Dust ; Female ; Humans ; Male ; Occupational Exposure ; adverse effects ; Pneumoconiosis ; diagnostic imaging ; etiology ; Poaceae ; Radiography, Thoracic ; Silicates ; adverse effects

Integrative Medicine ; Professional Competence

Objective To evaluate the value of captopril challenge test (CCT) in the diagnosis of primary aldosteronism (PA).Methods A total of 674 patients [(45.0±13.7) years, men 341, women 333] admitted to Peking Union Medical College Hospital from 2000 to 2015 were analyzed.Among them, 222 subjects were with essential hypertension (EH), 28 were with pheochromocytoma (PHEO), 246 were with idiopathic hyperaldosteronism (IHA) and 178 were with aldosterone producing adenoma (APA).All patients received CCT.24 h urine sodium was measured in partial patients.Plasma renin activity (PRA), aldosterone (ALD) were detected.Results Compared with EH [PRA: before 0.5(0.2,0.9) μg·L-1·h-1, after 0.8(0.4,1.5) μg·L-1·h-1;ALD: before (393±122) pmol/L, after (360±97) pmol/L] and PHEO [PRA: before 0.3(0.1,0.9) μg·L-1·h-1, after 0.4(0.1,1.6) μg·L-1·h-1;ALD: before (396±108) pmol/L, after (374±114) pmol/L], lower levels of PRA and higher levels of ALD before and after CCT were observed in PA patients [PRA: before 0.1 (0.1,0.2) μg·L-1·h-1, after 0.1 (0.1,0.2) μg·L-1·h-1;ALD: before (468±216) pmol/L;after (457±199) pmol/L].After CCT, the suppression rate of ALD [2.8% (-8.8%,15.4%) vs 6.6% (-4.3%, 17.6%)] and increasing rate of PRA [0(0,50%) vs 50%(0, 200%)] in PA patients were lower than those in EH patients.The ALD/PRA ratio (ARR) were higher in PA than that in EH or PHEO patients.In the EH subjects, ALD levels of seated posture were higher than those of recumbent posture both before and after receiving captopril, but with no changes in ARR after CCT.No significant differences in ALD and ARR (before and after receiving captopril) were observed between seated and recumbent position in the PA group.The ARR after CCT tended to decrease in EH subjects with elevated urine-sodium compared with those with normal urine-sodium.No changes could be viewed in ALD and PRA levels between normal urine-sodium and elevated urine-sodium groups among APA, IHA and EH patients either before or after CCT.Among patients with APA, the ALD levels before CCT and the ARR after CCT were lower in the patients with AngiotensionⅡ(AngⅡ) reactive than those without.A ROC curve analysis suggested that the optimal cutoff value was 46.2 (ALD unit:ng/dl;PRA unit:μg·L-1·h-1) for ARR after challenge in diagnosing PA, with the sensitivity of 88.7% and specificity of 84.8%.Conclusions ARR after 25 mg captopril had high sensitivity and specificity in diagnosis of PA with the cutoff of 46.2.Seated CCT could replace recumbent CCT as a more confirmatory test.The PRA increasing rate should be taken into consideration when diagnosis of PA.

Objective To explore the histopathological features of chronic hepatitis B virus ( HBV) carriers and chronic hepatitis B( CHB) patients with mildly elevated serum alanine aminotransferase ( ALT) . Methods 105 patients were divided into three groups according to serum ALT levels; Croup A [ALT level ≤0. 5 × upper limits of normal ( ULN)] , Group B (0. 5 × ULN ＜ ALT level≤ 1 × ULN) and Group C( 1 × ULN ＜ ALT level ＜ 2 × ULN ). Grade of liver inflammation and stage of liver fibrosis in the three groups were compared. The changes in clinical parameters were then observed in patients who had liver histopathological changes. Results Among 40. 95% of the patients, hepatitis degree went to G2 or even worse; and among 30.43% of the patients whose ALT level were normal, the hepatitis degree reached G2 or even worse. In 26. 67% of the patients, degree of fibrosis went to S2 or even worse, and for the 17. 39% patients whose ALT level were normal, degree of fibrosis went to S2 or even worse. The aggravation of liver inflammation and fibrosis was correlated with ALT and hyaluronic acid increasing ( all P ＜ 0. 05 ) . Conclusions Frequent monitoring of serum ALT and hyaluronic acid may help to understand histopathological changes in the liver. Liver biopsy applied to CHB should be regarded as a main basis if antiviral therapy should be conducted.

Objective To investigate the relationship between serum HBV DNA loads and liver histology damage in the patients with HBeAg-negative chronic hepatitis B.Methods The retrospective study was performed.The 514 patients were divided into two groups according to the HBeAg status and the HBeAg positive group was as control.The relationship among HBV DNA loads,live histological inflammation grades and fibrosis stages was analyzed.Results The HBV DNA loads in HBeAg-negative group and HBeAg-positive group were(5.38±1.27)log10 copies/ml and(6.80±1.18)log10 copies/ml respectively(P<0.001).The inflammation grades and fibrosis stages of liver tissues in HBeAg-negative group were all significantly higher than those in HBeAg-positive group(P<0.001).In HBeAg-negative group,HBV DNA loads displayed a positive correlation with the inflammation grades and fibrosis stages of liver tissues(P<0.001).Conclusion In the patients with HBeAg-negative chronic hepatitis B,HBV viral loads are lower than those with HBeAg-positive chronic hepatitis B,and HBV viral loads display a positive correlation with liver the inflammation grades and fibrosis stages of liver tissues.

Objective To investigate the efficacy of PEG-interferon α (PEG-IFN α) treatment of HBeAg-positive chronic hepatitis B and HBV genotypes and liver tissues effect of HBeAg seroconversion.Methods 54 cases confirmed by liver biopsy,genotype clear HBeAg positive chronic hepatitis B (CHB) patients according to body weight,respectively,subcutaneous injection of PEG-IFN-α2a 135 μg or 180 μg,or PEG-IFN-α2b 50 μg,80 μg or 100 μg once weekly treatment for 48 weeks and followed for 24 weeks after discontinuation.Statistics of HBeAg seroconvertion,HBV genotypes and liver histology e antigen seroconversion after the end of treatment.Results 54 patients were followed up at the end of HBeAg seroconversion rate was 29.63％ (16/54).Genotype B patients with HBeAg seroconversion rate was 35.29％,27.03％ higher than the C-type patients,but the difference was not statistically significant (x2 =0.382,P =0.537).Inflammation of the liver activity highter(＞ G2),the degree of fibrosis heavier(＞ S1)HBeAg seroconversion rate (50.00％ vs.25.00％,40.90％ vs.21.88％),but were not statistically significant(x2 =1.391、1.444,P =0.238、0.229).Activity of HBV genotype,liver inflammation,liver fibrosis and other factors by multivariate Logistic regression analysis,only liver inflammation activity of the important factors of HBeAg seroconversion.Conclusion Important factors,liver inflammation activity of PEG-interferon αt treatment of HBeAg-position chronic hepatitis B patients and HBV genotypes and liver fibrosis may be of little significance.

Objective In order to provide a scientific basis for influenza prevention and control,analyzing the epidemic characteristics and laws of influenza outbreaks in Xuzhou area during 2005-2011.Method Using fluorescent-PCR method to detect influenza virus nucleic acid on Nasopharyngeal swab specimens collected from influenza outbreak cases during 2005-2011 and fast classifying influenza virus A1 (H1N1),A3 (H3N2),new H1N1 BV (Victoria) and BY (Yamagate) on subtypes.At the same time,isolating the influenza virus with MDCK cells,and sending them to the National Influenza Center for review,after the preliminary identification of the isolated influenza virus.Results During 2005-2011,there are 53 influenza outbreaks in Xuzhou area,which caused by influenza virus subtype BV accounting for 26.42％ (14/53),A3 accounting for 49.1％ (26/53),A3 and A 1 mixture accounting for 3.77％ (2/53) and the new H1N1 accounting for 20.75％ (11/53).The outbreaks in 2007 and 2009 mainly caused by A3,and show that the winter spring (January) and summer autumn (September) as two popular peaks during 2005-2011 ; BV mainly causes the outbreaks from Feb.to Jun.Conclusion In Xuzhou area,since the winter of 2005,influenza virus subtype BV,the A3,and new H1N1 has alternately as mainly predominant strain,caused local influenza outbreaks.In which BV has increased trend year by year during 2005-2011.The students in primary and secondary schools are the major crowd of influenza outbreaks.Fluorescent-PCR detection methods could be a preferred method for reliable and rapid diagnostic of epidemic influenza outbreaks.

OBJECTIVETo conduct an etiological molecular epidemiological survey and laboratory test on a foodborne disease epidemic outbreak to make clear of the cause and implement effective prevention and control on it.

METHODSOn May 12th 2012, 135 kindergarten children were sent to Xuzhou City People's Hospital and Children's Hospital with gastrointestinal infection disease. A total of 34 anus swab samples and 4 vomit samples were collected from the patients. Real-time PCR rapid detection, strains separation and cultivation, phage lysis experiments, ATB automated identification system were used to make etiological detection and identification. The genomic DNA of salmonella enteritidis were typed with the pulsed-field gel electrophoresis (PFGE), cluster analysis were carried out together with the patterns of local Salmonella infections.

RESULTSChildren in 20 classes were suffered from the gastrointestinal infection among the 21 classes. There were no significant aggregation of class distribution. Among the 135 patients, 76 were boys (56.3%) and 59 were girls (43.7%). The main symptoms were fever (above 38°C), diarrhea and bellyache. Through real-time PCR detection and strains separation, 19 salmonella enteritidis were isolated from 34 anus swab samples of suspected cases and the detection rate was 56%. There were no strains detected from vomit samples. All of the 19 salmonella enteritidis showed the same serological subtype, biochemical reaction, drug sensitivity and phage lysis pattern. The salmonella enteritidis had the identical PFGE pattern (100% similarity), and were different from the pattern of local sporadic infection cases.

CONCLUSIONIt was confirmed that this was an epidemic outbreak of foodborne disease caused by homologous salmonella enteritidis by epidemiological survey, clinical information, lab etiological test and molecular typing.

Bacteriophage Typing ; Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Female ; Humans ; Male ; Molecular Epidemiology ; Salmonella Food Poisoning ; epidemiology ; microbiology ; Salmonella enteritidis ; classification ; isolation & purification

Objective To provide scientific evidences for improving children early integrated development,through analyzing the mental developmental status and characteristics of 322 cases of 2-year-old children in Nanjing.Methods Intelligence and motor development condition in 322 cases of 2-year-old children were assessed by using Bayley Scales of Infant Development test,and the assessed results were analyzed.Results 1.The incidences of the children whose mental development index(MDI)or psychomotor development index(PDI)were under 69 were 3.1% and 5.6%,respectively;2.The MDI mean score(114.34?19.65)was significantly higher than that of PDI(101.73?21.53)(t=9.71,P0.05).Conclusions The incidences of mental retardation in this study were consistent with the result reported by World Health Organization.There were differences between motor and intelligence development in children,as well as the intelligence development between male and female.Therefore,it should be implemented early childhood developmental screening in child health care.Parents should be given scientific guides about intelligence and motor development of children.

Ischemia-reperfusion injury (IRI) is a major complication in liver transplantation (LT) and it is closely related to the recovery of grafts' function. Researches has verified that both innate and adaptive immune system are involved in the development of IRI and Kupffer cell (KC), the resident macrophages in the liver, play a pivotal role both in triggering and sustaining the sterile inflammation. Damage-associated molecular patterns (DAMPs), released by the initial dead cell because of the ischemia insult, firstly activate the KC through pattern recognition receptors (PRRs) such as toll-like receptors. Activated KCs is the dominant players in the IRI as it can secret various pro-inflammatory cytokines to exacerbate the injury and recruit other types of immune cells from the circulation. On the other hand, KCs can also serve in a contrary way to ameliorate IRI by upregulating the anti-inflammatory factors. Moreover, new standpoint has been put forward that KCs and macrophages from the circulation may function in different way to influence the inflammation. Managements towards KCs are expected to be the effective way to improve the IRI.
Cytokines ; Hand ; Immune System ; Inflammation ; Ischemia* ; Kupffer Cells ; Liver Transplantation* ; Liver* ; Macrophages* ; Receptors, Pattern Recognition ; Reperfusion Injury* ; Reperfusion* ; Toll-Like Receptors