Objective To measure the reliability and validity of the Lam Assessment of Stages of Employment Readiness (LASER) Putonghua version for injured workers, and observe the confidence of return to work on different preparation stages. Methods 85 injured workers with limb fractures were included. The data was obtained through face-to-face structured interview. The test-retest reliability and internal consistency were measured. Factor analysis was used to examine construct validity of the Putonghua version LASER. Results Principle component analysis extracted four factors, which was consistent with the original version of LASER. Intra- class correlation coefficient (ICC) of test-retest ranged 0.27~0.89, whereas the internal consistence among these 4 stages ranged 0.691~0.796. There were significantly differences in confident scores in different stages among 3 different confidence groups. Conclusion The structure validity of Putonghua version of LASER is useful for reflecting the readiness of injured workers' return to work. However, the reliability coefficient is rather low in some of the items, which could be resulted in incorrect judgment of readiness of return to work of injured workers. The further study on items correction and development is apparent.

Objectives: To determine the efficacy of low-dose heparin in preventing central catheter occlusion and its safety among neonates. Materials and Methods: A randomized controlled trial was conducted among 42 neonates requiring peripherally inserted central catheter (PICC) lines. The neonates were divided into two groups: low dose heparin (0.5 units/kg/hr =0.2 units/ml) and control group (0.5 units/ml). The efficacy outcomes were duration of catheter patency, completion of catheter use, and the presence of catheter occlusion or thrombosis. The safety outcomes include heparin complications. Results: The study participants had a mean age of 17 days old at 35 weeks gestational age and mean weight of 1.97 kg. The participants given low dose heparin were 36% more likely to complete the use of central line and 12% less likely to develop catheter occlusion. Analyses showed non-statistically significant risk ratio of active bleeding, thrombocytopenia, and deranged prothrombin time in the low dose heparin group. Conclusion The use of low dose heparin (0.5 units/kg/hr = 0.2 units/ml) appears as effective as the control dose in completion of catheter use and prevention of catheter occlusion. There was also no significant difference in the adverse effects. Low dose heparin can be used as continuous infusion for preventing central line occlusion; however, it has no advantage in lowering the risk of complications.
Hemorrhage

Disinfection ; Escherichia coli ; isolation & purification ; Hospitals ; Medical Waste ; Sewage ; Waste Products ; Water Microbiology

ObjectiveTo explore the clinical effect of modified Wuhutang in the treatment of children with acute asthma. MethodA total of 130 children with acute asthma were randomly divided into an observation group and a control group， with 65 cases in each group. The observation group was treated with modified Wuhutang and the control group was treated with procaterol hydrochloride for one week. The scores of primary symptoms （wheezing， cough， shortness of breath， and chest tightness） and secondary symptoms （mental status， runny nose， dry mouth， tongue texture， tongue coating， stool， etc.）， lung functions， immunoglobulin E （IgE） expression， eosinophil （EOS） count， and serum inflammatory factors， including interleukin （IL）-5， IL-6， IL-8， and IL-1β in two groups before and after treatment were compared. ResultThe data of 126 children were statistically analyzed. As revealed by the results， compared with the conditions before treatment， the scores of primary symptoms and secondary symptoms， serum levels of IL， IgE expression， and EOS count were both reduced in two groups （P<0.05）， lung functions were increased in the two groups（P<0.05）. Compared with the control group after treatment， the observation group showed decreased scores of cough and secondary symptoms （P<0.05）， and insignificant decrease in IL-1β （P<0.05）. The improvement in lung functions， IgE expression， and EOS count in observation group was equivalent to that in control group. ConclusionModified Wuhutang for treatment of acute asthma in children （phlegm-heat obstructing lung syndrome） can significantly relieve the clinical symptoms， improve lung functions， and reduce IgE， IL-5， IL-6， IL-8， IL-1β expression levels and EOS count， and its overall clinical efficacy is superior or equivalent to that of tprocaterol hydrochloride.

Objective: The purpose of this study was to explore the application value of digital surgery in the reconstruction of mandibular composite defects with a chimeric deep circumflex iliac artery perforator flap (DCIAPF). Methods: Six patients with complex defects within half of the mandible underwent reconstruction using DCIAPF from January 2019 to January 2020 in Shenzhen People’s Hospital. Doppler was used to locate the deep iliac circumflex artery, the range of mandibular osteotomy was designed, and DCIAPF was used to repair the mandibular composite under the guidance of the guide plate during the operation. Twelve months postoperatively, the facial shape, jaw height, and occlusal relationship were evaluated Results: DCIAPF was harvested successfully in 6 patients, and the heights of all alveolar ridges and occlusal function of patients were significantly restored, without pain or snapping in the temporomandibular joint area. Conclusion The blood supply of DCIAPF is rich, and soft-bone tissue is sufficient for the reconstruction of mandibular composite defects. Combined with digital surgery, the accuracy and safety are improved.

Objective： ：To investigate the expression of miR-137 in cervical cancer tissues and cells, and to explore its effect on proliferation, migration and invasion of cervical cancer cells as well as the mechanisms. Methods： ：Thirty-two pairs of cervical cancer tissues and corresponding para-cancerous tissues that surgically resected at the Department of Gynecology and Obstetrics of Dongguan People's Hospital from January 2017 to March 2018 were collected for this study. In addition, cervical cancer cell lines C33A, HeLa, SiHa and cervical epithelial immortalized cell line H8 were also collected. The expression of miR-137 in cervical cancer tissues and cell lines was detected by RT-PCR. miR-137 mimics and miR-137 NC were respectively transfected into C33Aand HeLa cells, and the effects of miR-137 over-expression on proliferation, migration and invasion of cervical cancer cell lines were observed by CCK-8 and Transwell assay. Luciferase reporter gene assay and WB were used to determine the relationship between miR-137 and Wnt5a in cervical cancer. Wnt5a over-expression vector was constructed, and the effects of simultaneous over-expression of Wnt5a and miR-137 on proliferation, migration and invasion of C33Aand HeLa cells were observed. Results： ：The expression level of miR-137 was significantly down-regulated in cervical cancer tissues and cell lines, as compared to para-cancerous tissues and H8 cells (all P<0.05). The over-expression of miR-137 significantly inhibited cell proliferation, migration and invasion of C33A and HeLa cells (all P<0.05). Moreover, Wnt5a was identified as a target of miR-137 by luciferase reporter gene assay. Furthermore, Wnt5a over-expression, to a certain degree, attenuated the suppressive effects of miR-137 on the proliferation, migration and invasion of C33A and HeLa cells. Conclusion： ：miR-137 can inhibit the proliferation, migration and invasion of cervical cancer cells via targeting Wnt5a, which may be an effective target for the treatment of cervical cancer.

Objective: To compare the effects of high-volume hemofiltration (HVHF) and continuous veno-venous hemofiltration (CVVH) on cardiopulmonary functions, lung fluid balance, lung damage and cytokine expression in endotoxin-induced acute lung injury piglet model, and to further evaluate the value of high-volume hemofiltration in acute lung injury. Method: Eighteen piglets were randomly divided into the control group (6 piglets), the CVVH group (6 piglets) and the HVHF group (6 piglets). By general anesthesia, the intravenous infusion of 0.15 mg/kg endotoxin were received in all the animals and induced acute lung injury.High-volume hemofiltration and continuous veno-venous hemofiltration were addressed to different groups.Subsequently, hemodynamic parameters (heart rate, mean arterial blood pressure, central venous pressure, pulse contour cardiac index, systemic venous resistance index and extravascular lung water index) as well as gas exchange and lung mechanics parameters (respiratory rate, partial pressure of carbon dioxide, partial pressure of oxygen/fraction of inspired oxygen, dynamic lung compliance and airway resistance) were intermittently measured.Lung tissues were collected for further analysis (the lung wet-to-dry weight ratio, lung injury scoring). The plasma protein levels of cytokines (interleukin(IL) -6, 10 and tumor necrosis factors alpha(TNF-α)) were also assessed.Two-way analysis of variance (ANOVA) and Bonferroni post-test were conducted to identify significant differences among the control, CVVH and HVHF group. Result: Compared with CVVH, HVHF had the capacity to improve significantly the index of Cdyn(HVHF (2.3±0.5) vs. CVVH (1.5±0.5) ml/(cmH₂O·kg), 1 cmH₂O=0.098 kPa, P<0.05)and Rrs(HVHF (22.0±1.9) vs.CVVH (29.5±1.5) cmH₂O/(L·s), P<0.05)at the time of 6 h, and decreased lung water accumulation(index of EVLWI in HVHF (22.7±2.1) vs.CVVH (39.5±2.6) ml/m^2, P<0.01) at the time of 6 h, and the plasma concentration of cytokines(IL-6, IL-10, TNF-α)in the HVHF group had an obvious decline compared with those in the CVVH group at the time of 6 h( (200±55) vs. (280±61), (74±17) vs. (102±21), (54±13) vs. (73±21) pg/ml, all P<0.05). The lung injury scoring of HVHF group was significantly lower than those of CVVH group((7.8±1.9) vs. (11.3±2.2) scores, P<0.05). Although the plasma concentration of cytokines(IL-6, IL-10, TNF-α) in the CVVH group were lower than those in the control group at the time of 6 h((374±55), (137±25), (98±17) pg/ml, all P<0.05), the indexes of respiratory function were not improved (all P<0.05). Conclusion Different doses hemofiltration can reduce plasma inflammatory mediators indicators in piglets.Early high volume hemofiltration can improve respiratory function of piglets with endotoxin-induced acute lung injury and reduce lung injury pathological score.

We retrospectively analyzed all patients presenting with upper gastrointestinal bleeding to Seremban Hospital over a one-year period. A quarter of the oesophagogastro-duodenoscopies (OGD) performed were performed as emergency for upper gastrointestinal tract bleeding. Gastric ulcers and duodenal ulcers were the two most common findings. Our results suggest that there is a male preponderance of 2:1, the Chinese were more likely to be affected and the elderly (> 60 years) were at highest risk.
Endoscopy, Gastrointestinal ; Gastrointestinal Hemorrhage/ethnology ; Gastrointestinal Hemorrhage/*etiology ; Gastrointestinal Hemorrhage/therapy ; Malaysia ; Retrospective Studies ; Risk Factors ; Sex Factors

AIM: To study the efficacy of laser combined with ranibizumab in the treatment of proliferative diabetic retinopathy(PDR)and its effects on levels of plasminogen activator inhibitor(PAI), tissue plasminogen activator(t-PA)and vascular endothelial growth factor(VEGF)in aqueous humor.

METHODS: Totally 76 cases of patients(76 eyes)with PDR were divided into observation group(n=41)and control group(n=35)according to the use of ranibizumab or not. Control group was given routine laser surgery, and observation group was added with ranibizumab for adjuvant treatment. The laser energy and density used in treatment, and the best corrected visual acuity(BCVA), central macular thickness(CMT)and levels of PAI, t-PA and VEGF in aqueous humor after treatment, postoperative complications and prognosis were compared between the two groups.

RESULTS: The sunfleck quantity, laser energy and energy density in observation group were lower than those in control group(P<0.05). After treatment, the BCVA in the two groups was gradually increased while the CMT was gradually decreased, and the difference within-groups at different times was statistically significant(P<0.05), and the BCVA in observation group was higher than that in control group at the same time while the CMT was lower than that in control group(P<0.05). After treatment, the levels of VEGF, t-PA and PAI in aqueous humor were gradually increased, and were significantly lower than preoperative levels(P<0.05), and there was a statistically significant difference at different time points within-groups(P<0.05), and the levels of VEGF, t-PA and PAI in aqueous humor in observation group were lower than those in control group at the same time(P<0.05). The incidence rates of postoperative macular edema in the two groups were 17% and 37% respectively(P<0.05). The PDR recurrence rates at 1a after operation were 6% and 16% respectively(P>0.05).

CONCLUSION: Laser combined with ranibizumab for PDR can significantly reduce the expression levels of serum VEGF, t-PA and PAI in aqueous humor, decrease the CMT, and improve the BCVA. And combined therapy is beneficial to reduce the sunfleck quantity, laser energy and energy density during treatment, and lower the laser damage towards the retina.

In recent years, the incidence of idiosyncratic drug-induced liver injury (IDILI) has been increasing, posing a threat to human health. This article reviews the incidence, pathogenesis, and the principles of clinical diagnosis and treatment of IDILI. Because there is limited literature on IDILI in children, so this article simply describes the experience in the diagnosis and treatment of IDILI in children. It is considered that to reduce the incidence of IDILI in children, drug indications should be strictly followed, and molecular test and accurate medical treatment should be promoted.