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In the face of a serious occupational disease prevention and control situation, the lack of efficient supervision and regulation methods has become a prominent contradiction. This paper reviewed the progress and application of occupational health grading and classification supervision methods for employers in China in recent years, and analyzed the characteristics and limitations of selected methods. The grading and classification supervision methods have gradually developed from considering only inherent health risk of occupational disease hazards, to considering both inherent attributes of occupational disease hazards and exposure duration. Some regional authorities introduced trial measures for grading and classification of occupational health supervision by embracing exposure level of an occupational disease hazard of interest, associated outcome severity, and occupational health management situation of targeted employers. In October 2022, the National Disease Control and Prevention Bureau issued the Notice on Carrying out Pilot Work of Occupational Health Classification Supervision and Law Enforcement, which further promoted the establishment of a differentiated occupational health supervision model. Grading and classification of occupational health supervision can improve the supervision efficiency of public health administration departments and promote employers to fulfill the main responsibility of occupational disease prevention and control.
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Objective:To evaluate the barrier-free level of village clinics of a city in the aging era, for references in improving the barrier-free medical environment for the elderlies.Methods:The village dectors of 156 village clinics in 12 counties of a city were selected as the objects of a questionnaire survey from Dec.2020 to Jan.2021, with 6 evaluation indexes established, each set with 1-10 points. This questionnaires was used to survey the barrier-free construction levels of village clinics. The data were statistically analyzed by rank sum ratio and quadrant graph model.Results:The barrier-free buildings of such clinics scored 32.86 points in average. Among the six indexes, the barrier-free access and doors(7.21 points) scored the highest, and the barrier-free parking space(4.71points) and toilets(3.28 points) scored the lowest. All the counties of the city fell into four categories, including 2 counties with high degree of aging-high level of accessibility, 4 counties with low degree of aging-high level of accessibility, 4 counties with low degree of aging-low level of accessibility, and 2 counties with high degree of aging-low level of accessibility, according to the quadrant graph model built based on the aging degrees and the barrier-free levels of village clinics.Conclusions:The barrier-free level of the village clinics in a city needs to be further improved, and the barrier-free transformation of parking space and toilets should also be strengthened in the future. The government should take different measures in view of conditions of each county to improve the accessibility of village clinics and facilitate the health care-seeking of elderlies.
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The phenomenon of workers working beyond standard working hours is called long working hours. In recent years, more and more relevant studies at home and abroad have shown the association between long working hours and adverse health effects of occupational populations, such as increased risks of cardiovascular diseases, diabetes, and various psychological conditions such as depression and occupational stress. However, the current research has not yet reached a consistent conclusion. The main reason is that the physiological and psychological effects of exposure to long working hours need to be explored in depth. Therefore, based on the relevant research progress at home and abroad, this article introduced the health effects of long working hours from both physical and psychological aspects, including hypertension, cardiovascular diseases, diabetes, depression, and job burnout, expounded related mechanisms involved, and indicated deficiencies in current research on long working hours and the next research directions.
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Background Non-Gaussian noise has become the dominant noise type in industry. However, the epidemiological characteristics of non-Gaussian noise exposure and associated noise-induced hearing loss (NIHL) are still unclear. Objective To summarize the epidemiological characteristics of NIHL associated with non-Gaussian noise in manufacturing industry in China and provide a basis for the early prevention and control of occupational hearing loss. Methods Chinese and English literature on hearing loss associated with non-Gaussian noise in China were retrieved. The overall prevalence was calculated based on the prevalence data provided by each included study. A meta-analysis of studies with Gaussian noise as a control group was also performed and the overall weighted odds ratio (OR) was calculated to compare the effects of non-Gaussian noise and Gaussian noise on hearing loss. Publication bias was evaluated by funnel plot and Egger regression, and a sensitivity analysis was performed by eliminating references in turn. Results A total of 37 cross-sectional studies involving 25 055 Chinese manufacturing workers exposed to non-Gaussian noise were included, 92.5% of whom were male. These workers aged (32.7±9.6) years were exposed to non-Gaussian noise at (87.0±4.2) dB(A) for (6.8±4.9) years. The mean cumulative noise exposure (CNE) was (95.9±8.0) dB(A)·year. The prevalence rate of high-frequency NIHL (HFNIHL) and speech-frequency NIHL (SFNIHL) were 29.0% and 14.2%, respectively. The results of the meta-analysis treating 19 cross-sectional studies with Gaussian noise as a control group showed that there were no significant differences in age, exposure duration, and equivalent continuous A-weighted sound pressure level (LAeq), and CNE between the non-Gaussian noise group and the Gaussian noise group. The overall weighted OR of HFNIHL was 1.87 (95%CI: 1.46−2.41), which was statistically significant. The funnel plot showed good symmetry and the result of Egger regression was t=−0.11, P=0.910 (>0.05), suggesting a low risk of publication bias in this meta-analysis. The sensitivity analysis showed no significant changes of results after eliminating references in turn, indicating that the results were robust. Conclusion Chinese manufacturing workers, mainly young adult males, are exposed to non-Gaussian noise at high levels for a long time and have a high prevalence of NIHL. Compared to workers exposed to Gaussian noise, those exposed to non-Gaussian noise suffer from more serious hearing loss.
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Background Occupational noise-induced hearing loss (NIHL) is one of the most prevalent occupational diseases in the world. With the development of industry, noise sources in the workplace have become increasingly complex. Objective To apply kurtosis-adjusted cumulative noise exposure (CNE) to assess the occupational hearing loss among furniture manufacturing workers, and to provide a basis for revising noise measurement methods and occupational exposure limits in China. Methods A cross-sectional survey was conducted to select 694 manufacturing workers, including 542 furniture manufacturing workers exposed to non-Gaussian noise, and 152 textile manufacturing workers and paper manufacturing workers exposed to Gaussian noise. The job titles involving non-Gaussian noise were gunning and nailing, and woodworking, while those involving Gaussian noise were weaving, spinning, and pulping. High frequency noise-induced hearing loss (HFNIHL) and noise exposure data were collected for each study subject. Noise energy metrics included eight-hour equivalent continuous A-weighted sound pressure level (LAeq,8 h) and CNE. Kurtosis was a noise temporal structure metric. Kurtosis-adjusted CNE was a combined indicator of noise energy and temporal structure. Results The age of the study subjects was (35.64±10.35) years, the exposure duration was (6.71±6.44) years, and the proportion of males was 75.50%. The LAeq,8 h was (89.43±6.01) dB(A). About 81.42% of the study subjects were exposed to noise levels above 85 dB(A), the CNE was (95.85±7.32) dB(A)·year, with a kurtosis of 99.34 ± 139.19, and the prevalence rate of HFNIHL was 35.59%. The mean kurtosis of the non-Gaussian noise group was higher than that of the Gaussian noise group (125.33±147.17 vs. 5.86±1.94, t=−21.04, P<0.05). The results of binary logistic regression analysis showed that kurtosis was an influential factor of workers' HFNIHL after correcting for age, exposure duration, and LAeq,8 h (OR=1.49, P<0.05). The results of multiple linear regression analysis showed that the effects of age, exposure duration, LAeq,8 h, and kurtosis on noise-induced permanent threshold shift at frequencies of 3, 4, and 6 kHz of the poor hearing ear were statistically significant (all P<0.05). The results of chi-square trend analysis showed that when CNE ≥ 90 dB(A)·year, the HFNIHL prevalence rate elevated with increasing kurtosis (P<0.05). The mean HFNIHL prevalence rate was higher in the non-Gaussian noise group than in the Gaussian noise group (31.7% vs. 22.0%, P<0.05). After applying kurtosis-adjusted CNE, the linear equation between CNE and HFNIHL prevalence rate for the non-Gaussian noise group almost overlapped with that for the Gaussian noise group, and the mean difference in HFNIHL prevalence rate between the two groups decreased from 9.7% to 1.4% (P<0.05). Conclusion Noise kurtosis is an effective metric for NIHL evaluation. Kurtosis-adjusted CNE can effectively evaluate occupational hearing loss due to non-Gaussian noise exposure in furniture manufacturing workers, and is expected to be a new indicator of non-Gaussian noise measurement and assessment.
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The existing measuring methods of noise exposure on the basis of equal energy hypothesis are applicable to Gaussian noise while not fully applicable to non-Gaussian noise. Studies have shown that temporal structure (kurtosis) combined with noise energy has the potential to quantify non-Gaussian noise exposure effectively. However, there is no unified measuring method adopting this joint metric. In this paper, the measuring method of non-Gaussian noise exposure based on kurtosis adjustment was introduced, detailing measurement indicators, adjustment schemes, applicable objects, instrument requirements, and measurement steps. Adjusting the exposure duration of cumulative noise exposure (CNE) by kurtosis or adjusting the equivalent continuous A-weighted sound pressure level (LAeq) by an adjustment coefficient based on animal or population studies can more accurately quantify workers' exposure to non-Gaussian noise and improve the underestimation of hearing loss caused by non-Gaussian noise. A large number of population studies are warranted in the future to verify the effectiveness of these two adjustment schemes.
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Background Occupational hearing loss associated with noise is becoming more and more serious, and occupational noise-induced deafness has become the second most frequently reported occupational disease in China. Objective To characterize occupational hearing loss in Zhejiang Province so as to provide a basis for the formulation of hearing protection strategies and measures. Methods Through the occupational diseases reporting system, the data of new cases of occupational noise-induced deafness in Zhejiang Province from 2006 to 2020 and the audiometry results of laborers who were exposed to occupational noise and participated in physical examinations from 2015 to 2020 were collected. The distribution of new cases of occupational noise-induced deafness were described in categories of region, year, industry, enterprise scale, age, onset age, and length of work, as well as the detection of increased high-frequency hearing threshold of workers who ordered occupational health examination in each year. Results A total of 575 cases of occupational noise-induced deafness were reported in Zhejiang Province from 2006 to 2020, of which 526 cases were male and 49 were female. The mean onset age of patients with noise-induced deafness was (44.8±8.0) years. There was a significant difference in mean onset age between male and female (t=3.420, Ρ=0.001). The median length of work [M (P25, P75)] at the time of onset was 9.0 (5.5, 13.2) years. The number of cases of noise-induced deafness and its proportion to the total number of occupational diseases in a year showed an increasing trend from 2006 to 2020 and the average annual growth rate was 22.11%. The patients were mainly distributed in the Hangzhou, Ningbo, and Jiaxing, and the number of cases were 194, 140, and 112, respectively, accounting for 77.5% of the total cases in Zhejiang Province. Manufacturing industry was dominant one in terms of the number of cases, which accounted for 89.6% (515 cases). Private economic enterprise, in terms of economic type, accounted for 57.4% (330 cases). There were significant differences in the length of work at the time of onset among different economic types of enterprises (H=29.081, Ρ<0.001). There were 215 cases in the medium-sized enterprises and 265 in the small- and micro-sized enterprises, respectively, accounting for 83.5% of the the total number of cases. Conclusions From 2006 to 2020, the cases of occupational noise-induced deafness in Zhejiang Province present an increasing trend, with a relatively short length of work at the time of onset, and regional and industrial agglomeration.
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Objective:To analyze the clinical characteristics of severe adenovirus pneumonia with bacterial infection in children, so as to provide clinical evidences for early diagnosis and reliable treatment.Methods:A total of 72 pediatric cases with severe adenovirus pneumonia admitted to Pediatric Intensive Care Unit at the First People′s Hospital of Chenzhou from January 2018 to August 2019 were included.The clinical features, laboratory and imaging data, efficacy of the treatments and prognosis were investigated retrospectively.Patients were divided into with bacterial infection group and without bacterial infection group.The clinical characteristics were analyzed.Results:Among the 72 children, there were 54 males and 18 females, aging from 3 months to 5 years, including 37cases with bacterial infection and 35 cases without bacterial infection.Compared with the group without bacterial infection, the group with bacterial infection had longer heat duration and hospital stay [12.0 (10.0, 18.5) days vs.10.0 (9.0, 12.0) days; 6.0(4.0, 7.0) days vs.11.0(6.5, 16.0) days, P<0.05], the incidences of diarrhea and hepatomegaly were higher[35.1% (13/37) vs.14.3%(5/35); 45.9%(17/37)vs.8.6%(3/35), P<0.05], the proportion of five lobes involved in lung imaging was higher [91.8% (34/37) vs. 57.1%(20/35), P<0.05]. The incidences of complications with respiratory failure, hemophagocytic lymphohistiocytosis, and bronchiolitis obliterans in the group with bacterial infection were significantly higher than those of without bacterial infection group ( P<0.05). Conclusion:For children under 2 years old age with severe adenovirus pneumonia, there are prolonged high fever and extensive pulmonary lesions.We should be highly alert to the combination of bacterial infection and timely anti-infection therapy.Children with severe adenovirus pneumonia with bacterial infection have severe clinical manifestations and many complications with respiratory failure, hemophagocytic lymphohistiocytosis, and bronchiolitis obliterans.
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Background Noise is the most common occupational hazard in the automobile manufacturing industry with the most workers exposed. Automobile manufacturing industry is a high-risk industry for noise-induced hearing loss. Objective To understand the epidemiological characteristics of noise-induced hearing loss among workers in automobile manufacturing industry and explore related influencing factors. Methods A questionnaire survey, individual noise recording, and pure tone audiometry were conducted among workers (n=656) exposed to noise from five automobile manufacturing enterprises. The data on age, sex, exposure duration, noise intensity, kurtosis, and hearing loss were obtained. The positive rates of high-frequency noise-induced hearing loss (HFNIHL) and speech-frequency noise-induced hearing loss (SFNIHL) were calculated, and each factor was compared between workers with and without HFNIHL. Chi-square test and analysis of trend were conducted among different groups of age, sex, exposure duration, A-weighted equivalent continuous sound pressure level normalized to a nominal 8-hour working day (LAeq,8h), and kurtosis. Logistic regression analysis was conducted to analyze the factors influencing the positive rates of HFNIHL and SFNIHL. Results The exposure rates of non-Gaussian noise was 73.6%. The positive rates of HFNIHL and SFNIHL were 32.6% (214 workers) and 6.7% (44 workers), respectively. The HFNIHL workers showed older age, higher proportion of male, longer exposure duration, higher noise intensity (LAeq,8 h), and increased kurtosis than those without HFNIHL (P<0.05). The positive rates of HFNIHL increased with the increase of age, exposure duration, LAeq,8 h, and kurtosis (\begin{document}$ {\chi
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Objective@#We conducted a meta-analysis of randomized controlled trials to explore whether vitamin D supplementation is beneficial for symptom improvement in children with autism spectrum disorder. @*Methods@#We systematically searched the PubMed database, EMBASE, Cochrane Library, Web of Science, Sino-Med, Wanfang Data, and China National Knowledge Infrastructure mainly up to September 2019. Using a fixed effects model, we calculated the standard mean difference with 95% confidence interval. Furthermore, we analyzed baseline serum 25-hydroxyvitamin D levels and outcome scores including the Social Responsiveness Scale and Child Autism Rating Scale scores after vitamin D supplementation. @*Results@#There was no significant difference in baseline serum 25-hydroxyvitamin D levels among 203 children included from three studies in the meta-analysis. After vitamin D supplementation, the outcome scores in the experimental group were dramatically elevated compared with those in the control group (p = 0.03). @*Conclusion@#Vitamin D supplementation improves the typical symptoms of autism spectrum disorder, as indicated by reduced Social Responsiveness Scale and Child Autism Rating Scale scores; thus, it is beneficial for children with autism spectrum disorder.
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Objective:To explore the predictive value of complement and coagulation indicators in sepsis related acute kidney injury (AKI).Methods:Clinical data of 217 patients with sepsis admitted to the Department of Internal Medicine and Intensive Care Unit of Affiliated Hospital of Jiangnan University from January 2018 to June 2019 were retrospectively analyzed. All patients were divided into sepsis with AKI group and without AKI group. Laboratory indicators of all patients were collected, including complement C 3, complement C 4, activated partial thrombin time (APTT), prothrombin time (PT), international normalized ratio (INR), D-dimer, procalcitonin(PCT), etc. logistic regression analysis was used to explore the risk factors of sepsis related AKI. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of independent risk factors. Results:Among 217 patients, 120 patients developed sepsis related AKI and 97 patients didn′t. PCT, lactic acid, PT, APTT, INR and D-dimer in AKI patients were significantly higher than those without AKI ( P<0.01). Complement C 3 and complement C 4 were significantly lower in AKI group ( P<0.01). Multivariate logistic regression analysis suggested that blood pressure<90/60 mmHg (1 mmHg=0.133 kPa)( OR=3.705, 95% CI 1.536-8.934, P=0.004), increased lactic acid ( OR=1.479, 95% CI 1.089-2.008, P=0.012), decreased complement C 3 ( OR=0.027, 95% CI 0.005-0.152, P<0.001) and prolonged APTT ( OR=1.090, 95% CI 1.047-1.137, P<0.001)were independent risk factors predicting AKI. The area under the ROC curve (AUC) of these multivariates were 0.741 (95% CI 0.675-0.807), 0.798 (95% CI 0.732-0.864), 0.712 (95% CI 0.643-0.781) and 0.716 (95% CI 0.648-0.783) respectively. The relevant sensitivity was 57.5%, 80.8%, 87.5%, 59.2%, and the specificity was 90.7%, 75.3%, 51.5%, 77.3%, respectively. The AUC of the combined four indicators was 0.880 (95 %CI 0.835-0.926) with the sensitivity 75.0% and the specificity 90.7%. Conclusion:The low level of complement C 3 and prolonged APTT predict sepsis related AKI, and the predictive value can be enhanced if hypotension and hyperlactacidemia are added.
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OBJECTIVE@#To prepare monoclonal antibody against cotinine (COT) and to establish immunoassay for detecting COT in human urinary samples.@*METHODS@#BALB/c mice were immunized with synthesized cotinine-bovine serum albumin (COT-BSA) to screen monoclonal antibody with technique of cell fusion. The monoclonal antibody was used for the indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) and colloidal gold immunochromatographic strip assay for the detection of COT in human urine.@*RESULTS@#The monoclonal antibody against COT was identified by ic-ELISA with a 50%inhibitive concentration (IC@*CONCLUSIONS@#The ic-ELISA and colloidal gold immunochromatographic strip assay using the prepared monoclonal antibody against COT have been proved to be reliable for the rapid detection of COT in human urines, which may be used for monitoring of environmental tobacco smoke.
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Animals , Humans , Mice , Antibodies, Monoclonal , Cotinine/urine , Enzyme-Linked Immunosorbent Assay , Gold Colloid , Mice, Inbred BALB C , Urinalysis/methodsABSTRACT
Objective:To analyze the serum 25-hydroxyvitamin [25(OH)D] nutritional status of children with febrile seizures in Luzhou area of Sichuan Province, and the relationship of 25(OH)D with gender, age and the local season, so as to provide reference for vitamin D supplementation and prevention of febrile seizures in children in this area.Methods:One hundred and sixty-seven children diagnosed with febrile seizures in the Affiliated Hospital of Southwest Medical University from January 2015 to July 2018 were enrolled in the febrile seizures group, and 170 children aged 0-8 years who underwent health examinations in the outpatient department in the same period were included in the healthy control group.The serum total calcium, serum 25(OH)D and hemoglobin level of children with febrile seizures were analyzed.The correlation of febrile seizures with the level of serum 25 (OH)D was evaluated from the aspects of children gender, age and season.Results:(1) The serum 25(OH)D level of healthy children [(40.6±3.07) μg/L] was significantly higher than that of the children with febrile seizures [(27.18±6.68) μg/L], and the diffe-rence was statistically significant ( t=3.15, P=0.03). The serum 25(OH)D level in children with febrile seizures decreased with age.There was no deficiency found in serum total calcium and hemoglobins of all children with febrile seizures.(2) The incidence rate of febrile seizures was the highest in January (35 cases, 20.96%) and in 2-year-old toddlers (72 cases, 44.91%). Boys were significantly more susceptible to febrile seizures than girls (1.73∶1.00). (3) The serum 25(OH)D level of children with febrile seizures in the region decreased in winter and summer (27.47-30.37 μg/L), and increased in spring and autumn (31.58-35.13 μg/L). The serum 25(OH)D level of children in winter [(27.47±1.80) μg/L] was statistically significantly different from that in spring [(31.58±1.31) μg/L] and in autumn [(35.13±3.93) μg/L] (all P<0.05). The serum 25(OH)D level in children with febrile seizures were inversely proportional to the high temperature in summer [T>35 ℃, 25(OH)D<30 μg/L]. The 25(OH)D level showed a downward trend when the temperature exceeded 35 degrees Celsius.The optimum temperature for children in this area to absorb vitamin D by sun-irradiation was 25-35 ℃. Conclusions:The occurrence of febrile seizures in children of all ages in Luzhou is closely related to the deficiency of vitamin D. Two-year-old boys are prone to be attacked by febrile seizures in January of each year.In addition to winter, children, especially those over 2 years old, are advised to supply vitamin D in high temperature periods in summer when outdoor activities are reduced.
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Objective To evaluate the role of hippocampal phosphatidylinositol 3-kinase/serinethreonine kinase/glycogen synthase kinase-3 beta (PI3K/Akt/GSK-3β) signaling pathway in dexmedetomidine-induced reduction of long-term cognitive decline caused by propofol in neonatal rats.Methods A total of 110 clean healthy male Sprague-Dawley rats,aged 7 days,weighing 10-15 g,were divided into 11 groups (n=10 each) using a random number table:normal saline group (NS group),fat emulsion group (F group),10％ dimethyl sulfoxide (DMSO) group (D2 group),dexmedetomidine group (DEX group),TDZD-8 group (TDZD group),10％ DMSO group (D1 group),LY294002 group (LY group),propofol group (P group),dexmedetomidine plus propofol group (PD group),LY294002 plus dexmedetomidine plus propofol group (LYPD group) and TDZD-8 plus dexmedetomidine plus propofol group (TDPD group).Normal saline,fat emulsion,10％ DMSO 100 μl,dexmedetomidine 75 μg/kg and TDZD-8 1 mg/kg were intraperitoneally injected in NS,F,D2,DEX and TDZD groups,respectively.10％ DMSO 5 μ1 and LY294002 25 μg/5 μl were injected via the lateral cerebral ventricle in D1 and LY groups,respectively.Propofol 50 mg/kg was intraperitoneally injected,and an increment of propofol 50 mg/kg was given after recovery of righting reflex in group P.Dexmedetomidine 75 μg/kg was intraperitoneally injected and 30 min later propofol was injected in group PD.LY294002 was injected,30 min later dexmedetomidine was injected,and 30 min later propofol was injected in group LYPD.In group TDPD,TDZD-8 was injected and the other treatment was similar to those previously described in group LYPD.Then the rats were fed to 9 weeks old after returning to the state of consciousness.Morris water maze test was performed to evaluate the cognitive function.Rats were then sacrificed and their hippocampi were harvested for detection of the expression of PI3K,Akt,GSK-3β and PSD95 mRNA (using real-time polymerase chain reaction) and expression of Akt,pAkt(ser473),GSK-3β,pGSK-3β(ser9) and PSD95 (by Western blot).Results Compared with NS group,the escape latency was significantly prolonged,the number of crossing the original platform was reduced,the expression of PI3K,Akt and PSD95 mRNA was down-regulated,the expression of GSK-3β mRNA was up-regulated,p-Akt(ser473)/Akt ratio was decreased,the expression of PSD95 was downregulated,and pGSK-3β (ser9)/GSK-3β ratio was increased in P group (P＜ 0.05).Compared with P group,the escape latency was significantly shortened and the number of crossing the original platform was increased in PD,LYPD and TDPD groups,the expression of PI3K,Akt and PSD95 mRNA was up-regulated,and the expression of GSK-3β mRNA was down-regulated in PD group,and pAkt(ser473)/Akt ratio was increased,the expression of PSD95 was up-regulated,and pGSK-3β (ser9)/GSK-3β ratio was decreased in PD and TDPD groups(P＜0.05).Compared with PD group,the escape latency was significantly prolonged,the number of crossing the original platform was reduced,the expression of GSK-3β mRNA was up-regulated,the expression of PSD95 mRNA was down-regulated,pAkt (ser473)/Akt ratio was decreased,the expression of PSD95 was down-regulated,and pGSK-3β (ser9)/GSK-3β ratio was increased in LYPD group,and the escape latency was significantly shortened,the number of crossing the original platform was increased,the expression of GSK-3β mRNA was down-regulated,the expression of PSD95 mRNA was up-regulated,pGSK-3β(ser9)/GSK-3β ratio was decreased,and the expression of PSD95 was up-regulated in TDPD group(P＜0.05).Conclusion Hippocampal PI3K/Akt/GSK-3β signaling pathway is involved in dexmedetomidine-induced reduction of long-term cognitive decline caused by propofol in neonatal rats.
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Objective To explore the long-term effects of dexmedetomidine on the brain development in propofol-induced neonatal rats.Methods Thirty-five seven-day-old Sprague-Dawley rats of both genders,weighing 10-15 g,were randomly divided into seven groups (n =5) using a random number table:normal saline group (group N),intralipid group (group F),propofol 100 mg/kg group (group P),dexmedetomidine 75 μg/kg (group D),dexmedetomidine 25 μg/kg,50 μg/kg and 75μg/kg+propofol 100 mg/kg groups (groups PD25,PD50 and PD75),neonatal rats in each group were treated according to the corresponding dosing regimen.After fully awake,the rats were allowed to mature until postnatal week 9 and the spatial learning and memory capacities were tested by Morris water maze.The rats were sacrificed after the tests.Brain was sliced for determination of hippocampal apoptosis by TUNEL assays and the expression of postsynaptic density protein 95 (PSD95) by immunohistochemistry.Results Compared with group N,the escape latency was significantly prolonged,the times of platform crossing were significantly decreased,the hippocampal apoptosis ratio was significantly increased and the expression of PSD95 was significantly down-regulated in groups P,PD25 and PD50 (P＜0.05).Compared with group P,the escape latency was significantly shortened,the times of platform crossing were significantly increased and the hippocampal apoptosis were significantly decreased in groups PD50 and PD75 (P＜0.05),the expression of PSD95 was up-regulated in group PD75 (P＜0.05).Compared with group PD25,the escape latency was significantly shortened,the number of platform crossing was significantly increased and the hippocampal apoptosis were significantly decreased in groups PD50 and PD75 (P＜0.05),the expression of PSD95 was significantly up-regulated in group PD75 (P＜0.05).Compared with group PD50,the hippocampal apoptosis were significantly decreased,the expression of PSD95 was significantly up-regulated in group PD75 (P＜ 0.05).Conclusion The addition of dexmedetomidine 50,75 μg/kg attenuates propofol-induced neurocognitive impairment in neonatal rats after aducthood,partially by attenuating hippocampal apoptosis and upregulating the expression of PSD95.Dexmedetomidine alone was not neurotoxic to the developing brain.
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Objective To evaluate the effect of dexmedetomidine on the activity of glycogen synthase kinase-3 beta (GSK-3β) during propofol-induced apoptosis in hippocampal nerve cells of newborn rats.Methods Sixty male 7-day-old Sprague-Dawley rats,weighing 10-15 g,were divided into 6 groups (n=10 each) using a random number table:normal saline group (group NS),fat emulsion group (group F),propofol group (group P) and different doses of dexmedetomindine groups (group D25,group D50 and group D75).Normal saline and fat emulsion 100 μl were injected intraperitoneally in group NS and group F,respectively.In group P,propofol 50 mg/kg was intraperitoneally injected,and an increment of propofol 50 mg/kg was added after righting reflex completely recovered,with the total amount of 100 mg/kg.In group D25,group D50 and group D75,dexmedetomidine 25,50 and 75 μg/kg were intraperitoneally injected,respectively,and 30 min later propofol 100 mg/kg was administered.At 2 h after emergence,the rats were sacrificed,their brains were removed for determination of apoptosis in hippocampal nerve cells (by TUNEL),and the hippocampi were isolated for detection of the expression of GSK-3β and phosphorylated GSK-3β (p-GSK-3β) by Western blot analysis.The apoptosis index (AI) and ratio of p-GSK-3β/GSK-3β were calculated.Results Compared with group NS,AI was significantly increased,the expression of p-GSK-3β was down-regulated,and the p-GSK-3β/GSK-3β ratio was decreased in P,D25,D50 and D75 groups (P＜0.05).Compared with group P,AI was significantly decreased,the expression of p-GSK-3β was up-regulated,and the p-GSK-3β/GSK-3β ratio was increased in D25,D50 and D75 groups (P＜0.05).Compared with group D25,AI was significantly decreased (P＜0.05),and no significant change was found in the expression of p-GSK-3β or ratio of p-GSK-3β/GSK-3β in D50 and D75 groups (P＞0.05).Compared with group D50,AI was significantly decreased (P＜0.05),and no significant change was found in the expression of p-GSK-3β or ratio of p-GSK-3β/GSK-3β in group D75 (P＞0.05).Conclusion The mechanism by which dexmedetomidine attenuates propofol-induced apoptosis in hippocampal nerve cells may be related to inhibition of GSK-3β activity in newborn rats.
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Objective To explore the effect of dexmedetomidine on phosphoinositide 3-kinase/protein kinase B (PI3K/Akt ) pathway in hippocampus of propofol anesthetized neonatal rats. Methods Eighty Sprague-Dawley male rats,aged 7 days,weighing 10-1 5 g,were randomly divided into 8 groups (n= 10 each):normal saline group (group N),DMSO group (group D),intralipid group (group I),propofol group (group P),dexmedetomidine 25 μg/kg,50 μg/kg and 75 μg/kg +propofol 100 mg/kg groups (groups PD25 ,PD50 and PD7 5 ),LY294002 25 μg + dexmedetomidine 75μg/kg + propofol 100 mg/kg group (group LYPD).The hippocampus of rats in all groups were taken 2 h after the animals fully awake.The ultrastructure of hippocampal neurons was observed by transmission electron microscope.The pAkt-(ser473 )protein and Akt protein in the hippocampus were evaluated by Western blot analysis.Results There was no significant difference in the expression of Akt protein among the eight groups.Compared with group N,the expression of pAkt (ser473)protein was significantly down-regulated in groups P,PD25 ,PD50 ,PD7 5 and LYPD (P <0.05).Compared with group P,the expression of pAkt (ser473)protein was increased significantly in groups PD7 5 and LYPD (P <0.05).Compared with group PD7 5 ,the expression of pAkt (ser473) protein was significantly down-regulated in group LYPD (P <0.05 ).The structure of hippocampal neurons was normal in groups N,I and D.Nuclear nuclei swelling,chromatin decreasing and mito-chondrion vacuolar degeneration were observed in group P while improved gradually with dexmedeto-midine in a dose-dependent manner in groups PD25 ,PD50 and PD7 5 .Neurons karyopyknosis,partial dissolution of nuclear membrane,chromatin condensation,mitochondria vacuolar degeneration were observed in group LYPD.Conclusion Dexmedetomidine pretreatment provides neuroprotection against propofol-induced hippocampal destruction by preserving PI3K/Akt pathway activity in the de-veloping brains.
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Objective To evaluate the effect of morphine on the growth of subcutaneous tumor of human gastric cancer cells in nude mice.Methods Thirty SPF male BALB/C nude mice,aged 4-5 weeks,weighing 15-20 g,in which the model of subcutaneous tumor of human gastric cancer cell line MGC-803 was established,were randomly divided into 3 groups (n=10 each) using a random number table:control group (group C),normal saline group (group N),and morphine group (group M).The mice in group C received no treatment.Morphine 20 mg/kg was intraperitoneally injected once a day for 14 consecutive days in group M,while normal saline 1.5 ml/kg was given instead of morphine in group N.The caliper was used to measure the tumor size every 2 days starting from 3 days after beginning of administration,and the relative tumor volume was calculated.The nude mice were sacrificed on 15th day,and the tumor tissues were obtained for determination of nuclear factor-kappa B activity and Bcl-2 and Bax protein and mRNA expression by real-time reverse transcriptase polymerase chain reaction and Western blot.Results Compared with group C,the relative tumor volume was significantly decreased,the activity of nuclear factor-kappa B in tumor tissues was significantly decreased,the expression of Bcl-2 protein and mRNA was significantly down-regulated,and the expression of Bax protein and mRNA was significantly up-regulated at each time point in group M (P＜0.05),and no significant change was found in each parameter mentioned above in group N (P＞0.05).Conclusion Morphine can inhibit the growth of subcutaneous tumor of human gastric cancer cells in nude mice,and the mechanism is associated with promotion of apoptosis in tumor cells.
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Objective To investigate the effect of establishing external device quality management system in the operating room of primary hospital.Methods 100 pieces external orthopaedic surgical instrument cleaned and packaged by company personnel in 2012 were randomly selected as control group,and 100 packages of orthopaedic surgical instrument cleaned by the professional of our hospital were randomly selected and set as the observation group.The cleaning quality of the two groups were compared.Results The numbers of no blood on the surface,sur-face of the device without rust,instrument storage box no stains,cloth bag no stains in the control group were 92,91, 86,90,respectively,which in the observation group were 99,98,97,98.The cleaning quality improved obviously in the observation group,and there were statistically significant differences between the two groups (χ2 =4.19,471,7.78, 5.67,all P <0.05).Conclusion To establishment of surgical patients external device quality management system in the operating room of primary hospital,standardized management of external devices,can ensure that the management and implementation of quality control of external devices in all aspects and to ensure clinical safety.
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Objective To analyze the characteristics of blood loss for laboratory test of critically ill premature infants,and to seek feasible measures to reduce the blood loss.Methods Two hundred and forty-six cases of critically ill premature infants admitted to the neonatal intensive care unit from April 2012 to April 2013 were analyzed the blood loss for test during the hospitalization and the clinical features of blood loss with different gestational age,different weight within the first four weeks after admission.Then the application of blood loss according to test category was described.The blood volume demanded in theory was determined by the formula B =5 (∑ s + 0.1),then calculated the phlebotomy overdraw on the basis of the practical blood loss and analyzed the characteristics of overdraw per patients per day in first two weeks after admission.Results Among 246 patients,The median blood loss figure was 25.57 ml for each infants with the range between 7.10 ml ～ 119.20 ml,and the blood loss concentrated in first four weeks,which showed a decreasing trend with time.There was a statistically significant difference(P ＜0.05)that the smaller gestational age,the lower birth weight,the more daily blood loss per patient per day in first two weeks,but no significant differences(P ＞ 0.05) between the third and fourth week.The largest proportion of the blood samples was used for clinical chemical tests(31.49％),followed by blood gas analysis (19.03％),immunoassays (12.69％),blood cultures (12.63％),hematology (12.28％).The practical blood loss was about twice times of blood volume demanded for tests in theory,which the median was 7.8 times to the latter(25.57 ml vs 3.26 ml).It showed statistically significant difference(P ＜0.05) between blood overdraw per patients per day in the first week and the second week.Compared with different gestational age and birth weight,the difference of overdraw was also statistically significant(P ＜0.05).According to test category,blood culture was the most significant samples of phlebotomy overdraw,followed by biochemical,other,blood gas analysis,the percentage was 76％,64％,45％ and 41％ respectively.Conclusion The blood loss for laboratory test and the phenomenon of blood waste is serious in critically ill preterm infants.The smaller the gestational age is,the lower the weight is,the amount of blood loss and phlebotomy overdraw are more significantly.Biochemical and blood gas analysis are the main items of blood loss.