Objective: To observe the application value of right heart contrast echocardiography in the cannulation of veno-venous extracorporeal membrane oxygenation (V-V ECMO). Methods: A total of 18 patients with acute respiratory failure caused by severe pneumonia who underwent V-V ECMO treatment were enrolled. The patients were intubated through right femoral vein and right internal jugular vein cannulation, and then were divided into contrast group (n=8) and control group (n=10) according to whether underwent right heart contrast echocardiography during intubation or not. Central venous pressure (CVP) and cardiac output (CO) of all patients were measured and recorded. After the operation of ECMO, patients in contrast group received cardiovascular routine ultrasound examination and right heart contrast echocardiography simultaneously to observe and adjust the position of the cannula tip in the inferior vena cava (IVC), while patients in control group received only cardiovascular routine ultrasound to observe the direction of blood flow at the valve of IVC and the position of cannula tip in IVC. The distance between cannula tip and diaphragm (DCTD) and the left femoral artery partial pressure were measured and recorded. The differences of DCTD, left femoral artery oxygen partial pressure, CVP and CO of 2 groups were compared between 2 groups. Results: DCTD (5.14[4.68,5.81]mm) and left femoral artery oxygen partial pressure in contrast group(90.05[85.06, 95.33]mmHg) were both higher than those in control group (3.31[2.96,3.69]mm, 78.61[71.82,81.04]mmHg, Z=-1.93, -2.20, both P<0.05). No significant difference of CVP nor CO was found between 2 groups (Z=-1.79, -1.80, both P>0.05). Conclusion: Right heart contrast echocardiography can help to optimize the position of cannula tip in IVC during intubation of V-V ECMO and improve clinical therapeutic effect by reducing recirculation.

Objective To analyze the effects of food allergies on asthma in children over 6 years old in Zhongshan. Methods A case-control study was designed. 279 children over 6 years old with asthma diagnosed in Boai Hospital of Zhongshan were enrolled as the case group, and 980 children without asthma from primary school were enrolled as the control group. The food allergy exposure, other related risk factors, and food allergy characteristics of the two groups were retrospectively analyzed. Logistic regression was used to analyze the OR values ​​of each factor. Results The asthma children's food allergy, family asthma history, family medicine and food allergy history, artificial feeding, adding beef and mutton or seafood before the age of one year, and frequent consumption of puffed foods such as shrimp chips were significantly higher than those of non-asthmatic children. Using multivariate logistic regression analysis, food allergy (OR=3.143, P<0.001), artificial feeding (OR=3.045, P<0.001), family history of asthma (OR=2.250, P<0.001) remained significantly in the multivariate model. For food allergies, children with asthma had more types of food allergies than children without asthma (P<0.001), and had a higher proportion of allergies to milk and eggs (P<0.001). There were higher proportion of introduction of beef and mutton and seafood before 1 year old (P<0.001), and higher proportion of frequently consuming puffed foods (P<0.001) in children with asthma than children without asthma, while the rate of desensitization treatment was lower (P<0.001). Conclusion Food allergy may be an independent risk factor for asthma. Children with asthma had a variety of allergies associated with food allergies. Desensitization treatment for food allergies may reduce the risk of asthma.

Objective To analyze the genetic characteristics of Legionella pneumophila isolated from cooling water of central air conditioning system in public places in Zhongshan from 2012 to 2018, and to understand the spatiotemporal distribution of homologous strains, in order to provide evidence for the prevention, control and traceability of Legionella pneumophila infection. Methods Eighty-five Legionella pneumophila strains were isolated for serotype identification, and the molecular typing of the 85 isolates was performed using pulsed field gel electrophoresis (PFGE). The strain location data was converted into latitude and longitude coordinates by GIS geocoding technology. The converted location data was overlaid on the map of Zhongshan City, mapping the molecular typing distribution of clusters using Qgis2.18.11 spatial processing software. Results Eighty-five strains of Legionella pneumophila included 9 serotypes, and the highest proportion was LP1, accounting for 61.18% (52/85). According to the similarity of 100%, 85 strains of Legionella pneumophila were divided into 56 patterns of PFGE bands (T1-T56), with 3 types being dominant. Same serotype of Legionella pneumophila strains showed diverse PFGE patterns. Different serotypes of Legionella pneumophila strains were basically identified as different PFGE patterns, while some were identified as same PFGE pattern. According to over 85% similarity, 8 clusters (A-H) were designated, strains of which were distributed in 12 districts. PFGE clustering clusters did not display obvious temporal and regional distribution differences, nor did they have temporal and regional clustering distributions. Conclusion Strains of Legionella pneumophila isolated from cooling water of central air conditioning system in public places in Zhongshan from 2012 to 2018 showed genetic diversity, and the main serotype was LP1. Isolates of clusters did not exist in different years or regions.

OBJECTIVETo evaluate the expression of the type I growth factor receptor family [epidermal growth factor receptor (EGFR), ErbB2 and ErbB3] by the epithelial cells in pterygium.

METHODSImmunoflourescent staining and Western blotting were performed to detect the expression pattern and quantity of EGFR, ErbB2 and ErbB3 proteins in the epithelia of 15 patients with primary pterygium and 12 subjects with normal conjunctiva.

RESULTSIn immunofluorescent staining, the EGFR protein was present in the basal cells while the ErbB2 and ErbB3 were expressed by the superficial cells in normal conjunctival epithelium. Of the pterygium cases 15, 11 were stained by EGFR, ErbB2 and ErbB3 in the full thickness of the epithelium and showed stronger staining compared with the control group. Four of them showed a similar staining pattern to the normal conjunctiva group. The density of protein bands detected by Western blotting for all three growth factor receptors was consistent with the immunofluorescent staining. Compared with normal conjunctiva, stronger protein bands of these three receptors were found in all of the pterygium specimens, in which EGFR, ErbB2 and ErbB3 were expressed in the full thickness, as shown by immunofluorescent staining.

CONCLUSIONSThe increased expression of EGFR, ErbB2 and ErbB3 proteins was present in pterygium, which indicated that pterygium is a disorder with abnormal proliferation. The abnormal expression of EGFR, ErbB2 and ErbB3 by the epithelium and the communication with cytokines in the stroma in pterygium may be a key pathogenic factor in this disorder.

Adult ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pterygium ; metabolism ; Receptor, Epidermal Growth Factor ; metabolism ; Receptor, ErbB-2 ; metabolism ; Receptor, ErbB-3 ; metabolism

【Objective】To investigate the expression of FosB in invasive breast cancer and its correlation to the ultrasound findings and clinical significance.【Methods】Immunohistochemical and ultrasound examination were performed for 155 cases with invasive breast cancer，36 cases with paracancerous tissue and 30 cases with normal breast tissue. To investigate the correlations between the different expression of FosB with histological grade ，lymph nodes，and ultrasound findings.【Results】①The expression of FosB in paracancerous tissue and normal breast tissue was higher than that in invasive breast cancer（P＜0.01）. ②Based on immunohistochemical staining，high positive expression rate of FosB was associated with low histological grade，ER positive and PR positive（P＜0.05）. There was no correlation between FosB and age，tumor diameter，lymph nodes，Her2 and clinical stages（P＞0.05）③The expression of FosB was higher in microcalcification positive and lymph nodes bigger tissues（P＜0.05）. There was no correlation between FosB and tumor size， regular shape，boundary，posterior attenuation ratio and blood flow（P＞0.05）.【Conclusion】The expression of FosB in invasive breast cancer was lower than that in paracancerous tissue and normal breast tissue. The different expression of FosB was correlated with histological grade，ER positive and PR positive. To study the expression of FosB in invasive breast cancer may be helpful for differential diagnosis and targeted treatment. The different expression of FosB was correlated with microcalcification，lymph nodes，and combined FosB with ultrasound findings may contribute to prognostic evaluation of breast cancer.

Objective To investigate the potential effect of bifidobacterial supplement on intestinal mucosal microstructural damage and reparation in rats after sever burns.Methods Fifty wistar rats were randomly divided into burn control group(group B,n=20),burn plus treatment group(group A,n=20),and control group(group C,n=10).The ileum mucosal injuries were observed under microscope.Results There were fewer ileum mucosal injuries and more reparation in group A compared with those of group B after thermal injury.Conclusion The supplement of exogenous bifidobacterium can reduce the ileum mucosal microstructural injuries and facilitate the improvement of mucosal barrier function.

OBJECTIVE: To investigate the prevalence of occupational musculoskeletal disorders(OMD) in workers of manufacturing industry,and to analyze its influencing factors.METHODS: A total of 1 168 first-line workers from 3manufacturing enterprises were selected as study subjects using convenient sampling.The self-designed questionnaire was used to investigate the basic information and the ergonomics of work process.The Nordic Musculoskeletal Questionnaire was used to investigate the prevalence of OMD.The workers were divided into non-OMD group and OMD group.RESULTS: The prevalence of OMD in these 1 168 workers was 34.9%.Comparing with the non-OMD group,the score of using auxiliary tools to carry the weights in the OMD group was higher(P<0.01),and the scores of straight waist and bent knees when transporting heavy object was lower(P<0.01).Logistic regression analysis showed that male workers had a higher risk of OMD than female workers(P<0.05).The longer the length of service,the greater the risk of OMD(P<0.01).Shift workers had the higher risk of OMD than non-shift workers(P<0.01).The higher scores of using auxiliary tools to carry the weights and straight waist and bent knees when transporting heavy object(it mean that less use of the above labor behavior and posture),the greater the risk of OMD(P<0.05).CONCLUSION: Sex,length of service,shift,labor behavior and posture are the influencing factors of OMD.

OBJECTIVETo explore the features and treatment strategy of delayed infection of proximal junctional zone after posterior spinal internal fixation.

METHODSThe clinical data of 1325 patients underwent posterior spinal internal fixation were retrospectively analyzed. Delayed infection occurred in 10 patients, among which 4 infections occurred at the proximal junction (non-operative site). And these 4 patients were treated with combined broad-spectrum antibiotics. Their clinical symptoms and signs, lab tests, MRI findings, pathology findings, and clinical effects were analyzed.

RESULTSAll four patients were followed up from 6 months to 4 years. No infection recurrence was found. All patients obtained satisfactory results after hospital discharge. No nerve injury was found. One patient developed kyphosis in the proximal junctional zone 2 years after the operation. According to the criteria of N.Nakano and T.Nakano, 3 cases obtained excellent results, while 1 poor.

CONCLUSIONSThe incidence rate of delayed infections was rare after spinal operation. Delayed infections occurred in proximal junctional zone may be attributed to the stress concentration of adjacent segments after fixation and the degeneration of adjacent segments, thus forming inflammation areas. For refractory lumbar and back pains, an elevated blood sedimentation rate, C-reactive protein level, MRI manifestation and focal pathology would be helpful for establishing a definite diagnosis. Full course of combined broad-spectrum antibiotics in treating the infection can lead to satisfactory clinical results.

Back Pain ; Fracture Fixation, Internal ; Humans ; Kyphosis ; Lumbar Vertebrae ; Lumbosacral Region ; Retrospective Studies ; Spinal Fusion ; Surgical Wound Infection ; drug therapy ; epidemiology ; Treatment Outcome

OBJECTIVE: To examine the hearing status of pre-job workers exposed to noise in metal manufacturing industries,and to analyze the related influencing factors. METHODS: A judgement sampling method was adopted to choose1 597 pre-job workers exposed to noise in metal manufacturing industries as the study subjects. The data of workers' occupational health examination was collected,and the influencing factors of hearing loss were analyzed. RESULTS: Among the 1 597 individuals,631( 39. 5%) cases reported occupational noise exposure history( noise exposure group) with the length of service of 0. 20( 0. 10-0. 30) years; 966( 60. 5%) cases denied occupational noise exposure history( no-noise exposure group). The hearing loss detection rate was 46. 1%( 737 /1 597); among them,the occupational contraindication detection rate was 13. 9%( 222 /1 597),and the detection rate of other kinds of hearing loss was 32. 2%( 515 /1 597).The detection rates in workers with occupational contraindication and the other kinds of hearing loss in noise exposure group were higher than those in the non-noise exposure group( 16. 5% vs 12. 2%,50. 6% vs 43. 3%,P < 0. 05). The male workers had higher incidence than female workers [the odds ratio( OR) were 1. 958 and 2. 331,respectively,P < 0. 01);the workers with age > 25 years had higher incidence than those with age ≤ 25 years( OR were 2. 390 and 2. 245,respectively,P < 0. 01); the noise exposure workers had higher incidence than non-noise exposure ones( OR were 1. 536 and 1. 287,respectively,P < 0. 05). CONCLUSION: Pre-job occupational health examination is helpful for early detection of occupational contraindication in noise exposure workers. Attention should be paid to the male workers,the older workers,and those with occupational noise exposure history when conducting occupational health examination.

【Objective】ToinvestigatetheexpressionandclinicalsignificanceofJunDinmolecularsubtypesofinva⁃ sivebreastcarcinoma，benignandmalignantbreastlesions.【Methods】Immunohistochemicalexaminationwasperformed for160patientswithinvasivebreastcarcinoma，191patientswithbreastintraductalproliferativelesionsand20patients withnormalbreasttissue.【Results】①ComparisonwithothersubtypesshowedthattheexpressionofJunDwassignificantly increasedinTBNCsubtype（P＜0.05）anddifferencesbetweenothersubtypeswerenotstatisticallysignificant（P＞0.05） . ②TheexpressionofJunDininvasivebreastcarcinomawaslowerthanthatinbreastintraductalproliferativelesionsand normalbreasttissuse（P <0.01） .③Basedonimmunohistochemicalstaining，highpositiveexpressionrateofJunDwas associatedwithlowhistologicalgrade（P <0.01）.ThereisnocorrelationbetweenJunDandtumordiameter，age，lymph nodes，ER，PRandhistologicalgrade（P >0.05） .【Conclusions】TheexpressionofJunDwassignificantlyincreasedin TBNCsubtype.TostudytheexpressionofJunDinTBNCsubtypeofinvasivebreastcarcinomamayprovideanevaluation intargetedtreatment.ThedifferentexpressionofJunDinbenignandmalignantbreastlesionsmaybehelpfulfortheir differentialdiagnosis.