China ; Humans ; Industry ; Pneumoconiosis

Objective To assess the awareness and knowledge about chronic obstructive pulmonary disease ( COPD ) among community general practitioners and general practice residency trainees in Shanghai.Methods Questionnaire was designed and used to investigate the knowledge of COPD among 59 general practitioners from 10 community health centres and 75 general practice trainees in Shanghai from July to September 2012.Results Of the 134 respondents, 49 were male and 85 were female with average age of (30.4 ±8.0) years.In the self-evaluation of “the knowledge about COPD”, “the diagnosis of COPD”,“the differential diagnosis of COPD and asthma”, “the interpretation of lung function report”, “aerosol using method”, “method about absorption apparatus”, “the side effects of bronchodilator”, “COPD rehabilitation” and “long term oxygen therapy, the rates of knowledge mastery were 61.9% ( 83/134 ) , 81.3%(108/133), 83.6% (112/134), 59.0% (79/134), 83.6% (93/134), 35.8% (48/134), 61.2%( 82/134 ) , 56.7% ( 76/134 ) and 61.2% ( 72/134 ) .Except interpretation of “lung function report”, the sores of all items in self-evaluation of the community general practitioners were higher than those of residency trainees ( all P<0.01 ) .Among the COPD related questions, the hightest accuracy rate was 93.3%(125/134) ( smoking cessation can attenuate the declined lung function) and the lowest accrurcy rate was 16.4% ( 22/134 ) ( the differential diagnosis of COPD and asthma ) .Compared with the general practice residents, community general practitioners got lower scores in question “how differentiate COPD from asthma” (6.8%vs.24.0%,χ2 =7.136, P=0.008) and got higher scores in question“the treatment of moderate COPD” (55.9%vs.30.7%,χ2 =8.655, P=0.003).More than half [56.7%(76/134)] of respondents thought that“it is necessary to develop COPD screening in community”, and 20.1%(27/134) thought that“absolutely necessary”.Conclusion The awareness and knowledge about COPD among the community general practitioners and general practice residency trainees are not satisfectory. The future training should focus on the risk factors, the differential diagnosis and treatment of COPD.

Objective To investigate the clinical efficacy of atlantoaxial pedicle screw fixation plus bony fusion in treatment of traumatic upper cervical instability.Methods From October 2009 to August 2013,29 patients with traumatic upper cervical spine instability were treated with posterior atlantoaxial pedicle screws.The patients underwent autografting (n =19) and allografting (n =10) for spinal fusion.Surrcal outcomes were recorded including intraopcrativc blood loss,operation time,with or without nerve,blood vessel and spinal cord injury,wound healing and bone fusion rate.Results All operations were completed smoothly with operation time of 110 minutes (range,85-135 minutes) and blood loss of 150 ml (range,80-500 ml).At the follow-up of 10 months to 5 years (mean 18 months),bony fusion was detected for all the patients.Postoperative radiographs verified all patients were bony fusion with satisfactory cervical spine stability.No complications of reduction loss,fixation failure,and spinal cord or vertebral artery injury were observed except for 1 patient with low viruleut infection and 2 with delayed wound healing.Conclusion Single posterior atlantoaxial pedicle screw fixation provides security and reliable stability in treatment of upper cervical instability,however wound healing problems should be taken seriously.

Objective To investigate the effect of placing subcutaneous drain tube and preseting triclosan-coated polyglactin 910 suture with delayed suturing to incision infection after typeⅢabdominal surgery. Methords Dividing 504 patients with typeⅢincisions undergone abdominal surgery into 3 groups. The number of group A patients with thoroughly incision washing and primary triclosan-coated polyglactin 910 suture after abdominal surgery was 143. The number of group B with closed anterior rectus sheath, opened skin and subcutaneous fat with preseted triclosan-coated polyglactin 910 suture was 190. The number of group C with subcutaneous drain tube after abdominal surgery was 171. We compared the incidence rates of incision infection and the second phase debridement suture rates among the 3 groups. Results For the group A, B, C, the number of incision infection people was 11, 4, 3 and the incision infection rate was 7.69%, 2.11%and 1.75%respectively. The difference of the 3 groups incision infection rate were statistically significant (P<0.05). The incision infection rate of the group B and group C were lower than that of group A and the difference were statistically significant (P<0.016 7). There were no significant differences in second phase debridement suture rates among the 3 groups. Conclusion Preseting triclosan-coated polyglactin 910 suture with delayed incision sutue and placing subcutaneous drain tube can decrease the incision infection rates for type Ⅲpatients after abdominal surgery, but can not decrease the second phase debridement suture rates of the infectious incision.

Objective To evaluate clinical safety and efficacy of autologous tissue antigens loaded dendritic cells (DC)in the treatment of elderly patients with gastric cancer.Methods Fresh tumor cells were isolated from surgical specimens in twenty patients with gastric cancer. Single cell suspensions were obtained and induced to apoptosis by heat shock. The apoptotic tumor cells were frozen before use.Peripheral blood mononuclear cells were isolated and cultured with recombinant human granulocyte macrophage-colony stimulating factor (GM-CSF) and interleukin-4 (IL-4).DCs were loaded with apoptotic tumor cells. The immunological and clinical responses were examined after the final vaccination. ResultsVaccination of dendritic cells was well tolerated and no toxicity was observed. The cytokine levels in serum such as IL-2(46 pg/mg vs 89 pg/mg), IL-12(44 pg/mg vs. 86 pg/mg) and IFN-γ(38 pg/mg vs.82 pg/mg) were increased after vaccinations as compared with pretherapy. DTH test were positive in five patients (5/10). The antigen special cells for CD8+/ IFN-γ+ were increased in five patients(5/10). The size of retroperitoneal lymph node of one patient was reduced. The tumor marker CEA level were decreased in five patients, stable in eight patient and increased in two patients.Conclusions Autologous DC vaccines loaded with autologous tumor antigens could improve function of non specific immunity and elicit specific T cells immunologic response and is one of safe and effective treatments for gastric cancer.

Objective To study the therapeutic effect on murine allergic asthma with recombinant Bla g 2(rBla g 2) allergen and its possible mechanism.Methods Eighteen BALB/C mice were randomly divided into three groups:normal control group(group A) , asthma model group(group B) , and recombinant protein rBlag2 treatment group(group C).Mice in groups B and C were subcutaneously immunized weekly with rBla g 2(50 mg) formulated in Al(OH)3 adjuvant for three weeks.Group A received only adjuvant emulsified with normal saline.Two weeks after the last inoculation, mice in group C were administered each with rBla g 2(100 mg) /dose, and groups A and B were given PBS.All the mice received eight doses at 2-day intervals.One week after the last immunotherapy, mice in groups B and C were intranasally challenged with 50 mg rBla g 2 daily for seven days, while mice in group A received PBS.Twenty-four hours after the challenge, the following items were examined:airway hyperresponsiveness of mice, total cellular score and cell classification in bronchoalveolar lavage fluid(BALF) , level of rBla g 2-specific IgE and IgG2a in serum, lung inflammation by HE stain, and Bcl-2 expression of eosinophils of lung by immunohistochemistry.Results Compared with group B, group C showed a decreased Penh value of airway hyperresponsiveness(P

ObJective To evaluate the multi-slice spiral CT (MSCT) in the diagnosis of early small renal cell carcinoma (RCC). Methods 32 cases of small RCC proved by pathology were retrospectively analyzed. The relationship of imaging features MSCT with pathology was compared. Results Of the 32 RCC in this study, 19 patients were with low density, 6 medium density, and 5 minimal high density. In 24 patients, the lesion were seen as a mixed enhancement pattern, 8 were with the homogeneous enhancement pattern.In cortical phase, clear cell RCC (25/32) tended to be marked enhancement or mixed enhancement pattern; 2 chromophobe lesions and 2 angsarcomakoid renal cell carcinoma (2/32, 2/32 respectively) tended to enhance moderately, papillary lesions (3/32) were mostly hypovascular and homogeneous enhancement pattern. The detection and characterization as well as accuracy of staging in 32 small RCC on MSCT were 100%, 93.75%, and 84.38%, respectively. Conclusion Muhiphase enhanced MSCT scan was a reliable technique in the dectection and clinical predicting subtype of small RCC.

Objective Finding out the kinds and activities in protease of brain,heart,lung,kidney,eyes,skin and muscle of Andrias davidianus. Methods Using protease returned electrophoresis technique(G-PAGE). Results 1.Activity of proteases in brain was weak at pH 4.5,and showed no activity at pH 7.0 and pH 9.5;2.Proteases of heart and lung had activities at pH 4.5 and pH 7.0;3.Activity of kidney proteases was strong at pH 4.5 and stronger at pH 7.0,and kinds of proteases were more at pH 7.0 than at pH 4.5;4.Proteases in eyes had no activity at pH 4.5 and pH 9.5;5.Activity of proteases in muscle was very strong at pH 7.0 and pH 9.5,and kinds of proteases were more at pH 7.0 than at pH 9.5;6.Activity of skin proteases was similar to that of muscle,but the former was weaker than the later. Conclusions Among the seven kinds of tissues and organs of Andrias davidianus,kinds and activities of kidney and muscle proteases were stronger and more than others;and the eyes showed almost no protease activity.The proteases-activity optimal pH of brain was acidic;The proteases-activity optimal pH of heart,lung and kidney was acid of neutral;and the proteases-activity optimal pH of skin and muscle was neutral.

Objective To study the correlation between time of fever onset in the course of patients'illness and etiologies of fever of unknown origin (FUO).Methods A total of 1 570 patients with FUO admitted from January 2013 to December 2014 were retrospectively analyzed, and clinical data ( sex, age, time of fever onset) of 348 patients meeting FUO diagnosis criteria with definite etiology diagnosis and time of fever onset were collected for multivariate logistic regression analysis after bias check.Results No statistically significant bias was found between 348 selected cases and 1 570 overall cases in gender (χ2 =0.029, P=0.903) and age (t=-1.040, P=0.299), and multivariate logistic regression analysis showed positive correlation between fever onset during 13: 00-18: 00 and infection (P=0.044, B=1.275), 18:00-24: 00 and connective tissue diseases ( P =0.029, B =0.838 ) , and showed negative correlation between age and miscellaneous (P =0.010, B =-0.042).Conclusions Characteristics of fever onset time may have significant value in preliminary diagnosis and guiding the correct direction of final definite diagnosis by means of targeted examinations or diagnostic treatments.It is worth to be further studied and discussed.

Objective To investigate the efficacy and safety of butenafine hydrochloride 1% aerosol in the treatment of tinea pedis,tinea cruris or tinea corporis.Methods A randomized,double-blind,multi-center clinical trial was conducted.Efficacy was assessed in terms of mycological cure,total clinical sign and symptom scores,and clinical response,at baseline,mid-term,end of study,and 2 weeks after treatment.Results One hundred and seventeen patients with tinea cruris or tinea corporis were randomly allocated to individual groups treated with either butenafine 1% aerosol (n = 58,male 53,female 5,age 29.45 ? 11.80,course of disease 3.0 ? 5.0 months) or bifonazole 1% aerosol (n = 59,male 49,female 10,age 34.12 ? 12.98,course of disease 3.0 ? 11.0 months).One hundred and nineteen patients with tinea pedis were also allocated to two groups treated with either butenafine (n = 59,male 59,age 22.97 ? 3.97,course of disease 24.0 ? 36.0 months) or bifonazole (n = 60,male 60,age 23.77 ? 4.12,course of disease 36.0 ? 48.0 months).The cure rates and total response rates were 25.86% vs.40.68%,and 86.21% vs.91.53%,in the study group and the control group,respectively,at the end of study,and 58.62% vs.74.58%,and 96.55% vs.96.61% in 2 weeks following-up,for the patients with tinea cruris or tinea corporis.Also,the cure rates and total response rates were 23.73% vs.25.00%,81.36% vs.78.33%,in the study group and the control group,respectively,at the end of study,and 37.29% vs.41.57% and 81.36% vs.90.00% in 2 weeks following-up,for the patients with tinea pedis.Local adverse reactions were recorded in 13 of butenafine group,and 20 of bifonazole group.The differences of above data between two groups were not statistically significant.Conclusion Butenafine hydrochloride 1% aerosol is effective and well tolerated for the treatment of tinea pedis,tinea cruris or tinea corporis.