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Background According to the Classification and Catalogue of Occupational Diseases, brucellosis is one of the notifiable occupational infectious diseases, which occurs from time to time in the occupational population. Objective To compare the work-related injury appraisal process and results of 13 cases of brucellosis at both provincial and municipal levels, analyze and summarize the bias in the practical work of labor capacity identification for occupational diseases such as brucellosis by appraisal management departments and experts, and propose suggestions for optimizing appraisal work. Methods A comparative study was conducted on the objective examination results and labor capacity appraisal conclusions based on the occupational contact history, clinical diagnosis, occupational disease diagnosis staging, and labor capacity appraisal of 13 patients with brucellosis. The reasons for the inconsistency between the initial appraisal conclusion by institutions at the municipal level and the final appraisal conclusion by institutions at the provincial level were compared and analyzed. Results All of the 13 patients with brucellosis applied for municipal-level labor capacity identification after being identified as work-related injuries, 11 of which did not receive a disability level, and 2 were rated as level 10 disability. Four of those who did not receive the disability rate applied for provincial-level labor capacity identification. As a result, 2 cases were maintained original appraisal conclusions, while the other 2 changed the conclusions to level 9 disability and level 10 disability respectively. It was the first time in Shijiangzhuang municipal-level primary labor capacity appraisal and Hebei provincial-level labor capacity re-appraisal that the work-related injury caused by occupational brucellosis was rated as level 9 disability or level 10 disability. Hence, the lessons learned from this comparative analysis are that the degree of target organ damage and (or) organ dysfunction are the direct basis for work-related injury appraisal; an objective and scientific labor capacity identification for occupational brucellosis should base on the each case of disability evaluation, identify the relevant target organ damage and the degree of dysfunction, and rate the disability level after a comprehensive appraisal. Conclusion This analysis would be a guidance to the identification of labor capacity for occupational brucellosis in Hebei Province and the whole country. There is a hysteresis issue in the occupational disease provisions in the national standard GB/T 16180—2014 Standard for identify work ability—Gradation of disability caused by work-related injuries and occupatiaonal diseases. In current situation, appraisal experts should not only search for clauses that directly correspond to the occupational diseases and injuries, but also target conditions not covered in the clauses and conduct assessment based on the characteristics of occupational diseases, with scientific, accurate, and flexible application of the clauses in the standard and appendix, so as to make fair, just, and professional appraisal conclusions.
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BACKGROUND@#There has been minimal research on the role of benevolent childhood experiences (BCEs) and how such events may offer protection from the insidious effects of adverse childhood experiences (ACEs) or later in life.@*OBJECTIVES@#This research aims to learn how BCEs and ACEs interact to affect adolescents' psychological distress.@*METHODS@#Cross-sectional survey was conducted in three cities (Xuzhou, Nanjing, and Wuhan) in China from March 2021 to May 2021. Latent class analysis (LCA) was used to classify the patterns of ACEs and BCEs. We adopted hierarchical multivariable regression to examine the influences of ACEs and BCEs on depression and suicidal ideation.@*RESULTS@#To explore the relationship between childhood experience and suicidal ideation and depression, LCA revealed three patterns of ACEs: (1) emotional abuse (10.57%); (2) high ACEs (0.55%); and (3) low ACEs classes (88.88%). Adolescents with emotional abuse (depression: OR = 3.82, 95%CI = 2.80-5.22, P < 0.001; suicidal ideation: OR = 5.766, 95%CI = 3.97-8.38, P < 0.001) and high ACEs class (suicidal ideation: OR = 5.93, 95%CI = 1.19-29.66, P < 0.05) had an increased risk of psychological distress (reference: low ACEs). LCA revealed four patterns of BCEs: (1) relationship support (14.54%); (2) low BCEs (4.85%); (3) high BCEs (55.34%); and (4) high quality of life classes (25.28%). Adolescents with a high quality of life (depression: OR = 0.09, 95%CI = 0.05-0.16, P < 0.001; suicidal ideation: OR = 0.22, 95%CI = 0.12-0.40, P < 0.001) and high BCEs (depression: OR = 0.05, 95%CI = 0.03-0.09, P < 0.001; suicidal ideation: OR = 0.15, 95%CI = 0.09-0.26, P < 0.001) protected the mental health of adolescents (reference: low BCEs).@*CONCLUSIONS@#High ACEs and emotional abuse classes were significantly associated with poorer mental health symptoms, including suicidal ideation and depression. In contrast, high BCEs and high quality of life classes were associated with better mental health. These findings point out that it is more necessary to identify and support victims of ACEs, and it is urgent to increase BCEs in early childhood.
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Adolescent , Humans , Cross-Sectional Studies , Depression , East Asian People , Latent Class Analysis , Quality of Life , Suicidal Ideation , Adverse Childhood ExperiencesABSTRACT
Objective To study the expression of interleukin-1β in aortic dissections and aneurysms. Methods Aortic specimens were obtained from patients with type Ⅰ thoracic aortic dissection (11 cases),ascending thoracic aortic aneurysms (10 cases),and healthy organ donors (7 cases).Expression of interleukin-1β,matrix metalloproteinase-9,and signal transduction factors phospho-p38 and phospho-JNK were detected by real time RT-PCR,Western blot,and immunohistochemistry,respectively.TUNEL staining was performed to detect apoptosis of media cells. Results Apoptosis in the media of thoracic aortic dissection and ascending thoracic aortic aneurysms was dramatically higher than control group.Expression of interleukin-1β gradually increased in an order of control group,thoracic aortic dissection to ascending thoracic aortic aneurysms ( P < 0.01,respectively).Expression of matrix metalloproteinase-9significantly increased in the media of thoracic aortic dissection and ascending thoracic aortic aneurysms compared with control group (P < 0.01,respectively).There were positive correlations between interleukin1 β and matrix metalloproteinase-9,interleukin-1β and phospho-p38 in thoracic aortic dissection ( P < 0.01,respectively),interleukin-1β and apoptosis in ascending thoracic aortic aneurysms (P < 0.01 ).Conclusions Interleukin-1β and interferon-γ might effect the formation of thoracic aortic dissection and ascending thoracic aortic aneurysms possibly through the up-regulation of matrix metalloproteinase-9 and apoptosis of media cells in humans.
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Objective To evaluate open and endovascular procedures for the treatment of visceral arterial naeurysms.Methods Clinical data of 93 cases were reviewed from Jan 2001 to Jan 2011,including 47 males,and 46 females.Splenic artery aneurysm in 45 cases,superior mesenteric artery aneurysm in 15 cases,renal artery aneurysms in 10 cases,common hepatic artery aneurysm in 7,celiac artery aneurysms in 11 and gastroduodenal artery aneurysm in 5 cases.All cases had either open procedures or endovascular procedures after comprehensive evaluation.Results Surgical open procedures were performed on 34 cases,and endovascular procedures were performed on 59 cases.The perioperative complication rate were 52.9% and 13.6% for open and endovascular groups respectively.The mean follow-up time was 36.8 months ( 11 months to 10 years).1 -year survival rate and 5-year survival rate were 100%and 60.6% in open surgery group,compared with 100% and 84.5% in endovascular group.Conclusions Endovascular repair is effective for visceral artery aneurysm with lower perioperative complication rate and better long-term survival rate.
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Objective To evaluate popliteal artery local technique in superficial femoral artery antegrade subintimal recanalization.Methods From January 2009 to Dec 2011,550 limbs in 476 TASC (Trans-Atlantic Inter-Society Consensus) Ⅱ C/D cases underwent endo-therapy at our department.The success rate、operation time、symptom progress and follow up were analyzed retrospectively.Results In the 550 limbs,62 limbs received popliteal artery local technique directly.There was 9 technical failures.Procedures succeeded in 53 limbs(85.5% ).The average operation time was (69 ±24) min,(1.8 ±0.6) stents were used and the main covered length was ( 33 ± 6) cm.Symptoms of 46 limbs was improved and unchanged in 6,amputation needed to be done in one limb.One year follow up accomplished for 39 limb.The 6 and 12 months patence rate was 87.1% and 69.2%.For 488 limbs using traditional approach 378 achieved anti-grade recanalization,the average operation time was ( 89 ± 30) min,average (2.1 ± 0.6) stents were used and the main covered length is (31 ± 13) cm.Symptom in 300 limbs improved.The half and one year patence rate in 292 limbs was 92.1% and 61.0%.Conclusions The popliteal artery local technique is as effective as with traditional approach and is time saving.