Adolescent ; Adult ; China ; Dust ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Industry ; Male ; Middle Aged ; Occupational Exposure ; prevention & control ; Transients and Migrants ; psychology ; Young Adult

Objective To assess the effect of anti- Helicobacter pylori (Hp) treatment on patients with chronic idiopathic thrombocytopenic purpura (cITP). Methods Fifty-nine patients with cITP and positive-Hp were divided into two groups by random digits table:Hp eradication group (30 cases,given a standard anti-Hp treatment) and placebo controlled group (29 cases,received a placebo). The platelet response of two groups was compared after three months' follow-up. Result The platelet response in Hp eradication group (63.3%, 19/30) was significantly higher than that in placebo controlled group (27.6%,8/29 )(χ2 = 7.59, P ＜ 0.05 ), and the increasing level of platelet count in Hp eradication group [ (33.5 ± 21.6)× 109/L] was higher than that in placebo controlled group [(12.6 ± 19.5) × 109/L] (t = 5.52,P ＜0.05).Conclusion Hp eradication treatment can promote the platelet recovery in mild and moderate cITP patients with positive-Hp.

Gastroenterology ; Humans ; Integrative Medicine

ObjectiveTo dynamically observe the paradoxical effect (inhibitory at low concentratin but promotive at high concentration) of caspofungin and micafungin across Candida species in vitro.MethodsA broth microdilution testing was performed following the Clinical and Laboratory Standards Institute(CLSI) M27-A2 document to observe the paradoxical effect of caspofungin and micafungin across 85 Candida strains.The growth of Candida was observed on a daily basis for 7 days.ResultsAt 48 hours,the prevalence of paradoxical growth in C.albicans,C.glabrata,C.parapsilosis,C.tropicalis,C.dubliniensis and other species of Candida was 90％,20％,41.7％,37.5％,33.3％ and 28.6％ respectively after caspofungin treatment,and 5％,0,0,25％,33.3％and 0 respectively after micafungin treatment.The concentration range of caspofungin required for the paradoxical growth of C.albicans,C.glabrata,C.parapsilosis,C.tropicalis,C.dubliniensis and other species of Candida was 4-16,8-32,8-32,2-8,2-8,8-32 μg/ml respectively,and that of micafungin for the paradoxical growth of C.albicans,C.tropicalis and C.dubliniensis was 4-16,4-32 and 1-8 μg/ml,respectively.After 48 hours,the prevalence of paradoxical growth still increased in C.parapsilosis,C.glabrata,and other species of Candida following caspofungin treatment,and in C.albicans and C.glabrata following micafungin treatment.ConclusionsThe occurrence,and time of occurrence,of paradoxical effect of echinocandins is Candida speciesand drug-specific.The prevalence of paradoxical effect is higher for caspofungin than for micafungin,which seems unrelated to their MICs against Candida species.

OBJECTIVETo evaluate the efficacy of water knife needle release combined with bone peptide injection in the management of heel pain.

METHODSThirty-five patients with unilateral heel pain were treated with water knife needle release and bone peptide injection under local anesthesia. The deep tissue with the tenderness was released in the operation, and the result was evaluated 1 week after the surgery to decide whether to conduct another surgery. No more than 3 treatment sessions were administered. The efficacy was evaluated according to nimodipine method by the principles of Chinese clinical drug guidance, and the complications of the surgery were observed.

RESULTSSix months after the surgery, 28 cases had excellent results, 3 had good outcomes, 2 showed improvement, and 2 failed to respond favorably, with a rate of good and excellent result of 94.2%. No adverse side effect was recorded in the follow up of the patients.

CONCLUSIONWater needle knife release combined with bone peptide injection can produce a good result in the treatment of heel pain.

Adult ; Aged ; Female ; Foot Diseases ; therapy ; Heel ; Humans ; Injections ; Male ; Middle Aged ; Needles

Objective To investigate the effects of Candida albicans on the expression of tumor necrosis factor-α(TNF-α)and activation of the intracellular signaling molecule p38 mitogen-activated protein kinase(p38MAPK)in a human acute monocytic leukemia cell line THP-1. Methods Some THP-1 cells were divided into several groups in vitro: two C. albicans groups treated with 105 CFU/ml and 106 CFU/ml heat-killed C. albicans respectively, a lipopolysaccharide (LPS)group treated with 100 μg/L LPS, a blank control group treated with RPMI 1640 medium, two dexamethasone-inhibited groups pretreated with 40 μg/L dexamethasone for 30 minutes followed by treatment with 106 CFU/ml heat-killed C. albicans and LPS respectively. After treatment for 1, 3 and 6 hours, real-time fluorescence-based quantitative PCR was performed to measure TNF-α mRNA expression in THP-1 cells in the above groups. Enzyme-linked immunosorbent assay(ELISA)was conducted to determine the level of TNF-α protein in the supernatant of THP-1 cells treated with 106 CFU/ml heat-killed C. albicans, 100 μg/L LPS or RPMI 1640 medium(blank control group)for 24 hours. Western blot was performed to measure the protein expression of p38MAPK and phosphorylated p38MAPK in THP-1 cells after treatment with 106 CFU/ml heat-killed C. albicans or RPMI 1640 medium (blank control group)for 30 and 60 minutes. Statistical analysis was carried out by using two-way analysis of variance, one-way analysis of variance and the least significant difference(LSD)-t test. Results Significant differences were observed in the mRNA expression level of TNF-α among the C. albicans groups, LPS group and blank control group (F = 110.98, P < 0.001). The mRNA expression level of TNF-α in THP-1 cells increased over time in a time-dependent manner after C. albicans treatment, with significant differences among different time points (F = 701.680, P < 0.001). Compared with the blank control group, both 106-CFU/ml C. albicans group and LPS group showed a significant increase in TNF-α protein expression (6385.70 ± 533.99 ng/L and 3212.06 ± 353.00 ng/L vs. 147.10 ± 0.53 ng/L, P < 0.001 and 0.005, respectively). An obvious increase was observed in the expression level of phosphorylated p38MAPK protein, but no significant changes were noted in that of p38MAPK protein, in THP-1 cells treated with 106 CFU/ml C. albicans for 30 and 60 minutes compared with the blank control group. The mRNA expression level of TNF-α significantly decreased in dexamethasone-pretreated 106-CFU/ml C. albicans group and LPS group compared with those without dexamethasone pretreatment(3.77 ± 0.62 vs. 208.50 ± 10.50, 6.20 ± 1.93 vs. 161.35 ± 1.65, both P < 0.001). Conclusions Heat-killed C. albicans can induce the activation of p38MAPK in and secretion of TNF-α by human THP-1 cells, which then participate in the innate immune response against C. albicans.

Objective To investigate the potential effect of cetyltrimethyl ammonium bromide(CTAB)separated mannan of cell wall from Candida albicans on the production of IL -6and IL -8in h uman peripheral blood mononuclear cells(PBMC)induced by lipopoly saccharide(LPS).Methods PBMCs were pretreated with differen t concentrations of CTAB mannan(1.000mg /mL?0.100mg /mL?0.010mg /mL)for 24h.LPS(50?g /mL)was added and co-incubated for 24h.And a t 48h,the supernatants were collected.At 24h and 48h,only the super-natants of stimulated by CTABmannan were collected.LPS(50?g /mL)was the positive control,unstimula ted culture medium the negative control.The con tents of IL -6and IL -8in the supernatants were determined by ELISA.Re-sults At 24h and 48h,no IL -6and IL -8were detected in 3different concentration-CTAB mannan groups.LPS could induce IL -6(478.507?24.876ng /mL),IL -8(529.655?53.279ng /mL).The contents of IL -6and IL -8of negative control were not detectable.In 1.000mg /mL CTAB mannan +LPS group the contents of IL -6were(85.620?16.058ng /mL,P=0.004),IL -8were(123.940?20.319ng /mL,P=0.011).In 0.100mg /mL CTAB mannan +LPS group,IL -6(210.086?27.874ng /mL,P=0.007),IL -8(206.798?31.878ng /mL,P=0.022).In 0.010mg /mL CTAB mannan +LPS grou p,IL -6(201.387?32.396ng /mL,P=0.014),IL -8(203.133?36.012ng /mL,P=0.015).Conclusion CTAB mannan of cell wall from Candida albicans could downregulate the production o f IL -6and IL -8from human peripheral blood mononuclear cells induced by LPS.

Objective To evaluate the application of abbreviated protocol (AP) of magnetic resonance imaging (MRI) in screening of breast cancer with dense breast tissue.Methods Total 478 patients with dense breast tissue,who had negative X-ray mammography (MG),underwent dynamic contrast-enhanced MRI (DCE-MRI).The AP MRI,which consisted of first postcontrast subtracted (FAST) and maximum-intensity projection (MIP),and full diagnostic protocol (FDP) MRI images were analyzed by Breast Imaging Reporting and Data System (BI-RADS).Among 478 patients the histopathological diagnosis was available in 39 cases (41 breast lesions).With pathological diagnosis as gold standard,the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of AP and FDP in breast cancer detection were evaluated.Results In 41 breast lesions there were 16 malignant lesions and 25 benign lesions.FDP detected all 16 malignant lesions,including 9 cases of ductal carcinoma in situ,6 cases of invasive ductal carcinoma and 1 case of mucinous carcinoma;AP detected 15 out of 16 cases of breast cancer.The sensitivity of FDP and AP in detection of breast malignant lesions was 16/16 and 15/16,respectively (x2 =0.725,P =0.224).The specificity of FDP and AP was 92％ (23/25) and 76％ (19/25),respectively (x2 =6.327,P =0.012).Conclusion For women with dense breast tissue AP of MRI can be used in early screening of breast cancer.

Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.

Objective To investigate whether human neutrophils kill Candida albicans through recognition of insoluble β-glucan in cell walls of C.albicans (CalG) by dectin-1,a C-type lectin receptor.Methods Neutrophils were obtained from peripheral blood of healthy human subjects and cultured in vitro.Real-time PCR was carried out to quantify the mRNA expressions of dectin-1 and Toll-like receptor 2 (TLR2) in neutrophils challenged with CaIG of 100 mg/L for 1,6,and 24 hours.A Fluoro hydrogen peroxide (H2O2) detection kit was used to determine H2O2 levels in some neutrophils exposed to CaIG (100 mg/L) for 15 minutes,2 hours,6 hours,as well as in some neutrophils preincubated with laminarin (a dectin-1 inhibitor) of 100 mg/L and 50 mg/L for 30 minutes followed by challenge with CaIG of 100 mg/L for 2 hours.Colony forming units (CFUs) were counted after the incubation of C.albicans with neutrophils pretreated with laminarin of 100 mg/L and 50 mg/L for 30 minutes.Results The relative mRNA expression level of dectin-1 was 2.8195 + 0.1669,5.4859 + 0.7244 and 3.6041 + 0.5372 in neutrophils challenged with CaIG for 1,6 and 24 hours,respectively,significantly higher than that in unchallenged neutrophils at these corresponding time points (all P ＜ 0.01).The level of H2O2 was (64.55 + 15.67),(290.34 + 30.56),and (208.54 ± 26.88) μ mol/L respectively in neutrophils treated with CaIG for 15 minutes,2 hours,and 6 hours respectively,compared to (22.05 ± 3.99) μmol/L in untreated neutrophils (all P ＜ 0.01).The pretreatment with laminarin of 100 and 50 mg/L attenuated the release of H2O2 in CaIG-treated neutrophils by 73％ ((80.45 + 22.41) μ mol/L,P＜ 0.01) and 45％ ((130.42 + 44.55) μmol/L,P＜ 0.01),respectively,compared with neutrophils treated with CaIG only.The fungicidal activity of neutrophils against C.albicans was also significantly inhibited by pretreatment with laminarin of 50 and 100 mg/L (both P＜ 0.01).Conclusions Dectin-1 may be involved in the secretion of H2O2 as well as killing of C.albicans by human neutrophils,which may provide a preliminary evidence for adoptive transfer of neutrophils as an approach to the treatment of systemic C.albicans infection.