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Background Sleep is a crucial physiological activity for the human body, and research has shown that air pollution can affect sleep quality. However, the association between polycyclic aromatic hydrocarbons (PAHs) exposure, neurotoxic compounds in air pollutants, and sleep quality remains uncertain. Objective To evaluate the association of PAHs exposure with sleep quality, and to provide evidence for improving sleep quality. Methods This study used a cross-sectional design. We selected 632 workers from a coking plant of a large state-owned enterprise as the exposure group, and 477 workers from the energy and power plant of the same enterprise as the control group. All workers worked in three shifts. A questionnaire survey was conducted to collect basic information including gender, years of service, age, educational level, smoking, alcohol consumption, consumption of fried foods, cooking frequency, types of cooking fuels. Worker's post-shift morning midstream urine was sampled to determine the concentrations of eight PAHs metabolites (OH-PAHs) using gas chromatography-tandem mass spectrometry (GC-MS). Worker's sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI). A higher PSQI score indicated a lower sleep quality. Associations of urinary OH-PAHs levels with sleep quality in the workers were analyzed using linear regression, Bayesian kernel-machine regression (BKMR), and quantile g-computation. Results The median (P25, P75) concentration of total OH-PAHs in the exposure group [88.84 (46.27, 151.96) μg·L−1] was higher than that in the control group [54.33 (24.86, 97.97) μg·L−1]. Additionally, the PSQI score (\begin{document}$ \overline{x}\pm {s} $\end{document}) in the exposure group (5.16±3.84) was higher than that in the control group (4.60±3.17). The multiple linear regression revealed that an increase in the sum of the concentrations of eight OH-PAHs after natural logarithmic transformation (lnΣ8OH-PAHs) was associated with an increase of 0.3646 (95%CI: 0.1337, 0.5955) in PSQI score, and an increase in lnΣlow-ring OH-PAHs was associated with an increase of 0.2954 (95%CI: 0.0941, 0.4967) in PSQI score. The BKMR analysis demonstrated that PSQI score was gradually increased as the increasing of lnΣ8OH-PAHs concentration. The quantile g-computation analysis indicated that a quantile increase in lnΣ8OH-PAHs concentration was associated with an increase of 0.4062% (95%CI: 0.1176%, 0.6949%) in PSQI score. Conclusion Compared to the controls, the coking workers show a higher concentration of urinary OH-PAHs and report worse sleep quality. The concentration of OH-PAHs is significantly negatively associated with sleep quality.
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@#Abstract: AIDS combined with Pneumocystis jirovecii pneumonia (PJP) and disseminated infections of Talaromyces marneffei and Cryptococcus neoformans are rare. This paper summarizes and analyzes the diagnosis and treatment of an AIDS patient with multiple fungal infections for reference. A 79-year-old male patient was admitted to the hospital with "stool habit change for more than 20 days". The white blood cell count was 4.57×109/L, the percentage of neutrophils was 81.8%, the absolute count of CD4+ lymphocytes was 6/μL, and the CD4/CD8 ratio was 0.17. HIV antibody positive was confirmed by CDC. The cerebrospinal fluid and alveolar lavage fluid were positive for Cryptococcus neoformans capsular antigen, and Pneumocystis jirovecii was found by the bronchoalveolar lavage fluid stained with hexamine silver. The cerebrospinal fluid culture was positive for Cryptococcus neoformans, and the blood culture was positive for Cryptococcus neoformans and Talaromyces marneffei. CT showed that bronchovascular bundles in both lungs were more thick, patchy and cable-like high-density shadows were seen in both lungs, and the edges were blurred. Nodular and cable-like high-density shadows were seen in the posterior apical segment of the left upper lobe, with clear margins. Infection of both lungs was considered, and secondary pulmonary tuberculosis occurred in the left upper lobe. After admission, the patient was treated with various anti-bacterial and fungal drugs due to recurrent fever, but the effect was not effective. The fever symptoms of the patient could not be significantly improved, and his condition continued to worsen, and he eventually died. The patient with AIDS complicated with bacterial and fungal infection, especially PJP infection in serious condifiton and has a poor prognosis for rapid development, so clinical attention should be paid to.
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PURPOSE@#To investigate whether dexmedetomidine (Dex) can reduce the production of inflammatory factor IL-1β by inhibiting the activation of NLRP3 inflammasome in hippocampal microglia, thereby alleviating the inflammatory response of the central nervous system induced by surgical injury.@*METHODS@#Exploratory laparotomy was used in experimental models in this study. Totally 48 Sprague Dawley male rats were randomly divided into 4 groups (n = 12 for each), respectively sham control (group A), laparotomy only (group B); and Dex treatment with different doses of 5 μg/kg (group D1) or 10 μg/kg (group D2). Rats in groups D1 and D2 were intraperitoneally injected with corresponding doses of Dex every 6 h. The rats were sacrificed 12 h after operation; the hippocampus tissues were isolated, and frozen sections were made. The microglia activation was estimated by immunohistochemistry. The protein expression of NLRP3, caspase-1, ASC and IL-1β were detected by immunoblotting. All data were presented as mean ± standard deviation, and independent sample t test was used to analyze the statistical difference between groups.@*RESULTS@#The activated microglia in the hippocampus of the rats significantly increased after laparotomy (group B vs. sham control, p < 0.01). After Dex treatment, the number was decreased in a dose-dependent way (group D1 vs. D2, p < 0.05), however the activated microglia in both groups were still higher than that of sham controls (both p < 0.05). Further Western blot analysis showed that the protein expression levels of NLRP3, caspase-1, ASC and downstream cytokine IL-1β in the hippocampus from the laparotomy group were significantly higher than those of the sham control group (all p < 0.01). The elevated expression of these proteins was relieved after Dex treatment, also in a dose-dependent way (D2 vs. D1 group, p < 0.05).@*CONCLUSION@#Dex can inhibit the activation of microglia and NLRP3 inflammasome in the hippocampus of rats after operation, and the synthesis and secretion of IL-1β are also reduced in a dose-dependent manner by using Dex. Hence, Dex can alleviate inflammation activation on the central nervous system induced by surgical injury.
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Animals , Male , Dexmedetomidine , Pharmacology , Dose-Response Relationship, Drug , Hippocampus , Metabolism , Immunohistochemistry , Inflammasomes , Metabolism , Inflammation Mediators , Metabolism , Injections, Intraperitoneal , Interleukin-1beta , Metabolism , Laparotomy , Microglia , Metabolism , NLR Family, Pyrin Domain-Containing 3 Protein , Metabolism , Rats, Sprague-Dawley , Time FactorsABSTRACT
Objective To measure the extracerebral space width of normal infants with magnetic resonance imaging(MRI)and observe the variation tendency with age for quantitative diagnosis of hydrocephalus.Methods We measured the distance of interhemispheric fissure and bilateral frontal subarachnoid space on MRI images of 213 normal infants.The width of extracerebral space was expressed as mean ± standard deviation.The gender and bilateral differences were compared by rank sum test,and the variation trend of extracerebral space with age was observed by the scatterplots fitting regression curve.Results The width of infant extracerebral space had two milestones,4-month-old extracerebral space was the widest,and the amplitude of variation tended to be mild after 1 year of age.There was no significant difference between the genders in gap of extracerebral space(P＞ 0.05). However,bilateral frontal subarachnoid space differed significantly between genders(P＜0.05).Conclusion The width of extracerebral space,a dynamic process with age in infants,is most pronounced under 10 months old.The accurate diagnosis of pathological external hydrocephalus should be based on the reference value of the extracerebral space at different months,and it is very important to combine it closely with clinical history.
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Objective To investigate the impact of a single sub-anesthetic dose of ketamine on postoperative emotional reactions of anxiety and depression during colorectal tumors surgery. Methods A total of 42 patients undergoing selective colorectal surgery,aged 18 to 65 years,were randomly divided into ketamine group (group K)and control group (group C).After induction of an-esthesia,a single intravenous injection of 0.3 mg/kg ketamine and saline were used in Group K and group C 5 minutes before the operation respectively.The intravenous analgesia program was identical between the two groups.The patients??emotional reactions (anxiety,depression)were assessed using the Hospital Anxiety and Depression Scale (HAD),the quality of recovery was assessed using the QoR-40 questionnaire on the day before operation and within postoperative 48 hours respectively.Pain was estimated by the visual analog scale (VAS)and sedation was assessed with Ramsay score 30 mi-nutes after extubation.The time of anesthetic end and extubation were recorded.The complications during anesthesia and recovery such as cough, agitation 30 minutes extubation were recorded. Results The HAD-A and HAD-D scores of group K were lower than group C (P <0.05)48 h post-operatively.There was no difference on the QoR-40 score postoperative 48 h between the two groups. The patients??emotional state QoR-40 score of group K were higher than group C (P <0.05 ).The VAS scores 30 minutes after extubation of group K were lower than group C (P <0.05).There was no significant difference on sedation score 30 minutes postoperatively between the two groups.There was no significant difference in extubation time,cough,agitation and delirium between the two groups.There was no dizziness, nausea, vomiting or diplopia 30 minutes after extubation. Conclusion A single subanesthetic dose of ketamine can significantly reduce the scores of postopera-tive anxiety and depression,improve the quality of recovery,and no postoperative adverse reactions increased.
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OBJECTIVE:To observe the clinical efficacy and safety of Kudiezi injection combined with alprostadil in the treat-ment of posterior circulation ischemic vertigo. METHODS:Totally 180 patients with posterior circulation ischemia were randomly divided into group A,group B and group C. All patients were given aspirin,atorvastatin,nutrition nerve,antihypertensive,hypo-glycemic and other conventional treatment. On this basis,group A was given Alprostadil injection 10 μg,adding into 0.9% Sodium chloride injection 100 ml,iv,once a day;Kudiezi injection 30 ml,adding into 0.9% Sodium chloride injection 250 ml,iv,once a day. Group B was given Alprostadil injection(the same usage as group A);group C was given Kudiezi injection(the same usage as group A). The course was 14 d. The clinic data was observed,including clinical efficacy;blood flow velocity in left vertebral ar-tery(LVA),blood flow velocity in right vertebral artery(RVA),blood flow velocity of basilar artery(BA),changes of peak laten-cy(PL)and incubation period latency(IPL)before and after treatment;and the incidence of adverse reactions. RESULTS:The to-tal effective rate in group A was significantly higher than group B and C,with significant difference(P0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Kudiezi injection combined with alprostadil has better effica-cy than only Kudiezi injection or alprostadil in the treatment of posterior circulation ischemic vertigo,with good safety.
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Parenting stress is regarded as a criterion to evaluate the parent's mentation of children with chronic illness,it not only influence parent's care of children,but also decrease the quality of children's life.Si multaneously,it is a main reason of family imbalance.This paper introduces the definition of parenting stress and evaluation tool summarizes the cunent situation of research in abwad,provides a foundation in order to promote the research of parenting stress among caregivers of children with chronic illness.
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Pediatric medical traumatic stress is a new research which is based on posttraumatic stress,which is attracting more and more nursing workers' attention.The paper gives a brief introduction of pediatric medical traumatic stress and its related symptom,summarizes the achievement abroad,learns the experience of pediatric medical traumatic stress abroad,provides a reference for nursing workers to have a better understanding of pediatric medical traumatic stress in order to let the sick children receive better treatment.
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<p><b>OBJECTIVE</b>To construct and compare the immunogenicities of DNA vaccines expressing pol genes derived from B`/C and A/E recombinant subtypes of HIV-1 in China.</p><p><b>METHODS</b>Two DNA vaccines were constructed by inserting the codon optimized pol genes derived from B'/C and A/E subtypes of HIV-1 into mammalian expression vector pSV1.0. In vitro expression efficiencies of the two DNA vaccines were determined by Western blotting and their immunogenicities were compared by i.m. immunizing female BALB/c mice. After immunization, mice splenocytes were isolated sterilely and IFN-γ based enzyme linked immunospot assay (ELISPOT) was employed to read out the specific T cell immunity.</p><p><b>RESULTS</b>The constructed DNA vaccines were validated by restriction enzyme digestion and DNA sequencing. Western blotting result showed both of the two DNA vaccines could be expressed at appreciable levels in vitro. Under the stimulation of Consensus B Pol peptide pools, specific T cell frequency elicited by pSVAE-Pol was (636±178) SFCs/10(6) splenocytes; specific T cell frequency elicited by pSVCN-Pol was (468±265)SFCs/10(6) splenocytes (P=0.412). Under the stimulation of HIV-1 AE2f Pol peptide pools, specific T cell frequency elicited by pSVAE-Pol was (1378±611) SFCs/10(6) splenocytes; specific T cell frequency elicited by pSVCN-Pol was (713±61) SFCs/10(6) splenocytes (P=0.134). Further analysis suggested pSVAE-Pol induced specific T cell responses mainly focused on Pol 1 peptide pool, while, in addition to induce Pol 1 specific T cell responses, pSVCN-Pol could also elicit T cell responses against consensus B Pol 2 peptide pool.</p><p><b>CONCLUSION</b>Although pSVAE-Pol was more immunogenic, pSVCN-Pol could induce T cell responses against broader epitope spectrum. Rational vaccine design may need combine them together.</p>
Subject(s)
Animals , Female , Mice , AIDS Vaccines , Genetics , Allergy and Immunology , Genes, pol , Allergy and Immunology , HIV-1 , Genetics , Allergy and Immunology , Immunity, Cellular , Immunization , Mice, Inbred BALB C , T-Lymphocytes , Allergy and Immunology , Vaccines, DNA , Genetics , Allergy and ImmunologyABSTRACT
Background Bevacizumab is primarily aimed at pathologic angiogenesis for off-label uses such as the treatment of ocular neovascular disorders.However,as a new anti-fibrotic and anti-angiogenic agent following trabeculectomy,the safety and efficacy of bevacizumab by multiple-time and high-dose subconjunctival injection are still under study.Objective This study was to assess the safety and efficacy of bevacizumab after multiple-time and high-dose subconjunctival injections.Methods Regular trabeculectomy filtration surgery was performed on both eyes of 18 clean New Zealand White rabbits 0.1ml of bevacizumab(25g/L) was subconjunctivally injected intraoperatively and 3,5,7 days postoperatively in the left eyes of rabbits,and no any intervene in the right eyes were as normal controls.Bleb morphology was examined every 2 days and graded based on Moorefield's criteria and compared between the bevacizumab-treated eyes and normal saline(NS) eyes.The animals were sacrificed at 10,20 and 30 days after surgery respectively.The histopathological changes of the blebs were detected by hematoxylin and eosin stain to evaluate the cellular element around the bleb,and Masson stain was used to assess the degree of fibroblast proliferation.The degree of vascularity of bleb was identified by anti-vWf stain.Approval of this protocol was obtained and permitted from People's Hospital Institutional Animal Care and Use Committee of Peking University.The use of experimental animals complied with the Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results Compared to the NS-treated eyes,bevacizumab-treated eyes showed the larger and more diffusely elevated blebs with the significant difference(2.48±0.22cm2 versus 1.73±0.27cm2,t=5.194,P＜0.05).The survival time of the filtration bleb in bevacizumab panel was longer in bevacizumab-treated eyes compared to control eyes,showing a significantly difference between them(21.0±1.56 days versus 12.5±1.97 days,t=3.830,P=0.005).Histological and immunohistochemical analysis confirmed that bleb and adjacent conjunctiva vascularity(A value) was significantly less in bevacizumab-treated eyes than that in control eyes at 20 days after surgery with the difference value 14320.7±4134.9(t=12.275,P＜0.05),and fibroblast deposition value was evidently diminished after bevacizumab treatment at 30 days following surgery in comparison with control eyes with the mean difference 0.27±0.03(t=15.980,P＜0.05＝.Conclusion Repeated subconjunctival injection of bevacizumab can effectively prolong the survival time of bleb in a rabbit model of trabeculectomy and limit the degree and area of vascularization in 30 days following surgery.Bevacizumab inhibit fibroblast-meditated tissue formation significantly in the later phase of vascularization after trabeculectomy.
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<p><b>OBJECTIVE</b>To investigate the efficacy and mechanism of Fangchuan Mixture (FCM) in treating children with mild continuous asthma.</p><p><b>METHODS</b>One hundred and seventy-five patients in the three groups were treated with FCM (A), Flixotide (B), and the combination of FCM and Flixotide (C), respectively for 12 weeks. Their condition of asthma and TCM syndrome were observed, peak expiratory flow (PEF) and serum levels of immunoglobulin (Ig), interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) were determined.</p><p><b>RESULTS</b>All the indexes determined were improved significantly in the three groups after treatment (P <0.05). Paired comparison among groups showed that the improvements in non-asthma time, time required beta-receptor activator, expectoration, complexion, appetite, and increasing serum IFN-gamma after treatment were superior in Group C than in Group A and B (P <0.05); the improvements in hidrosis, faint pulse and decreasing serum IL-4 level in Group A and C were better than those in Group B (P <0.05), and the effect for alleviating symptoms of rhinitis such as nasal obstruction and nasal discharge in Group C was more significant than that in Group B (P <0.05).</p><p><b>CONCLUSION</b>FCM could attenuate the allergic inflammation of bronchi to improve its hypersensitive state in children with asthma, and shows a cooperative action with Flixotide.</p>
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Adolescent , Child , Child, Preschool , Female , Humans , Male , Androstadienes , Therapeutic Uses , Asthma , Drug Therapy , Bronchodilator Agents , Therapeutic Uses , Drug Therapy, Combination , Drugs, Chinese Herbal , Therapeutic Uses , Fluticasone , Phytotherapy , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate an enzymatic method for determining serum beta-hydroxybutyrate (beta-HB) with the National Committee for Clinical Laboratory Standards (NCCLS) projects, and to discuss its clinical values in diabetic ketoacidosis (DKA).</p><p><b>METHODS</b>The precision, accuracy, specificity, linearity and interference of the enzymatic method were analyzed. This method was used to determine serum beta-HB in 60 cases of normals, 50 cases of diabetes, and 34 cases of DKA by autochemistry analyzer.</p><p><b>RESULTS</b>Enzymatic beta-HB assay was precise (within-run CV, day-to-day CV, and total CV < 5%). The linearity studies showed the method was linear up to 4 mmol/L. Recovery rate was 98.5%-104.1%. Hemolysis (Hemoglobin up to 18.2 g/L), icteric samples with total bilirubin up to 224 mumol/L, and lipemia up to triglyceride concentration of 2.28 mmol/L did not interfere with the beta-HB results in this method. Serum beta-HB levels were significantly elevated in DKA patients compared with DM patients and controls (P < 0.01). Positive rate of serum beta-HB in DKA patients was significantly higher than that of urinary ketone (P < 0.05).</p><p><b>CONCLUSIONS</b>Enzymatic method is convenient and reliable, allows full automation, and is rapid enough to be used for both routine and urgent determinations of serum beta-HB. It can be used in diagnosing and monitoring treatment of DKA.</p>
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Adolescent , Adult , Female , Humans , Male , Middle Aged , 3-Hydroxybutyric Acid , Blood , Autoanalysis , Diabetes Mellitus , Blood , Diabetic Ketoacidosis , Blood , Evaluation Studies as TopicABSTRACT
<p><b>OBJECTIVE</b>To find a simple, fast, accurate, and quantitative PCR-based method for mutation detection, so as to identify mitochondrial DNA 11778 G-->A point mutation in patients with Leber's hereditary optic neuropathy (LHON).</p><p><b>METHOD</b>On the basis of sequencing of mtDNA from LHON proband, M primer for mutation and N primer for normal were designed to be coupled with reverse primer respectively. Specific PCRs were done on an amplifying condition with high stringency such as a well controlled annealing temperature, low Mg2+ concentration and less thermal cycles. The objective pedigree includes 10 individuals, were against 40 normal control persons.</p><p><b>RESULTS</b>Different ratios of indicative mtDNA 11778A-->G mutation were checked out from the proband, affected maternal members and a 10 year-old boy (up to now no appearance yet), whereas not appeared on normal spouses, paternal offsprings in the family, neither did on 40 controls.</p><p><b>CONCLUSION</b>This site-specific PCR method is a kind of general mutation analysis way, without the restriction of existence of endonuclease site. It can be applied for the gene diagnosis of known-mutation hereditary diseases such as LHON.</p>
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Adult , Female , Humans , Male , DNA, Mitochondrial , Genetics , Optic Atrophy, Hereditary, Leber , Genetics , Pedigree , Point Mutation , Polymerase Chain Reaction , MethodsABSTRACT
To clarify the prognostic contribution of peripheral blood cell and bone marrow megakaryocyte counts in patients with idiopathic thrombocytopenic purpura, a series of data of 299 ITP patients including the counts of peripheral white blood cells and platelets, their increase potentials after treatment and the megakaryocytic counts on the bone marrow smears at diagnosis as well were collected and retrospectively analyzed to correlate with the disease development. The results showed that peripheral white blood cell and platelet counts at diagnosis were not associated with the prognosis, but positively associated with the increment of platelet counts after treatment. The cure rate reached up to 94.9% in the group with the platelet level restored to 100 x 10(9)/L in two weeks of therapy. The numerous megakaryocyte counts in bone marrow at diagnosis indicated good prognosis that the cure rate was up to 86.1% when the counts were more than 100 per 1.5 x 3 cm of smear. In conclusion, bone marrow examination on the quantity and quality of megakaryocyte would be critical for diagnosis and evaluation of the prognosis. Consecutive platelet counts during therapy is useful to estimate the disease development.
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Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Bone Marrow Cells , Cell Biology , Leukocyte Count , Megakaryocytes , Cell Biology , Platelet Count , Prognosis , Purpura, Thrombocytopenic, Idiopathic , Blood , TherapeuticsABSTRACT
To investigate contribution of soluble interleukin-2 receptor (SIL-2R) to the clinical progress of idiopathic thrombocytopenic purpura (ITP), SIL-2R levels were measured in the plasma of 34 patients and 34 normal controls with double antibody sandwich ELISA. The cohort consisted of 12 patients with chronic ITP, 15 with acute ITP and 7 with ITP in remission. The results showed that the mean SIL-2R level of chronic ITP group was significantly higher than those of both the control and acute ITP group (P < 0.001 and P < 0.01, respectively). The SIL-2R level of 7 cases in remission, however, was not significantly different from that of normal controls. Furthermore, the plasma levels were dramatically lowered in patients responsive to VLAP regimen (vincristine, L-imidazole, antaisu and prednisone), and those were not evidently decreased in unresponsive patients. It was concluded that T cell activation may play a role in the development of ITP, and further, the level of plasma SIL-2R might predict the prognosis of ITP.
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Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Purpura, Thrombocytopenic, Idiopathic , Drug Therapy , Allergy and Immunology , Receptors, Interleukin-2 , BloodABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of two kinds homogenous assays for direct determination of high-density lipoprotein cholesterol (HDL-C) based on the principle of polyanion polymer/detergent (PPD method) and polyethylene glycol-modified enzyme (PEGME) method.</p><p><b>METHODS</b>The two homogenous methods were compared with the precipitation method (PTA-Mg2+ method), their precision, accuracy, specificity and interference were also analyzed.</p><p><b>RESULTS</b>Both homogenous HDL-C assays were precise, having a within-run CV < 3%, day-to-day CV < 3% and total CV < 4%. The HDL-C values measured by the two homogenous methods correlated well with those by PTA-Mg2+ method (X): Y = 0.9316 X + 0.1063, r = 0.9762 for PPD method (Y); and Y = 0.9106 X + 0.1368, r = 0.9894 for PEGME method (Y). The linearity studies showed the two homogenous methods to be linear up to 4.14 mmol/L. The lowest detectable concentration of the two methods was apparently 0.08 mmol/L. Recoveries of the two methods were 94.1%-106.2%. Hemoglobin did not interfere with the HDL-C results in the two homogenous methods, whereas icteric samples with total bilirubin > 200 mg/L showed discrepancies. Lipemia up to triglyceride concentration of 17.0 mmol/L did not interfere with the two homogenous HDL-C assays.</p><p><b>CONCLUSIONS</b>The two new homogenous HDL-C assays meet the requirements for accuracy, precision, ease of handling with massive sample, allow full automation, and are clinically useful.</p>