[Analysis of 6344 cases of hospitalized migrant workers with pneumoconiosis].

Objective: To analyze the situation of hospitalized migrant workers with pneumoconiosis in Hunan Province, and to provide reference for the prevention and treatment of pneumoconiosis. Methods: In July 2019, the data of pneumoconiosis migrant workers hospitalized in Hunan Prevention and Treatment Institute for Occupational Diseases from February 2017 to February 2019 were retrospectively analyzed, and the general situation, region distribution, diagnosis and complications were analyzed. Results: From February 2017 to February 2019, a total of 6344 migrant workers with pneumoconiosis were treated, mainly distributed in Zhuzhou city (1283 cases, 20.22%) , Yiyang city (1048 cases, 16.52%) and Loudi city (783 cases, 12.34%) . Coal worker's pneumoconiosis (4242 cases, 66.87%) and silicosis (2089 cases, 32.93%) were the main types of pneumoconiosis. Among them, 1433 cases (22.59%) were in stage I, 1318 cases (20.77%) were in stage II, and 3593 cases (56.64%) were in stage III. The age of the patients was mainly between 41-60 years old (4584 cases, 72.26%) . 3869 patients (60.99%) had complications and chronic obstructive pulmonary disease (3046 cases, 48.01%) and pulmonary infection (1703 cases, 26.84%) were the most common complications. There were 1510 patients (23.80%) who had two or more complications. There were significant differences in the number of complications among patients with different diagnosis stages and age stages (χ(2)=764.43, 90.24, P<0.01) . Conclusion: Coal worker's pneumoconiosis and silicosis are the main types of pneumoconiosis among hospitalized migrant workers in Hunan Province, and most patients were in stage III. Older patients with higher pneumoconiosis stage have more complications, early diagnosis and treatment should be taken.

Simplified noncultured autologous cell grafting for the treatment of chronic nonhealing ulcers: the six-well plate technique.

Chronic recalcitrant ulcers are associated with severe morbidity, and there are few effective treatment options available. Living skin substitutes are an important form of adjuvant therapy to enhance healing of such wounds. We investigated a novel, simplified, noncultured, autologous, cell grafting procedure, using a six-well plate technique, to treat chronic recalcitrant wounds. This was a prospective pilot study that involved harvesting an ultrathin split-skin graft from the gluteal region, which was washed, separated and prepared in six different wells to obtain an autologous mixture of keratinocytes, melanocytes and fibroblasts; this was subsequently applied directly to the wound using a hyaluronic acid (HA) matrix. Eight patients with a total of 14 ulcers were recruited. The primary endpoint assessed was the percentage of re-epithelialization of the ulcers. Secondary endpoints included quality of life and wound bed indices. At baseline, the median wound surface area was 7.4 cm(2) (mean 17.6 ± 23.6 cm(2) , range 0.5-80.0 cm(2) ) with a median duration of 18 months (mean 70.2 ± 95.9, range 3-216 months). The median wound surface area was reduced by 74.3%, from 7.4-1.9 cm(2) , at the final visit. Overall, 28.3% of the ulcers achieved complete healing, and 71.3% of the ulcers had reduction in wound size. Post-graft, there was also improvement in secondary wound bed parameters and all quality of life domains of the Cardiff Wound Impact Schedule. These results suggest that this noncultured autologous six-well technique might be beneficial for treating recalcitrant ulcers.

Traumatic intracerebral haemorrhage: is the CT pattern related to outcome?

It is believed by many neurosurgeons that in addition to age and neurological status, the CT patterns of traumatic intracerebral haemorrhages are related to outcome. The aim of this study was to find out whether this is the case. The study was conducted in a regional level I trauma centre in Hong Kong. We prospectively collected data of patients with traumatic intracerebral haematomas over a 4-year period. Of 464 patients with head injuries, traumatic intracerebral haematoma was significantly associated with inpatient mortality and one year unfavorable outcome after adjustment for age, sex, post-resuscitation GCS, and presence of acute subdural haematoma. One hundred-and-fourteen patients had traumatic intracerebral haematomas and were included for further analysis. The mean age was 49, the male to female ratio was 2 to 1, and the median Glasgow Coma Scale (GCS) score on admission was 12. Logistic regression analysis showed that age and GCS score/GCS motor component score were significant factors for inpatient mortality, one-year mortality and one-year outcome. There was an association between temporal haematomas and inpatient mortality, subdural haematomas and inpatient mortality, and bilateral haematomas and unfavourable one-year outcome. In patients with severe head injury, a traumatic haematoma of more than 50 ml was associated higher inpatient mortality. In addition to age and GCS score, the CT patterns of bilateral haematomas, temporal haematomas and associated subdural haematomas were suggestive of poor outcome or mortality.

Cutaneous large B-cell lymphoma of the leg: presenting initially as mononeuritis multiplex.

We report a rare case of primary B-cell lymphoma of the leg presenting with mononeuropathy multiplex. A 79-year-old Chinese woman who was being investigated for mononeuritis multiplex had an incidental finding of indurated erythematous plaques on the breast and left leg. A skin biopsy from the nodular area on the right breast showed a dense and diffuse infiltrate of atypical cells with large, round, hyperchromatic nuclei with prominent nucleoli. These atypical lymphocytes were CD20+, Bcl-2+ and Mum-1+. A diagnosis of diffuse large B-cell lymphoma, leg type involving the breast and leg with extracutaneous involvement, was made. This case highlights the importance of a full systemic and cutaneous examination in patients presenting with progressive, painful peripheral neuropathy.

Apparently normal oestrogen receptor system in ovariectomized ewes with impaired response to oestrogen after prolonged grazing on oestrogenic pasture.

Functional abnormalities have been observed previously in the oestrogen-responsive tissues of ovariectomized ewes with permanent infertility resulting from prolonged exposure to oestrogenic pastures. In the present study, such ewes had higher rates of protein and glycoprotein synthesis in the cervix and uterus than control ewes, but the number of oestradiol-17 beta receptors in the nucleus was similar in each group. After treatment with oestradiol-17 beta, the increase in synthesis of protein and glycoprotein in the uterus and cervix was less in clover-affected ewes, but the amount of oestradiol-17 beta-receptor complex in the nucleus of uterine cells 6 h after ewes were injected with oestradiol-17 beta was similar in clover-affected and control ewes. The rate of replenishment of oestradiol-17 beta receptors in the cytoplasm at 24 and 48 h after oestradiol-17 beta injection was also similar in both groups. The abnormal function seen in the genital tract of clover-affected ewes could not, therefore, be shown to depend on changes in oestradiol-17 beta receptors.

Changed control of cervical secretion from infertile ewes previously exposed to oestrogenic clover pasture.

The amount of cervical mucus recovered from control ovariectomized ewes increased with increasing doses of oestradiol benzoate (OB), while the maximum Spinnbarkeit of mucus occurred at an intermediate dose of OB. Neither the amount nor the Spinnbarkeit of mucus varied with the dose of OB in ewes with permanent infertility caused by grazing oestrogenic pasture (clover-affected ewes). Furthermore, the increase in Spinnbarkeit of cervical mucus seen in normal ewes treated over a 3-day period with OB or with implants containing oestradiol did not occur in affected ewes. In control ewes treated repeatedly with OB, production of mucus declined within 5 days, but no change in secretion was detectable in clover-affected ewes. Therefore, neither the amount nor the duration of oestrogenic stimulation affected the cervical mucus in ewes with clover disease. Affected ewes produced more mucus than did controls in the absence of oestrogenic stimulation. It is concluded that the relatively normal volume of mucus in affected ewes treated with OB results largely from autonomous production. The Spinnbarkeit does not increase in these ewes because the ability of the cervix to respond to oestrogen is impaired.

Proportions of nucleic acids in the uteri of ewes with clover disease and the effect of oestrogen after ovariectomy.

In entire ewes, the ratio of RNA to DNA in the uterus was higher at oestrus than at dioestrus but did not differ between control and clover-affected ewes at either stage of the oestrous cycle. After ovariectomy the ratio of RNA to DNA in the uteri decreased in both control and clover-affected ewes, but the decrease was greater in the control ewes (P less than 0.01). Subsequently when ewes received a single injection of oestradiol-17 beta, a similar rise in uterine RNA/DNA ratio occurred in the two groups. However, following injection of the ewes with oestradiol-17 beta for 3 days, the ratio of uterine RNA to DNA was higher in control than in clover-affected ewes (P less than 0.05). Thus, the uteri from clover-affected ewes undergo less regression after ovariectomy and yet show less response to repeated oestrogenic stimulation that do that of control ewes. This pattern of response is consistent with the hypothesis that the permanent changes caused by phyto-oestrogens in ewes are analogous to the differentiation which normally occurs during organogenesis.

Oestrogen receptors and metabolic activity in the genital tract after ovariectomy of ewes with permanent infertility caused by exposure to phytooestrogens.

Characteristics of the uterus anc cervix after ovariectomy of ewes with permanent phytooestrogen infertility (PPI) were compared with controls. Ewes with PPI had more oestrogen-binding sites in the cervix, but not in the uterus. There was no difference between the two groups of ewes in the binding affinity constant of receptors from the uterus or cervix. There were more keratinized cells in the vaginal epithelium of ewes with PPI, and the rates of protein and glycoprotein synthesis in the uterus and cervix were higher in ewes with PPI. These results offer further evidence that PPI in adult ewes is similar to the "persistent oestrus' syndrome in rodents oestrogenized neonatally.

Effect of equol on oestrogen receptors and on synthesis of DNA and protein in the immature rat uterus.

In immature, 3-week-old female rats, 5 mg equol given by subcutaneous injection increased uterine wet weight 24 h later to the same degree as did 5 microgram oestradiol-17 beta. At this dose there was more receptor complex binding to the nucleus in the equol-injected rats than in the rats injected with oestradiol-17 beta even after 6 h. However, the equol-receptor complex that bound to the nucleus was more extractable with 0 x 3 M-KCl. In the equol-injected rats the duration of uterine growth was shorter and there was less receptor replenishment and synthesis of protein and DNA than in the rats injected with oestradiol-17 beta 30 h after either injection. It was concluded that equol is a weakly oestrogenic compound which is antagonistic to oestradiol-17 beta by competing with oestradiol-receptor complex for nuclear binding and yet fails to initiate the replenishment of oestrogen receptors effectively in the cytoplasm.

Increase in plasma cortisol concentrations in ewes fed oestrogenic subterranean clover.

Pen-feeding oestrogenic clover to ewes increased their plasma cortisol concentration by the third day. This was not due to any change in the variation of cortisol concentration with time of day. Ovulation rate was not affected during the experiment as judged by the levels of plasma progesterone and laparoscopy. The plasma cortisol concentration of ewes also rose within three days of their being placed on oestrogenic clover pasture. During the next 21 days, their mean plasma cortisol was increased by 58 per cent. A previous history of clover disease did not affect this response.

Changes in ovine cervical mucus in response to oestrogen treatment.

After 10 days pretreatment with 10 mg progesterone daily, ovariectomized ewes were injected i.m. with 12.5, 25, 50 or 100 micrograms oestradiol benzoate (OB) and cervical mucus was collected 16, 24, 32, 40 and 48 h later (Exp. 1), or were injected with 12.5, 40 or 100 micrograms OB daily, and the mucus examined, for 9 days (Exp. 2). The Spinnbarkeit was affected by the dose of OB over 9 days, but at all doses it increased over the first 3 days of treatment (Exp. 2). The wet weight of the mucus, the amount and proportion of water, and therefore the degree of arborization, increased with the dose of OB but decreased after 3 days in Exp. 2. The amount of dry matter, protein or carbohydrate did not have any clear relationship to dose or duration of OB treatment.

Ultradian and circadian rhythms in the plasma concentration of cortisol in sheep.

Three Merino ewes, adapted for about 3 weeks to their environment, were bled at 10 min intervals through a jugular venous cannula. Radioimmunoassay of plasma samples for cortisol revealed marked diurnal variations with peak levels just after midnight and lowest values in the afternoon. This rhythm appeared to result from a changing amplitude associated with a distinct ultradian rhythm (frequency 0.8-1.2 cycles/h) in the plasma level of cortisol. Calculation of the daily rate of secretion of cortisol from the hormone profiles gave a mean value of 8.49 mg. Arguments are put forward in favour of this method for obtaining the true rate of secretion of cortisol.

Changes in oestradiol-17beta binding in the hypothalami and pituitary glands of persistently infertile ewes previously exposed to oestrogenic subterranean clover: evidence of alterations to oestradiol receptors.

The binding of [3H]oestradiol-17beta to the hypothalamus and pituitary gland of clover-affected permanently infertile and control ovariectomized ewes was compared in vivo and in vitro. When [3H]oestradiol-17beta was infused into the carotid artery (10 ng/min), the total homogenate and the nuclear and protamine-precipitable cytosol fractions of hypothalami and pituitary glands from clover-affected ewes bound significantly more[3H]oestradiol than those of the controls. Cytoplasmic oestradiol-17beta receptors from the pituitary glands of clover-affected ewes showed a significantly lower apparent association constant and a higher number of binding sites/mg protein in vitro. It is suggested that the hypothalami and pituitary glands of ewes made permanently infertile by oestrogenic clover are less sensitive to feedback regulation of oestradiol-17beta at physiological levels.

Enzyme activities and protein and carbohydrate concentrations in cervical secretions at dioestrus in normal ewes and ewes with permanent phytooestrogenic infertility.

Cervical secretions of clover-affected and control ewes in the luteal phase of the ovarian cycle were obtained by flushing the anterior vagina. The flushings were analysed for proteins, carbohydrates and enzyme activities, and were found to be similar to the secretions of the normal ovine uterus. There was significantly more protein, carbohydrate and acid-soluble glycoprotein but less alkaline phosphatase, N-acetylglycosidases (EC 3.2.1.30 and 3.2.1.53) and ribonuclease I in the vaginal flushings of clover-affected ewes. The observed changes were not due to more inflammation in the cervix of clover-affected ewes as there were fewer bacteria, leukocytes and epithelial cells and no elevation of lysozomal enzyme activities in their flushings. It is suggested that the cervix of the clover-affected ewe behaves as though under a stronger than normal oestrogenic stimulation during dioestrus.