Objective To investigate the diagnostic values of imaging techniques and endoscopy in detection the causes of post-hepatic obstructive jaundice.Methods The clinical data of 57 patients with post-hepatic obstructive jaundice were retrospectively studied.The causes of the obstruction and the findings of uhrasonography(US),computerized tomography(CT),magnetic resonance imaging(MRI)or MRIcholangiopancreatography(MRCP),endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasonography(EUS)were compared.Results The causes of 57 patients with post-hepatic obstruetive jaundice were benign obstruction in 42(including stones in common bile duct in 38,ascariasis of CBD in 1,postoperative stricture in 2 and chronic pancreatitis in 1),and malignant lesions in 15(including pancreatic head carcinoma in 11 and ampullary carcinoma in 4).The diagnostic accuracy in terms of lesion location of US,CT,MRI+MRCP,ERCP and EUS were 71.93%(41/57),88.00%(22/25),94.59% (35/37),100.00%(47/47)and 96.77%(30/31),respectively;the diagnostic accuracy of cause of obstruction were 63.16%(36/57),80.00%(20/25),83.78%(31/37),100%(47/47)and 96.77% (30/31),respectively.Conclusion Benign diseases are the main causes of post-hepatic obstructive jaundice,but malignant ones are not rare.It is important to combine miscellaneous imaging techniques and endoscopy in diagnosis.

OBJECTIVE: To establish a simultaneously detecting method for 9 kinds of anion in workplace air by ion chromatography. METHODS: Nine kinds of anions in workplace air include fluoride ion,chloride ion,nitrite ion,bromide ion,nitrate ion,sulfate ion,phosphate ion,oxalate denominationbl and iodide ion were sampled with sodium carbonatesodium bicarbonate( concentration 3. 2,1. 1 mmol/L respectively),separated by the anion column,detected by the conductivity detector and quantified by external standard method. RESULTS: The linearity of the 9 anions in the corresponding mass concentration range was good( correlation coefficient > 0. 999). The detection limit was 0. 02-0. 18mg/L and the marking recovery was 96. 0%-100. 5%. The within-run relative standard deviation( RSD) was 0. 3%-2. 5%,and the between-run RSD was 0. 4%-3. 1%. All the sampling efficiencies were > 96. 8%,and the samples could be stored at room temperature for 5 days. CONCLUSION: The method has good accuracy,high sensitivity,with simple and rapid operation,and can simultaneously measure various anions in the air of workplace.

Objective:To develop a recombinant protein vaccine based on KPC-2, a drug resistance target in Klebsiella pneumoniae, and evaluate its immunogenicity, protective efficacy and mechanism in a mouse model of pneumonia. Methods:KPC-2 was expressed in Escherichia coli and purified using GST affinity chromatography. A recombinant protein vaccine was prepared with KPC-2 and used to immunize New Zealand rabbits through subcutaneous injection. Serum samples were isolated from cardiac blood and Protein G chromatography was used to purify polyclonal antibodies against KPC-2. Opsonophagocytic killing assay was used to assess the bactericidal activity of the polyclonal antibodies in vitro. Female BALB/c mice were immunized three times with the recombinant protein vaccine, and the titers of specific IgG antibodies in serum were measured by indirect ELISA. One week after the last vaccination, the mice were infected with Klebsiella pneumoniae strain SRT through tracheal intubation, and received a single intravenous dose of meropenem (0.1 mg) 1 h later. The protective efficacy of the KPC-2 recombinant protein vaccine was evaluated by comparing the survival rates, bacterial colonization and histopathological changes between vaccine group and adjuvant group as well as the survival rates between meropenem group and normal saline group. Moreover, the protective efficacy of polyclonal antibodies against KPC-2 was evaluated through passive immunization. Results:The level of specific IgG antibodies in serum was significantly higher in the vaccine group than in the adjuvant group ( t=4.325, P<0.05). The survival rate in the vaccine group was also higher than that of the adjuvant group [70% (7/10) vs 10% (1/10), P<0.05]. Furthermore, lung inflammation was less severe and bacterial burden was reduced in the vaccine group as compared with those of the control group ( t=3.127, P<0.05). Both active and passive vaccination strategies demonstrated strong protective efficacy against Klebsiella pneumoniae infection, and had a synergistic effect when used in combination with antibiotic therapy. The polyclonal antibodies against KPC-2 had bactericidal activity in vitro ( t=5.427, P<0.05). Conclusions:The prepared KPC-2 vaccine has better immunogenicity and protective efficacy. It can induce strong humoral immune responses. This study suggest that drug resistance target may be used as a candidate antigen for future vaccine development.

OBJECTIVE: To understand the exposure of occupational hazards, occupational and mental health status of high-speed railway locomotive drivers. METHODS: A total of 150 male high-speed railway locomotive drivers from Nanchang Railway administration were selected as experimental group, and 80 male ordinary train drivers were selected as control group by using a judgment sampling method. The occupational disease hazard testing and occupational health examinations were conducted in drivers of these two groups. The mental health status survey was conducted using the Symptom Checklist 90(SCL-90). RESULTS: The noise, power frequency electric field, formaldehyde, benzene, toluene, xylene and carbon dioxide in all the work place of these two groups were in line with the national occupational health standards. The exposure noise intensity of the experimental group was lower than that of the control group [(70.5±3.7) vs(77.4±4.1) dB(A), P<0.05]. The detection rates of hypertension and chronic gastritis were higher in the experimental group(18.7% vs 34.7%, 26.2% vs 42.0%, P<0.05). The detection rate of high frequency hearing loss decreased in the experimental group compared with the control group(22.5% vs 10.7%, P<0.05). The total score of SCL-90 in the experimental group was higher than that in the control group [(169.5±6.1) vs(148.0±6.0) score, P<0.01]. The positive rate of psychological symptoms was higher in the experimental group than that of the control group(41.3% vs 23.8%, P<0.01). CONCLUSION: The concentration/intensity of occupational disease hazards in the workplace of high-speed railway locomotives drivers is within normal limit. The occupational health status of high-speed railway locomotive drivers is generally good, but attention should be paid to their occupational mental health hazards.