Humans ; Noise, Occupational ; adverse effects ; Occupational Exposure ; standards

ObjectiveTo present the innovative transurethral resection of the distal ureter and bladder cuff by Holmium laser and to compare the perioperative and oncological outcomes following nephroureterectomy using three different methods of managing the distal ureter and bladder cuff.Methods From January 2000 to December 2010,162 patients underwent excision of the distal ureter and bladder cuff by transurethral Holmium laser (32 cases,Group A),transurethral electric resection (51 cases,Group B) or open procedure (79 cases,Group C) combined with open or retroperitoneal laparoscopic nephroureterectomy.5 French ureteral balloon catheter was inserted into the targeted ureter to prevent possible microscopic tumor seeding.The therapeutic effectiveness,perioperative complications,postoperative recovery and oncologic outcomes were compared among groups.The follow-up time was 3 -96 months.ResultsGroup A and B showed statistically significant better results on the operative time (203.6 ± 31.5 min and 207.2 ±24.3 min),blood loss ( 127.4 ± 63.2 ml and 135.0 ± 82.7 ml) and postoperative hospital stay (5.8 ± 1.3d and 5.6 ±1.2 d) than those of Group C (248.0 ±42.9 min,484.5 ±217.7 ml,8.7 ±3.5 d),respectively ( P ＜ 0.01 ).Six cases of obturator nervous reflex occurred in Group B,with 3 cases of bladder peroration and 2 conversions to open procedure.There were no difference in bladder tumor occurrence,retroperitoneal recurrence,tumor cell seeding and cancer-specific survival among the 3 groups.ConclusionsOur data have validated the superiority of transurethral approach over conventional open procedure including perioperative index,recovery and comparable oncologic outcomes with open group.Holmium laser demonstrated better results including fewer complication,cleaner surgical vision and operating accuracy than that of electric resection.Transurethral Holmium laser resection of the distal ureter and bladder cuff has been proved to be a technically innovative minimally invasive and oncological safe method.

To study and compare the protective effects of Cordyceps sinensis from different habitats on acute injury of hepatic tissue induced by carbon tetrachloride ( CCl4 ) . Methods:The rat model of acute injury of hepatic tissue induced by CCl4 was established. The biochemical indicators of alanine aminotranferease ( ALT) and aspartate aminotransferease ( AST) in the serum and superoxide dismutase ( SOD) and L-glutathione( GSH) in the liver tissue were detected, and the liver tissue HE staining was used for the histopathology determination. Results:Compared with those in the model group, the levels of AST and ALT in the serum were sig-nificantly reduced, the levels of SOD and GSH in the liver tissue were notably increased, and the necrosis of liver cells was improved in Cordyceps sinensis groups at low, medium and high dose from different habitats (P<0. 05), however, the differences between the two different habitats were not significant (P>0. 05). Conclusion: Cordyceps sinensis from Qinghai and Tibet shows some positive differences in the protective effect on the acute chemical liver injury induced by CCl4 in rats,however, the differences are not remarka-ble.

Objective To study the changes of apoptosis and cell cycle progression of Hela cells after the poly(ADP-ribose) polymerase(PARP) was inhibited by its inhibitor 3-aminobenzamid(3-AB) and the mechanisms of PARP interaction with Hela cells damaged by irradiation.Methods Hela cell line was used.Flow cytometry(FCM) was used to examine the PARP expression of control and 3-AB groups at 0,2,4,8,12 h after administration with 5 mmol?L-1 3-AB.The percentage of apoptotic cells and cell cycle progression of control,irradiation,3-AB plus irradiation groups were measured with FCM at 2,8,12,24 h after exposure to 2 Gy irradiation following administration with 5 mmol?L-1 3-AB.Results The percentage of Hela cells with positive expression of PARP protein decreased after administration with 3-AB and there was significant difference between 3-AB plus irradiation group and control group(P

Objective To study the influence of hemodialysis on inflammatory state and immune function by analyzing the change of serum protein components in uremic patients before and after hemodialysis.Methods 75 cases of uremic patients confirmed by the Nephrology from October 2013 to May 2014 were selected as the observation group,and 15 healthy volun-teers at the same time as the control group.Then the serum protein electrophoresis pattern of observation group beford the first hemodialysis,after the first hemodialysis,after one month’s treatment and control group were compared with each oth-er.Results In the observation group before and after the first hemodialysis,the ALB levels were lower,α1 and α2 globulin levels were higher than those in control group.There was a statistically significant between the observation group before and after the first hemodialysis and control group (P <0.001).After the first hemodialysis,there were differences inα1 globulin levels compared with before the first hemodialysis (P <0.01).ALB was no significant difference after one month’s hemodi-alysis compared with before the first hemodialysis,andα1,α2 globulin were significantly reduced and the difference was sta-tistically significant (P <0.001),ALB was lower than the control group and was statistically significant (P <0.001).After one month’s hemodialysis,the levels ofγglobulin were higher than those in control group,before the first hemodialysis and after the first hemodialysis.There were significant differences (P <0.001 or P <0.01).Conclusion Regular and effective hemodialysis can improve inflammatory state and immune function of uremic patients.

Objective To evaluate the relevant causes of neurologic complications following liver transplantation.Methods 155 adult patients (131 males, 24 females) who received liver transplantation for the first time at Tongji Hospital between January 2005 and September 2009 were identified.Case notes were reviewed and demographic data, details of the liver disease, neurologic complications, MELD score and discharge information were recorded.Results Neurologic complications occurred following 36 transplants (23.2 %), The complications included mental symptoms in 15 cases (41.7 %), disorder of consciousness and action in 9 cases (25 %), and coma in 12 cases (33.3 %).Twelve percent patients with liver cancer experienced a neurologic complication, which was lower than for other transplant indications, like acute and chronic hepatic failure because of HBV infection (33.3 %, P＜0.01), inborn/metabolic disease (40 %, P＜0.05), and HCV Infection (25 %, P = 0.36).Patients who experienced a neurologic problem had significantly higher MELD score (for non-cancer patients:22.93 ± 8.21; for cancer patients:17 ± 5.4) than the other Patients (for non-cancer patients:18.33 + 8.47, P＜0.05; for cancer patients:13 ±3.4, P＜0.01).The rate of infection (36.1 %) and mortality (30.5 %) were significantly higher in patients with neurologic complications (P＜0.01).The levels of ALT, TBil, ALB, PT and the concentrations of serum sodium and chlorine had no impact on neurologic complications.Conclusion Neurologic complications are common in liver transplant recipients.These complications are related to primary disease and liver function before the operation, and increase the rate of infection and mortality.

We have obtain a steady and reliable dyeing methods for the uniuncleate and dicaryotic hyphae of Pleurotus tuber-regium by using different foster hyphae way, comparing two kinds of fastness liquid and three dye stuff on the hyphae nuclear stain effect, and then optimization grouping.

Objective:To observe the clinical efficacy of moxibustion with seed-sized moxa cone plus opioid drugs for moderate-to-severe cancer pain, and the effect on immune function in patients with cancer pain. Methods: A total of 80 patients with moderate-to-severe cancer pain were randomized into an observation group and a control group by the random number table method, with 40 cases in each group. Both groups were treated with opioid drugs for analgesia according to the standardized management principles for cancer pain. In addition, the observation group was given moxibustion with seed-sized moxa cone. The treatment was performed once a day, continuous 5-day treatment with a 2-day interval constituted a treatment course, and a total of 2 courses were performed. The score of numerical rating scale (NRS) and 24 h equivalent morphine consumption was compared between the two groups before treatment, after 1 treatment course and after 2 courses of treatment. The immune functions were compared between the two groups before and after 2 courses of treatment. Results: During the treatment, there were 3 dropouts in the control group, and 2 dropouts in the observation group. Before the treatment, there were no significant differences in the NRS score and 24 h equivalent morphine consumption between the two groups (both P＞0.05). The NRS scores of both two groups were quite stable during the whole treatment period, and there was no significant difference in the intra-group comparison after treatment (both P＞0.05), and there was no significant difference between the two groups at the same time point (both P＞0.05). In the control group, the 24 h equivalent morphine consumption showed an increasing trend. The dosage after 1 treatment course and 2 courses of treatment was statistically different from that before treatment in the control group (both P＜0.01). There was no significant change in the mean 24 h equivalent morphine consumption in the observation group compared with that before treatment (both P＞0.05). After 2 courses of treatment, the 24 h equivalent morphine consumption in the observation group was significantly lower than that in the control group at the same time point (P＜0.05). Before treatment, there was no significant difference in the levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) between the two groups (all P＞0.05). After treatment, the levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) in the control group were lower than those before treatment (all P＜0.05), while the levels in the observation group were higher than those before treatment, and the levels of CD3+ and CD4+ were significantly different from those before treatment (both P＜0.05). After treatment, the levels of T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) of the observation group were significantly higher than those of the control group at the same time point (all P＜0.05). Conclusion: Moxibustion with seed-sized moxa cone can reduce the dosage of opioid drugs used in patients with moderate-to-severe cancer pain and improve their immune functions.

Objective To analyze the curative effect of simultaneous liver and kidney transplantation (SLKT) for patients with end-stage liver and kidney diseases and liver cirrhosis patients with hepatorenal syndrome.Methods All SLKTs (n=21) performed at our center from January 1999 to December 2010 were reviewed and SLKT outcomes were compared with those of kidney transplantation (KT) (n=609) and liver transplantation (LT) (n=133) performed during the same period.Results There were 3 deaths due to infection 2 weeks, 6 months and 5 years respectively after operation. One patient died due to multiple organ dysfunction syndrome 2 weeks after operation. One patient was dead 5 years after operation because of rejection. MELD level between SLKT and LT had no significant difference, but serum creatinine in SLKT group was significantly higher than in LT group (516.0±329.9 vs 111.4±138.1 mmol/L, P<0.01). The 1-year acute kidney rejection rate and rate of delayed graft function (DGF) of the kidney had no significant difference between SLKT group (0 vs 9.5 %) and KT group (6 % vs 17.3 %). There was no significant difference in one-, 3- and 5-year patient survival rate between SLKT group (87.7 %, 67.8 % and 67.8 %) and LT group (84.2 %, 73.5 % and 69.4 %).Conclusion SLKT is a safe and effective treatment for end-stage liver and kidney diseases.

Objective:To investigate and analyze the influencing factors in the implementation of essential drugs in the medical in-stitutions in Hubei in order to provide reference for promoting the implementation of national essential drugs. Methods: The medical staff participating in the training class of clinical application guidelines and formulary of national essential drugs in Hubei (2014) was surveyed by a questionnaire to analyze and evaluate the statistical influencing factors in essential drugs implementation. Results: A-mong the factors affecting the implementation of essential drugs, the score of rational use was the highest (3. 86) followed by that of medicine quality, rational varieties of essential drugs, affordability and management system, and the factors with score below 3. 0 were pharmacy trusteeship and income of essential drugs in medical institutions. Conclusion: Based on the investigation and evaluation of influencing factors, the corresponding measures should be adopted, which can further improve the basic drug system and enhance the use effects of essential drugs.