OBJECTIVETo sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems.

METHODSWe retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems.

RESULTSFGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score.

CONCLUSIONBoth ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.

Age Factors ; Aged ; Fournier Gangrene ; diagnosis ; mortality ; surgery ; Humans ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index

Objective To evaluate the additional efficiency of aldosterone blockers (AB) during angiotensin Ⅱ receptor blockers (ARB) treatment on hypertensive left ventricle hypertrophy in the elderly. Methods Forty-five cases of hypertensive left ventricular hypertrophy detected by Doppler ultrasonic cardiogram examination were enrolled,and were randomized to receive treatment with ARB plus AB (Group A) or ARB plus diuretics (Group B) for 48 weeks. The indicators of left ventricle hypertrophy were checked before and after the treatment. Results The both regimens could significantly decrease the blood pressure,and there was significant difference in the effects on lowering blood pressure between the regimens. Both regimens could alleviate left ventricle hypertrophy,but the regimen of ARB plus AB was superior to the regimen in Group B. Conclusion The addition of AB treatment during the ARB treatment was a good antihypertensive regimen for reducing left ventricle hypertrophy.

Objective To select the optimal exacting process for Chuanping prescription (CP).Methods The anti- and the anti- asthma ticanti effects of extracts obtained by different extracting processes from CP were observed.Results The anti- asthmatic effect of extract obtained by ion exchange resin(IER) method was better than that by acid- liquid- extraction alcohol- precipitate method (ALEAP) (P

Objective: To investigate the prevalence and influencing factors of work-related musculoskeletal disorders (WMSDs) in neck and shoulder among workers in pharmaceutical and chemical enterprises, so as to provide the basis for prevention of WMSDs. Methods: Workers in 8 pharmaceutical and chemical enterprises in Jinhua City, Zhejiang Province from July to October 2023 were sampled using a stratified random sampling method, and demography, work conditions and WMSDs prevalence were collected using questionnaire surveys. Factors affecting WMSDs in neck and shoulder were analyzed using a multivariable logistic regression model. Results: A total of 1 343 workers were surveyed, including 496 males (36.93%) and 847 females (63.07%). The mean age of workers was 38 (15) years, and the length of service in current posts was 6 (8) years. There were 356 workers with WMSDs (26.51%), with 206 workers with neck WMSDs (15.34%) and 167 workers with shoulder WMSDs (12.43%). Multivariable logistic regression analysis showed that gender (female, OR=1.692, 95%CI: 1.203-2.381), sufficient rest time (OR=0.660, 95%CI: 0.471-0.926) and maintaining same neck posture for a long time (OR=1.690, 95%CI: 1.148-2.510) were factors affecting neck WMSDs; gender (female, OR=1.572, 95%CI: 1.060-2.311), sufficient rest time (OR=0.619, 95%CI: 0.422-0.906), repetitive daily work (OR=1.678, 95%CI: 1.064-2.647), uncomfortable work posture (OR=3.791, 95%CI: 1.330-10.803), multiple repetitive movements per minute (OR: 1.988-2.413, 95%CI: 1.060-4.161) and maintaining same neck posture for a long time (OR=1.926, 95%CI: 1.218-3.043) were factors affecting shoulder WMSDs. Conclusion The prevalence of WMSDs in neck and shoulder are high among workers in pharmaceutical and chemical enterprises in Jinhua City, and mainly affected by gender, rest time and adverse ergonomics.

Adult ; Air Pollutants, Occupational ; poisoning ; Humans ; Male ; Middle Aged ; Occupational Diseases ; etiology ; Occupational Exposure ; adverse effects ; Pneumoconiosis ; etiology ; Silicon Dioxide ; poisoning

Objective To explore the role of CD 30 on CD4 + T lymphocyte and T lymphocyte subset activation in asthma pathogenesis.Methods Twenty seven asthma active attack patients,16 acute upper respiratory infection patients and 19 control children were randomly selected. Direct immunofluorescence flow cytometry was used to detect the CD 30 positive percentage on CD4 +cell; ELISA was used to detect the levels of interleukin(IL) 4 and IL 13 in culture supernatants of peripheral blood mononuclear cells(PBMC) and plasma total immunoglobulin E(IgE) level.Results Compared with control group and acute upper respiratory infection group, in asthmatic children the CD4 +CD 30 + percentage on CD4 + cell was elevated significantly; 2.The levels of IL 4 and IL 13 in supernatants of cultured lymphocyte were increased significantly, the plasma total IgE level was increased significantly;3.There was a significant positive correlation of CD4 +CD 30 + cell percentage with the levels of IL 4 and IL 13 in culture supernatants and plasma total IgE.Conclusions The cell that could produce Th2 derived cytokine may consist of CD 30 +cell;When CD 30 L combined with CD 30 on CD4 + cells ,it might result in Th2 cell proliferation ,develop and release Th2 derived cytokine; IL 4 and IL 13 could induce B cell production and secrete more IgE. It is suggested that CD 30 and imbalance of Th2 subset may play an important role in asthma pathogenesis.

Objective To evaluate serum soluble intercellular adhesion molecule-1 (sICAM-1) before and after lung transplantation for diagnosing acute rejection. Methods Biotin-streptavidin time resolved fluoroimmunoassay (BSA-TRFIA) was used to detect the concentration of serum sICAM-1 before and after lung transplantation in 26 patients. All patients were divided into stable lung transplantation group (n =16), acute rejection group (n =4) and infected group (n =6). The serum level of sICAM-1 in those groups was compared with that of the control group ( n = 30 ) by the non-parametric rank sum test ( KruskalWallis H test). Results No significant difference was found for serum sICAM-1 among the three groups and the control group before operation: (357.07 ± 220.01 ), ( 396. 18 ± 136.25 ), (468.95 ± 85.48 ) μg/L vs(348.63 ±69. 12) μg/L, H=6. 0436, P ＞0.05. However, when rejection and infection happened after operation, the serum sICAM-1 increased in the acute rejection group (455.53 ± 126.51 μg/L) and decreased in the infection group (146.43 ± 327.11 μg/L), and the level in the stable transplantation group was (274.23 ± 157.53 ) μg/L (H = 21. 8994, P ＜ 0.01 ). Conclusion Serum sICAM-1 level might be a potential marker to differentiate acute rejection from infection after lung transplantation.

Objective To investigate the methods and techniques for organ procurement from donation after cardiac death (DCD),and to evaluate post-transplant outcomes.Methods In this retrospective study,clinical data of 26 cases of DCD organ procurements were analyzed through either epigastric multivisceral organ harvesting or solitary organ harvesting.Results Twenty livers,44 kidneys and 2 multivisceral grafts were procured,followed by 24 cases of liver transplantation,42 cases of kidney transplantation,and 2 cases of multivisceral transplantation.The operations were successful and all transplanted organs were satisfactorily recovered with no primary nonfunction or other complications observed.Conclusion Our methods and techniques for organ procurement from DCD donors require experienced surgery skills,while can maximatily shorten donor organ ischemic time,guarantee procurement of high quality of organs and ensure a favourable transplant outcomes.

Animals ; Calcitriol ; pharmacology ; Diabetes Mellitus, Experimental ; complications ; Diabetes Mellitus, Type 2 ; complications ; Liver ; drug effects ; Liver Diseases ; complications ; drug therapy ; Male ; Rats ; Rats, Sprague-Dawley

Objective To study the validity and reliability of Tengdao's swallowing standard for stroke pa-tients with dysphagia.Methods A total of 128 patients with postroke dysphagia took the swallowing test and then were divided into three sub-groups.Their scores on Tengdao's evaluation and their fluoroscopy results were analyzed using Spearman's correlation coefficient.Intra-class coefficients (ICCs)were used to examine the intra-rater and in-ter-rater reliability of Tengdao's evaluation.Results TenIgdao's evaluation possessed good validity and reliability.There was a high correlation between the scores in Tengdao's evaluation and fluoroscopy results. Conclusions Tengdao's evaluation is valid,reliable,simple and safe.It can be used in the clinic to evaluate the stroke patients with dysphagia.