Occupational health management of dispatched cleaning personnel at the nuclear medicine workplace in a medical institution / 中华放射医学与防护杂志

In recent years, labor dispatch has become a new form of employment in medical institutions for final disinfection, cleaning, garbage recycling and other work. Concerning the ambiguity of responsibilities and obligations in regard to dispatching workers′ occupational health management, most of employers and labor dispatching agencies failed to protect the legal rights and interests of dispatching workers during working. This article discusses the case of occupational health management and supervision of labor dispatch for cleaning worker at a nuclear medicine workplace in a medical institution.

Dose-response relationship of alfentanil inhibiting gag reflex when combined with propofol in elderly patients undergoing painless gastroscopy / 中华麻醉学杂志

Objective:To evaluate the dose-response relationship of alfentanil inhibiting gag reflex when combined with propofol in elderly patients undergoing painless gastroscopy.Methods:Patients of American Society of Anesthesiologists physical statusⅠor Ⅱ, aged ≥60 yr, scheduled for elective painless gastroscopy, were selected. Propofol 1.5 mg/kg combined with alfentanil was given intravenously in all the patients. The dose of alfentanil was determined by the Dixon up-and-down method. The initial dose of alfentanil was set at 5 μg/kg. The dose of alfentanil in the next patient was determined according to the development of gag reflex, and the ratio between the two successive doses was 1.1. The median effective dose (ED 50) and 95% confidence interval of alfentanil-induced inhibition of gag reflex when combined with propofol in elderly patients undergoing painless gastroscopy were calculated using the by up-and-down sequential allocation. Results:The ED 50 (95% confidence interval) of alfentanil-induced inhibition of gag reflex when combined with propofol 1.5 mg/kg was 2.8 (2.4-3.2) μg/kg in elderly patients undergoing painless gastroscopy. Conclusion:When combined with propofol 1.5 mg/kg, the ED 50 of alfentanil inhibiting gag reflex is 2.8 μg/kg in elderly patients undergoing painless gastroscopy.

PDA-mediated Mild Photothermal Therapy Combined with Autophagy Inhibitors Kill Breast Cancer Cells / 肿瘤防治研究

Objective To explore whether inhibiting autophagy can enhance the sensitivity of photothermal treatment under mild photothermal conditions. Methods CQ@PLGA@PDA NPs were prepared by an improved double emulsification method and a PDA-based surface modification method. After basic characterization, CCK-8 method was used to detect the cytotoxicity of nanoparticles; the near-infrared laser irradiation nanoparticle solution was used to detect the heating effect; CCK-8 method and live-dead cell staining were used to detect the killing effect of tumor cells; Western blot was used to detect the expression of autophagy-related proteins. Results The CQ@PLGA@PDA NPs were successfully prepared, with a particle size of 253.10±2.39 nm, a zeta potential of -22.57±0.80 mV, uniform particle size and good dispersion. The temperature of nanoparticle solution increased to 45℃ after the near-infrared laser irradiation for 10 min. CQ@PLGA@PDA NPs had no obvious toxicity to cells. The survival rates of breast cancer cell MDA-MB-231 and mouse embryonic fibroblast NIH-3T3 cell were above 95%. The inhibition of autophagy under mild photothermal conditions could improve the sensitivity of photothermal therapy. Conclusion The prepared CQ@PLGA@PDA NPs have good photothermal performance and high biological safety; by inhibiting autophagy, they can effectively kill tumor cells under mild photothermal conditions(< 50℃).

Emphasis on individual health actions as the cornerstone for Healthy China initiative / 中华医院管理杂志

Healthy China action is a key to the Healthy China initiative. Promoting Healthy China is faced with such challenges as coordinating actions of the society at large, and reliance on individual incentives. To overcome these difficulties, the authors propose to adopt a concentrating-on-the-main-points approach. As proposed, the government should focus on the key points of the overall situation and uphold the Healthy China initiative, and base all the actions on individual health actions as the focus. Community health service centers are expected to manage individual health actions so as to cover the population of the country. In this view, the government should formulate the policy of initiating and managing individual health actions by community health service centers.

Effect of low-frequency pulsed magnetic field on blood-brain barrier permeability of rat hippocampus / 中华放射医学与防护杂志

Objective To investigate the effect of pulsed magnetic radiation on BBB permeability of hippocampus in Sprague-Dawley rats at different exposure intensity.Methods A total of 72 male SD rats were randomly divided into sham exposure group,positive control group and magnetic field treatment groups (100,400,800,1 200 mT,30 pulses each group).At three hours after exposure,the morphological structure of hippocampus was evaluated by HE staining,the extravasation of albumin around microvessels in rat hippocampus was detected immunohistochemically,the EB extravasation around microvessels was observed with Evans blue (EB) fluorescence method,and the levels of BBB-related protein ZO-1 and Occludin in hippocampus were measured with Western blot assay.Results Compared with the control group,no significant change in the hippocampus morphology structure,the extravasation of albumin and EB around the microvessels were observed after the pulsed magnetic exposures.The protein levels of ZO-1 and Occludin had no changes in the exposed groups (P＞ 0.05) except that ZO-1 was significantly reduced in 1 200 mT exposure group (t =14.26,P ＜ 0.05).Conclusions Low-frequency pulsed magnetic field could not affect the permeability of BBB in SD rats but impairs the integrity of BBB at 1 200 mT.

Clinical features of patients with venous thromboembolism: 177 case analysis in 10 years / 中华危重病急救医学

Objective To analyze the clinical characteristics and risk factors of patients with confirmed venous thromboembolism (VTE) in order to improve recognition of VTE, and reduce the rate of missed diagnosis and wrong diagnosis. Methods A retrospectively review was performed for 205 patients diagnosed with VTE confirmed by CT pulmonary angiography (CTPA), radionuclide pulmonary ventilation/perfusion (V/Q) imaging, lower extremity deep vein ultrasound or venography in the First Affiliated Hospital of Bengbu Medical College from January 2009 to December 2018. The clinical manifestations, laboratory examination results, imaging results, treatment and prognosis of patients diagnosed with VTE were analyzed. The clinical possibility was assessed by pulmonary thromboembolism (PTE) simplified Wells score and deep venous thrombosis (DVT) Wells score. 130 non-VTE patients admitted in the same period were enrolled as controls, and the risk factors of VTE were screened by multivariate Logistic regression analysis. Results Among 205 VTE patients, 14 cases had incomplete data, 2 cases were complicated with other diseases deteriorated, 2 cases were excluded because of economic reasons, 10 cases abandoned treatment because of serious illness, and finally 177 cases were included in the analysis. The main clinical symptoms of VTE patients were chest tightness (36.16%), followed by chest pain (29.94%), dyspnea (29.38%) and hemoptysis (24.29%). Swelling or tenderness of unilateral/bilateral lower extremities (38.98%) and lung moist rale (20.90%) were the most common signs. ST-T changes were the main changes in electrocardiogram (ECG, 49.15%), followed by SⅠQⅢTⅢ or QⅢTⅢ changes (35.03%). Only 5.65% of the patients had plasma D-dimer less than 0.5 mg/L. 31.07% (55/177) patients had normal arterial blood gas results. Of the 177 VTE patients, 175 were diagnosed as PTE by CTPA, with bilateral/multi-lobar pulmonary artery embolism and its branches being the main type [44.57% (78/175)]. Two cases were diagnosed as PTE by V/Q imaging. Among them, 112 cases were received lower extremity deep venous ultrasound or lower extremity deep venography, 51 cases were diagnosed as lower extremity DVT, with thrombosis of popliteal and above vein as common [68.63% (35/51)]. The clinical possibility assessment showed that 67.23% (119/177) patients might have PTE (PTE simplified Wells score greater than or equal to 2), 38.98% (69/177) patients might have lower extremity DVT (DVT Wells score greater than or equal to 2). Multivariate Logistic regression analysis showed that operation less than 4 weeks [odds ratio (OR) = 5.503, 95% confidence interval (95%CI) = 1.577-19.206, P = 0.007], trauma or fracture less than 3 months (OR = 6.771, 95%CI = 1.510-30.370, P = 0.012), VTE history (OR = 0.072, 95%CI =0.009-0.549, P = 0.011) were independent risk factors for VTE occurrence. Thrombolytic therapy was administered in 13 cases while anticoagulant therapy alone was prescribed in 164 cases. 176 patients recovered, while 1 case died. Conclusions VTE clinical manifestations are not specific. Patients with risk factors should be vigilant, be strengthen with diagnostic awareness, paid attention to the evaluation of clinical possibilities. Timely thrombolytic or anticoagulant treatment after diagnosis, can improve the survival rate.

Clinicopathological features and treatment of bilateral asynchronous breast cancer: report of 13 cases / 中华全科医师杂志

Objective To analyze the clinicaopathological features and treatment of bilateral asynchronous breast cancer.Methods The clinical and pathological data of 13 patients with bilateral asynchronous breast cancer admitted in our hospital from 2010 to 2016 ere retrospectively reviewed.Results The bilateral asynchronous breast cancer accounted for 1.7% of all breast cancer patients admitted n the same period (13/782).The median age of patients at first onset was 47.The modified radical operation was the main surgical lity (12/13 for the first cancer;8/13 for the second cancer).The clinical stage Ⅱ was predominant in all patients (10/13 of the first r;9/13 of the second cancer).Invasive ductal cancer was the most common pathologic type (in 11/13 of the first cancer;11/13 of the cond cancer).Hormone receptors were highly expressed in most of the cases (9/13 of the first cancer;7/13 of the second cancer).The disease-free interval was more than 10 years in most cases (8/13).Among 13 cases local recurrence was detected in 1 case, distant metastases in 2 cases, and 1 case died from distant metastasis.Conclusion The bilateral asynchronous breast cancer has a low incidence;however, a close follow up is necessary for early detection and treatment of the second carcinoma.

Comparison of vacuum-assisted excision with periareola incision surgery for benign breast tumor / 中华全科医师杂志

Objective To compare vacuum-assisted excision with periareola incision surgery for benign breast cancer.Methods One hundred and twenty one patients with benign breast nodules treated in our hospital from October 2014 to October 2015 were enrolled in the study,including 58 cases received vacuum-assisted excision (study group) and 63 cases received periareola incision surgery (control group).There were no differences in age[(30.2 ±5.4) vs.(32.1 ±6.2) years] and tumor diameter[(1.3 ±0.4) vs.(1.5 ± 0.3) cm] between two groups.Results There were no severe complications in both groups.Compared with the control group,the operation time was shorter] (20.4 ±4.7) vs.(48.2 ± 15.4)min,t =3.165,P =0.006],intraoperative blood loss was less [(18.4 ± 5.7) vs.(17.2 ± 3.7) ml,t =-0.297,P =0.672],malformation rate was lower [5.2％ (3/58)vs.22.2％ (14/63),x2 =7.27,P =0.007],incidence of postoperative hematoma was higher [20.7％ (10/58) vs.6.3％ (4/63),x2 =3.502,P =0.041],and the cost of surgery was more expensive(5 100 ± 300) vs.(3 400 ± 1 200) Yuan,t =2.181,P =0.023].Conclusion Comparing with conventional periareolar incision surgery,the vacuum-assisted excision has its advantages and disadvantages for treatment benign breast tumors,and two surgical modalities can be chosen accordingly.

Protective effect of ligustrazine on lipopolysaccharide induced vascular hyperpermeability / 实用医学杂志

Objective To investigate whether ligustrazine can reduce endotoxemia and inhibit the increase of lipopolysaccharide (LPS)-induced vascular permeability by suppressing Rho/ROCK signaling pathway in guinea pigs. Methods Eighteen of white male healthy guinea pigs were divided into three groups randomly and pretreated with intravenous injection of ligustrazine(3 or 6 mg/kg) or saline. 30 min later, LPS (100, 300, 1 000 μg/0.1 mL/site) and saline (0.1 mL/site) were administered intracutaneously at the dorsum of guinea pigs. Vascular permeability was determined by leakage area and absorbance of 610 nm (OD610) of Evans Blue dye after intracutaneous injection of LPS (100-1 000 μg/site). Results Dye leakage in the skin began to increase at 5 min, and revealed significant increase 2 h after LPS injection. Significant differences in the dye leakage area(F = 5.77, P < 0.05) and the OD610 (F = 7.736, P < 0.05) induced by 100, 300 and 1,000 ug/site of LPS administration were demonstrated between the control and ligustrazine groups (3 or 6 mg/kg). Conclusion Ligustrazine has protective effect on the hypermeability of endothelial cells induced by lipopolysaccharide, and inhibition of Rho/ROCK signaling pathway is a possible mechanism.

Cultivating Medical Humanities in Intern Doctors of Respiratory Department / 中国医学伦理学

Through discussing the connotation of medical humanities spirit and the current situation of medical humanities education in our country, the authors put forward that in clinical practice, respiratory medicine interns medical ways for the cultivation of the humanistic spirit, which include: guide the trainee doctors in treating pa-tients alike, on the basis of understanding and respect for life and death;to cultivate the ability of effective commu-nication between patient and physician internship; interns cultivated the spirit of collaboration and leadership skills;the in-depth, on the basis of clinical practice, in practice the doctor to write a detailed records;construc-tion of a high level of teacher love team, set an example for the students.

Calcium activated potassium channel and protein kinase C participate in the cardiac protection of remote post conditioning

The present study was designed to investigate the roles of Ca[2+] activated K[+] channel [KCa] and protein kinase C [PKC] in the protective mechanisms of remote ischemic post conditioning [RPostC] when rat heart was subjected to ischemia/reperfusion [I/R] injury in vivo. Rat heart was subjected to regional ischemia for 45 min and reperfusion for 180 min in vivo to mimic I/R injury. RPostC was induced by 5 min right femoral artery occlusion followed by 5 min reperfusion for 3 cycles [totally 30 min] after 15 min of cardiac ischemia. Delayed remote ischemic post conditioning [delayed RPostC] was induced after 10 min of cardiac reperfusion. The hemodynamic parameters including mean arterial blood pressure and heart rate [HR] were recorded, and lactate dehydrogenase [LDH] release in plasma and infarct size were determined, and arrhythmia scores were calculated. In contrast to I/R, RPostC reduced infarct size and LDH release during reperfusion, the occurrence of arrhythmia was decreased, but no changes in delayed RPostC. The specific inhibitor of KCa iberiotoxin and PKC inhibitor chelerythrine both attenuated the role of RPostC. The findings indicated that RPostC had a protective effect on myocardial ischemia/reperfusion injury. Opening of KCa and activating of PKC may be involved in the mechanisms of RPostC

Impact of enteral nutrition through jejunal feeding tube during chemotherapy on the nutritional status and immunologic function of patients after total gastrectomy / 中华临床营养杂志

Objective To investigate the impact of enteral nutrition (EN) through jejunal feeding tube on the nutritional status and immunologic function of patients during chemotherapy after total gastrectomy.Methods Totally 86 patients with gastric cancer who had undergone total gastrectomy with radical resection and jejunostomy received adjuvant venous chemotherapy in our department from January 2009 to June 2010.They were divided into EN group ( n =43 ) and control group ( n =43 ) according to the hospitalization number.The EN group maintained the jejunostomy tube until the end of 6 courses of chemotherapy,and was given EN support for 7 days through jejunal tube during each course of chemotherapy; the control group removed the tube before chemotherapy without further dietary restriction or nutrition support.The nutritional and immunologic indicators on the 1 st day before chemotherapy and the 1st day after 6 chemotherapy courses were measured.ResultsThree patients in the EN group withdrew from the study because of catheter blockage or catheter loss and 2 patients in the control group failed to complete the trial because of chemotherapy side effects or economic reasons; 81 patients entered the final analysis.After 6 courses of chemotherapy,both groups experienced body weight loss,but the percentage is significantly lower in EN group than in control group (6.9％ ± 0.95％ vs.11.2％ ± 1.32％,P =0.0000).Compared with the nutritional status before the first chemotherapy,the prognosis nutritional index (PNI) in both groups declined after the 6th chemotherapy.Such decline was not statistically significant in EN group ( P =0.1534) but was significant in control group (P =0.0000).The PNI in EN group after chemotherapy was significantly higher than that in control group (P =0.0040).The levels of IgG,NK,CD4 +,and CD4 +/CD8 + were significantly higher in EN group than in control group ( P =0.0083,0.0143,0.0000,and 0.0000,respectively) after chemotherapy.ConclusionEN during postoperative chemotherapy may improve the nutritional status and immunologic function in gastric cancer patients after total gastrectomy.

The impact of exogenous trypsin supplement on the quality of life of patients after total gastrectomy / 中华普通外科杂志

Objective To improve the quality of life in gastric cancer patients after total gastrectomy by exogenous trypsin supplement.Method In this study 106 patients were divided into two groups,with 53 patients in each group,oral pancreatic enzyme capsule was given in comparison without in control group.Patients were asked to fill in EORTC QLQ-C30 questionnaire and Korenaga questionnaire at half a year postoperation,stool sample was collected at the same time for fecal fat assay.Results A total of 86 patients completed this test at postoperation half a year.With a comprehensive assessment of quality of life in patients by the scoring system of EORTC QLQ-C30 and Korenaga and the fecal fat contents measurement.Exogenous trypsin plays a positive role in preventing weight loss,improving emotional function,alleviating loss of appetite,insomnia,fatigue,postprandial fullness,nausea,vomiting and diarrhea,and improving intestinal tolerance to fat and the overall health status of patients.Conclusions Total gastrectomy causes exocrine pancreatic dysfunction,exogenous supplement of the enzyme improves postoperative quality of life in these patients.

The Serum Markers of Hepatitis B Virus (HBV) Infection and the Natural History of Chronic HBV Infection / 中国疫苗和免疫

105 copies/mL would develop liver-related complications, such as cirrhosis, hepatocellular carcinoma and liver failure. Available evidences indicate that control of HBV replication with antiviral drugs can decrease the incidence of these complications and mortality.

Genetic Supports of blaOXA-23 in Acinetobacter baumannii and Their Clinical Significance / 中华医院感染学杂志

OBJECTIVE To study the genetic supports of OXA-23 in Acinetobacter baumannii isolates and investigate the relationship between imipenem resistance acquiring and use of antibiotics.METHODS Consecutive selection of the 24 highly susceptive A.baumannii clinical isolates by imipenem was carried out.Genes of carbapenemases were detected by PCR and the colonial relationship of these isolates was evaluated by ERIC-PCR.Plasmids conjugation experiments and blaOXA-23 hybridization were performed to explore the gene location of blaOXA-23.RESULTS From all 24 susceptible A.baumannii isolates 10 were selected,including 6 multi-colonial blaOXA23 harboring strains.Plasmid conjugation experiments and Southern blotting experiments demonstrated that blaOXA-23 was not associated with integrons.CONCLUSIONS BlaOXA-23 may exist in a certain subset of apparently carbapenem sensitive Acinetobacter strains.When under consecutive selective pressure,bacteria harboring blaOXA-23 become the predominant group and subsequently the antibiotics resistance properties appear.It highlights the reasonable use of this category of antibiotics.

The antagonism of rhizoma gastrodiae to lead-induced damage of hippocampus in rats / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe and explore the antagonism of rhizoma gastrodiae (RGT) to the impairment of learning and memory ability induced by lead in rats.</p><p><b>METHODS</b>36 Wistar rats were randomly divided into 3 groups, 12 rats in every group, (1) control group: treated with distilled water; (2) lead group: treated with lead acetate (0.1 g.kg-1.d-1); (3) lead-RGT group: lead acetate (0.1 g.kg-1.d-1) + RGT(4.0 g.kg-1.d-1). The ability of learning and memory of the rats was measured monthly by swimming test; 3 months later, the rats were decapitated and nitric oxide(NO) and total antioxidative capacity(TAOC) in hippocampus were measured immediately and the examination for pathology was also made.</p><p><b>RESULTS</b>(1) In swimming test, the number of seeking for anchorage in lead group(1, 2, 3 month: 10.10 +/- 1.10, 7.80 +/- 1.32, 5.40 +/- 0.97 respectively) were significantly decreased, compared with the control(P < 0.01); the number of seeking for anchorage in RGT-lead group(1, 2, 3 month: 11.90 +/- 0.95, 10.90 +/- 0.95, 9.70 +/- 0.96 respectively) were significantly increased, compared with lead group(P < 0.01). (2) NO (0.733 +/- 0.015) mumol/g pro and TAOC (0.945 +/- 0.017) U/mg pro in hippocampus of lead group were significantly decreased compared with the control(P < 0.01) whereas NO(0.769 +/- 0.021) mumol/g pro and TAOC(0.986 +/- 0.010) U/mg pro in hippocampus of RGT-lead group were significantly increased compared with lead group(P < 0.01). (3) Pathological examination showed that in lead group, marked atrophy in hippocampus, cellular denaturation and necrosis, dissolution and disappearance in axon were found. In lead-RGT group, the atrophy of hippocampus was not obvious, the cell morphology was nearly normal, no obvious abnormal changes were seen.</p><p><b>CONCLUSION</b>RGT is antagonistic to the impairment of hippocampus and of learning and memory ability induced by lead.</p>

Research of field size dosage calculation based on two-dimensional localization image / 医疗卫生装备

According to the deficiencies of the present treatment planning systems,a research of field size dosage calculation based on two-dimensional localization image is presented.The technologies are emphasized including coordinate transformation,image preprocessing,edge detection & extraction and field size dosage calculation,etc.