Association between number of lymphadenectomy and postoperative complication in surgery for esophageal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association between the number of lymph nodes retrieval and the incidence of postoperative complications in patients with esophageal carcinoma.</p><p><b>METHOD</b>From January 2008 to December 2009, 794 patients with esophageal carcinoma underwent esophagectomy and lymphadenectomy in the Department of Thoracic Surgery at the West China Hospital of Sichuan University. The clinical data, surgeons, the extent of lymphadenectomy and its association with operative morbidity were retrospectively analyzed.</p><p><b>RESULTS</b>There was no operative death. A total of 84 patients with complication(10.6%) were documented. There were 11,770 lymph nodes harvested in total with an average of 14.8. Multivariate logistic regression showed that gender, number of metastatic lymph nodes, level of anastomosis, and surgeons' experience were risk factors associated with postoperative complications (all P<0.05), while the number and group of lymph node resection were not(all P>0.05).</p><p><b>CONCLUSION</b>Within a rational range of lymphadenectomy(<50) following esophagectomy, the postoperative complications are significantly associated with the gender, extent of regional lymph nodes metastasis, site of anastomosis and the expertise of the surgeons, but not associated with the number and group of lymph nodes resection.</p>

A cross-sectional study on the industrial noise over-limit status in Guangzhou factories / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the industrial noise over-limit status of the worksites in Guangzhou factories, so as to promote the prevention and control of occupational noise hazards.</p><p><b>METHODS</b>211 factories in Guangzhou were monitored and investigated. The analysis and assessment were developed for the properties and size of the factories, the districts of the factories being located, the industries of the factories being classified and the date of monitoring.</p><p><b>RESULTS</b>In this understudied factories, most of them were national-owned and joint-ventures, medium size, located in urban, and mainly involved in the industries of manufacturing of motor vehicle, shipping, electron and electric equipment, and the industries of petroleum and chemicals. The prevalence of noise over-limit was higher in joint-ventures (36.0%) and private-run enterprises (31.2%). The over-limit status mainly presented in industries of textile, food and beverage processing, and leather producing, with getting prevalence of over-limit 46.7%, 43.1% and 41.3% respectively. Subsequence were industries of manufacturing of electron and electric equipment, motor vehicle and shipping, and industries of printing and goods producing for culture and sports, with the prevalence for all > 35%. Factories monitored during spring and summer also had higher prevalence of noise over-limit. The similar results were got after adjustment for each other using multivariable regression. The most common over-limit sites mainly focused on the operation of cutting and sawing, milling and planing, pressing, riveting, drilling, jointing, assembling and quality inspecting in industries of mechanism processing and manufacturing, on quality inspecting and packing in industries of pharmacy and food and beverage manufacture, on spinning and scutching in textile industry, and on cleaning and maintaining as assistant jobs, and patrolling and inspecting air-press machine, ventilation machine, dynamotor and pump.</p><p><b>CONCLUSION</b>Noise in Guangzhou factories widely exists with different industries and districts. To strengthen noise occupational hazards prevention and control for the high risk districts, industries and worksites should be the key job in the future.</p>

Esophagogastrostomy by side-to-side anastomosis in prevention of anastomotic stricture: a randomized clinical trial / 中华外科杂志

<p><b>OBJECTIVE</b>To compare a side-to-side esophagogastric anastomosis with conventional hand-sewn or stapled esophagogastrostomy for prevention of anastomotic stricture by randomized clinical trial.</p><p><b>METHODS</b>Between November 2007 and September 2008, 160 patients with esophageal carcinoma or gastric cardia cancer were consecutively admitted and underwent surgical treatment. After excluding 5 patients (2 refused to participate in and 3 did not meet inclusion criteria), the remaining 155 patients were completely randomized to receive either a side-to-side esophagogastric anastomosis (SS group), or the conventional hand-sewn (HS group), or a circular stapled (CS group) anastomosis, after the removal of esophageal tumor. The primary outcome measured the incidence of anastomotic stricture at 3 months after the operation (defined as the diameter of the anastomotic orifice <or= 0.8 cm on esophagogram), analyzed by intention-to-treat.</p><p><b>RESULTS</b>There was 1 operative death (in HS group) and 1 simple exploration (in SS group). The anastomotic leakage was observed in 4 patients (2 cervical and 1 intrathoracic leaks in HS group, and 1 intrathoracic leak in CS group). The follow-up rate was 96.1% (1 patient in SS group, 3 in HS group, and 2 in CS group were lost). Finally 45 patients in SS group, 52 in HS group, and 47 in CS group were included in the analysis. The 3 groups were preoperative similar. The anastomotic stricture rate was 0% (0/45) in SS group, 9.6% (5/52) in HS group, and 19.1% (9/47) in CS group, respectively (Fisher exact probability test, P = 0.005). The reflux/regurgitation score among 3 groups was similar (chi(2) = 1.681, P = 0.432).</p><p><b>CONCLUSION</b>The side-to-side esophagogastric anastomosis could prevent stricture formation, without increasing gastroesophageal reflux.</p>

Epidemiological application of ion chromatography for urinary iodine monitoring / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a method of ion chromatography for urine iodide determination and evaluate its application in epidemiological studies.</p><p><b>METHODS</b>Urinary iodine was determined using ICS-2500 ion chromatography coupled with IonPac AS7 analytical column (4 mm x 250 mm), silver electrode and direct current amperometry for 467 elderly subjects (above 50 years) with their urinary Tsh and FT4 also determined. The history of thyroid diseases was examined among these subjects.</p><p><b>RESULTS</b>The peak area of the ion chromatography was linearly correlated with urinary iodine concentration, with the correlation coefficient of 0.9999. The detection limit of iodide was around 3.5 microg/L (S/N=3), with coefficients of variation ranging from 3.16% to 3.45% and mean recovery rate of 95%. The urinary iodine level in the 467 elderly subjects showed a positively skewed distribution with the median level of 224.7 microg/L.</p><p><b>CONCLUSION</b>Ion chromatography for urinary iodine determination has excellent selectivity, sensitivity, reliability, accuracy and stability, and may ensure satisfactory effect for application in epidemiological studies.</p>

Mercury concentration in cerebrospinal fluid in patients with chronic mercury poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the changes of mercury (Hg) levels in cerebrospinal fluid (CSF) in patients with chronic mercury poisoning and elucidate the neurotoxic mechanism of mercury.</p><p><b>METHODS</b>Nine patients with chronic mercury poisoning (poisoning group) as well as eight patients without exposure to mercury were included in this study. Mercury concentrations of 24 hour urine (U-Hg) and CSF (CSF-Hg) were measured with cold-vapor atomic absorption spectrometry-alkali stannous chloride method. The concentration of blood (B-Hg) at the same day was measured with cold-vapor atomic absorption spectrometry-acidic stannous chloride method. In five patients of poisoning group, these concentrations before chelation therapy were compared with those after chelation therapy.</p><p><b>RESULTS</b>The levels of B-Hg, U-Hg, and CSF-Hg in poisoning group (250.00 +/- 48.54, 160.07 +/- 91.15, 20.22 +/- 10.21 nmol/L, respectively) were significantly higher than those in control group (81.04 +/- 63.01, 24.73 +/- 9.96 nmol/L, undetectable, respectively; P < 0.01). In nine patients of poisoning group, CSF-Hg concentrations were correlated with B-Hg (r = 0.675, P < 0.05), but not U-Hg. After chelation therapy with dimercaptopropane sulfonate in five patients of poisoning group, the levels of B-Hg, U-Hg, and CSF-Hg were decreased significantly (P < 0.05). The reduction of CSF-Hg was not related with B-Hg and U-Hg.</p><p><b>CONCLUSION</b>CSF-Hg concentration in chronic mercury poisoning patient is increased with the rise of B-Hg, but not U-Hg. When the levels of B-Hg and U-Hg drop to normal, the CSF-Hg level is still high enough to be detected. It indicates that mercury is combined with protein after entering brain and this complex is difficult to cross through blood-cerebral barrier. The complex may cause neuromuscular disorder and fremitus in chronic mercury poisoning.</p>

A study on lymphocyte DNA damage in traffic policemen in Guangzhou / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the effect of occupational exposure to traffic exhaust and smoking on DNA damage in traffic policemen.</p><p><b>METHODS</b>812 traffic policemen (741 men and 71 women, 130 of office-work and 682 of outside work) from 8 districts in Guangzhou were investigated. Blood samples were taken by venipuncture and lymphocytes were collected by using lymphocyte separation medium and centrifugation. The comet assay was used to measure DNA damage.</p><p><b>RESULTS</b>The office-work policemen [(37.7 +/- 9.5) years] were older than the outside-work ones [(32.3 +/- 8.1) years, P < 0.001]. No significant difference was observed in sex (P = 0.08) and age (P = 0.45). Comet assay showed that occupational exposure to traffic exhaust significantly increased tail length [4.20 micro m, 95% CI: (3.98 - 4.42) micro m vs 3.23 micro m, 95% CI: (2.82 - 3.7) micro m, P < 0.001]. Smokers had longer tail length [4.66 micro m, 95% CI: (4.37 - 4.97) micro m] than ex-smokers [3.28 micro m, 95% CI: (2.57 - 4.17) micro m] and nonsmokers [3.47 micro m, 95% CI: (3.21 - 3.75) micro m, P < 0.001]. In nonsmokers, significant increase in tail length was observed by passive smoking at home (P = 0.004) but not at work (P = 0.22). When out-door nonsmokers were excluded, passive smoking at work also significantly increased tail length (P = 0.007). Analysis of covariance showed that occupational exposure to traffic exhaust, tobacco smoking, and female had independent effect on lymphocyte DNA damage (P < 0.001) after these factors were adjusted. Passive smoking and age had no effect on lymphocyte DNA damage.</p><p><b>CONCLUSIONS</b>Occupational exposure to traffic exhaust and tobacco smoking respectively increase lymphocyte DNA damage. Female traffic policemen may have more severe DNA damage than male.</p>