Dimethylacetamide-induced toxic hepatitis in spandex workers: clinical presentation and treatment outcomes

Measuring the quantity of harmful volatile organic compounds inhaled through masks

An increase in the concentration of environmental particulate matter and the spread of the COVID-19 virus have dramatically increased our time spent wearing masks. If harmful chemicals are released from these masks, there may be harmful effects on human health. In this study, the concentration of volatile organic compounds (VOCs) emitted from some commonly used masks was assessed qualitatively and quantitatively under diverse conditions (including different mask material types, time between opening the product and wearing, and mask temperature). In KF94 masks, 1-methoxy-2-propanol (221 ± 356 µg m^-3), N,N-dimethylacetamide (601 ± 450 µg m^-3), n-hexane (268 ± 349 µg m^-3), and 2-butanone (160 ± 244 µg m^-3) were detected at concentrations 22.9-147 times higher than those found in masks made from other materials, such as cotton and other functional fabrics. In addition, in KF94 masks, the total VOC (TVOC) released amounted to 3730 ± 1331 µg m^-3, about 14 times more than that released by the cotton masks (267.5 ± 51.6 µg m^-3). In some KF94 masks, TVOC concentration reached over 4000 µg m^-3, posing a risk to human health (based on indoor air quality guidelines established by the German Environment Agency). Notably, 30 min after KF94 masks were removed from their packaging, TVOC concentrations decreased by about 80% from their initial levels to 724 ± 5.86 µg m^-3; furthermore, 6 h after removal, TVOC concentrations were found to be less than 200 µg m^-3. When the temperature of the KF94 masks was raised to 40 ^oC, TVOC concentrations increased by 119-299%. Since the types and concentrations of VOCs that will be inhaled by mask wearers vary depending on the mask use conditions, it is necessary to comply with safe mask wearing conditions.

Clinical manifestation score and characterization of cytokines and lymphocytes of dimethylacetamide-induced toxic hepatitis in spandex workers

Occupational exposure to dimethylacetamide (DMAc) has been reported to cause toxic hepatitis. Sixty spandex workers were included in this study to research the clinical manifestations and expression of cytokines and lymphocytes in DMAc-induced toxic hepatitis. Chinese drugs (reduced glutathione and Hugan tablets) were used to treat them. The manifestations including jaundice, asthenia, appetite, nausea, emesis, abdominal distension, yellow urine, and dizziness were scored. The percentages of patients rated as 0-3, 4-6, 7-9, and 10-12 points were 33.3%, 43.3%, 21.7%, and 1.7%, respectively, before treatment, and all patients showed 0-3 points after the treatment. The ultrasonic and CT imaging revealed diffuse intrahepatic hypodensity, intrahepatic calcification, signs of liver injury, and splenomegaly, which improved after therapy. Blood analysis showed that ALT, AST, TBIL, IL-6, IL-10, TNF-α, IFN-γ, CD3⁺%, and CD4⁺/CD8⁺ statistically decreased after drug treatment. Correlation analysis demonstrated positive linear correlations between ALT and TBIL, AST and TBIL, IL-10 and ATL, IL-10 and AST, IL-10 and TBIL, IFN-γ and IL-6, IFN-γ and TNF-α, and CD3⁺% and ALT. Pro-inflammatory cytokines and lymphocytes in DMAc-induced toxic hepatitis reflected an active immune state that decreased after treatment. IL-10 may inhibit the immune response in this disease, as a protective mechanism.

Effectiveness of polyene phosphatidylcholine and its combination with other drugs in patients with liver diseases based on real-world research

OBJECTIVES

Polyene phosphatidylcholine (PPC) is a widely used hepatoprotective drug. We aim to explore the effectiveness of PPC in patients with liver diseases based on real-world research, and compare with other hepatoprotective drugs.

METHODS

This was a "three-phase" retrospective study, including a descriptive study, a self-control case study, and a specific-disease cohort study. 14,800 hospitalized patients were enrolled in phase I from January 1, 2015, to January 1, 2020, of which 793 patients using PPC alone were included for phase II & III. The major measurement of effectiveness analysis was the ALT level and its changes. Wilcoxon signed rank test, Chi-Square Test and Mann-Whitney U Test were used.

RESULTS

In patients without liver tumor, ALT level decreased after using PPC (p < 0.01), and the decrease of ALT level using PPC was greater than using glutathione or magnesium isoglycyrrhizinate alone (p=0.044; p=0.038). In patients without liver tumor but having abnormal liver function, the decrease of ALT level using PPC + glutathione was greater than using glutathione alone (p=0.047).

CONCLUSION

PPC had a beneficial effect on liver function in patients without liver tumor, and PPC could enhance the liver protective function of glutathione and magnesium isoglycyrrhizinate.

Sequential Grafting of Fresh and Cryopreserved Fat After Mechanical Processing is a Safe and Effective Facial Rejuvenation Strategy

BACKGROUND

The survival rate of fat transplants is variable and consequently multiple operations are often required to achieve satisfactory results. Fat cryopreservation technology is a good solution to this problem. At present, cryopreservation of fats needs to be added with cryopreservation agents, which brings unsafety and operational complexity to clinical applications. An efficient and safe strategy for fat cryopreservation must be developed.

METHODS

A retrospective study was performed of all patients who underwent facial fat grafting and agreed to have their fat tissue cryopreserved from January 2018 to May 2021. Fat samples were physically processed to obtain SVF-gel, which was cryopreserved at - 20 °C for up to 3 months and injected after thawing. Images acquired by pre- and post-operative 3D scanning of the temporal region were compared to evaluate the retention rate of transplanted cryopreserved SVF-gel.

RESULTS

No patients experienced serious complications after receiving cryopreserved fat transplantation. The retention rate of cryopreserved SVF-gel was 46.3 ± 7.7% at 3 months and 43.1 ± 7.2% at 6 months after transplantation. The swelling duration was significantly shorter after cryopreserved SVF-gel transplantation (5.5 ± 0.8 days) than after fresh fat transplantation (7.5 ± 0.7 days) (p < .031).

CONCLUSION

Injection of cryopreserved SVF-gel achieves good retention rate for facial rejuvenation and has few side effects. Cryopreservation of SVF-gel is a safe and effective strategy for serial fat grafting for facial rejuvenation.

LEVEL OF EVIDENCE IV

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Effectiveness and Economic Evaluation of Polyene Phosphatidyl Choline in Patients With Liver Diseases Based on Real-World Research

Aims: Liver disease has high prevalence, number, and disease burden in China, and polyene phosphatidyl choline (PPC) is a widely used liver protective drug. We aim to explore the effectiveness and economy of PPC in patients with liver diseases based on real-world research and compare with other hepatoprotective drugs.

Methods: This is a “three-phase” study from three medical centers, including descriptive study of patients using PPC injection, self-control case study of patients using PPC injection, and specific-disease cohort study of patients using PPC injection or control drugs. The major measurements of liver function for effectiveness analysis were the alanine transaminase (ALT) level changes and recovery rate. The main statistical methods were Wilcoxon signed rank test, χ² test, and Mann–Whitney U test. Propensity score matching was applied to reduce bias. Cost-effectiveness analysis, cost minimization analysis, and sensitivity analysis were used for economic evaluation.

Results: PPC alone or in combination with glutathione and magnesium isoglycyrrhizinate shows less total hospitalization cost (p < 0.05) and smaller cost-effectiveness ratio and was effective in protecting liver function, especially in patients with liver transplantation or postoperation of nontumor liver disease (ALT decreased significantly after PPC treatment; p < 0.05). Glutathione and magnesium isoglycyrrhizinate combined with PPC could enhance the protective function of liver.

Conclusion: PPC was an effective and economic liver protective drug in patients with specific liver diseases, and PPC could enhance the liver protective function of glutathione and magnesium isoglycyrrhizinate.

Polyene Phosphatidylcholine Interacting with TLR-2 Prevents the Synovial Inflammation via Inactivation of MAPK and NF-κB Pathways

Rheumatoid arthritis (RA) is a chronic autoimmune joint disease that causes cartilage and bone damage or even disability, seriously endangering human health. Chronic synovial inflammation has been shown to play a vital role in disease sustainability. Therefore, downregulation of synovial inflammation is considered to be an effective discipline for RA therapy. Polyene phosphatidylcholine (PPC) is a hepatoprotective agent, which was observed to inhibit inflammation in macrophages and prevent collagen-induced arthritis (CIA) of rats in our previous study. However, the underlying mechanism remains unclear. The present study further reported that PPC can inhibit synovial inflammation. In lipopolysaccharide (LPS)-stimulated primary synovial fibroblasts (SFs) of mice, PPC significantly decreased pro-inflammatory cytokines production while increasing anti-inflammatory cytokines level. In this process, PPC downregulated the expression of TLR-2 and their downstream signaling molecules such as MyD88, p-ERK1/2, p-JNK1/2, and p-P38 in MAPK pathway and p-IκBα and NF-κB-p65 in NF-κB pathway. Moreover, the inhibitory effect of PPC on the above molecules and cytokines was weakened after pre-treatment with TLR-2 agonist Pam3CSK4. In addition, PPC lost its anti-inflammatory effect and its suppressing capability on MAPK and NF-κB pathways in TLR-2^-/- primary SFs after exposure to LPS. Collectively, this study demonstrated that PPC can alleviate synovial inflammation through TLR-2-mediated MAPK and NF-κB pathways, which can be proposed to be a potential drug candidate for RA prevention.

Impact of the COVID-19 pandemic on psychological well-being of students in an Italian university: a web-based cross-sectional survey

Background

Italy was the first European country to implement a national lockdown because of the COVID-19 pandemic. Worldwide, this pandemic had a huge impact on the mental health of people in many countries causing similar reaction in terms of emotions and concerns at the population level. Our study investigated the impact of the COVID-19 pandemic on psychological well-being in a cohort of Italian university students.

Methods

We conducted a cross-sectional survey in the period immediately after the first lockdown through the administration of a questionnaire on the personal websites of students attending their undergraduate courses at the Università Cattolica del Sacro Cuore. We used the Patient-Health-Engagement-Scale, Self-Rating-Anxiety-Scale, and Self-Rating-Depression-Scale to assess engagement, anxiety symptoms, and depression symptoms of our sample.

Results

The sample size was 501 subjects, of which 35.33% were classified as anxious and 72.93% as depressed. Over 90% of respondents had good understanding of the preventive measures despite over 70% suffered from the impossibility of physically seeing friends and partners. Around 55% of students would have been willing to contribute much more to face the pandemic. An increase in the occurrences of anxiety was associated with being female, being student of the Rome campus, suffering from the impossibility of attending university, being distant from colleagues, and being unable of physically seeing one’s partner. Performing physical activity reduced this likelihood.

Conclusion

University students are at risk of psychological distress in the case of traumatic events. The evolution of the pandemic is uncertain and may have long-term effects on mental health. Therefore, it is crucial to study the most effective interventions to identify vulnerable subgroups and to plan for acute and long-term psychological services to control and reduce the burden of psychological problems.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12992-021-00680-w.