Prevalence of musculoskeletal symptoms among industrial employees in a modern industrial region in Beijing, China.

BACKGROUND: Growing industrialization of China exposes its labor population to the risk of musculoskeletal disorders (MSDs). This study aimed to investigate the prevalence and risk factors of MSDs in a modern industrial region of Beijing. METHODS: A cross-sectional study included 1415 employees in six industrial companies was conducted between January 2018 and May 2018 in Fangshan district, Beijng, China. Nordic Musculoskeletal Questionnaire (NMQ) was used to collect the information about MSDs. Demographic factors, lifestyle factors, health and medical factors, and work-related factors were collected as independent variables. Descriptive statistics, the chi-squared (χ) test, and binary logistic regression analysis were used to analyze data. RESULTS: Among 1415 participants, 498 reported MSDs. The regions involved were the neck (25.16%), shoulders (17.17%), and upper back (13.29%). There was a significant statistical difference between frontline industrial workers and other staff in the prevalence of self-reported symptoms involving the shoulders (χ = 4.33, P = 0.037), wrists and hands (χ = 8.90, P = 0.003), and ankles and feet (χ = 12.88, P < 0.001). Increased age (P = 0.005, OR = 1.63; P = 0.001, OR = 2.33), a high or a low salary (P < 0.001, OR = 0.49; P < 0.001, OR = 0.30), night-shift (P = 0.027, OR = 1.46), two-week-history of illness and treatment (P = 0.004, OR = 5.60; P = 0.013, OR = 4.19), concurrent chronic diseases (P = 0.001, OR = 3.45; P = 0.092, OR = 7.81), limited access to health information (P = 0.004, OR = 0.49), and negative attitude towards seeking healthcare (P = 0.010, OR = 1.77; P = 0.009, OR = 2.75) were associated with MSDs in frontline workers. Female gender (P < 0.001, OR = 2.30), high education (P = 0.001, OR = 1.96), no exercises (P = 0.027, OR = 0.59), night-shift (P = 0.017, OR = 1.98), concurrent chronic diseases (P = 0.002, OR = 3.73; P = 0.020, OR = 13.42), limited access to health information (P = 0.013, OR = 0.53), far distance to medical institution (P = 0.009, OR = 1.83), and negative propensity (P = 0.009, OR = 1.94; P = 0.014, OR = 2.74) were associated with MSDs in other staffs. CONCLUSIONS: The prevalence of MSDs among industrial employees has changed. Frontline workers had different prevalence and risk factors for MSDs compared with other employees. Negative propensity to healthcare, limited ways to obtain health knowledge, and concomitant chronic diseases were associated with MSDs. Surprisingly, highly educated and high-income employees had a higher risk of MSDs.

A core-shell metal-organic-framework (MOF)-based smart nanocomposite for efficient NIR/H2O2-responsive photodynamic therapy against hypoxic tumor cells.

Core-shell MOF-based smart nanocomposite UCNPs/MB@ZIF-8@catalase (UCNPs = upconversion nanoparticles; MB = methylene blue; ZIF = zeolitic imidazolate framework) has been constructed for bio-imaging and efficient NIR/H2O2-responsive photodynamic therapy against hypoxic tumor cells. The nanoporous MOF shell can prevent aggregation of photosensitizers and serve as an efficient self-sufficient oxygen gas acceptor.

Establishment of a Novel Mouse Model of Coronary Microembolization.

BACKGROUND: Coronary microembolization (CME) has been frequently seen in acute coronary syndromes and percutaneous coronary intervention. Small animal models are required for further studies of CME related to severe prognosis. This study aimed to explore a new mouse model of CME. METHODS: The mouse model of CME was established by injecting polystyrene microspheres into the left ventricular chamber during 15-s occlusion of the ascending aorta. Based on the average diameter and dosage used, 30 C57BL/6 male mice were randomly divided into five groups (n = 6 in each): 9 µm/500,000, 9 µm/800,000, 17 µm/200,000, 17 µm/500,000, and sham groups. The postoperative survival and performance of the mice were recorded. The mice were sacrificed 3 or 10 days after the surgery. The heart tissues were harvested for hematoxylin and eosin staining and Masson trichrome staining to compare the extent of inflammatory cellular infiltration and fibrin deposition among groups and for scanning transmission electron microscopic examinations to see the ultrastructural changes after CME. RESULTS: Survival analysis demonstrated that the cumulative survival rate of the 17 µm/500,000 group was significantly lower than that of the sham group (0/6 vs. 6/6, P = 0.001). The cumulative survival rate of the 17 µm/200,000 group was lower than those of the sham and 9 µm groups with no statistical difference (cumulative survival rate of the 17 µm/200,000, 9 µm/800,000, 9 µm/500,000, and sham groups was 4/6, 5/6, 6/6, and 6/6, respectively). The pathological alterations were similar between the 9 µm/500,000 and 9 µm/800,000 groups. The extent of inflammatory cellular infiltration and fibrin deposition was more severe in the 17 µm/200,000 group than in the 9 µm/500,000 and 9 µm/800,000 groups 3 and 10 days after the surgery. Scanning transmission electron microscopic examinations revealed platelet aggregation and adhesion, microthrombi formation, and changes in cardiomyocytes. CONCLUSION: The injection of 500,000 polystyrene microspheres at an average diameter of 9 µm is proved to be appropriate for the mouse model of CME based on the general conditions, postoperative survival rates, and pathological changes.

Short-term safety and efficiency of cryoablation for renal sympathetic denervation in a swine model.

BACKGROUND: Renal sympathetic nerves are involved in the reflective activation of the sympathetic nervous system in circulatory control. Catheter-based renal denervation (RDN) ameliorated treatment-resistant hypertension safely, but 10%-20% of treated patients are nonresponders to radiofrequency denervation. The purpose of this study was to investigate the safety and efficiency of cryoablation for sympathetic denervation in a swine model and to explore a new way of RDN. METHODS: Seven swines randomly assigned to two groups: Renal cryoablation (CR) group and control group. The control group underwent renal angiogram only. The CR group underwent renal angiogram plus bilateral renal cryoablation. Renal angiograms via femoral were performed before denervation, after denervation and prior to the sacrifice to access the diameter of renal arterial and the pressure of aorta abdominalis. Euthanasia of the swine was performed on 28-day to access norepinephrine (NE) changes of the renal cortex and the changes of renal nerves. RESULTS: Cryoablation did not induce severe complications at any time point. There was no significant change in diameter of renal artery. CR reduced systolic blood pressure (BP) from 145.50 ± 9.95 mmHg at baseline to 119.00 ± 14.09 mmHg. There was a slight but insignificant decrease in diastolic BP. The main nerve changes at 28-day consisted of necrosis with perineurial fibrosis at the site of CR exposure in conjunction with the nerve vacuolation. Compared with the control group, renal tissue NE of CR group decreased by 89.85%. CONCLUSIONS: Percutaneous catheter-based cryoablation of the renal artery is safe. CR could effectively reduce NE storing in the renal cortex, and the efficiency could be maintained 28-day at least.

Simvastatin suppresses vascular inflammation and atherosclerosis in ApoE(-/-) mice by downregulating the HMGB1-RAGE axis.

AIM: High mobility group box protein 1 (HMGB1) and receptor for the advanced glycation end product (RAGE) play pivotal roles in vascular inflammation and atherosclerosis. The aim of this study was to determine whether the HMGB1-RAGE axis was involved in the actions of simvastatin on vascular inflammation and atherosclerosis in ApoE(-/-) mice. METHODS: Five-week old ApoE(-/-) mice and wild-type C57BL/6 mice were fed a Western diet. At 8 weeks of age, ApoE(-/-) mice were administered simvastatin (50 mg·kg(-1)·d(-1)) or vehicle by gavage, and the wild-type mice were treated with vehicle. The mice were sacrificed at 11 weeks of age, and the atherosclerotic lesions in aortic sinus were assessed with Oil Red O staining. Macrophage migration was determined with scanning EM and immunohistochemistry. Human umbilical vein endothelial cells (HUVECs) were used for in vitro study. Western blots were used to quantify the protein expression of HMGB1, RAGE, vascular cell adhesion molecule-1 (VCAM-1) and monocyte chemoattractant protein-1 (MCP-1). RESULTS: Vehicle-treated ApoE(-/-) mice exhibited significant increases in aortic inflammation and atherosclerosis as well as enhanced expression of HMGB1, RAGE, VCAM-1, and MCP-1 in aortic tissues as compared to the wild-type mice. Furthermore, serum total cholesterol, triglyceride and LDL levels were markedly increased, while serum HDL level was decreased in vehicle-treated ApoE(-/-) mice. Administration with simvastatin in ApoE(-/-) mice markedly attenuated the vascular inflammation and atherosclerotic lesion area, and decreased the aortic expression of HMGB1, RAGE, VCAM-1, and MCP-1. However, simvastatin did not affect the abnormal levels of serum total cholesterol, triglyceride, LDL and HDL in ApoE(-/-) mice. Exposure of HUVECs to HMGB1 (100 ng/mL) markedly increased the expression of HMGB1, RAGE and VCAM-1, whereas pretreatment of the cells with simvastatin (10 µmol/L) blocked the HMGB1-caused changes. CONCLUSION: Simvastatin inhibits vascular inflammation and atherosclerosis in ApoE(-/-) mice, which may be mediated through downregulation of the HMGB1-RAGE axis.

Low-dose taurine upregulates taurine transporter expression in acute myocardial ischemia.

Taurine exerts a protective effect on cardiomyocytes. The aim of this study was to determine whether the protective effect of taurine is associated with the upregulation of taurine transporter (TAUT) expression in acute myocardial ischemia (AMI). To this end, we investigated TAUT expression in cultured cardiomyocytes exposed to hypoxia as well as in rats with AMI treated with or not with taurine. The morphology of cardiac tissues, the apoptosis of cardiomyocytes and cardiac function were examined. In addition, the taurine content and the expression of TAUT were measured. Our data demonstrated that taurine reversed the apoptosis induced by hypoxia and AMI, thereby, effectively protecting the myocardium. Taurine content and TAUT expression levels were significantly decreased when cardiomyocytes and cardiac tissues were subjected to hypoxic or ischemic stress, while the expression of cysteine sulfinate decarboxylase was unchanged. Moreover, treatment with taurine (100 mg/kg/day) significantly upregulated TAUT expression and elevated the taurine content in ischemic myocardial tissues. In vitro, the low-dose (40 mM) but not the high-dose (120 mM) administration of taurine significantly induced TAUT expression and elevated the intracellular taurine content in hypoxic cardiomyocytes. In conclusion, our data demonstrate that taurine exerts a protective effect on the ischemic myocardium. Low-dose but not high-dose taurine treatment upregulated TAUT expression and increased the intracellular taurine content in cardiomyocytes subjected to hypoxia as well as in AMI tissues.

Effects of traditional Chinese medicine on intestinal mucosal permeability in early phase of severe acute pancreatitis.

BACKGROUND: Traditional Chinese medicine has been used widely for many years in China to treat acute pancreatitis. We have investigated the effects of Dachengqi decoction on intestinal mucosal permeability and outcome in patients with severe acute pancreatitis (SAP). METHODS: Forty patients with sustained SAP that required admission to the surgical intensive care unit were enrolled prospectively in the study. All of these patients were divided randomly into the Dachengqi decoction group (n = 20) and control group (n = 20) on admission. Intestinal permeability was assessed by measuring absorption of two metabolically inert markers, lactulose (L) and mannitol (M), which were administered orally. Serum concentrations of endotoxin (lipopolysaccharide, LPS) and the ratio of lactulose to mannitol in urine (L/M) were detected in all patients. RESULTS: Compared with those in the control group, urinary L/M ratio decreased significantly in the Dachengqi decoction group on the 7th day after admission (P = 0.001). Also, serum concentrations of LPS were reduced on the 5th and 7th day after admission (P = 0.006, P = 0.008, respectively). Incidence of multiple organ dysfunction syndrome (MODS) and pancreatic infection was significantly lower in the Dachengqi decoction group compared with those in the control group (P = 0.038,P = 0.025, respectively). CONCLUSION: Dachengqi decoction may promote the recovery of intestinal mucosal permeability and decrease the incidence of MODS and pancreatic infection in patients with SAP.

Inhibiting effects of total saponins of panax ginseng on immune maturation of dendritic cells induced by oxidized-low density lipoprotein.

Total saponins of panax ginseng (TSPG) are the major active components in panax ginseng. Dendritic cells (DCs) play an active role in the immunological processes related to atherosclerosis. The purpose of this study was to determine the effect and possible mechanisms of TSPG on the maturation and immune function of DCs. Compared with those untreated, the DCs pre-treated with TSPG and then induced by oxidized-LDL exhibited a significantly lower expression of the maturation-associated markers of CD40, CD86, HLA-DR, and CD1a, together with an increased endocytosic function as well as decreased secretions of cytokine. However, silencing the expression of PPARgamma in DCs, the inhibitory effect of TSPG on the maturation DCs was significantly reduced. In conclusion, TSPG could inhibit the maturation of DCs induced by oxidized-LDL which suggests beneficial effects on atherosclerosis and this effect was partly dependent on the PPARgamma pathway at least.

Novel biologic model for percutaneous renal surgery learning and training in the laboratory.

OBJECTIVES: To improve the learning and training of percutaneous renal access and intrarenal procedures with a biologic porcine kidney model. METHODS: We set up a biologic bench model using a porcine kidney. The kidney was wrapped in a full-thickness skin flap with subcutaneous fascia and muscle and fixed to a wooden board with 2 long steel nails. The ureter was catheterized to inject radiologic contrast medium or normal saline. Percutaneous renal manipulations were then practiced on the model under radiographic or ultrasound guidance. RESULTS: Urologists with "partial" experience in advanced endourologic surgery were trained using this model. Of the 33 trainees practiced the percutaneous hands-on manipulations on this model, 20 (60.6%) attained success in performing the whole percutaneous procedure. One to three percutaneous access tracts were established successfully on each kidney practiced on. Of the 42 attendants, 36 (85.7%) rated this model for simulation as "very helpful" or "helpful." CONCLUSIONS: The porcine kidney model we developed is simple and easy to build with readily available materials. It provides realistic and reproducible practice for percutaneous renal surgery in the laboratory.

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage.

AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of IAH/ACS and outcome. METHODS: Patients (n = 74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n = 44) with IAP >or= 12 mmHg were assigned in IAH group, and the remaining patients (n = 30) with IAP < 12 mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality. RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE II scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 +/- 3.90 vs 15.70 +/- 4.25, P = 0.616; 3.70 +/- 0.93 vs 3.47 +/- 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period of the first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r = 0.635, P < 0.001). Although ACS patients had obvious amelioration in physiological variables within 24 h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P < 0.001; septic shock: 70.0% vs 11.1%, P < 0.001; MODS: 90.0% vs 31.5%, P < 0.001; mortality: 75.0% vs 3.7%, P < 0.001). CONCLUSION: IAH/ACS is a frequent finding in patients admitted to the ICU because of AP. Patients with IAP at approximately 10-12 mmHg and early signs of changes in physiologic variables should be seriously considered for urgent decompression to improve survival.

[Effects of duration of early organ dysfunction and therapeutic strategy on outcomes in patients with severe acute pancreatitis].

OBJECTIVE: To investigate the characteristics of early organ dysfunction in patients with severe acute pancreatitis (SAP) and therapeutic regimens. METHODS: A total of consecutive 74 patients with a confirmed diagnosis of SAP admitted between January 2000 and June 2005 were divided into two groups, transient group (72 h, n = 54). The differences in local complications and mortality were compared between the two groups. RESULTS: Among the seventy-four SAP patients, the incidence rate of cardiovascular dysfunction was 80%, respiratory dysfunction 47%, hepatic dysfunction 37% and renal dysfunction 20%. The incidence of multiple organ dysfunction in transient group was much lower than that in persistent group (P < 0.01). The local complications and death in transient group patients were less than that in persistent group (P = 0.038, P = 0.054, respectively), irrespective of onset of organ dysfunction on admission or later during the first week. CONCLUSIONS: The important determinant of risk of death from SAP is the persistence of early organ dysfunction for more than 72 h. Consequently, aggressively ameliorating the blood perfusion and the oxygenation in tissue is the priority in reducing organ dysfunction or shortening the duration of organ dysfunction.

[Clinical analysis of complications after non- invasive positive pressure ventilation and an inquiry into the respiratory treatment strategy in patients with SARS].

OBJECTIVE: To analyze the clinical data of severe acute respiratory syndrome (SARS) patients with pneumothorax and mediastinal emphysema occurring after the non-invasive positive pressure ventilation (NIPPV), and to inquire into relevant strategy in respiratory treatment in the SARS patients. METHODS: Twenty-seven serious cases of SARS undergone NIPPV were analyzed retrospectively. RESULTS: Pneumothorax and mediastinal emphysema occurred in 7 of 27 serious cases of SARS with NIPPV, and mediastinal emphysema occurred in 1 of 189 cases of SARS without mechanical ventilation (MV). The incidence of pneumothorax and mediastinal emphysema in serious cases of SARS with NIPPV was significantly higher (chi2=25.052, P<0.01) than that in cases of SARS without receiving MV. The peripheral blood oxygen saturation level was not changed significantly after reasonable adjustment of ventilation pressure and increase in oxygen concentration inhaled. Seven cases of pneumothorax and mediastinal emphysema improved gradually. CONCLUSION: The incidence of pneumothorax and mediastinal emphysema in serious SARS patients with NIPPV is significantly higher than that in SARS patients without receiving MV. This might be related to SARS related pulmonary injuries, intensive cough and high mechanical ventilation pressure. The pneumothorax and mediastinal emphysema improve gradually in all cases after reasonable adjustment of mechanical ventilative pressure. So when NIPPV is used in the treatment of serious SARS patients to improve hypoxemia, optimized mechanical ventilative pressure should be acquired in order to avoid pneumothorax and mediastinal emphysema.

[Evaluation of operation and anesthesia on hemodynamic variables in patients undergoing elective abdominal surgery by noninvasive thoracic bioimpedance technique].

OBJECTIVE: To analyse and discuss the effects of elective abdominal operation and anaesthesia on patients' cardiac output via noninvasive thoracic bioimpedance technique. METHODS: Noninvasive monitoring system HeMo-601 was applied to detect the hemodynamic variables of 32 elective abdominal surgery patients. The clinical data of cardiac output (CO), cardiac index (CI), cardiac working per minute (CW), left ventricular end-diastolic pressure (LVEDP), stroke volume (SV), cardiac stroke working (SW) and heart rate (HR) were analysed at 1 hour before operation, 4-6 hours after operation and 24 hours after operation, respectively. RESULTS: No significant differences were found in CO, CI, CW and LVEDP between various time points and preoperation (all P>0.05). SV and SW at 4-6 hours after operation were significant lower than those before operation (all P<0.05). Whereas, SV and SW at 24 hours after operation were no significant differences compared with those before operation (all P>0.05). As compared with preoperation, HR at 4-6 hours after operation was significantly faster (P<0.05). However, there was no significant difference in HR between 24 hours after operation and preoperation (P>0.05). CONCLUSION: The reductions in SV and SW at 4-6 hours after operation might be a result of anaesthesia that could weaken the contraction of heart. The presence of rapidness of HR at 4-6 hours after operation might be a compensatory mechanism for the decreases in SV and SW. Therefore, optimizing adequate infusion by the greatest extent during and after operation is very crucial for the maintenance of CO, CI and tissue perfusion.