Occupational protection effect of two protective devices for manual cleaning and oiling of dental handpieces on operators / 中华劳动卫生职业病杂志

Objective: To explore the occupational protective effect of different protective devices on the operators during manual cleaning and oiling of dental handpieces, and to provide a basis for the selection of appropriate protective methods. Methods: From November 2020 to December 2021, 20 high-speed dental handpieces of the same brand were selected and randomly divided into disposable protective bag group and small aerosol safety cabinet group by drawing lots, with 10 in each group. After recording the model, they were distributed to the clinical fixed consulting room for use, and were collected by specially-assigned personnel every day for manual cleaning under the protection of the two devices. By measuring the number of airborne colonies, the concentrations of particulate matter and the satisfaction of operators, the occupational protection effect of the two protective devices on operators was evaluated. Results: Under the protection of the two devices, the average number of airborne colonies after operation was less than 1 CFU/ml. When no protective device was used, the number concentration of particulate matter produced during operation was (21595.70±8164.26) pieces/cm(3). The number concentrations of particles produced by disposable protective bag group [ (6800.24±515.05) pieces/cm(3)] and small aerosol safety cabinet group [ (5797.15±790.50) pieces/cm(3)] were significantly lower than those without any protective device (P<0.001). The number concentration of particle matter of small aerosol safety cabinet group was significantly lower than that of disposable protective bag group (P<0.001). In the satisfaction evaluation of operators, small aerosol safety cabinet group [ (3.53±0.82) points] was significantly better than disposable protective bag group [ (2.23±1.10) points] (P<0.001) . Conclusion: The use of small aerosol safety cabinet during manual cleaning and oiling of dental handpieces has good protective effect, superior safety performance and strong clinical applicability, and has advantages in occupational protection of clinical operators.

Impact of interventional therapy on top of standard drug therapy on left ventricular structure and function in HFrEF patients complicating with middle aortic syndrome caused by Takayasu arteritis / 中华心血管病杂志

Objective: To evaluate the impact of interventional therapy on top of drug therapy on cardiac function and structure in heart failure with reduced ejection fraction (HFrEF) patients complicating with middle aortic syndrome caused by Takayasu arteritis (TA-MAS). Methods: It was a retrospective longitudinal study. The data of patients with TA-MAS and HFrEF, who received interventional therapy on top of drug therapy in Fuwai Hospital from January 2010 to September 2020, were collected and analyzed. Baseline clinical data (including demographic data, basic treatment, etc.) were collected through the electronic medical record system. Changes of indexes such as New York Heart Association (NYHA) classification, N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI) before and after therapy were analyzed. Results: A total of 10 patients were collected. There were 8 females in this patient cohort, age was (18.4±5.0) years and onset age was (15.3±5.0) years. All 10 patients received standard heart failure medication therapy in addition to hormone and/or immunosuppressive anti-inflammatory therapy, but cardiac function was not improved, so aortic balloon dilatation and/or aortic stenting were performed in these patients. The median follow-up was 3.3(1.3, 5.6) years. On the third day after interventional therapy, the clinical symptoms of the 10 patients were significantly improved, NYHA classfication was restored from preoperative Ⅲ/Ⅳ to Ⅱ at 6 months post intervention(P<0.05). Compared with preoperation, NT-proBNP (P=0.028), LVEDD (P=0.011) and LVMI (P=0.019) were significantly decreased, LVEF was significantly increased (P<0.001) at 6 months after operation. Compared with preoperation, NT-proBNP (P=0.016), LVEDD (P=0.023) and LVMI (P=0.043) remained decreased, LVEF remained increased (P<0.001) at 1 year after operation. Conclusion: Results from short and medium term follow-up show that interventional therapy on top of heart failure drug therpay can effectively improve left cardiac function and attenuate cardiac remodeling in patients with TA-MAS comorbid with HFrEF.

The Impact of Renal Artery Stenting Techniques on Interventional Therapy Upon Anatomical Correlation of Abdominal Aorta and Renal Artery / 中国循环杂志

Objective: To evaluate the impact of renal artery stenting techniques upon anatomical correlation of abdominal aorta and renal artery. Methods: A total of 182 patients with unilateral atherosclerotic renal stenosis and received renal artery stenting in our hospital from 2012-01 to 2013-12 were retrospective studied. Based on the angle of infrarenal abdominal aorta and renal artery, the patients were divided into 3 groups: Group A (91-120)°, n=20, Group B (61-90)°, n=125 and Group C, (30-60)°, n=37. According to the tortuosity of infrarenal abdominal aorta and/or iliac artery, the patients were divided into 2 groups: Non-tortuosity group, n=146 and Tortuosity group, n=36. Operative techniques included in ①wire anchoring alone, ②wire anchoring+balloon rod assisting and③anchoring with wire and balloon. The ratio of upper extremity artery approaching (brachial or radial artery), X-ray exposure time, operation time, contrast dosage and relevant complications were compared among different groups upon stent placing. Results: Compared with Group A and Group B, the following parameters were increased in Group C: ratios for using technique ② + ③ (100.0% vs 20.0%, 31.2%), for extremity artery approaching (10.8% vs 0.0%, 1.6%); X-ray exposure time (9.2±3.8) min vs (5.2±3.1) min, (5.3±2.8) min, operation time (27.4±6.5) min vs (18.6±5.7) min, (20.5±6.1) min; contrast dosage (59.3±8.4) ml vs (44.8±7.2) ml, (48.4±7.3) ml and the incidences of relevant complications (8.1% vs 0.0%, 0.8%), all P<0.05. The above parameter were similar between Group A and Group B. Compared with Non-tortuosity group, the following parameters were elevated in Tortuosity group: ratios for using technique ②+③ (72.2% vs 11.6%), for extremity artery approaching (11.1% vs 1.4%), the total incidences of X-ray exposure time, operation time, contrast dosage and relevant complications (8.3% vs 0.7%), all P<0.05. Conclusion: The acute angle of infrarenal abdominal aorta and renal artery as well as the tortuosity of infrarenal abdominal aorta may increase the difficulty in renal artery interventional therapy .

Safety and Feasibility Assessment for Treating Severe External Carotid Artery Stenosis and Ipsilateral Internal Carotid Artery Occlusion by External Carotid Artery Stenting / 中国循环杂志

Objective: To assess the safety and feasibility for treating the patients with severe external carotid artery (ECA) stenosis and ipsilateral internalcarotid artery (ICA)occlusion by external carotid artery steting (ECAS). Methods: A total of 17 consecutive patients with severe ECA stenosis and ipsilateral ICA occlusion treated in our hospital by ECAS from 2008-01 to 2013-06 were retrospectively studied. Post-operative improvements of cerebral ischemia and neurocognitive function [Mini-mental state examination (MMSE) and Montreal cognitive assessment (MOCA)] were evaluated, complications at peri-operative and 12 months follow-up period were recorded. Results: The patients' mean age was (65.4±8.0) years including 13(76.5％) male. The success rate of ECAS was 100％;2 patients had hemodynamic depression at peri-operative period and were completely recovered by 2 days treatment.1 patient suffered from contralateral minor stroke at 12 months follow-up time, the other 16 patients were without cerebral ischemia symptoms. No complication occurred at peri-operative and 12 months follow-up period. Compared with pre-operative condition, MMSE score [(25.1±1.4) vs (23.3±1.8), P<0.01] and MOCA score [(23.9±1.2) vs (22.2±1.6), P<0.01] were increased at 3 months after ECAS; both scores were continuously increasing during 12 months follow-up period. Conclusion: ECAS may improve cerebral ischemia and cognitive function in patients with severe ECA stenosis and ipsilateral ICA occlusion.

A comparative study on the treatment of bronchiectasis between VATS and open thoracotomy / 中华胸心血管外科杂志

Objective To evaluate the safety,effectivity and feasibility of Video-assisted thoracoscopic surgery(VATS) for the treatment of bronchiectasis.Methods The data of patients with bronchiectasis treated by surgery from January 2010 to September 2016 in Tangdu hospital,the Forth Military Medical University,were reviewed and analyzed retrospectively.Results There were 343 cases enrolled in this study,which were divided into Thoracotomy group(230 cases) and VATS group(113 cases,17 of them were converted into open surgery).There were 125 males and 105 females in Thoracotomy group,with the average age of(46.1 ± 14.4) years,and 45 males and 68 females in VATS group with the average age of(45.8 ± 13.4) years.Four patients died during the perioperative period and all of them were from Thoracotomy group.Compared with the Thoractomy group,the blood loss [(292.1 ± 301.7) ml vs(475.7 ± 525.4) ml,P =0.001],length of hospitalization [(6.4 ± 2.4) dvs.(9.1 ±6.6)d,P＜0.001],drainage time[(6.4 ±2.4)d vs.(9.1 ±6.6)d,P ＜0.001] were significantly lower in VATS group,but no difference in operation time.The cost in VATS group was higher [(4.5 ± 1.3) ten-thousand yuan vs (3.9 ± 1.8) ten-thousand yuan,P =0.001].For patients without comorbidities,the incidence of postoperative complications was lower in VATS group compared with that in Thoractomy group (P =0.003).There was no significant difference between two groups for patients with comorbidities (P =0.274),but there was a trend of declining in VATS group.Conclusion VATS is safe,effective and feasible to treat bronchiectasis,and should be a priority.

Ganoderma triterpenoids from aqueous extract of Ganoderma lucidum / 中国中药杂志

A new triterpenoid and 18 analogues were isolated from the water extract of Ganoderma lucidum by column chromatographic techniques, including silica gel, ODS, Sephadex LH-20, and HPLC. The new compound was elucidated as 2β-acetoxy-3β,25-dihydroxy-7,11,15-trioxo-lanost-8-en-26-oic acid on the basis of analyses of extensive spectroscopic data and its physicochemical properties. Comparison of NMR data with those reported in literature, the known analogues were determined as ganoderic acid H (2), 12β-acetoxy-3β,7β-dihydroxy-11,15,23-trioxo-lanost-8,16-dien-26-oic acid (3), ganoderenic acid D (4),ganoderic acid C1 (5),ganoderic acid G (6),3β,7β-dihydroxy-11,15,23-trioxo-lanost-8,16-dien-26-oic acid (7),ganoderic acid B (8),ganoderic acid C6 (9),3β,15α-dihydroxy-7,11,23-trioxo-lanost-8,16-dien-26-oic acid (10),ganoderic acid A (11),ganolucidic acid A (12),lucidenic acid E2 (13),lucidenic acid N (14),lucidenic acid P (15), lucidenic acid B (16),lucidenic acid A (17),lucidenic acid C (18),and lucidenic acid L (19), respectively. Compound 1 is new compound and compounds 2-19 have been reported from G. lucidum. The present study enriches the knowledge of the chemical constituent of G. lucidum and completes chemical investigation of water decoction that is traditional use of G. lucidum.