Traditional Chinese medicine treatment of asymptomatic infection of SARS-CoV-2 / 中华危重病急救医学

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been infected rapidly and is generally susceptible to population. Moreover, it has become the most serious public health problem in the world. In the process of coronavirus disease 2019 (COVID-19) treatment, the traditional Chinese medicine (TCM) intervention has achieved positive efficacy and which is widely recognized. However, the COVID-19 epidemic is still very serious, especially due to the characteristics of asymptomatic infection such as concealment, limitations and subjective symptoms, which has increased the difficulty of prevention and control. In view of asymptomatic infection, isolation is the main management. There is little mention of specific treatment options in each version of COVID-19 treatment plan. Through systematic study of TCM theory, we explored the way of diagnosis and treatment of asymptomatic infections. Based on the theory of latent evil, clearing away latent pathogens to truncate the course of disease and reduce the incidence. Based on the theory of prevention of disease, strengthen the lung and stomach to protect the place from pathogen and prevent the transmission of disease evil. It is supplemented by accurate treatment according to individual, timing and local conditions, in order to provide reference for the treatment of asymptomatic infection.

Prevalence and workload-related risk factors of neck-shoulder pain among nurses in Hunan tertiary general hospitals / 环境与职业医学

Background Neck-shoulder pain is one of the most common discomfort symptoms among nursing staff, mostly caused by a heavy workload, restricted workstation, and prolonged poor posture. Objective To investigate the prevalence of neck-shoulder pain among nursing staff in tertiary general hospitals in Hunan Province, and to analyze workload-related risk factors. Methods From October to December 2018, a multi-stage stratified randomized cluster sampling method was adopted to select a total of 1 200 nursing staff who met the inclusion andexclusion criteria in six tertiary general hospitals from five geographic subdivisions of Hunan Province were selected. A self-designed questionnaire was used to collect demographic characteristics, and past 1-month prevalence of neck-shoulder pain, a neck disability index (NDI) was used to assess the impact of neck pain on daily life, and functional disability was graded by the index of impaired neck function; a self-designed questionnaire was adopted to evaluate potential workload-related risk factors (working time, postural load, and force load) of neck-shoulder pain after a Delphi expert consultation. A total of 1 161 valid questionnaires were returned, and χ２test and logistic regression model were used to screen the potential risk factors for neck-shoulder pain. Results The prevalence rate of neck-shoulder pain in the past 1 month was 87.5% (1 016/1 161) and varied by different characteristics of the nursing staff, ranging from 76.9% to 91.2%. The scores of the 10 items of the NDI ranged from 0 to 5, but most of them were 0, 1, and 2; of the 10 items, neck pain had the greatest impact on sleep (1.30±1.21) and the least impact on self-care behaviors (0.35±0.65). The index of impaired neck function showed that the majority (65.4%) of nurses had mild cervical spine dysfunction and 30.1% had moderate cervical spine dysfunction. The univariate analysis results revealed that 24 out of the 31 workload-related risk factors had significant differences, and further multiple analysis results showed that three variables entered the logistic regression model. Under the same conditions, nurses with ≥5 h of cumulative head-down tasks per shift had 3.03 times higher neck-shoulder pain risks compared with those with ＜1 h. Compared with “occasionally or never”, nurses who “sometimes” and “often” tilted their necks back and maintained this posture for a long time showed 2.36 and 2.94 times higher risks for neck-shoulder pain respectively. The nurses who reported “sometimes” and “often” having difficulty using their force at work due to unnatural posture had 2.78 times and 7.08 times higher neck-shoulder pain risks than those who “occasionally or never” respectively. Conclusion The reported rate of neck-shoulder pain among nurses in tertiary general hospitals in Hunan Province is high, but most of them are mild dysfunction. Working hours and posture load may affect the risk of neck-shoulder pain.

Protective effect of Lindera aggregata on lipopolysaccharide-induced mice acute respiratory distress syndrome by regulating p38MAPK/ERK pathway / 中华危重病急救医学

Objective:To explore the protective effect of Lindera aggregata on acute respiratory distress syndrome (ARDS) induced by lipopolysaccharide (LPS) in mice and its possible mechanism.Methods:Forty C57BL/6 mice were randomly divided into sham operation group, ARDS model group, low-dose Lindera aggregata (L-LA) group and high-dose Lindera aggregata (H-LA) group, with 10 mice in each group. ARDS model was established by injecting 5 mg/kg LPS through the trachea. The L-LA group and H-LA group were orally administrated 1 g/kg and 5 g/kg of the Lindera aggregate extract once a day, respectively, while the ARDS model group was given the same volume of normal saline, the sham group received no treatment. The Lindera aggregata was preadministered for 3 days before modeling, and continued for 2 days after modeling, then the animals were sacrificed, and bronchoalveolar lavage fluid (BALF) and lung tissue were collected. The pathological changes of lung tissue in each group of mice were observed under the microscope and the wet/dry weight ratio (W/D) of the lung were measured. Enzyme linked immunosorbent assay (ELISA) was used to examine the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in mice serum and BALF, and flow cytometry was used to detect the expression rate of CD40 on the surface of BALF macrophages. The phosphorylation levels of p38 and extracellular signal-regulated protein kinase 1/2 (ERK1/2) proteins in lung tissue were measured by Western blotting.Results:Lung histopathology under light microscope showed that the damage of alveolar structure, thickening of alveolar septum and infiltration of inflammatory cells in the H-LA group were less severe than those in the ARDS model group, while the pathological characteristics of ARDS in the L-LA group were not significantly different from those in the ARDS model group. Compared with the sham operation group, the lung W/D ratio, TNF-α and IL-6 protein contents in serum and BALF, BALF macrophage CD40 expression rate and lung tissue p38 and ERK1/2 protein phosphorylation levels were significantly increased in ARDS model group. The W/D ratio, the concentrations of TNF-α and IL-6 in serum and BALF, the expression rate of CD40 in BALF macrophages, and the phosphorylation levels of p38 and ERK1/2 protein in lung tissue in the L-LA group were not significantly different from those in the ARDS model group. The above indexes in the H-LA group were significantly lower than those in the ARDS model group and the L-LA group [W/D ratio: 5.70±0.19 vs. 6.20±0.31, 6.01±0.17; serum TNF-α (ng/L): 83.63±15.04 vs. 111.75±18.45, 108.12±13.98; serum IL-6 (ng/L): 111.38±8.75 vs. 244.13±26.85, 227.50±9.37; BALF TNF-α (ng/L): 36.25±2.82 vs. 51.13±5.44, 47.50±5.78; BALF IL-6 (ng/L): 35.63±2.20 vs. 49.63±4.90, 46.38±3.50; CD40 expression rate (%): 23.28±2.45 vs. 30.32±2.40, 28.17±1.98; p-p38/p38: 0.50±0.04 vs. 0.74±0.07, 0.69±0.04; p-ERK1/2/ERK1/2: 0.47±0.07 vs. 0.72±0.07, 0.68±0.05; all P < 0.01]. Conclusions:Lindera aggregata can inhibit LPS-induced lung inflammation and alleviate lung injury in ARDS mice. The mechanism may be related to the inhibition of the activation of p38 mitogen activated protein kinase/ERK (p38MAPK/ERK) signaling pathway.

A five-year follow-up report on lung imaging and exercise endurance of a patient with paraquat poisoning / 中华劳动卫生职业病杂志

A patient with paraquat poisoning was followed up for five years, and it was showed that the interstitial lesion areas in chest CT of this patient gradually decreased after acute period of the poisoning and no significant changes were found six months later. After that the density of the lesions gradually reduced, while the cystic air cavities slowly increased. In addition, the patient's exercise endurance gradually improved over time, and the lung function was close to the normal level five years after poisoning. The follow-up report helps clinicians to have a deeper understanding of the long-term outcome of paraquat poisoning.

Functional and binding studies of gallic acid showing platelet aggregation inhibitory effect as a thrombin inhibitor / 中草药·英文版

Objective: This study was devoted to identifying natural thrombin inhibitors from traditional Chinese medicine (TCM) and evaluating its biological activity in vitro and binding characteristics. Methods: A combination strategy containing molecular docking, thrombin inhibition assay, surface plasmon resonance (SPR) and molecular dynamics simulation were applied to verify the study result. Results: Gallic acid was confirmed as a direct thrombin inhibitor with IC

Two case reports: chronic obstructive pulmonary disease developed in long term survived patients after acute paraquat poisoning / 中华危重病急救医学

Patients with acute paraquat poisoning mostly die of respiratory failure, and the surviving ones may live with pulmonary fibrosis, but the long-term changes in lung function are still un-clear. Two patients with acute paraquat poisoning survived for more than 7 years were followed up in Northern Jiangsu People's Hospital to evaluate the imaging and spirometric changes. Eight years after poisoning, 1 patient's chest computerized tomography (CT) revealed interstitial pneumonia, chronic bronchitis, emphysema, accompanied by bronchiectasis. Spirometric test showed very severe obstructive ventilatory dysfunction [percentage of vital capacity (VC) to predicted values was 63.7%, percentage of forced expiratory volume in one second (FEV1) to predicted values was 33.2%, percentage of forced vital capacity (FVC) to predicted values was 64.7%, forced expiratory volume in one second to forced vital capacity (FEV1/FVC) was 52.5%, percentage of maximal mid-expiratory flow (MMEF) to predicted values was 9.9%, percentage of diffusion capacity for carbon monoxide in single breath (DLCO-SB) to predicted values was 49.3%]. The radiography of the other patient who survived over 7 years after poisoning also discovered chronic bronchitis, emphysema and bullae, along with pleural effusion. Spirometry identified severe mixed ventilatory dysfunction, mainly obstructive ventilatory disorder (percentage of VC to predicted values was 47.8%, percentage of FEV1 to predicted values was 35.6%, percentage of FVC to predicted values was 49.3%, FEV1/FVC was 74.1%, percentage of MMEF to predicted values was 17.1%, percentage of DLCO-SB to predicted values was 21.8%). These 2 cases indicate that acute paraquat poisoning had long-term effects on lung structure and pulmonary function, which may be manifested as chronic obstructive pulmonary disease.

Effects of TMEM16F on the Proliferation and Migration of Breast Cancer Cells / 中国医科大学学报

Objective To investigate the expression of transmembrane protein 16 F (TMEM16 F) in breast cancer cells and to elucidate the effect of the knockdown of its gene on proliferation and migration of T47 D breast cancer cells. Methods The expression of TMEM16 F protein in MDA-MB-231 and T47 D breast cancer cells was detected by Western blotting. The effect of TMEM16 F knockdown on the proliferation of T47 D breast cancer cells was detected by CCK-8 cell proliferation assay, and its effect on the migration of T47 D breast cancer cells was examined by cell scratch assay. Results Western blotting results showed TMEM16 F protein expression in breast cancer cells.The results of CCK-8 cell proliferation assay showed that compared to the Scrambled shRNA group, the proliferation of T47 D breast cancer cells was decreased after TMEM16 F knockdown (P = 0.037 0). The results of the scratch test showed that the migration ability of T47 D breast cancer cells was enhanced after TMEM16 F knockdown, compared to the control group (P = 0.002 7). Conclusion TMEM16 F is highly expressed in T47 D breast cancer cells. Knockdown of TMEM16 F can inhibit the proliferation and promote the migration of T47 D breast cancer cells.

A Case of Typical Ciliated Muconodular Papillary Tumor of the Lung: A Clinicopathological Analysis / 中国肺癌杂志

BACKGROUND@#The pathogenesis of a ciliated muconodular papillary tumor (CMPT) of the lung is extremely rare which is difficult to distinguish from other lung lesions and it is easy to cause misdiagnosis and missed diagnosis. By collecting CMPT data, its clinical and pathological features can provide medical treatment ideas for the majority of medical workers and reduce medical errors.@*METHODS@#The clinical data, pathological features, immunophenotype of a typical CMPT patient and related literature were analyzed.@*RESULTS@#The chest computed tomography (CT) showed there was a mixed density nodule in the right lower lung near the pleura with a diameter of about 9 mm. We performed a wedge resection on the patient. The pathological results showed that the nodule was composed of proliferated ciliated cells, mucous cells, and basal-like cells. The ciliated cells were lined on the surface of papillary structures. The basal-like cells were located in the outer layer, while the mucous cells were located between the two. The cell atypia was not obvious. Immunohistochemistry: epithelial cells CEA (+), CK7 (+), CA125 (+), weakly positive for TTF-1, CK20 (-), Ki67 (1%+), CK5/6 (+), and basal cells P63 (+).@*CONCLUSIONS@#CMPT is a rare pulmonary neoplasm. There is no definite conclusion about its biologic nature, but most experts prefer a benign to a malignant tumor. CMPT can show many malignant tumor signs on imaging and is often mistaken for lung adenocarcinoma. According to its typical histopathological characteristics and immunohistochemical phenotype, it can be differentiated from other pulmonary diseases. Whether gene mutation is the driving factor is still unknown. Surgical resection for the tumor reveals a good prognosis.

Seroepidemiology of varicella among the healthy population aged 1-19 years in Harbin, China / 中国当代儿科杂志

OBJECTIVE@#To investigate the level of IgG antibody to varicella in the healthy population aged 1-19 years in Harbin, China.@*METHODS@#Random sampling was performed to select 1 203 healthy individuals aged 1-19 years in Harbin. According to age, they were divided into ≥1 years group (n=240), ≥4 years group (n=396), ≥7 years group (n=364) and 14-19 years group (n=203). Enzyme-linked immunosorbent assay was used to measure the concentration of varicella-zoster virus (VZV)-IgG antibody in serum, and a concentration of VZV-IgG antibody of ≥100 mIU/mL was considered positive, suggesting that the subject had the ability to resist VZV infection.@*RESULTS@#The overall positive rate of VZV-IgG antibody was 71.49% (860/1 203), and the concentration of VZV-IgG antibody was 447±17 mIU/mL. The concentration of VZV-IgG antibody tended to increase with age (P<0.05). The positive rate of VZV-IgG antibody in the urban population was significantly higher than that in the rural population (P<0.05). There was significant difference in the positive rate of VZV-IgG antibody between the populations with different doses of varicella vaccination (P<0.05), and the population with 2 doses of vaccination had the highest positive rate of VZV-IgG antibody. There was a significant difference in the concentration of VZV-IgG antibody between the populations with different medical histories (P<0.05), and the population with a past history of varicella had the highest concentration.@*CONCLUSIONS@#Among the healthy population aged 1-19 years in Harbin, there is a significant difference in the level of VZV-IgG antibody between the urban and rural populations, as well as between different age groups. Varicella vaccination should be strengthened in areas with a low vaccination rate and the population aged <14 years.

Clinical significance and correlations of IL-10, IL-12 and IFN-γ levels in the patients with chronic hepatitis B virus infection / 中华实验和临床病毒学杂志

Objective@#To determine the changes in peripheral plasma concentrations of interleukin-10 (IL-10), interleukin -12 (IL-12) and interfoeron-γ(IFN-γ) in the patients with chronic hepatitis B virus (HBV) infection and their correlations with HBV infection stage or HBV DNA load of HBV carriers.@*Methods@#Data of 135 patients with chronic HBV infection from March 2016 to March 2017 were collected, the patients included 32 chronic HBV carriers, 61 with chronic hepatitis and 42 with cirrhosis. Forty healthy subjects served as controls. The concentrations of IL-10, IL-12 and IFN-γ were determined using enzyme-linked immunosorbent assay (ELISA). Correlation analysis was performed using the Pearson correlation test, which was performed to analyze the correlation between IL-10, IL-12, IFN-γ and HBV infection stage, HBV DNA load of HBV carriers.@*Results@#Compared with those in healthy controls, plasma IL-10 and IL-12 levels in patients with chronic hepatitis and cirrhosis increased significantly (F=22.06, 15.67, P=0.013, 0.021), plasma IL-10 and IL-12 levels in cirrhosis cases were higher than those in chronic hepatitis (all P<0.001), plasma IL-10 and IL-12 levels in chronic hepatitis were higher than those in chronic HBV carriers (all P<0.001). Plasma IFN-γ level in chronic HBV carriers, chronic hepatitis and cirrhosis were significantly higher than those in healthy controls (F=18.36, P=0.017). There were statistically significant differences in IFN-γ levels among the three groups in the chronic HBV carriers, chronic hepatitis and cirrhosis. IL-10, IL-12 and IFN-γ levels of the low, medium and high HBV DNA load groups were statistically significant (all P<0.05). There was no correlation between IL-10 and HBV DNA. IFN-γ, IL-12 and HBV DNA load were negatively correlated. There was no correlation between IL-10 and IFN-γ (r=0.103, P>0.05), IL-12 and IFN-γ were significantly positively correlated (r=0.687, P<0.05).@*Conclusions@#IL-10, IL-12 and IFN-γ may play an important role in the chronic HBV infection.

Comparison of the efficacy of lamivudine and enticavir in preventing hepatitis B virus reactivation in patients with B-cell non-Hodgkin lymphoma / 中国基层医药

Objective@#To investigate the efficacy of enticavir and lamivudine in preventing rituximab-associated hepatitis B virus(HBV) reactivation in patients with B-cell non-Hodgkin lymphoma complicated with resolved hepatitis B during chemotherapy.@*Methods@#This retrospective study included 216 B-cell non-Hodgkin lymphoma patients with complete data from January 2012 to January 2018 treated in 3 hospitals.Of 78 patients with resolved hepatitis B, they were divided into lamivudine prophylactic group(17 cases), entecavir prophylactic group(11 cases) and control group(50 cases). The changes of HBVM, HBV DNA and liver function before or after rituximab combination chemotherapy were analyzed.The incidence of HBV reactivation, liver function injury and chemotherapy delay were compared.@*Results@#Compared to the other 71 patients, 7 cases experienced HBV reactivation in 78 patients with resolved hepatitis B. There were no statistically significant differences between the two groups in patient demographics, pathological pattern, chemotherapy regimen.Six patients in the control group developed HBV reactivation(12%) and 1 patient in lamivudine prophylactic group(5.88%), none had HBV reactivation in enticavir prophylactic group.There was statistically significant difference among three groups(Fisher P=0.016). A total of 7 cases experienced HBV reactivation in 78 patients with resolved hepatitis B respectively, 2 cases in the first chemotherapy period, 2 cases in the third chemotherapy period, 1 case in the fifth chemotherapy period, the last one occurred after the completion of chemotherapy.Four patients had HBsAg reverse seroconversion, occurred in the 1, 3, 5 cycles during and after the completion of chemotherapy.Twenty patients (40.0%) experienced liver function parameters abnormal in the control group, 4 cases(23.5%) in lamivudine prophylaxis group, 2 cases (18.2%) in enticavir prophylaxis group during chemotherapy.@*Conclusion@#Antiviral prophylaxic therapy can potentially prevent rituximab associated HBV reactivation in patients with resolved hepatitis B. Entecavir can more reduce the risk of rituximab associated HBV reactivation than lamivudine.

Acute lung injury model induced by single dose of paraquat intratracheal aerosolization in mice / 中华急诊医学杂志

Objective@#To establish a mouse model of acute lung injury (ALI) via intratracheal aerosolization of paraquat (PQ).@*Methods@#Thirty male C57BL/6J mice of 8-10 weeks old were randomly(random number) divided into the paraquat model group (n = 15) and the saline control group (n = 15). Mice in the paraquat model group were administered PQ solution (0.4 mg/mL) at a single dose of 50 μL per mouse via intratracheal aerosolization. Mice in the saline control group received an equal volume of saline. Mice were sacrificed 72 h post-PQ administration and samples were collected. The general physical condition of mice including body weight as well as mortality was monitored daily. Pulmonary function, cell counting and classification of bronchoalveolar lavage fluid (BALF), proinflammatory cytokines (TNF-α, IL-1β, and IL-6) levels of BALF and serum, MPO activity and total protein concentration of BALF and pathological lung injury scores were obtained.@*Results@#The body mass of mice decreased progressively within 72 h after PQ intratracheal administration. The static compliance of lung decreased (P<0.01) and the resistance increased (P<0.01). The number of inflammatory cells in BALF was significantly higher than that of the saline control group (all P<0.01), the levels of proinflammatory cytokines were significantly upregulated in both BALF and serum (all P<0.01), and the activity of MPO in BALF was also remarkedly increased (P<0.01). The total protein concentration of BALF was significantly elevated (P<0.01). The pathological observation of lung tissue showed a large number of inflammatory cells infiltration accompanying pulmonary hemorrhage, alveolar collapse, hyaline membrane formation and alveolar septal thickening, and the lung injury scores significantly increased (P<0.01).@*Conclusions@#Intratracheal aerosolization of a single dose of 0.02 mg PQ can successfully induce ALI in mice.

Acute lung injury model induced by single dose of paraquat intratracheal aerosolization in mice / 中华急诊医学杂志

Objective To establish a mouse model of acute lung injury (ALI) via intratracheal aerosolization ofparaquat (PQ).Methods Thirty male C57BL/6J mice of 8-10 weeks old were randomly(random number) divided into the paraquat model group (n =15) and the saline control group (n =15).Mice in the paraquat model group were administered PQ solution (0.4 mg/mL) at a single dose of 50 μL per mouse via intratracheal aerosolization.Mice in the saline control group received an equal volume of saline.Mice were sacrificed 72 h post-PQ administration and samples were collected.The general physical condition of mice including body weight as well as mortality was monitored daily.Pulmonary function,cell counting and classification of bronchoalveolar lavage fluid (BALF),proinflammatory cytokines (TNF-α,IL-1β,and IL-6) levels of BALF and serum,MPO activity and total protein concentration of BALF and pathological lung injury scores were obtained.Results The body mass of mice decreased progressively within 72 h after PQ intratracheal administration.The static compliance of lung decreased (P＜0.01) and the resistance increased (P＜0.01).The number of inflammatory cells in BALF was significantly higher than that of the saline control group (all P＜0.01),the levels of proinflammatory cytokines were significantly upregulated in both BALF and serum (all P＜0.01),and the activity of MPO in BALF was also remarkedly increased (P＜0.01).The total protein concentration of BALF was significantly elevated (P＜0.01).The pathological observation of lung tissue showed a large number of inflammatory cells infiltration accompanying pulmonary hemorrhage,alveolar collapse,hyaline membrane formation and alveolar septal thickening,and the lung injury scores significantly increased (P＜0.01).Conclusions Intratracheal aerosolization of a single dose of 0.02 mg PQ can successfully induce ALI in mice.

Discussion on Professor WU Liang-cun's Experience in Treating Primary Hepatic Carcinoma with Enriching Water to Nourish Wood Method / 中国中医药信息杂志

Professor WU Liang-cun is good at the treatment of primary hepatic carcinoma. He views that the main pathogenesis of primary hepatic carcinoma is liver and kidney deficiency. Therefore, treatment should be based on enriching water to nourish wood, with soothing the liver and regulating qi, clearing the gallbladder and removing dampness, promoting blood circulation for removing blood stasis, detoxicating and resolving masses.

Studying on the Interaction of Mental Health, Internet Addiction Disorder, Nociceptive Behavior and Sleep Quality among College Students in Lanzhou University / 沈阳医学院学报

Objective:To study the status and relationship of mental health,internet addiction disorder,nociceptive behavior and sleep quality among college students,and to provide evidence for healthcare. Methods:A total of 2 868 college students were chosen from Lanzhou University and surveyed with questionnaires on the status of mental health, internet addiction disorder, nociceptive behavior and sleep quality. Results:Sleep quality and health risk behaviors in girls were better than boys (P<0.05) . Psychological state in medical students was best. Sleep quality score in engineering students was the highest. Health risk behaviors in science students had highest score. Internet addiction behavior in engineering students had the highest score. Mental health score in three or more students was less than that in junior students,while sleep quality and internet addiction behavior score was higher (P<0.01) . Conclusion:Mental health has a negative influence on nociceptive behavior and internet addiction disorder,while it has a positive effect on sleeping quality. A negtive correlation lies between sleeping quality and nociceptive behavior or internet addiction disorder. The departments should pay attention to the status of mental health,internet addiction disorder,nociceptive behavior and sleep quality among college students,and the appropriate prevention is necessary.

A new designed multi-functional lacrimal sac nasal drainage stent used in endoscopic dacryocystorhinostomy / 国际眼科杂志(Guoji Yanke Zazhi)

To observe the reliability and short-term and mid-term efficacy of a new designed multi-functional lacrimal sac nasal drainage stent on the treatment of nasolacrimal duct obstruction after endonasal endoscopic dacryocystorhinostomy ( EES-DCR ) , and to evaluate its clinical application value. METHODS: A retrospective case series study was carried out. Seventy - six patients ( 79 eyes ) with nasolacrimal duct obstruction underwent EES-DCR and a new type of multi-functional lacrimal sac nasal drainage stent was implanted. The nasal lacrimal drainage stent was pulled out 2~3mo later after surgery and the patients received 3~6mo follow-up afterwards. RESULTS: ln 79 eyes, stents were successfully implanted in 77 eyes (97. 5%). All stents of 77 eyes could be pulled out successfully 2 ~ 3mo after the operation. Sixty eyes were cured with unobstructed lacrimal irrigation and symptom of epiphora disappeared;15 eyes were improved of epiphora and mild reflux during lacrimal irrigation were found, overall effective rate was 97. 4%, 2 eyes failed in stent implantation. ln 6mo follow-up, nocomplications such as stent displacement or slip was occurred, the epithelization of anastomotic stoma was good.CONCLUSlON: Surgical technique of using the multi-function nasolacrimal stent is simple and fast, and implantation of the new designed stents has a rapid recovery with fewer complications. The usage of the new stents not only improves the success rate but also broadens surgical indications of EES-DCR, it is a safe and effective method for the treatment of nasolacrimal duct obstruction.

Analysis of early clinical risk factors of severe acute organic fluorine inhalation poisoning / 中国中西医结合急救杂志

ObjectiveTo investigate the early clinical risk factors of severe acute inhaled organic fluorine poisoning.Methods The clinical data of patients with acute poisoning of organic fluorine inhalation admitted since 2004 in Northern Jiangsu People's Hospital were retrospectively analyzed. According toDiagnostic Criteria of Occupational Acute Fluorohydrocarbon Poisoning(GBZ66-2002), all the patients were divided into three groups: mild, moderate and severe poisoning groups, the severe cases were included in the intensive group, and the others were grouped in the non-intensive group. The contents in the survey were as follows: gender, age, vital signs on admission (body temperature, pulse rate, respiratory rate, systolic blood pressure), arterial blood gas analysis record〔arterial oxygen saturation(SaO2), oxygenation index(PaO2/FiO2), lactic acid(Lac) and arterial partial pressure of carbon dioxide(PaCO2), pH value(pH)〕. Before treatment, the white blood cell(WBC) count, platelet(PLT) count, levels of alanine transaminase(ALT), creatinine(Cr), blood glucose, electrolytes(potassium, sodium, chloride, calcium), creatine kinase isoenzyme(CK-MB), etc. were examined and recorded. All the patients were immediately arranged for bedside chest X-ray examination, and the chest X-ray lung injury scores were recorded. By univariate and multivariate logistic regression analyses, the receiver operating characteristic curve(ROC curve) was drawn to evaluate the diagnostic value of the clinical risk factors.Results Sixty-two cases consisting with the standard criteria of enrollment were collected in the study, 36 cases being in intensive group and 26 cases in non-intensive group. The univariate analysis showed that the differences in pulse rate, respiratory rate, PaO2/FiO2, WBC, SaO2, Lac, pH, and lung injury score were statistically significant(P<0.05 orP<0.01). Logistic multiple regression analysis showed that PaO2/FiO2, WBC, Lac and chest X-ray lung injury score were the four indexes for predicting the independent risk factors of severe acute inhaled organic fluorine poisoning. The area under ROC curve(AUC) of PaO2/FiO2 was the highest(0.884), 95% confidence interval(95%CI) was 0.784 - 0.984, the critical value was 96.5 mmHg(1 mmHg=0.133 kPa), with the sensitivity of 75.6%, specificity of 95.2%, positive predictive value(PPV) of 92.3% and the negative predictive value(NPV) of 71.4%, in sequence, the rest were WBC(AUC 0.846, 95%CI 0.728 - 0.965, the criticalvalue 12.15×109/L), Lac(AUC 0.800, 95%CI 0.662 - 0.938, the critical value 4.2 mmol/L), chest X-ray lung injury score(AUC 0.795, 95%CI 0.652 - 0.938, the critical value 2.50), the sensitivity of the above three items was 90.2%, 83.6%, 88.5%, specificity was 90.2%, 83.6%, 88.5%, the PPV was 86.7%, 82.4%, 85.8% and NPV was 72.0%, 73.9%, 69.2% respectively.ConclusionThe blood WBC count, Lac, PaO2/FiO2 and chest X-ray lung injury score can be used as the early clinical risk factors of severe acute inhaled organic fluorine poisoning.

Association of CYBA rs7195830 polymorphism with estimated glomerular filtration rate in an adult Han sample from Jiangsu province, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Reactive oxygen species are thought to contribute to the development of renal damage. The P22phox subunit of nicotinamide adenine dinucleotide phosphate (NAPDH) oxidase, encoded by the cytochrome b245a polypeptide gene, CYBA, plays a key role in superoxide anion production. We investigated the association of CYBA rs7195830 polymorphism with estimated glomerular filtration rate (eGFR) and the role it plays in the pathogenesis of chronic kidney disease (CKD) in a Han Chinese sample.</p><p><b>METHODS</b>The Gaoyou study enrolled 4473 participants. Serum levels of creatinine were measured and eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equations. The CYBA polymorphisms were genotyped. Then we investigated the association between eGFR and the rs7195830 polymorphism in the recessive model.</p><p><b>RESULTS</b>The AA genotype of rs7195830 was associated with significantly lower values of eGFR compared with the GG and AG genotypes ((102.76 ± 17.07) ml×min(-1)×1.73 m(-2) vs. (105.08 ± 16.30) ml×min(-1)± 1.73 m(-2)). The association remained significant in the recessive model after adjusting for age, gender, body mass index, smoking, hypertension, diabetes mellitus, uric acid, triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol (β=1.666, P=0.031). The rs7195832 AA genotype was an independent risk factor for CKD: eGFR <60 ml×min(-1)×1.73 m(-2) (odds ratio=3.32; 95% CI=1.21-9.13).</p><p><b>CONCLUSION</b>The AA genotype of rs7195830 is independently associated with lower estimated glomerular filtration rate and is significantly associated with CKD.</p>

Effects of calcitriol, training on balance and lower extremity muscle strength on fall risk of postmenopausal osteoporotic women / 中华健康管理学杂志

ObjectiveTo investigate the effects of caleitriol,training on balance and lower extremity muscle strength on fall risk of postmenopausal women with osleoporosis or osteopenia.Methods A total of 200 postmenopausal women with osteoporosis or osteopenia,whose balance test confirmed higher fall risk,were randondy assigned to group A or B.Those of group A received the following intervention:( 1 ) 0.25 μg calcitriol,QD; (2) general information on fall and osteoporosis; (3) balance training; (4) lower extremity muscle strength exercises.Those of group B were only treated with 0.25 μg calcitriol.All the participants were supplemented with 600 mg/d calcium and 125 IU/d vitamin D.Fall index,bone mineral density,serum levels of calcium and phosphorus,and adverse reactions were record.Results After 3 months' intervention,the fall index of both groups was significantly decreased ( group A:t =2.16,P＜0.05 ; group B:t =2.08,P＜0.05 ).After 6 months' intervention,the fall index of both groups went on decreasing,and significant difference of fall index between 6 month and baseline of group A and between group A and group B at 6 months was found.After 1-year intervention,the fall index of group A was further decreased in comparison with group B ( t =2.66,P＜0.05 ).No hypercalcemia occurred during the study period.Conclusion The fall risk of the patients with postmenopausal osteoporosis or osteopenia was reduced after 3 months' intervention.Twelve months' active vitamin D intervention could either reduce the risk of fall or improve bone mineral density.Patient education,balance training and muscle exercise may be effective intervention to reduce fall risk.

5 mg zoledronic acid for treatment of postmenopausal women with osteoporosis and osteoporotic fracture / 中华创伤骨科杂志

Objective To investigate the effect of once yearly zoledronic acid of 5 mg on postmenopausal women with osteoporosis of different causes. MethodsFrom October 2009 to December 2009,a total of 89 postmenopausal women with osteoporosis were enrolled and assigned into 2 groups.There were 45 cases of primary postmenopausal osteoporosis,including 27 cases of fresh fracture,in group A.They were aged from 47 to 83 years,with an average of 63.7 years.There were 44 cases of secondary postmenopausal osteoporosis,including 28 cases of fresh fracture,in group B.All patients were given a.single 30-minute intravenous injection of zoledronic acid (5 mg),supplemented by 1,25-dihydroxyvitamin D of 0.25 μg and calcium of 600 mg with VitD125 IU daily.At pre-intervention and 12 months after intervention respectively,bone mineral density (BMD) was measured by dual-X-ray absorptiometry (DXA) at the lumbar spine and hip,and a balance test(Sunlight Tetrax- Ⅱ) was performed to evaluate the risk of falling.Intervention compliance of the patients and adverse events related to zoledronic acid infusion were observed. Results All cases of fresh fracture healed well at 3-month follow-up.At 12 months,43 subjects in group A and 42 subjects in group B completed the follow-up.In group A,BMD increased by 5.8％ at the lumbar spine,by 2.9％ at the femoral neck,by 5.2％ at the Words area,by 5.3％ at the greater trochanter and by 3.9％ at the total hip while the risk of falling decreased by 26.1％; in group B,BMD increased by by 3.4％ at the lumbar spine,by 2.1％ at the femoral neck,by 3.2％ at the Words area,by 3.0％ at the greater trochanter and by 2.5％ at the total hip while the risk of falling decreased by 21.8％.The differences between pre-intervention and post-intervention were significant in both groups ( P ＜ 0.05).No intolerable adverse events occurred in both groups except that one new fracture happened in each group but responded to conservative treatment.ConclusionA once-yearly infusion of zoledronic acid of 5 mg is a convenient and effective therapy for treatment of osteoporosis in postmenopausal women.