Objective:To investigate the clinical value on the determination of the peripheral blood ICAM 1 level in Graves's disease(GD).Methods:The serum soluble Intercellular Adhesion Molecule 1(sICAM 1)concentration were analyzed by ELISA and the expression of ICAM 1(CD54 +) on PB lymphocytes in 37 GD patients and 22 normal subject were measured,while TsAb,TpoAb,TGAb;CD4 +,CD3 +,CD8 +,CD19 +,CD25 +were examined by FACS.Each marker between the two groups and the positive rate between the TsAb and sICAM 1 whe compared.In addition ,the relationship between the ICAM 1 level on PB and immunity markers in GD patients were analysed.Results:The mean sICAM 1 concentration was significantly higher in untreatd GD patients than in normal controls(P

The serum level of CXCL10 was determined in both patients with Graves' disease (GD) and normal control subjects.Serum CXCL10 levels in untreated and relapsed GD groups were higher compared with the remission group and control group( P＜0.01 ).A significant difference was observed between the former two GD groups (P＜0.01 ),but no difference was found between latter two groups( P＞0.05 ).Serum CXCL10 levels were positively correlated with FT3 and FT4,and negatively correlated with TSH by multiple linear regression analysis( P＜0.01 ).

Objective To explore whether low-dose occupational ionizing radiation exposure can affect the prevalence of lens opacity.Methods Annual occupational health checkup data of 1 007 radiation workers was taken from a provincial medical institution for the purpose of statistical analysis.Logistic regression analysis was used to estimate occupational exposure odds ratios (OR) of lens opacity,adjusted for age,gender and length of service.Eye lens opacity was grouped into cortical,nuclear and posterior subcapsular opacity according to the position of the opacity occurrence site.Opacity occurred in any one of the both eye lens was recorded as turbidity.Results Only 730 cases coupled with complete information could be used in the statistical analysis.The rate of lens opacity for all the radiation workers was 10.27％.The rates of lens opacity by exposure group were estimated to be 9.07％ for radiation diagnosis and therapy group,11.11％ for intervention group,18.18％ for nuclear medicine group,and 9.33％ for industrial application group,respectively.Compared with those in the radiation diagnosis and therapy group,the workers engaged in intervention medicine,or nuclear medicine,were more likely to suffer from the lens opacity in posterior subcapsular position.The OR and its 95％ confidence intervals were 3.00 (1.23-7.33),4.12 (1.68-10.11) for the workers in intervention medicine or nuclear medicine group.Conclusions Medical radiation workers,who were exposed to long-term low-dose of ionizing radiation,especially those who engaged in intervention or nuclear medicine,were at significantly higher risk to develop lens opacity.

Objective To study the effect of propofol used for outpatient painless enteroscope on cognitive function.Methods One hundred and twenty ASAⅠ~Ⅱpatients scheduled for enteroscope were randomly divided into three groups .Propofol was given 1.5mg/kg(groupⅠ), 2mg /kg (group Ⅱ) or 2.5 mg/kg ( group Ⅲ) intravenously .The enteroscope was inserted when patient showed unconsciousness and no reaction to dictation .SpO2 was kept above 95%96% throughout enteroscope .All patients received neurobehavioral cognitive status examination ( NCSE ) and mini-mental state examination ( MMSE ) test 1 hour before enteroscope examination and 5 minutes,30 minutes, 1 hour after enteroscope examination was o-ver and must finish it within 15 min.The enteroscope examination time , vital signs, analgesia effects and intraoperative awareness were record .Results The ability of memory and calculation at 5 minutes after en-teroscope examination showed a statistical difference between group Ⅰ and ⅡorⅢ( P <0.05),there was no significant difference between in group II and in group Ⅲ( P >0.05 ) , The ability of memory and calcu-lation at 30 minutes, 1 hour after enteroscope examination there was no significant difference in three groups ( P >0.05 ) .In all patients ,the MMSE scores at 5 minutes after enteroscope examination were significant-ly lower than the baseline value ( P <0.05).The MMSE scores at 30 minutes, 1 hour after enteroscope examination in Ⅲgroup patients were significantly lower than the baseline value ( P <0.05 ) .The MMSE scores at 30 minutes, 1 hour after enteroscope examination in I group patients were significantly higher than that inⅡor Ⅲgroup( P <0.05).The MMSE scores at 30 minutes, 1 hour after enteroscope examination there was no significant difference between in group II and in group Ⅲ( P >0.05 ) .The NCSE and MMSE scores at 3hour, 12 hour after enteroscope examination there was no significant difference between in group I and II or Ⅲ( P >0.05).Conclusion Propofol 1.5mg/kg used for painless enteroscope examination has no effect on cognitive function .MMSE and NCSE are suitable for evaluation of outpatient's cognitive func-tion.

Objective To explore the mediating effects of resilience between family function and geriatric depression. Methods By convenient sampling, 212 elderly people who were from the communities in Yuexiu, Guangxhou city were analyzed by using Geriatric Depression Scale (GDS-30) and Family Concern Index Questionnaire (APGAR) and Connor-Davidson Resilience Scale (CD-RISC) and the self-designed General Condition Questionnaire, and a mediating model was proposed and the impacts of resilience on family function and geriatric depression were tested. Results The incidence rate of depression among the community elderly was 23.6% (50/212), and the average score of APGAR was 7.87 ± 2.83, and the average score of CD-RISC was 83.66 ± 12.88. The scores of GDS-30 showed significantly negative correlation with the scores of APGAR (r=-0.582,P<0.01)and the scores of CD-RISC (r=-0.425, P<0.01), and there was positive correlation between the scores of APGAR and the scores of CD-RISC (r=0.335, P < 0.01). The mediating model had high degree of fitting, and level of path had statistical significance (P < 0.01). Resilience was the mediator between family function and geriatric depression. Family function had direct effects (0.50) on geriatric depression and indirect effects (0.11) through resilience, and the combined effects of family function and resilience determined 45%changing range of geriatric depression. Conclusions Family function was a direct predictor of geriatric depression, and resilience had mediating effects between family function and geriatric depression. Community mental health work should pay enough attention to the effects of family function on the life of the aged, and increased the care to the elderly with family dysfunction, while promote and develop family-centered mental health education, propaganda and psychological guidance, so that improves resilience of the aged and help the aged positively coping and maintain good mental health status.

Objective To understand effects of the interventional operation on thyroid,peripheral blood indexes and chromosomal aberrations (CA) of peripheral lymphocyte of children with congenital heart disease (CHD).Methods Follow-up studies were conducted in 70 child patients undergoing cardiac catheterization and 23 with open heart surgery as control from 2010 to 2013.Postoperative follow-up examinations included thyroid ultrasound,blood routine indexes and analyses of CAs.Results Difference in thyroid ultrasound abnormality rate was not statistically significant between children with cardiac catheterization and control group (40.0％ vs.43.5％,P ＞ 0.05).There was no significant difference in white blood cell (WBC) count between interventional group and control group (P ＞ 0.05).The effects of disease type and operation time on thyroid ultrasound and WBC count were not observed (P ＞ 0.05).The frequency of chromosome aberrations,including acentric fragment,dicentrics and translocation in interventional group [(0.76 ± 0.07) ％],was higher than in control group [(0.25 ± 0.07) ％,(Z =-3.631,P ＜ 0.05],and the rates of acentric fragment and translocation were also higher in interventional group (Z =-2.531,-2.397,P ＜ 0.05).Conclusions Effect of intervention therapy on thyroid structure and WBC count in children with CHD was not observed,but the genotoxic effects remain in children with cardiac catheterization.

OBJECTIVE: To investigate the effects of blood lead level on the occupational health examination index in workers with lead exposure. METHODS: Using judgment sampling method,412 workers exposed to lead from a lead acid battery factory were selected. According to the blood lead levels,the participants were divided into 5 groups( < 100. 0,100. 0-,200. 0-,300. 0- and 400. 0- μg / L). The effects of blood lead level on the health status of the workers such as clinical symptoms,electrocardiogram( ECG),routine urine and blood pressure,liver function and blood routine were analyzed.RESULTS: The median( the 25 th and 75 th percentiles) of the blood lead level was 169. 0( 76. 6,320. 4) μg / L in the 412 workers,and over standard rate was 12. 6%. Male workers 'blood lead level was higher than that of female workers[225. 8( 91. 3,351. 2) vs 131. 0( 64. 6,248. 9) μg/L,P < 0. 01]. In the female workers,the abnormal rate of ECG in the < 100. 0 μg / L group was lower than those of the 400- μg / L group( 6. 7% vs 41. 2%,P < 0. 005); the level of diastolic pressure in the < 100. 0 μg / L group was lower than that of the 300. 0- μg / L group [( 78. 4 ± 11. 7) vs( 72. 6 ±5. 6) mm Hg,P < 0. 01]. It was no correlation between blood lead level and urine β2-microglobulin( rS=- 0. 044,P =0. 82),while it was positive correlation between blood lead level and 24 hours urine lead content( rS= 0. 657,P < 0. 01).CONCLUSION: Lead exposed could cause the increase of cardiovascular abnormalities in female workers than that of male workers. Routine blood index,liver function index and routine urine index( urine protein) could not early reflect the blood,liver and kidney toxicity of lead.

OBJECTIVE To evaluate the effect of PDCA cycle on prophylactic use of antibiotics in laparoscopic cholecystectomy during perioperative period and to conduct pharmacoeconomic analysis. METHODS Using retrospective analysis method， 80 discharged patients of each group underwent laparoscopic cholecystectomy were randomly selected from Hefei Second People’s Hospital before PDCA cycle （from May to June 2019）， after the first round of PDCA cycle （from May to June 2020）， after the second round of PDCA cycle （from May to June 2021） according to real or basic reasons for irrational drug use. The rationality of prophylactic use of antibiotics for patients was evaluated. The general situation， antibiotic use， clinical efficacy and treatment cost of patients were compared before cycle and after the first and second rounds of PDCA cycle. Cost-effectiveness analysis method and sensitivity analysis method were adopted to evaluate pharmacoeconomic significance of PDCA cycle. RESULTS After two rounds of PDCA cycle， the irrational rate of antibiotics， cost ratio of antibiotics， the number of days of antibiotics use， DDDs， drug utilization index， the frequency of antibiotics use per capita， the total amount of antibiotics， the cost of antibiotics， the total amount of drugs， and the total cost of hospitalization all decreased significantly （P＜0.05）. The results of cost-effectiveness analysis indicated that the pharmacoeconomic effect was the best after two rounds of PDCA cycle； the results of sensitivity analysis were consistent with it， which confirmed the reliability of the research results. CONCLUSIONS PDCA CPA- cycle promotes the rational use of antibiotics of laparoscopic cholecystectomy during perioperative period， reduces the cost of antibiotics and relieves the economic burden of patients.

Since the implementation of the Measures for the Management of Radiation Workers’ Occupational Health in November 2007, it has played an extremely important role in protecting the occupational health of radiation workers. There are more than 700 000 radiation workers in about 100 000 workplaces with potential radiation exposure, as well as a large number of miners exposed to high levels of radon. As the radiation health monitoring project suggests, measures of occupational health management such as personal dose monitoring and occupational health examination of radiation workers have been widely implemented and achieved good results in the protection of radiation workers. However, the risks of chromosomal aberration and specific turbidity of the eye lens of radiation workers have increased in high-risk positions such as interventional radiology, nuclear medicine, and industrial flaw detection. The control of high radon exposure in miners needs to be strengthened. It is necessary to adapt to the new situation in view of new challenges and actively promote the revision of the Measures for the Management of Radiation Workers’ Occupational Health, so as to further improve the occupational health management of radiation workers in China.