Anesthesia Management at Fuwai Hospital:Practice, Evidence and Outcomes / 中国医学科学杂志(英文版)

Fuwai Hospital was established in 1956 and the Anesthesia Department of Fuwai Hospital was one of the earliest anesthesia departments then in China. Under the leadership of several department directors and with the concerted efforts of all generations of colleagues, the Anesthesia Department of Fuwai Hospital has dramatically transformed, upgraded and modernized. For more than six decades, the Anesthesia Department has been providing high-quality peri-operative anesthesia care for cardiovascular surgeries, conducting innovative experimental and clinical researches, and offering comprehensive training on cardiovascular anesthesiology for professionals across China. Currently, Fuwai Hospital is the National Center for Cardiovascular Diseases of China and one of the largest cardiovascular centers in the world. The present review introduces the Anesthesia Department of Fuwai Hospital, summarizes its current practice of anesthesia management, the outcomes of cardiovascular surgeries at Fuwai Hospital, accumulates relevant evidence, and provides prospects for future development of cardiovascular anesthesiology.

Towards a scientific rationale for traditional properties of Chinese medicinal plants: “natures” and “flavors” / 中草药·英文版

Objective: According to theory of Chinese medicine property, the ecological environment shapes properties (natures and flavors) of Chinese materia medica (CMM) and there are close relationships between certain natures and flavors. However, to date these observations have not been validated scientifically in the context of the whole flora of a region. The present study aims to address this gap. Methods: We collected geographical distributions of 3637 vascular plant species native to the Xinjiang region of northwest China, of which around 812 are medicinal plants. The CMM property characters of these medicinal plants were also collected. All medicinal plants were then analyzed in the occurrence of their natures (cold, cool, neutral, warm, and hot) and flavors (sweet, bitter, sour, salty, and pungent). Possible correlations between these properties and environmental factors, notably climate, as well as correlations with plant species richness of the wider native flora of Xinjiang were then investigated using permutation test and regression. Results: Cold species (38.5%) were more numerous than warm (21.0%) and neutral (22.3%), while bitter species (43.3%) were more numerous than pungent (25.6%), sweet (22.4%) and sour (6.7%) ones. Species with bitter flavor were most commonly also cold (48.6%) in nature, sour flavor usually coincided with cold (44.2%) or cool nature (26.0%), whereas pungent or sweet species tended to be warm (34.4%, 28.4%) or neutral (27.8%, 28.4%). The percentages of species of cold/cool nature, bitter flavor were higher in mountainous regions, and the percentages of warm/neutral and pungent/sweet/sour were higher in basins. The percentages of species of cold/cool, bitter were positively correlated with actual evapotranspiration (AET), and also plant species richness but had a bell-shaped relationship with potential evapotranspiration (PET), whereas the inverse situation was shown for warm/neutral and pungent/sweet/sour species. Conclusion: Analysis of the data in Xinjiang region of China supports the qualitative observations concerning natures and flavors in traditional theory of Chinese medicine property. Specifically, (i) certain natures and flavors co-occur more frequently than if randomly distributed; (ii) correlations between proportions of natures and flavors and climatic variables suggest a role for the environment in shaping the properties of CMM.

Accumulation of nitidine chloride in rat heart and the underlying mechanism / 药学学报

Nitidine chloride (NC) is a compound with prominent anti-tumor activity. To determine potential cardiotoxicity of NC, this study was designed to investigate the distribution of NC in rat heart and the underlying mechanism. The animal studies were approved by Institutional Animal Care and Use Committee of Zhejiang University Medical Center (2015-380-01) and complied with the standards of animal welfare in China. At 0.25, 0.5 and 2 h after a single intravenous injection (iv) of 5 mg·kg-1 NC, the concentrations of NC in rat heart were 47.7, 71.1 and 63.2 μg·g-1 respectively, which were 576, 1 352 and 1 212 folds of that in plasma. This study also revealed that the NC concentration in heart was 458.5 μg·g-1 (7 336 folds of that in plasma) at 2 h after the last dose in rats, after daily iv administration of NC at 5 mg·kg-1·day-1 for successive 20 days. Further studies showed that the accumulations of NC in MDCK-hOCT1 and MDCK-hOCT3 cells were 16.1 and 4.99 folds higher than that of the mock cells, respectively. There is no significant difference between the accumulations of NC in MDCK cells transfected with hOCTN1, hOCTN2 or hPMAT and the mock cells. Additionally, quinidine, L-tetrahydropalmatine and Decynium 22, the inhibitors of OCTs, clearly reduced the accumulations of NC in primary cardiomyocytes and cardiac fibroblasts from neonatal rats. MTT assay showed that the LC50 of NC on cardiomyocytes and cardiac fibroblasts were 10.9 and 10.4 μmol·L-1, respectively. Moreover, treatment of the primary cardiomyocytes and cardiac fibroblasts with NC (1～15 μmol·L-1) for 48 h resulted in significantly increased LDH enzyme leakage. These results indicated that NC can be highly accumulated in the heart, and accumulation is mediated by OCT1 and OCT3, but not by OCTN1, OCTN2 and PMAT. The accumulated NC has potential cytotoxicity as shown in the results from primary cardiomyocytes and cardiac fibroblasts.

Joinpoint regression analysis of road traffic injuries tendency in China from 1997 to 2016 / 中华疾病控制杂志

Objective To analyze the tendency of road traffic injuries and explore its main influencing factors in China from 1997 to 2016, so as to provide references for decision-making of prevention and control. Methods Data was collected from national data website. Annual percent change (APC) and average annual percent change (AAPC) were calculated and trend tests were performed by Joinpoint Regression Program 4.6.0.0. Results The overall trend of the indexes was basically the same, reaching the highest record in 2002. The following downward tendency was different and tended to level off after 2009. However, the forecast showed that the fatality of road traffic accidents would increase slightly in recent years. For different road traffic modes, only the average annual percent change of motor vehicle injuries statistically descended (AAPC=-1.83, Z=-2.23, P=0.026). The average annual decreases of non-motor vehicle deaths were statistically significant (AAPC=-1.98, Z=-2.47, P=0.014), and the number of injured showed a notable upward trend instead (AAPC=3.95, Z=5.16, P<0.001). The indexes of walking and riding were declined markedly (AAPC≥7.90, P<0.001). Conclusions The status of walking and riding had been improved significantly, but motor vehicles injuries were still the main traffic mode causing road traffic injuries. The safety situation of non-motor vehicles was increasingly serious. Adopting legal compulsory measures and other intervention to routine systematic management was quite necessary.

Purification and characterization of rat optic nerve head astrocytes / 眼科新进展

Objective To develop a set of methods for the culture and purification of astrocytes grown from explanted rat optic disc.Methods Rat optic disc and optic nerve were separated with anatomic microscopy and the blocks were cultivated primarily in culture flask with the medium containing DMEM/F-12.After digested by 2.5 g · L-1 trypsin,astrocytes were purified on the selective medium and passaged for two generations.Then cells were identified by immunofluorescent staining of glial fibrillary acidic protein (GFAP),neural cell adhesion molecule (NCAM) and Vimentin.Next,epidermal growth factor (EGF) was used to stimulate the purified cells for 24 h to observe their morphologic alteration.Finally,Western blot was used to detect the expression of GAFP,NCAM and Vimentin in the cells.Results When the tissue blocks were attached to the wall for 10 days,cells began to crawl out of the tissues and had different morphologies.After purified by the selective culture medium,satellite or anomalistic cells,possessing abundant cytoplasm,began to take a leading place.Immunofluorescent staining showed GFAP,NCAM and Vimentin were stained positively,and the purity of positive cells was above 90％.After stimulated by EGF,cells proliferated and the morphology changed;meanwhile,there was an increasing expression of GFAP,NCAM and Vimentin after stimulated by EGF when compared with the blank control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Highly-purified astrocytes can be achieved by the culture of explanted lamina cribiosa and optic disc of rats in vitro.

Clinical Observation of Grain-sized Moxibustion at Back-Shu Points of Zang-organs for Vascular Cognitive Impairment-no Dementia / 上海针灸杂志

Objective To observe the clinical efficacy and action mechanism of grain-sized moxibustion at Back-Shu points of Zang-organs in treating vascular cognitive impairment-no dementia (VCIND) due to marrow insufficiency. Method Ninety-two patients with VCIND due to marrow insufficiency were randomized into a grain-sized moxibustion group, an electroacupuncture group and a Western medication group. Since the grain-sized moxibustion group and electroacupuncture group each had 1 dropout case, there were 90 valid recruited cases, 30 in each group. Xinshu (BL15) and Shenshu (BL23) were selected as the major points, with Middle Line of Vertex (MS5), Middle Line of Forehead (MS1), Lateral Line 1 of Vertex (MS8), Zusanli (ST36), Sanyinjiao (SP6), Xuanzhong (GB39) and Taixi (KI3) as the adjunct points. The grain-sized moxibustion group and electroacupuncture group respectively received grain-sized moxibustion and electroacupuncture at Xinshu and Shenshu, and the adjunct points were treated with ordinary acupuncture. The intervention was given once a day, successive 5 d a week, and 4 weeks as a course of treatment, for 2 courses in total. The Western medication group was prescribed with oral administration of Piracetam tablet, 0.4 g per dose, 3 times a day, for successive 8 weeks. The clinical efficacies, Montreal Cognitive Assessment (MoCA) and Activities of Daily Living (ADL) scores, homocysteine (Hcy) and folic acid contents in serum were compared among the three groups after 8 weeks. Result The total effective rate was 86.7% (26/30) in the grain-sized moxibustion group, superior to 63.3% (19/30) in the electroacupuncture group and 36.7% (11/30) in the Western medication group (P<0.05,P<0.01). The MoCA and ADL scores and serum contents of Hcy and folic acid were significantly improved after the treatment in the three groups (P<0.01), and the grain-sized moxibustion group was significantly better than the electroacupuncture group and Western medication group (P<0.05,P<0.01), and the electroacupuncture group and superior to the Western medication group (P<0.05). Conclusion Grain-sized moxibustion at Back-Shu points of Zang-organs can produce significant efficacy in treating VCIND due to marrow insufficiency, and the effect is possibly realized by declining Hcy and increasing folic acid levels in blood.

The Application of Sclera Fixing Surgery in Suture Less Posterior Chamber Intraocular Lens / 昆明医科大学学报

Objective To evaluate the clinical efficacy of sclera fixing surgery in suture less posterior chamber intraocular lens (IOL). Method From March 2016 to February 2018, 60 patients undergoing IOL implantation in the Yuxi People's Hospital were selected as the study objects. They were randomly divided into thd study group (n=30) and the control group (n=30).The control group was given suture and fixation of ciliary sulcus in intraocular lens. The study group was treated with sclero fixing surgery in suture less posterior chamber intraocular lens, and we analyzed the visual acuity, intraocular lens stability, and occurrence of adverse reactions in both groups.Result The visual acuity of the study group was significantly better than that of the control group (P＜0.05). The stability of the intraocular lens was better in the study group than in the control group (P＜0.05). The incidence of adverse reactions in the study group was significantly higher than that of the control group (6.67％) (P＜0.05). Conclusions The sclera fixation surgery in suture less posterior chamber intraocular lens is a safe and effective treatment method for posterior chamber IOL without lens implantation with full capsular support, which has less trauma and fewer complications than sclera suture fixation of posterior chamber intraocular lens.It can effectively improve the vision of patients, significantly reduce the incidence of adverse reactions, and is beneficial to to patient's prevention, and it is worth for promoting.

Clinicopathological features of congential intestinal solitary fibromatosis: 2 cases report and literature review / 临床与实验病理学杂志

Purpose To study the clinicopathological features of congenital solitary intestinal fibromatosis (SIF).Methods Clinical,radiological and pathological features of 2 cases of SIF were analyzed along with a literature review.Results Two cases of SIF with one girl and one boy.Both presented with vomiting and abdominal distention at the birth day.A plain abdominal radiograph revealed small bowl obstruction and pneumoperitoneum.Jejunum atresia and perforation were detected at surgery.Microscopically,spindle tumor cells diffusely infiltrated in the whole intestinal wall,tumor cells were monomorphic with bland looking and rare mitosis was reviewed.Immunohistochemically,vimentin was positive while muscular markers as SMA,desmin and Myogenin were all negative.And S-100,CD117,CD34,ALK and β-catenin were not expressed.ETV6 split gene was not detected in one of the patients by FISH.Two patients of SIF had no tumor recurrence with follow-up till now.Conclusion Congenital SIF is a rare and unique intestinal tumor in neonate,and it should be differentiated from congenital fibrosarcoma and myofibroma.SIF appears a very good prognosis after segmental resection.

Performance verification of diluted thrombin time assay for detecting Dabigatran level in plasma / 临床检验杂志

Objective To evaluate the performance of diluted thrombin time (dTT) assay for detecting Dabigatran levels and observe whether this assay may meet the requirements of clinical laboratory.Methods According to EP15-A2,EP6-A,EP7-A and C-24 documents of the Clinical and Laboratory Standards Institute (CLSI),the precision,trueness,analytical measurement range,carryover rate and anti-biological interference of dTT assay were evaluated and the stability of specimen for dTT assay was observed.Results Both the within-day and between-day coefficient of variation (CV) of dTT assay for detecting Dabigatran levels were consistent with manufacturer's stated CV.Compared with target values of Dabigatran,the relative bias of 3 levels of proficiency test materials from College of American Pathologists (CAP) were less than 10％.The results meet linear verification when Dabigatran concentration was between 30.92 and 249.13 ng/mL.The carryover rate was-0.84％.There was no interference for Dabigatran levels by dTT assay for detecting Dabigatran when Hb≤3 g/L,triglyceride≤873 mg/dL,heparin≤2.2 IU/mL and FDP≤29 mg/L.The results of stability showed that plasma specimens for dTT could not be stored at room temperature more than 4 hours,at 4 ℃ more than 4 days,at-20 ℃ exceed 1 month,while at-80℃ the plasma specimens could be stored at least 6 months for dTT assay.Conclusion The precision,trueness,analytical measurement range,carryover rate,anti-biological interference of dTT assay may meet the requirement of clinical laboratory.The stability of the specimen can fulfill the clinical requirements.

Establishment and application of cell models with stable expression of hOCTN1/2 / 药学学报

Human carnitine/organic cation transporter 1 and 2(hOCTN1 and hOCTN2) mediate transport of endogenous and exogenous compounds. The present study aimed to establish cell models with stable expression of hOCTN1 or hOCTN2 to study interactions with compounds and transporters. MDCK cells were transfected with pcDNA3.1(+) plasmid vector containing hOCTN1 or hOCTN2(pcDNA3.1(+)-hOCTN1/2), several stable transfected clones were obtained after G418 screening. hOCTN1 and hOCTN2 clones were screened with ergothioneine and mildronate respectively as substrates to identify the best candidates. We explored interactions of endogenous substances, alkaloids, flavonoids and ACEIs with hOCTN1/2. As a result, the cellular accumulation of ergothioneine in MDCK-hOCTN1 or mildronate in MDCK-hOCTN2 was 122 and 108 folds of the control cells, respectively. The kinetic parameters, Km and Vmax of ergothioneine, mediated by MDCK-hOCTN1, were 8.19±0.61 μmol·L-1 and 1427±49 pmol·mg-1(protein)·min-1; while Km and Vmax of mildronate by MDCKhOCTN2 were 52.3±4.3 μmol·L-1 and 2454±64 pmol·mg-1(protein)·min-1. Dopamine, glutamine, piperine, berberine, nuciferine, lisinopril and fosinopril could inhibit ergothioneine or mildronate uptake by MDCKhOCTN1/2. In conclusion, cell models with good stable hOCTN1 and hOCTN2 functions have been established successfully, which can be applied to the study of interactions between compounds and transporters of hOCTN1 and hOCTN2.

A Special Electroencephalography Pattern Might Help in the Diagnosis of Antibody-positive Encephalitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Patterns observed with electroencephalography (EEG) for patients who have encephalitis are usually known as generalized nonspecific cerebral abnormalities. The aim of this study was to investigate the presence of a special EEG pattern for patients with encephalitis and to explore features related to this special and uncommon pattern.</p><p><b>METHODS</b>EEG monitoring was performed for every patient aged >15 years with encephalitis who was hospitalized between December 2011 and March 2014. Clinical characteristics and EEG recordings were collected and evaluated.</p><p><b>RESULTS</b>Fifty-two patients with encephalitis were enrolled in our study with a 2-h median EEG recording time, and extreme beta brushes (EBBs) occurred in 17 patients (32.7%). Its presence was not significant regarding gender, age, psychiatric medication use, EEG rhythmic disorganization (P > 0.05). Nevertheless, among the patients with EBBs, nine patients (52.9%) had epileptic seizures that had a significant detection rate (P < 0.05); moreover, the cerebrospinal fluid (CSF) or serum of 15 patients (88.2%) with EBBs was positive for antibodies (P < 0.05). Four patients (23.5%) who had EBB had corresponding regional distributions on neuroimaging scans. The EBBs completely correlated with the regional distributions of spike discharges for four patients.</p><p><b>CONCLUSION</b>EBB is a special EEG pattern for patients with encephalitis, especially those with epileptic seizures or who have antibody-positive CSF/serum, and should be considered in clinical practice.</p>

Establishment of MDCK cell models expressing human MATE1 or co-expressing with human OCT1 or OCT2 / 药学学报

To establish single- and double-transfected transgenic cells stably expressing hMATE1, hMATE1 cDNA was cloned by RT-PCR from human cryopreserved kidney tissue, and subcloned into pcDNA3.1(+) plasmid by virtue of both HindIII and Kpn I restriction enzyme sites. Subsequently, the recombined pcDNA3.1(+)- hMATE1 plasmid was transfected into MDCK, MDCK-hOCT1 or MDCK-hOCT2 cells using Lipofectamine 2000 Reagent. After a 14-day-cultivation with hygromycin B at the concentration of 400 µg · mL(-1), all clones were screened with DAPI and MPP+ as substrates to identify the best candidate. The mRNA content of hMATE1, the cellular accumulation of metformin with or without cimetidine as inhibitor, or transportation of cimetidine was further valuated. The results showed that all of the three cell models over expressed hMATE1 mRNA. The cellular accumulation of metformin in MDCK-hMATE1 was 17.6 folds of the control cell, which was significantly inhibited by 100 µmol · L(-1) cimetidine. The transcellular transport parameter net efflux ratios of cimetidine across MDCK-hOCT1/hMATE1 and MDCK-hOCT2/hMATE1 monolayer were 17.5 and 3.65, respectively. In conclusion, cell models with good hMATE1 function have been established successfully, which can be applied to study the drug transport or drug-drug interaction involving hMATE1 alone or together with hOCT1/2 in vitro.

Native Medicinal Plant Richness Distribution Patterns and Environmental Determinants of Xinjiang, Northwest China / 中草药·英文版

Objective: To comprehensively map the distribution patterns of native medicinal plants of Xinjiang Uygur Autonomous Region, China; To find the environmental determinants and to give suggestions for the conservation planning of medicinal plants in Xinjiang region. Methods: Firstly, we compiled the distribution data of native medicinal plants at a county level in Xinjiang region, including the source plants of Chinese Materia Medica (CMM), Uygur Medicine (UM), and Kazak Medicine (KM); Secondly, we divided the distribution data into grid with a resolution of 0.1° × 0.1° and overlaid it on the topography and climate data in Arcgis 10.0; Finally, we analyzed the correlations of medicinal plant richness and environmental variables with ordinary least square (OLS) regressions and partial regressions. Results: UM has more non-native species in Xinjiang region than KM. The species richness of medicinal plants is high in Altay Mountains, western Tianshan Mountains, and part of Kunlun Mountains. The richness of medicinal plants is highly correlated with the vascular plant species richness and climate, and further, the independent effects of vascular plant species richness are higher than the independent effects of climate. The whole plant, root & rhizome, and seed & fruit are more frequently used than stem and leaf for CMM in Xinjiang region. Conclusions: The distribution patterns of medicinal plants are concordant with vascular plant species, which could be carefully considered in the conservation planning of this region. Taking full advantage of current nature reserves is a low-costing approach to the conservation of medicinal plants although they were not originally established for medicinal plant protection. Nevertheless, it is urgent to further study the distributions and protection status of medicinal plants in the nature reserves of Xinjiang region.

Clinical research on acupoint catgut implantation in the prevention and treatment of postpartum pain of uterine contraction with qi and blood deficiency / 中国针灸

<p><b>OBJECTIVE</b>To observe the impacts of the acupoint catgut implantation on postpartum pain of uterine contraction with qi and blood deficiency.</p><p><b>METHODS</b>One hundred and ten primiparas of natural delivery differentiated as qi and blood deficiency pattern in TCM were selected as the subjects. They were randomized into an acupoint catgut implantation group (55 cases) and a routine nursing group (55 cases). In the acupoint catgut implantation group, the catgut was implanted in Zigong (EX-CA 1), Zusanli (ST 36), Sanyinjiao (SP 6), Pishu (BL 20) and Geshu (BL 17) in 6 h after delivery; additionally, the routine post-delivery nursing was adopted. In the routine nursing group, the routine post-delivery nursing was applied simply. Visual analogue scale (VAS) and the pain relief time of uterine contraction were compared in 24 h, 48 h, 72 h and 96 h after acupoint catgut implantation between the two groups.</p><p><b>RESULTS</b>VAS Scores in 24 h, 48 h, 72 h and 96 h after acupoint catgut implantation in the acupoint catgut implantation group were lower apparently than those in the routine nursing group (3.31 +/- 0.39 vs 4.31 +/- 0.29, 1.86 +/- 0.29 vs 2.66 +/- 0.25, 0.89 +/- 0.21 vs 1.59 +/- 0.24, 0.35 +/- 0.10 vs 0.69 +/- 0.13, all P < 0.05). The pain relief was achieved in (72.06 +/- 6.83) h in the acupoint catgut implantation group and was (123.42 +/- 11.12) h in the routine nursing group. The pain relief in the acupoint catgut implantation group was achieved more quickly (P < 0.01).</p><p><b>CONCLUSION</b>The intervention of acupoint catgut implantation in 6 h after natural delivery in primiparas prevents effectively postpartum pain of uterine contraction.</p>

Motor dysfunction in stroke of subacute stage treated with acupuncture: multi-central randomized controlled study / 中国针灸

<p><b>OBJECTIVE</b>To verify the clinical efficacy of acupuncture on motor dysfunction in ischemic stroke of subacute stage.</p><p><b>METHODS</b>The multi-central randomized controlled trial was adopted. One hundred and twenty-six cases of ischemic stroke of subacute stage were randomized into an acupuncture group (61 cases) and a conventional treatment group (65 cases). The basic treatment of western internal medicine and rehabilitation training were applied to the patients of the two groups. In the acupuncture group, acupuncture was supplemented at the body points located on the extensor of the upper limbs and the flexor of the lower limbs. In combination, scalp acupuncture was applied to NS5, MS6 and MS6 on the affected side. The treatment was given 5 times a week and totally 8 weeks were required. The follow-up observation lasted for 3 months. The scores in Fugl-Meyer scale and NIHSS scale and Barthel index were compared between the two groups before treatment, in 4 and 8 weeks of treatment and the 3-month follow-up observation after treatment separately.</p><p><b>RESULTS</b>In 4 and 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score was improved obviously in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score in the acupuncture groupwas im proved much apparently as compared with that in the conventional treatment group [68. 0 (43. 0,86. 5) vs 52. 5 (30.3, 77.0), 77.0 (49.5, 89.0) vs 63. 0 (33.0, 84.0), both P<0. 05]. Except that NIHSS scale score was not reduced apparently in 4 weeks of treatment in the conventional treatment group (P>0.05), the results of NIHSS scale at the other time points were all decreased obviously as compared with those before treatment in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, the results in the acupuncture group were reduced much apparently as compared with those in the conventional treatment group [5. 0 (3.0,8.0) vs 7. 0 (3.0,13.8), 4. 0 (1.5,7.0) vs 6.0 (2.0,11.7) ,both P<0. 05]. In 8 weeks of treatment and the follow-up observation, Barthel index was improved obviously as compared with that before treatment in the patients of the two groups (all P<0. 05). The improvement in the acupuncture group was much more significant as compared with the conventional treatment group [75. 0 (60. 0,87. 5) vs 65. O (36. 3, 87. 5), P<0. 051.</p><p><b>CONCLUSION</b>Based on the conventional treatment, Acupuncture achieves the satisfactory clinical efficacy on motor dysfunction in ischemic stroke of subacute stage.</p>

Cause analysis of 280 case of fractures nonunion / 中国骨伤

<p><b>OBJECTIVE</b>To research many clinical data of nonunion cases and discover the reasons for low capacity of bone growth.</p><p><b>METHODS</b>From October 1999 to April 2009,the source material of 280 nonunion cases were conducted and followed up. The data of the study included 230 males and 50 females,with an average age of 39.4 years old ranging from 19 to 62 years. The fracture position was femur in 129 cases,tibia in 83 cases,humerus in 47 cases, feet radius bone in 21 cases, the ratio was 46:29.6:16.8:7.5. The survey included primary injury process,damage degree and the effect of first treatment,hospital level of first treatment,timing of surgery for the first time, the early callus growth conditions and whether there were obvious technical errors.</p><p><b>RESULTS</b>There were 129 femoral nonunion cases with complete data,121 cases derived from closed fractures, 8 cases from open fractures; 111 cases was aseptic nonunion. 90% of femoral aseptic nonunion had no obvious callus growth, 80% of first treatment performed intraday surgical internal fixation, 10% were undergone operation within three days and 90% was early surgery totally.</p><p><b>CONCLUSION</b>Low quality of bone callus growth is the main reason for current nonunion and the early surgical fixation has much to do with low quality of bone callus growth.</p>

Investigation of current demands for professional continuing medical education in ophthalmic nurses / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the current demands for professional continuing medical education (CME) in ophthalmic nurses and their influential factors, and to provide evidence for properly setting the curriculum of professional CME for nurses.</p><p><b>METHODS</b>Qualitative and quantitative analysis was performed on 60 nurses in an ophthalmic hospital by questionnaire survey and group interview.</p><p><b>RESULTS</b>Of the nurses surveyed, 49 (81.7%) thought the training time of professional CME needs to be adjusted, 40 (66.7%) referred to the training pattern, and 53 (88.3%) the training contents. The demanded courses of training mainly included professional nursing knowledge, professional nursing skills, and ophthalmic knowledge. Most nurses considered the influential factors for training were unreasonable training time and lack of applicability of some courses.</p><p><b>CONCLUSION</b>To improve the quality of professional CME for ophthalmic nurses, the training curriculum should be designed in consideration of ophthalmic characteristics, different work experiences of nurses, and different nursing positions, the training time should be arranged properly, and various training patterns should be adopted flexibly.</p>

Risk factors of low back pain among the Chinese occupational population: a case-control study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the risk factors of low back pain among the Chinese occupational population in several major industries.</p><p><b>METHODS</b>A total of 7200 subjects (3600 cases and 3600 controls) were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall's rank correlation. Finally, binary logistic regression model was used for multi-factor analysis.</p><p><b>RESULTS</b>Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posture for long periods (OR=1.408) was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk (OR=1.402), carrying out identical work almost for the whole day (OR=1.340). Additionally, sufficient normal break was a protective factor of low back pain.</p><p><b>CONCLUSION</b>Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.</p>

Relationships between psychosocial factors and work-related musculoskeletal disorders in coal miners / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To estimate the associations of psychosocial factors with work-related musculoskeletal disorders (WMSDs), providing scientific evidence for targeted strategies for the prevention of WMSDs in Chinese coal miners.</p><p><b>METHODS</b>A total of 500 coal miners were consecutively enrolled to this cross-sectional study. The prevalence of WMSDs was assessed using the Standardized Nordic Questionnaire. Logistic regression analyses were conducted to estimate the associations between psychosocial factors and WMSDs.</p><p><b>RESULTS</b>Among coal miners, of 277 coal miners, 61% self-reported WMSDs in a 12-month period. Especially, back pain was the most frequent musculoskeletal symptom. WMSDs were statistically correlated with high job demands (OR = 1.3, 95%CI: 1.3 ∼ 3.5), low job control (OR = 1.6, 95%CI: 1.0 ∼ 2.4), low level of interpersonal relations (OR = 1.9, 95%CI: 1.2 ∼ 3.0) and low job satisfaction (OR = 1.6, 95%CI: 1.0 ∼ 2.4).</p><p><b>CONCLUSION</b>The results of this study demonstrate psychosocial factors were associated with WMSDs among coal miners, and psychosocial factors be considered for the prevention of WMSDs.</p>

Analysis of the lag-effects of temperature on the five cities' mortality in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the characteristics of the effect of different temperatures on mortality of different cities through analyzing the relationship between mortality and meteorology of five Chinese cities.</p><p><b>METHODS</b>We get the demography and climate data of Beijing, Tianjin, Shanghai, Nanjing and Changsha cities from National Center of Disease Control and Prevention and Climate net respectively. Then we applied the R software and Distributed Lag Non-linear Models (DLNM) package to analyze our data and find the nonlinear and lag effects on mortality using DLNM.</p><p><b>RESULTS</b>The city of Beijing and Tianjin are located in the temperate zone. And the climate of Shanghai, Nanjing, Changsha belong to subtropical monsoon climate. When the daily mean temperature arrived 30°C and on lag 0 day, the values of relative risk of effect of high mean temperature on mortality in Nanjing (1.31, 95%CI: 1.21 - 1.41) and Changsha (1.25, 95%CI: 1.13 - 1.39) are larger than that in Beijing (1.18, 95%CI: 1.12 - 1.25), Tianjin (1.18, 95%CI: 1.10 - 1.26) and Shanghai(1.15, 95%CI: 1.06 - 1.24). While the relative risk of effect of low mean temperature on mortality is lower and lasts for a longer lag time. During the whole lag time, the relative risk of effect of the lowest daily mean temperature of each city on mortality in Tianjin, Changsha, Beijing, Nanjing, and Shanghai is 3.41, 95%CI: 1.60 - 7.27, 2.15, 95%CI: 1.11 - 4.15, 2.24, 95%CI: 1.12 - 4.48, 2.80, 95%CI: 1.75 - 4.48, 1.53, 95%CI: 1.12 - 2.03, respectively. The cumulative effect of mean temperature on mortality appears like a U-shape. When on lag 0-1 day, the value of relative risk of effect of extremely high temperature and the highest mean temperature on mortality is larger than 1. While the effect of low temperature on mortality becomes obvious after lag 2 days.</p><p><b>CONCLUSION</b>Depending on this research, extremely low temperature and the lowest mean temperature has a more obvious impact on mortality in the northern area than in the south. Extremely high temperature and the highest daily mean temperature is on the contrary. Meanwhile, different temperatures have different impacts on mortality in the same city: high temperature has an acute impact while there is a longer lag time in low temperature.</p>