Comparing one-step common bile duct exploration plus cholecystectomy with two-step endoscopic sphincterotomy plus cholecystectomy in patients over 80 years with concomitant gallbladder and common bile duct stones / 中华肝胆外科杂志

Objective:To compare safety and efficacy of one-stage laparoscopic common bile duct exploration plus laparoscopic cholecystectomy (LCBDE+ LC) with endoscopic retrodrade cholangiopancreatography plus laparoscopic cholecystectomy (ERCP+ LC) in elderly patients with concomitant gallbladder and common bile duct (CBD) stones.Methods:This is a two-center retrospective study with clinical data on 492 patients aged over 80 years diagnosed with concomitant gallbladder and CBD stones treated between January, 2014 and December, 2020 at The First Affiliated Hospital of Wenzhou Medical University and Quzhou Hospital Affiliated to Wenzhou Medical University. There were 254 males and 238 females, aged (83.9±3.0) years. These patients were divided into two groups based on their operative methods: the one-stage group (LCBDE+ LC, n=186) and the two-stage group (ERCP+ LC, n=306). Differences in surgery, stones and hospitalization costs were compared between the two groups. Results:When compared with the ERCP+ LC group, the LCBDE+ LC group had significantly higher incidences of previous gastrectomy [21.5%(40/186) vs 4.2%(13/306)], multiple stones [77.4%(144/186) vs 49.3%(151/306)], larger stone diameter [13.7(6.4, 18.6)mm vs 10.9(5.7, 16.1) mm], and increased hospitalization expenditure [(2.37±0.31) Wanyuan vs (3.26±0.44) Wanyuan] (all P<0.05). However, the rates of residual stone [2.7%(5/186) vs 1.3%(4/306)], stone recurrence [2.2%(4/186) vs 5.2%(16/306)], postoperatively overall complications [3.2%(6/186) vs 1.3%(4/306)], and total hospital stay [(10.7±6.2) d vs (11.3±5.4) d] were not significantly different between the two groups (all P>0.05). Conclusions:Allowing for the similar safety and effectiveness, and lower hospitalization expenditure, LCBDE+ LC was a preferred choice for patients aged over 80 year, especially in patients who had previous gastrectomy, multiple large CBD stones, or who could not accept endoscopic procedures for treatment of CBD stones.

Mechanism of Artesunate in Reversing Epithelial-mesenchymal Transition and Akt /Snail Signaling Pathway in Colorectal Carcinoma / 中国实验方剂学杂志

Objective:To investigate the effects of artesunate （ART） on epithelial-mesenchymal transformation （EMT） of colorectal cancer HCT-8 cells，and explore the effects of ART on cell migration，invasion，EMT ability， and protein kinase B （Akt）/Snail signaling pathway of colorectal cancer. Method:3-（4-5-Dimethylthiazol-2-yl）2，5-diphenyltetrazolium bromide （MTT） assay was used to detect the effects of ART at different concentrations on the proliferation of HCT-8 cells. Wound healing assay and Transwell assay were used respectively to detect the effects of ART on migration and invasion of colorectal cancer cells. The effects of different concentrations of ART on the distribution of EMT-related proteins vimentin and E-cadherin in HCT-8 cells were detected by double-immunofluorescent staining. The effects of ART on protein expression levels of EMT markers E-cadherin，vimentin and N-cadherin in HCT-8 cells and the expression of Akt1， p-Akt1， and Snail1 in the Akt/Snail signaling pathway were determined by Western blot. Result:The dose-dependent inhibitory effects of ART on the proliferation of HCT-8 cells were determined and the inhibition rate was calculated. A dose-response curve was plotted accordingly. The half-maximal inhibitory concentration （IC₅₀） of ART on HCT-8 cells was （16.67±1.95） μmol·L^-1. The following four groups were set up： a control group （0 μmol·L^-1），and low-， medium-， and high-dose ART groups（2， 10， 50 μmol·L^-1）. Compared with the results in the control group，ART inhibited the migration and invasion of HCT-8 cells（<italic>P</italic><0.05）. Specifically， the expression of E-cadherin in HCT-8 cells was significantly up-regulated，and that of vimentin and N-cadherin was significantly down-regulated （<italic>P</italic><0.05）. The expression levels of p-Akt1 and Snail1 were significantly decreased after ART treatment，thus inhibiting EMT（<italic>P</italic><0.05）. Conclusion:The findings of this study suggested that ART inhibited the EMT-triggered migration and invasion of HCT-8 cells presumedly by inhibiting the activation of the Akt/Snail pathway to reverse EMT.

The value of PET/CT imaging for detecting primary malignant tumor to patients with elevated serum CA19-9 / 中国医师杂志

Objective To investigate the diagnostic accuracy of malignant tumor of 18F-fluorodeoxyglucose positron emission tomography/computed tomograprhy (18F-FDG PET/CT) imaging in the patients of elevated serum carbohydrate antigen 19-9 (CA19-9) and its correlation with maximum standardized uptake value (SUVmax) and serum CA19-9 level.Methods Whole-body 18F-FDG PET/CT scan was performed in 149 patients with elevated serum CA19-9 level without the history of malignancy.Blood sample was drawn in each case for CA19-9 assay two weeks or less before the performing PET/CT.Final diagnoses were confirmed by operation/biopsy pathological results and clinical follow-ups.Results Among the 149 patients,64 cases were finally diagnosed as malignancies and 85 cases of non-malignancy diseases.The true positive of the diagnoses by 18F-FDG PET/CT was 60 cases,the false positive 13 cases,the true negative 72 cases,the false negative 4 cases.The accuracy of diagnosis of malignant tumor with elevated serum CA19-9 was 43.0％,while elevated serum CA19-9 combined with 18F-FDG PET/CT imaging was 88.6％,with statistically significant difference (x2 =59.882,P ＜ 0.05).The serum CA19-9 was divided into 4 groups according to the different levels of 37-100 U/ml,100-500 U/ml,500-1000 U/ml and ＞ 1 000 U/ml.The diagnostic accuracy of each group of PET/CT was 94.5％,84.9％,81.3％ and 88.0％,respectively.There was no statistically significant difference between each group (x2 =3.503,P ＞ 0.05).The area under the curve (AUC) of the serum CA19-9 for the diagnosis of malignant tumor (ROC) was 0.726,and the sensitivity and specificity of the diagnostic boundary value of 152.75 U/ml were 70.3％ and 68.2％,respectively.The AUC of SUVmax in diagnosis of malignant tumor was 0.742,the best cutoff value was 6.95,and the sensitivity and specificity were 73.3％,69.2％ respectively.Conclusions 18 F-FDG PET/CT is useful for detecting malignant tumors combined with serum tumor marker CA19-9.The patients with elevated serum CA19-9 are necessary to do PET/CT imaging,especially serum CA19-9 ＞ 152.75 U/ml.And it should be considered malignant tumor when SUVmax ＞ 6.95.

Overexpression of TLR2,TLR4 and MyD88 is associated with inflammation in C3H mice during Chlamydia respiratory infection / 中国免疫学杂志

Objective:To investigate the mechanism of excessive inflammation in the lung of C3H/HeN(C3H) mice following Chlamydia muridarum(Cm) airway infection.Methods:Chlamydial pneumonitis was induced in C3H and C57BL/6(C57) mice by intranasal inoculation with 1×103IFU (inclusion forming unites) of Cm strains.The expression of TLR2,TLR4 and MyD88 mRNA in the lung at different time point post-infection was measured by RT-PCR.Results:Cm infection induced Toll-like receptors expression in two strains of mice.The expression of TLR2 and TLR4 mRNA,especially TLR2 mRNA(P<0.001 or P<0.05),were significantly higher in highly susceptible C3H mice on day 7 and day 14 d post-infection compared with C57 mice.Further studies showed that the expression of MyD88 mRNA was also significantly higher in C3H mice on day 7 post-infection,and maintained high expression untill the day 14.Conclusion:Cm lung infection induced high level of TLR2,TLR4 and MyD88 mRNA expression in C3H mice,which may associate with excessive inflammation in C3H mice.

Application Value of Total Membrane Dissection in Endoscopic Thyroidectomy / 中国微创外科杂志

Objective To study the application value of endoscopic thyroidectomy via total membrane dissection. Methods One hundred and sixteen patients with benign thyroid nodules were given axillo-breast approach endoscopic thyroidectomy via total membrane dissection from January 2014 to December 2016. Results Endoscopic thyroidectomy was completed in all the patients without conversion to open surgery.The operation time was 45-125 min[mean,(65.6 ±36.7)min],the blood loss was 10-220 ml[mean,(43.2 ±22.7)ml],the postoperative drainage volume was 25-305 ml[mean,(95.3 ±53.8)ml], the postoperative drainage time was 2-4 d[mean,(2.3 ±0.7)d)],and the length of hospital stay was 3-6 d[mean,(4.1 ±1.1)d].Short-term twitch occurred in 1 case and seroma occurred in 2 cases.No other complications such as hoarseness,bucking or asphyxia occurred in this series. Conclusion Endoscopic thyroidectomy via total membrane dissection can effectively avoid the injury of recurrent laryngeal nerve and parathyroid gland.

Application of priority processing for splenic pedicle in laparoscopic splenectomy for portal hypertension and splenomegaly / 中华肝胆外科杂志

A retrospective study was conducted based on the clinical data of 42 patients of portal hypertension and splenomegaly who underwent laparoscopic splenectomy.The patients were divided into two groups including pedicle priority group and conventional group by different operative method.The operation time and intraoperative blood loss in the pedicle priority group were significantly lower than those in the conventional group (both P ＜ 0.05),and there was no statistically significant difference on the conversion rate of laparotomy,active time postoperation,exhaust time,postoperative hospitalization stay and the incidence of complications (all P ＞ 0.05).Priority processing for splenic pedicle has obvious advantages in laparoscopic splenectomy for portal hypertension and splenomegaly,and it could reduce the difficulty of operation,shorten the operation time and reduce bleeding.

Current Development of Breast-Specific Gamma Imaging (BSGI) Technique / 中国医疗器械杂志

Breast-Specific Gamma Imaging (BSGI) is an improved and optimizing nuclear medicine breast imaging technique on the basis of traditional gamma camera. It uses a high resolution, small field-of-view scintilla detector. The detector is designed with 3 073 individual detector crystals and 48 position-sensitive photomultiplier tubes. The FOV of detector is 15 cm x 20 cm, and optimal system resolution for breast imaging is 3 mm, can detect the diameter of only 2-3 mm small lesions. BSGI has better sensitivity in detecting subcentimetre or nonpalpable breast cancer. The sensitivity for the diagnosis of breast cancer is high, not influenced by the density of the breast tissue, implants, architectural distortion-or scars from prior surgery or radiation. So it is called a high resolution, small field-of-view breast-specific gamma camera.

Clinical diagnostic value of (18)F-FDG PET-CT in incidental finding of focal hypermetabolism focus in the colon and rectum / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the value of incidental focal (18)F-FDG uptake in the colon and rectum and characteristics of functional anatomic form for differential diagnosis of colorectal benign or malignant diseases.</p><p><b>METHODS</b>Clinical data and images of incidental focal hypermetabolism focus in colon and rectum of 37 individuals undergoing (18)F-FDG PET-CT were analyzed retrospectively. According to the eventual outcomes of pathological examination and clinical follow-up, these cases were divided into four subgroups: malignant disease, benign tumor (including precancerous change), inflammation and physiological uptake. Radioactive uptake level (SUVmax) and change of delayed imaging (RI) of focal hypermetabolism focus were compared between groups. The data analysis was performed using variance analysis.</p><p><b>RESULTS</b>The average SUVmax was 6.3±3.7, 8.8±6.5, 5.2±1.4, and 3.8±0.9 in malignant disease (n=11), benign (precancerous) tumor (n=9), inflammation (n=9) and physiological uptaking (n=8) respectively. The average SUVmax was 7.6±5.6 in benign and malignant tumor, and 4.7±1.5 in inflammation and physiological uptake. The distinction of average SUVmax was not statistically significant between benign and malignant tumor or inflammation and physiological uptake. But it was higher in tumors as compared to inflammation or physiological uptake with a statistically difference (P<0.05). The RI was 0.3±0.2, 0.4±0.1, 0.3±0.2, 0.4±0.2 in above 4 groups respectively, and the differences were not statistically significant.</p><p><b>CONCLUSIONS</b>The incidental focal hypermetabolism focus in the colon the rectum during (18)F-FDG PET-CT may indicate potential colorectal malignant diseases and precancerous lesions. SUVmax value in focal hypermetabolism focus in the colon and rectum can help to distinguish tumor from inflammation or physiological uptake. But there is no diagnostic value for distinguishing malignant disease from benign tumor.</p>

Value of radical dissection with vagus nerve preservation for proximal gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the feasibility and influence of vagus nerve preservation in radical operation for proximal gastric cancer.</p><p><b>METHODS</b>Thirty-two patients with early or T2 cardia cancer from May 2007 to May 2009 were enrolled and randomized into two groups, i.e. vagus nerve preservation group(n=16) and control group(n=16). Two groups were compared with regard to operative time, anastomotic fistula, digestive discomforts, body weight, survival rate, findings on gastroscope and abdominal ultrasonography.</p><p><b>RESULTS</b>There were no statistically significant differences between the two groups in operative time (2.8 vs. 2.5 h), postoperative complications rate (25.0% vs. 31.3%). No recurrence or mortality was observed after one-year follow-up. However, patients who underwent vagus nerve preservation had less postprandial discomforts(3 vs. 12 cases), bile reflux(3 vs. 10 cases), atrophic gastritis(1 vs. 9 cases), gallstones(1 vs. 8 cases), body mass index, and diarrhea(P<0.05).</p><p><b>CONCLUSION</b>For patients with early gastric cancer, preservation of the vagus nerve during radical gastrectomy results in less complications and does not compromise patient survival.</p>

Influence of nursing intervention on hormone treatment compliance of patients with nephrotic syn-drome / 中国实用护理杂志

Objective To investigate the influence of nursing intervention on hormone treatment compliance of patients with nephrotic syndrome. Methods 130 patients with nephrotic syndrome who received hormone treatment were randomly divided into the experimental group and the control group ac-cording to the time of admission. The control group were treated with conventional nursing, and the ex-perimental group was given whole-process health education besides conventional nursing.Using question-naires, the level of relevant knowledge and medication compliance were compared between the two groups .The results underwent χ2 and t test. Results The treatment compliance was not significant be-fore nursing intervention, while after nursing intervention, the treatment compliance of the experimental group was better than that of the control group. The score of relevant knowledge about nephrotic syn-drome of the experimental group was higher than that of the control group Conclusions Active nurs-ing intervention can improve the health knowledge level of patients and improve the treatment compli-ance of hormone therapy.

Cerebral perfusion semi-quantitative imaging for assessing the treatment of delayed encephalopathy from carbon monoxide poisoning / 中华物理医学与康复杂志

Objective To evaluate the effects of hyperbaric oxygen (HBO) combined with drug therapy on patients with delayed encephalopathy caused by carbon monoxide poisoning ( COP). Methods Twenty to forty sessions of HBO therapy were used to treat 34 COP patients. Assessment relied on 99mTc-ethyl cysteinate dimer (~(99m)Tc-ECD) single photon emission computed tomography (SPECT) imaging of cerebral perfusion before and after treatment. Results After HBO therapy, cerebral perfusion in the COP patients improved significantly. There was a significant difference of the SPECT images before and after treatment. Conclusions SPECT imaging of cerebral perfusion can play an important role in the diagnosis of delayed encephalopathy caused by carbon monoxide poisoning, and it can be used for the therapeutic surveillance of HBO treatment.

Cohort studies on cancer mortality of digestive system among workers exposed to asbestos: a meta-analysis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To determine if there are excessive risks of malignant tumors or not among workers exposed to asbestos by applying a meta-analysis technique.</p><p><b>METHODS</b>All data meeting the criteria of cohort studies on cancer mortality of digestive system among workers exposed to asbestos would be incorporated into the meta-analysis. The pooled standardized mortality ratios (SMR) and their corresponding 95% confidence intervals (CIs) for main cancer sites of digestive system were calculated by using two approaches of un-weighted ratio and random effects model. The heterogeneity and its sources of the results were examined with a Q-statistic and Z-score test.</p><p><b>RESULTS</b>69 asbestos-exposed cohorts were summarized. The significantly elevated meta-SMR for all deaths (1.16), all cancers (1.42), cancer of digestive system (1.15) and cancer of stomach (1.20) among workers exposed to chrysotile alone or mixed asbestos were observed (P < 0.01). The stomach cancer SMR was significantly increased in the asbestos cement workers, the screening mine workers and the insulators, (1.27, 1.21 and 2.13 respectively) (P < 0.05). meta-SMR for cancers at other sites of digestive system including esophagus, colon, rectum and liver were not significant.</p><p><b>CONCLUSION</b>There are likely excessive risks of cancer of stomach among workers exposed to asbestos. However, there is likely no convincing indication of an etiological association between asbestos exposure and cancers at other sites of digestive system.</p>

Evaluation of hyperbaric oxygen treatment of neuropsychiatric disorders following traumatic brain injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Improvement of clinical symptoms following hyperbaric oxygen (HBO) treatment of neuropsychiatric disorders arising from traumatic brain injury was proved by our previous study. This study was aim to obtain the evidence of other changes.</p><p><b>METHODS</b>Three hundred and ten patients with neuropsychiatric disorders arising from traumatic brain injury were treated twice with hyperbaric oxygen. Cerebral single photon emissions computed tomography (SPECT) images and computed tomography scans (CT) before and after hyperbaric oxygen treatment, were compared.</p><p><b>RESULTS</b>Before treatment, the proportion of abnormal cerebral changes detected by SPECT was 81.3% but only 15.2% by CT. After HBO treatment, 70.3% of SPECT scans showed no abnormalities and these patients were clinically improved. Treatment improved regional cerebral blood flow.</p><p><b>CONCLUSION</b>SPECT was much more sensitive than CT in the diagnosis of neuropsychiatric disorders following hyperbaric oxygen treatment of neuropsychiatric disorders arising from traumatic brain injury.</p>

Effect of injectable Xuebijing on proliferation of murine brain microvascular endothelial cell line bEnd.3 / 中华急诊医学杂志

Objective To investigate the effect of injectable Xuebijing on the proliferation of mouse brain microvascular endothelial cell in vitro.Methods Cultured mouse brain microvascular endothelM cell line bEnd. 3 was treated by injectable Xuebijing of different concentrations,0 (control),5,25 and 50 mg/ml.The regulatory. effect of Xuebijing on the proliferation of cell line bEnd.3 was observed and studied by means of MTT method and cell cycle analyzed with flow cytometry.Results Compared to the control group,MTT and proliferation index (PI) of 5 and 25 mg/ml groups were significantly increased at 12 and 24 h,and PI,but not MTT,of these 2 groups was decreased remarkably at 48 h.Meanwhile,50 mg/ml group showed significantly decreased MTT at 24 and 48 h,and PI of this group was increased obviously at 12 and 24 h,but decreased significantly at 48 h. Conclusions Injectable Xuebijing at certain concentrations might promote the proliferation of cultured mouse brain microvascular endothelial,cells within specific time frame.

89SrCl2 in the treatment of cancer patients with bone metastasis and pain / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of (89)SrCl(2) (Ke xing Inc, Shanghai) as a palliative therapy modality for cancer patients with bone metastasis.</p><p><b>METHODS</b>In 504 cancer patients with painful limitation of movement due to bony metastasis, a dose of 1.48-2.22 MBq/kg (40-60 uCi/kg) iv infusion of (89)SrCl(2) was given.</p><p><b>RESULTS</b>In 97 patients (19.2%) there was no improvement in pain and life quality, 298 patients (59.1%) showed mild to moderate improvement (moderately effective), 109 patients (21.6%) became free of pain and were subsequently fully ambulatory (markedly effective). The pain relief appeared from D1-D46 after (89)SrCl(2) administration, most frequently from D5-D14. The palliative effect could last for about 56 days to 13 months. Repeated bone scans of some patients showed that the metastatic foci in the bone became smaller or even disappeared gradually after the administration of (89)SrCl(2). Approximately 55% of patients experienced grade I approximately III bone marrow depression attributable to (89)SrCl(2), which would return to the pre-treatment level within 3 approximately 9 months.</p><p><b>CONCLUSION</b>(89)SrCl(2) is effective and safe for the relief of bone pain and improvement of quality of life in cancer patients with painful bony metastasis.</p>

Expression and purification of three fusion proteins containing a single B-cell epitope (beta5, beta9 or beta8) of human chorionic gonadotropin beta subunit / 生物工程学报

The possibility of using a subunit or fragment of human chorionic gonadotropin (hCG) as an immunogen for birth control has been actively explored for many years. This protein homone is produced by the fertilized egg and is required for implantation of the blastocyst into the maternal uterus and the maitenance of pregnancy. In previous studies, several bio-synthesized hCG chimeric peptides (CP) that contain three linear B-cell epitopes (beta5, beta9 and beta8) of beta-hCG subunit together with various foreign 'promiscuous' T-cell epitopes were constructed and expressed as potential new hCG vaccine immunogens. In order to detect antibodies to each of the individual B-cell epitopes present in the animal antiserum raised against the hCG CPs, we decided to construct three recombinant proteins, each contains a single target B-cell epitope (betaE) of beta-hCG. Two sets of DNA fragments were chemically synthesized encoding the beta5, beta9 and beta8 epitopes (betaE) 45 approximately 52, 113 approximately 116 or 133 approximately 144 of beta-hCG subunit and were inserted into the downstream of streptavidin (Stv) gene in pTSA18 separately, with or without an extra TAA codon at the 3'-terminals of the genes. SDS-PAGE analysis revealed that only Stv-betaE (-beta5, -beta9 or -beta8) fusion genes set with the TAA codon can be expressed in E. coli BL21 (DE3) pLysS strain at high level after 1mM IPTG induction for 4 hours. Additionally, these fusion proteins can all be recognized by specific polyclonal antiserum (RS-4157) generated upon immunization with the loop peptide 38 approximately 57 of beta-hCG, monoclonal antibody (mAb) FB12 to beta9 epitope and mAb OT3A that specially recognizes reporter sequence 133 approximately 139 of beta8 epitope 137 approximately 144. Each of the proteins can be purified to 95% relative homogeneity using an improved method of preparative gel polyacrylamide gel electrophoresis. The yields were 5 mg per 1 L culture. The three target Stv-betaE fusion proteins will be useful in determining the immunogenicity of designed hCG CPs and hCG vaccines, including hCG DNA vaccines.

Cohort studies on cancer mortality among workers exposed only to chrysotile asbestos: a meta-analysis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine whether there was excessive risk of cancer among workers exposed to chrysotile fiber alone by applying a meta-analysis technique.</p><p><b>METHODS</b>All data meeting the criteria of cohort studies on cancer mortality among workers exposed only to chrysotile were incorporated into meta-analysis. Pooled standardized mortality ratios (SMRs) and their corresponding 95% confidence intervals (CIs) for main cancer sites were calculated using two approaches of unweighted ratio and random effect model. The heterogeneity and its sources of the results were examined with a Q-statistic and Z-score test. The dose-response effect as reflected in the percentage of all deaths due to mesothelioma served as a proxy measure of chrysotile exposure.</p><p><b>RESULTS</b>A cohort of twenty six workers exposed to chrysotile alone was summarized. The significantly elevated meta-SMRs for all deaths (1.27), all cancers (1.28), cancers of respiratory organs (2.51), cancers of lung (2.35) and cancers of stomach (1.24) were observed. The significantly elevated meta-SMRs for lung cancer within occupational strata were observed among textile workers (3.55), asbestos product manufacturers (3.30), miners and millers (2.24), cement product workers (1.22), and for stomach cancer among asbestos product manufacturers (1.49). Meta-SMRs for cancers at other sites were not significant. Meta-SMR for lung cancer showed an increasing trend with an elevated percentage of all deaths from mesothelioma, but no such trend for stomach cancer.</p><p><b>CONCLUSION</b>There are excessive risks of lung cancer and mesothelioma among workers exposed to chrysotile fiber alone, and likely no convincing indication of an etiological association between chrysotile exposure and cancers at other sites.</p>

A meta-analysis of cohort studies on cancer mortality among workers exposure to chrysotile fiber alone / 中华预防医学杂志

<p><b>OBJECTIVE</b>To determine there was excessive risk of malignant tumors or not among workers exposure to chrysotile fiber alone by applying a meta-analysis technique.</p><p><b>METHODS</b>All data meeting the criteria of cohort studies on cancer mortality among workers exposed only to chrysotile would incorporate into the meta-analysis. The pooled standardized mortality ratios (SMR) and their corresponding 95% confidence intervals (95% CI) for main cancer sites were calculated using two approaches of unweighted ratio and random effects model. The heterogeneity and its sources of the results were examined with a Q-statistic and Z-score test.</p><p><b>RESULTS</b>26 chrysotile-exposed alone cohorts were summarized. The significantly elevated meta-SMRs for all deaths (1.28), all cancers (1.26), cancers of respiratory organs (2.24), cancer of lung (2.29) and cancer of stomach (1.27) were observed. The significantly elevated meta-SMRs for lung cancer within occupational strata were observed among textile workers (3.64), asbestos products manufacturers (3.07), miners and millers (2.24), cement products workers (1.22), and for stomach cancer among asbestos products manufacturers (1.48). Meta-SMRs for cancers at other sites were not significant.</p><p><b>CONCLUSION</b>There were excessive risks of lung cancer and mesothelioma among workers exposure to chrysotile fiber alone, and likely no convincing indication of an etiological association between chrysotile exposure and cancers at other sites.</p>

Cerebral perfusion SPECT imaging for assessment of the effect of hyperbaric oxygen therapy on patients with postbrain injury neural status / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the effects of hyperbaric oxygen (HBO) therapy on patients with postbrain injury neural status.</p><p><b>METHODS</b>Two to 4 courses of HBO therapy and/or medications were used to treat 320 patients who were randomly divided into two groups. Assessment was made with (99m)Tc-ethyl cysteinate dimer ( (99m)Tc-ECD) single photon emission computed tomography (SPECT) before and after treatment.</p><p><b>RESULTS</b>There was a significant difference between the HBO therapy group and the non-HBO therapy group. HBO therapy was superior to medication treatment alone in the recovery of clinical symptoms, control of epilepsy, and resolution of hydrocephalus (P<0.01).</p><p><b>CONCLUSIONS</b>HBO therapy has specific curative effects on patients with postbrain injury neural status, and (99m)Tc-ECD SPECT could play an important role in diagnosing postbrain injury neural status and monitoring the therapeutic effects of HBO.</p>