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OBJECTIVE@#The study aimed to estimate the benchmark dose (BMD) of coke oven emissions (COEs) exposure based on mitochondrial damage with the mitochondrial DNA copy number (mtDNAcn) as a biomarker.@*METHODS@#A total of 782 subjects were recruited, including 238 controls and 544 exposed workers. The mtDNAcn of peripheral leukocytes was detected through the real-time fluorescence-based quantitative polymerase chain reaction. Three BMD approaches were used to calculate the BMD of COEs exposure based on the mitochondrial damage and its 95% confidence lower limit (BMDL).@*RESULTS@#The mtDNAcn of the exposure group was lower than that of the control group (0.60 ± 0.29 vs. 1.03 ± 0.31; P < 0.001). A dose-response relationship was shown between the mtDNAcn damage and COEs. Using the Benchmark Dose Software, the occupational exposure limits (OELs) for COEs exposure in males was 0.00190 mg/m 3. The OELs for COEs exposure using the BBMD were 0.00170 mg/m 3 for the total population, 0.00158 mg/m 3 for males, and 0.00174 mg/m 3 for females. In possible risk obtained from animal studies (PROAST), the OELs of the total population, males, and females were 0.00184, 0.00178, and 0.00192 mg/m 3, respectively.@*CONCLUSION@#Based on our conservative estimate, the BMDL of mitochondrial damage caused by COEs is 0.002 mg/m 3. This value will provide a benchmark for determining possible OELs.
Subject(s)
Male , Female , Animals , Coke , Polycyclic Aromatic Hydrocarbons , DNA Copy Number Variations , Benchmarking , Occupational Exposure/analysis , DNA, Mitochondrial/genetics , DNA DamageABSTRACT
OBJECTIVE@#To investigate the distribution of Ret-He and RBC in thalassemia and the value of combining HbA2 in the detection of thalassemia among patients with microcytic or hypochromic.@*METHODS@#145 patients with microcytic or hypochromic outpatient or hospitalization in our hospital from May 2018 to December 2019 were selected and were divided into the thalassemia group(68 cases) and the non-thalassemia group (77 cases), and at the same time, the patients were divided into four groups of the non-anemia, mild anemia, moderate anemia and severe anemia group according to the degree of anemia. The Ret-He, RBC, RDW-CV and HbA2 in patients were detected, and the distribution of these parameters were compared, and the joint detection of Ret-He, RBC and HbA2 about its sensitivity, specific and other indicators of auxiliary diagnosis of thalassemia were analyzed.@*RESULTS@#Among patients with microcytic or hypochromic, according to the anemia grade Ret-He gradually decreased from the non-anemia group to the severe anemia group (P<0.05); while RDW-CV was increased gradually from the mild anemia group to the severe anemia group (P<0.05); both RBC and Ret-He were increased in the thalassemia group as compared with the non- thalassemia group (P<0.05); while RDW-CV was decreased in the thalassemia group as compared with the non-thalassemia group (P<0.05); meanwhile Ret-He in the α-thalassemia group was higher than that in the β-thalassemia group. ROC curve analysis showed that combined with HbA2, the specificity was 93.51%, the sensitivity was 66.18%, the positive predictive value was 90% and the negative predictive value was 75.189% when Ret-He was truncated with 19.25 pg and RBC was truncated with 4.95×10@*CONCLUSION@#Among patients with microcytic or hypochromic, the distribution of RBC, Ret-He and RDW-CV was different in the thalassemia group and the non-thalassemia group, and was also affected by the degree of anemia. Combined Ret-He and RBC could improve the diagnostic specificity for thalassemia, which were screened by HbA2 in patients with microcytic or hypochromic.
Subject(s)
Humans , Anemia, Iron-Deficiency , Erythrocyte Indices , Proto-Oncogene Proteins c-ret , ROC Curve , alpha-Thalassemia , beta-Thalassemia/diagnosisABSTRACT
Tetanus consists of neonatal tetanus and non-neonatal tetanus. Non-neonatal tetanus remains a serious public health problem, although neonatal tetanus has been eliminated in China since 2012. Non-neonatal tetanus is a potential fatal disease. In the absence of medical intervention, the mortality rate of severe cases is almost 100%. Even with vigorous treatment, the mortality rate remains 30%-50% globally. These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China, in order to improve medical quality and safety. These specifications introduce the etiology, epidemiology, pathogenesis, clinical manifestations and laboratory tests, diagnosis, differential diagnosis, grading and treatment of non-neonatal tetanus.
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Tetanus consists of neonatal tetanus and non-neonatal tetanus.Non-neonatal tetanus remains a serious public health problem,although neonatal tetanus has been eliminated in China since 2012.Non-neonatal tetanus is a potential fatal disease.In the absence of medical intervention,the mortality rate of severe cases is almost 100％.Even with vigorous treatment,the mortality rate remains 30％-50％ globally.These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China,in order to improve medical quality and safety.These specifications introduce the etiology,epidemiology,pathogenesis,clinical manifestations and laboratory tests,diagnosis,differential diagnosis,grading and treatment of non-neonatal tetanus.
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Cardiovascular and cerebrovascular diseases are the leading cause of death for residents in China. Danhong Injection(DHI) decoction piece is prepared from Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos, with the function of promoting the blood circulation, removing the blood stasis, relaxing the sinews and dredging the collaterals. In recent years, about 100 million bottles of DHI have been sold. Consequently, its safety and effectiveness are very important to a large number of patients. Raw materials are the source and foundation for production of traditional Chinese medicine injections. In this article, we reviewed the identification of Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos, resource distribution, cultivation, quality control, and detection of xenobiotic pollutants, in order to guide the production of high-quality, stable, and pollution-free raw materials. This will be a benefit in ensuring the safety and effectiveness of DHI and reducing the incidence of adverse reactions from the raw materials. By comparing the similarities and differences between the quality standards of Salviae Miltiorrhizae Radix et Rhizoma, Carthami Flos and DHI, we provided some comments for improving the quality standards and post-marketing reevaluation of DHI, and provided some theoretical supports for the production of high-quality herbal raw materials.
Subject(s)
Humans , China , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Quality ControlABSTRACT
Tetanus consists of neonatal tetanus and non-neonatal tetanus. Although neonatal tetanus in China has been eliminated since 2012, non-neonatal tetanus remains a serious public health problem. Non-neonatal tetanus is a potential fatal disease, and the mortality rate of severe cases is almost 100% in the absence of medical intervention. Even with vigorous treatment, the mortality rate is still 30~50% globally. In order to standardize the diagnosis and treatment of non-neonatal tetanus in China, this specification is hereby formulated. This standard includes etiology, epidemiology, pathogenesis, clinical manifestations, laboratory tests, diagnosis, differential diagnosis, classification, grading and treatment of non-neonatal tetanus.
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Sepsis is a heterogeneous syndrome which varies in etiology, pathogenesis, clinical manifestation, treatment and prognosis. According to the difference in these respects, sepsis can be divided into different phenotypes and endotypes, which may serve as valuable guidance in the individualized clinical treatment and precise prognostic judgment of the disease.
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The treatment of severe burn involves circulation, respiration, infection, surgical operation and so on. Coagulation disorder is also one of the main problems in severe burn patients, but there is no definite standard of diagnosis and treatment. The above clinic problems also weaken the diagnosis and treatment of the Severe Burn Induced Coagulopathy (SBIC). Therefore, for a long time, specialist medical staff have lost sensitivity to SBIC, missing diagnosis and misdiagnosis often occur, affecting prognosis. In this article, the pathogenesis, clinical manifestation, diagnosis and treatment of SBIC are described. The purpose is to make specialist medical staff pay attention to the diagnosis of SBIC and to start comprehensive intervention as soon as possible, in order to improve the prognosis.
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Objective:To study the expression of tumor suppressor factors SEMA3F,CYLD and miR-454 in rectal cancer.Methods:21 patients with colorectal cancer admitted in our hospital from January to March in 2016 were selected as the study materials.The tumor inhibitoryfactor SEMA3F in rectal cancer tissue,cancerous surrounding tissue and normal rectum tissue were detected respectively,CYLD and miR-454,and to analyze the correlation between tumor suppressor factors SEMA3F,CYLD and miR-454,and to explore their roles in the carcinogenesis and progression of rectal cancer.Results:The expression of SEMA3F,CYLD and miR-454 in cancer tissue,paracancer tissue and normal tissue were statistically significant (P＜0.01).The levels of SEMA3F and CYLD were significantly lower in patients with metastasis than those without metastasis,and miR-454 was significantly higher than that in patients without metastasis (P＜0.01).The expression level of SEMA3F and CYLD in CRC tissues was significantly higher than that in moderately and poorly differentiated tissues,and the expression of miR-454 was significantly lower than that in moderately and poorly differentiated ones (P＜0.01).There was significant negative correlation between tumor suppressor CYLD and miR-454 (r=-0.971,P＜0.01).There was a significant negative correlation between tumor inhibitory factor SEMA3F and miR-454(r=-0.955,P＜0.01).Conclusion:The tumor suppressor factors SEMA3F and CYLD play an important role in inhibiting the formation and proliferation of cancer cells in colorectal cancer.The expression of tumor suppressor factors SEMA3F and CYLD in colorectal cancer is high in the early stage and gradually declines with the progression of the disease.MiR-454 can promote the growth of rectal cancer cells The expression of tumor suppressor factors SEMA3F,CYLD and miR-454 in colorectal carcinoma were significantly higher than those in SEMA3F and CYLD.The expression of tumor suppressor factors such as SEMA3F,CYLD and miR-454 were significantly correlated with the progression and prognosis of rectal cancer The evaluation has important reference value.
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Objective:To investigate the relationship between the expression of EZH2 and the prognosis of elderly patients with rectal cancer and the mechanism of EZH2 in the progression of rectal cancer.Methods:36 cases of elderly patients with rectal cancer who underwent surgery in our hospital from January to June 2010 were included in this study.The expression of EZH2 in colorectal cancer tissues and adjacent tissues was analyzed and the differences were analyzed.All the patients were divided into positive and negative groups according to the expression level of EZH2.The correlation factors and risk factors of EZH2 expression were analyzed.All patients were followed up for 1 year to assess the quality of life of patients with prognosis and to analyze the correlation with the expression of EZH2;5-year follow-up of patients in both groups compared to 5-year progression-free survival rate of progression-free survival And overall survival(PFS) and overall survival (OS) survival curves were recorded.Results:The positive rate of EZH2 was 69.44％ in CRC and 38.89％ in cancerous tissues,and the positive rate of EZH2 in cancer tissues was significantly higher than that in adjacent tissues (P＜0.01).Age,pathologic type,The positive rate of EZH2 expression in lymph node metastasis group was significantly higher than that in lymph node metastasis group (P＜0.05).Logistic regression analysis showed that EZH2 expression was an independent risk factor of CRC lymph node metastasis.The QLQ-30 quality of life score was significantly higher in EZH2 low-expression group than that in EZH2 high-expression group (P＜0.01).The expression level of EZH2 was negatively correlated with QLQ-30 quality of life score (r=-0.573,P＜0.01).The 5-year progression-free survival rate of the 5-year EZH2 low-expression group was 86.67％ and the 5-year overall survival rate was 93.33％.The 5-year progression-free survival rate was 52.38％ 61.90％.The 5-year progression-free survival rate and 5-year overall survival rate of EZH2 low expression group were significantly higher than those of EZH2 high expression group (P＜0.05).Conclusion:The high expression of EZH2 is closely related to the progression of rectal cancer.It can be used as an important predictor of prognosis quality of life,progression-free survival time and overall survival time.
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To provide molecular evidence for medical material identification, we analyzed the nucleotide sequence of ITS2, psbA-trnH gene in Morus genus plants and commercial products which were obtained from different places in Xinjiang. The sequence of ITS2 and psbA-trnH in fifty-one samples were amplified and sequenced, MEGA 6.0 was used to analyze the intra- and interspecific K-2P distances, neighbor-joining (NJ) tree was used to constructing clustering tree. ITS2 sequence analyzed results showed that there is no intra-specific variation among Morus alba, M. alba var. tatarica and M. nigra, but 13 variations sites were exist between M. alba and M. nigra and their inter-specific K-2P distances was 0.04, which indicated that there had significant variation in them. We didn't find informative variation sites between Morus genus plants and commercial products, and we also found that M. nigra can be distinguished from other two species by NJ Tree. PsbA-trnH analysis results showed there was only one variation site between M. alba and M. nigra, but insertion or deletion variation were remarkable evidence among M. alba, M. alba var. tatarica and M. Nigra. Inter-specific variation was accordance with intra-specific variation of commercial products. So ITS2 and psbA-trnH gene were important marker for M. alba, M. alba var. tatarica and M. nigra identification. This study provided important evidence for Uygur medicine identification and market supervision.
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Building a powerful navy is the key to safeguarding China’s maritime rights and interests and developing maritime strategy. Improving the level and capability of trauma care for naval battle is one of the important tasks for safeguarding naval combat capability and keeping up morale. This paper analyzes the characteristics of naval battle and both the key points and difficulties of medical support under the conditions of modern war, and draws lessons from the experiences of United States navy in the construction of medical support mode, force allocation and maritime health platform, and refers to its training mode and evaluation methods by relying on advanced medical equipment to carry out simulated trauma care efficiently. This paper considers and analyzes the mode of maritime health support, the allocation and utilization of mobile medical service force, the research work related to trauma for naval battle and the training of health professionals. The aim of this study was to provide some effective suggestions for improving capacity and efficiency of trauma care for naval battle.
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Morphology and molecular identification technology were used to identify 3 original plants of Fructus Elaeagni which was commonly used in Uygur medicine. Leaves, flowers and fruits from different areas were selected randomly for morphology research. ITS2 sequence as DNA barcode was used to identify 17 samples of Fructus Elaeagni. The genetic distances were computed by kimura 2-parameter (K2P) model, and the Neighbor-Joining (NJ) and Maximum Likelihood phylogenetic trees were constructed using MEGA5.0. The results showed that Elaeagnus angustifolia, E. oxycarpa and E. angustifolia var. orientalis cannot be distinguished by morphological characteristics of leaves, flowers and fruits. The sequence length of ITS2 ranged from 220 to 223 bp, the average GC content was 61.9%. The haplotype numbers of E. angustifolia, E. oxycarpa and E. angustifolia var. orientals were 4, 3, 3, respectively. The results from the NJ tree and ML tree showed that the 3 original species of Fructus Elaeagni cannot be distinguished obviously. Therefore, 3 species maybe have the same origin, and can be used as the original plant of Uygur medicineal material Fructus Elaeagni. However, further evidence of chemical components and pharmacological effect were needed.
Subject(s)
DNA Barcoding, Taxonomic , Methods , DNA, Plant , Genetics , DNA, Ribosomal Spacer , Genetics , Drug Contamination , Drugs, Chinese Herbal , Chemistry , Classification , Elaeagnaceae , Classification , Genetics , Fruit , Classification , Genetics , Molecular Sequence Data , Phylogeny , Quality ControlABSTRACT
<p><b>OBJECTIVE</b>To investigate the analgesic and sedative effects of inhaling a mixture of nitrous oxide and oxygen on burn patient during and after dressing change.</p><p><b>METHODS</b>A total of 240 burn patients hospitalized in the Institute of Burn Research of Changhai Hospital Affiliated to the Second Military Medical University, Department of Burns of the First People's Hospital in Zhengzhou, and Department of Burns and Plastic Surgery of General Hospital of Ningxia Medical University from October 2011 to September 2012 were enrolled in our study, and they were all in accordance with the inclusion criteria. The 240 patients were divided into control group (n = 60, treated with inhalation of oxygen during dressing change) and treatment group (n = 180, treated with inhalation of a mixture of 65% nitrous oxide and oxygen during dressing change) according to the computer-generated list of random number. The other treatments in control group and treatment group were the same. Before, during, and after dressing change, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation (SO2), and adverse effects were observed. The degree of pain and anxiety felt by the patients were respectively evaluated with the visual analogue scale (VAS) and Chinese version of the burn specific pain anxiety scale (C-BSPAS) at the same time points as above. Data were processed with analysis of covariance, chi-square test, analysis of variance, and rank sum test.</p><p><b>RESULTS</b>There were no significant differences between control group and treatment group in the levels of HR, SBP, DBP, and SO2 before dressing change (with F values respectively 0.76, 0.06, 1.11, 0.70, P values all above 0.05). Compared with those of control group, the levels of HR, SBP, DBP, and SO2 in treatment group were significantly ameliorated during dressing change (with F values respectively 81.78, 146.36, 226.44, 205.62, P values all below 0.01). After dressing change, the levels of DBP in the two groups were close (F = 0.31, P > 0.05), but the levels of HR, SBP, and SO2 showed statistical differences (with F values respectively 7.02, 8.69, 12.23, P < 0.05 or P < 0.01). Before dressing change, the VAS scores were approximate between control group and treatment group (Z = 0.21, P > 0.05). Compared with those in control group (9.4 ± 0.7, 1.7 ± 2.5), the VAS scores were significantly lowered in treatment group during and after dressing change (1.6 ± 1.3, 0.7 ± 1.1, with Z values respectively 11.84, 3.35, P values all below 0.01). There was no significant difference in C-BSPAS score between control group and treatment group before dressing change (Z = 0.62, P > 0.05). Compared with those in control group (75 ± 13, 73 ± 12), the C-BSPAS scores in treatment group were decreased during and after dressing change (9 ± 15, 9 ± 14, with Z values respectively 11.91, 12.28, P values all below 0.01). There were no obvious adverse effects in two groups before, during, and after dressing change.</p><p><b>CONCLUSIONS</b>A mixture of nitrous oxide and oxygen seems to have obvious analgesic and sedative effects on burn patients during dressing change, and it can be widely used.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Administration, Inhalation , Analgesia , Methods , Bandages , Burns , General Surgery , Hypnotics and Sedatives , Therapeutic Uses , Nitrous Oxide , Therapeutic Uses , Oxygen , Therapeutic UsesABSTRACT
Burns and traumas are common injuries during both peace time and wartime. Lung is the earliest organ subjected to dysfunction and the incidence is highest. The systemic protective technology for the burn and trauma related lung injuries is based on evidence-based medicine and translational medicine. It includes a series of effective measures, such as rescue and treatment scheme for massive burn casualties, prophylactic tracheostomy, protective ventilation strategy, sequential cell protection, and prevention and treatment of sequelae, which prevents aggravation of lung injuries caused by ischemia reperfusion, oxidative stress, and iatrogenic factors, as well as reduces the incidence of complications to ensure the recovery after burns and traumas.
Subject(s)
Humans , Burns , Evidence-Based Medicine , Lung Injury , Translational Research, BiomedicalABSTRACT
Patients who suffer severe burns are at increased risk for local and systemic infections. The incidence of fungal infections has increased in recent years, and these infections represent a major issue in burn intensive care units. Herein, we report three cases of fungal infection due to Candida species occurring in patients undergoing supportive therapy and antibiotic treatment during their hospitalization. Two of these patients were infected with Candida parapsilosis, and one was infected with Candida albicans. The risk factors for these patients' Candida infections were multiple and prolonged courses of antimicrobial treatment, steroid treatment, tracheal intubation and smoke inhalation. Susceptibility testing of nine antifungal compounds was performed, and the minimum inhibitory concentration (MIC) values of all isolated strains were lower than the breakpoint MIC value for resistance of the relevant drug. All three patients were cured by treatment with antifungal agents. Candida infection may occur 1 - 3 weeks after thermal injury, and the prompt recognition and treatment of such infections with antifungal therapies may result in decreased morbidity and mortality associated with these infections in burn patients.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Antifungal Agents , Therapeutic Uses , Burns , Microbiology , Candida albicans , Virulence , Candidiasis , Drug Therapy , Microbial Sensitivity TestsABSTRACT
<p><b>BACKGROUND</b>More and more Chinese drink hot water from water dispensers while many children were scalded due to this change. The present study aimed to propose a feasible strategy for prevention.</p><p><b>METHODS</b>A retrospective study was conducted for all water dispensers related pediatric burns admitted to Changhai Hospital from January 2005 to December 2009.</p><p><b>RESULTS</b>The number of new cases and incidences of pediatric burns due to hot water from water dispensers was significantly increasing year after year. In the total 238 involved cases, 175 cases happened on males and 78.9% were at the age of 1 - 4 years. The burn areas were mainly located in upper extremities. All water dispensers in the surveyed families had no isolate protection devices and 85.2% of their locations were easy for children to reach. Nearly half of the children were in the same room with their guardians when injured. Total 196 burned children were playing the taps of water dispensers before injured, unfortunately, 80.6% of them have not been stopped until burned.</p><p><b>CONCLUSION</b>As the kind of burns is quite serious and with bad outcome, some recommendations should be followed, such as buying water dispensers with protection devices, keeping children from touching them and so on.</p>
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Accidents, Home , Burns , Epidemiology , Retrospective Studies , WaterABSTRACT
Burn surgery belongs to disaster medicine. Burn is a common trauma that occurs in social activities of human beings in all ages, either in the time of peace or war. During the development of human medicine in modern times, the summary of experience in treating massive burn casualties due to severe fire accidents has effectively promoted the renovation of treating technology and theory of burns and the development of burn surgery. The results of treatment of burn injury in casualties occurred in the fire of Cocoanut Grove night club in Boston in 1942, and the high-rise apartment house fire in Shanghai in 2010 were summarized and analyzed in this article, emphasizing the correlating issues of inhalation injury.
Subject(s)
Humans , Burns , Therapeutics , Burns, Inhalation , Therapeutics , Disaster Medicine , Disaster Planning , FiresABSTRACT
It is of great importance to know the endogenous mechanism in burn-induced organ injuries, not only for the understanding of pathophysiological processes after burn, but also for guiding the clinical treatment. Recent studies have widened and deepened our scope and understanding of secondary injuries to various organs. However, a unanimous understanding of molecular pathway involved in all burn-induced organ injuries has not been attained. Relatively, the mechanism of endogenous cellular injuries as a result of burn injury could be regarded as a common one to explain the causation of cellular injury, and to guide the prevention and treatment for the burn-induced complications using cytoprotection strategy. This review summarized four aspects of the mechanism of endogenous cellular injuries, including cellular injuries induced by ischemic/hypoxic-oxidative stress, excessive inflammatory factors released by inflammatory cells, immunosuppression caused by suppression of function of adaptive immune cells, and dysfunction of important supportive cells of various organs.
Subject(s)
Humans , Apoptosis , Burns , Metabolism , Pathology , Inflammation , Oxidative Stress , Signal TransductionABSTRACT
<p><b>BACKGROUND</b>Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation (UD) in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients.</p><p><b>METHODS</b>A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square (χ(2)) or Fisher's exact test.</p><p><b>RESULTS</b>Patients with UD were often burned with head and neck (67%) and combined with inhalation injury (62%). The majority of them (76%) were transferred patients, occurred early (55%) and were accidental UD (79%). UD events tended to happen in day shift (90%) and to be associated with the medical procedure that was performing by caregivers at besides (79%). Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients' death.</p><p><b>CONCLUSIONS</b>UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.</p>