Humans ; Medical Staff ; Occupational Exposure ; prevention & control ; Occupational Health

Objectives To explore the changes of serum interleukin-33 (IL-33), IgA anti-endothelial cell antibodies (AECA) and IgA anticardiolipin antibodies (ACA) in acute stage of Henoch-Sch?nlein purpura (HSP) in children and its clinical signiif-cance. Methods Thirty-seven children with acute HSP admitted to hospital were selected from Nov.2012 to Jan.2013. Twenty healthy children were selected as healthy controls. The serum levels of IL-33 were measured by double anti-body sandwich en-zyme-linked immunosorbent assay (ELISA) and the serum levels of AECA-IgA and ACA-IgA were detected by double antigen sandwich ELISA. Results Serum levels of IL-33, AECA-IgA and ACA-IgA in patients with acute HSP were signiifcantly higher than those in healthy controls (P<0.001). According to different clinical types, the serum levels of IL-33, AECA-IgA and ACA-IgA were signiifcantly higher in mixed-type HSP (with joint involvement and gastrointestinal symptoms and/or kidney damage) than those in HSP patients with only joint, abdomen or renal involvement (P<0.05). Serum levels of IL-33 in acute stage of HSP had a positive correlation with AECA-IgA (r=0.752, P<0.001) and ACA-IgA (r=0.788, P<0.001). Conclusions The immune pathological injury in vessels caused by the interaction of IL-33, AECA-IgA and ACA-IgA may be the important pathogenesis of HSP, which may provide a clue for the early diagnosis and treatment for HSP.

Sinus histiocytosis with massive lymphadenopathy( SHML) is also called Rosai-Dorfman disease.It is a kind of benign lymphoid tissue proliferative diseases with unknown etiology.SHML appeared mostly in children and adolescent.It has diverse clinical manifestations accompanied with multiple organ inju-ry,and no clear laboratory indicators could support the disease,being a rare disease in pediatrics,easyot miss diagnosis.Thsi article reviewde the latest progress on diagnostis and treatment of SHML,to improve teh un-derstanding of the disease.

BACKGROUND:There are less reports about the external use of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) hydrogel to repair thick skin graft donor sites. By now, relevant self-control studies have not been retrieved. OBJECTIVE:To observe the effect of rhGM-CSF on the repair of thick skin graft donor sites. METHODS:Sixty patients with burns and scar hyperplasia undergoing autologous thick skin grafting were enroled, 47 males and 13 females, aged 18-65 years. The thigh was selected as donor sites. According to the depth of donor sites, the patients were divided into 0.4 mm and 0.55 mm groups, with 30 cases in each group. Wounds on the symmetric areas with equal area and same depth were selected or wounds with same depth were selected and divided equaly. The wounds were randomly assigned into treatment group and control group. The treatment group was treated with rhGM-CSF hydrogel externaly; the control group was only given vaseline dressing. At postoperative 3, 7, 10, 14 days, the fresh dressing was changed. Then, the wound appearance, healing time, healing rate and adverse effects were observed in the two groups. RESULTS AND CONCLUSION:At 14 days after operation, the wound surface was smoother and the pigmentation was relatively less in the treatment group compared with the control group; the degree of wound pain
was less in the treatment group than the control group during dressing change (P < 0.05). At 10 and 14 days after operation, the healing rate and healing time were better in the treatment group than the control group (P < 0.05). No general malaise or hypersensitivity cases were reported, and local issue hyperplasia was also not found. Al the above indicate that the external use of the rhGM-CSF hydrogel can evidently shorten the healing time and improve the healing condition when it is applied in the thick skin graft donor sites.

Objective To evaluate the prognostic value of 18 F?FDG PET/CT in untreated small cell lung cancer ( SCLC) . Methods A total of 49 SCLC patients( 35 males, 14 females, median age 61 years) with pathologically confirmed SCLC had underwent 18 F?FDG PET/CT scan before treatment from January 2008 to December 2013 and were retrospectively analyzed in this study. Clinical staging were mainly deter?mined by 18 F?FDG PET/CT scan. Performance status ( PS) was acquired according to the clinical symptoms before PET examination. Patients were followed up for at least 6 months and the survival interval was recor?ded. Two?sample t test, Kaplan?Merier, log?rank and Cox regression analysis were used for statistical analy?sis. Results (1)Among 49 patients, 20 died during the follow?up, 1 patient was lost to follow?up, and 45 patients(91.84%) had metastasis. Patients with limited disease (LD) and extensive disease (ED) were 27 and 22 respectively according to 18F?FDG PET/CT imaging. (2)The median OS was 23.68 months and me?dian PFS was 19.93 months. LD patients had significantly longer OS and PFS than ED patients (35.30 months vs 12.57 months, 28.87 months vs 11.30 months;χ2=18.810, 13.647, both P<0.05). (3)SUVmax of primary tumor ranged from 1.97 to 21.50. The SUVmax of primary foci had no difference between LD(8.27± 3.14) and ED(9.68±5.36)patients(P>0.05). SUVmax of primary tumor showed no significant correlation with OS and PFS (both P>0.05).There were no significant differences in OS and PFS between low SUVmax group and high SUVmax group in both LD and ED patients (χ2=0.001-0.565, all P>0.05). (4) Staging based on 18 F?FDG PET/CT results and PS score were independent prognostic factors ( hazard ratios:3.93, 5?00, both P<0.05) , while SUVmax showed no significant prognostic value. Conclusions PS score before PET scan and imaging staging based on 18 F?FDG PET/CT results are independent prognostic factors. The predictive value of primary foci SUVmax needs further investigation.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Combined Modality Therapy ; Exercise Therapy ; Female ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Spinal Diseases ; therapy ; Sprains and Strains ; therapy ; Young Adult

Objective To investigate the effect of pre- hospital emergency care programs in children with febrile seizures,in order to reduce damage by febrile seizures and obtain the best firstaid effect. Methods 112 cases of children with febrile seizures were treated in pediatric department of our hospital from April 2009 to February 2011.The parents of 75 children patients were given guidance of prehospital emergency care,they were set as the pre-hospital emergency care group.The other 37 cases were set as the non-pre-hospital emergency care group,routine emergency care was given until the medical personnel arrived at the spot.The conditions of aspiration,tongue bite injury,another episode of febrile seizures and brain damage were recorded in two groups of children. Results Only one case of aspiration and three cases of febrile seizures occurred in the pre-hospital emergency care group by misoperation of parents.Non brain damage and tongue bite injury occurred.The incidence rate of improper consequences was 5.3％in the pre-hospital emergency care group,lower than that of the non-pre-hospital emergency care group,51.4％. Conclusions To give pre-hospital emergency care guidance to parents of children patients by mobile phones before the health care workers reach the spot can significantly reduce accidental injury of children,stabilize the emotion of parents,decrease the impact of seizures on children,all the above has a positive effect on follow-up treatment.

Objective To evaluate the effect of situational health education in glycemic control in type 2 diabetes patients.Methods A total of 98 patients with type 2 diabetes was randomly assigned to the control(n=49)and the study group(n=49).The control group received conventional diabetes education,while the study group received situational health education.Fasting blood glucose(FBG),2-hour plasma glucose (2 hPG),HbAlc and the self-care behaviors were observed at baseline and 1-year after the intervention.Paired t test was used for data analysis.Results FPG,2hPG,HbA1c and self-care behavior scores were not significantly different between the two group at baseline.After 1-year intervention,FPG,2hPG and HbA1c of the two groups were significantly decreased,and FPG,2hPG and HbA1c of the study group were significantly lower than those of the control group(t values were 2.71,3.35 and 2.90,respectively; all P＜ 0.05).In comparison with the control group,self-care scores of the study group were increased(t values were 7.36,6.51,5.24,5.07,6.57 and 6.77,respectively; all P＜0.05).Conclusion Situational health education could improve self-management and glycemic control of type 2 diabetic patients.

Objective To investigate the relationship between the expression of Toll-like receptor 4 (TLR4) on mononuclear cells in peripheral blood and changes of serum vitamin D level in children with bronchiolitis.Methods The children who were diagnosed as bronchiolitis and received treatment in the Second Affiliated Hospital of Harbin Medical University from October 2013 to January 2014 were chosen as the pre-treatment group,and then divided them into moderate group and severe group according to the clinical symptoms,20 cases for each group.Then the cases in pre-treatment group who recovered after treatment were recruited as the after-treatment group,and the children who were healthy and medical examination in the Second Affiliated Hospital of Harbin Medical University in the same period were recruited as the healthy control group.The expressions of TLR4 on CD14 labeled mononuclear cells in the periphera were measured by flow cytometry.The level of 25 (OH) D in serum was detected by enzyme linked immunosorbent assay (ELISA).Results (1) The expression level in children with bronchiolitis of TLR4:the mode-rate group [(18.98 ±2.29)％] and severe group [(30.13 ±2.13)％] increased significantly (P ＜0.05) compared with control group [(1.17 ± 0.57) ％].And the expression level of moderate group [(2.02 ± 0.48) ％] and severe group [(11.43 ± 1.52) ％] decreased significantly after treatment (P ＜0.05).(2) Serum vitamin D level in children with bronchiolitis of the moderate group[(17.16 ± 3.34) μg/L] and severe group [(6.56 ± 2.28) μg/L] were lower than healthy control group [(53.69 ± 20.18) μg/L] before treatment (P ＜ 0.05),especially the severe group [(6.56 ±2.28) μg/L].The level of moderate group [(9.59 ± 2.31) μg/L] and severe group [(4.70 ± 0.67) μg/L] became lower after treatment (P ＜ 0.05).(3) Both severe group (r =-0.491,P ＜ 0.05) before treatment and moderate group (r =-0.436,P ＜ 0.05) after treatment showed negative correlation between TLR4 on mononuclear cells in peripheral blood and serum 25 (OH)D level in children with bronchiolitis.And no correlation was found among healthy control group,moderate group before treatment and severe group after treatment (P ＞ 0.05).Conclusions The conditions of children with bronchiolitis was positively correlated with the expression level of TLR4,and negatively correlated with the vitamin D level.The serum 25 (OH) D decreased steadily during the treatment.The expression of TLR4 in monocytes has a certain correlation with the level of vitamin D in children with bronchiolitis.

10.3969/j.issn.2095-4344.2013.23.018