Noise, Occupational ; prevention & control ; Occupational Health Services ; standards ; Threshold Limit Values

OBJECTIVETo investigate the effect of early escharectomy on resting energy expenditure (REE) in severely burned patients dynamically with the metabolic monitoring and diagnostic system.

METHODSFifty-six adult male patients with severe burns were divided into early escharectomy (group A, n = 39, escharectomy within 5 PBDs) and non-early escharectomy (group B, n = 17, escharectomy after 5 PBDs) groups. The wounds of full thickness and deep partial thickness burn in the two groups were all excised and covered with allogeneic skin and autologous micro-skin in the first operation. The changes in REE were observed dynamically at the bedside of the patients with the metabolic monitoring and diagnostic system. The plasma contents of IL-6, IL-8, TNF-alpha and LPS from 9 patients in group A and 7 in group B were also determined dynamically.

RESULTSAll patients survived. The REE in both groups was elevated markedly, but REE in group A was lower compared with group B before and after escharectomy within 14 days. (P < 0.05). The plasma level of IL-6, IL-8, TNF-alpha and LPS in group A were obviously lower than those in group B (P < 0.05).

CONCLUSIONThe hypermetabolic response of burn patients with severe burns could be lowered by early escharectomy, and it seemed to be related to the decrease of the release of proinflammatory mediators.

Adult ; Basal Metabolism ; Burns ; metabolism ; physiopathology ; surgery ; Humans ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Lipopolysaccharides ; blood ; Male ; Postoperative Care ; Time Factors ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo investigate the hepatotoxic effects of N, N-dimethylformamide (DMF) in the workers of a synthetic leathers factory, and the effects on liver function of covariates such as alcohol consumption and other factors.

METHODSThe workers were classified into three groups (low, high and the control) by the concentration of DMF in workplace which was determined in the past two years. A questionnaire was drawn up for relevant demographic characteristics and other factors influencing liver function. The bloods were collected for laboratory test which included parameters especially relevant to the liver (ALT AST and gamma GT).

RESULTSLow and high-exposure groups were significantly associated with elevated ALT and gamma GT, and high-exposure group was significantly associated with elevated Liver index. Modeling by stepwise regression analysis demonstrated that high concentration of DMF and BMI were associated with and elevated ALT, gamma GT and Liver index, besides DMF and BMI, the elevation of ALT was also associated with high TRIG. AST was only associated with alcohol consumption. The AST/ALT ration < 1 was present in 86.7% of the exposure workers of liver function abnormal.

CONCLUSIONDMF can cause liver function alternations even if air concentration of DMF was below PC-TWA. Besides the levels of DMF exposure, obesity (BMI) and alcohol consumption are covariates alternating liver function. Liver index can be a parameter for assessment liver function, and the AST/ALT ration < 1 may serve as markers of risk in health screening programs.

Adult ; Alanine Transaminase ; blood ; Dimethylformamide ; toxicity ; Female ; Humans ; Liver ; metabolism ; physiopathology ; Liver Function Tests ; Male ; Occupational Exposure

OBJECTIVETo investigate abnormal liver function associated with polymorphism of GSTT1, GSTM1 and CYP2E1 in workers exposed to N, N-dimethylformamide.

METHODSSixty-nine workers with abnormal liver function in a synthetic leather factory were recruited as case. One hundred and twenty five control subjects with similar work tasks were selected from the same factory. Genotypes for GSTT1 and GSTM1 were determined by multiplex PCR, and for CYP2E1 PstI by PCR-RFLP assay.

RESULTSThe frequency of positive GSTM1 was 59.42% in cases and 38.40% in control, with an odds ratio (OR) of 2.34,95% CI: 1.29-4.29 (P=0.005). For GSTT1 and CYP2E1 PstI, the frequencies of genotypes showed no significant difference between case and control.

CONCLUSIONGSTM1 positive genotype may be genetic risk factors for development of abnormal liver function in workers exposed to N, N-dimethylformamide.

Adult ; Chemical and Drug Induced Liver Injury ; etiology ; genetics ; Cytochrome P-450 CYP2E1 ; genetics ; Dimethylformamide ; adverse effects ; Female ; Genotype ; Glutathione Transferase ; genetics ; Humans ; Male ; Occupational Exposure ; adverse effects ; Polymorphism, Genetic

Objective To assess the dermal exposure levels of N'N-dimethylformamide (DMF) in synthetic leather workers. Methods Potential dermal exposure levels of DMF was measured with skin wiping and hand washing samples in printing workers. The DMF concentration in personal air samples and urinary NMF were also detected. Results DMF was detected in all the hand washing (0.35～15.34 mg DMF) and skin wiping (29.58～110.45 μg DMF) samples. DMF level in hand washing samples and cumulative exposure level were correlated with NMF level in urine after logarithm transform. There was no good correlation between the DMF level of skin wiping samples and the urinary NMF level. Conclusion The sampling method of hand washing is a reasonable method to determine dermal exposure level.

Objective To investigate the effect of glucocorticoids of different dosages on mortality and hippocampal neuron apoptosis in rats after traumatic brain injury (TBI).Methods All the adult male Wistar rats were allocated into normal control group,dexamethasone (DXM) treatment group,methylprednisolone (MP) treatment group,injury control group,low-dose DXM treatment group,moderate-dose DXM treatment group,high-dose DXM treatment group,low-dose MP treatment group,moderate-dose MP treatment group,and high-dose MP treatment group (n=22).Rats in the later seven groups (the injuried groups) accepted fluid percussion injury to induce TBI models,and then,treatments were given.The injury severity was evaluated with modified Neurological Severity Scale 24 h after injury.The number ofhippocampal neuron apoptosis was examined using TUNEL after 24 and 48 h,and 7 and 14 d of injury.The mortality of rats in each group was also observed during a 14-day-follow-up period.The changes of brains,pituitaries,hearts and lungs in the dead rats were examined by H.E.staining.Results No significant difference on the scores of modified Neurological Severity Scale was noted in the injuried groups 24 h after the injury (P＞0.05).The hippocampal neuron apoptosis began to appear 24 h after inju~,peaked at 48 h,and declined in 7 to 14 d.At 48 h after injury,the number of hippocampal neuron apoptosis in high-dose DXM treatment and high-dose MP treatment groups was significantly higher than that in the injury control group (P＜0.05).The mortality of rats in high-dose DXM treatment and high-dose MP treatment was significantly higher than that in the injury control group (P＜0.05).The autopsy of dead rats in each group revealed various degrees of interstitial pneumonia and hypophysial congestion in rats receiving high-dose glucocorticoids.Conclusion TBI could induce hippocampal neuron apoptosis,and early administration of high-dose glucocorticoids aggravates the apoptosis and increases the mortality,for which interstitial pneumonia and hypophysial congestion would account.

Objective To assess the dermal exposure levels of N'N-dimethylformamide (DMF) in synthetic leather workers. Methods Potential dermal exposure levels of DMF was measured with skin wiping and hand washing samples in printing workers. The DMF concentration in personal air samples and urinary NMF were also detected. Results DMF was detected in all the hand washing (0.35～15.34 mg DMF) and skin wiping (29.58～110.45 μg DMF) samples. DMF level in hand washing samples and cumulative exposure level were correlated with NMF level in urine after logarithm transform. There was no good correlation between the DMF level of skin wiping samples and the urinary NMF level. Conclusion The sampling method of hand washing is a reasonable method to determine dermal exposure level.

OBJECTIVETo analyze the correlations between increased spinal cord signal intensity on magnetic resonance images (MRI) and the clinical prognosis of compressive cervical myelopathy.

METHODSSixty-six patients with cervical spondylotic myelopathy underwent surgeries through the anterior approach. In all the patients, the diagnoses were established on the basis of both neurological examination and MRI findings that showed spinal cord compression. The patients were divided into two groups according to preoperative MRI, namely isointense MRI T1/T2 signal group and iso/hyperintense MRI T1/T2 group. The JOA scores of the patients were evaluated before and at 6 and 12 months after the operation.

RESULTSThe patients were followed up for 12 to 38 months after the operation (mean 21 months), and no statistically significant difference were found in the pre- and postoperative JOA scores between the two groups (P>0.05).

CONCLUSIONThe peoperative hyperintense signals on T2 weighted MRI does not correlate to the prognosis of patients with compressive cervical myelopathy, who may also have favorable clinical outcomes after the operation.

Adult ; Cervical Vertebrae ; pathology ; surgery ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prognosis ; Spinal Cord Compression ; diagnosis ; etiology ; surgery ; Spinal Osteophytosis ; complications ; diagnosis ; surgery

BACKGROUNDPortasystemic shunts, especially total shunts, are effective tools for reducing portal pressure and controlling variceal bleeding but lead to high risk of encephalopathy and accelerating liver failure. The purpose of this study is to evaluate the clinical effects of small-diameter expanded polytetrafluoroethylene (ePTFE) H-graft portacaval shunts in the treatment of portal hypertension.

METHODSThirty-one patients with portal hypertension were treated with ePTFE small-diameter H-graft portacaval shunts from December 1995 to April 2002. Twenty-one had externally ringed grafts and 10 had non-ringed grafts; 20 had 10 mm diameter grafts and 11 had 8 mm grafts. The left gastric artery and coronary vein were ligated in 22 patients. Additionally, 6 patients underwent pericardial devascularization, and splenectomies were performed on 30 patients.

RESULTSAn average decrease of free portal pressure (FPP) from (32.13 +/- 4.86) cmH2O before shunting to (12.55 +/- 5.57) cmH2O after shunting was observed. Portal blood flow was reduced by 1/3 compared with the levels measured before shunting. Twenty-eight patients survived after the operation, and no upper gastrointestinal rebleeding occurred in the follow-up period (40.2 months on average). We lost contact with one patient. Color Doppler ultrasonography and/or portography revealed the shunts to be patent in 28 cases and occluded in 2 (6.4%) cases. Encephalopathy developed in 4 patients (12.9%).

CONCLUSIONSmall-diameter ePTFE H-graft portacaval shunts can effectively reduce portal pressure. Moreover, the majority of the hepatopetal flow from the portal vein can be adequately maintained. The reinforced shunts may achieve a higher rate of patency. Morbidity from encephalopathy was less frequent than in patients receiving total shunts. Small-diameter H-graft portacaval shunts are also effective in preventing recurrent variceal bleeding.

Adult ; Blood Vessel Prosthesis ; Female ; Humans ; Hypertension, Portal ; surgery ; Male ; Middle Aged ; Polytetrafluoroethylene ; Portacaval Shunt, Surgical ; methods ; Treatment Outcome

Objective To investigate the occupational hazards in automobile maintenance industry in Hangzhou and to provide field-research based evidence for prevention and control. Methods We visited 12 workshops of automobile maintenance to investigate the actors of occupational hazards, examine the protective facilities, and evaluate the occupation-related risk using MES method. Results The factors of occupation-related hazards at polishing posts met the criteria. At the painting posts in the painting room, the factors of chemical hazards satisfied the criteria, however, the levels of xylene and butyl acetate exceeded the standard lines in some enterprises when the ventilation system was close. The noise was higher than the limit at a few posts of sheet metal. The ventilation in spray paint room and the dust collector in dry mill room work well. The risks of occupational hazards at grinding, painting, and sheet metal posts were slightly harmful. Conclusion The occupational hazard factors in automobile repair enterprises were much more complicated. The noise hazard of the sheet metal posts was relatively prominent.