Analysis of 5 cases of occupational asbestos-induced pleural mesothelioma / 中国职业医学

OBJECTIVE: To retrospectively analyze the clinical characteristics of 5 cases of occupational asbestos-induced pleural mesothelioma. METHODS: The clinical features and occupational diagnostic data of 5 patients with pleural mesothelioma caused by occupational asbestos exposure were collected. The occupational history, the occupational hazard exposure history, the length of latency, the clinical features, chest computed tomography(CT) and immunohistochemical staining examination of these 5 patients were analyzed. RESULTS: The median of occupational asbestos exposure length was 8 years and the median of latent period was 30 years in these 5 patients. One patient had been diagnosed as occupational asbestos lung. Typical chest CT findings of asbestos-induced pleural mesothelioma were one-sided pleural effusion, pleural nodules and enlarged mediastinal lymph nodes. The clinical symptoms were mainly chest pain, cheat tightness, and fatigue. Erythrocyte sedimentation rate increased in 3 cases. According to immunohistochemical findings, 4 patients showed that melanocortin, calretinin, cytokeratin 5/6, and cytokeratin 7 were positive, and 3 patients showed that wilms′ tumor nuclear protein were positive. Examination of lung function in 4 patients showed restrictive ventilation dysfunction. CONCLUSION: Most patients with pleura mesothelioma showed insignificant symptoms at early stage. The occupational health surveillance and chest CT examination of occupational asbestos-exposed workers should be strengthened, and early diagnosis should be made as soon as possible to win surgical opportunities.

The change of reactive oxygen species and cell cycle in bone marrow cells of mice with benzene-induced aplastic anemia / 中国职业医学

OBJECTIVE: To explore the effect of reactive oxygen species(ROS) and cell cycle in bone marrow cells in benzene-induced aplastic anemia(AA) mouse model. METHODS: Specific pathogens free male CD1 mice were randomly divided into control group and exposure group(n=10, each group). The mice in exposure group were subcutaneously injected with benzene at a dose of 2 mL/kg body weigh diluted 1 ∶1 in corn oil, while the mice in control group were treated with equal volume of corn oil, 3 times a week for a total of 25 times. After exposure, the blood routine and reticulocyte percentage of peripheral blood of mice were examined. The femur histopathology was performed. The levels of benzene and its metabolites hydroquinone, and phenol in blood, liver and bone marrow were tested by solid-phase extraction gas chromatography mass spectrometry. The level of ROS and the changes of cell cycle in bone marrow mononuclear cells(BMMNCs) were determined by flow cytometry. The protein expression of Cyclin D1 and cyclin-dependent kinase 4(CDK4) in BMMNCs was detected by Western blot. RESULTS: Since the 10 th benzene exposure, the body mass of mice in the exposure group was lower than that in the control group at the same time point(P<0.05). After the benzene exposure, all the counts of white blood cell, red blood cell, platelet, and hemoglobin level and reticulocyte percentage in peripheral blood of mice in the exposure group were decreased when compared with the control group(P<0.05). Bone marrow histopathological examination showed that bone marrow hematopoietic cells were decreased and non-hematopoietic cells were increased in the exposure group. In this study, a mouse model of AA induced by benzene was successfully established. The levels of benzene, hydroquinone and phenol in exposure group increased in blood, liver, and bone marrow compared to control group(P<0.05). Furthermore, the level of benzene from high to low were blood, liver and bone marrow, while the levels of hydroquinone and phenol were mainly stored in the blood and bone marrow in exposure group. Compared with the control group, the level of ROS, S phase fraction, and the relative protein expression of Cyclin D1 and CDK4 in BMMNCs increased, while the G1 phase fraction decreased in exposure group(P<0.01). CONCLUSION: The results suggest that benzene and its metabolites induce an increase of ROS level and S phase cell arrest, that play an important role in the pathogenesis and development of benzene-induced AA.

Treatment of idiopathic macular hole: internal limiting membrane peeling or inverted internal limiting membrane flap / 中华实验眼科杂志

Surgical management of idiopathic macular hole (IMH) is a hot topic in the field of fundus disease,and its classical surgery is internal limiting membrane peeling.In recent years,many researchers explored inverted internal limiting membrane flap technique for IMH.However,how large the IMH is necessary for inverted internal limiting membrane flap technique? Does the inverted internal limiting membrane flap technique have more advantages in operating procedure,anatomical and functional recovery of IMH in comparison with internal limiting membrane peeling? Our clinical researches and relative literature showed that it is better to use inverted internal limiting membrane flap technique for ＞550 μm IMH.There is still no available evidence showed inverted internal limiting membrane flap technique is of more benefit to the anatomical repair and functional restoration in comparison with internal limiting membrane peeling for IMH.Some viewpoints in this field are open to question.

Therapeutic effects of flute-needle vacuum assistant hole closure technique for large idiopathic macular hole / 中华实验眼科杂志

Objective To evaluate the therapeutic effects of flute-needle vacuum assistant hole closure technique for large idiopathic macular hole (IMH).Methods The clinical data of 25 eyes with IMH of 408-939 μm in 23 patients who received pars plana vitrectomy with internal limiting membrane (ILM) peeling and flute-needle vacuum assistant hole closure technique from Feburary in 2017 to June in 2018 in Peking University International Hospital were retrospectively analyzed.The changes of best corrected visual acuity (BCVA) before and after operation were evaluated.The shapes of the hole closure were categorized,and the manifestations of outer retina were observed by optical coherence tomography (OCT),including external limiting membrane (ELM) and ellipsoid zone(EZ).Results The hole closure rate after surgery were 100％ (25/25),with the U type closure in 16 eyes and V type closure in 9 eyes.The BCVA was 0.76 ± 0.27 after operation,which was significantly improved in comparison with 1.05 ±0.29 before operation (t =3.61,P =0.01).The ELM of OCT image was (1 050.00±380.39)μm before operation,and that after operation reduced to (623.32 ± 328.66) μm,showing a significant difference between them (t =6.63,P=0.00).A fully reduced EZ band was seen after operation in comparison with before operation ([1 147.28±354.41] μm versus ([818.28±247.33] μm) (t=4.12,P=0.00).Conclusions A combination procedure of vitrectomy with flute-needle vacuum assistant hole closure technique is effective for large IMH,which is beneficial to the anatomical repair and functional recovery of outer retina.

Clinical significance of the N-terminal pro-B-type natriuretic peptide levels in pneumoconiosis patients with chronic pulmonary heart disease / 中华劳动卫生职业病杂志

Objective@#To determine the diagnosis value and therapy significance of peripheral blood N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in pneumoconiosis patients with chronic pulmonary heart disease (CPHD) .@*Methods@#A total of 22 pneumoconiosis complicated with CPHD (A group) , 20 pneumoconiosis complicated with coronary heart disease (B group) and 25 pneumoconiosis without heart disease (C group) were selected. The level of blood NT-proBNP was examined and analyzed in the three groups. We observed the difference blood level of NT-proBNP concentration between before and after of therapy in pneumoconiosis patients with CPHD. The optimal cutoff value of blood NT-proBNP was determined according to the principle of maximum Youden's index associated with clinical analysis.@*Results@#Blood NT-proBNP concentrations were 543.19±78.92, 1017.38±731.06, 109.56±57.46 pg/ml in three groups, respectively. Compared with C group, there was a significant increase in the blood levels of NT-proBNP in both A and B groups (P<0.05, P<0.01) , especially for B group. Compared with NT-proBNP 543.19±78.92 pg/ml before therapy, the153.34±58.40 pg/ml was significantly declined after therapy in B group (P<0.05) . The optional threshold for peripheral blood NT-proBNP level as a diagnostic indicator for pneumoconiosis complicated with CPHD was 450 pg/ml. The specificity and sensitivity of NT-proBNP were 95.46% and 54.17%, respectively.@*Conclusion@#Blood NT-proBNP level may be useful as a tool for monitoring the effect of pneumoconiosis patients with CPHD treatment with higher sensitivity in. Blood NT-proBNP cut-off >450 pg/ml should be applied in clinical practice as a valuable diagnostic prediction for pneumoconiosis patients with CPHD.

Hospitalized but not admitted and influencing factors for pneumoconiosis patients / 中华劳动卫生职业病杂志

Objective@#To investigate the situation where pneumoconiosis patients who should be in hospital are not hospitalized, to analyze the main reasons and influencing factors for their restricted use of hospitalization medical services, and to provide a reference for relevant policy making.@*Methods@#Subjects were sampled in nine provinces, including Zhejiang, Jiangsu, Shandong, and Hebei, using a method that combined stratified sampling and typical sampling, from March 2017 to January 2018. These subjects were patients occupationally diagnosed with pneumoconiosis and patients clinically diagnosed with pneumoconiosis. The questionnaire The health seeking behaviors of pneumoconiosis patients and their influencing factors was used as the survey tool to investigate their health seeking behaviors such as going to the outpatient clinic and being hospitalized. Andersen's Behavioral Model of Health Services Use was used as the analysis model; The χ2 test was used for univariate analysis, and the multivariate logistic regression model was used for multivariate analysis.@*Results@#A total of 1 037 patients with pneumoconiosis were surveyed, with a mean age of 55.9±11.2 years and 67.5% (700/1 037) living in rural areas for a long time. Occupational injury insurance and medical insurance for urban and rural residents were the main insurances used, accounting for 40.9% (424/1 037) and 59.4% (616/1 037) of the cases, respectively. A total of 177 (17.1%) patients were once advised by the doctors to be hospitalized because of pneumoconiosis, while they did not. The proportion of patients who should be in hospital but did not do so among rural patients was significantly higher than that in urban patients (20.1% (141/700) vs 10.7% (36/337) , P<0.05) . Financial difficulties (12.0%, 124/1 037) and self-rated mild symptoms (3.2%, 33/1 037) were the main reasons for not being hospitalized. Model analysis showed that the propensity factor, ability factor, health needs, health seeking behaviors, and self-rated health factor in the Anderson model were all statistically significant (P<0.05) . The main features of high proportion of patients who should be in hospital but did not do so were as follows: personal monthly income below 1 000 RMB (odds ratio[OR]of no income=2.92, 95% confidence interval[CI]: 1.14-7.48; OR of less than 1 000 RMB=3.55, 95%CI: 1.35-9.35) , no occupational injury insurance (OR=2.05, 95%CI: 1.16-3.43) , and concurrent emphysema (OR= 1.98, 95%CI: 1.12-3.50) .@*Conclusion@#Low income, no occupational injury insurance, and concurrent emphy-sema are the main constraining factors for hospitalization services use in pneumoconiosis patients.

Comparison of intravitreal injection of conbercept and macular photocoagulation for non-ischemic macular edema secondary to branch retinal vein occlusion / 眼科新进展

Objectlve To assess the clinical effects and safety of intravitreal injection of conbercept and macular photocoagulation for non-ischemic macular edema secondary to branch retinal vein occlusion (BRVO).Methods A total of 50 patients (50 eyes) with non-ischemic macular edema following BRVO were retrospectively analyzed.Patients were divided into 2 groups:ICI group (26 eyes) received intravitreal injection of conbercept,laser group (24 eyes) received standard-of-care grid laser for macular edema.The best-corrected visual acuity (BCVA) and central macular thickness (CMT) were observed before and 1 week,1 month,2 months and 3 months after treatment.Then,the changes in pre-treatment and post-treatment were compared,and the related complications were recorded.Results The difference of BCVA before treatment was not significant between two groups (P ＞ 0.05).BCVA at 1 week,1 month,2 months and 3 months after treatment in two groups were all improved,the differences were statistically significant compared with before treatment (all P ＜ 0.05),and the differences were statistically significant between two groups after treatment (all P ＜0.05).At 3 months after treatment,BCVA of 18 patients (69.23％) in ICI group and 8 patients (33.33％) in ICI group improved 2 lines.The difference of CMT before treatment was not significant between two groups (P ＞ 0.05),CMT at 1 week,1 month,2 months and 3 months after treatment in two groups were all decreased,the differences were statistically significant compared with before treatment (all P ＜ 0.05),and the differences were statistically significant between two groups after treatment (all P ＜0.05).13 eyes received repeat intravitreal injection in ICI group,including 2 eyes at 1 month,7 eyes at 2 months with CMT ＞250 μm,and 3 eyes at 3 months.No severe side effect related with drug and intravitreal injection occurred in the two groups.Conclusion Mean BCVA change and CMT change are significantly greater in the intravitreal injection of conbercept than the standard-of-care grid laser group for the macuiar edema secondary to non-ischemic BRVO.

Effects of cleaning and disinfection of thermoplastic masks on hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To investigate the effects of cleaning and disinfection of thermoplastic masks on the hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma ( NPC). Methods A prospective study was performed among 102 patients receiving precise radiotherapy for NPC from 2013 and 2016, consisting of 18 patients with early?stage ( I, Ⅱ) disease and 84 patients with advanced (Ⅲ, IV) disease. All patients were randomly divided into group A and group B using a random number table. For group A, the marker lines of thermoplastic masks were sandwiched by double plastic tapes;cleaning and disinfection plus ultraviolet ( UV ) disinfection were applied to the masks 1 h prior to radiotherapy and immediately after radiotherapy. For group B, only conventional UV disinfection was applied to the masks. The surface of the masks was examined and hospital infection during radiotherapy was evaluated. Results At the 18th radiotherapy, group A had a significantly lower mask surface colony count than group B (7.90±650 vs. 139.05±12929 CFU/cm2, P=0000). Group A also had a significantly lower incidence of hospital infection than group B (725% vs. 882%, P=0046). For the patients with early stage NPC, particularly, there was no significant difference in the incidence of infection between the two groups (556% vs. 667%, P=0629). For patients with advanced NPC, group A had a significantly lower incidence of infection than group B ( 762% vs. 929%, P=0035) . There were no significant differences in incidence rates of oral mucosal, skin, and respiratory system infections between the two groups ( 471% vs. 510%, P=0692;176% vs. 235%, P=0463;78% vs. 137%, P=0338) . In both groups A and B, the incidence of oral mucosal infection was significantly higher than the incidence rates of skin infection ( P=0001, 0000) and respiratory system infection ( P=0004, 0000) . Conclusions Thermoplastic mask is one of the risk factors for hospital infection in patients receiving precise radiotherapy for NPC. Timely cleaning and disinfection plus UV disinfection can significantly reduce the surface colony count and the incidence of hospital infection in patients with NPC, particularly in those with advanced NPC receiving precise radiotherapy. The incidence of hospital infection is the highest in the oral mucosa, followed by the skin and the respiratory system.

Quorum Sensing Negatively Controls Type Ⅲ Secretion Expression in Aeromonas hydrophila AH-1 / 生物化学与生物物理进展

A systematic analysis of the typeⅢ secretion genes of Aeromonas hydrophila strain AH-1 by constructing ahyR and ahyI mutant revealed that they are under quorum-sensing control. This observation was supported by the down-regulation of the TTSS genes in the presence of lacZ-TTSS gene promoter and the corresponding advanced secretion of AexT in ahyI mutant.

Effects of Estradiol-17β on the Synthesis of Gonadotropin Releasing Hormone and Growth Hormone in Submandibular Gland of Rat / 解剖科学进展

Objective　To study the effects of estradiol-17β (17β-E2) on the synthesis of GnRH and GH in submandibular gland of rat. Method　Immunohistochemical ABC method was used to observe the localization of GnRH and GH in submandibular gland of rat.Results　　The synthsis of GnRH was promoted and the synthesis of GH was inhibited by 17β-E2 in rat's submandibular gland.　Conclusion　The 17β-E2 may play an important regulative role in the synthesis of GnRH and GH.