[Analysis of incidence characteristics of occupational chronic benzene poisoning under two diagnostic criteria]

Objective: To analyze the incidence characteristics of occupational chronic benzene poisoning under two diagnostic criteria. Methods: In March 2020, 126 patients who were divided into the old criteria group (74 cases) and the new criteria group (52 cases) were retrospectively analyzed. These patients were diagnosed with occupational chronic benzene poisoning, and were diagnosed in our hospital during the period of January 2009 to December 2019. The gender composition, age of onset, years of benzene exposure, industry distribution, work type, benzene concentration in working environment and diagnostic grade of the two groups of patients were analyzed and compared. The follow-up of 22 benzene poisoning observation subjects under the old criteria were retrospectively analyzed. Results: There were no statistically significant differences in gender composition, age of onset, years of benzene exposure, industry distribution and work type between the old criteria group and the new criteria group (P>0.05) . In the old criteria group and the new criteria group, 41.9% (31/74) and 17.3% (9/52) of the patients' workplace benzene concentration exceeded the maximum allowable concentration, respectively. The composition of different benzene concentration in the workplace between the two groups showed statistically significant (P<0.05) . In the old criteria group, the proportion of mild poisoning (79.7%, 59/74) was the majority, while in the new criteria group, the proportion of moderate and severe poisoning (51.9%, 27/52) were the majority, and there was statistically significance in the composition ratio of diagnostic grade between the two groups (P<0.05) . Under the old criteria, after folow-up of 22 cases of benzene poisoning observation subjects, we observed that 8 cases (36.4%) progressed to the level of chronic benzene poisoning. Conclusion: The revision of diagnostic criteria for benzene poisoning may affect the composition of diagnosis classification. Based on the rights and interests of workers, formulating more complete diagnostic criteria and system policies will be more conducive to the development of occupational benzene poisoning prevention and control.

[Analysis on endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach under the microscope for skull base tumor with intra and extra-cranial involvement]

Objective: To evaluate the application of combination use of endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach microscopically in skull base tumor with intra and extra-cranial involvement. Methods: A total of 7 patients (4 males and 3 females, aging from 27 to 65 years old, with a medium age of 48) undergone complicated skull base surgeries via endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach microscopically from May 2016 to January 2018 were reviewed respectively. The patients included 2 cases of recurrent invasive pituitary adenoma, 3 cases of basal skull meningiomas, 1 case of clivus chondrosarcoma, and 1 case of recurrent nasopharyngeal carcinoma. The lesion extensively infiltrated nasal cavity, extending to the paranasal sinus, bilateral cavernous sinus, sellar region, suprasellar, superior clivus, temporal lobe, pterygopalatine fossa, infratemporal fossa and important intracranial vessels. All the 7 patients were treated under general anesthesia by endoscopic endonasal approach combined with frontotemporal orbitozygomatic approach under the microscope. Total excision rate, intraoperative and postoperative complications and postoperative curative effect were observed. All of them were followed up for 6 to 12 months. The Glasgow Outcome Scale (GOS) was used to evaluate the prognosis. Result: Total tumor removal was performed in 5 cases, subtotal removel in 2 cases. There was no complication during the operation. Postoperative severe complications occurred in 2 cases, including 1 case of cerebrospinal fluid rhinorrhea and intracranial infection, which was cured by lumbar cistern drainage and intrathecal injection; 1 case occurred oculomotor nerve paralysis, which recovered during follow-up. Postoperative complications occurred in 1 case of trochlear nerve dysfunction, 2 cases of facial numbness, and 1 case of tinnitus. During follow-up, all patients recovered to varying degrees. There was no bleeding and death after the operation. No tumor recurred during the follow-up period. All patients were recovered well with GOS grade Ⅳ-Ⅴ. Conclusions: Endoscopic transnasal approach combined with microscopic frontotemporal orbitozygomatic approach can remove tumors in one stage, reduce surgical complications and improve surgical effect. It has good application prospects and is suitable for excising complex intracranial and extracranial communicating tumors of widely involving sellar, clivus and petrous apex area.

[Analysis of new pneumoconiosis in Yantai from 2010 to 2019]

Objective: To analyze the characteristics of new cases of pneumoconiosis in Yantai from 2010 to 2019, and to provide scientific basis for the prevention and control of pneumoconiosis. Methods: In March 2020, 2575 new pneumoconiosis cases in Yantai City from January 1, 2010 to December 31, 2019 were obtained through the "Health Hazard Information Monitoring System" platform under "China Disease Prevention and Control Information System" and patient hospital files. Excel 2007 was used to sort out the database of pneumoconiosis and analyze the epidemiological characteristics of new pneumoconiosis, including gender, age, length of service, type of work, etc. Results: From 2010 to 2019, the majority of new pneumoconiosis cases were male (2542 cases, 98.72%) , and the age of onset was 40-<60 years old (2074 cases, 80.54%) . The main age of onset was 15-<30 years (1534 cases, 59.57%) . Silicosis was the most common type of new pneumoconiosis (2313 cases, 89.83%) . There were 2262 cases (87.84%) with one stage of pneumoconiosis. The main types of work were rock driller (799 cases, 31.03%) , hauler (797 cases, 30.95%) , other mine workers (391 cases, 15.18%) . The economic type of enterprises was mainly state-owned enterprises (1156 cases, 44.89%) . The scale of enterprises mainly concentrated in large enterprises (1897 cases, 73.67%) . Conclusion: The new pneumoconiosis in Yantai City shows obvious concentration of disease and work types.It is necessary to strengthen the prevention and treatment of silicosis and the training of protection knowledge for rock drillers and transport workers.

[Clinical study of sequential glucocorticoids in the treatment of acute mercury poisoning complicated with interstitial pneumonia]

Objective: To study the clinical efficacy of sequential glucocorticoids in the treatment of acute mercury poisoning complicated with interstitial pneumonia. Methods: Retrospective analysis of 37 patients with acute mercury poisoning complicated with interstitial pneumonia admitted from January 2009 to April 2019, including the sequential treatment group (15 cases) and the conventional treatment group (22 cases) , all patients were treated with sodium dimercaptopropane sulfonate, and given anti-inflammatory, liver-protecting and other drugs for symptomatic treatment. The conventional treatment group was given methylprednisolone 1mg/kg once a day for 5-7 days. The sequential treatment group was given 1 mg/kg of methylprednisolone once a day for 5-7 days, then gradually reduced to 20 mg, and the total course of treatment was 14-21 days. To observe the changes of clinical symptoms, signs, lung function including forced vital capacity (FVC) , forced expiratory volume in the first second (FEV(1)) and ratio of forced expiratory volume in the first second to forced vital capacity (FEV(1)/FVC) , and chest CT indexes before and after treatment in the two groups. Results: The clinical symptoms and signs of the two groups were significantly improved compared with those before treatment, and there was no significant difference between the apparent efficiency and the total effective rate of the two groups (P>0.05) . The FVC, FEV(1), and FEV(1)/FVC of the two groups were significantly higher than those before treatment. After treatment, the indexes of the sequential treatment group were significantly higher than that of the conventional treatment group, and the difference was statistically significant (P<0.05) . The apparent efficiency (93.3%, 14/15) of CT lesions in the sequential treatment group was significantly higher than those of the conventional treatment group (59.1%, 13/22) , and the difference was statistically significant (P< 0.05) . Conclusion: Sequential glucocorticoid treatment of acute mercury poisoning complicated with interstitial pneumonia could improve the effect of clinical signs and symptoms which is equal to conventional treatment, but it could better promote the recovery of lung function and the absorption of lung lesions.

Phase II trial of a 2-hour infusion of gemcitabine plus carboplatin as first-line chemotherapy for advanced non-small cell lung cancer

17099

Background: Prolonged infusion of gemcitabine have shown increased levels of the active triphosphate metabolite that theorically could increase the response rate and toxicity. The objectives of this study were to evaluated the efficacy and safety of this combination of using gemcitabine as a rate infusion of 10 mg/m2 per min with carboplatin in front-line chemonaive patients with advanced NSCLC. Methods: Fifty-four chemonaive patients have been included. 44 were male and 10 female. Median age was 63 years (19–75). 13% had ECOG 0 and 53.7% ECOG 1 and 33.3% ECOG 2. 32 (59.2%) patients had adenocarcinoma, 13 (24.1%) squamous cell, 1 (1.9%) large cell carcinoma, and 8 (14.8%) others. Eight (14.8%) had stage IIIB and 46 (85.2%) stage IV. Treatment was consisted of 1200 mg/m2 gemcitabine given as a 2-hour continuous infusion (10 mg/m2 per min) on days 1 and 8 of each cycle an AUC 5 carboplatin as on day 1, repeating each cycle every 21 days. A total of 223 chemotherapy cycles were administered, with a median of 4 cycles per patient (range 1–6), and 15 (27.8%) patients received all six cycles. Results: Of the fifty-four patients enrolled, all were evaluated for toxicity (according to the WHO scale) and 51 assessed for response (according to the RECIST criteria), the overall response rate (ORR) was 41.2% (95% confidence interval, 28% to 57%), including two complete responses (CRs: 3.9%) and 19 partial responses (PRs: 37.3%). As per the intent-to-treat (ITT) analysis, the ORR was 38.9%. With a median follow-up time of 10.8 months, the median TTP was 5.0 months (range 3.7–6.3 months), median OS time was 11.5 months (range 9.9–13.1 months) and 1-year survival was 41.7% (95% CI 26% to 57%) and 2-year survival was 19.3% (4.4% to 34.2%).The main grade 3–4 toxicity consisted of neutropenia (55.6%) and thrombocytopenia (57.4%).Patients were required platelet transfusion in 27 cycles (12.1%) and haematopoietic growth factors support care in 56 (25.1%) cycles. No bleeding episodes were recorded. Grade 3 nausea/vomiting occurred in 5.6% and grade 1–2 skin rash occurred in 42.6%. Conclusions: Prolonged gemcitabine infusion combined with carboplatin is manageable tolerated and its efficacy is similar to that of other chemotherapeutic schemes used for NSCLC treatment.

No significant financial relationships to disclose.

[Evaluation of application of transparent keratoscope in ocular microsurgery]

The clinical effects of application of a transparent keratoscope in cataract extraction and intraocular lens implantation were reported. The patients were divided into 2 groups: 1 group without and the other group with the application of a transparent keratoscope to control the corneal curvature by regulating the strength of the continuous suture during the microsurgery. The pre-operative and the post-operative corneal curvatures of patients in both groups were measured and the results were compared. The comparison shows that the clinical effect in regard to the corneal curvature is better in the group with the application of a transparent keratoscope. In this group, 63% of the post-operative corneal astigmatism is less than 2D, 91% less than 3D and none more than 4D.

[Two new types of keratoscope and their clinical application]

The author reports the clinical application of his 2 new types of keratoscope for qualitative observation of the corneal curvature: the reflective type and the transparent type. The latter was particularly useful in controlling the corneal astigmatism during intraocular microsurgery. According to practical use on 30 patients, the positive rate of astigmatic detection and the recognition of astigmatic meridian by these keratoscopes were satisfactory.

[A microdialmeter for measurement of the anterior chamber depth]

A microdialmeter is designed to measure the anterior chamber depth by determining the distance advanced by the slitlamp that is focused first on the posterior surface of the cornea and then on the anterior surface of the lens. An isosceles right triangular block is fixed onto the slitlamp to transform its anterior-posterior movement into the transverse direction to be measured conveniently by the microdial with a precision of 0.01 mm.