[Influence of occupational stress on salivary immunoglobulin G concentration in employees].

OBJECTIVE: To investigate the possibility of salivary immunoglobulin G(IgG) as an objective assessment index for occupational stress. METHODS: In September 2014, a total of 186 employees in a solar photovoltaic company were selected as research subjects, and a questionnaire survey was performed. Enzyme-linked immunosorbent assay was used to measure salivary IgG concentration. RESULTS: The salivary IgG concentration showed a significant difference between employees with different working years and shifts(P<0.05). The employees with ≤15 working years had a lower salivary IgG concentration than those with >20 working years (49.93±7.97 µg/ml vs 53.80±8.22 µg/ml), and the employees with long-day shifts had a higher salivary IgG concentration than those with day-night shifts(54.98±7.62 µg/ml vs 51.85±7.94 µg/ml). The employees with low levels of job demands and job danger had a significantly higher salivary IgG concentration than those with high levels(54.09±6.68 µg/ml vs 50.65±8.81 µg/ml, P<0.05; 53.73±7.35 µg/ml vs 50.73±8.73 µg/ml, P<0.05). The employees with a high score of mental health had a significantly higher salivary IgG concentration than those with a low score(54.39±5.28 µg/ml vs 50.73±9.36 µg/ml, P<0.05). The salivary IgG concentration was positively correlated with the score of mental health(r=0.314, P<0.05), but negatively correlated with job demands, job routinization, job danger, job prospects, physical complaints, and daily stress(r=-0.249, -0.159, -0.157, -0.030, -0.035, and -0.176, all P<0.05). The multivariate linear regression analysis showed that the salivary IgG concentration was mainly influenced by job demands and mental health. CONCLUSION: Salivary IgG concentration can be applied as an objective assessment index for occupational stress.

[Correlation between job burnout and salivary immunoglobulin G in employees].

OBJECTIVE: To investigate the influence of job burnout on salivary immunoglobulin G(IgG) concentration in employees. METHODS: In September 2014, evaluation of job burnout was performed for 186 employees in a solar photovoltaic company, and enzyme-linked immunosorbent assay was used to measure salivary IgG concentration. RESULTS: The employees with over 20 working years had a significantly higher salivary IgG concentration than those with ≤15 working years(53.80±8.22 µg/ml vs 49.93±7.97 µg/ml, P<0.05). The employees with long-day shifts had a significantly higher salivary IgG concentration than those with day-night shifts (54.98±7.62 µg/ml vs 51.85±7.94 µg/ml, P<0.05). The employees with depersonalization had a significantly lower salivary IgG concentration than those without depersonalization(50.69±9.89 vs 53.19±6.54, P<0.05). The salivary IgG concentration was negatively correlated with the scores of emotional exhaustion, depersonalization, and job burnout (r=-0.194, -0.152, and -0.210, all P<0.05). CONCLUSION: Job burnout is negatively correlated with salivary IgG concentration, which tends to decrease with the increasing severity of job burnout. Therefore, salivary IgG can be used as a biomarker for the identification and evaluation of job burnout.

Effects of predistention with normal saline containing adrenaline on blood-vessel injury during epidural catheter placement.

This study investigated the effects of predistention with normal saline containing adrenaline on vascular plexus injury during epidural catheter placement. Three hundred parturients undergoing caesarean sections were randomly divided into three groups. Group I (n = 102) received an epidural injection with 5 ml normal saline; group II (n = 93) received 5 ml normal saline containing adrenaline (5 µg/ml); group III (n = 100) received direct epidural catheter placement. Five women were excluded from the analysis for technical reasons. The incidence of bloody fluid in the epidural needle was significantly lower in groups I and II compared with group III (eight [7.8%] and seven [7.5%] versus 17 [17.0%], respectively). There were no significant differences in the incidence of bloody fluid in the epidural catheter or in the incidence of intravascular epidural catheter placement between the three groups. Predistention with 5 ml normal saline before catheter insertion reduced the incidence of blood-vessel injury during epidural catheter placement, but adrenaline provided no additional protective effects.

Effects of acute hypervolaemic haemodilution on the expression of plasma interferon-inducible protein-10 and bactericidal/permeability-increasing protein in patients undergoing total hip replacement.

This prospective, randomized controlled study evaluated the effects of acute hypervolaemic haemodilution (AHH) on the expression of plasma interferon-inducible protein-10 (IP-10) and bactericidal/permeability-increasing protein (BPI) in patients undergoing elective total hip replacement. Twenty patients were randomized to receive an infusion of either hydroxyethyl starch (HES group) or lactated Ringer's solution (LR group) immediately after anaesthesia. Plasma concentrations of IP-10 and BPI were measured before anaesthesia (baseline), at the start of surgery, 30 min after the start of surgery and at the end of surgery. Blood loss and the volume of blood transfused were significantly lower in the HES group compared with the LR group. Compared with baseline, IP-10 and BPI concentrations increased significantly in both groups 30 min after the start of surgery. The IP-10 concentrations were significantly lower and BPI concentrations significantly higher in the HES group compared with the LR group 30 min after the start of surgery and at the end of surgery. It is concluded that AHH with HES may be helpful in ameliorating immune function during total hip replacement and in reducing blood loss and the extent of blood transfusion.

Which has the least immunity depression during postoperative analgesia--morphine, tramadol, or tramadol with lornoxicam?

BACKGROUND: Analgesics are commonly used to provide pain relief after surgery. These drugs produce some extended depression of immunity. A prospective randomized controlled trial was designed to observe expressions of T-lymphocyte subsets (CD3(+), CD3(+)CD4(+) and CD3(+)CD8(+)), natural-killer cells (CD3(-)CD16(+)CD56(+)), and activated T-lymphocytes (CD3(+)CD25(+)) of patients undergoing gastric cancer surgeries and receiving patient-controlled intravenous analgesia (PCIA). METHODS: Forty-five patients undergoing elective gastric cancer surgeries under general anesthesia were randomly allocated into 3 groups. Group I received PCIA using morphine after surgery, group II using tramadol, and group III using tramadol with lornoxicam. The analgesic efficacy was evaluated by visual analog scale (VAS) and Bruggrmann comfort scale (BCS). Expressions of CD3(+), CD3(+)CD4(+), CD3(+)CD8(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) were measured as percentages of total lymphocytes by flow cytometer at 5 time points. RESULTS: There was no significant difference in analgesic efficacy and the baselines of CD3(+), CD3(+)CD4(+), CD3(+)CD8(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) in all groups. Compared with the baseline, CD3(+)CD8(+) had no changes in all groups at any time point. Ninety minutes after incision, CD3(+), CD3(+)CD4(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) were lower in all groups (P<0.05). 24 h after surgery, CD3(+), CD3(+)CD4(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) were lower in group I and group II (P<0.05); meanwhile CD3(+), CD3(+)CD4(+), and CD3(+)CD25(+) returned to the baseline but CD3(-)CD16(+)CD56(+) was still low (P<0.05) in group III. 48 h after surgery, CD3(+), CD3(+)CD4(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) returned to the baseline in group II and group III, but not in group I (P<0.05). 72 h after surgery, CD3(+), CD3(+)CD4(+), CD3(+)CD4(+)/CD3(+)CD8(+) returned to the baseline, but CD3(+)CD25(+) and CD3(-)CD16(+)CD56(+) were still low in group I (P<0.05). CONCLUSION: PCIA using lornoxicam with tramadol has the same good analgesic efficacy and less immunity depression than PCIA using morphine or tramadol.

[A survey of advanced schistosomiasis patients with upper gastrointestinal bleeding].

Among 4,950 advanced schistosomiasis patients examined, 709 (14.3%) had upper gastrointestinal bleeding, and in patients who had been treated with splenectomy, 532 presented history of bleeding. Of the 338 cases with a history of bleeding, 268 (79.3%) ceased bleeding after operation and 70 cases (20.7%) bled again. In 194 cases (7%) who had no history of bleeding before operation, bleeding occurred, suggesting that simple splenectomy has certain effect in preventing upper gastrointestinal bleeding, but the incidence of bleeding is higher in those who had a history of bleeding before operation. Gastrofibroscopic examinations in 50 cases who bled recently indicated that 74% of the patients had gastro-duodenal lesion as a concomitant disease. Prevention and treatment of upper gastrointestinal bleeding of advanced schistosomiasis patients are discussed.