The prevalence and associated factors of functional constipation among primary and middle school students in Shaanxi Province / 中国学校卫生

Objective@#To understand the prevalence and associated factors of functional constipation(FC) among primary and middle school students in Shaanxi Province, in order to provide a basis for preventing FC in students.@*Methods@#A stratified cluster random sampling method was used to conduct a questionnaire survey on 9 133 primary and middle school students aged 10-18 in eight primary and secondary schools in Shaanxi Province from March to September,2017. Chi square test and multivariate Logistic regression were used to analyze the associated factors of FC among primary and middle school students in Shaanxi Province.@*Results@#There were a total of 364 students meeting the FC Rome IV diagnostic criteria, with a prevalence rate of 3.99%. Among them, there were 155 male students with a prevalence rate of 3.43%, and 209 female students with a prevalence rate of 4.53%. Univariate analysis showed that gender, breastfeeding, separation from parents, long term school meals, types of staple foods, breakfast frequency, cold foods eating frequency, spicy foods eating frequency, fried food eating frequency, pickled food eating frequency, desserts eating frequency, vegetables eating frequency were related to FC, and the differences were statistically significant ( χ 2=7.30,18.75, 20.89,35.54,22.43,16.05,21.31,13.97,10.33,23.96,16.25,17.74, P <0.05). Multivariate Logistic regression analysis showed that female, non breastfeeding, separation from parents, long term school meals, low consumption of staple food/staple food dominated by rice, and never eating vegetables were positively correlated with FC( OR =1.37,1.96,1.52,2.07,1.76,1.58,2.31, P < 0.05 ).@*Conclusions@#The prevalence of functional constipation is higher in primary and middle school students. Attention should be paid to factors related to students dietary habits and food classification to prevent the occurrence of FC in primary and middle school students.

Application of self-made multifunctional accessory stent in endoscopic mucosal dissection / 中国实用护理杂志

Objective:To investigate the safety and efficacy of self-made multifunctional endoscopic instrument accessory stent in endoscopic mucosal dissection (ESD).Methods:A total of 80 patients who received ESD in 924th Hospital of Joint Logistic Support Force of Chinese People′s Liberation Army from May 2019 to February 2021 were selected as research object. Random number table method was used to divide patients into control group and experimental group, 40 cases in each group. The experimental group used self-made endoscopic instrument accessory stent, and the control group did not use self-made endoscopic instrument accessory stent. The length of operation, the number of instruments taken by mistake, the number of instruments polluted during operation and the infection of postoperative 3-7 days under the same operation position, operating doctors and nurses were analyzed and compared between the two groups.Results:The incidence of instruments taken by mistake, the incidence of instruments polluted during operation and the infection rate of postoperative 3-7 days were 0.9% (8/856), 1.4% (12/856) and 2.5% (1/40) in the experimental group, which in the control group were 10.8% (96/887), 11.8% (105/887) and 15.0% (6/40) respectively, there were significant differences between the two groups ( χ2=75.92, 75.76, 3.91, all P<0.05). The length of operation in the experimental group was (51.56 ± 2.32) min, and that in the control group was (79.02 ± 2.83) min, the difference was statistically significant ( t=-8.72, P<0.05). Conclusions:When the patients underwent ESD surgery, the self-made multifunctional accessory stent was used to place the required instrument accessory. The length of operation was shorter, the incidence of instruments taken by mistake, the incidence of instruments polluted during operation and the infection rate of postoperative 3-7 days were reduced, the quality of minimally invasive endoscopic surgery was improved.

Case report of Langerhans cell histiocytosis in 2 neonates / 中华实用儿科临床杂志

To analyze the clinical data of 2 neonates with Langerhans cell histiocytosis (LCH). The rashes appeared in both cases shortly after birth.Case 1 had both rashes and neonatal sepsis, and no other tissues and organs were involved.After anti-infective treatment, the rashes gradually disappeared.Case 2 had secondary pneumonia, abnormal coagulation function and gastrointestinal bleeding.Both cases were positive for CD1a and S-100 by immunohistochemical staining of skin biopsy, and they were diagnosed as multi system-LCH.The early diagnosis of LCH is particularly important.The detection methods of skin or lymph node biopsy like immunohistochemistry, need to be performed as early as possible.Because the course of the disease is not clear, a close monitoring and follow-up are needed.

A meta-analysis on advantages of peripheral nerve block post-total knee arthroplasty

Background@#Postoperative pain management is crucial for patients undergoing total knee arthroplasty (TKA). There have been many recent clinical trials on post-TKA peripheral nerve block; however, they have reported inconsistent findings. In this meta-analysis, we aimed to comprehensively analyze studies on post-TKA analgesia to provide evidence-based clinical suggestions. @*Methods@#We performed a computer-based query of PubMed, Embase, the Cochrane Library, and the Web of Science to retrieve related articles using neurothe following search terms: nerve block, nerve blockade, chemodenervation, chemical neurolysis, peridural block, epidural anesthesia, extradural anesthesia, total knee arthroplasty, total knee replacement, partial knee replacement, and others. After quality evaluation and data extraction, we analyzed the complications, visual analogue scale (VAS) score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. @*Results@#We included 16 randomized controlled trials involving 981 patients (511 receiving peripheral nerve block and 470 receiving epidural block) in the final analysis. Compared with an epidural block, a peripheral nerve block significantly reduced complications. There were no significant between-group differences in the postoperative VAS score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. @*Conclusions@#Our findings demonstrate that the peripheral nerve block is superior to the epidural block in reducing complications without compromising the analgesic effect and patient satisfaction. Therefore, a peripheral nerve block is a safe and effective postoperative analgesic method with encouraging clinical prospects.

Research progress in mechanisms of idiosyncratic drug-induced liver injury mediated by inflammatory stress / 药学学报

Idiosyncratic drug-induced liver injury (IDILI) is an unpredictable serious adverse drug reaction, which only occurs in a minority of special susceptible individuals. Although the mechanism of IDILI has not been fully understood, several hypotheses have been proposed to explain the action mode and specific mechanism of IDILI. Of these hypotheses, inflammatory stress hypothesis is one of the most important theories. Under the condition of inflammatory stress, drugs interact with inflammation and mediate the occurrence of IDILI through a variety of mechanisms, which can induce the production of inflammatory cytokines, activate coagulation system, affect the activity of metabolites, induce cholestasis, affect mitochondrial damage, and others. This review will summarize the main mechanisms and influencing factors of IDILI mediated by inflammatory stress, in order to provide a reference for preclinical drug development and basic research on drug-induced liver injury.

Epidemiological characteristics of the notifiable infectious diseases reported in Zhejiang Province, 2020 / 预防医学

Objective@#To analyze the epidemiological characteristics of notifiable infectious diseases reported in Zhejiang Province in 2020 for prevention and control.@*Methods@#Data of notifiable infectious diseases reported in Zhejiang Province in 2020 were extracted from China Information System for Disease Control and Prevention. The incidence and death of notifiable infectious diseases were analyzed and compared with the averages from 2015 to 2019; then the characteristics of some key diseases such as coronavirus disease 2019 ( COVID-19 ), influenza and other infectious diarrhea were summarized. @*Results@#Totally 487 271 cases of 30 kinds of infectious diseases were reported. The incidence and mortality rate was 832.94/100 000 and 0.615 4/100 000, which were 7.05% and 14.60% lower than the average value of 2015-2019.The weekly morbidity of Class A and Class B infectious diseases fluctuated between 1.24/100 000 and 3.68/100 000, and hit the bottom in the sixth to eighth week. The morbidity of Class C infectious diseases was 154.19/100 000 in the first week, then dropped to 4.83/100 000 in the second to sixth week and maintained at a low level. High morbidity of infectious diseases were reported in Hangzhou ( 1 412.62/100 000 ), Jinhua ( 960.35/100 000 ) and Ningbo ( 921.25/100 000 ). The morbidity of class C infectious diseases in Hangzhou was 1 248.80/100 000, which was far higher than that of other ten prefecture-level cities. The diseases with high reported morbidity were influenza (438.45/100 000), other infectious diarrhea (140.29/100 000 ), hand-foot-and-mouth disease ( 99.64/100 000 ), pulmonary tuberculosis ( 41.92/100 000 ), syphilis (41.37/100 000) and viral hepatitis ( 30.48/100 000 ). More deaths were reported in AIDS and pulmonary tuberculosis, and the mortality were 0.482 1/100 000 and 0.116 2/100 000. A total of 1 306 confirmed cases, 302 asymptomatic infections and 1 death of COVID-19 were reported. @*Conclusion@#In 2020, the incidence rate of notifiable infectious diseases in Zhejiang decreased compared with the average value of 2015-2019. Pulmonary tuberculosis, syphilis and hepatitis B still have high morbidity, and the COVID-19 epidemic spread widely. The morbidity of some respiratory infectious diseases and imported infectious diseases have dropped significantly compared with previous years.

A meta-analysis on advantages of peripheral nerve block post-total knee arthroplasty

Background@#Postoperative pain management is crucial for patients undergoing total knee arthroplasty (TKA). There have been many recent clinical trials on post-TKA peripheral nerve block; however, they have reported inconsistent findings. In this meta-analysis, we aimed to comprehensively analyze studies on post-TKA analgesia to provide evidence-based clinical suggestions. @*Methods@#We performed a computer-based query of PubMed, Embase, the Cochrane Library, and the Web of Science to retrieve related articles using neurothe following search terms: nerve block, nerve blockade, chemodenervation, chemical neurolysis, peridural block, epidural anesthesia, extradural anesthesia, total knee arthroplasty, total knee replacement, partial knee replacement, and others. After quality evaluation and data extraction, we analyzed the complications, visual analogue scale (VAS) score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. @*Results@#We included 16 randomized controlled trials involving 981 patients (511 receiving peripheral nerve block and 470 receiving epidural block) in the final analysis. Compared with an epidural block, a peripheral nerve block significantly reduced complications. There were no significant between-group differences in the postoperative VAS score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. @*Conclusions@#Our findings demonstrate that the peripheral nerve block is superior to the epidural block in reducing complications without compromising the analgesic effect and patient satisfaction. Therefore, a peripheral nerve block is a safe and effective postoperative analgesic method with encouraging clinical prospects.

Preparation of highly sensitive monoclonal antibody against aflatoxin B_1 and its application in rapid detection of contamination in Ziziphi Spinosae Semen / 中国中药杂志

A highly sensitive monoclonal antibody against aflatoxin B_1(AFB_1) was prepared and an indirect competition enzyme-linked immunosorbent assay(ic-ELISA) was established based on the antibody which was used for high-throughput and rapid screening of AFB_1 contamination in Chinese herbal medicines to ensure the safety of medication. In this study, the structure of AFB_1 was modified by improved oxime method, and the carrier protein was coupled by EDC-NHS method to obtain the complete antigen of AFB_1, which was more convenient and environmental friendly. The Balb/c female mice were immunized using increasing the immunization dose and various ways of injection, and finally the AFB_1 monoclonal antibody was prepared. The AFB_1 monoclonal antibody belongs to IgG_(2 b) immunoglobulin by identifying its immunological characteristics, and its sensitivity(IC_(50)) can reach 0.15 μg·L~(-1), and the affi-nity is 2.81×10~8 L·mol~(-1). The cross-reaction rates of AFB_2, AFG_1, and AFG_2 were 35.07%, 8.75%, and 1.15%, respectively, and there was almost no cross-reactivity with other mycotoxins. Based on the high sensitivity and specificity of the antibody, an ic-ELISA method was established and applied to the determination of AFB_1 contamination in Ziziphi Spinosae Semen. According to the matrix matching standard curve, the linear concentration range for AFB_1 was 0.05-0.58 μg·L~(-1)(R~2=0.992), the recoveries were 88.00%-119.0%, and the detection limit was 1.69 μg·kg~(-1). The AFB_1 in 33 batches of Ziziphi Spinosae Semen samples was determined by ic-ELISA, and the contamination level was 3.62-206.58 μg·kg~(-1). The linear correlation coefficient between the detection results of ic-ELISA and UHPLC-MS/MS was 0.996, and there were no false positive and false negative cases. It indicates that the established ic-ELISA is accurate and reliable, and could provide a simple and effective technique for fast screening of AFB_1 contamination in Ziziphi Spinosae Semen, and also could be considered as the reference for the detection and monitoring of AFB_1 contamination in other Chinese herbal medicines.

Epigenetic research progress in colorectal cancer / 中南大学学报(医学版)

Colorectal cancer is one of the common malignant tumors, which seriously threatens human health. Its morbidity and mortality rank the third and the second among all malignant tumors. The progress of colorectal cancer is a complex process involving the accumulation of genetic and epigenetic changes. Epigenetic changes of colorectal cancer mainly include DNA methylation, histone modification, non-coding RNAs (such as microRNAs and lncRNAs), which are of great significance to early diagnosis and prognosis evaluation, and to chemosensitivity assessment for colorectal cancer, providing a new thought for the treatment of colorectal cancer.

Therapeutic observation on acupuncture-moxibustion at different intervals for persistent allergic rhinitis / 针灸推拿医学（英文版）

Objective:To observe the therapeutic effect of acupuncture-moxibustion at different intervals on persistent allergic rhinitis. Methods: A total of 90 patients conforming to the inclusion criteria were randomized into three groups named A, B and C by randomized block method. Patients in all three groups received the same treatment of acupuncture and herbal cake-partitioned moxibustion at the same acupoints, while the treatment frequency was different. Patients in group A received the treatment once a week, group B twice a week and group C three times a week, and all the treatment lasted for 4 weeks. The total nasal symptom score (TNSS), total ocular symptom score (TOSS) and Sino-nasal outcome test-20 (SNOT-20) were evaluated before and after treatment. The self-rating score of symptoms was evaluated during treatment and 2 weeks after treatment. Results: The total effective rate was 80.0% in group A, 93.3% in group B, and 100.0% in group C. The total effective rate in group A was statistically different from that in group B and group C (both P＜0.05), but there was no significant inter-group difference in total effective rate between group B and group C (P＞0.05). After treatment, scores of TNSS, TOSS and SNOT-20 in all three groups dropped significantly, and statistically different from those before treatment (all P＜0.05); between-group comparison showed group B and group C decreased more obvious than group A (all P＜0.05). In self-rating score of symptoms, there were no inter-group statistically significant differences in the first 3-week treatment (all P＞0.05); after 4-week treatment, the score in group A was higher than that in group B and group C, and showed statistical significant (both P＜0.05); at 2 weeks after treatment, the score in group A was higher than that in group B and group C based on an everyday record, showing statistical significance (both P＜0.05). At the 11th day after treatment, the score in group B was higher than that in group C (P＜0.05). There were no significant differences between group B and group C at other time points (all P＞0.05). Conclusion: All three protocols are effective for allergic rhinitis. With the increase of treatment frequency, the therapeutic efficacy with a treatment frequency of twice a week and three times a week is superior to that of once a week. Frequency of three times a week has a better long-term effect than once and twice a week, together with the least fluctuation of symptoms.

Characteristics of Acupoints Selection in Acupuncture-moxibustion Treatment of Primary Dysmenorrhea Based on Data Mining / 上海针灸杂志

Objective To summarize the characteristics of acupoints selection in acupuncture-moxibustion treatment of primary dysmenorrhea (PD) based on data mining. Method Clinical literatures published in the recent 10 years related to acupuncture-moxibustion treatment of PD were collected to establish a prescription database by using Excel. The descriptive analysis, association rules analysis and clustering analysis were conducted by Python and Clementine12.0. Result A total of 74 acupoints were involved with a total frequency of 1072. The leading three meridians were Spleen Meridian (325 times), Conception Vessel (260 times) and Bladder Meridian (158 times); the leading acupoints were Sanyinjiao (SP6, 174 times), Guanyuan (CV4, 111 times), Diji (SP8, 79 times), Ciliao (BL32, 73 times) and Qihai (CV6, 67 times). The utilization of the specific acupoints accounted for 66.22% (49/74). The crossing acupoints were predominant (393 times), especially Sanyinjiao, Guanyuan and Zhongji (CV3), followed by the five-Shu points (195 times), Front-Mu points (195 times) and Yuan-Primary points (99 times). The association rules analysis showed that Guanyuan and Sanyinjiao had the most significant correlation. The clustering analysis figured out 8 core clustering groups. Conclusion The characteristics of acupoints selection revealed in this study provide ideas and references for acupuncture-moxibustion treatment of PD in clinic.

Quantification of amlodipine in human plasma by LC-MS/MS method: elimination of matrix effects by improving chromatographic conditions / 药学学报

A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the quantification of amlodipine in human plasma. The influence of alkalizer, extraction solvent and the chromatographic conditions on the matrix effects was investigated. The stable isotope-labeled amlodipine (amlodipine-d4) was used as an internal standard. Sample preparation involved simple liquid-liquid extraction procedure using methyl tertiary butyl ether. Chromatographic separation was achieved on a Welch Ultimate XB-C18(100 mm×2.1 mm, 3 μm) column with acetonitrile/2 mmol·L-1 ammonium formate (pH 3.0) under gradient condition at a flow rate of 0.6 mL·min-1. Detection was performed using electrospray ionization (ESI) in positive ion multiple reaction monitoring (MRM) mode. The linear range of the analyte was 0.1-20.0 μg·L-1, with the lower limit of quantitation (LLOQ) of 0.1 μg·L-1. The matrix factor for low, medium, high concentration quality control samples and internal standard was (93.9±1.8)%, (95.8±4.9)%, (93.9±1.5)% and (97.9±5.3)%, respectively. The method showed excellent specificity, linearity, intra-day and inter-day accuracy and precision, extraction recovery and stability, according to the CFDA guidance for bioanalytical method validation. The matrix effect was significantly improved through optimizing the chromatographic conditions. This economical, simple, robust, sensitive and specific method is entirely able to meet the requirement of the determination of amlodipine in human plasma samples obtained from bioequivalence studies.

Imbalance of Tc and Th in Peripheral Blood of Patients with Systemic Lupus Erythematosus and Its Significance / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the imbalance of Tc1/Tc2,Th1/Th2 and Tc/Th in patients with systemic lupus erythematosus(SLE) and its relationship with the clinical stages of SLE.</p><p><b>METHODS</b>The full blood culture and flow cytometry with fluorescence-labelled T lymphocytes were used to detect the levels of T-lymphocyte subsets and its intracellular factors IFN-γ and IL-4 in peripheral blood from SLP patients in active, inactive stages and normal healthy persons as controls, to compare the changes of Tc1,Tc2; Th1,Th2 levels and Tc/Th ratio in SLP patients in active and inactive stages, and to analyze their relationship with SLEDAI staging.</p><p><b>RESULTS</b>Compared with healthy controls, the levels of CD4/CD8in active SLE patients were significantly lower, but the levels of Tc1,Th1 in active SLE patients were higher than those in inactive SLE patients and normal controls. The ratio of Tc1/Tc2 and Th1/Th2 in the active SLE was higher than that in inactive SLE and normal controls(P<0.05), but the difference between inactive SLE patients and controls was not statistically significant (P>0.05).</p><p><b>CONCLUSION</b>The Tc/Th imbalances and change of Tc and Th cells to Tc1 and Th1 cells play an important role in the pathogenesis of SLE.</p>

Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients, / Acurácia diagnóstica do protocolo de ultrassom pulmonar à beira do leito em situações de emergência para diagnóstico de insuficiência respiratória aguda em pacientes com ventilação espontânea

Objective: Bedside lung ultrasound (LUS) is a noninvasive, readily available imaging modality that can complement clinical evaluation. The Bedside Lung Ultrasound in Emergency (BLUE) protocol has demonstrated a high diagnostic accuracy in patients with acute respiratory failure (ARF). Recently, bedside LUS has been added to the medical training program of our ICU. The aim of this study was to investigate the accuracy of LUS based on the BLUE protocol, when performed by physicians who are not ultrasound experts, to guide the diagnosis of ARF. Methods: Over a one-year period, all spontaneously breathing adult patients consecutively admitted to the ICU for ARF were prospectively included. After training, 4 non-ultrasound experts performed LUS within 20 minutes of patient admission. They were blinded to patient medical history. LUS diagnosis was compared with the final clinical diagnosis made by the ICU team before patients were discharged from the ICU (gold standard). Results: Thirty-seven patients were included in the analysis (mean age, 73.2 ± 14.7 years; APACHE II, 19.2 ± 7.3). LUS diagnosis had a good agreement with the final diagnosis in 84% of patients (overall kappa, 0.81). The most common etiologies for ARF were pneumonia (n = 17) and hemodynamic lung edema (n = 15). The sensitivity and specificity of LUS as measured against the final diagnosis were, respectively, 88% and 90% for pneumonia and 86% and 87% for hemodynamic lung edema. Conclusions: LUS based on the BLUE protocol was reproducible by physicians who are not ultrasound experts and accurate for the diagnosis of pneumonia and hemodynamic lung edema. .

Objetivo: O ultrassom pulmonar (USP) à beira do leito é uma técnica de imagem não invasiva e prontamente disponível que pode complementar a avaliação clínica. O protocolo Bedside Lung Ultrasound in Emergency (BLUE, ultrassom pulmonar à beira do leito em situações de emergência) demonstrou elevado rendimento diagnóstico em pacientes com insuficiência respiratória aguda (IRpA). Recentemente, um programa de treinamento em USP à beira do leito foi implementado na nossa UTI. O objetivo deste estudo foi avaliar a acurácia do USP baseado no protocolo BLUE, quando realizado por médicos com habilidades básicas em ultrassonografia, para orientar o diagnóstico de IRpA. Métodos: Ao longo de um ano, todos os pacientes adultos consecutivos respirando espontaneamente admitidos na UTI por IRpA foram prospectivamente inclusos. Após treinamento, 4 operadores com habilidades básicas em ultrassonografia realizaram o USP em até 20 minutos após a admissão na UTI, cegados para a história do paciente. Os diagnósticos do USP foram comparados aos diagnósticos da equipe assistente ao final da internação na UTI (padrão-ouro). Resultados: Foram inclusos na análise 37 pacientes (média etária: 73,2 ± 14,7 anos; APACHE II: 19,2 ± 7,3). O diagnóstico do USP demonstrou concordância com o diagnóstico final em 84% dos casos (kappa total: 0,81). As causas mais comuns de IRpA foram pneumonia (n = 17) e edema pulmonar cardiogênico (n = 15). A sensibilidade e a especificidade do USP comparado ao diagnóstico final foram de 88% e 90% para pneumonia e de 86% e 87% para edema pulmonar cardiogênico, respectivamente. Conclusões: O USP baseado no protocolo BLUE foi reproduzível por médicos com habilidades básicas em ultrassonografia e acurado para o diagnóstico de pneumonia e de edema pulmonar cardiogênico. .

Expression and significance of p53-inducible gene 3 (PIG-3) in diffuse large B cell lymphoma / 中国实验血液学杂志

This study was aimed to investigate the expression of p53-inducible gene 3 (PIG-3) in diffuse large B cell lymphoma (DLBCL) and the relationship between PIG-3 and the pathogenesis of lymphoma. The expression of PIG-3 in 20 patients with DLBCL and 20 healthy adults (as a control group) was detected by Western blot and RT-PCR. The results showed that the expression of PIG-3 protein in patients with DLBCL was significantly lower than that in controls, but the expression of PIG-3 was higher after chemotherapy for 6 months than that before chemotherapy. RT-PCR detection demonstrated that the size of PIG-3 amplified product is 1285 bp, which is coincident with theoretic value. It is concluded that the down-regulation of PIG-3 expression may be closely related to pathogenesis of DLBCL, so the PIG-3 gene can considered as a important marker for judging therapeutic efficacy and prognosis of patients with DLBCL.

Effects of whole lung lavage on pulmonary function and exercise capacity in patients with pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the effects of whole lung lavage (WLL) on the pulmonary function and exercise capacity in patients with pneumoconiosis.</p><p><b>METHODS</b>Forty-one patients with pneumoconiosis who quit dust-exposed work not more than 6 months before underwent WLL. Clinical symptom assessment, pulmonary function test, and cardiopulmonary exercise test were performed before and one week after WLL, and the results were compared.</p><p><b>RESULTS</b>The patients with pneumoconiosis showed no significant changes in clinical symptoms after WLL. At one week after WLL, the patients with pneumoconiosis showed nonsignificant increases in forced vital capacity, forced expiratory volume in one second (FEV1.0), and percent predicted FEV1 (P > 0.05); peak oxygen uptake (peak VO₂) increased from 2140.6 ± 353.2 ml/min before WLL to 2374.6 ± 362.4 ml/min after WLL, percent predicted peak VO₂ increased from 82.2 ± 13.7% before WLL to 91.0 ± 14.0% after WLL, peak VO₂/kg increased from 30.6 ± 3.5 ml/min×kg before WLL to 34.2 ± 3.7 ml/min×kg after WLL, and ventilatory equivalent for carbon dioxide decreased from 30.6 ± 3.1 before WLL to 26.1 ± 2.7 after WLL (P < 0.05).</p><p><b>CONCLUSION</b>WLL can remarkably improve the oxygen uptake and ventilatory efficiency in patients with pneumoconiosis during exercise, so it can improve the exercise capacity of these patients.</p>

Clinical application of Cheatham-Platinum covered stent in treatment of aortic coarctation / 中国医师进修杂志

Objective To evaluate the clinical safety and efficacy of Cheatham-Platinum(CP)covered stent in treatment of aortic coarctation.Methods The therapeutic efficacy was retrospectively analyzed in 15 patients with aortic coarctation who were treated by BIB balloon dilation and CP covered stent implantation.Results All patients were well recovered,the stent did not appear displaced,folded,aorta dissection and rupture.The pressure difference was 5-10 mm Hg(1 mm Hg=0.133 kPa)between proximal part and distal end after operation.Following up(20±12)months,the therapy efficacy of all the patients was stable and there was no fracture,removal,aortic stenosis or dysarteriotony.Heart ultrasounds demonstrated good close of the cases with patent ductus arteriosus.Conclusion CP covered stent is a safe and available clinical therapy,featured by minimum aorta injuries.

Correlation analysis between cytokines levels in serum and bronchoalveolar lavage fluid, blood T cell subsets and pneumoconiosis severity / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze the correlation between the pneumoconiosis severity and the cytokines levels in serum and bronchoalveolar lavage fluid (BALF) or blood T cell subsets.</p><p><b>METHODS</b>The subjects were divided into five groups: control group (6 cases), group exposed to dusts (6 cases) and 3 pneumoconiosis groups (36 in stage I, 12 in stage II and 10 in stage III). ELISA was used to detect IL-6, sIL-2R and TNF-α levels in serum and BALF. The subsets of blood T cells were classified by flow cytometer.</p><p><b>RESULTS</b>As compared with control group and group exposed to dusts, the levels of serum IL-6 and sIL-2R in patients with II or III stages significantly increased, which were positively correlated with pneumoconiosis stages (r(1) = 0.74, r(2) = 0.81, P < 0.05). The level of serum TNF-α significantly decreased in patients with III stages, as compared with control group and group exposed to dusts. There was a negative correlation between serum TNF-α level and pneumoconiosis severity (r = -0.58, P < 0.05). There was a positive correlation between the levels of IL-6, sIL-2R and TNF-α in BALF and the levels of IL-6, sIL-2R and TNF-α in serum (r(1) = 0.77, r(2) = 0.96 and r(3) = 0.88, P < 0.05). The proportion of CD(4)(+)T cells and the ratio of CD(4)(+)/CD(8)(+) decreased dramatically in patients with II and III stages. But there was no correlation between these values and disease severity.</p><p><b>CONCLUSION</b>The immune function in Th cell was inhibited. The levels of IL-6, sIL-2R and TNF-α in serum and BALF were associated with the severity of pneumoconiosis.</p>

Application of transbronchial lung biopsy in pneumoconiosis diagnosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the role of transbronchial lung biopsy (TBLB) pathology in pneumoconiosis diagnosis.</p><p><b>METHODS</b>During Jan 2003 to Jun 2010 in our hospital. 418 patients exposed to dusts were examined with TBLB. The chest radiographs of all subjects showed the pneumoconiosis-like opacities. Because the dust property or accumulated doses didn't match with abnormality on chest radiographs or there were no a series of chest radiographs, it was required for subjects to perform the TBLB for diagnosis. Three hundred seventy nine cases with satisfying samples served as the study subjects. The dust deposition, fibrosis and birefringent particles were found in TBLB pathological examinations. From May 2005, the Prussian blue iron reaction test was conducted on the TBLB samples. A panel made pneumoconiosis diagnosis according to GBZ 70-2002 and GBZ 70-2009 Pneumoconiosis Diagnostic Criteria, consulting subjects' accounts and pathologic results.</p><p><b>RESULTS</b>Among 379 subjects, 376 cases (99.2%) showed the lung interstitial fibrosis, 228 cases (60.2%) demonstrated the dust deposition, 111 cases (29.3%) expressed the birefringent particles by polarized light microscopy. Birefringent particles positive rate was 37.8% (62/164) in 164 patients exposed to either silica or potter dusts or cement dusts or coal-silica dusts or foundry dusts, which was much higher than that (22.7%, 49/215) in patients exposed to other dusts (welding fume or asbestos or aluminum dusts) (P < 0.05). The positive rate of Prussian blue iron reaction in 177 patients exposed to welding fume or burnishing dusts was 53.1% (94/177), which was significantly higher than that (23.2%, 13/56) in patients exposed to other dusts (cement dusts, casting dusts or silica) (P < 0.001). There were no significantly differences in rates of lung fibrosis, dust deposition and birefringent particles between pneumoconiosis and none-pneumoconiosis subjects. The rate of lung fibrosis in pneumoconiosis cases was significantly higher than that in non- pneumoconiosis cases (P < 0.05).</p><p><b>CONCLUSION</b>TBLB could provide the evidence of exposure to dusts and pathological changes, which may be useful to the pneumoconiosis diagnosis.</p>

Pathologic analysis of transbronchial lung biopsy in workers exposed to dusts / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the role of transbronchial lung biopsy (TBLB) in pathologic diagnosis of pneumoconiosis.</p><p><b>METHODS</b>In our hospital during May 2011 and Sep 2011, the TBLB samples from 35 cases occupationally exposed to dusts were compared with the video-assisted thoracoscopic surgery or lobectomy samples from 27 cases not exposed to dusts for pathological indexes, including fibrotic proliferation, nodule or nodule-like, dust deposition and needle-shaped birefringent particles.</p><p><b>RESULTS</b>In group exposed to dusts, there were 6 cases (17.1%) with the moderate dust deposition and 28 cases (80.0%) with fibrotic proliferation. But in group not exposed to dusts, there were 0 case with the moderate dust deposition and 11 cases (40.0%) with fibrotic proliferation. There were significant differences between two groups (P < 0.05). In group exposed to dusts, there were 6 cases (17.1%) with Nodules-like and needle-shaped birefringent particles, but in group not exposed to dusts, there was 0 case with Nodules-like and needle-shaped birefringent particles.</p><p><b>CONCLUSION</b>TBLB could provide the evidence of pathological changes in lung tissue induced by dusts, and TBLB play an important role in pneumoconiosis diagnosis.</p>