Occupational Health

It is one heated topic to enhance the humanistic quality of current college students.This paper investigates and analyzes the status quo of humanistic education among the college students in two medical colleges in Tianjin city,exploring related issues in the humanistic education in the English language lecture teaching in medical colleges.

Asthma is heterogeneous disorder which caused by a complicated interaction between multiple genes and environmental factors. A increasing number of attention has paid in the researches about its pathogenic mechanism and therapeutic strategies. Not only can Toll-like receptors and signal transduction pathways mediate relevant immunocyte of asthma, but also induce or restrain development of asthma. TLRs is a land of pattern recognition receptor(PRRs), which can rely on the conserved sequence of gene encoding to identify pathogenic microorganism, meanwhile activate innate immunity,adjust acquired immunity and induce immune tolerance.

Objective To compare the outcomes of operative with non-operative treatment for thoracolumbar burst fracture without neurological deficit using Meta-analysis.Methods Electronic database were searched from inception to February 2014 by two independent reviewers,including Pubmed Medline,Excerpta Medica Database (Embase),Cochrane Central Register of Controlled Trials,Chinese Biology Medicine (CBM),Chinese Wanfang Database,and China National Knowledge Infrastructure (CNKI).Inclusion and exclusion criteria were applied to select the studies.Quality appraisal and data extraction were based on Cochrane Collaboration guidelines.Results Two randomized controlled trials (RCTs),which reported outcomes for 79 patients (41 with operative treatment and 38 with nonoperative treatment) at a follow-up of two years or more were included.Between-study heterogeneity was found to be significant,for one reported better results in surgery group concerning pain relief,function recovery and returning to work.However,opposite results were found in another trial.Meta-analysis showed surgery led to higher complication rates (RR =2.85,95％ CI 0.83-9.75),including subsequent surgery (RR =8.39,95％ CI 1.12-62.87).Conclusion Operative and nonoperative managements produce similar results with respect to pain relief,function regain,and returning to work when performed for thoracolumbar burst fractures without neurologic deficit,but operation is often associated with more complications.

ObjectiveTo observe the effects of mechanical ventilation with different tidal volumes (VT) on coagulability and fibrinolytic characteristics in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hits with oleic acid (OA) and lipopolysaccharide (LPS).Methods Forty healthy adult male rabbits were randomly divided into five groups (8 rabbits in each group): sham operation group, model group, low VT group (6 mL/kg), rontine VT group (10 mL/kg), high VT group (15 mL/kg). ARDS model was reproduced by sequential injection of 0.1 mL/kg OA and 500μg/kg LPS via auricular vein, and the rabbits in sham operation group received normal saline in same volume. Mechanical ventilation was performed in different VT groups after model reproduction, and the end of the experiment was determined as 6 hours after LPS injection. Blood was collected from the carotid artery at 30 minutes and 360 minutes after LPS injection, with which arterial partial pressure of oxygen (PaO2) was determined, and oxygenation index was calculated. Internal jugular vein blood was collected at 5, 120, 240, and 360 minutes after LPS injection, and activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib) and antithrombinⅢ(AT-Ⅲ) were determined. The blood was collected at the end of the experiment, and then the rabbits were sacrificed, and serum levels of procollagen typeⅢ (PⅢP), plasminogen activator inhibitor-1 (PAI-1) as well as PⅢP level in lung tissue were determined. The wet/dry weight ratio (W/D) of lung tissues was calculated.Results Compared with sham operation group, oxygenation index at both 30 minutes and 360 minutes were significantly decreased in model group, while W/D ratio was significantly increased. PT and APTT at 5 minutes were significantly shortened followed by a gradual increase. Fib and AT-Ⅲ showed no change at 5 minutes followed by a gradual decrease, while serum PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly increased. There was no significant difference in oxygenation index between all VT groups and model group, with a tendency to increase in low VT group. W/D ratio in low VT group was the lowest (5.09±0.19), and it was significantly lower than that of the model group (6.02±0.27, P< 0.01), while it was the highest in high VT group (6.27±0.32). PT and APTT in all VT groups were gradually prolonged, and Fib and AT-Ⅲ were gradually decreased. PT and APTT in low VT group were significantly shorter than those in model group from 120 minutes on [PT (s): 120 minutes: 8.90±0.28 vs. 11.43±0.28, 240 minutes: 9.18±0.21 vs. 11.99±0.50, 360 minutes: 9.25±0.15 vs. 12.49±0.29; APTT (s): 120 minutes: 69.09±3.91 vs. 76.08±4.21, 240 minutes: 67.53±2.14 vs. 79.71±2.25, 360 minutes: 66.95±1.13 vs. 83.21±4.01, allP< 0.05], Fib (g/L) was significantly elevated (120 minutes: 3.80±0.09 vs. 3.38±0.15, 240 minutes: 3.91±0.05 vs. 2.47±0.16, 360 minutes:4.06±0.13 vs. 2.39±0.16, allP< 0.05), and no significant difference was found in AT-Ⅲ. Serum contents of PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly lowered [serum PAI-1 (ng/L): 1.14±0.26 vs. 1.63±0.91, serum PⅢP (ng/L): 1.62±0.52 vs. 2.91±0.64, lung PⅢP (ng/L): 4.40±0.58 vs. 5.75±0.47, allP< 0.01]. The change tendency of all parameters in routine VT group was lower than that in low VT group, PT at 120 minutes and 360 minutes, APTT at 240 minutes and 360 minutes was significantly shorter than that in model group, and Fib at 120 minutes and 240 minutes were significantly higher than those in model group (allP< 0.05). No significant difference was found in AT-Ⅲ, serum PAI-1 and PⅢP as well as lung PⅢP as compared with model group. PT and APTT at 360 minutes in high VT group were significantly longer than those in model group, Fib at 360 minutes was significantly lower than that in model group, and lung PⅢP was significantly higher than that in model group. Conclusions There are some important changes in coagulability which changes from a hyper state into a hypo coagulate state, while fibrinolysis is inhibited during the pathological process of ARDS produced by two-hit of OA and LPS. Mechanical ventilation with low VT can obviously improve coagulability and fibrinolytic status, while ventilation with routine VT has little effect on coagulability and fibrinolytic status. Mechanical ventilation with high VT, however, will greatly deteriorate the coagulability and fibrinolytic function in ARDS.

Objective To investigate the utility of urodynamic testing in the evaluation of neurogenic vesicoureteral reflux in patients with thoracolumbar spinal cord injury at the T10 to L2 level.Methods Twenty-six patients with thoracolumbar spinal cord injury at the T10 to L2 level and who displayed vesicoureteral reflux were enrolled and divided into a detrusor hyper-reflexia group (n =21) and a detrusor a-reflexia group (n =5)according to their cystourethrograms and urodynamic test results.Their bladder volume,detrusor pressure (Pdet) and compliance were observed and analyzed at the vesicoureteral reflux point and the leak point.Results The bladder volume and compliance of the detrusor hyper-reflexia group at the vesicoureteral reflux point were (122.46 ± 87.89) ml and (5.94 ± 4.96) ml/H2 O respectively,significantly different from the detrusor a-reflexia group (P ＜ 0.01).At the leak point,the average bladder volume of the detrusor hyper-reflexia group was (210.81 ± 69.72)ml,while the average bladder compliance was (9.53 ± 5.43)ml/H2O and the average detrusor pressure was (42.29 ± 9.57)cm H2O.All were significantly different from the detrusor a-reflexia group's averages.Moreover,there was a significant difference in the Pdet between the leak point and the vesicoureteral reflux points in the detrusor hyper-reflexia group.Conclusions Patients with thoracolumbar spinal cord injuries at the T10 to L2 level with neurogenic bladder and detrusor hyper-reflexia have low bladder volumes and compliance,and vesicoureteral reflux tends to occur at an early stage after injury with a destrusor pressure lower than 40 cm H2 O.For patients with detrusor a-reflexia,vesicoureteral reflux and bladder leakage may occur when detrusor pressure is low.

With regard to the traditional processing of pilose antler, two big companies of Chinese Medicine decoction pieces and one private patrimonial TCM clinic were investigated. The result indicates that the processing techniques in these three regions can be found in the ancient books of TCM and belong to the traditional processing of Chinese Medicine, but the processing procedures are different. On the basis of that, starting with the different manifestation forms of regional culture, the author discusses the effect of regional culture on the traditional processing of Chinese Medicine. The research indicates that, different geographical nature environments result in the three specific aspects, which are the specific resources and products, the specific historical culture, and the specific characters. These three specific aspects result in different tools, conventional supplementary materials and techniques of processing, and on the basis of this, different traditional processing schools of Chinese Medicine come into being with different characteristics. Therefore, to protect the traditional processing of Chinese Medicine in different regions has important significance to supplement the deficiencies in Pharmacopoeia of PRC (2010 edition) and the TCM processing standards of different provinces and municipalities, and to bequeath and develop the different characteristics of different processing schools, and it's a full embodiment to carry out the core spirit of National Intangible Cultural Heritage Law.

Objective To investigate the effect of Lecarnidipine on hypertension and circulation hematopoietic progenitor cells (HPCs) count in elderly patients.Methods A total of 61 elderly patients with hypertension were selected in Renji Hospital geriatric hypertension clinic from January 2014 to August 2014.Patients were randomly divided into two groups:Lercanidipine treatment group (n=32,Lercanidipine hydrochloride 5-10 mg/day),the control group (n=29,thiazide diuretics and / or beta blockers according to patient's condition).Patients were observed for 12 weeks,and the target blood pressure level was ＜140/90 mmHg (1 mmHg=0.133 kPa).Blood lipids and glucose levels,liver and kidney function and erythrocyte sedimentation rate (ESR) were determined before and after treatment.The quantity of circulation HPCs (the percentage of CD34+ CD45dim in peripheral blood in 100000 mononuclear cells) was detected by flow cytometry analysis.Results Blood pressure in Lercanidipine treatment group was decreased after the treatment (P＜0.01),and patients reached the target blood pressure.There was no difference in the decrease of blood pressure level between the two groups (P＞0.05).The number of CD34+ CD45dim cells was increased after 12 weeks of Lecarnidipine treatment [(0.022 + 0.003)％ vs.(0.034 + 0.028)％,P＜0.05].Compared with the control group,the number of CD34+ CD45dim cells in lercanidipine group had a rising trend,but it had no statistical difference (P＞0.05).Taking the number of CD34+ CD45dim as the independent variables,the multiple stepwise linear regression analysis showed that the number of CD34+ CD45dim cells was negatively correlated to systolic pressure.Conclusions The number of circulation HPCs is negatively correlated with systolic pressure in the elderly.Lercanidipine can increase the number of circulation HPCs,and does not rely on its antihypertensive effect.

Objective To explore the relationship between physical activity ( PA) in college students and self?efficacy,and provide guarantee for improving health education in colleges. Methods International physical ac?tivity questionnaire( IPAQ) ,scales of physical behavior,scales of stage of change in physical exercise behavior,and scales of self?efficacy were used to test 504 students from some of colleges in Zhejiang province. Results Signifi?cantly more males (38.52%) than females (27.27%) were in the high activity tertile (P<0.01); the amount of PA per week in males and females were (4608±872.07)MET and(4361±674.03)MET(P<0.01); the scores of males and females were (3.32±0.44) and(3.04±0.36),(P<0.01). The number of males (35.5%) in maintenance period and period of action is greater than that of females (28.9%). Males had higher self?efficacy and more scores of behavior than females (P<0.05) . There were significant characteristics of PA in their self?efficacy,score of be?havior and stages of change( F=18.38, F=15.08, F=34.71, P<0.01),and a significant correlation between PA and self?efficacy,stages of change and physical exercise behavior ( r=0.336, r=0.36, r=0.46, P<0.01).Conclu?sion Self?efficacy may have important effect on the level of PA. Stages of change and scores of behavior may ex?plain difference of PA between males and females.

Objective:To establish an HPLC method compatible with the mass spectrometry for the determination of the content and related substances in amlodipine besylate tablets. Methods:The sample was separated on a CAPCELL PAK C18 column (250 mm × 4. 6 mm, 5 μm) with the mobile phase consisting of methanol and 20 mmol·L-1 ammonium acetate (60∶40) at a flow rate of 1. 0 ml·min-1 . The detection wavelength was set at 237 nm. The column temperature was 35℃ and the injection volume was 20 μl. Be-sides, an HPLC-QTOF MS method was used to identify the molecular structure of the related substances of amlodipine. Results: The related substances were completely separated from amlodipine. The linear range of amlodipine besylate was 10-100 μg · ml-1 ( r =0. 999 8), and the mean recovery was 99. 2%(RSD=1. 0%,n=9). The main related substances could be detected by HPLC-QTOF MS. Conclusion:The established method is accurate, reliable and reproducible, which can be used in the quality control of amlodip-ine besylate tablets.