Application of a light-weighted convolutional neural network for automatic recognition of coal workers' pneumoconiosis in the early stage / 中华劳动卫生职业病杂志

Objective: To construct and verify a light-weighted convolutional neural network (CNN), and explore its application value for screening the early stage (subcategory 0/1 and stage Ⅰ of pneumoconiosis) of coal workers' pneumoconiosis (CWP) from digital chest radiography (DR) . Methods: A total of 1225 DR images of coal workers who were examined at an Occupational Disease Prevention and Control Institute in Anhui Province from October 2018 to March 2021 were retrospectively collected. All DR images were collectively diagnosed by 3 radiologists with diagnostic qualifications and gave diagnostic results. There were 692 DR images with small opacity profusion 0/- or 0/0 and 533 DR images with small opacity profusion 0/1 to stage Ⅲ of pneumoconiosis. The original chest radiographs were preprocessed differently to generate four datasets, namely 16-bit grayscale original image set (Origin16), 8-bit grayscale original image set (Origin 8), 16-bit grayscale histogram equalized image set (HE16) and 8-bit grayscale histogram equalized image set (HE8). The light-weighted CNN, ShuffleNet, was applied to train the generated prediction model on the four datasets separately. The performance of the four models for pneumoconiosis prediction was evaluated on a test set containing 130 DR images using measures such as the receiver operating characteristic (ROC) curve, accuracy, sensitivity, specificity, and Youden index. The Kappa consistency test was used to compare the agreement between the model predictions and the physician diagnosed pneumoconiosis results. Results: Origin16 model achieved the highest ROC area under the curve (AUC=0.958), accuracy (92.3%), specificity (92.9%), and Youden index (0.8452) for predicting pneumoconiosis, with a sensitivity of 91.7%. And the highest consistency between identification and physician diagnosis was observed for Origin16 model (Kappa value was 0.845, 95%CI: 0.753-0.937, P<0.001). HE16 model had the highest sensitivity (98.3%) . Conclusion: The light-weighted CNN ShuffleNet model can efficiently identify the early stages of CWP, and its application in the early screening of CWP can effectively improve physicians' work efficiency.

Effects of heat exposure and vitamin C intervention on oxidative stress and blood pressure changes in treadmill rats / 中华劳动卫生职业病杂志

Objective: To investigate the effect of oxidative stress caused by heat exposure on the blood pressure increase of treadmill rats and the intervention of antioxidants. Methods: In June 2021, Twenty-four healthy SD male rats were randomly divided into four groups: normal temperature feeding, normal temperature treadmill, high temperature treadmill and high temperature treadmill supplementation with vitamin C groups, 6 rats in each group. The rats run on the platform in normal temperature or heat exposure environment for 30 min in the morning and in the afternoon daily, 6 days per week. The daily vitamin C supplement dose of high temperature treadmill supplementation with vitamin C group was 10 mg/kg. BP recordings were done at the end of the week. The rat vascular lipofuscin (LF) was detected by ELISA, the rat serum nitric oxide (NO) was detected by nitrate reductase method, the serum malondialdehyde (MDA) was detected by thibabituric acid method, the serum glutathione peroxidase (GPx) and superoxide dismutase (SOD) were detected by chemiluminescence method, and the serum catalase (CAT) was detected by ammonium molybdate method. The total antioxidant capacity (T-AOC) of serum was measured by iron reduction/antioxidant capacity method, and the content of nuclear erythroid 2-related factor 2 (Nrf2) in vascular tissue was measured by Western blot. The intra-group mean was compared by repeated measurement analysis of variance, and the inter-group mean was compared by single-factor analysis of variance and post-event LSD-t test. Results: Compared with the previous time point, the systolic BP and diastolic BP of the high temperature treadmill group were significantly increased at 7, 14 and 21 d, and decreased at 28 d which were higher than the initial level (P<0.05), and the systolic BP and diastolic BP values at each experimental time point were significantly higher than those of normal temperature treadmill group (P<0.001). The changes of thickening of the artery wall, no smoothing of the endodermis and irregular arrangement of muscle cells in high temperature treadmill group were observed. Compared with the normal temperature treadmill group, the content of MDA in serum, and LF in vascular tissue were significantly increased, the activities of SOD, CAT, T-AOC, the content of NO in serum, and the expression of Nrf2 in vascular tissue were significantly decreased in high temperature treadmill group (P<0.05). Compared with the high temperature treadmill group, the systolic BP and diastolic BP values at 7, 14, 21 and 28 d, the content of serum MDA and LF in vascular tissue were significantly decreased, the activities of CAT and T-AOC, and the expression of Nrf2 in vascular tissue significantly increased (P<0.05), the histopathological changes of the artery wall improved in high temperature treadmill supplementation with vitamin C group. Conclusion: Heat exposure has effect on oxidative stress, which may be related to the increase of BP. Vitamin C as an anti-oxidative enhancer can prevent those negative effects, which could alleviate the pathological changes of vessel intima in heat-exposed rats. And the Nrf2 may be a regulated factor to vascular protection.

Correlation between intestinal and respiratory flora and their metabolites in a rat pneumoconiosis model / 中华劳动卫生职业病杂志

Objective: Differential flora and differential metabolites shared by the intestinal and respiratory tracts of rats were screened to analyze the possible role of changes in intestinal flora and metabolites in the progression of pneumoconiosis in rats. Methods: In April 2020, 18 SD rats were randomly divided into three groups (control group, coal mine dust group and silica group, 6 in each group) , rats in the coal mine dust group and silica group were perfused with 1 ml of 50 mg/ml coal mine well dust suspension and silica suspension by nontracheal exposure, respectively. While rats in the control group were perfused with an equal dose of sterilized normal saline. Twenty four weeks after dust staining, rat feces, throat swabs, and lung lavages were collected. 16SrDNA gene sequencing and UHPLC-QTOF-MS untargeted metabolomics were used to analyze the flora and metabolites in feces, throat swabs and lung lavage fluid of rats in each group, to screen for shared differential flora and shared differential metabolites in intestinal and respiratory tract, and the correlation analysis between the differential flora and metabolites was performed using Spearman's statistics. Results: Compared with the control group, a total of 9 species shared differential flora between intestinal and respiratory tract were screened at phylum level, and a total of 9 species shared differential genus between intestinal and respiratory tract were screened at genus level in the coal mine dust group, mainly Firmicutes, Actinobacteria, Streptococcus, Lactobacillus, etc. Compared with the control group, a total of 9 shared differential flora were screened at the phylum level, and a total of 5 shared differential genus were screened at the genus level in the silica group, mainly Proteobacteria, Actinobacteria, Allobactera, Mucilaginibacter, etc. Compared with the control group, a total of 7 shared differential metabolites were screened for up-regulation of Stigmatellin, Linalool oxide and Isoleucine-leucine in both intestinal and respiratory tract in the coal mine dust group. Compared with the control group , a total of 19 shared differential metabolites werescreened in the silica group, of which Diethanolamine, 1-Aminocyclopropanecarboxylic acid, Isoleucine-leucine, Sphingosine, Palmitic acid, D-sphinganine, 1, 2-dioleoyl-sn-glycero-3-phosphatidylcholine, and 1-Stearoyl-2-oleoyl-sn-glycerol 3-phosphocholine were up-regulated in both the intestinal and respiratory tract. Conclusion: There is a translocation of intestinal and respiratory flora in pneumoconiosis rats, and rats have an imbalance of lipid metabolism during the progression of pneumoconiosis.

Development of Plantar Force Assessment Model for Patients with Patellofemoral Pain / 医用生物力学

Objective To develop plantar force model of patellofemoral pain (PFP), so as to provide theoretical references for the assessment of PFP rehabilitation. Methods The case-control study was conducted, and a total of 126 patients with PFP and 126 healthy controls matched by gender and age were enrolled in the study. The participants were tested for plantar force and pressure during level walking, and twelve plantar regions were divided and recorded. Whether the participants suffered PFP was analyzed as dependent variable, meanwhile the peak force and peak pressure in 12 plantar regions of participants at selected speed during level walking were analyzed as independent variables. Conditional logistic regression (CLR) equations of peak force and peak pressure with PFP were established, respectively. The receiver-operating characteristic (ROC) curve of the corresponding equations was derived, and the area under ROC curve was calculated to analyzed the validity of different equations on PFP assessment. Results The CLC equation of peak force in 12 plantar regions of the participants with FFP was constructed, and only peak force of lateral heel was in the equation. The CLC equation of peak pressure in each plantar region included medial heel, midfoot, 1st and 2nd metatarsals. Meanwhile, the area under ROC curve of the pressure equation was larger than that of the force equation. Conclusions Peak force and pressure at different plantar regions can be used to assess PFP during level walking, and peak pressure is more effective for assessment.

Prediction of occupational coal workers′ pneumoconiosis incidence by a multi-layer perceptron neural network model / 中国职业医学

OBJECTIVE: To construct and verify the incidence prediction model of occupational coal workers′ pneumoconiosis(CWP) in coal mine workers exposed to dust(hereinafter referred to as ″dust exposure″) based on a multi-layer perceptron(MLP) neural network, and explore its application value in predicting CWP incidence. METHODS: A total of 17 023 dust exposed workers in a coal mining group in Hebei Province from 1970 to 2017 were selected as the research subjects by a typical sampling method. Among them, 839 patients were confirmed as CWP and 16 185 workers did not suffered from CWP. The MLP neural network model was established with the incidence of CWP as the target output variable, and the type of work, age, beginning year of dust exposure, observation year(i.e. incubation period) and cumulative dust exposure as the input variable. The receiver operating characteristic(ROC) curve was used to evaluate the predictive ability of the built model. The established model was used to predict the high-risk group and key monitoring group population of CWP in dust-exposed workers in the following 10 years. RESULTS: There were 44 synapses in the hidden layer of the established MLP neural network model. The area under ROC curve was 0.91. The accuracy, sensitivity and specificity of the model were 92.7%, 74.8% and 93.6%, respectively. In the validation samples, the accuracy, sensitivity and specificity were 92.1%, 70.5% and 93.2%, respectively. The MLP neural network model was used to predict 1 534 workers with high risk of CWP in the following 10 years, and the individuals were located. The number of workers in need of actively monitored was 7 599. Among them, it is predicted that the incidence of CWP in different types of dust exposed workers in the following 10 years from high to low is tunneling worker, coal miner, mixing worker and auxiliary worker(P<0.01). The earlier the dust exposure began, the higher the risk of CWP(P<0.01). CONCLUSION: The MLP neural network model based on the type of work, age, beginning year of dust exposure, incubation period and cumulative dust exposure has a good performance in predicting the incidence of CWP in coal mine dust exposure workers, and can provide a reference for early preventive management measures to prevent and cure CWP.

Analysis on protein expression of ferritin light chain in alveolar macrophages of patients with occupational silicosis / 中国职业医学

OBJECTIVE: To observe the protein expression of ferritin light chain(FTL) in alveolar macrophages(AM) of patients with occupational silicosis(hereinafter referred to as silicosis). METHODS: The male patients with silicosis at stage Ⅰ, Ⅱ, and Ⅲ were separately selected as the silicosis groupⅠ, Ⅱ, and Ⅲ using judgment sampling method, with 15 patients in each group. Meanwhile, 15 male silicon dust workers with small lung shadows but not diagnosed as silicosis were selected as the control group. Bronchoalveolar lavage fluid was collected from the four groups, and AM was separated and purified, and protein was extracted after lysis of the AM. Western blotting was used to detect the relative expression of FTL protein in the AM. RESULTS: The relative expression of FTL protein in AM of silicosis groupⅠ, Ⅱ, and Ⅲ was lower than that in the control group(all P<0.05). The relative expression of FTL protein in AM decreased with the increase of silicosis stage(P<0.05).CONCLUSION: The expression of FTL protein in AM was down-regulated in patients with silicosis in a dose-response manner. It is speculated that FTL may have a negative regulatory effect in the progress of silicosis fibrosis.

Value of quantitative MRI T2WI parameters in predicting surgical outcome of thoracic ossification of the ligamentum flavum / 中国组织工程研究

BACKGROUND: MRI has high sensitivity to thoracic myelopathy, which can assess the spinal cord injury by morphology and magnitude of cervical spinal cord compression. Additionally, it is a valuable tool for the prognosis evaluation of thoracic spinal stenosis. OBJECTIVE: To explore the value of quantitative MRI T2WI parameters in predicting surgical outcome of thoracic ossification of the ligamentum flavum, and to establish the prediction model of poor prognosis, so as to provide reference for prognosis evaluation. METHODS: From January 2010 to January 2019 at Cangzhou Central Hospital, clinical and imaging data of 87 cases of thoracic ossification of the ligamentum flavum treated by thoracic laminectomy were reviewed retrospectively. According to the JOA recovery rate at 6-month follow-up, the patients were divided into good recovery group (≥ 50%) and poor recovery group (< 50%). Age, sex, duration of disease, JOA score, Sato type of ossification, maximum spinal cord compression, cross-sectional area, distribution of hyperintense signal, signal intensity ratio, intramedullary signal size, local kyphosis, kyphosis correction, number of decompressed levels and incidence of cerebrospinal fluid were compared between two groups. Univariate analysis was used to analyze indicators with significant differences. Receiver operating characteristic curve was plotted to analyze prognosis. Areas under the curve and cut-off values were recorded. The independent predictors of poor recovery were estimated through multivariate logistic regression analysis and the prediction model was established. RESULTS AND CONCLUSION: (1) The duration of disease, JOA score, maximum spinal cord compression, cross-sectional area, signal intensity ratio and intramedullary signal size showed significant difference between good recovery and poor recovery groups (P < 0.05). (2) Receiver operating characteristic curve analysis showed that the area under the curve of the duration of disease, JOA score, maximum spinal cord compression, cross-sectional area, signal intensity ratio and intramedullary signal size was 0.670, 0.733, 0.647, 0.715, 0.753 and 0.765 respectively. The cut-off value was duration of 13 months, score 4, 29.8%, 0.25 cm2, 1.593 and 13.64 mm respectively. The duration of disease and maximum spinal cord compression had low discrimination power (the area under the curve < 0.7) in predicting poor recovery, whereas the JOA score, cross-sectional area, signal intensity ratio and intramedullary signal size had moderate discrimination power (the area under the curve 0.7-0.9). The area under the curve indicates good ability of signal intensity ratio and intramedullary signal size in combination (the area under the curve=0.791). (3) Logistic multivariate regression analysis showed that JOA score, cross-sectional area and combination of signal intensity ratio and intramedullary signal size were independent risk factors of poor recovery. A predicting model was built according to the result of the logistic regression analysis. It was shown that the area under the curve of this model was 0.890, which was significantly higher than that of the JOA score, cross-sectional area and combination of signal intensity ratio and intramedullary signal size (P < 0.05). (4) Combination of signal intensity ratio and intramedullary signal size had higher predictive ability than other MRI parameters. JOA score, together with quantitative MRI T2WI parameters may have a better predictive value for the risk of poor recovery in patients with thoracic ossification of the ligamentum flavum.

Effect of business process reengineering on multisectors' participation in prevention and control of multidrug-resistant organism infection / 中国感染控制杂志

Objective To investigate the effect of business process reengineering(BPR)on improving multisectors'participation in management of multidrug-resistant organism(MDRO)infection, and provide methodological guidance for hospital multisectors'collaborative management.Methods Related data about management and disposal of 672 cases of MDRO infection occurred from July 2015 to June 2017 were selected, 370 patients before BPR (from July2015to June 2016)were as control group, 302 patients after BPR(from July2016to June 2017)were as a trial group, BPR was used to improve the process of detection, report, cooperation, and disposal of MDROs in hospital, various quality evaluation indexes of healthcare-associated infection before and after BPR were compared. Results After the BPR was implemented, time of MDRO information transmitted from laboratory to clinical departments shortened from(240±30)minutes to(8±2)minutes;incidence of MDRO HAI decreased from2.39‰to 1.56‰, isolation rate of MDROs decreased from13.42％ to 11.09％, differences were all significant(all P＜ 0.05).Compliance rates and awareness rates of various MDRO prevention and control measures increased from 58.11％-71.89％to 84.11％-92.05％, usage rate of antimicrobial agents decreased from53.18％to 48.45％, defined daily doses(DDDs)of antimicrobial use density decreased from44.76 to 38.26, specimen submission rate before antimicrobial use increased from46.68％to 53.62％.Conclusion BPR can enhance the cooperation between different departments, give full play to the complementary advantages of interdisciplinary, and improve the efficiency of HAI management.

Effects of PI3K / Akt signaling pathway on the autophagy of rat alveolar macrophages exposed to dust / 中国职业医学

OBJECTIVE: To determine the regulating role of phosphatidylinositol 3-kinase( PI3K) / protein kinase B( Akt)signaling pathway in the autophagy activity of rat NR8383 cells exposed to silicon dioxide( SiO_2). LY294002 was used to block PI3 K pathway. METHODS: i) The normal NR8383 cells were used and divided into blank group and silica exposure group( final concentrations of SiO_2 suspension were 0 and 50 mg / L respectively). They were cultured for 3,6,12,20 and24 hours. The enzyme linked immunosorbent assay( ELISA) was used to assess the amount of tumor necrosis factor-α( TNF-α) and transforming growth factor-β1( TGF-β1) in supernatants of cultured cells,and then the optimal time of cells exposed to dust was determined. ii) NR8383 cells were divided into control group( treated with a same volume of F-12 K medium without serum),silica group( treated with SiO_2 suspension,final concentration 50 mg / L) and intervention group( treated with SiO_2 suspension and PI3 K inhibitor LY294002,final concentration 50 mg / L and 20 μmol / L,respectively).Cells were harvested following incubation. ELISA was used to detect the levels of TNF-α and TGF-β1 at the time point of20 hours after incubation. To reveal the autophagy status of cells,Western blotting was used to detect Akt and microtubuleassociated proteins 1 light chain 3( LC3) protein at time point of 20 hours; laser scanning confocal microscope( LSCM)was used to observe the immunofluorescence expression of autophagy at time points of 3,6,12 and 20 hours. The cells were also treated with the lysosomal inhibitor chloroquine diphosphate( CDP) at the same time of SiO_2 treatment. RESULTS: i) The time point of 20 hours was confirmed to be the best dust exposure time for in vitro cell model of NR8383 cells.ii) The levels of TNF-α and TGF-β1 of supernatant in the silica group were higher than those of the control group( P <0. 05). The levels of TNF-α and TGF-β1 of supernatant in the intervention group were higher than those of the control group and silica group( P < 0. 05). The Akt protein expression of the intervention group was lower than those in the control group and the silica group,respectively. The LC3 Ⅱ / Ⅰ protein level of the silica group was higher than those of the control group and intervention group( P < 0. 05),but no statistical significance was found between the control group and intervention group( P > 0. 05). LSCM results indicated that autophagy expression at time points of 3 and 6 hours were stronger than those of 12 and 20 hours in control group; autophagy expression at time point of 12 hours was stronger than those of 3 and 6 hours in the silica group,while the autophagy expression at time point of 20 hours was slightly weaker than that of 12 hours,but still stronger than those of 3 and 6 hours. Compared with the same time point in control group,autophagy expression at 3 and 6 hours were weaker in the silica group,while the expressions increased obviously at time points of 12 and 20 hours. Autophagy expression at all time points decreased in the intervention group compared with silica group,especially at the time point of 20 hours. The autophagy expression in each group increased in varying degrees after added with CDP blocking. CONCLUSION: Silica dust exposure can induce autophagy in rat NR8383 cells. PI3 K inhibitor LY294002 can reduce the autophagy expression indicating that the PI3 K / Akt signaling pathway might participate in the autophagy process of silica dust inducing autophagy in alveolar macrophages.

Correlation between Expression of CD200 and Regulatory T Cells in Multiple Myeloma and Its Significance in Prognostic Stratification / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the correlation between expression of CD200 and regulatory T cells (Tregs) in multiple myeloma(MM) patients and to explore its significance in prognostic stratification.</p><p><b>METHODS</b>CD200 and other immunophenotypes, including CD38, CD138, CD56, CD19, CD20, CD117, cytoplasm light chain Kappa and Lambda in bone marrow samples, and Tregs in peripheral blood were detected by flow cytometry from 78 newly diagnosed MM patients. Serum concentrations of hemoglobin(Hb), β2 microglobulin (β2-MG) and lactate dehydrogenase (LDH) were detected, respectively. The new risk stratification of patients was carried out according to international stage system (ISS) and cytogenetic characteristics. The correlation between expression of CD200 and Tregs in MM patients was analyzed and their differences in prognosis were compared.</p><p><b>RESULTS</b>The positive rate of CD200 expression was 71.79% in 78 patients (56/78). The expression of CD200 in sex and age of patients was no significant different. The expression of CD117 in CD200group was significantly higher than that of in CD200group (P=0.032). There was no significant difference in the expression of CD20, CD56 and CD19 between 2 groups. The level of Hb in CD200group was significantly lower than that in CD200group (P=0.035). The level of β2-MG in CD200group was significantly higher than that in CD200group (P=0.013). There was no significant difference in the level of LDH between 2 groups. In CD200group, 17 patients were in stageⅠ, accounting for 58.62% (17/29), 30 patients were in stageⅡ, accounting for 75% (30/40), 9 patients were in stage Ⅲ, accounting for 100% (9/9). With the increase of CD200 expression intensity, the risk of prognostic stratification went up (P=0). The brighter CD200 expressed, the worse the prognosis was. The percentage of Trges in CD200group was significantly higher than that of in CD200group (P=0.043). The content of Tregs was positively correlated with the expression of CD200 (r=0.743, P=0.044). Overall survival in CD200group was significantly higher than that in CD200group (P=0.036). Progression-free survival in CD200group was a bit higher than that of in CD200group, but it wasn't statistically significant.</p><p><b>CONCLUSION</b>The expression of CD200 positively correlates with the percentage of Tregs in MM patients. It is an important factor of poor prognosis and a reliable indicator for the evaluation by clinical efficacy in MM patients.</p>

Expression and Subcellular Distribution of Costimulatory Molecules B7-H1,B7-H3 and B7-H4 in Human Hematologic Malignancy Cell Lines / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the expression and subcellular distribution of costimulatory molecules B7-H1, B7-H3 and B7-H4 in human hematologic malignancy cell lines.</p><p><b>METHODS</b>The expression and subcellular distribution of B7-H1, B7-H3 and B7-H4 in 13 human hematologic malignancy cell lines were determined by RT-PCR, qPCR, Western blot and flow cytometry, the peripheral blood mononuclear cells (PB MNC) of 12 volunteers were used as control.</p><p><b>RESULTS</b>The mRNA of B7-H1, B7-H3 and B7-H4 was widely expressed in PB MNC and hematologic malignancy cell lines, with a lower level of B7-H4. The mRNA expression of 3 molecules was highest in Maver, Z138, and HL-60, respectively, while among them the B7-H3 and B7-H4 had no expression in CZ1. The nuclear and cytoplasmic protein of 3 costimulatory molecules abnormally overexpressed only in hematologic malignancy cell lines, with the highest level in U937, Z138, and Raji, respectively, while the B7-H3 and B7-H4 had no expression in CZ1. There were differences among mRNA expression, nuclear and cytoplasmic protein expression of 3 molecules in cell lines derived from the same type of tumor, but the differences of expression in mRNA and protein levels were not exactly the same. The B7-H3 expression abundance in membrane localization was higher in U937, Maver and Z138, while the membrane protein of B7-H1 and B7-H4 had no or low expression in 13 cell lines.</p><p><b>CONCLUSION</b>The mRNA expression of costimulatory molecules B7-H1, B7-H3 and B7-H4 can be widely detected. The protein level of 3 costimulatory molecules abnormally overexpressed only in hematologic malignancy cell lines, moreover the subcellular localizations mostly was found in nucleus and cytoplasm, while the membrane protein expresses in low level or had no expression. There are differences among the expression of 3 molecules in cell lines derived from the same type of tumor.</p>

Effects from sequential removal of posterior ligamentous complex on stability of injured thoracolumbar spine / 医用生物力学

Objective To investigate the effect from sequential removal of posterior ligamentous complex (PLC) on stability of injured thoracolumbar spine, and verify the role of supraspinous ligaments in maintaining stability of injured thoracolumbar spine complex. Methods Eight fresh human thoracolumbar specimens (T11-L3) were selected, and 1/3 of the L1 vertebral body was resected for "V" shape. The specimens were then mounted on the universal testing machine and subjected flexion and compression to make a fracture in L1. PLC in T12-L1 segment was then resected in a sequential manner from facet capsular ligament (FCL), interspinous ligament (ISL), supraspinous ligament (SSL) to ligamentum flavum (LF). The range of motion (ROM) and neutral zone (NZ) of the T12-L1 segment under flexion, extension, lateral bending and rotation movement were measured at each ligament removal step. Results Under flexion and extension, ROM and NZ presented a significant increase after fracture and removal of SSL. Under right lateral bending, ROM increased sharply after reduction of vertebrae and FCL, while the NZ showed a slight increase. Under left axial rotation, removal of vertebrae and FCL resulted in a significant increase in ROM, while the NZ showed no significant increase. Conclusions After removal of SSL, the stability of the T12-L1 segment decreases sharply, especially under flexion motion, and SSL is the pivotal ligament for PLC to maintain the stability of thoracolumbar spine.

Prevalence of Nontraumatic Osteonecrosis of the Femoral Head and its Associated Risk Factors in the Chinese Population: Results from a Nationally Representative Survey / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Nontraumatic osteonecrosis of the femoral head (NONFH) is a debilitating disease that represents a significant financial burden for both individuals and healthcare systems. Despite its significance, however, its prevalence in the Chinese general population remains unknown. This study aimed to investigate the prevalence of NONFH and its associated risk factors in the Chinese population.</p><p><b>METHODS</b>A nationally representative survey of 30,030 respondents was undertaken from June 2012 to August 2013. All participants underwent a questionnaire investigation, physical examination of hip, and bilateral hip joint X-ray and/or magnetic resonance imaging examination. Blood samples were taken after overnight fasting to test serum total cholesterol, triglyceride, and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels. We then used multivariate logistic regression analysis to investigate the associations between various metabolic, demographic, and lifestyle-related variables and NONFH.</p><p><b>RESULTS</b>NONFH was diagnosed in 218 subjects (0.725%) and the estimated NONFH cases were 8.12 million among Chinese people aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females (1.02% vs. 0.51%, χ2 = 24.997, P < 0.001). Among NONFH patients, North residents were subjected to higher prevalence of NONFH than that of South residents (0.85% vs. 0.61%, χ 2 = 5.847, P = 0.016). Our multivariate regression analysis showed that high blood levels of triglycerides, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol, male, urban residence, family history of osteonecrosis of the femoral head, heavy smoking, alcohol abuse and glucocorticoid intake, overweight, and obesity were all significantly associated with an increased risk of NONFH.</p><p><b>CONCLUSIONS</b>Our findings highlight that NONFH is a significant public health challenge in China and underscore the need for policy measures on the national level. Furthermore, NONFH shares a number of risk factors with atherosclerosis.</p>

lnfluence of phacoemulsification with different incision on tear film / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To investigate the influence of phacoemulsification with different incision on tear film. METHODS:Tear film was monitored in 152 patients (169 eyes) after phacoemulsification. Patients were divided into two groups according to the type of incision:group A (76 patients, 83 eyes) with a 3. 2mm corneoscleral limbus incision phacoemulsification and group B (76 patients, 86 eyes ) with a sclemtic tunnel incision. Tear break-up time ( BUT ) , cornea fluorescein staining ( CFS ) , lid-parallel conjunctival folds ( LlPCOF) and lid-wiper epitheliopathy ( LWE ) were observed at 3d preoperatively and 1wk, 1, 3 and 6mo postoperatively. The results were analyzed using a Chi-square test and t-test with SPSS 17. 0. RESULTS:BUT: The BUT of two groups was obviously shorter at 1wk, 1mo postoperatively, the differences were statistically significant (P0. 05). CFS score:There was a large increase in CFS at 1wk, 1mo postoperatively, the differences were statistically significant between the two groups(P0. 05). LlPCOF:There was a large increase in LlPCOF at 1wk, 1 and 3mo postoperatively, the differences were statistically significant between the two groups (P0. 05). LWE: There was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The differences were statistically significant between the two groups (P0. 05). CONCLUSlON:The stability of tear film in patients with scleral tunnel incision is much better than in patients with 3. 2mm corneoscleral limbus incision phacoemulsification. There is no significant difference between the two groups during later postoperative periods.

Emergence of novel variants of gyrA, parC, qnrS genes in multi-drug resistant Klebsiella caused pneumonia / 中华流行病学杂志

Objective To investigate the resistant mechanism of quinolones on multi-drug resistant Klebsiella caused pneumonia(MDR-KPN).Methods From August 2008 to May 2010,47 strains of MDR-KPN were collected from 6 hospitals in Hangzhou and Huzhou in Zhejiang province in China.Drug target genes to quinolones (gyrA,parC) and quinolone-resistance genes mediated by mobile genetic elements [qnrA,qnrB,qnrS,aac (6')-Ⅰ b-cr,qepA] were analyzed by PCR and verified by DNA sequencing.Results Positive results were found in 47 strains of MDR-KPN,43 strains (91.5％) of gyrA mutation,40 strains(85.1％) ofparC mutation,3 strains (6.4％) of qnrB2,1 strain (2.1％) ofqnrB 4,8 strains (17.0％) ofqnrS 1,5 strains (10.6％) of qnrS 4,2 strains (4.3％)of aac (6')-Ⅰ b-cr respectively.Moreover,5 novel variants of gyrA (GenBank accession number:JN811952,JN811953,JN811954,JN811955,JN811956),5 novel variants of parC (GenBank accession number:JN817432,JN817433,JN817434,JN817435,JN817436)were also identified.In addition,qnrS4 (GenBank accession number:JN836269) appeared to be the novel variants of qnrS.Conclusion Quinolone-resistance-determining region played a key role on the resistance to quinolones in this group of MDR-KPN,and quinolone-resistance genes mediated by mobile genetic elements [qnrB2,qnrB4,qnrS1,qnrS4,aac (6')-Ⅰ b-cr] showed positive in some parts of the strains.This was the first report on emergence of qnrS4 in the world.

A new monacolin analogue from Xuezhikang capsule / 药学学报

Xuezhikang capsule (ethanol extract of red yeast rice) which produced by Beijing WBL Peking University Biotech Co., Ltd., is a traditional Chinese medication with 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibiting activity. Clinical trials indicated that Xuezhikang with lipid-lowering action could reduce the risk of cardiac events and total mortality of Chinese coronary heart disease patients. To exactly explain the clinical features of Xuezhikang, we undertook a complete study of the chemical constituents of Xuezhikang. This study resulted in the isolation of a new monacolin analogue, named alpha, beta-dehydromonacolin L (1), along with two known compounds: monacolin L (2) and 3-(2, 6-dimethyl-1, 2, 4a, 5, 6, 7, 8, 8a-octahydronaphthalen-1-yl)propanoic acid (3). The chemical structures were determined by extensive 1D and 2D NMR and MS spectroscopic analysis.

Case-control study of relationship between polymorphisms of interleukin-4 gene and susceptibility of silicosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the relationship between polymorphisms of interleukin-4 (IL-4) gene (-33, +45, VNTR, +429, +448) and the susceptibility of silicosis.</p><p><b>METHODS</b>In a case-control study, the case group consisted of 101 patients with silicosis, and was matched with the control group (121 workers without silicosis), according to the age, sex, nationality, working place, exposure to dust. The polymorphisms of IL-4 (five locus) detected by the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques.</p><p><b>RESULTS</b>There was no difference of age, exposure and smoking between case group and control group (P > 0.05). The two groups had good comparability. Only the GA genotype in the IL-4 (+429) locus was found, the genotypes of AA and GG were not found. The CC genotype in the IL-4 (+448) locus was found, the genotypes of CG and GG were not found. The frequencies of AA, GG and AG of IL-4 (+45) locus in the case and control groups were 55.4%, 10.9%, 33.7% and 62.0%, 11.6%, 26.4%, respectively, there was no the significant difference between case and control groups (P > 0.05). The frequencies of B1B1, B2B2 and B1B2 of IL-4 (VNTR) locus in the case and control groups were 73.3%, 1.0%, 25.7% and 68.6%, 1.7%, 29.8%, respectively, there was no the significant difference between case and control groups (P > 0.05). The frequencies of TT, CC and CT in IL-4 -33 locus in the case group were 55.4%, 11.9% and 32.7%, which were significantly higher than those (69.4%, 4.1%, 26.4%) in control group (P < 0.05).</p><p><b>CONCLUSIONS</b>There was no relationship between IL-4 (+45, VNTR) genotypes and prevalence of silicosis in this study. The polymorphisms of IL-4 (+448) site were not found which may be related to the race. The relationship between genetic polymorphism of IL-4 (-33) locus and silicosis development was found, Workers with IL-4 (-33) allele C are susceptible to the silica.</p>

Investigation about prevention behavior for dust workers in machinery, ceramic, and metallurgy industry / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>The purposes of this thesis were to study the behavior about workers exposed to dust and provide scientific basis for health promotion.</p><p><b>METHODS</b>We designed a questionnaire and carry it on the 746 dust workers in the 3 representative corporations of Machinery, Ceramic, and Metallurgy Industry. All data were input into computer. And a database was established with Excel. SPSS11.5 statistical analysis software was used to analyze the influence on protecting behavioral between the application of qualifications, different jobs, training or protection, and other aspects etc.</p><p><b>RESULTS</b>The rates were 94.4% and 75.3% about the regular physical examination and requirements for protective equipment. The rate of choosing an effective way of protection was generally low (15.4%). There was significant difference for among different educational background workers (P < 0.01). The rates of choosing an effective way of protection (20.3%), the regular physical examination (98.3%) and requirements for protective equipment (86.4%) in the dust workers who participated in the training of dust protection were superior than those who did not participated in the training. There was the significant difference (P < 0.05, P < 0.01). There was the significant difference for the rate of effective way of protection, regular physical examination, and requirements for protective equipment among the different corporations (P < 0.05).</p><p><b>CONCLUSIONS</b>Dust workers' using rate about the choosing an effective way of protection was generally low in Machinery, Ceramic, and Metallurgy Industry. Those who were not educated had a lower using rate about the protection behavior, regular physical examination, and requirements for protective equipment than those educated.</p>

The relationship between polymorphisms of interleukin-4 gene and silicosis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the relationship between polymorphisms of interleukin-4 (IL-4) gene (-33, +45, intron3, +429, +448) and the susceptibility of silicosis.</p><p><b>METHODS</b>A case-control study was carried out. 101 silicosis patients were selected as cases. As strictly matching, 121 of non silicosis workers were selected as the controls. The polymophisms of IL-4 (five locus) were detected by the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques.</p><p><b>RESULTS</b>The GA genotype in the IL-4+429 locus and the CC genotype in the IL-4+448 locus were found. The frequencies of AA, GG and AG of IL-4+45 locus in the cases were 55.4%, 10.9%, and 33.7% and in the controls were 62.0%, 11.6%, and 26.4%. The differences between cases and controls were not significant. The frequencies of B1B1, B2B2, and B1B2 of intron3 VNTR locus in the cases were 73.3%, 1.0%, and 25.7% and in the controls were 68.6%, 1.7%, and 29.8%. The differences were not significant. The frequencies of TT, CC, and CT in -33 locus in the cases were 55.4%, 11.9%, and 32.7% and in the controls were 69.4%, 4.1%, and 26.4%. The differences were significant (P=0.034).</p><p><b>CONCLUSION</b>The relationship between genetic polymorphism of IL-4-33 site and silicosis has been found and -33TT is a protective genotype for silicosis.</p>

Coagulase-negative staphylococcus and enterococcus as predominant pathogens in liver transplant recipients with Gram-positive coccal bacteremia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gram-positive bacteria such as Staphylococcus aureus have been a common cause of infection among liver transplant (LT) recipients in recent decades. The understanding of local epidemiology and its evolving trends with regard to pathogenic spectra and antibiotic susceptibility is beneficial to prophylactic and empiric treatment for LT recipients. This study aimed to investigate etiology, timing, antibiotic susceptibility and risk factors for multidrug resistant (MDR) Gram-positive coccal bacteremia after LT.</p><p><b>METHODS</b>A cohort analysis of prospectively recorded data was performed to investigate etiologies, timing, antibiotic susceptibility and risk factors for MDR Gram-positive coccal bacteremia in 475 LT recipients.</p><p><b>RESULTS</b>In 475 LT recipients in the first six months after LT, there were a total of 98 episodes of bacteremia caused by Gram-positive cocci in 82 (17%) patients. Seventy-five (77%) bacteremic episodes occurred in the first post-LT month. The most frequent Gram-positive cocci were methicillin-resistant coagulase-negative staphylococcus (CoNS, 46 isolates), methicillin-resistant Staphylococcus aureus (MRSA, 13) and enterococcus (34, E. faecium 30, E. faecalis 4). In all Gram-positive bacteremic isolates, 59 of 98 (60%) were MDR. Gram-positive coccal bacteremia and MDR Gram-positive coccal bacteremia predominantly occurred in patients with acute severe exacerbation of chronic hepatitis B and with fulminant/subfulminant hepatitis. Four independent risk factors for development of bacteremia caused by MDR Gram-positive coccus were: LT candidates with encephalopathy grades II - IV (P = 0.013, OR: 16.253, 95%CI: 1.822 - 144.995), pre-LT use of empirical antibiotics (P = 0.018, OR: 1.029, 95%CI: 1.002 - 1.057), post-LT urinary tract infections (P < 0.001, OR: 20.340, 95%CI: 4.135 - 100.048) and abdominal infection (P = 0.004, OR: 2.820, 95%CI: 1.122 - 10.114). The main infectious manifestations were coinfections due to gram-positive cocci and gram-negative bacilli.</p><p><b>CONCLUSIONS</b>Methicillin-resistant CoNS and enterococci are predominant pathogens among LT recipients with Gram-positive coccal bacteremia. Occurrences of Gram-positive coccal bacteremia may be associated with the severity of illness in the perioperative stage.</p>