analyzed. Univariate analysis was conducted using the chi-square test and logistic regression analysis was used to identify the influencing factors of patients' medical-seeking behavior. Results: A total of 492 pneumoconiosis patients were registered in basic rehabilitation stations in Henan Province. Among them, 204 cases (41.5%) went to the rehabilitation station, In the past year, 288 cases (58.5%) did not visit. Patients with pneumoconiosis who have no income, whose employer has purchased work-related injury insurance, whose pneumoconiosis type is silicosis, and whose disease score is 15-20 points have a high rate of visits to rehabilitation stations (OR=8.35, 95%CI: 4.40-15.84; OR=13.89, 95%CI: 7.69-25.08; OR=3.20, 95%CI: 1.18-8.68; OR=5.18, 95%CI: 2.04-13.14) . The top five reasons for the analysis of not visiting were: the self-induction symptoms lighter (58.7%, 169/288) , online consultation or telephone follow-up (17.0%, 49/288) , buying medicine in a drugstore (14.6%, 42/288) , thinking of seeing a doctor is useless, can not be cured (6.9%, 20/288) , medical expenses are high and cannot be reimbursed (6.3%, 18/288) . Conclusion: Economically disadvantaged silicosis patients with work-related injury insurance and severe conditions prefer seeking treatment at nearby rehabilitation stations. The main reasons for reluctance to seek medical care are low treatment demand and concerns over high costs. Greater attention should be paid to the demand of pneumoconiosis patients for "Internet+healthcare" services at grassroots-level rehabilitation stations.

This paper analyzes the treatment process of a patient who developed severe acute respiratory distress syndrome (ARDS) following a chemical leak of dimethyl sulfate caused by factory operational error in February 2023, and explores the efficacy of extracorporeal membrane oxygenation (ECMO) in patient management. The patient developed severe respiratory symptoms five hours after chemical exposure and received sequential treatment with nasal high-flow oxygen therapy and invasive mechanical ventilation upon admission. When the oxygenation index dropped below 100 mmHg, veno-venous (VV) ECMO was initiated alongside 12-hour daily prone position ventilation to improve oxygenation and lung compliance. The patient recovered and was discharged following treatment. For patients with dimethyl sulfate poisoning complicated by severe ARDS, early implementation of VV-ECMO significantly improves treatment outcomes and prognosis.

Objective: To explore the moderating effect of social support on the effect of occupational stress affecting job burnout, and to provide a theoretical basis for effectively reducing job burnout of medical workers. Methods: In April 2021, a cluster sampling method was adopted. Two units were randomly selected from the tertiary, secondary and primary medical institutions in Shanghai to carry out the survey. The survey was conducted by distributing electronic questionnaires online, and a total of 1963 valid questionnaires were collected. The questionnaire employed Maslach Burnout Inventory-General Survey (MBI-GS) to measure job burnout, and Job Content Questionnaire to measure occupational stress and social support. The questionnaire also collected demographic characteristics and work-related information. Mann-Whitney U test and Kruskal-Wallis H test were used for one-way analysis to test whether there was any difference in the distribution of occupational stress, job burnout, and social support on different demographic characteristics. Spearman's rank correlation coefficient was used to analyze the correlation between occupational stress, job burnout, and social support. Bootstrap method was used to analyze the moderating effect of social support on occupational stress affecting job burnout. Results: The occupational stress score was 1.232 (1.039, 1.530) , the job burnout score was 2.480 (1.560, 3.240) , and the social support score was 3.500 (3.125, 4.000) . Occupational stress, job burnout and social support were distributed differently on sex, job position, hospital level, monthly income, daily working hours, break duration per shift, and break duration between shifts (P<0.05) . Occupational stress was positively associated with job burnout (r(s)=0.49, P<0.001) , and social support was negatively associated with both occupational stress (r(s)=-0.44, P<0.001) and job burnout (r(s)=-0.48, P<0.001) . Social support played a moderating role in the influence of occupational stress on job burnout (B=0.321, 95%CI: 0.216~0.426) . Conclusion: The problem of job burnout is more prominent among medical workers. In the context of enhanced social support, improving job stress condition can lead to a greater decrease in job burnout.