Objective:To analyze the incidence characteristics of occupational chronic benzene poisoning under two diagnostic criteria.Methods:In March 2020, 126 patients who were divided into the old criteria group (74 cases) and the new criteria group (52 cases) were retrospectively analyzed. These patients were diagnosed with occupational chronic benzene poisoning, and were diagnosed in our hospital during the period of January 2009 to December 2019. The gender composition, age of onset, years of benzene exposure, industry distribution, work type, benzene concentration in working environment and diagnostic grade of the two groups of patients were analyzed and compared. The follow-up of 22 benzene poisoning observation subjects under the old criteria were retrospectively analyzed.Results:There were no statistically significant differences in gender composition, age of onset, years of benzene exposure, industry distribution and work type between the old criteria group and the new criteria group ( P>0.05) . In the old criteria group and the new criteria group, 41.9% (31/74) and 17.3% (9/52) of the patients' workplace benzene concentration exceeded the maximum allowable concentration, respectively. The composition of different benzene concentration in the workplace between the two groups showed statistically significant ( P<0.05) . In the old criteria group, the proportion of mild poisoning (79.7%, 59/74) was the majority, while in the new criteria group, the proportion of moderate and severe poisoning (51.9%, 27/52) were the majority, and there was statistically significance in the composition ratio of diagnostic grade between the two groups ( P<0.05) . Under the old criteria, after folow-up of 22 cases of benzene poisoning observation subjects, we observed that 8 cases (36.4%) progressed to the level of chronic benzene poisoning. Conclusion:The revision of diagnostic criteria for benzene poisoning may affect the composition of diagnosis classification. Based on the rights and interests of workers, formulating more complete diagnostic criteria and system policies will be more conducive to the development of occupational benzene poisoning prevention and control.

Objective:To investigate perioperative management of anesthesia for septic shock.Methods:Anesthesia performed on an elderly patient with septic shock who underwent emergency surgery in Beijing Hospital was analyzed and summarized, with a literature review.Results:Etomidate, Ketamine, cis Atracurium and Remifentanil are preferred for anesthesia induction, and Remifentanil and Sevoflurane are the first choices for anesthesia maintenance.Combined application with Dexmedetomidine may improve patients' prognosis.For septic shock patients with new-onset atrial fibrillation, β-blockers are preferred for perioperative anti-arrhythmia.If necessary, propafenone or amiodarone can be used for cardioversion.Perioperative ultrasound evaluation may be used to guide perioperative fluid therapy and vasoactive drug administration for septic shock in the future.Conclusions:Anesthesiologists should place a high value on and have a good command of the main aspects of perioperative management of anesthesia for septic shock.

Objective:To analyze the incidence characteristics of occupational chronic benzene poisoning under two diagnostic criteria.Methods:In March 2020, 126 patients who were divided into the old criteria group (74 cases) and the new criteria group (52 cases) were retrospectively analyzed. These patients were diagnosed with occupational chronic benzene poisoning, and were diagnosed in our hospital during the period of January 2009 to December 2019. The gender composition, age of onset, years of benzene exposure, industry distribution, work type, benzene concentration in working environment and diagnostic grade of the two groups of patients were analyzed and compared. The follow-up of 22 benzene poisoning observation subjects under the old criteria were retrospectively analyzed.Results:There were no statistically significant differences in gender composition, age of onset, years of benzene exposure, industry distribution and work type between the old criteria group and the new criteria group ( P>0.05) . In the old criteria group and the new criteria group, 41.9% (31/74) and 17.3% (9/52) of the patients' workplace benzene concentration exceeded the maximum allowable concentration, respectively. The composition of different benzene concentration in the workplace between the two groups showed statistically significant ( P<0.05) . In the old criteria group, the proportion of mild poisoning (79.7%, 59/74) was the majority, while in the new criteria group, the proportion of moderate and severe poisoning (51.9%, 27/52) were the majority, and there was statistically significance in the composition ratio of diagnostic grade between the two groups ( P<0.05) . Under the old criteria, after folow-up of 22 cases of benzene poisoning observation subjects, we observed that 8 cases (36.4%) progressed to the level of chronic benzene poisoning. Conclusion:The revision of diagnostic criteria for benzene poisoning may affect the composition of diagnosis classification. Based on the rights and interests of workers, formulating more complete diagnostic criteria and system policies will be more conducive to the development of occupational benzene poisoning prevention and control.

With the development of science and technology and the improvement of living standards, people's understanding of "health" has also changed. The patients with chronic diseases and the people who do not have obvious symptoms of disease all hope to further improve the quality of life as well as the sense of happiness, gain and security. Disabled people and the elderly people with degraded physical functions are in need of corresponding rehabilitation devices. These needs determine that the research scope of biomedical engineering should be expanded, so as to use modern scientific technology and medical methods to study related issues and improve the health of the people. As a result, the concept of "healthcare medical engineering" emerged. In this paper, the definition of healthcare medical engineering were proposed, its significance, characteristics, content, and outlook for the future were introduced. This paper is expected to broaden the horizons and inspire ideas of researchers engaged in biomedical engineering research for future research in finding solutions to many problems in the field of medical and health care, thereby improving the quality of medical services and management, and promoting the development of the national health industry.

Objective:To explore the effect of prenatal and postnatal seamless personalized nursing intervention mode on breastfeeding of pregnant women and newborns.Methods:A total of 300 healthy mothers who were examined and delivered at Jinshan Branch of Shanghai Sixth People's Hospital from April 2018 to September 2018 were selected and randomly divided into observation group and control group. The control group was given routine care, and the observation group was given perinatal seamless nursing interventions. Clinical evaluations were performed on both maternal (how much lactation, maternal breastfeeding knowledge, swelling and cleft palate, and exclusive breastfeeding within 6 months after delivery) and neonatal aspects (abnormal temperature, crying before bedtime, and jaundice).Results:In the observation group, 63.33% (95/150) of maternal in the observation group were sufficient lactation which was significantly more than 51.33% (77/150) in the control group; the rate of knowledge of breastfeeding in the observation group was 64.00% (96/150), which was significantly higher than 54.67% (82/150) in the control group; the incidence of mammary tenderness and cleft palate in the observation group was 11.33% (17/150), which was significantly lower than 28.67% (43/150) in the control group; in the observation group within 6 months after delivery, the monthly exclusive breastfeeding rate was higher than in the control group; 44 cases of neonatal jaundice in the observation group were significantly less than the control group with 61 cases, the difference was statistically significant ( χ2 values were 4.23-15.01, P<0.05). Conclusion:By implementing this seamless individualized nursing intervention for healthy adult mothers, it is possible to increase maternal milk production and allow mothers to acquire knowledge about breastfeeding, while reducing the occurrence of breast tenderness and cleft palate, which has a positive effect on improving exclusive breastfeeding Promoting effect can also reduce the incidence of jaundice for newborns.

Objective: To explore the relationship between coronary tortuosity and coronary microvascular disease (CMVD). Methods: Patients with typical angina symptoms and without serious coronary artery stenosis by coronary angiography were enrolled from June 2014 to December 2016, and CMVD was diagnosed by single photon emission tomography (SPECT). According to the SPECT results, patients were divided to the CMVD group and non-CMVD group. The baseline clinical characteristics, results of coronary angiography were compared between the two groups. The logistic analysis was used to analyze the relationship between coronary tortuosity and CMVD. Result: A total of 117 cases were enrolled, with 69 cases in the CMVD group and 48 cases in the non-CMVD group. No differences were found in gender distribution, age, hypertension, lipid abnormality, hyperuricemia and uses of statins between the two groups (all P>0.05). Incidence of diabetes (78.26%(54/69) vs. 35.42% (17/48) , P<0.05), hs-CRP ((4.29±2.15)mmol/L vs. (2.63±1.20)mmol/L, P<0.001), LDL-C ((2.98±0.96)mmol/L vs. (2.52±0.83)mmol/L, P=0.008) and homocysteine ((13.7±5.61)mmol/L vs. (11.5±4.38)mmol/L, P=0.025) levels were higher in the CMVD group than in the non-CMVD group. The data derived from echocardiographic examination were similar between the two groups. The Corrected TIMI frame counts were higher in the CMVD group than in non-CMVD group (LAD: 31.56±4.92 vs. 27.31±3.75, LCX: 29.47±4.18 vs. 26.62±3.19, RCA: 29.09±5.05 vs. 26.24±3.28, all P<0.001). The incidences of coronary atherosclerosis (76.81% (53/69) vs. 27.08% (13/48) , P<0.001) and coronary tortuosity ( (60.87% (42/69) vs. 33.33% (16/48) , P=0.035) were also higher in the CMVD group than in non-CMVD group. Logistic analysis found that coronary tortuosity (OR=6.111, 95%CI 2.707-13.794, P<0.001), diabetes (OR=6.565, 95%CI 2.883-14.948, P<0.001) and coronary atherosclerosis (OR=8.918, 95%CI 3.822-20.808, P<0.001) were independent risk factors of CMVD. Conclusion Coronary tortuosity, diabetes and coronary atherosclerosis are related to CMVD in this patient cohort.

Objective: To explore the impact of ticagrelor on myocardial microcirculation in patients of non-ST elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI). Methods: A total of 80 NSTEMI patients treated in our hospital from 2015-03 to 2015-12 were enrolled. All patients received coronary angiography (CAG) and PCI, they were randomly divided into 2 groups: ticagrelor (TA) group and clopidogrel (CA) group, n=40 in each group. The baseline condition, PCI related parameters, plasma levels of SOD, MDA at pre- and 24h, 72h post-PCI were compared, the incidence of major adverse cardiac events (MACE) within 30 days after PCI was also compared between 2 groups. Results: The baseline condition, proportion of infarction-related vessels, average length and diameter of implanted stents were similar between 2 groups, all P>0.05. Compared with CA group, TA group had the less post-operative CTFC in LAD and RCA, P<0.05; while CTFC in LCX was similar between 2 groups, P>0.05. The ratios of acute pre-operative, post-operative TIMI grade 3 and slow flow incidence were similar between 2 groups, P>0.05. The peak values of CK-MB and cTnI in TA group were lower than CA group, P<0.05. Compared with baseline condition, MDA levels at 24h and 72h post-operation were increased in both groups, all P<0.001; compared with CA group, TA group had the lower MDA level at 24h post-operation, P=0.023, MAD was further reduced at 72h post-operation in TA group, P=0.043. Compared with baseline condition, SOD levels at 24h and 72h post-operation were decreased in both groups, all P<0.001; compared with CA group, TA group had the higher SOD level at 24h post-operation, P=0.013, SOD was elevated at 72h post-operation in both groups, the elevation was more obvious in TA group, P=0.049. The incidence of MACE was similar between 2 groups within 30 days of PCI,. Conclusion: Ticagrelor could improve myocardial microcirculation in NSTEMI patients after PCI; it was safe and without obvious adverse effects.

Objective To study the effect and its possible mechanism of p66shc on endothelial dysfunction induced by hydrogen peroxide(H2O2).Methods Human umbilical vein endothelial cells (HUVEC) were used and cultured.H UVEC cells were untreated(control group)or treated with four groups of H2O2,H2O2 plus protein kinase C (PKC) inhibitors,H2O2 plus PKC activator,H2O2 plus P38 inhibitor for 30 minutes respectively,and cells were collected after 24 hours.The apoptosis,viability,proliferation of HUVEC were detected with immune fluorescent staining,MTT and Ki-67 respectively.P66shc and ser36 p66shc (p-p66shc)protein expressions were assessed using Western blotting.P66shc mRNA expression was measured with real-time quantitative polymerase chain reaction (RT-PCR).Results H2O2 induced HUVEC dysfunction which decreased HUVEC proliferation and increased the apoptosis of HUVEC.The expressions of p66shc,p-p66shc protein and p66shc mRNA were significantly increased after treating with H2O2.PKC inhibitor inhibited a H2O2 induced HUVEC dysfunction through increasing HUVEC proliferation activity and reducing cell apoptosis.The expressions of p66shc,p-p66shc protein and p66shc mRNA were significantly decreased after treating with H2O2 plus PKC inhibitor.PKC activator enhanced H2O2-induced HUVEC dysfunction and increased the expressions of p66shc.P38 inhibitor had no obvious effect on H2O2-induced HUVEC dysfunction and the expressions of p66shc.Conclusions p66shc may play an important regulatory rote in endothelial dysfunction caused by H2O2.P66shc may regulate a H2O2-induced endothelial dysfunction through PKC signal pathway.

OBJECTIVETo evaluate the clinical value of serum 1,3-beta-D-glucan (BG) and galactomannan (GM) detection for early diagnosis of invasive aspergillosis (IA) in patients after renal transplantation.

METHODSBlood samples collected from 69 renal transplant recipients were divided into diagnosis group, clinical diagnosis group, suspected diagnosis group, and non-infected group for detection of serum BG and GM.

RESULTSThe mean serum levels of BG in the diagnosis group, clinical diagnosis group, and suspected diagnosis group were significantly higher than that in non-infected group (P<0.05). The sensitivity, specificity, and positive and negative predictive values of BG was 69.49%, 70%, 93.18% and 35.71% for IA diagnosis, respectively. The serum levels of GM in the 3 diagnosis groups were also significantly higher than that in the non-infected group (P<0.05) with the sensitivity, specificity, and positive and negative predictive values of 84.75%, 90%, 96.15% and 52.63% for IA diagnosis, respectively.

CONCLUSIONIncreased serum BG and GM levels can serve as the evidence for early diagnosis of IA with a high diagnostic sensitivity and specificity in renal transplant recipients.

Aspergillosis ; diagnosis ; Early Diagnosis ; Humans ; Kidney Transplantation ; Mannans ; blood ; Sensitivity and Specificity ; beta-Glucans ; blood

Objective To investigate the effect and underlying mechanisms of ghrelin in a rat model of renal fibrosis. Methods Male Sprague-Dawley rats were divided into 4 groups , including sham operation +saline or brain gut peptide treatment group , model + saline or brain gut peptide treatment group. Unilateral ureteral obstruction (UUO) was established by left ureteral ligation. 7 days and 14 days after operation, the rats were sacrificed , while the kidney tissue of obstruction side was harvested for pathlogical changes through Masson coloration. Expression of α-smooth muscle actin (α-SMA), transforming growth factor beta1 (TGF-β1) and phosphorylated Smad3 (p-Smad3) in renal tissues were analyzed through immunohistochemistry. Expression of α-SMA and TGF-β1 mRNA was detected by real-time-PCR. Apoptosis kidneys cells were marked with TUNEL. Results Ghrelin inhibited renal fibrosis by reducing the production of collagen , restraining extracellular matrix (ECM) deposition and decreasing the expression of α-SMA. Meanwhile, ghrelin inhibited the accumulation of myofibroblasts by blocking the transforming growth factor-β1/Smad3 (TGF-β1/Smad3) signaling pathway. Moreover, ghrelin could attenuate renal tubular cell apoptosis induced by UUO injury. Conclusion Ghrelin can reduce renal fibrosis and renal cell apoptosis induced by UUO , demonstrating that ghrelin is a potent antifibrotic agent that may have therapeutic potential for patients with obstructive nephropathy.