[Analysis of the detection of metals and metalloids in the bronchoalveolar lavage fluid for the etiological diagnosis value of pneumoconiosis].

Objective: To analyze the differences of the concentrations of metals and metalloids in bronchoalveolar lavage fluid (BALF) of patients with pneumoconiosis, so as to provide reference for the etiological diagnosis of pneumoconiosis. Methods: From September 2019 to August 2020, 47 pneumoconiosis patients hospitalized in Chongqing Prevention and Treatment Center for Occupational Diseases and undergoing bronchoalveolar lavage were selected as the research objects using cluster sampling method. The general situation and occupational history of patients were investigated by questionnaire, The BALF of 47 pneumoconiosis patients was collected, and the concentrations of metals and metalloids in BALF were detected by inductively coupled plasma mass spectrometry (ICP-MS) , the differences among patients with different types of pneumoconiosis, different stages of silicosis and different occupational history were analyzed by one-way ANOVA. Results: The concentrations of 50 metals and metalloids in BALF were detected, and 21 of them were analyzed. Compared with different types of pneumoconiosis, the concentrations of Zn, Mn and Sn in BALF were statistically significant (F=9.959, 3.635, 9.488, P<0.05) . The concentrations of K, Mg, Fe, Zn, Cu and Ni in BALF were significantly different in different stages of silicosis (F=4.271, 4.334, 3.588, 5.120, 7.340, 3.905, P<0.05) . The concentrations of Zn and Sn in pneumoconiosis patients with different types of work and types of exposed dust were significantly different (P<0.05) . Conclusion: The detection of Zn, Mn, Sn, and other metals in BALF can provide reference basis for the etiological diagnosis of pneumoconiosis and provide a new idea for the diagnostic method of pneumoconiosis.

Open peroral endoscopic myotomy for the treatment of achalasia: a case series of 82 cases.

During peroral endoscopic myotomy (POEM), creation of the tunnel is highly technically demanding and mucosal injury is one of the most common potential complications. We explored a method without a submucosal tunnel, which we call open peroral endoscopic myotomy (O-POEM). This study aimed to assess the feasibility and safety of O-POEM. O-POEM was performed on 82 patients with achalasia. Treatment success was defined as an Eckardt score of less than or equal to 3 after the myotomy. Adverse events including operative and postoperative adverse events were recorded. Treatment success and procedure-related adverse events were analyzed. After a median follow-up of 18 months (range: 6-26 months), the treatment success (Eckhart score ≤3) was achieved in 96.3% of cases (mean score pre- vs. post-treatment (7.4 vs. 1.8); P < 0.001) with a recurrence of 3 cases. Ten patients (12.2%) had adverse events consisting of 2 cases of mediastinitis, 1 case of post-O-POEM bleeding, 1 case of subcutaneous emphysema, 6 cases of pleural effusion. Two cases of mediastinitis required intraprocedural drainage, and other patients were managed by endoscopy and conservative medical treatment. There were no deaths. No patients required surgical conversion. Clinical reflux occurred in 15.9% of patients (13/82). O-POEM was reliable and effective for the treatment of achalasia. In addition, O-POEM might be a better option for patients with severe submucosal fibrosis.

Open peroral endoscopic myotomy (O-POEM) for the treatment of achalasia.

With the development of endoscopic interventions and inspired by the success of peroral endoscopic myotomy (POEM) for the treatment of achalasia, we investigated an old method of direct peroral endoscopic myotomy without a submucosal tunnel for the treatment of achalasia, which we call open peroral endoscopic myotomy (O-POEM). In this study, Clinical success was achieved in the patient after O-POEM. A reduction of LES pressure, Eckardt score, and a timed barium esophagogram were observed during follow-up. There were no severe complications and no recurrences during two months of follow-up. Therefore, open peroral endoscopic myotomy is a feasible and effective endoscopic treatment modality for achalasia. However, long-term outcomes of O-POEM requires further follow-up.

Models of logistic regression analysis, support vector machine, and back-propagation neural network based on serum tumor markers in colorectal cancer diagnosis.

We evaluated the application of three machine learning algorithms, including logistic regression, support vector machine and back-propagation neural network, for diagnosing congenital heart disease and colorectal cancer. By inspecting related serum tumor marker levels in colorectal cancer patients and healthy subjects, early diagnosis models for colorectal cancer were built using three machine learning algorithms to assess their corresponding diagnostic values. Except for serum alpha-fetoprotein, the levels of 11 other serum markers of patients in the colorectal cancer group were higher than those in the benign colorectal cancer group (P < 0.05). The results of logistic regression analysis indicted that individual detection of serum carcinoembryonic antigens, CA199, CA242, CA125, and CA153 and their combined detection was effective for diagnosing colorectal cancer. Combined detection had a better diagnostic effect with a sensitivity of 94.2% and specificity of 97.7%; combining serum carcinoembryonic antigens, CA199, CA242, CA125, and CA153, with the support vector machine diagnosis model and back-propagation, a neural network diagnosis model was built with diagnostic accuracies of 82 and 75%, sensitivities of 85 and 80%, and specificities of 80 and 70%, respectively. Colorectal cancer diagnosis models based on the three machine learning algorithms showed high diagnostic value and can help obtain evidence for the early diagnosis of colorectal cancer.

[Analysis of features of ocular tilt reaction for patients with vestibular neuritis].

Objective:To analyze the clinical characteristics of ocular tilt reaction in vestibular neuritis patients and discuss its value to the diagnosis of vestibular neuritis.Method:Thirty-five patients with vestibular neuritis confirmed between January 2016 and March 2018 underwent bedside vestibular function physical examination including nystagmus, head impulse test(HIT),head shaking nystagmus(HSN), ocular tilt reaction(OTR), Romberg sign, Fukuda stepping. All patients underwent head CT scan and brain MRI scan + DWI to exclude bleeding and infarction. Pure tone audiometry and acoustic impedance check to understand the hearing and middle ear pressure.Result:In all the 35 patients with vestibular neuritis, OTR was observed in 29 patients (82.8%); Typical OTR was seen in 5 of 35 patients (14.3%), atypical OTR was seen in 24 of 35 patients (68.5%), static ocular torsion were observed in 4 of 35 patients (11.4%). Ipsiversive skew deviation and head tilt were observed in 20 of 35 patients (57.1%). In 29 cases, the symptoms of patients with OTR disappeared after 1-4 days, with an average of (2.62 ± 0.26) days.Conclusion:As an important index for diagnosis of vestibular neuritis, OTR is often neglected by clinicians, and its positive rate is high, which can be used as a key inspection items of bedside vestibular function physical examination.

[Expression of eosinophils and IL-33 levels in peripheral blood of patients with allergic rhinitis].

Objective:To investigate the relationship between the count of eosinophils(EOS) in peripheral blood and the serum levels of IL-33, and to discuss the relations among serum levels of IL-33, the count of EOS, visual analog scale (VAS) in different groups.Method:According to different treatments, the patients are divided into three groups: the untreated allergic rhinitis (AR) group (group A), the AR group who had been treated subcutaneous imunotherapy (SCIT) for at least a year (group B) and the AR complicated with allergic asthma group who had been treated subcutaneous imunotherapy (SCIT) for at least a year (gourp C). All subjects were conducted blood cell analysis, and EOS were counted. The serum levels of IL-33 were measured by enzyme linked immune (ELISA), and the obtained date were analysed by GraphPad.Prism 5.0 and SPSS 22.0.AR patients were asked to fill out VAS and were assessed nasal symptoms.Result:The serum levels of IL-33 in the group A were higher than that in other subjects (P<0.05).The serum levels of IL-33 in the group B showed no significant difference between the group B and the group C (P> 0.05).The serum levels of IL-33 in the group B were higher than that in the control group (P<0.05).The serum levels of IL-33 in the group C were higher than that in the control group (P<0.05).The count of EOS in the group A were higher than that in other subjects, and there is no difference between with each other (P> 0.05).The VAS in the group A were higher than that in the group B (P<0.05) and there is no significant difference between the group A and the group C (P<0.05).There is no difference between the group B and the group C(P<0.05).After at least one-year SCIT, the symptoms of AR patients were obviously relieved, such as consciously rhinobyon, rhinorrhea, sneezing and so on. Spearman test showed the serum levels of IL-33 in the AR patients has a weak correlation with the count of eosinophils (P> 0.05, r=0.287).Conclusion:SCIT is an effective treatment for AR patients. role on AR, which can alleviate the symptoms of patients, also can reduce the levels of IL-33 and the count of EOS in peripheral blood.

[A murine model of local allergic rhinitis].

OBJECTIVE: To establish the murine models of local allergic rhinitis (LAR) and allergic rhinitis (AR) by using ovalbumin (OVA), and to investigate the relationship between them. METHODS: Thirty BALB/c mice were divided into 5 groups, (1) the nasally sensitized group (group A1) that was challenged with OVA by a 10 d procedure, (2) the control group of A1 that was challenged with phosphate-buffered saline (PBS), (3) the nasally sensitized group (group A2) that was challenged with OVA by a 25 d procedure, (4)the control group of A2 that was challenged with PBS, (5) the intraperitoneally sensitized group (group B) .The numbers of sneezing after final challenge were counted, and the serum OVA-specific immunoglobulin E (OVA-sIgE), interleukin (IL) -4, IL-13, IL-5 levels in nasal lavage fluid were measured by ELISA. Hematoxylin-eosin staining was performed to evaluate the histological change of nose and lung tissues. Graph Pad Prism 6 software was used to analyze the data. RESULTS: Nasally sensitized group A1 displayed LAR symptoms of sneezing and eosinophilic infiltrating, but without increased OVA-sIgE in serum on day 10 compared with the control group of A1(t=0.697, P>0.05), OVA-sIgE in serum of group A2(2.710±1.406)ng/ml reached to statistical significance and with airway remodeling on day 25 compared with the control group of A2((0.221±0.080)ng/ml, t=4.329, P<0.05). IL-5 and IL-13 in nasal fluid showed a significant increase in the nasally sensitized group A1, compared with the group A2(t values were 2.442, 2.804, P values were less then 0.05). CONCLUSIONS: A short time intranasal instillation with OVA could establish LAR murine model, continuing OVA challenge could increase serum sIgE level and with airway remodeling. LAR mice show a unique characteristic by expressing higher IL-5 and IL-13 in nose than AR mice, but sIgE in serum remains at a normal level.

[The clinical observation of early neonatal pure breast-feeding].

Through observation on the rate of physiological body weight loss, the percentage of body weight regaining and the incidence of infection in hospital of 160 newborns with rooming in and pure breast-feeding after uneventful delivery or caesarean section. The average rates of physiological body weight loss were 6.70% and 6.47% in pure breast-feeding group with normal delivery and caesarean section respectively, whereas 5.03% and 5.57% in mix feeding group. The percentage of body weight regaining at discharge were 34.00% and 53.33% in pure breast-feeding group compared with 11.46% and 40.00% in mix feeding group. The incidence of neonatal infection in hospital were 2.00% and 13.33% in pure breast-feeding group, instead 14.00% and 13.33% in mix feeding group. The results showed advantages and feasible of pure breast-feeding.