Dust ; Humans ; Iron ; Mining ; Noise, Occupational ; Occupational Exposure ; statistics & numerical data ; Vibration

Objective To evaluate the safety and accuracy of CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome.Methods A total of 25 cases with hepatic lesions near the diaphragmatic dome were undertaken CT-guided cutting needle biopsy using 16 gauge or 18 gauge core biopsy needles.Results Histological examination showed malignancy in 17 cases and benign in 8 with 2 false negative results(8%),and there were no false positive results.The specificities of malignant and benign lesions were 100% and 75%,respectively.Overall accuracy was 92%.Pneumothorax,needle tract hemorrhage,and subcapsular hepatic hemorrhage occurred in 2(8%),1(4%)and 1(4%),respectively.Conclusion CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome is a reliable and relatively safe diagnostic method.(J Intervent Radiol,2007,16:838-840)

Objective To investigate the expression and significance of major histocompatibility complex classⅡgene in multiple organ dysfunction syndrome.Methods Two-hit porcine model of MODS was duplicated in 18 swine that were randomly assigned into experimental group(Group M,n=9) and control group(Group C,n=9).The Group M was given compound factors including hemorrhagic shock,reperfusion injury and endotoxemia,and the Group C only underwent anesthesia and arterious/ve- nous eannula.After seven days,the animals were killed to remove splenic tissues fro extracting total RNA by Trizol method.The primer of SLA-DQA(MHC classⅡgene of swine)was designed to construct cD- NA by reverse transcription and the quantity of SLA-DQA mRNA detected with real time fluorescent quan- titative polymerase chain reaction(real time FQ-PCR).The standard curve was described by UVP com- puter image analysis system.Results The mortality of Group M was 78%(7/9),and the incidence rate of MODS was 89%(8/9).The expressing quantity of Group M was(1.376?1.006)?10~3,signifi- cantly lower than(5.330?3.053)?10~3 of Group C(P＜0.01).Conclusion Duplication of por- cine MODS model is satisfactory.Down-regulation of MHC classⅡgene may be due to control of classⅡtransactivator(CⅡTA)and release of multiple eytokine,such as TNF-?and IL-10.

OBJECTIVETo observe the efficacy and the influence on quality of life (QOL) of syndrome differentiation treatment with Chinese medicine (CM) for opioid-induced constipation as well as the safety and influence on analgesic effect of opioids.

METHODSTotally 406 cases enrolled from 53 collaborating medical centers were randomly assigned to a CM group and a control group. The CM group were treated with CM decoction based on syndrome differentiation, and the control group were treated with Phenolphthalein Tablet. Both groups were treated for 14 days. Cleveland constipation score (CCS), numerical rating scale (NRS) of pain and Chinese version of European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire-C30 V3.0 (EORTC QLQ-C30 V3.0) were used to evaluate the efficacy, pain controlled and QOL status.

RESULTSThe comparisons of CCS score reduction and QOL between the two groups after treatment suggested that the improvements of constipation and QOL in the CM group were better than that in the control group (P<0.05). The total efficiency of the CM group was better than the control group (93.5% vs. 86.4%, P<0.05). There was no significant difference in NRS scores between before and after treatment in both groups. There was no serious drug-related adverse event during the course of study.

CONCLUSIONCM decoction could effectively treat opioid-induced constipation and improve patients' QOL at the same time. It is safe and doesn't affect the analgesic effect of opioids when treating constipation.

Aged ; Analgesics, Opioid ; administration & dosage ; adverse effects ; Constipation ; chemically induced ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasms ; complications ; Pain, Intractable ; drug therapy ; Phenolphthalein ; administration & dosage ; Quality of Life ; Treatment Outcome

BACKGROUNDFor patients undergoing off-pump coronary artery bypass grafting (OPCABG), it is important to establish a hemodynamic monitoring system to obtain powerful parameters for better intraoperative treatment. This study aimed to observe the clinical feasibility of arterial pressure-based cardiac output (APCO) for cardiac output (CO) monitoring and to evaluate the correlation between APCO and pulmonary artery catheter (PAC) for CO measurement for patients undergoing OPCABG intraoperatively.

METHODSFifty patients of American Society of Anaesthesiologists (ASA) classification II-III, undergoing elective OPCABG at Beijing Anzhen Hospital were randomly enrolled into this study. All patients were assigned to CO monitoring by PAC and APCO simultaneously. Patients with pacemaker, severe valvular heart disease, left ventricular ejection fraction (EF) < 40%, cardiac arrhythmias, peripheral vascular disease, application of intra-aortic balloon pump (IABP) and emergent diversion to cardiac pulmonary bypass were excluded. The radial artery waveform was analyzed to estimate the stroke volume (SV) and heart rate (HR) continuously. CO was calculated as SV ' HR; other derived parameters were cardiac index (CI), stroke volume index (SVI), systemic vascular resistance (SVR), and systemic vascular resistance index (SVRI). PAC was placed via right internal jugular vein and the correct position was confirmed by PAC waveforms. Continuous cardiac output (CCO), CI and other hemodynamic parameters were monitored at following 5 time points: immediate after anesthesia induction (baseline value), anastomosis of left internal mammary artery to left anterior descending artery (LAD), anastomosis of left circumflex (LCX), anastomosis of posterior descending artery (PDA) and immediate after sternal closure.

RESULTSIn the 50 patients, preoperative echocardiography measured left ventricular EF was (52.8 ± 11.5)%, and 35 patients (70%) showed regional wall motion abnormalities. The correlation coefficient of CO monitored by APCO and PAC were 0.70, 0.59, 0.78, 0.74 and 0.85 at each time point. The bias range of CI monitored from both APCO and PAC were (0.39 ± 0.06) L×min(-1)×m(-2), (0.48 ± 0.12) L×min(-1)×m(-2), (0.26 ± 0.06) L×min(-1)×m(-2), (0.27 ± 0.06) L×min(-1)×m(-2), (0.30 ± 0.05) L×min(-1)×m(-2) at each time point. The results of SVR by two hemodynamic monitoring techniques had good correlation during OPCABG. The variation trends of SVR were opposite comparing with the results of CO. SVR collected from PAC obtained the highest value of (1220.0 ± 254.0) dyn×s×cm(-5) at PDA anastomosis, but the highest value obtained from APCO was (1206.0 ± 226.5) dyn×s×cm(-5) in LCX anastomosis.

CONCLUSIONSAPCO is feasible in hemodynamic monitoring for patients undergoing OPCABG. The results of hemodynamic monitoring derived from APCO and PAC are closely correlated. Its characterizations of timely, accurate and continuous display of hemodynamic parameters are also obviously demonstrated in the present study.

Aged ; Arterial Pressure ; physiology ; Cardiac Output ; physiology ; Catheterization, Swan-Ganz ; methods ; Coronary Artery Bypass ; methods ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods

Objective To investigate the distribution and antimicrobial resistance of Pseudomonas aeruginosa (P.aeruginosa) from intensive care units(ICUs) and general wards of a hospital,and provide scientific basis for rational use of antimicrobial agents in clinic.Methods Identification and antimicrobial susceptibility testing of clinically isolated bacteria in this hospital in 2016 were performed by VITEK 2 Compact automatic microbial analysis system,difference in antimicrobial resistance of P.aeruginosa between ICUs and general wards was compared.Results The tested specimens were mainly sputum in both ICUs and general wards,accounting for 78.7％ and 66.5％ respectively.There was no significant difference in the isolation rate of P.aeruginosa between ICUs and general wards (11.7％ vs 11.0％,P＞0.05).P.aeruginosa isolated from ICUs had the highest resistance rate to aztreonam (73.8％),resistance rates to piperacillin/tazobactam,cefoperazone/sulbactam,ceftazidime,imipenem,and meropenem were all up to more than 50％;P.aeruginosa detected in general wards had the highest resistance rate to aztreonam(59.6 ％),followed by piperacillin/tazobactam and imipenem,accounting for 48.0 ％ and 44.3 ％ respectively;resistance rates of P.aeruginosa isolated from ICUs to 12 kinds of antimicrobial agents were all higher thanthose of general wards(P＜0.05).Conclusion Resistance rate of P.aeruginosa from ICUs is higher than that in general wards,which should be paid attention,antimicrobial agents should be selected for clinical treatment of infection according to the results of antimicrobial susceptibility testing result.

OBJECTIVESTo establish the testicular fibrosis model in rats.

METHODSWistar rats were divided into control group(n = 12) and model group(n = 40) randomly. Testicular fibrosis model was built with the classical method of establishing experimental autoimmune orchitis (EAO) combined with injecting Bacille Calmette-Guerin (BCG) into left testis.

RESULTSThe incidence rate of EAO and the rate of testicular fibrosis were 100%, 11.1% and 100%, 81.5% at 80, 140 days after the first infection, respectively.

CONCLUSIONSThe model of rat testicular fibrosis was established successfully.

Animals ; Autoimmune Diseases ; pathology ; Disease Models, Animal ; Fibrosis ; Male ; Mycobacterium bovis ; Orchitis ; pathology ; Rats ; Rats, Wistar ; Testis ; pathology

OBJECTIVETo explore the relation between hepatitis B virus DNA load and genotype with the level of large envelope protein.

METHODSSerum HBV DNA was quantitively detected by using real time polymerase chain reaction (RT-PCR). The LHBs were detected by using enzyme linked immuno sorbent assay (ELISA) and HBV markers were detected by time differentiate immunofluorescence assay in 140 serum samples collected from chronic hepatitis B patients.The genotypes of HBV were identified by DNA sequencing; and analyze their relationship.

RESULTSThere was no significant difference between positive rate of LHBs and that of HBV DNA in HBeAg negative and positive group (P > 0.05); The HBV LHBs absorbency was markedly correlated with the HBV DNA load ( R2 = 0.9267). The difference of HBV LHBs absorbency between HBV genotype B and C was not significant.

CONCLUSIONSThe close correlation between HBV LHBs absorbence and HBV DNA load illustrated that he level of serum LHBs can be used to estimate the state of HBV replication; and there is no relationship between HBV LHBs absorbency and genotypes. So HBV LHBs may be used as a new serological marker to detect HBV replication.

Adolescent ; Adult ; Aged ; DNA, Viral ; analysis ; genetics ; immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Genotype ; Hepatitis B ; genetics ; virology ; Hepatitis B virus ; chemistry ; genetics ; Humans ; Male ; Middle Aged ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Envelope Proteins ; chemistry ; genetics ; Virion ; chemistry ; genetics ; Young Adult

OBJECTIVETo explore the best methods and skill for the removal of difficult and high risk tracheobronchial foreign body under bronchoscope.

METHODSA retrospective review was performed between August 1995 to August 2012. There were 4217 children with tracheobronchial foreign body, among them, 272 were diagnosed as high-risk, highly difficult tracheobronchial foreign bodies confirmed by clinical manifestations, foreign body type and bronchoscopy.

RESULTSIn 271 children, the tracheobronchial foreign body was removed under bronchoscope, the success rate was 99.6%; only one child with a pen cap blocking the left lower lobe bronchus was transferred to the department of thoracic surgery, and the foreign body was finally removed by thoracotomy. Eighty-five children (among them, 82 children were under 1 year of age) had II-II degree laryngeal obstruction, the emergency surgery was performed to remove the foreign body and to relieve the laryngeal obstruction. Twenty-six children had lung infection and 27 children had failed foreign body removal surgery before, in all these children, the foreign body was removed after infection control. There were 17 children with the pen cap as the tracheobronchial foreign body, direct removal was successful in 12 children with the history less than two weeks; in 4 children, the foreign body was removed after 0.1% epinephrine saline flush, and 1 case with the homemade bronchial foreign body hook remove. There were 26 children with the whistle as the foreign body, and 32 children had large and sharp foreign bodies. In these cases, the foreign bodies were removed together with the bronchoscope. Forty-two children had multiple or fragile foreign bodies, and 16 children had subsegmental bronchial foreign bodies. In these cases, the foreign bodies were removed with forceps under direct vision and intraoperative bronchial lavage.In This series, 129 children received intraoperative bronchial lavage, among them, 127 children showed normal X-ray changes one week after operation. Two children with a history of more than 1 month complicated with pulmonary consolidation. After bronchial lavage, pneumothorax and subcutaneous emphysema occurred, which recovered after treatment. No glottic edema, asphyxia, and other complications were found, the complication rate of surgery was 0.7%.

CONCLUSIONFor the removal of highly difficult and high risk tracheobronchial foreign bodies, preoperative analysis and discussion should be sufficient, appropriate surgical skill and surgical instruments may improve the success rate of the surgery and prevent the operation complications.

Adolescent ; Bronchi ; Bronchoscopy ; methods ; Child ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Infant ; Male ; Retrospective Studies ; Trachea

OBJECTIVESevere pneumonia is one of the common severe diseases in children. Increasing evidences show that immune response greatly contribute to severe pneumonia. Dendritic cells (DC) are the important antigen presenting cells in the lung. To study the role of dendritic cells in development of severe pneumonia in children, the authors measured the number of mature DC in bronchoalveolar lavage fluid (BALF), and evaluated the relationship among IL-12, pro-inflammatory cytokines and clinical scores.

METHODSThe following 3 groups of children were enrolled in this study: severe pneumonia group: 27 children with severe pneumonia treated between November 2002 and May 2003 in PICU; mild pneumonia group: 30 children with mild pneumonia in department of pulmonology; control group: 29 children without pneumonia but receiving ventilator treatment for chest surgery. Mature DC in BALF was determined in severe pneumonia group and the control group on the day of tracheal intubation for mechanical ventilation. Acute lung injury scores and severe disease scores were evaluated in children with severe pneumonia and mild pneumonia. All children's serum levels of TNF-alpha, IL-6 and IL-12 were measured by using ELISA within 24 hours after admission. SPSS version 11.5 was used for statistical analysis.

RESULTS(1) The percent of mature DC in children with severe pneumonia was significantly higher when compared with the control group on the first day after ventilation [14.2 (3.9 - 51.8)] vs. [1.3 (0.2 - 22.5)] (Z = 5.44, P < 0.01). (2) In severe pneumonia group, the concentration of serum IL-12 [117.0 (79.9 - 159.4) ng/L], TNF-alpha [90.6 (52.2 - 185.9) ng/L], IL-6 [128.7 (73.3 - 793.8) ng/L] were significantly higher than those in mild pneumonia group where the values were [71.6 (19.4 - 196.8)], [26.6 (2.5 - 113.9)], and [39.9 (7.8 - 82.5)] (P < 0.01), and the control group [6.4 (12.2 - 92.0)], [6.4 (1.8 - 91.9)], and [23.0 (6.4 - 54.2)] (P < 0.01). Serum IL-12, TNF-alpha and IL-6 levels in children with mild pneumonia were higher than those of control group (P < 0.01). (3) The percent of mature DC was increased with the serum level of IL-12 (r = 0.48, P < 0.01), TNF-alpha (r = 0.58, P < 0.01), IL-6 (r = 0.51, P < 0.01) and lung injury scores (r = 0.39, P < 0.05), but it did not correlate with severe disease scores (r = -0.11, P > 0.05).

CONCLUSIONSThere is excessive production of pro-inflammatory cytokines and over-stimulation of lung dendritic cells in children with severe pneumonia. Over-stimulation of lung dendritic cells, the increased serum levels of IL-12, TNF-alpha, IL-6 and the severity of pneumonia may suggest that DC plays an important role in pathogenesis of severe pneumonia in children.

Bronchoalveolar Lavage Fluid ; cytology ; Child, Preschool ; Cytokines ; biosynthesis ; blood ; Dendritic Cells ; immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant ; Interleukin-12 ; biosynthesis ; Interleukin-6 ; biosynthesis ; Male ; Pneumonia ; immunology ; pathology ; physiopathology ; Severity of Illness Index ; Tumor Necrosis Factor-alpha ; biosynthesis