Objective To investigate the prevalence of occupational asthma,airway inflammation and analyze the risk factors for workers exposed to isocyanates.Methods A cross-sectional study was applied.Totally 429 isocyanates exposed workers were surveyed and the prevalence of occupational asthma and airway inflammation situation were examined by questionnaire,physical examination and laboratory tests.Multivariate logistic regression was applied to analyze the possible risk factors of isocyanate-induced occupational asthma.Results (1) A total of 366 patients with complete data were included in the study,and finally 11 cases were diagnosed as isocyanate-induced occupational asthma with a prevalence of 3.0％.(2) Neutrophil percentage in the induced sputum of occupational asthma increased significantly [42.00％ (34.00％-55.00％) before work and 59.00％ (51.00％-70.00％) after work (Z =-2.940.P ＜ 0.05)].(3) Length of service (OR =3.096,P =0.025) and rhinitis (OR =1.901,P =0.008) were independent dangerous factors,and protective measures (OR =0.074,P =0.015) was protective factors to isocyanateinduced occupational asthma.Conclusions Neutrophilic inflammation can be triggered by isocyanate exposure.Regular health examinations,effective protective measures can reduce the prevalence of isocyanateinduced occupational asthma.

Objective To analyze the pregnancy outcomes and effect on fertility in women with Graves' disease after 131I therapy and the health status of their newborns.Methods From year 2009 to 2012,a total of 102 female patients with Graves' disease,who were pregnant during propylthiouracil (PTU)/L-thyroxine (euthyrox) maintenance treatment,were retrospectively recruited.The subjects were divided into 131I therapy group (n=57) and non-131I therapy group (n=45).The time interval between 131I (non-131I) therapy and getting pregnant were at least 6 months.They were followed for their pregnancy outcomes.During the pregnancy period,recorded parameters included serum thyroid biochemistry,dose of PTU/euthyrox,health conditions of the newborns and termination of pregnancy.Medication compliance,delivery mode,baby gender and body weight between the 2 groups were compared byx2 test,Mann-Whitney u test,Fisher exact test and two-sample t test.Results Ninety-seven patients had normal labor.In 131I therapy group and non-131I therapy group,15 vs 22 patients were treated by PTU,31 vs 18 by euthyrox and 11 vs 5 without any medication during pregnancy (x2=5.69,P＞0.05).The medical compliance (PTU and euthyrox: u=163.50,233.50,both P＞0.05) was similar between the 2 groups.The delivery mode (natural labor/cesarean: 36/19 vs 28/14,x2 =0.016),baby gender (male/female: 32/23 vs 18/24,x2 =2.239) and body weight ((3.18t0.47) vs (3.07±4.17) kg,t=1.154) were also similar between the 2 groups (all P＞0.05).Condusion Women of reproductive age with Graves' disease were found to have normal pregnancy after 131I therapy,on the condition that their thyroid function could be reasonably controlled and maintained by the proper medication before and during pregnancy.

AIM:To reveal the characteristics and patterns of mental activity in the cerebral cortex of patients with attention deficit hyperactivity disorder (ADHD) and explore the pathogenetic characteristics of ADHD.METHODS: The ADHD patients were asked to record their mental activity, general health condition and obsessions before the onset of pathological symptoms by means of psychological introspective reports.RESULTS: The direct cause of attention distraction and failure of attention focus is the patients' inability to perform cognitive tasks (including perception, memory and recollection, imagination, association and thought)in a continuously ongoing manner in relaxation. The frequent stagnancy and pause during the course of recognition precipitated the patients in a stressful state, which contributed to the onset of various hyperactivities and also resulted in the acquisition of "silent verbal thinking". This is an important psychopathological phenomenon long been neglected. All theses abnormalities caused the patients much discomfort, which was naturally relieved by means of impulsive and irritable behaviors.CONCLUSION: A series of clinical symptoms of ADHD arises from the same pathogenic factor of difficulty in mental activity and inability to carry out the activities in the cerebral cortex in a relaxed manner. The difficulty in mental activity is the key problem of ADHD and the source of various synptoms, which should be ;reated for the first place. The cause of this key problem is possibly lowered metabolism of the cerebral cortex, and the effect of "instinct" can not be neglected in the attempt to explain the pathogenesis of ADHD.

Objective To explore the significance and the change of miRNAs expression profile in different period of HBV infection.Methods Establish the detection method of microRNA(miRNA) by RNA DNA probe liquid chip (flexible multi-analyte profiling,xMap) and estimate the specificity,repeatability and accuracy of this method.From October 2010 to October 2011,collect HBV infected patients' periphcral blood of the First affiliated hospital of SooChow University,including acute hepatitis B,chronic hepatitis B,hepatits B liver cirrhosis,liver cancer patients and health control,each group contains 40 cases.The levels of miR-191,-223,-222,-145,-21,-31,-126,-20a,-372 of peripheral blood mononuclear cell were detected by xMap liquid chiptechnology.The level of miR-103 was taken as reference.The ratio of (the mean fluorescence intensity of target miRNAs-corresponding backgroud mean fluorescence intensity)/( the mean fluorescence intensity of miR-103-corresponding backgroud mean fluorescence intensity) as a valid data and analysis the characteristics of miRNAs expression.The SPSS 17.0 was used as statistical software.The single factor analysis of variance was used as the method to analysis group comparison,and make multiple comparison by the LSD-t method if the result with a significant difference.Results The specificity of Xmap liquid chip method to detect miRNAs was 100％ ;The repeated experiment proved that the CV value was less than 5％ in the high value reference miRNA test,less than 10％ in the low value reference miRNAs test;the accruracy experiment proved that the recovery rate was ( 100 ± 5)％ in the nine miRNAs.There were no statistically differences with miR-222 ( F =1.32,P ＞ 0.05),-191 ( F =1.98,P ＞ 0.05),-145 ( F =0.78,P＞0.05),-21(F=0.64,P ＞0.05),-31 (F =0.83,P ＞0.05),-372(F =1.75,P ＞0.05)in different groups; There was statistically significant differences in miR-223 ( F =14.56,P ＜ 0.05) among different groups,with the highest expression level in actue hepatitis B group (15.37 ± 4.01),and the lowest expression level in liver cancer group (6.91 ±3.18) ; There was statistically significant differences in miR126 (F =17.43,P ＜ 0.05)among different groups,with the highest expression level in health control group (6.33 ±2.75) and the lowest expression level in liver cancer group (2.38 ± 1.07).There were statistically significant differences in miR-20a ( F =19.484,P ＜ 0.05) among different groups,with the highest expression level in health control group (0.33 ±0.18) and the lowest expression level in liver cancer group (0.81 ±0.24).Conclusion The detection method of miRNA by Xmap liquid chip has strong specificity,high accuracy and good repeatability,suitable for large throughput clinical testing.The study for miRNA in HBV infected diseases provides a new clue to the research of chronic progress mechanism.

Objective To evaluate the safety and feasibility of simplified fast track surgery in gastric surgery.Methods The study enrolled consecutive cases of elective gastric surgery from March 2010 to December 2011.The patients were randomized into two groups:simplified fast track surgery group (n =149) and traditional clinical pathway group (n =154).Demographic,intra-operative and post-operative data between two groups were compared.Results The outcome of demographic and intra-operative data between simplified fast track surgery group and traditional clinical pathway group were not different statistically (P ＞ 0.05).The time of post-operative recovery and discharge of simplified fast track surgery group was significantly shorter than traditional clinical pathway group (P ＜ 0.05).Difference of post-operative complications of two groups was not significant (P ＞ 0.05).Conclusion The programme of simplified fast track surgery in gastric surgery is safe and feasible.

Objective To investigate the safety and feasibility of reoperatively laparoscopic technique in treatment for locally recurrent rectal cancer.Methods The study enrolled 17 patients with locally recurrent rectal cancer between February 2004 and September 2009 from Shanghai Minimally Invasive Surgery Center.The patients were divided into two groups according to their pelvic recurrence types:central recurrence group (n =14) and anterior recurrence group (n =3).Demographic,surgical data and survival outcomes between two groups were compared.Results The outcomes of demographic data between two groups were not different(P＞ 0.05 ).Compared with central recurrence group,anterior recurrence group had longer operating time (P =0.028).However,the differences of operative blood loss,complications,postoperative rehabilitative outcomes and ratio of R0 resction between groups were not significant ( P ＞ 0.05 ).The overall 5- year survival rate of all the patients was 36％.And the median survival time was 42 months without significant difference between two groups (x2 =1.641,P =0.200).Conclusions Reoperatively laparoscopic technique in treatment for locally recurrent rectal cancer is safe and feasible.Selected patients,specialist operation and higer ratio of R0 resection are the key factors conducive to better short-and long-term outcomes.

Objective To compare the safety and efficiency of laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) procedure for herniorrhaphy. Methods Between Jan 1997 and Jan 2005, 235 patients (274 hernias) underwent laparoscopic inguinal hernia repair with 163 TAPP in 139 patients and 111 TEP procedures in 96 patients. Postoperative patients were followed-up for 6-24 months. Results No conversion was necessary. There were no significant differences between TAPP and TEP when considering operating time, postoperative hospital stay, VAS and time to return to daily activity. The recurrence rate was 1. 8% and 0. 9% respectively in TAPP and TEP( P = 0. 524). The total incidence of postoperative complications were 15. 3% and 10. 8% respectively ( P = 0. 282 ) , with seroma, transient neurapraxia and urinary retention being 5. 5% vs. 4. 5% ( P = 0. 707 ) , 5. 5% vs. 3. 6% ( P = 0.464) and 3. 1% vs. 2.7%(P = 1.000). The inhospital cost was significantly higher in TAPP than in TEP(P=0.000). Conclusion TAPP and TEP are both safe and efficient tension-free technique. Surgeons' experience was more important than choice of approach to laparoscopic repair for groin hernias.

ObjectiveTo evaluate intraoperative cholangiography (IOC) and laparoscopic ultrasonography (LUS) for detection of occult common bile duct stones (CBDS) during laparoscopic cholecystectomy (LC). Methods From Jun. 2000 to Sep. 2001, 98 patients undergoing LUS and IOC during LC were analyzed prospectively.Results[The successful rate of LUS and IOC were 100% and 95% respectively, the time for LUS (7 7?2 1) min was significantly shorter than IOC (11 4?3 5) min ( P 0 05). The visualization of intrapancreatic portion of CBD by LUS was 62% vs 97% by IOC ( P

OBJECTIVETo investigate the cause of hemorrhage from the gallbladder bed during laparoscopic cholecystectomy.

METHODSColor Doppler ultrasound was used to examine the cause of venous hemorrhage from the gallbladder bed during laparoscopic cholecystectomy in 1 patient postoperatively and to examine the anatomic relationship between the gallbladder bed and branches of the middle hepatic vein in 91 patients preoperatively.

RESULTSThere is a major branch of middle hepatic vein extended close to the gallbladder bed. The branch of the middle hepatic vein was completely adherent to the gallbladder bed in 14 of 91 patients (15.4%). The mean distance between the closest point of the middle hepatic vein and the gallbladder bed is 5.0 +/- 4.6 mm, the mean diameter of this point is 3.2 +/- 1.1 mm.

CONCLUSIONSPatients with large branches of the middle hepatic vein close to the gallbladder bed are at risk of hemorrhage during laparoscopic cholecystectomy and should be identified preoperatively with ultrasound.

Cholecystectomy, Laparoscopic ; adverse effects ; Female ; Hepatic Veins ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage ; etiology ; Risk Factors ; Ultrasonography, Doppler, Color

Objective To analyze the clinical and laboratory characteristics of systemic lupus erythematosus (SLE) in children. Methods Fifty-three inpatients, 5 boys and 48 girls with SLE, who aged from 7 to 14 years with a median age at 12 years, were enrolled into this study. A retrospective study was carried out to assess the clinical and laboratory features of these pediatric patients. Results The ratio of male to female patients was 1:9.6. Skin eruption was the most common initial manifestation (41.51%), followed by fever (20.75%) and arthralgia (20.75%). Systemic involvement was common, and 84.90% of these patients had hematological abnormalities, 60.38% renal involvement, 18.87% nervous involvement. The most common manifestation of hematological, renal and nervous involvement was anemia, proteinuria and seizures, respectively. Among the immunologic parameters tested, anti-nuclear antibody showed the highest positivity rate of 90.57%, followed by anti-dsDNA with a positivity rate of 67.92%. There was no significant difference between the male and female patients in the age of onset, SLEDAI score at admission and discharge, duration of hospitalization or the dose of corticosteroid used initially and at the discharge. Conclusion The manifestations of pediatric SLE are various, and multisystem involvement is common in these patients. Early diagnosis and active treatment might benefit the prognosis of pediatric SLE.