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@#Objective - （ ） To analyze the occurrence pattern of work related musculoskeletal disorders WMSDs among workers Methods in a shipyard based on latent category model. A total of 446 workers from a shipyard in Guangdong Province were selected as the research subjects using convenience sampling method. The prevalence of WMSDs in the past year was ， investigated using China Musculoskeletal Questionnaire and the occurrence patterns of WMSDs were analyzed by latent class. Results （ ） The prevalence of WMSDs in the past year was 71.1% 317/446 . The prevalence of WMSDs in single site was 24.4% （ ）， （ ） - 109/446 and was 46.6% 208/446 in multiple sites. The prevalence of WMSDs in multiple sites was 3.9 17.3 times higher than that in single site. The fitting results of latent class model showed that the model with three latent classes was the best - （ ）， model. The three potential categories of WMSDs occurrence patterns in the study subjects were the all site group 28 patients （ ）， （ ）， ， the neck and lower back/waistgroup 153 patients and the few or no site group 265 patients accounting for 6.3% 34.3% ， Conclusion and 59.4% respectively. WMSDs of shipyard workers have obvious category characteristics. Latent class analysis can be used to explore the occurrence pattern of WMSDs in shipyard workers.
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Objective:To construct the quality evaluation system for tracheal extubation in the patients undergoing general anesthesia based on zero-defect management theory.Methods:Based on the model of zero-defect theory, literature review, semi-structured interviews, expert consultation and analytic hierarchy process were used to determine the content and weight of each index of the quality evaluation system for tracheal extubation in the patients undergoing general anesthesia.Results:The effective recovery rates of the two rounds of expert consultation questionnaires were 93% and 96% respectively; the expert authority coefficients were 0.946 and 0.947 respectively; the Kendall harmony coefficients were 0.247 and 0.250 respectively ( P<0.001). The final evaluation index system included 3 first-level indicators, 11 second-level indicators and 48 third-level indicators.The consistency coefficients of indicators at all levels were <0.1. Conclusions:The quality evaluation system for endotracheal extubation constructed for patients undergoing general anesthesia is highly scientific and reliable and can provide a basis for the quality evaluation of and continuous improvement in endotracheal extubation in the patients undergoing general anesthesia.
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Objective:To explore the risk factors of intensive care unit-acquired weakness (ICU-AW), and to establishment and verify its risk prediction model.Methods:A modeling group of 231 patients who met the inclusion criteria and were admitted to the intensive care unit (ICU) of the First Hospital of Jiaxing from July 2019 to June 2020 was collected by convenience sampling method. According to whether they developed ICU-AW, they were divided into ICU-AW group (55 cases) and non ICU-AW group (176 cases). The clinical data were collected concerning patients' individual information, disease-related factors, treatment-related factors and laboratory indicators, and the differences of the above indexes between two groups were compared. Logistic regression was used to analyze the ICU-AW risk factors and a risk prediction model was constructed. Calculate the area under ROC curve (AUC) to test the prediction effect of the model. At the same time, 60 patients who admitted to ICU from July to October 2020 and met the standards were collected to verify the model.Results:Compared with non ICU-AW group, there were more males in ICU-AW group [61.8% (34/55) vs. 44.3% (78/176), P < 0.05], with higher levels of systemic inflammatory response syndrome (SIRS), sepsis, immobilization and the use of neuromuscular blockers [SIRS: 30.9% (17/55) vs. 3.4% (6/176), sepsis: 12.7% (7/55) vs. 2.3% (4/176), immobilization: 72.7% (40/55) vs. 39.2% (69/176), the use of neuromuscular blockers: 50.9% (28/55) vs. 14.2% (25/176), all P < 0.05], and acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, blood lactic acid level and duration of mechanical ventilation, length of hospital stay were all increased [APACHEⅡ score: 18 (15, 24) vs. 12 (8, 17), blood lactic acid (mmol/L): 2 (1, 2) vs. 1 (1, 2), duration of mechanical ventilation (days): 7 (4, 12) vs. 2 (2, 5), length of hospital stay (days): 10 (6, 16) vs. 5 (3, 9), all P < 0.05]. SIRS, APACHEⅡ score, duration of mechanical ventilation and blood lactic acid were included to construct a risk prediction model [odds ratio ( OR) values were 4.835, 1.083, 1.210, 1.790, P values were 0.018, 0.013, 0.015, 0.013]. The model equation was P = exp [-5.207+(1.576×SIRS)+(0.079×APACHEⅡ)+(0.191×duration of mechanical ventilation)+(0.582×blood lactic acid)]. Internal verification: Calibration diagram showed the calibration curve above the ideal curve, AUC = 0.888, 95% confidence interval (95% CI) was 0.839-0.938; when the cut-off value was 0.166, the sensitivity was 89.1%, the specificity was 75.6%, and the maximum index was 0.649. External verification: Calibration diagram showed that the calibration curve was above the ideal curve, and the plotted AUC = 0.853, 95% CI was 0.753-0.953. When the cut-off value of the corresponding predictive risk value was 0.367, the sensitivity was 68.8%, the specificity was 86.4%, and the maximum approximate index was 0.552. Conclusion:The risk prediction model of ICU-AW constructed in this study has good consistency and prediction efficiency, which can provide reference for medical personnel to identify high-risk groups of ICU-AW patients in the early stage and provide targeted interventions in advance.
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OBJECTIVE: To evaluate the application value of finger systolic blood pressure(FSBP) in the diagnosis of vibration-induced vascular injury. METHODS: Thirty patients with vibration-induced vascular injury [vibration-induced white finger(VWF)] were selected as the case group by a non-randomized concurrent controlled trial, and 30 hand-transmitted vibration workers without VWF were selected as the control group. The FSBP test was performed on the tested hands of all subjects, and the FSBP index of each Finger(F_( i)) was measured. RESULTS: The F_i of the index finger, middle finger, ring finger and tail finger of the tested hand in the case group were lower than that in the control group(all P<0.01). In the case group, the F_i of index finger was lower than ring finger and tail finger(all P<0.01). The abnormal rates of F_i on the index, middle and ring fingers in the case group were higher than those in the control group(86.7% vs 10.0%, 76.7% vs 13.3%, 43.3% vs 10.0%, all P<0.01). The area under the receiver operator characteristic curve of the measured F_i of the index finger, middle finger, ring finger and tail finger were 0.884, 0.843, 0.764 and 0.687 respectively. The diagnostic cut off value of the F_i of index finger was 80.2%. The sensitivity and specificity were 86.7% and 90.0%, respectively. CONCLUSION: FSBP test has a good application value in the diagnosis of vibration-induced vascular injuries. It is suggested that the F_i of index finger be the first choice as the diagnostic index, and the abnormal value can be set at 80.0%.
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OBJECTIVE: To analyze the stability of test results of fingertip thermotactile perception threshold(TPT) among healthy individuals and the influencing factors of the TPT test. METHODS: Fifty healthy young volunteers aged 20-25 were selected as the study subjects using the convenience sampling method. The HVLab thermal aesthesiometer was used to perform the fingertip TPT test under the standard condition. Right index, middle, ring, little, left index and little fingers were tested. According to the method of random number table, we selected 25 subjects to receive second test after the interval of two weeks. RESULTS: Intraclass correlation coefficient(ICC) for cold threshold of right little finger was bigger than 0.75, suggesting the test-retest reliability was excellent. The ICC for hot threshold of six test fingers, cold threshold of right and left index fingers, right middle and left little finges was in the range of 0.60-0.74, indicating the test-retest reliability was good. However, the ICC for cold threshold of right ring finger was less than 0.40, and the test-retest reliability was poor. The hot threshold of right middle, ring and little fingers, and the cold threshold of left little finger of males were higher than those of females(all P<0.05). The cold threshold of right index and little fingers were lower than those of left hand in males(all P<0.05). The cold threshold of right middle and ring fingers were lower than that of the right index finger in females(all P<0.05). The cold threshold of right little finger was lower than those of right index, middle and ring fingers in females(all P<0.05). CONCLUSION: The stability of the fingertip TPT result is good in healthy young adults aged 20-25. The fingertip TPT test could be used for occupational health surveillance of workers exposed to hand-transmitted vibration. We should take into account the influence of gender, the right or left hand and different fingers when developing TPT reference values.
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OBJECTIVE: To test and analyze the vibration transmissivity of three common kinds of protective gloves, and to determine their actual protecting effect. METHODS: Three kinds of protective gloves were selected as test materials, and five healthy volunteers were selected as subjects using typical sampling methods. According to the ISO 10819:2013 Mechanical Vibration and Shock--Hand-arm Vibration--Measurement and Evaluation of the Vibration Transmissibility of Gloves at the Palm of the Hand(hereinafter referred to as ISO 10819:2013), investigation and measurement of basic parameters of protective gloves. The gloved vibration transmission(GVT) test system was used to test the vibration transmission of different protective gloves worn by the subjects, and the spectrum analysis of vibration reduction characteristics was carried out. RESULTS: The thickness of damping material of all the three kinds of protective gloves met the standard requirements. The mean value for the corrected frequency-weighted glove vibration transmissibility values at 25.0-200.0 Hz were 0.91, 0.75 and 0.94, and 1.05, 0.85 and 1.10 at 200.0-1 250.0 Hz, for the protective gloves A, B and C, respectively. The results of anti-vibration characteristic spectrum analysis show that there has no vibration reduction effect at the frequency of 25.0-200.0 Hz when wearing these three kinds of gloves. Wearing gloves A and B on part of the 200.0-1 250.0 Hz frequency vibration has an amplifying effect. Wearing glove C has a partial vibration reduction effect at the 200.0-1 250.0 Hz frequency, and the vibration reduction efficiency is the highest at the frequency of 1 250.0 Hz.CONCLUSION: According to the ISO 10819:2013 standard, the mean value of GVT measured when wearing the three kinds of protective gloves does not meet the relevant requirements, and the anti-vibration effect is poor. These gloves cannot be defined as anti-vibration gloves.
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Objective:To investigate the rehabilitation resources of community health centers in Shanghai. Methods:December, 2018, all 247 community health centers in 16 districts of Shanghai were investigated with Health Institution Questionnaires, including the number of rehabilitation personnel (physiatrician, physical therapists) and the number of rehabilitation beds, etc. Results:There were 152 physiatrician and 597 physical therapists in community health centers in Shanghai. The numbers of physiatrician and physical therapists per 1000 registered population were 0.01 and 0.04, and were 0.03 and 0.12 for per 1000 registered elderly population. There were 17 484 beds in community health centers, in which the rehabilitation beds were 1425, accounting for 8.15%. Besides, the numbers of rehabilitation beds per 1000 registered population and registered elderly population in Shanghai were 0.10 and 0.30. Conclusion:The development of community-based rehabilitation in Shanghai is unbalanced. There is lack of community-based rehabilitation resources, the supply of service is insufficient, and there is gap between supply and demand. It is suggested to strengthen the support to community-based rehabilitation, and improve the supply of community-based rehabilitation resources.
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OBJECTIVE@#To explore the tensile mechanics and anatomical characteristics of the posterior hip capsule, and provide biomechanical and anatomical evidence for capsule repair in total hip replacement.@*METHODS@#Six bone-capsule-bone specimens were obtained from posterior hip joint of fresh frozen cadavers. The maximum strain, load, elastic modulus and load strain curves of the capsule ligament complex specimens were recorded by Instron Universal Material Testing Machine. Twelve cadaveric hip specimens were dissected to the capsule. The tensile strain of normal capsule and conventionally reconstructed capsule at 90 degrees of hip flexion were documented. The suture area of the posterior capsule was divided into nine sections, and the thicknessof different sections was measured and compared. Posterior capsule of the cadavers was repaired in conventionally way and anatomical way separately and simulated rehabilitation was conducted. The effect of rehabilitation on the repaired capsule was observed.@*RESULTS@#The load-strain curve of capsule ligament complex conforms to rheological and viscoelastic characteristics. The maximum tensile strain of the complex was (39.21±5.23)%, the maximum load was (142.06± 34.15) N, the tensile strength was (1.65±0.38) MPa, and the elastic modulus is (14.23±5.62) MPa. At 90 ° hip flexion, the tensile strain of repaired capsule was higher than that of normal capsule, and the difference was statistically significant (< 0.05). Tensile strain of conventionally reconstructed capsule is:upper part (37.0±4.9)%, middle part ( 53.3±1.1)%, lower part (68.3±6.2)%, tensile strain of normal capsule is:upper part (17.0±2.6)%, middle part (24.1±1.4)%, lower part (26.0± 4.3)% . The thickness of the posterior joint capsulein different sections is statistically significant (<0.05), and capsule at 0.5cm proximal to the femoral insertion is suitable for suture. There the average thickness of capsule is:upper part (3.48 ± 0.11) mm, middle part (2.36 ± 0.09) mm, lower part (1. 59±0.24) mm. The posterior inferior joint capsule is thinnest at (1.42± 0.02) cm proximal to the femoral insertion, and sutures should be avoided here. After simulating rehabilitation, avulsion occurred in the lower part of the posterior capsule repaired conventionally (10/12), and the anatomically repaired capsule remained intact.@*CONCLUSION@#The lower part of conventionally repaired capsule is overstretched and tends to fail. Anatomically repaired capsule conforms to tensile mechanics and is helpful to reduce the failure rate of repair.
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Humans , Arthroplasty, Replacement, Hip , Biomechanical Phenomena , Femur , Hip Joint , General Surgery , Joint Capsule , General Surgery , Tensile StrengthABSTRACT
OBJECTIVE: To observe the prewarming effect of transcutaneous acupoint electrical stimulation (TAES) preconditioning of Dazhui (GV14) and Mingmen (GV4) in patients undergoing elective video-assisted thoracoscopic lobectomy, so as to determine whether TAES can improve intraoperative hypothermia. METHODS: A total of 80 patients undergoing elective video-assisted thoracoscopic lobectomy were randomly divided into TAES group (40 cases) and control group (40 cases). Before surgery, all the patients were transferred to the fixed area of an anesthetic preparation room by using a surgery cart carrying the same temperature sheets and quilts before surgery. TAES (2 Hz/100 Hz, 20-30 mA) was applied to Dazhui (GV14) and Mingmen (GV4) for 30 min for patients of the TAES group and the same sheet electrodes of EA stimulator were only attached to GV14 and GV 4 without electrical current transmission for patients in the control group. Then, these patients in the two groups were transferred to the operation room and treated by total intravenous anesthesia, and their anesthetic depth was monitored with bispectral index (BIS, between 45-60) and end-tidal carbon dioxide tension (PETCO2, between 30-45 mmHg). The auricular tympanic temperature was monitored, and when the temperature was below 35.5 ℃, forced-air blanket was used to warm the patient as the remedial measure. The same temperature of operation room, surgical drape, infusion solution and pleural lavage fluid were controlled. The patients' body temperature in the preparation room and operation room during surgery, incidence of hypothemia, blood pressure (BP), heart rate (HR), duration of anesthesia, duration of operation, blood loss volume, urine output, total infusion volume, recovery (awaking) time, and chills during recovery were recorded. RESULTS: The body temperature of patients in the TAES group was significantly higher than that in the control group at the time of entering the operation room (P0.05). CONCLUSION: TAES preconditioning of GV14 and GV4 can produce prewarming effect before anesthesia, shorten the awaking time and reduce the incidence of chills in the recovery period in patients undergoing elective video-assisted thoracoscopic lobectomy.
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Objective To construct a recombinant oncolytic virus vvmIL33 that can steadily se-crete mouse IL-33 protein (mIL-33) in targeted tumor cells and to study its synergistic inhibitory effect on tumor. Methods Mouse IL-33 gene sequence was amplified by PCR and inserted into the eukaryotic ex-pression vector pCMS1. The constructed pCMS1-mIL33 was transfected into the parent virus (vJS6)-infected cells by Lipofactamine. Recombinant oncolytic virus vvmIL33 was purified by cell flow sorting. Enzyme-linked immunosorbent assay ( ELISA) was used to detect the level of mIL-33 protein in the culture superna-tant of vvmIL33-infected tumor cells. Recombinant oncolytic virus vvmIL33 and parental virus vJS6 were re-spectively used to infect tumor cells, and then analyzed by plaque formation assay and MTS kit. T cell co-culture experiments were performed to examine the anti-tumor ability of T cells induced by vvmIL33-infected tumor cells. Results Electrophoresis results of the recombinant plasmid pCMS1-mIL33 showed that mIL-33 gene was inserted successfully. Compared with the control group, vvmIL33 could steadily secrete high levels of mIL-33 protein in MC38 cells after infection (P<0. 001). Results of the plaque formation assay showed that vvmIL33-or vJS6-infected CV1 and MC38 cells produced similar amounts of virus at various time points without statistical difference (P>0. 05). Under different multiplicity of infection (MOI), the lytic ability of vvmIL33 against tumor cells was similar to that of vJS6 without statistical difference (P>0. 05). In the T cell co-culture experiments, the concentration of INF-γ protein produced by T cells in the vvmIL33-infected MC38 cell group was significantly increased as compared with that of the vJS6 group (P<0. 05). Moreover, the cytotoxic effect of induced T cells on tumor cells was also significantly increased (P<0. 05). Conclusion The recombinant oncolytic virus vvmIL33 was successfully constructed without damaging its ability to repli-cate and induce tumor cell lysis. Oncolytic virus carrying mIL-33 enhanced the immune effect of T cells and increased anti-tumor effect.
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Objective:To better understand the pathogenesis of obstructive jaundice (O J),a variety of rat OJ and biliary drainage models have been tried;however,complications are still common.We aimed to establish a stable rat model of OJ using microsurgical techniques,and to assess its reversal by internal bile drainage(IBD).Methods:After the pilot study,we developed a standardized surgical procedure.All operations were carried out under an operating microscope.In the first laparotomy,the proximal common bile duct (CBD) of the rat was ligated and transected.A tube was introduced into the distal end of the duct,and the other end of the tube was sealed and fixed.In the second laparotomy,the drainage tube was inserted into the (by now markedly dilated) proximal CBD,and ligated into position.We evaluated the general condition of the rats,the status of the liver and pancreas before and after IBD.Results:Complications such as intestinal reflux and bile duct blockage,were not found.Pancreatic injury was not evident by day 4 after the first laparotomy.After biliary drainage,the serum glucose and albumin concentration rapidly returned to normal levels.Liver weight/body weight ratio increased.The biochemical indicators and ultrasonographic elastography results for the liver gradually returned to normal.Conclusion:Using microsurgical techniques,we have developed a stable rat model of OJ reversed by IBD.
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Objective To study the therapeutic effect of anti-CD80 bivalent antibody on mouse lu-pus nephritis and to explore the possible molecular mechanism. Methods A mouse model of lupus nephritis was established through intraperitoneal injection of 0. 5 ml of pristine in female C57BL/6J mice. Appearance of urinary protein and significantly increased levels of peripheral antinuclear antibody ( ANA) and anti-doub-le-stranded DNA ( anti-dsDNA) antibody in the fourth month after injection indicated that the mouse model was established successfully. Then the mice were divided into two groups including anti-CD80 bivalent anti-body intervention group (injected with 200μg of anti-CD80 bivalent antibody at day 1, 3, 5, 8 and 15, fol-lowed by three times of injection with an interval of one month) and model group ( injected with the same protein using the same strategy). A normal control group was set up accordingly. Albustix test paper was used to monitor the dynamic changes in mouse urinary protein. Flow cytometry was used to analyze the acti-vation of immune-related cells in spleen. Levels of autoantibodies ( ANA and anti-dsDNA) and levels of IFN-γ and IL-4 in serum were detected by indirect immunofluorescence assay. Renal tissue samples were an-alyzed with hematoxylin and eosin ( HE) staining and immunocomplex ( IC) assay. Results Urinary pro-tein level of the anti-CD80 bivalent antibody intervention group was significantly lower than that of the model group (P<0. 05). Activated macrophages, dendritic cells, neutrophils and B cells in spleen tissues of the anti-CD80 bivalent antibody intervention group were significantly less than those of the model group ( P<0. 05), and the numbers of CD4+ and CD154+ T cells were significantly less than those of the model group (P<0. 05). Positive rates and titers of ANA and dsDNA in serum samples of the intervention group were lower than those of the model group (P<0. 05). Levels of IFN-γand IL-4 in serum samples of the interven-tion group were decreased as compared with those of the model group (P<0. 05). HE staining and immuno-fluorescence assay showed that glomerular inflammatory injury and necrosis were alleviated and kidney im-mune complex deposition was reduced after anti-CD80 bivalent antibody intervention. Conclusion Anti-CD80 bivalent antibody specifically binds to the CD80 molecule on antigen presenting cell surface, blocks the CD80/CD28 co-stimulatory signaling pathway and down-regulates the body′s immune response, which al-leviates and reverses the lupus-like nephritis-induced pathological damages in mice.
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Objective To study the therapeutic effect of anti-CD80 bivalent antibody on mouse lu-pus nephritis and to explore the possible molecular mechanism. Methods A mouse model of lupus nephritis was established through intraperitoneal injection of 0. 5 ml of pristine in female C57BL/6J mice. Appearance of urinary protein and significantly increased levels of peripheral antinuclear antibody ( ANA) and anti-doub-le-stranded DNA ( anti-dsDNA) antibody in the fourth month after injection indicated that the mouse model was established successfully. Then the mice were divided into two groups including anti-CD80 bivalent anti-body intervention group (injected with 200μg of anti-CD80 bivalent antibody at day 1, 3, 5, 8 and 15, fol-lowed by three times of injection with an interval of one month) and model group ( injected with the same protein using the same strategy). A normal control group was set up accordingly. Albustix test paper was used to monitor the dynamic changes in mouse urinary protein. Flow cytometry was used to analyze the acti-vation of immune-related cells in spleen. Levels of autoantibodies ( ANA and anti-dsDNA) and levels of IFN-γ and IL-4 in serum were detected by indirect immunofluorescence assay. Renal tissue samples were an-alyzed with hematoxylin and eosin ( HE) staining and immunocomplex ( IC) assay. Results Urinary pro-tein level of the anti-CD80 bivalent antibody intervention group was significantly lower than that of the model group (P<0. 05). Activated macrophages, dendritic cells, neutrophils and B cells in spleen tissues of the anti-CD80 bivalent antibody intervention group were significantly less than those of the model group ( P<0. 05), and the numbers of CD4+ and CD154+ T cells were significantly less than those of the model group (P<0. 05). Positive rates and titers of ANA and dsDNA in serum samples of the intervention group were lower than those of the model group (P<0. 05). Levels of IFN-γand IL-4 in serum samples of the interven-tion group were decreased as compared with those of the model group (P<0. 05). HE staining and immuno-fluorescence assay showed that glomerular inflammatory injury and necrosis were alleviated and kidney im-mune complex deposition was reduced after anti-CD80 bivalent antibody intervention. Conclusion Anti-CD80 bivalent antibody specifically binds to the CD80 molecule on antigen presenting cell surface, blocks the CD80/CD28 co-stimulatory signaling pathway and down-regulates the body′s immune response, which al-leviates and reverses the lupus-like nephritis-induced pathological damages in mice.
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<p><b>OBJECTIVE</b>To investigate whether Lactobacillus rhamnosus GG conditioned medium(LGG-CM)has preventive effect against E. coli K1-induced neuropathogenicity in vitro by inhibiting nuclear factor-κB (NF-κB) signaling pathway.</p><p><b>METHODS</b>An in vitro blood-brain barrier (BBB) model was constructed using human brain microvascular endothelial cells (HBMECs). The effect of LGG-CM on E. coli-actived NF-κB signaling pathway was assayed using Western blotting. Invasion assay and polymorphonuclear leukocyte (PMN) transmigration assay were performed to explore whether LGG-CM could inhibit E. coli invasion and PMN transmigration across the BBB in vitro. The expressions of ZO-1 and CD44 were detected using Western blotting and immunofluorescence. The changes of trans-epithelial electric resistance (TEER) and bacterial translocation were determined to evaluate the BBB permeability.</p><p><b>RESULTS</b>Pre-treament with LGG-CM inhibited E. coli-activated NF-κB signaling pathway in HBMECs and decreased the invasion of E. coli K1 and transmigration of PMN. Western blotting showed that LGG-CM could alleviate E. coli-induced up-regulation of CD44 and down-regulation of ZO-1 expressions in HBMECs. In addition, pre-treatment with LGG-CM alleviated E. coli K1-induced reduction of TEER and suppressed bacterial translocation across the BBB in vitro.</p><p><b>CONCLUSION</b>LGG-CM can block E. coli-induced activation of NF-κB signaling pathway and thereby prevents E. coli K1-induced neuropathogenicity by decreasing E. coli K1 invasion rates and PMN transmigration.</p>
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OBJECTIVE: To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on hemodynamic fluctuation caused by loosing tourniquet in the elderly patients undergoing knee joint replacement. METHODS: A total of 60 ASA (America Society Anesthesiologist) I or II elderly patients for elective knee joint replacement surgery were randomly divided into control group (30 cases) and TAES group (30 cases). Patients of both groups were treated by intravenous anesthesia, and monitored with bispectral index (BIS, between 45－60) for anesthesia depth, stroke volume variation (SVV) for fluid management, mean arterial pressure (MAP) and cardiac index (CI) for hemodynamic fluctuation evaluation, and with analgesia nociception index (ANI, between 50－70) for remifentanil dosage adjustment. TAES (2 Hz/100 Hz, 8－20 mA) was applied to bilateral Xinshu (BL 15), Feishu (BL 13), Neiguan (PC 6) and Hegu (LI 4) acupoints for 30 min first (followed by anesthesia induction and operation), and given continuously until 15 min after tourniquet loosing. Patients of the control group were only given with electrodes attachment without electrical stimulation. The levels of MAP, CI, and arterial blood pH, PaCO2, PaO2, base excess (BE) and lactic acid (Lac) 1 min before, and 5 and 15 min after tourniquet loosing, and the dosages of remifentanil and ephedrine after tourniquet loosing were recorded. RESULTS: The changed levels of MAP, CI and blood Lac at 5 min after tourniquet loosing (relevant to the baseline levels), and blood Lac content at 15 min after tourniquet loosing (relevant to 5 min after tourniquet loosing) were significantly lower in the TAES group than in the control group (P0.05). CONCLUSIONS: TAES has a positive effect on hemodynamics fluctuation caused by loosing tourniquet in the aged patients undergoing knee joint replacement.
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OBJECTIVE: To study the occupational exposure characteristics of hand-transmitted vibration in hand-held workpiece polishing and to provide the basis for occupational hazard prevention and control technology research in this kind of job. METHODS: The questionnaire and on site occupational health investigation were used to study 4 typical enterprises of hand-held workpiece polishing. The study was conducted by filling forms by enterprise,personal interviews with administrative staffs and front-line workers,as well as on site visit. RESULTS: Among the 4 factories,there were 835workers( 22. 4%) engaged in the hand-held workpiece polishing assignment. The principal vibrating tools used in these 4factories were polishing machine,flint glazing machine and polishing wheel,and the workpiece polished by workers were button,toilet lid,thermos,mobile phone shell and golf head. The polishing workers were all equipped with noise reduction earplugs and anti-dust respirators, but they did not wear anti-vibration gloves. The hand-held workpiece polishing assignment has the characteristics including indirect and continuous vibration exposure and fine operation. Some workers used their knees and abdomens as the support to polish workpieces. The vibration exposure time was 6-11 h / d. The 4hours energy equivalent frequency-weighted acceleration to vibration [ahw( 4)]was 1. 9-19. 4 m/s~2,with the maximum which exceeded the occupational exposure limit( 5. 0 m / s~2),showing a wide range ahw( 4)in the same enterprise. CONCLUSION: Compared with the traditional vibrating tools,the hand-held workpiece polishing operation has different characteristics of hand-transmitted vibration such as more sophisticated machine structure,finer polishing ways,more influencing factors of vibration exposure level and more extensive body parts involved.
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OBJECTIVE: To analyze the effects of hand-transmitted vibration exposure on the finger vibratory and pain perception thresholds among drill workers in a gold mine. METHODS: By the judgement sampling method,134 male drill workers from a gold mine in the northern area of China were selected as the hand-transmitted vibration exposure group and102 fit-up workers without vibration exposure in the same mine were chosen as the control group. The finger vibratory perception thresholds,the pain perception thresholds and the occupational health examination were conducted and analyzed in these two groups. Based on the self-report with vibration-induced white finger( VWF),the workers of hand-transmitted vibration exposure group were divided into non-VWF subgroup( 105 workers) and VWF subgroup( 29 workers). RESULTS: The incidence of finger numbness,pain and self-reported white finger in the exposure group were significantly higher than those in the control group( P < 0. 05). Compared with the control group,the vibratory perception thresholds of the index finger,middle finger and ring finger of the right hand among the vibration exposure group workers were significantly higher( P < 0. 05),but there was no significant difference in the vibratory perception thresholds of the left ring finger between the two groups( P > 0. 05). The vibratory perception thresholds of both ring fingers,right index finger and right middle-finger in VWF subgroup were higher than those in control group( P < 0. 05). But no significant differences was found in the above 4 indexes in these two groups after compared to those of control group,respectively( P > 0. 05). The vibratory perception thresholds of left ring finger,right ring finger and right index finger in VWF subgroup were all higher than those in non-VWF subgroup( P < 0. 05),but the vibratory perception thresholds of right middle finger in these two groups showed no significant difference( P > 0. 05). The pain perception thresholds of index finger,middle finger and ring finger in both hands of the vibration exposure group workers were all higher than those in control group( P < 0. 05). The pain perception thresholds of middle finger and ring finger in both hands of the VWF subgroup and non-VWF subgroup were higher than those of control group( P < 0. 05). CONCLUSION: The hand-transmitted vibration can increase the thresholds of finger vibratory and pain perception in drill workers. The finger sensory perception examination could be used to assist the early detection of peripheral nerve damage induced by hand-transmitted vibration.
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OBJECTIVE: To analyze the correlation between four vessel regulate factors and vibration-induced white finger( VWF) evaluating in workers exposed to hand-arm vibration,and discuss the value of regulate factors for VWF screening.METHODS: Using typical sampling method,77 male workers exposed to hand-arm vibration with more than 1 year of polish work from a metalwork factory were selected as the study subjects. Based on the workers' self-report,they were divided into VWF group( 43 workers) and non-VWF group( 34 workers). The venous blood from center elbow was collected and plasma was separated. The plasma level of endothelin( ET) was detected by radioimmunoassay. The plasma levels of transforming growth factor beta( TGF-β),soluble intercellular adhesion molecule-1( s ICAM-1) and 5-hydroxytryptamine( 5-HT) were detected by enzyme-linked immunosorbent assay. The regulate factors for evaluating VWF were screened and the new multivariable model index
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OBJECTIVE: To evaluate the major influence factors affecting the quality and accuracy of measuring instruments for power frequency electromagnetic fields in occupational hygiene technical service organizations by developing interlaboratory comparison in workplaces. METHODS: Six measuring instruments for power electromagnetic fields from 6occupational hygiene technical service organizations in Guangdong Province were selected by typical sampling method. A high-voltage substation was selected as a standard source. We set measurement sites underneath it as inter-laboratory comparison spots for power frequency electromagnetic fields. The stability of the standard source was evaluated by pairedsamples t-test and measure results were analyzed by z-score evaluation method based on quartile robust statistical technology. RESULTS: During and after the inter-laboratory comparison,the intensity of electric field and magnetic field of the standard source showed no significant difference [( 555. 03 ± 2. 94) vs( 555. 68 ± 3. 20) V / m,( 2. 30 ± 0. 06) vs( 2. 29 ± 0. 07) μT,P > 0. 05],which met the demand of stability of inter-laboratory comparison. The data of electric field measured by 2 measuring instruments without remote-reading system were found to be high because of proximity effect from its handheld status. The z-score of inter-laboratory( zB) of other 4 measuring instruments with remote-reading system ranged from- 0. 52 to 1. 10,while the z-score of within-laboratory( zW) ranged from- 1. 28 to 0. 37,and both results of| zB| and | zW| were satisfactory( < 2. 00). The zBof power frequency magnetic field measured by the 6 measuring instruments ranged from- 0. 67 to 1. 26,while zWranged from- 0. 59 to 0. 90,and both | zB| and | zW| were also satisfactory( < 2. 00). CONCLUSION: It is feasible that the inter-laboratory comparison of measuring instruments of power frequency electromagnetic fields could be implemented by a high-voltage substation as a standard source. The measuring instruments without remote-reading system could be used to measure the intensity of magnetic field but not the electric field. The measuring instruments with remote-reading system could be used to measure the intensity of either the electric field or the magnetic field,and the measurement results are satisfactory.
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<p><b>OBJECTIVE</b>In order to provide the evidence for taking the measures to prevent noise hazards, the condition sand influence factors of occupational noise deafness diagnosis in Jiangsu province from 2006 to 2013 were analyzed.</p><p><b>METHODS</b>According to the 13 administrating personnel report of noise deafness diagnosed occupational disease prevention and control institutions in Jiangsu province from 2006 to 2013, the diagnosis of occupational noise deafness were retrospectively analyzed.</p><p><b>RESULTS</b>By the end of December 31 2013, 297 cases of noise deafness were diagnosis occupational disease within this province. Occupational noise deafness has localized on the machinery industry, textile and light industry. Regional distribution mainly concentrated in Suzhou, Yangzhou, Nanjing, Nantong. 83.16% in 297 cases were mild noise deafness.</p><p><b>CONCLUSION</b>The distribution of occupational noise deafness cases in Jiangsu province has specific charateristics. It is not balanced in different regions, and most of them are the mild noise deafness, male, length of service in more than 15 years, the onset age is 40~60 years old, According to characteristics of the occupational noise deafness cases in Jiangsu province, Specific occupational health service will help to reduce the occurrence of occupational noise deafness, and protect the worker's health effectively.</p>