Objective To study the clinical efficacy of viable bifidobacterium combined with montmorillonite powder in the treatment of infantile diarrhea.Methods 100 patients with infantile diarrhea disease were randomly divided into control group and observation group,50 cases in each group.The control group was given montmorillonitc powder treatment,while the observation group was added viable bifidobacterium treatment based on control group.Effi-cacy,serum C reactive protein (CRP)level,clinical symptom improvement time and adverse reactions rate were com-pared between two groups.Results The total effective rates of clinical treatment in the control group and observation group were 78%(39 /50)and 96%(48 /50)(P1 =0.026).After treatment,the treatment time,diarrhea stopping time,body temperature returned to normal,frequency of defecate recovery time,shape of defecate recovery time and scrum CRP levels in the control group were (8.73 ±1.92)d,(2.32 ±0.85)d,(27.53 ±7.24)h,(2.52 ±0.85)d, (3.62 ±1.23)d and (13.63 ±2.15)mg/L,which in observation group were (6.15 ±1.26)d,(1.53 ±0.62)d, (19.65 ±5.71)h,(1.75 ±0.76)d,(2.56 ±0.85)d and (7.52 ±1.26)mg/L.The observation group were better than the control group (P2 =0.026,P3 =0.018,P4 =0.021,P5 =0.012,P6 =0.031,P10 =0.002).The incidence of adverse reactions between two groups had no obvious difference.Conclusion Viable bifidobacterium combined with montmorillonite powder can effectively treat infantile diarrhea,with advantages of significant clinical efficacy,quickly recovery of clinical symptoms,rapidly reduce of CRP level,and low adverse reactions,it is worthy of promotion.

Objective To investigate the related factors affecting prognosis of patients with colorectal cancer undergoing palliative resection.Methods The clinical data of 345 patients with colorectal cancer who underwent palliative resection at the First Affiliated Hospital of Guangxi Medical University between January 2007 and December 2011 were retrospectively analyzed.Patients selected the emergent operations or restrictive operation based on the conditions of patients,and then received chemotherapy,radiotherapy and biotherapy.Chemotherapy regimens included FOLFOX4 (5-FU/CF + oxaliplatin) regimen,XELOX (capecitabine + oxaliplatin) regimen and FOLFIRI (5-FU + CF + irinotecan) regimen.Biotherapy regimens included molecular targeted therapies using bevacizumab and cetuximab.The follow-up was applied to patients by outpatient examination,telephone interview and correspondence once every 3 months up to March 1,2014.The survival curve was drawn by the Kaplan-Meier method.The survival rate was analyzed using the Log rank test.The multivariate analysis was done using the COX regression model.Results Of the 1 930 patients,345 patients received palliative resection with a percentage rate of 17.876％.Among the 345 patients,104 patients received emergent operations and others received restrictive operations.After operation,178 patients received adjuvant treatment,FOLFOX4 regimens were done on 85 patients,XELOX regimens on 32 patients,FOLFIRI regimens on 20 patients,radiotherapy on 17 patients and molecular targeted therapies on 24 patients.Seven patients died in the perioperative period and other patients were followed up for 3.0-82.0 months with a median time of 14.0 months.The 1-,3-and 5-year survival rates and the mean survival time were 49.57％,11.88％,6.38％ and 22.6 months,respectively.The results of univariate analysis showed that the CEA levels,bowel obstruction,primary tumor resection,peritoneal implantation,distal metastasis,lymph node metastasis,tumor differentiation,postoperative adjuvant therapy were related factors affecting the prognosis of patients undergoing palliative resection (x2=3.742,18.795,37.641,13.470,4.228,5.835,4.108,6.875,P ＜0.05).The results of multivariate analysis showed that the bowel obstruction,without primary tumor resection,peritoneal implantation,low-differentiation of tumor and without postoperative adjuvant therapy were the independent risk factors affecting the prognosis of patients undergoing palliative resection (RR =1.674,2.273,1.947,1.582,1.342,95％ confidence interval:1.193-2.485,1.646-4.376,1.497-3.587,1.184-2.382,1.032-2.074,P ＜ 0.05).Conclusion The low-differentiation of tumor,peritoneal implantation,bowel obstruction,without primary tumor resection and without postoperative adjuvant therapy are the independent risk factors affecting the prognosis of patients with colorectal cancer undergoing palliative resection.

Type Ⅰ congenital biliary dilatation is a congenital biliary duct defect disease.It is also called congenital choledochocele cyst (CCC).Endoscopic ultrasonography (EUS),magnetic resonance cholangiopacreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are very important for the diagnosis.Operation is generally regaded as the best choose.It is recommended that cholecystectomy + choledochal cyst excision + hepatic duct jejunum Roux-Y anastomosis is the chief therapeutic method.This article reviews the pathogenesis,classifications,diagnosis and treatment of the disease.

Objective To discuss the relationship between TCM syndromes and peritoneal fluid cytokine IL-6, IL-8 and TNF-α of endometriosis infertility patients, and provide thoughts for clinical treatment. Methods Totally 105 patients of endometriosis infertility were differentiated to six syndrome groups, including kidney deficiency and blood stasis, qi stagnation and blood stasis, heat stagnation and blood stasis, cold congelation and blood stasis, qi deficiency and blood stasis, phlegm-dampness stagnation. Thirty patients of non-endometriosis infertility were selected as control group. Enzyme-linked immunosorbent assay was used to detect cytokine levels of IL-6, IL-8 and TNF-α. Results In 105 cases of EM infertility, 35 cases (33.33%) were syndrome of kidney deficiency and blood stasis, 22 cases (20.95%) were syndrome of cold congelation and blood stasis, 18 cases (17.14%) were syndrome of qi stagnation and blood stasis, 10 cases (9.52%) were syndrome of heat stagnation and blood stasis, 11 cases (10.48%) were syndrome of qi deficiency and blood stasis, 9 cases (8.57%) were phlegm-dampness stagnation syndrome. The levels of IL-6, IL-8 and TNF-αin each syndrome group of EM infertility were higher than control group (P<0.01). IL-6 level in kidney deficiency and blood stasis group were higher than other syndrome groups (P<0.05). The levels of IL-8 and TNF-α in kidney deficiency and blood stasis group, and heat stagnation and blood stasis group were higher than other syndrome groups (P<0.05). IL-8 in kidney deficiency and blood stasis group was higher than that in heat stagnation and blood stasis group (P<0.05). Conclusion TCM syndromes in patients with endometriosis infertility have some relevance with peritoneal fluid cytokine levels of IL-6, IL-8, TNF-α, which may guide clinical understanding and treatment of endometriosis infertility.

Objective:To evaluate the accuracy of lung ultrasound score (LUSS) in predicting emerging hypoxemia after tracheal extubation in the patients in postanesthesia care unit (PACU).Methods:A total of 333 patients of both sexes, aged 18-89 yr, of American Society of Anesthesiologist physical statusⅠ-Ⅲ, scheduled for elective abdominal surgery, were included in the study.Lung ultrasound examinations were performed before operation (T 0) and on admission to PACU (T 1), and the LUSS were recorded as LUSS 0 and LUSS 1.Arterial blood gas analysis was conducted at 20 min after tracheal extubation, and oxygenation index (PaO 2/FiO 2) were recorded.Patients were divided into 2 groups according to the oxygenation index: PaO 2/FiO 2<300 mmHg group (hypoxemia group), and PaO 2/FiO 2≥300 mmHg group (non-hypoxemia group). Multivariate logistic regression analysis and the receiver operating characteristic curve were used to evaluate the accuracy of LUSS 1 in predicting the emerging hypoxemia after extubation in the patients in PACU. Results:The incidence of emerging hypoxemia in PACU after extubation was 9.0%.Multivariate logistic regression analysis indicated that LUSS 1 and body mass index were independent risk factors for emerging hypoxemia after extubation in the patients in PACU.The area under the ROC curve for LUSS 1 was 0.873 ( P<0.001, 95%CI 0.812-0.935). The patients with LUSS 1<7 had a lower risk of hypoxemia after extubation (LR -=0.15, 95%CI 0.05-0.45), and the patients with LUSS 1>10 had a higher risk of hypoxemia after extubation (LR + =17.25, 95%CI 7.35-40.51). Conclusion:LUS can effectively predict the development of hypoxemia after tracheal extubation in the patients in PACU.

OBJECTIVE: To investigate the current status and influencing factors of occupational stress in female workers of labor-intensive enterprises. METHODS: Totally 910 female workers from 5 labor-intensive enterprises in Guangdong Province was selected as the research subjects by random cluster sampling method. A questionnaire survey on occupational stress was conducted using the Occupational Stress Inventory-Revised Edition. RESULTS: Among the 910 female workers,14. 9%( 136/910) showed medium or higher scale on occupational role level,20. 1%( 183/910) showed medium or higher scale on occupational stress level,and 21. 4%( 195/910) showed medium or higher scale on personal resources lack. Multivariate logistic regression analysis indicated that the risk of occupational stress was high in single female workers and/or those exposed to occupational hazards( P < 0. 01). The higher the occupational role level,the higher risk of occupational stress( P < 0. 01). The less personal resources,the higher risk of occupational stress( P < 0. 01).CONCLUSION: Some female workers in labor-intensive enterprises showed medium or higher occupational stress level. The main influencing factors of occupational stress are marital status,exposure to occupational hazards,occupational role and personal resources.

Noise is a common occupational hazard in workplaces. Long-term exposure to high-intensity noise mainly causes occupational noise-induced hearing loss (ONIHL). The development of ONIHL is irreversible, and there is currently no cure. At present, risk assessment methods based on noise exposure intensities mainly include risk index assessment method, Engineering Professional Council assessment method in United Kingdom (EDC assessment method in UK), National Institute of Occupational Safety and Health assessment method in United State (NIOSH assessment method in US), and International Standardization Organization assessment method (ISO assessment method). However, the risk index assessment method is subjective and does not consider the effectiveness of workers wearing protective equipment. The EDC assessment method in UK defines ONIHL differently from China. The NIOSH assessment method in US and ISO assessment methods have population data sources that deviate from China, which can lead to bias in risk assessment. In the future, it is necessary to further carry out application research on the risk assessment of ONIHL in Chinese noise-exposed workers, compare the applicabilities of various assessment methods, conduct large-sample population epidemiological studies for verification, and fully utilize the risk-prediction function to prevent and control ONIHL.

ObjectiveTo explore the protective effect of hearing protectors worn by noise-exposed workers and its influencing factors. Methods A total of 329 occupational noise-exposed workers were selected as the research subjects by judgment sampling method. A questionnaire survey on the use of ear protectors and individual suitability tests was conducted. Intervention was carried out for those whose personal attenuation rating (PAR) did not pass the baseline standard. Results The median (M) and the 25th and 75th percentiles of baseline PAR were 17.0 (5.0, 22.5) dB. The baseline PAR of the workers who were male, aged 25-<35 years, with a working experience of 5-<15 years, with a college degree or above, wearing ear protectors for 5-<15 years, knowing the right way to wear ear protectors, and workers who wore ear protectors correctly during work was relatively high (all P<0.01). The unqualified rate of baseline PAR of the study subjects was 32.8%. The unqualified rate of baseline PAR of workers in automobile manufacturing enterprises was lower than that of workers in plastic enterprises and textile enterprises (9.2% vs 43.6%, and 9.2% vs 50.0%, both P<0.01). The M of the 108 unqualified worker on baseline PAR was improved after intervention (22.0 vs 1.0 dB, P<0.01). The rates of knowing the right way to wear ear protectors, wearing ear protectors correctly during work, and receiving training on wearing ear protectors correctly for the research subjects were 88.1%, 84.8%, and 86.6%, respectively. Workers in automobile manufacturing enterprises and plastic enterprises had higher rates of knowing the right way to wear ear protectors, wearing ear protectors correctly during work, and receiving training on wearing ear protectors correctly than those in textile enterprises (all P<0.01). Conclusion Gender, age, working experience, education level, duration of wearing ear protectors, knowledge and use of ear protectors correctly are influencing factors of the protective effect of ear protectors for noise-exposed workers.

Objective:To investigate the value of radiomics signatures based on 18F-FDG PET/CT for predicting molecular classification and Ki-67 expression of breast cancer. Methods:A total of 134 female patients ((55.4±13.3) years) who underwent 18F-FDG PET/CT examination and were diagnosed with breast cancer by pathology in the First Affiliated Hospital of Soochow University from April 2016 to May 2023 were retrospectively enrolled. LIFEx software was used to extract radiomics features and the least absolute shrinkage and selection operator (LASSO) algorithm and independent-sample t test were used to screen potentially meaningful features and calculate the radiomics score, which were considered as radiomics models. Clinical characteristics were selected by supervised logistic regression and clinical models were established. Radiomics features and clinical characteristics were incorporated to logistic regression analysis to establish combined models. ROC curves were drawn and the differences among AUCs were analyzed by Delong test. Results:Among 134 patients, 22 were with triple negative breast cancer (TNBC), 47 were human epidermal growth factor receptor 2 (HER2) over-expression type, 37 were Luminal A type and the rest 28 were Luminal B type. The expression of Ki-67 was high in 85 patients, and was low in the rest 49 patients. The AUCs (95% CI) of the combined models for predicting TNBC, HER2 overexpression type, Luminal A type and Ki-67 expression were 0.843(0.770-0.900), 0.808(0.723-0.876), 0.825(0.711-0.908) and 0.836(0.762-0.894), respectively, which were higher than those of clinical models ( z values: 1.97-3.06, all P<0.05). Conclusion:The predictive model combining radiomics signatures based on 18F-FDG PET/CT and clinical characteristics can well predict the molecular classification and Ki-67 expression level of breast cancer.