Survey on occupational hazards of enterprises in Pingshan district of Shenzhen City / 中国职业医学

@#Abstract: Objective To analyze the occupational hazards of enterprises in Pingshan district of Shenzhen in 2017. Methods Occupational hazards were analyzed in 200 enterprises in Pingshan district of Shenzhen City selected using stratified Results random sampling method. A total of 24 industries were involved in the 200 enterprises. The declaration rate of ， occupational hazards was 91.5% and the exposure rate of occupational hazards among workers was 49.2%. The regular monitoring rate of occupational hazard factors in workplaces of the enterprises was 79.5%. There were 129 kinds of occupational ， ， hazard factors of which 19 factors exceeded the national occupational exposure limit accounting for 14.7%. The over standard ， ， ， ， ， ， ， ， rates of noise silica dust cotton dust methanol toluene and other dust were 28.7% 13.6% 11.8% 5.86% 0.5% and ， ， 0.4% respectively. There were 13 kinds of occupational hazard factors in the workplace of metal products industry all of which （ ） exceeded the occupational exposure limit. The exposure rate 56.7% of occupational hazard factors in workers was the highest. Conclusion ， ， The main occupational hazard factors were noise dust and chemical factor and the major occupational hazard industry was metal manufacturing in Pingshan district of Shenzhen City.

Cut-off values of lesion and vessel quantitative flow ratio in de novo coronary lesion post-drug-coated balloon therapy predicting vessel restenosis at mid-term follow-up / 中华医学杂志(英文版)

BACKGROUND@#Drug-coated balloons (DCBs) have emerged as potential alternatives to drug-eluting stents in specific lesion subsets for de novo coronary lesions. Quantitative flow ratio (QFR) is a method based on the three-dimensional quantitative coronary angiography and contrast flow velocity during coronary angiography (CAG), obviating the need for an invasive fractional flow reserve procedural. This study aimed to assess the serial angiographic changes of de novo lesions post-DCB therapy and further explore the cut-off values of lesion and vessel QFR, which predict vessel restenosis (diameter stenosis [DS] ≥50%) at mid-term follow-up.@*METHODS@#The data of patients who underwent DCB therapy between January 2014 and December 2019 from the multicenter hospital were retrospectively collected for QFR analysis. From their QFR performances, which were analyzed by CAG images at follow-up, we divided them into two groups: group A, showing target vessel DS ≥50%, and group B, showing target vessel DS <50%. The median follow-up time was 287 days in group A and 227 days in group B. We compared the clinical characteristics, parameters during DCB therapy, and QFR performances, which were analyzed by CAG images between the two groups, in need to explore the cut-off value of lesion/vessel QFR which can predict vessel restenosis. Student's t test was used for the comparison of normally distributed continuous data, Mann-Whitney U test for the comparison of non-normally distributed continuous data, and receiver operating characteristic (ROC) curves for the evaluation of QFR performance which can predict vessel restenosis (DS ≥50%) at mid-term follow-up using the area under the curve (AUC).@*RESULTS@#A total of 112 patients with 112 target vessels were enrolled in this study. Group A had 41 patients, while group B had 71. Vessel QFR and lesion QFR were lower in group A than in group B post-DCB therapy, and the cut-off values of lesion QFR and vessel QFR in the ROC analysis to predict target vessel DS ≥50% post-DCB therapy were 0.905 (AUC, 0.741 [95% confidence interval, CI: 0.645, 0.837]; sensitivity, 0.817; specificity, 0.561; P < 0.001) and 0.890 (AUC, 0.796 [95% CI: 0.709, 0.882]; sensitivity, 0.746; specificity, 0.780; P < 0.001).@*CONCLUSIONS@#The cut-off values of lesion QFR and vessel QFR can assist in predicting the angiographic changes post-DCB therapy. When lesion/vessel QFR values are <0.905/0.890 post-DCB therapy, a higher risk of vessel restenosis is potentially predicted at follow-up.

Intensive statin versus low-dose statin + ezetimibe treatment for fibrous cap thickness of coronary vulnerable plaques / 中华医学杂志(英文版)

BACKGROUND@#Acute coronary syndromes mainly result from abrupt thrombotic occlusion caused by atherosclerotic vulnerable plaques (VPs) that suddenly rupture or erosion. Fibrous cap thickness (FCT) is a major determinant of the propensity of a VP to rupture and is recognized as a key factor. The intensive use of statins is known to have the ability to increase FCT; however, there is a risk of additional adverse effects. However, lower dose statin with ezetimibe is known to be tolerable by patients. The present study aimed to investigate the effect of intensive statin vs. low-dose stain + ezetimibe therapy on FCT, as evaluated using optical coherence tomography.@*METHOD@#Patients who had VPs (minimum FCT 90°) and deferred from intervention in our single center from January 2014 to December 2018 were included in the trial. They were divided into the following two groups: intensive statin group (rosuvastatin 15-20 mg or atorvastatin 30-40 mg) and combination therapy group (rosuvastatin 5-10 mg or atorvastatin 10-20 mg + ezetimibe 10 mg). At the 12-month follow-up, we compared the change in the FCT (ΔFCT%) between the two groups and analyzed the association of ΔFCT% with risk factors. Fisher exact test was used for all categorical variables. Student's t test or Mann-Whitney U-test was used for analyzing the continuous data. The relationship between ΔFCT% and risk factors was analyzed using linear regression analysis.@*RESULT@#Total 53 patients were finally enrolled, including 26 patients who were in the intensive statin group and 27 who were in the combination therapy group. At the 12-month follow-up, the serum levels of total cholesterol (TC), total triglyceride, low-density lipoprotein (LDL-C), hypersensitive C-reactive protein (hs-CRP), and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels were reduced in both the groups. The ΔTC%, ΔLDL-C%, and ΔLp-PLA2% were decreased further in the combination therapy group. FCT was increased in both the groups (combination treatment group vs. intensive statin group: 128.89 ± 7.64 vs. 110.19 ± 7.00 μm, t = -9.282, P < 0.001) at the 12-month follow-up. The increase in ΔFCT% was more in the combination therapy group (123.46% ± 14.05% vs. 91.14% ± 11.68%, t = -9.085, P < 0.001). Based on the multivariate linear regression analysis, only the serum Lp-PLA2 at the 12-month follow-up (B = -0.203, t = -2.701, P = 0.010), ΔTC% (B = -0.573, t = -2.048, P = 0.046), and Δhs-CRP% (B = -0.302, t = -2.963, P = 0.005) showed an independent association with ΔFCT%.@*CONCLUSIONS@#Low-dose statin combined with ezetimibe therapy maybe provide a profound and significant increase in FCT as compared to intensive statin monotherapy. The reductions in Lp-PLA2, ΔTC%, and Δhs-CRP% are independently associated with an increase in FCT.

Epidemiological investigation on the first family aggregation epidemic of corona virus disease 2019 in Yangzhou / 上海预防医学

Objective To explore the transmission pattern of corona virus disease 2019 (COVID-19) in the population by describing an imported case of novel coronavirus infected pneumonia epidemic situation. Methods Using the method of field investigation, epidemiological investigations were carried out for the imported COVID-19 case and the close contacts related to this epidemic cluster.Data were collected concerning the date of onset, isolation of the case and close contacts.The novel coronavirus nucleic acid was collected from the throat swabs of the case and close contacts.These samples were detected by real-time fluorescence quantitative RT-PCR. Results In this epidemic cluster, there was one confirmed case, that had been exposed to 36 people (12 in the family and 24 outside the family) and 2 in the family were nucleic acid positive and diagnosed as asymptomatic infections. Conclusion COVID-19 transmission proves to be mainly through respiratory droplets and close contact, which easily causes family aggregation epidemic.

The Molecular Mechanism of LncRNA-CASC2/miR-155-5p/APC Axis Regulating the Progression of Non-Hodgkin Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of lncRNA-CASC2 (CASC2) /miR-155-5p/APC axis to the progression of non-Hodgikn lymphoma (NHL).@*METHODS@#The expression level of CASC2 and miR-155-5p in NHL cell lines were examined by qRT-PCR. Dual-luciferase reporter gene assay was used to verify the relationship between miR-155-5p, CASC2 and APC. The effects of CASC/miR-155-5p/APC axis to the proliferation, invasion and apoptosis of NK-92 cells were detected by MTT, Transwell assay and flow cytometry assay, respectively.@*RESULTS@#CASC2 was downregulated in NHL cell lines. Overexpression of CASC2 could inhibit the proliferation and invasion of NK-92 cells, and promote its apoptosis. Dual-luciferase reporter gene assay confirmed that there was a targeting relationship between miR-155-5p, CASC2 and APC. The restoration experiments proved that knockdown of both miR-155-5p and CASC2 or APC could restore the inhibitory effect of miR-155-5p silencing to the biological behavior of NK-92 cells.@*CONCLUSION@#Overexpression of CASC2 suppresses the proliferation and invasion of NK-92 cells, promote the apoptosis of NK-92 cells via targeting miR-155-5p and upregulating APC expression.

Effect of different glucocorticoid administration routes in treatment of children's secretory otitis media and impacts on immunologic function / 中国免疫学杂志

Objective:To analyze the effect of different glucocorticoid administration routes in the treatment of children's secretory otitis media and impacts on immunologic function.Methods:Clinical data of children with secretory otitis media received treatment at our hospital from January 2016 to June 2016 were analyzed.Patients were divided into two groups by different glucocorticoid administration routes,Group A:intratympanic injection;Group B:oral administration.After one week,clinical effects and immunologic functions were tested and compared between the two groups.Results:A total of 87 patients were analyzed,Group A 45 cases,Group B 42 cases.After one week treatment,both of the two groups got significantly improved in audiology indexe (P<0.05),however,these index were more better in Group A when compared with those of Group B(P<0.05).Meanwhile,Group A patients got higher cure rate than that of Group B (91.1%,41/45 vs 73.8%,31/42;X2=4.558,P=0.033).Both of the two groups got significantly improved in CD3+T,CD4+T and CD4/CD8 (P<0.05) and decreased in CD8,IL-4,IFN-γ and IL-4/IFN-γ(P<0.05),but these markers changed more significant in Group A (P<0.05).Group A patients had a lower recurrence rate than Group B patients one year after treatment, the difference was statistically significant (9.76%,4/41 vs 29.03%,9/31;Log-rank X2=4.698,P=0.030).Conclusion:The treatment of children's secretory otitis media,the intratympanic injection of glucocorticoid shows a better effect than that of oral cortico-steroids.

Spontaneous Coronary Artery Dissection as a Cause of Acute Myocardial Infarction in Young Female Population: A Single-center Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic but a rare and extremely dangerous clinical entity, it has a high prevalence in young female population with acute myocardial infarction (AMI). The previous reports were restricted to other countries' population, but rare in China. Hence, this study aimed to focus on the characteristics of SCAD as a cause of young female AMI population in Jiangsu, China.</p><p><b>METHODS</b>This study enrolled young female AMI patients aged ≤50 years who underwent coronary angiography (CAG) and intracoronary imaging in our center between January 2013 and December 2016. Their clinical presentations, risk factors, and CAG characteristics were analyzed.</p><p><b>RESULTS</b>A total of 60 young female AMI (<7 days) patients were enrolled. From their CAG and intracoronary imaging results, the prevalence of SCAD in young female AMI population was 35% (21/60), the prevalence of coronary atherosclerostic heart disease was 65% (39/60). In the SCAD group, 43% (9/21) presented with non-ST-elevation myocardial infarction (NSTEMI) and the remainder presenting as STEMI. SCAD usually occurred in a single vessel (20/21, 95%), especially in left anterior descending artery (14/21, 67%). Eighteen patients (18/21, 86%) underwent conservative treatment, whereas the remaining three patients (3/21, 14%) underwent percutaneous coronary intervention. Regarding the angiographic results of SCAD lesions, intramural hematoma was discriminated in 95% (20/21), and Type I imaging was observed in 5% (1/21), Type II was observed in 67% (14/21), and Type III was 29% (6/21). The average stenosis in the group was 76.9% ± 20.6%, and the mean lesion length was 36.6 ± 8.6 mm.</p><p><b>CONCLUSIONS</b>SCAD has a high prevalence in young female AMI population in Jiangsu, China. Discriminating the cause of AMI in young female population is very important.</p>

An investigation on knowledge,attitude and practice about tuberculosis prevention and treatment among close contacts of tuberculosis patients / 预防医学

Objective To learn the current situation of knowledge,attitude and practice (KAP)about tuberculosis prevention and treatment among close contacts of tuberculosis patients in Yangzhou City and to explore the influencing factors and relationship of KAP.Methods A total of 460 TB(tuberculosis)patients'families in Yangzhou were randomly selected by means of cluster random sampling.And 746 close contacts of tuberculosis patients were investigated by face - to - face interview.Their basic information,knowledge ,belief and behavior of TB were analyzed by descriptive analysis and multivariable logistic regression analysis.Results The overall awareness rate of tuberculosis prevention and control was 58.30% ,and the rate of positive belief was 50.19%,and the behavior holding rate was 59.25%.The multivariable logistic regression analysis showed that diagnostic types,degree of education and location were the major influencing factors. Conclusion Close contacts with low education level and with smear positive patients in the family should be paid more attention.

Efficacy of periprostatic nerve block anesthesia for pain control in transrectal ultrasound- guided systematic prostate biopsy / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of periprostatic nerve block anesthesia (PPNB) for pain relief in transrectal ultrasound-guided systematic prostate biopsy (PBx).</p><p><b>METHODS</b>We reviewed the data of patients undergoing initial PBx at our center from November, 2013 to January, 2015. Only the patients with 12-core systemic PBx were included and 111 patients were eligible for this study, among whom 52 patients received PPNB and 59 did not. PPNB was achieved by an injection of 5 mL of 1% lidocaine at the angle between the seminal vesicle and base of the prostate on each side before biopsy. The DRE pain score, probe insert pain score, and biopsy pain score were assessed by visual analogue scale (VAS) immediately after the biopsy. The complications were recorded and evaluated immediately after and at 7 days after the biopsy.</p><p><b>RESULTS</b>The mean age, prostate volume, total prostate specific antigen (tPSA), free PSA (fPSA), and abnormal DRE were comparable between the 2 groups (P>0.05). Immediately after the biopsy, no difference was found between the 2 groups in DRE pain score (1.40±0.98 vs 1.39±0.91, P=0.102) or probe insert pain score (2.07±0.96 vs 2.03±0.90, P=0.960), but the biopsy pain score was significantly lower in PPNB group than in no PPNB group (2.54±1.42 vs 3.07±1.43, P=0.033). The incidence of the procedure-related complications was similar between the 2 groups (P>0.05).</p><p><b>CONCLUSION</b>PPNB can significantly lower the biopsy pain score in PBx without increasing the incidence of complications.</p>

Association of 5-lipoxygenase expression and clinicopathological factors in colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To examine the association of 5-lipoxygenase (5-LOX) expression with clinicopathological factors in colorectal cancer.</p><p><b>METHODS</b>Immunohistochemical stain was used to detect the 5-LOX expression in 52 resected specimens of colorectal cancer. The association between 5-LOX expression and clinicopathological factors was examined.</p><p><b>RESULTS</b>The positive rate of 5-LOX expression in 52 specimens of colorectal carcinoma was 73.1% (38/52). In 41 colorectal cancer specimens with lymph node metastasis, the positive rate of 5-LOX expression was higher than that in the specimens without metastasis (87.8% vs. 18.2%, P<0.05). The positive rate of 5-LOX expression in the specimens with deep infiltration (T3 and T4) was higher than that in the specimens with superficial infiltration (T1 and T2) (81.1% vs. 53.3%, P<0.05). The positive rate of 5-LOX expression in TNM stage III and IIII cancer was higher than that in stage I and II (79.5% vs. 53.8%, P<0.05). The positive rate of 5-LOX expression in cancers of poor differentiation and non-differentiation adenocarcinoma was higher than that of well and moderately differentiated cancer (100% vs. 50.0%, P<0.05). There were no significant differences of 5-LOX expression with tumor size,vascular invasion and peritoneal dissemination.</p><p><b>CONCLUSION</b>5-LOX expression in colorectal carcinoma is closely associated with lymph node metastasis, infiltration depth, differentiation degree and TNM stage.</p>

The role of glycogen synthase kinase-3 beta in the pathogenesis of liver ischemia reperfusion injury / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the role of the key intracellular signaling molecule glycogen synthase kinase-3 beta in the mechanism of liver ischemia reperfusion (IR).</p><p><b>METHODS</b>C57BL/6 mice were subjected to 90 min warm liver cephalad lobe ischemia, followed by various length of reperfusion. Experiment groups included sham control group, liver IRI model group and glycogen synthase kinase-3 beta inhibitor-treated group (SB216763 in DMSO, 25 g/kg, i.p, 2 hour prior to the onset of liver ischemia). The expression of glycogen synthase kinase-3 beta protein was analysed by Western blotting. The serum ALT levels were determined to reflect the function of liver. The affected liver lobes were harvested for histology analysis. The inflammatory gene expression was detected by Quantitative PCR.</p><p><b>RESULTS</b>By western blot analysis, we found that ischemia itself activated glycogen synthase kinase-3 beta by a significant decrease of its phosphorylation. Glycogen synthase kinase-3 beta inhibitor SB216763-pretreatment ameliorated the liver damages significantly as compared to the controls (sALT: 2046+/-513 U/L vs 5809+/-1689 U/L, P = 0.0153), and suppressed the gene expressions of IL-12, TNFa, IL-1b and IL-6.</p><p><b>CONCLUSIONS</b>This study demonstrated that the ischemia process modulated liver innate immune activation via a GSK-3-dependent mechanism which favored the development of a pro-inflammation response and lead to liver tissue damages. GSK-3b may be a new therapeutic target to ameliorate liver IRI in transplant patients.</p>

Laparoscopic resection of metastic liver cancer: experience of 28 cases / 中华肝胆外科杂志

Objective To summarize the experience in laparoscopic resection of metastic liver cancer. Methods The clinical data of the patients receiving laparoscopic resection of metastic liver cancer performed in Brisbane hospital from 1999 to 2006 were retrospectively analyzed. Results A total of 28 patients received the laparoscopic resection of metastic liver cancer. Procedures included left lateral segmentectomy in 13 patients, right hemihepatectomy in 9 and segmental or subsegmental resection in 6. Survival rate and disease free survival rate in 12 patients with colorectal metastasis being followed up for 2 years were 75% and 67%. Conclusion Laparoscopic liver resection is safe and feasible in strictly selected patients with malignancy in an appropriate stage. The surgeons should have rich experience of open liver resection and advanced laparoscopic technique.

Characteristics of lymph node metastasis and prognostic analysis in 157 early gastric cancer patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the pattern of lymph node metastasis and its influence on the prognosis of early gastric cancer(EGC).</p><p><b>METHODS</b>The pattern of lymph node metastasis and the 3-,5-year survival rates in 157 EGC patients undergone surgery from October 1995 to October 2005 were analyzed retrospectively. The SPSS 11.5 statistics software was used to perform univariate and multivariate analysis.</p><p><b>RESULTS</b>Twenty-two cases had lymph node metastasis among 157 EGC patients(14%). Two mucous cancers(2.4%) and 20 submucosal tumors(27.0%) had lymph node metastases (P<0.01). Lymph node metastasis was not seen in minute gastric cancer(diameter < or =0.5 cm). Lymph node metastasis rates were 6.4% in the cancers with diameter 1.1-2.0 cm and 21.5% in the cancers with the diameter >2.0 cm(P<0.01). Besides, lymph node metastasis rate of well-differentiated EGC was 0, of moderate differentiated EGC 11.1%, and poor-differentiated EGC 0.9%(P<0.01). Of 9 cases with vascular cancer embolus, 4 had lymph node metastases. Logistic regression analysis showed that tumor size, vascular cancer embolus, histopathological type and depth of invasion were independent factors of lymph node metastasis in EGC. The 3- and 5-year survival rates of EGC patients with lymph node metastasis were 81.6 % and 79.5% respectively, which were much lower than those without lymph node metastasis(95.7% and 93.2%, P<0.01).</p><p><b>CONCLUSIONS</b>Lymph node metastasis in EGC is mainly correlated with depth of infiltration, tumor size, vascular cancer embolus and differentiation. For EGC treatment, choice should be made reasonably based on the risk of lymph node metastasis.</p>

Laparoscopic right hemihepatectomy( LRH):report of 12 cases / 中国普通外科杂志

Objective To evaluate the safety and feasibility of LRH for benign or malignant diseases. Methods In this study, 12 cases received LRH with 10 of suspected malignancy. The procedure included; ( 1) dissection of porta hepatis, (2) dissection of the vena cava, (3) hepatectomy. Results LRH was a complete laparoscopic procedure in 5 cases, hand-assisted in 5 cases and converted to open surgery in the remaining 2 cases. Four cases received blood transfusion. There was no mortality. Bile leakage and wound dehiscence developed in one each. The mean hospital stay was 8 days in the whole group, 4 days in the LRH group. Carcinoma was diagnosed in 9 of 12 cases. Two died during the follow-up with one of intrahepatic hepatocellular carcinoma metastasis and the other of widespread metastatasis after metastatic hepatectomy of colorectal carcinoma. Seven cases after metastatic hepatectomy from colorectal carcinoma were alive during the follow-up of 6 -24 months. Conclusion LRH is safe and feasible in selected primary and secondary hepatic cancer patients.