Antibiotic prophylaxis for surgical wound infections in clean and clean-contaminated surgery: an updated systematic review and meta-analysis.

BACKGROUND: The efficacy and necessity of prophylactic antibiotics in clean and clean-contaminated surgery remains controversial. METHODS: The studies were screened and extracted using databases including PubMed, Embase, Cochrane Library, Web of Science, and Clinical Trials.gov according to predefined eligibility criteria. Randomized controlled trials (RCTs) comparing the effect of preoperative and postoperative prophylactic antibiotic use on the incidence of surgical site infections (SSIs) in patients undergoing any clean or clean-contaminated surgery. RESULTS: A total of 16,189 participants in 48 RCTs were included in the primary meta-analysis following the eligibility criteria. The pooled odds ratio (OR) for SSI with antibiotic prophylaxis versus placebo was 0.60 (95% CI: 0.53-0.68). The pooled OR among gastrointestinal, oncology, orthopedics, neurosurgery, oral, and urology surgery was 3.06 (95% CI: 1.05-8.91), 1.16 (95% CI: 0.89-1.50), 2.04 (95% CI: 1.09-3.81), 3.05 (95% CI: 1.25-7.47), 3.55 (95% CI: 1.78-7.06), and 2.26 (95% CI: 1.12-4.55), respectively. Furthermore, the summary mean difference (MD) for patients' length of hospitalization was -0.91 (95% CI: -1.61, -0.16). The results of sensitivity analyses for all combined effect sizes showed good stability. CONCLUSION: Antibiotics are both effective, safe, and necessary in preventing surgical wound infections in clean and clean-contaminated procedures, attributed to their reduction in the incidence of surgical site infections as well as the length of patient hospitalization.

Case Report of a Novel Association between Anti-p200Pemphigoid and Acquired Haemophilia A

Anti-p200 pemphigoid is an uncommon subepidermal autoimmune bullous disease that, unlike many other autoimmune bullous diseases, has not previously been associated with hematological diseases. The diagnosis of anti-p200 pemphigoid in a patient with congruent clinical features requires the demonstration of subepidermal blistering, with linear deposition of immunoglobulin (Ig) G and/or C3 at the dermoepidermal junction on direct immunofluorescence, and a floor-binding pattern on indirect immunofluorescence. In addition, the detection of antibodies against p200 antigen via immunoblotting is ideal but not readily accessible in many facilities, leading to a potential under-recognition and under-diagnosis of this condition. In this case report, we describe a 53-year-old gentleman with recently diagnosed acquired hemophilia A who developed a concurrent vesiculobullous eruption and was evaluated to have anti-p200 pemphigoid. Both of his conditions were controlled with immunosuppression via prednisolone and cyclophosphamide. While we acknowledge the contemporaneous occurrence of both diseases in this patient may be a mere coincidence, it is important to recognize the possibility of this association given the potential clinical significance. Whether the activity of one disease parallels the other will require further evaluation.

Prevalence of depression, anxiety in China during the COVID-19 pandemic: an updated systematic review and meta-analysis.

Background: Mental health risks associated with the aftermath of the COVID-19 pandemic are often overlooked by the public. The aim of this study was to investigate the effects of the COVID-19 pandemic on depression and anxiety disorders in China. Methods: Studies were analyzed and extracted in accordance with the PRISMA 2020 flowchart. The studies were screened and extracted using electronic databases including PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov according to the predefined eligibility criteria. The Cochrane Review Manager software 5.3.1 was used for data analysis and the risk of bias assessment. Results: As of 2023, a total of 9,212,751 Chinese have been diagnosed with COVID-19 infection. A total of 913,036 participants in 44 studies were selected following the eligibility criteria, the statistical information of which was collected for meta-analysis. The pooled prevalence of depression and anxiety were 0.31 (95% CI: 0.28, 0.35; I2 = 100.0%, p < 0.001) and 0.29 (95% CI: 0.23, 0.36; I2 = 100.0%, p < 0.001), respectively. After performing a subgroup analysis, the prevalence of depression among women, healthcare workers, students, and adolescents was 0.31 (95% CI: 0.22, 0.41), 0.33 (95% CI: 0.26, 0.44), 0.32 (95% CI: 0.26, 0.39), and 0.37 (95% CI: 0.31, 0.44), respectively. Conclusion: The prevalence of depression and anxiety among the Chinese was overall high. Monitoring and surveillance of the mental health status of the population during crises such as sudden global pandemics are imperative. Systematic review registration: https://clinicaltrials.gov/, identifier [CRD42023402190].

Clinical implications and mechanism of histopathological growth pattern in colorectal cancer liver metastases.

Liver is the most common site of metastases of colorectal cancer, and liver metastases present with distinct histopathological growth patterns (HGPs), including desmoplastic, pushing and replacement HGPs and two rare HGPs. HGP is a miniature of tumor-host reaction and reflects tumor biology and pathological features as well as host immune dynamics. Many studies have revealed the association of HGPs with carcinogenesis, angiogenesis, and clinical outcomes and indicates HGP functions as bond between microscopic characteristics and clinical implications. These findings make HGP a candidate marker in risk stratification and guiding treatment decision-making, and a target of imaging observation for patient screening. Of note, it is crucial to determine the underlying mechanism shaping HGP, for instance, immune infiltration and extracellular matrix remodeling in desmoplastic HGP, and aggressive characteristics and special vascularization in replacement HGP (rHGP). We highlight the importance of aggressive features, vascularization, host immune and organ structure in formation of HGP, hence propose a novel "advance under camouflage" hypothesis to explain the formation of rHGP.

Neoadjuvant immunotherapy with nivolumab and ipilimumab induces major pathological responses in patients with head and neck squamous cell carcinoma.

Surgery for locoregionally advanced head and neck squamous cell carcinoma (HNSCC) results in 30‒50% five-year overall survival. In IMCISION (NCT03003637), a non-randomized phase Ib/IIa trial, 32 HNSCC patients are treated with 2 doses (in weeks 1 and 3) of immune checkpoint blockade (ICB) using nivolumab (NIVO MONO, n = 6, phase Ib arm A) or nivolumab plus a single dose of ipilimumab (COMBO, n = 26, 6 in phase Ib arm B, and 20 in phase IIa) prior to surgery. Primary endpoints are feasibility to resect no later than week 6 (phase Ib) and primary tumor pathological response (phase IIa). Surgery is not delayed or suspended for any patient in phase Ib, meeting the primary endpoint. Grade 3‒4 immune-related adverse events are seen in 2 of 6 (33%) NIVO MONO and 10 of 26 (38%) total COMBO patients. Pathological response, defined as the %-change in primary tumor viable tumor cell percentage from baseline biopsy to on-treatment resection, is evaluable in 17/20 phase IIa patients and 29/32 total trial patients (6/6 NIVO MONO, 23/26 COMBO). We observe a major pathological response (MPR, 90‒100% response) in 35% of patients after COMBO ICB, both in phase IIa (6/17) and in the whole trial (8/23), meeting the phase IIa primary endpoint threshold of 10%. NIVO MONO's MPR rate is 17% (1/6). None of the MPR patients develop recurrent HSNCC during 24.0 months median postsurgical follow-up. FDG-PET-based total lesion glycolysis identifies MPR patients prior to surgery. A baseline AID/APOBEC-associated mutational profile and an on-treatment decrease in hypoxia RNA signature are observed in MPR patients. Our data indicate that neoadjuvant COMBO ICB is feasible and encouragingly efficacious in HNSCC.

Effect of different tooth preparation designs on the marginal and internal fit discrepancies of cobalt-chromium crowns produced by computer-aided designing and selective laser melting processes

PURPOSE@#To evaluate the impact of five different tooth preparation designs on the marginal and internal fit discrepancies of cobalt-chromium (CoCr) crowns produced by computer-aided designing (CAD) and selective laser melting (SLM) processes. @*MATERIALS AND METHODS@#Five preparation data were constructed, after which design crowns were obtained. Actual crowns were fabricated using an SLM process. After the data of actual crowns were obtained with structural light scanning, intaglio surfaces of the design crown and actual crown were virtually superimposed on the preparation. The fit-discrepancies were displayed with colors, while the root means square was calculated and analyzed with one-way analysis of variance (ANOVA), Tukey’s test or Kruskal-Wallis test (α =.05). @*RESULTS@#The marginal or internal color-coded images in the five design groups were not identical. The shoulder-lip and sharp line angle groups in the CAD or SLM process had larger marginal or internal fit discrepancies compared to other groups (P < .05). In the CAD process, the mean marginal and internal fit discrepancies were 10.0 to 24.2 µm and 29.6 to 31.4 µm, respectively. After the CAD and SLM processes, the mean marginal and internal fit discrepancies were 18.4 to 40.9 µm and 39.1 to 47.1 µm, respectively. The SLM process itself resulted in a positive increase of the marginal (6.0 – 16.7 µm) and internal (9.0 – 15.7 µm) fit discrepancies. @*CONCLUSION@#The CAD and SLM processes affected the fit of CoCr crowns and varied based on the preparation designs. Typically, the shoulder-lip and sharp line angle designs had a more significant effect on crown fit. However, the differences between the design groups were relatively small, especially when compared to fit discrepancies observed clinically.

Unilateral vertebroplasty and kyphoplasty by digital subtraction angiography for the treatment of osteoporotic vertebral compression fractures / 中国骨伤

OBJECTIVE@#To explore the methods and efficacy of unilateral extra-pedicle precision puncture percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty(PKP) by digital subtraction angiography (DSA) for the treatment of osteoporotic vertebral compression fractures (OVCFs).@*METHODS@#The clinical data of 68 patients with osteoporotic vertebral compression fractures treated from August 2015 to December 2018 were retrospectively analyzed. There were 20 males and 48 females, aged 56 to 90(73.5±8.0) years, 40 cases of double segments, 28 cases of three segments, a total of 168 vertebrae. All the patients were performed PVP orPKP through unilateral extra pedicle precision puncture under the guidance of DSA. The vertebrae were distributed in T@*RESULTS@#All the punctures were successful in 68 patients. All the puncture needles reached the midline of vertebral body, and the bone cement was well dispersed in the vertebral body with symmetrical distribution. The operation time was 35 to 60 (41.6±3.2) minutes, and there was no puncture complications. The injection volume of bone cement was 3 to 5 (3.6±0.5) ml in each vertebra. There were 8 cases of bone cement leakage, with a leakage rate of 11.76%. All 68 patients were followed up from 12 to 27 (14.3±3.5) months in the study. VAS score and ODI at 3 days after surgery and at final follow-up time were significantly improved (@*CONCLUSION@#PVP or PKP under the guidance of DSA via a unilateral extrapedicular approach with precision puncture can effectively relieve pain, restore vertebral body height and spinal function, which is a safe, fast and effective method in the treatment of osteoporotic vertebral compression fractures.

Ligand-to-Ligand Interactions That Direct Formation of D2-Symmetrical Alternating Circular Helicate.

This work demonstrates that ligand-to-ligand interactions between achiral bis-ß-diketonate (BTP) and chiral bis(4-phenyl-2-oxazolinyl)pyridine [( R)- or ( S)-Ph-Pybox] are successfully directed to the fabrication of a D2-symmetrical alternating circular helicate with the general formula [( R)- or ( S)-Ph-Pybox]4(LnIII)4(BTP)6. The lanthanide(III) LnIII assemblies (LnIII4- RRRR and LnIII4- SSSS) have a nanometer-size squarelike grid (interatomic distances > 10 Å). X-ray structure analysis revealed that the circular helicate contains two double helicate LnIII2L2 units, where both show ( M)-helicity for LnIII4- RRRR and ( P)-helicity for LnIII4- SSSS, where π-π stacking interaction is present between the side arm of ( R)-Ph-Pybox (Ph1) and the adjacent BTP ligand around the EuIII metal center ( dππ = 3.636 Å: the diketonate plane···Ph1 distance). The newly obtained circular lanthanide(III) helicate exists as single and homochiral diastereomers in solution (LnIII4- RRRR and LnIII4- SSSS), exhibiting circularly dichroism (CD) and circularly polarized luminescence (CPL). Conversely, the circular helicate favors the heterochiral arrangement (i.e., LnIII4- RRRR/LnIII4- SSSS).

Accuracy and reproducibility of 3D digital tooth preparations made by gypsum materials of various colors

PURPOSE: The study aimed to identify the accuracy and reproducibility of preparations made by gypsum materials of various colors using quantitative and semi-quantitative three-dimensional (3D) approach. MATERIALS AND METHODS: A titanium maxillary first molar preparation was created as reference dataset (REF). Silicone impressions were duplicated from REF and randomized into 6 groups (n=8). Gypsum preparations were formed and grouped according to the color of gypsum materials, and light-scanned to obtain prepared datasets (PRE). Then, in terms of accuracy, PRE were superimposed on REF using the best-fit-algorithm and PRE underwent intragroup pairwise best-fit alignment for assessing reproducibility. Root mean square deviation (RMSD) and degrees of similarity (DS) were computed and analyzed with SPSS 20.0 statistical software (α=.05). RESULTS: In terms of accuracy, PREs in 3D directions were increased in the 6 color groups (from 19.38 to 20.88 µm), of which the marginal and internal variations ranged 51.36 – 58.26 µm and 18.33 – 20.04 µm, respectively. On the other hand, RMSD value and DS-scores did not show significant differences among groups. Regarding reproducibility, both RMSD and DS-scores showed statistically significant differences among groups, while RMSD values of the 6 color groups were less than 5 µm, of which blue color group was the smallest (3.27 ± 0.24 µm) and white color group was the largest (4.24 ± 0.36 µm). These results were consistent with the DS data. CONCLUSION: The 3D volume of the PREs was predisposed towards an increase during digitalization, which was unaffected by gypsum color. Furthermore, the reproducibility of digitalizing scanning differed negligibly among different gypsum colors, especially in comparison to clinically observed discrepancies.

Electron Transfer Capacities of Dissolved Organic Matter Derived from Swine Manure Based on Eletrochemical Method / 分析化学

Dissolved organic matter (DOM) is the most active fraction of compost organic matter. The presence of the redox-active functional groups in DOM allows it to act an electron shuttle to promote the electron transfer between microorganisms and terminal electron acceptors. In this study, the electron transfer capacities (ETCs) of compost DOM samples at eight different composting stages were determined by electrochemical method. The 2, 2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and Diquat dibro-mide monohydrate (DQ) were used to measured electron donating capacity (EDC) and electron accepting capacity(EAC) with working voltage 0.61 V/-0.49 V,respective. The evolution characteristics of the chemical structures and components were analyzed by combining the three-dimensional fluorescence spectra,fourier transform infrared (FTIR) spectra and elemental analysis. The results showed that the electron donating capacity(EDC) of DOMincreased from 16.850 μmol e-/(g C) to 22.077 μmol e-/(g C), The corresponding electron accepting capacity (EAC) decreased from 1.866 μmol e-/(g C)to 1.779 μmol e-/(g C). The results of three-dimensional fluorescence spectroscopy show that the relative contents of humuc-likeand protein-like components gradually increased and decreased, respectively, during the composting process. The humuc-like components were the main contributor for the ETC of DOM. FTIR spectra shows that there was no significant change in the hydroxyl and carboxyl group contentsof DOM during composting, suggesting no contribution of these function groups to the ETC of DOM. The elemental analysis showed that the content of oxygen in the DOM increased during the composting process, while the sulfur-containing group may be dominated contributor forits ETC.

Elevated production of IL-36α in chronic hepatitis B virus-infected patients correlates with viral load.

Chronic hepatitis B (CHB) infection is a typical inflammatory disease characterized by a dysregulated expression of cytokines, which contributes to the pathogenesis of chronic Hepatitis B virus (HBV) infection. IL-36 cytokines (IL-36α, IL-36ß, IL-36γ and IL-36Ra) are important players in infection and immunity. However, their roles in the pathogenesis of chronic HBV infection remain unknown. Here the circulating concentrations of IL-36 cytokines from 50 CHB patients and 30 healthy controls were determined by enzyme-linked immunosorbent assay (ELISA). Sera concentrations of IL-36α were found to be significantly elevated in CHB patients, while the concentrations of IL-36ß, IL-36γ and IL-36Ra were not significantly different in comparison to healthy donors. Furthermore, increased IL-36α concentrations correlated positively with HBV-DNA levels in CHB patients. Our study suggests that IL-36α production was up-regulated during CHB infection, which could be directly related to HBV-DNA loads in CHB patients. The immunoregulatory role of IL-36α in the pathogenesis of chronic HBV infection should be further studied.

Mechanism study of hypercoagulative state based on cytokines-NF-kappa B signaling pathway in Sjogren′s syndrome patients / 中国免疫学杂志

Objective:To observe the changes in coagulation parameters, peripheral blood cytokines, NF-kappa B signaling pathway protein, laboratory indexes in Sjogren′s syndrome ( SS ) patients, thus to explore the mechanism of hypercoagulable state. Methods:60 patients with SS and 20 healthy persons were randomly selected as the study group and the control group;Automatic coagulation analyzer was used to detect the value of coagulation parameters [ activated partial thromboplastin time ( APTT) ,prothrombin time ( PT) , plasma fibrinogen ( FIB ) , prothrombin time ( TT ) , D-dimer ( DD ) ]; ELISA method was performed to observe the expression of related cytokines(IL-1β,TNF-α,IL-10) and NF-κB signaling pathway proteins (p65,p50,IκBα); Westergren method was used to determine erythrocyte sedimentation rate ( ESR) ,and automatic biochemical analyzer to examine immune protein( IgG,IgA, IgM,GLO) and high sensitivity C-reactive protein (hs-CRP). Results: Blood coagulation parameters in 60 patients with SS were at least one abnormal for 46 cases,accounting for 76. 7% of the subjects. Among them,the abnormal rate of D-D was the highest,followed by FIB,APTT,PT,TT. Compared with the control group,D-D,FIB were significantly increased in SS patients,and TT,PT,APTT was not found obviously different. In addition,IL-1β,TNF-α,P50,P65,IκBα and inflammatory indexes like ESR,hs-CRP,IGg,GLO,ESSDAI, corneal staining score increased while the salivary flow rate,tear film break-up time and IL-10 decreased significantly( P<0. 05 or P<0. 01). Correlation analysis showed that the coagulation parameters FIB were positively correlated with the salivary flow rate,TNF-α, P50,P65,ESR,hs-CRP,while negatively correlated with IL-10,that TT was negatively correlated with TNF-α;that D-D was positively correlated with TNF-α, IL-1β, P65, ESR, hs-CRP, ESSDAI and corneal staining score, while negatively correlated with IL-10. Conclusion: SS patients generally have hypercoagulable state, and may be associated with the imbalance of cytokines, abnormal activation NF-kappa B signaling pathway,which mediates vascular endothelial cell damage,causing coagulation/fibrinolytic system dis-orders.

XFC improved mechanism of hypercoagulable state in OA patients based on NF-κB signaling pathway:a mechanism exploration / 中国免疫学杂志

Objective:To investigate the relationship between hypercoagulable state and the activation of the NF- kappa B pathway,inflammatory/suppression cytokines in patients with osteoarthritis. Methods:56 patients with OA were divided into two groups according to random number table:XFC group ( 28 cases ) and glucosamine ( GS ) group ( 28 cases ) . Two groups were treated for 3 months. Nine healthy people are healthy control group ( NC) . Determining the expression levels of the index of the NF-κB signaling pathway (p50,p65,TAK1,IκBα) and TNF-α,IL-1,IL-10,platelet activating factor(PAF) in serum by enzyme-linked immunosorbent assay. Detected the level of the indicators and laboratory indexes related with coagulation,observed the changes between the two group, used OA symptoms integral scale, LequesneMG, SF-36 and vas to assess efficacy;and made a correlation analysis. Results: After treatment,FIB,D-D, PAF, PLT, p50, p65, TAK1, IL-1, TNF-α, hs-CRP, ESR, IgG, LequesneMG, symptom integral meter, and VAS integral were significantly higher,APTT,PT,PAF-AH,IL-10 and each dimension integral of SF-36 significantly decreased in 2 groups (P<0. 05). XFC group was better than the GS group in reducing the level of PLT,FIB,TNF-α,p65,TAK1,hs-CRP,ESR,symptom integral meter,and VAS integral and increasing PT,each dimension integral of SF-36, etc (P<0. 05,P<0. 01). The results of Pearson correlation analysis show that PLT,FIB,D-D,PAF had positive correlation with p50,p65,TAK1,IL-1,TNF-α,hs-CRP,ESR,IgG,Le-quesneMG,symptom integral meter,and VAS integral,and negative correlation with IL-10 and each dimension integral of SF-36 ( P<0. 05,P<0. 01). PT had positive correlation with IL-10,GH and PF,and negative correlation with p50,p65,TAK1,IL-1,TNF-α,hs-CRP,ESR,IgG,symptom integral meter,and VAS integral (P<0. 05,P<0. 01). Conclusion: XFC could inhibit the NF-κB signaling pathway, raise the level of IL-10, reduce the expression of IL-1, TNF-α, P50, p65, TAK1 and so on, and reduce the abnormal inflammatory immune response. So as to achieve the purpose of delaying and inhibiting the production of hypercoagulable state,reduce joint disease,relieve the symptoms of joint pain and stiffness,eventually improve the patient’s quality of life.

Understanding the ligamentum teres of the hip: a histological study.

OBJECTIVE: To perform a histological study describing the microstructure of the ligamentum teres of the hip, with special emphasis on the presence of nerve bundles. Our study aims to correlate the microstructure of the ligamentum teres with its postulated functions, allowing greater understanding of its role within the hip joint. METHODS: Fresh specimens excised intra-operatively in 11 patients undergoing open hip procedures were preserved in formalin and sent to the laboratory for histological analysis by our collaborating pathologist. The specimens were sectioned and stained, and examined under the microscope to look at their microstructure. In addition, a novel staining technique was employed to detect neural elements within the individual specimens . RESULTS: The ligamentum teres is composed predominantly of a connective tissue matrix of collagen fibers, fibrous and adipose tissue, with an overlying layer of investing synovium. In addition, there are blood vessels of various sizes surrounded by a layer of encircling fat. In all specimens examined, there were nerve bundles of various shapes and sizes, regardless of the age of the patient. CONCLUSION: The ligamentum teres has both mechanical and biological functions within the hip joint and should no longer be considered a developmental vestige. Where possible, any surgical procedures around the hip joint should aim to limit damage to this structure to minimize any potential loss of function. Level of Evidence Basic Science Study.

Understanding the ligamentum teres of the hip: a histological study

Objective: To perform a histological study describing the microstructure of the ligamentum teres of the hip, with special emphasis on the presence of nerve bundles. Our study aims to correlate the microstructure of the ligamentum teres with its postulated functions, allowing greater understanding of its role within the hip joint. Methods: Fresh specimens excised intra-operatively in 11 patients undergoing open hip procedures were preserved in formalin and sent to the laboratory for histological analysis by our collaborating pathologist. The specimens were sectioned and stained, and examined under the microscope to look at their microstructure. In addition, a novel staining technique was employed to detect neural elements within the individual specimens . Results: The ligamentum teres is composed predominantly of a connective tissue matrix of collagen fibers, fibrous and adipose tissue, with an overlying layer of investing synovium. In addition, there are blood vessels of various sizes surrounded by a layer of encircling fat. In all specimens examined, there were nerve bundles of various shapes and sizes, regardless of the age of the patient. Conclusion: The ligamentum teres has both mechanical and biological functions within the hip joint and should no longer be considered a developmental vestige. Where possible, any surgical procedures around the hip joint should aim to limit damage to this structure to minimize any potential loss of function. Level of Evidence Basic Science Study.

Eruptive disseminated Spitz naevus (EDSN) in a young girl of Indian origin.

Eruptive disseminated Spitz naevus (EDSN) is a rare entity and has never been documented in a South-east Asian individual (of Indian origin) previously. We report an adolescent with this condition which, to our knowledge, has only been previously reported a few times.

Benzene homologues in environmental matrixes from a pesticide chemical region in China: Occurrence, health risk and management.

The contamination status and health risks of benzene, toluene, ethylbenzene and xylene (BTEX) in air, soil, dust and groundwater were evaluated in a pesticide chemical region located in Hebei province, China. The concentrations of BTEX in air ranged from 7.80 to 238ug/m(3) and those in soil and dust ranged from lower than limit of detection (LOD) to 32,360ng/g dw, and those in groundwater varied from 2.68 to 98.6ug/L. Generally, the levels of BTEX in multimedia matrixes were all below the standards established in China. Health risk assessment was performed based on the monitoring data via inhalation, dermal contact and ingestion pathways and hazard quotient (HQ) was calculated to be on the order of 10(-7), below 10(-6), and Hazard index (HI) levels of BTEX were lower than 1.0. However, both HQ and HI ascended with an increase in work experience/exposure. Integrated risk management was proposed to eliminate BTEX pollution and to protect occupational health of workers in those industries.

Unusual presentation of adult xanthogranuloma: a case report

Xanthogranulomas are the most common form of non-Langerhans cell histiocytosis. Both adult and childhood forms have been described. Adult cutaneous forms can present as solitary or multiple yellowish, orange-red or tan-hued papules. Herein, we present the case of a 28-year-old Chinese man with a skin-coloured nodule on his left nasal ala that persisted for several months. While initial impression was that of a fibrous papule of the nose, the results of an excision biopsy showed histological features corresponding to xanthogranuloma. This case demonstrates the condition’s myriad of dermatological presentations, and adds to the differential diagnoses of a cutaneous lesion found in the head and neck region.

Creation of Consistent Burn Wounds: A Rat Model

BACKGROUND: Burn infliction techniques are poorly described in rat models. An accurate study can only be achieved with wounds that are uniform in size and depth. We describe a simple reproducible method for creating consistent burn wounds in rats. METHODS: Ten male Sprague-Dawley rats were anesthetized and dorsum shaved. A 100 g cylindrical stainless-steel rod (1 cm diameter) was heated to 100degrees C in boiling water. Temperature was monitored using a thermocouple. We performed two consecutive toe-pinch tests on different limbs to assess the depth of sedation. Burn infliction was limited to the loin. The skin was pulled upwards, away from the underlying viscera, creating a flat surface. The rod rested on its own weight for 5, 10, and 20 seconds at three different sites on each rat. Wounds were evaluated for size, morphology and depth. RESULTS: Average wound size was 0.9957 cm2 (standard deviation [SD] 0.1845) (n=30). Wounds created with duration of 5 seconds were pale, with an indistinct margin of erythema. Wounds of 10 and 20 seconds were well-defined, uniformly brown with a rim of erythema. Average depths of tissue damage were 1.30 mm (SD 0.424), 2.35 mm (SD 0.071), and 2.60 mm (SD 0.283) for duration of 5, 10, 20 seconds respectively. Burn duration of 5 seconds resulted in full-thickness damage. Burn duration of 10 seconds and 20 seconds resulted in full-thickness damage, involving subjacent skeletal muscle. CONCLUSIONS: This is a simple reproducible method for creating burn wounds consistent in size and depth in a rat burn model.

Asymmetric left ventricular hypertrophy associated with morbid obesity mimicking familial hypertrophic cardiomyopathy

Asymmetric septal hypertrophy with systolic anterior motion of the mitral valve is frequently a phenotypic, but not pathognomonic, expression of genetic hypertrophic cardiomyopathy (HCM) with or without obstruction. It can, however, be associated nonspecifically with other forms of increased left ventricular (LV) afterload. We herein report the case of a young man with obesity cardiomyopathy and heart failure who presented with asymmetric septal hypertrophy and marked LV hypertrophy, and endomyocardial biopsy ruled out genetic HCM.