Objective To explore the effects of indoor environmental factors on the respiratory symptoms in children aged 4-17 years. Methods A cross-sectional survey of indoor environmental factors related respiratory symptoms in 6 551 children and teenagers aged 4-17 years was conducted throughout urban area of Shanghai in 2007. The information was obtained on certain aspects of the family socioeconomic status (SES) and other confounding factors,and the associations between indoor environmental factors and respiratory symptoms were analyzed. Results After controlling confounders,parent smoking,the house or the classroom nearby roads (

Objective To explore the indoor air pollution level related to traffic and fuel gas using for cooking and to assess its effect on the respiratory disease and symptoms in children and teenagers. Methods Based on a cross-sectional survey in 6 551 children and teenagers in the urban area of Shanghai in 2007, 197 children were randomly selected in stratified districts and the level of CO, NO2, PM10 and benzene in indoor air in their home were measured. The variables of distance of nearest street or way, traffic density and the time of using fuel gas for cooking were collected and a multiple linear regression model was established to estimate indoor air pollution level related traffic and fuel gas using for cooking. The associations between indoor air pollutants concentrations and respiratory symptoms and disease were analyzed with multiple Logistic Regression model. Results After potential founders being controlled, the significant associations were observed between per 20 ?g/m3 increase of indoor NO2 concentration and dry cough(OR:1.12,95%CI:1.03-1.20),morning cough(OR:1.08,95%CI:1.01-1.17), wheezing (OR: 1.09,95%CI:1.0-1.19), bronchitis (OR: 1.21, 95%CI:1.01-1.46). The similar effects were observed between the per 30 ?g/m3 increase of indoor PM10 concentration and dry cough(OR:1.28,95%CI:1.02-1.59),wheeze(OR:1.34,95%CI:1.04-1.71),current asthma (OR:1.87,95%CI:1.08-3.23). The significant associations were also observed between house was nearby major street/road (

Objective To evaluate the efficacy of clemastine fumarate in antagonizing atracuriuminduced release of histamine in the patients undergoing surgery under general anesthesia.Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 21-59 yr,with body mass index of 17-26 kg/m2,scheduled for elective modified radical mastectomy,were divided into 2 groups (n=40 each) using a random number table:control group (group C) and clemastine fumarat group (group CF).Clemastine fumarate 2 mg was injected intramuscularly at 20 min before induction of anesthesia.Anesthesia was induced with iv midazolam 0.1 mg/kg,etomidate 0.3 mg/kg,fentanyl 4-6 μg/kg and atracurium 0.8 mg/kg.The patients were mechanically ventilated after insertion of the larygeal mask airway.Anesthesia was maintained with inhalation of 2％ sevoflurane.Before administration of clemastine fumarate,at 20 min after administration,immediately before administration of atracurium,and at 2,5,10 and 20 min after administration of atracurium,arterial blood samples were taken for determination of plasma histamine concentrations,and the peak airway pressure and degree of cutaneous color were recorded.The development of histaminemia and adverse cardiovascular events was assessed.Steward recovery scores and Ramsay sedation scores were recorded at 10 min after removal of the laryngeal mask airway.Results The incidence of histaminemia was 60％ and 8％ in C and CF groups,respectively.Compared with group C,the plasma histamine concentrations,incidence of histaminemia,degree of cutaneous color,and incidence of hypotension and tachycardia were significantly decreased (P＜0.05),and no significant change was found in the peak airway pressure,Steward recovery scores and Ramsay sedation scores in group CF (P＞0.05).Conclusion For atracurium-induced release of histamine in the patients undergoing surgery under general anesthesia,clemastine fumarate 2 mg injected intramuscularly before operation can not only antagonize histamine at H1 level,but also reduce histamine release,and exerts no influence on recovery from anesthesia and produces good antihistamine efficacy.

Objective To understand the infectious pathogens distribution and drug resistance in the surgical departments of our hospital from 2007 to 2011 to provide the basis for the anti-infective therapy in the surgical patients.Methods TheVitek automatic microbial identification system was used to identify bacteria and fungi.The Kirby-bauer (KB)method was used to study the antibi-otic resistance in the pathogens isolated from the patients in the surgical departments.Results 1218 strains of pathogens were iso-lated,including 669 strains(55%)of Gram-negative bacteria,440 strains(36%)of Gram-positive bacteria and 109 strains (9%)of fungi.The top five of bacteria in turn were Escherichia coli in 182 strains(15%),Pseudomonas aeruginosa in 171 strains (14%), Staphylococcus aureus in 105 strains (9%),Klebsiella pneumoniae in 86 strains (7%)and Enterococcus faecalis in 61 strains(5%). Among 283 strains of Escherichia coli,Klebsiella pneumoniae and proteus mirabilis,the detection rate of ESBLs producing strains was 29.7%.Methicillin-resistant Staphylococcus aureus(MRSA)accounted for 63% of Staphylococcus aureus.The resistance rates of Staphylococcus and Enterococcus to multiple antibacterial drugs were above 50%.Enterobacteriaceae bacteria were more sensi-tive to carbapenems as well as compound antibacterial drugs containing enzyme inhibitor.The lowest resistance rate of Acinetobact-er to cefoperazone/sulbactam was 21.1%.Pseudomonas aeruginosa showed the most sensitive to compound antibacterial drugs con-taining enzyme inhibitor and its lowest resistance rate to cefoperazone/sulbactam was 17.4%.Conclusion The drug resistance phe-nomenon in the pathogens isolated from the surgical patients are relatively serious,this study provides some basis for the preventive antimicrobial drugs use in the perioperative period and the empirical medication in the infection therapy.

BACKGROUND:Chinese medicine therapy is effective for patients with mild-to-moderate lumbar spinal stenosis and also has a better long-term effect than surgical patients, which can enhance perioperative efficacy and prevent spinal restenosis. OBJECTIVE:To evaluate the clinical efficacy of “Tongmai songjin yigu” massage therapy on lumbar spinal stenosis. METHODS:Eighty-four patients with degenerative lumbar spinal stenosis were randomly and equaly divided into treatment group and control group. Treatment group were treated with “Tongmai songjin yigu” massage therapy; patients in the control group were treated according to the guidelines for diagnosis and treatment of common disease in orthopedics and traumatology promulgated by China Association of Chinese Medicine, once a day, continuous for 2 weeks. RESULTS AND CONCLUSION:After treatment, the visual analog scale score in the treatment group was improved significantly (P < 0.05), and there was a significant difference in the Japanese Orthopaedic Association Scores on subjective symptom and daily life between the treatment and control groups (P < 0.05). The effective rate of the treatment group was higher than that of the control group (P< 0.05). These findings indicate that “Tongmai songjin yigu” massage therapy is better than traditional massage, but clinical large-sample studies are required.

OBJECTIVETo explore the impacts on the life quality and the effect mechanism in the patients of allergic rhinitis (AR) treated with warm acupuncture in winter and summer.

METHODSTwo hundred and forty patients of AR were randomized into a summer and winter acupuncture group, a non-summer and winter acupuncture group and a western medication group, 80 cases in each one. In the two acupuncture groups, Dazhui (GV 14), Fengmen (BL 12), Feishu (BL 13), Pishu (BL 20) and Shenshu (BL 23) were selected. In the summer and winter acupuncture group, the warm acupuncture started at the first day of the three periods of hot season and the first day of the third nine-day period after the winter solstice. The treatment was given once every two days, continuously for 15 times. Totally, 30 treatments were required a year. In the non-summer and winter acupuncture group, the warm acupuncture was applied out of the three periods of the hot season and the third nine-day period after the winter solstice. The treatment was given once every two days and 30 treatments for a year. In the western medication group, cetirizine was taken orally, continuously for 30 days as one session. In the three groups, the treatment for 1 year was taken as one session. The second session started in the next year. Totally, 2 sessions were required. The score of rhinoconjunctivitis quality of life questionnaire (RQLQ) and the level of serum immunoglobulin E (IgE) were compared in the patients' of each group before treatment and in 1 and 2 sessions of treatment.

RESULTSAfter treatment, the scores of 7 domains, named activities, common complaints, practical problems, sleep, ocular symptoms, nasal symptoms and emotions were all improved as compared with those before treatment, in the patients of the three groups (all P < 0.05). After 2 sessions treatment, the results in the summer and winter acupuncture group were better than those in the other two groups (all P < 0.05), and the results in the non-summer and winter acupuncture group were better than those in the western medication group (all P < 0.05). After treatment, serum IgE level was lower averagely than that before treatment in the three groups (all P < 0.05). After 2 sessions treatment, the result in the summer and winter acupuncture group was lower than that in the other two groups (both P < 0.05), and the result in the non-summer and winter acupuncture group was lower than that in the western medication group (P < 0.05). After treatment, the total effective rate was 92.3% (72/78) in the summer and winter acupuncture group, better than 80.5% (62/77) in the non-summer and winter acupuncture group and 69.7% (53/76) in the western medication group (both P < 0.05).

CONCLUSIONThe warm acupuncture in both summer and winter achieves the definite efficacy on AR and the effect mechanism is relevant with reducing serum IgE level.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Rhinitis, Allergic ; therapy ; Seasons ; Treatment Outcome ; Young Adult

Objective: To analysis the clinical efficacy of dorsal digital nerves fasciocutaneous pedicle flap (DDNFPF) with superficial vein anastomosis in the treatment of the type III and type IV of fingertip defect, and the relationship between the incidence of vein crisis and superficial vein anastomosis. Methods: A total of 85 patients with 92 fingers, treated by DDNFPF from February, 2017 to December, 2018, were retrospectively analyzed. The superficial veins of 30 patients with 32 fingers were anastomosed, and 55 patients with 60 fingers were not. The difference of the superior rate and the incidence of venous crisis between superficial vein anastomosis and non-superficial vein anastomosis was compared by Chi-square test. The difference was considered as statistically significant when P<0.05. The regular postoperative followed-up was performed. Results: The average followed-up time was (7.0±2.9) months. The incidence of venous crisis in anastomosis group (1/32) was lower than that in non-anastomosis group (13/60). The difference was statistically significant (χ²=4.217, P<0.05) . There was no significant difference in the superior rate between the 2 groups after operation (96.8% and 90.0% respectively, χ²=0.596, P>0.05) . The repaired fingertips of the 2 groups were in good appearance, wear-resistant, stable holders and two-point discrimination was 5 to 8 mm. Conclusion DDNFPF for the type III and IV type of fingertip defect is safe and effective. A anastomosis of superficial veins in recipient area can significantly reduce the incidence of venous crisis.

Objective: To analyze the relationship between alcohol related knowledge, attitude,practice and alcohol use disorder among high school students, and to provide reference for alcohol abuse intervention. Methods: The study adopted stratified cluster sampling. A total of 811 high school students from 4 high schools in Changning District were selected to conduct a questionnaire survey on alcohol related knowledge, attitude,practice and alcohol dependence. The software SPSS 20.0 was used for statistical analysis. Results: There were 279 (34.4%) high school students with mild alcohol use disorder and 29 (3.6%) with severe alcohol use disorder. The average score of high school students alcohol related knowledge, attitude,practice scores were (9.56±3.55) ( 4.96± 2.36) and (2.81±1.29),respectively. High school students alcohol related knowledge, attitude,practice were negatively correlated with alcohol use disorder score ( r =-0.10, -0.39, -0.71, P <0.01). Multivariate Logistic regression indicated that the total score of alcohol related KAP ( OR=0.86, 95%CI =0.83-0.89) and the family economic level (high level: OR=2.05, 95%CI =1.26-3.32) were positively associated with mild alcohol use disorder. The total score of alcohol related KAP ( OR=0.76, 95%CI =0.70-0.83) and school type ( OR=3.72, 95%CI =1.51-9.18) were positively associated with severe alcohol use disorder ( P <0.05). Conclusion There is a correlation between low alcohol related KAP and alcohol use disorder, alcohol related health education should be strengthened, especially among vocational school students and students from high family economic level.

Objective To analyze the variation characteristics of rpoB,katG,inhA,rpsL and embB related genes of Mycobacterium tuberculosis(MTB)in Qinzhou,Guangxi.Methods PCR reverse point hybridization was used to detect 5 common resistance mutants of Mycobacterium tuberculosis in 237 MTB-DNA positive sputum samples.Results Among 237 cases of tuberculosis patients,72 cases(30.38%)were resistant to the four kinds of anti-TB drugs.The resistance mutation rate of rifampin,isoniazid and streptomycin was 2.53%, 13.92%,3.80%.The top 5 gene mutation detection loci of Mycobacterium tuberculosis were-15M,S531L and 43M.Conclusion The main drug-resistant strains are isoniazid resistance,and the mutation of inhA gene were the major one in Qinzhou,Guangxi.

ObjectiveTo analyze the association between alcohol dependence and overweight and obesity among high school students. MethodsThis study adopted stratified cluster sampling method. Four high schools （one vocational high school included） were selected as the research sites. We used self-designed questionnaires to investigate the drinking behavior of high school students. This study used propensity score matching method to control confounding factors （e.g gender， school type， etc.）. Then we compared the differences in drinking behavior between obese/overweight group and normal weight group after matching， and used a multivariate logistic regression model to analyze the relationship between drinking behavior and overweight and obesity. ResultsA total of 811 high school students participated in the survey. 60 people were excluded due to mild and moderate weight loss， and 751 people were normal or obese/overweight. After 1：1 propensity score matching， there were 217 people each in obese/overweight group and normal group. The characteristics of gender， school type， grade and family economic level of the two groups were balanced after matching. The difference was statistically significant （P<0.05） between obese/overweight and normal group in the following： drinking of alcohol at high school， alcohol dependence， the maximum drinks at one time， drinking of alcohol at family gatherings， whether bought alcohol for others， whether their family members recommended drinking， whether they have tried to quit drinking in the past year， and the time of blush after drinking. The multivariate logistic regression analysis indicated that the degree of alcohol dependence （the alcohol use disorder score ≥ 8） was a risk factor for overweight and obesity （OR=3.600， 95%CI： 1.244‒10.424）. Besides， having bought alcohol for others and family members advising alcohol consumption were suggested to be protective factors for overweight and obesity （OR=0.525， 95%CI： 0.309‒0.890 and OR=0.377， 95%CI： 0.222‒0.641）. ConclusionHigh school students who have alcohol dependence suffer a higher risk of obesity/overweight， while high school students who may have drinking behaviors but do not have alcohol dependence have a lower risk of obesity/overweight. It is critical to guide young people on drinking in terms of health.