Objective:To observe the efficacy and safety of dexzopiclone plus auricular acupressure in intervening primary insomnia.Methods:A total of 72 participants who met the inclusion criteria were enrolled in a randomized controlled trial,with 36 cases allocated to a treatment group and 36 cases allocated to a control group.Both groups were given dexzopiclone as the routine treatment.Patients in the treatment group were given auricular acupressure with Wang Bu Liu Xing (Semen Vaccariae) seeds at the auricular acupoints related to sleep and emotion based on meridian theory,whereas for patients in the control group,the medical plasters with Wang Bu Liu Xing (Semen Vaccariae) seeds were only gently stuck to acupoints unrelated to sleep without stimulation.Patients in both groups were required to visit the hospital once a week for replacing the seeds and plasters.The course of intervention lasted for 8 weeks and the patients were followed up for another 4 weeks.Pittsburgh sleep quality index (PSQI) and Karolinska sleep diary (KSD) were used to evaluate the outcomes.Meanwhile,adverse effects were monitored and recorded.Results:In the enrolled 72 cases,4 patients (one in the treatment group and three in the control group) reported thirst and a bitter taste,and one case in the control group reported nausea and vomiting.At last,3 cases in the control group dropped out for adverse reactions,and 69 cases completed the clinical trial.After 8 weeks of treatment,the global scores of PSQI in both treatment and control groups decreased significantly compared with the baseline (both P＜0.001).Furthermore,the global score of PSQI in the treatment group was lower than that in the control group (P＜0.01).The global scores of PSQI in both groups at the follow-up were significantly different from the baseline (both P＜0.001),but insignificantly different compared with the post-treatment results (both P＞0.05).According to KSD,both treatment protocols could prolong the total sleep time,shorten sleep-onset latency,improve sleep efficacy and sleep quality significantly,and the changes in the treatment group were more significant.The total effective rate was 88.9％ in the treatment group,higher than 81.8％ in the control group,though the difference was statistically insignificant (P＞0.05).Conclusion:Dexzopiclone plus auricular acupressure is effective and safe for patients with primary insomnia both in short and long terms,and it is more effective than monotherapy of dexzopiclone.

Objective To examine the associations between occupational physical activity,heredity factors and metabolic syndrome (MS) in a Chinese population.Methods Based on the MS cohort study in Jiangsu province,subjects were followed-up,and blood samples were collected at the same time for biochemical indicators measurement.Newly confirmed MS patients according to US.National Cholesterol Education Program Adult Treatment Guidelines Ⅲ (NCEP-ATP Ⅲ ) were recruited as eases.Controls were 1 :1 matched with eases by region,gender and age (±2 years).In total,389 MS patients and 389 eontrols were recruited as study subjects.Nested ease-control study was applied for the present analysis.TaqMan fluorescence probe method was used to detect the genetic polymorphism of PPARα intron 1A/C (rs135539).Results (1)Compared to low physical activity group,the subjects with heavy physical activity were positively associated with MS (OR=2.18,95%CI:1.08-4.38).(2)The subjects,with a family history of hypertension (OR= 1.44,95% CI:1.02-2.03 )or type 2 diabetes (OR=3.25,95CI:1.28-8.20),were significantly indreased the occurrence of MS.(3)The genotype(AA,AC,CC) of PPARα intron 1A/C was not found to be related to MS.The OR of AC and CC genotype (compared to the genotype AA) were 0.98(95%CI:0.70-1.36) and 0.75 (95% CI:0.44-1.29) ,respectively.(4) Effect modifications were observed between family history of hypertension and moderate physical activity (OR=2.47,95% CI:1.00-6.06 ) or heavy physical activity (OR=3.82,95%CI:1.31-11.15) on the development of MS.Conclusion Heavy physical activity,with family history of hypertension or type 2 diabetes,seemed to be positively correlated with the risk of MS.Effect modifications were observed between occupational physical activity and family history of hypertension which might be associated with an increased risk of MS.

OBJECTIVETo evaluate the long-term therapeutic effects of repairing the whole auricular defects with osseointegrated prosthetic ears.

METHODSFrom January 2002 to December 2005, 62 patients (63 ears) with the whole auricular defects were treated with osseointegrated prosthetic ears and followed up for 5 - 8 years (median 6.5 years) after operations. In all cases, the following items were analyzed: stability and dislocation rate of the implants fixing prosthetic ears, infection of tissues surrounding implants, time and appearance satisfaction of wearing prosthetic ears, rate and time length of replacement of prosthetic ears, and presence of systemic complications or not.

RESULTSAll 63 ears were healed with one surgery, with the appearances of life like shapes, stable fixation, and natural color. Infection of implants and their surrounding tissues occurred in all cases, but didn't influence the stability of the implants. All 126 implant particles in 63 ears survived after one surgery, except that 4 implant particles were dislocated by trauma. In all cases, the time of wearing prosthetic ears was more than 8 hours per day. Because of color fading and breakage, average time length of replacement of prosthetic ears was 3.0 years. There were no intracranial or systemic complications.

CONCLUSIONSOsseointegrated prosthetic ears can be used in the treatment of the patients with the whole auricular defects, because of its safety and reliability, the stability of long-term therapeutic effects, and the good satisfaction of the patients.

Adolescent ; Adult ; Child ; Ear Auricle ; abnormalities ; Female ; Humans ; Male ; Middle Aged ; Osseointegration ; Prostheses and Implants ; Reconstructive Surgical Procedures ; methods ; Young Adult

OBJECTIVETo investigate the clinical significance of intact canal wall mastoidectomy combined with facial recess opening in the treatment of secretory otitis media of children.

METHODSThe clinical data of 17 children (19 ears) with recurrent secretory otitis media yet failed tube insertion more than 3 times, and treated with intact canal wall mastoidectomy combined with facial recess opening, in the Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of SUN Yat-sen University, were reviewed. And because of the eustachian tube dysfunction, 7 ears simultaneously accepted tube insertion, which were removed after 1 to 3 months.

RESULTSPathological examination of the lesions in middle ear and mastoid of the 19 ears, revealed cholesterol granuloma in 9 ears and inflammatory granulation in 10 ears. All 19 ears recovered with normal tympanic membranes. There were 16 ears with type A tympanogram and 3 ears with type C tympanogram (negative pressure less than 150 mm H₂O). The air-bone gaps were less than 15 dB in 3 months after surgery. There was no recurrence in all cases after 2 - 3 years follow-up.

CONCLUSIONSIn case of recurrent otitis media in children, especially when tube insertion is ineffective, intact canal wall mastoidectomy combined with facial recess opening can be adopted to clear the lesions thoroughly, and to establish long-time and effective ventilation of eustachian tube, tympanic cavity, tympanic antrum, and mastoid.

Adolescent ; Child ; Face ; surgery ; Female ; Humans ; Male ; Mastoid ; surgery ; Otitis Media with Effusion ; surgery ; Retrospective Studies

Under the guidance of State Administration of Traditional Chinese Medicine, Shanghai Municipal Commission of Health and Family Planning and Shanghai Municipal Office for Development of Traditional Chinese Medicine, Traditional Chinese Medicine( TCM) preventive health care service system was started to construct in 2011 in Changning District of Shanghai.The system was residents'needs orien-ted.After five years of effort, TCM preventive health care service system characterized with integration of prevention and treatment, multicultural atmosphere, supported by TCM featured services was formed.The new model of community health management provided a positive and beneficial practice for the Healthy City construction with Chinese and Shanghai characteristics.

Objective:To investigate the exposure level of ionizing radiation in medical radiation workers in Guangdong province, as well as their abnormality in the lens of the eye, and to analyze associated influence factors.Methods:In this study, 1 501 radiation workers from 60 hospitals were selected by using convenient sampling method for retrospecotive analysis of absorbed doses ( DL) to the lens of the eye, health examination information and the relevant influence factors. Results:The median value M and the 25 th and 75 th percentile values ( P25, P75)of the distribution of absorbed doses were 4.86, 2.99 and 7.90 mGy, respectively. The median values for male and female were 5.14 and 3.94 mGy, respectively. The median values for the Levels I, Ⅱ and Ⅲ medical institutions were 2.95, 3.51 and 5.06 mGy, respectively. The median values were radiotherapy 4.05 mGy, radiodiagnosis 4.84 mGy, interventional radiology 5.39 mGy and nuclear medicine 6.71 mGy, as well as nurses 3.48 mGy, physicians 5.03 mGy and technologists 5.03 mGy, respectively. There were statistically significant differences in dose distribution for different gender, age, length of radiation service, age at the beginning of radiation exposure, level of medical institution, occupational category and post ( Z=-6.72, H=389.64, 511.17, 70.29, 53.29, 49.06, 39.89, P<0.05). The detectable rate for increased cortical density of lens was 22.45% (337/1 501) and for lens turbidity was 8.19% (123/1 501). The detectable rate of increased cortical density showed a linear increasing trend with the increase in age, age of radiation service, age at the beginning of exposure to radiation, level of medical institution and dose ( χ2=366.36, 313.77, 15.18, 21.61, 92.13, P<0.05). The detectable rate of lens opacity increased linearly with the increase in age, length of radiation service, level of medical institution and dose( χ2=69.64, 67.65, 67.65, 37.37, P<0.05), and decreased linearly with the increase in age at the beginning of radiation exposure ( χ2=4.25, P<0.05). Logistic regression analysis showed that age was the influencing factor of increased cortical density ( χ2=165.98, P<0.05), and the risk of cortical densification increased with age ( OR=1.33, 95% CI: 1.27-1.39). Age, length of radiation service and occupation were the influencing factors of lens opacity ( χ2=25.78, 4.99, 6.88, P<0.05). The risk of lens opacity increased with age ( OR=1.17, 95% CI: 1.10-1.24). The risk of lens opacity increased with age of radiation service ( OR=1.06, 95% CI: 1.01-1.12). The risk of ocular opacity was higher in interventional radiology than that in diagnostic radiology, radiotherapy and nuclear medicine ( OR=2.59, 95% CI: 1.27-5.25). Conclusions:Long-term exposure to low dose ionizing radiation has a certain correlation with the abnormal lens detectable rate of medical radiation workers. Age, length of radiation service and occupation are the influencing factors of lens opacity.

OBJECTIVE: To investigate the subjective symptoms of eyes induced by laser radiation in workers and its related influencing factors. METHODS: A total of 82 workers exposed to laser radiation were taken as exposure group, and 71 workers without laser radiation exposure as control group by judgment sampling method. The questionnaire survey and subjective symptoms of eyes were surveyed in these two groups. The work-site surveys of laser radiation job posts and laser irradiation testing were conducted to evaluate the exposure level of laser radiation on each post. The basic eye use and eye discomfort symptoms were investigated. RESULTS: The median of the laser radiation in 12 workplaces was 2.18×10~(-5) W/cm~2, and it was below occupational exposure limit(2.22×10~(-3) W/cm~2). The total detection rate of subjective discomfort of eyes in the exposed group was significantly higher than that in the control group(35.4% vs 15.5%, P<0.05). The results of multivariate logistic regression analysis indicated that laser exposure and smoking were the risk factors of subjective symptoms of eyes(P<0.05). CONCLUSION: Laser radiation operation has the risk of causing the subjective symptoms of eyes in exposed workers.

OBJECTIVE: To analyze the growth arrest and DNA damage gene 45( GADD45) mRNA expression in peripheral blood of radiation workers,and its relationship with exposure dose. METHODS: Using a typical sampling method,97 radiation workers from a hospital of Guangdong were selected as radiation group,48 hospital administrative staff without exposure to radiation and other occupational hazard factors were selected as control group. The real-time quantitative polymerase chain reaction was used to detect GADD45 mRNA expression of two groups. With the use of thermoluminescence dosimetry,we detected and collected personal dose data of radiation group over the past year. RESULTS: The GADD45 mRNA relative expression of the radiation group was higher than that of the control group( P < 0. 01).There was no correlation between GADD45 mRNA relative expression and factors such as personal dose,sex,age,length of service,smoking,and alcohol drinking( P > 0. 05). CONCLUSION: The ionizing radiation can lead to up-regulation of GADD45 mRNA expression in peripheral blood of radiation workers,but there was no linear relationship between GADD45 mRNA expression and its personal dose.