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

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

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： ：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: 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 study the effects of patient-controlled intravenous analgesia(PCIA) with Dexmedetomidine, Ropivacaine by local incision infiltration and combined analgesia on inflammatory factors and rapid rehabilitation in infants aged 3-6 months after radical resection of megacolon. Methods: From June 2016 to March 2018, 90 infants aged 3-6 months underwent radical resection of megacolon in Henan Provincial Children′s Hospital as the subjects.According to the postoperative analgesia mode applied to the children, they were divided into Dexmedetomidine group, Ropivacaine group and combined group (Dexmedetomidine PCIA combined with local infiltration of Ropivacaine), 30 cases in each group.The serum levels of interleukin(IL)-6 and IL-10 were measured and recorded 2 hours before operation and 24 hours after operation, and the analgesic scores of 4, 8, 12 and 24 hours after operation were recorded.The rapid recovery index of each group, standard and the number of complications were compared. Results: Compared with 2 hours before operation, the serum levels of IL-6 in the Dexmedetomidine group, Ropivacaine group and combined group [(24.61±1.44) ng/L vs.(13.84±0.65) ng/L, (26.39±1.29) ng/L vs.(13.85±0.67) ng/L, (20.58±2.06) ng/L vs.(13.87±0.63) ng/L], IL-10[(27.63±1.52) ng/L vs.(15.79±1.48) ng/L, (28.29±2.34) ng/L vs.(15.41±1.37) ng/L, (23.21±2.71) ng/L vs.(15.47±1.52) ng/L] were significantly higher (all P<0.05), while the levels of IL-6, IL-10 in combined group were lower than those in Dexmedetomidine group and Ropivacaine group (t_a=9.172, 9.835; t_b=10.221, 11.034, all P<0.05). At 4 h, 8 h, 12 h, 24 h after operation.The analgesic scores in combined group were(1.89±0.23) scores, (1.87±0.15) scores, (1.95±0.17) scores, (2.08±0.18) scores, those of dexmedetomidine group were(2.06±0.24) scores, (2.08±0.18) scores, (2.76±0.29) scores, (2.55±0.31) scores, those of Ropivacaine group were(2.10±0.26) scores, (2.15±0.26) scores, (2.32±0.19) scores, (3.00±0.28) scores, and the analgesic scores in combined group were significantly lower than those in Dexmedetomidine group and Ropivacaine group(t_a=8.526, 9.364, 10.287, 9.521; t_b=8.729, 9.514, 11.037, 9.184, all P<0.05). In comparison with the first exhaust time, anal extubation time, hospitalization days, hospitalization expenses and antibiotic use time in the three groups, it was found that combined group was significantly better than Dexmedetomidine group and Ropivacaine group(t_a=8.315, 8.294, 7.883, 9.261, 10.487; t_b=8.582, 8.329, 7.916, 9.348, 10.862, all P<0.05). The incidence of complications in the combined group, Dexmedetomidine group, and Ropivacaine group were not significantly different in 3 groups(χ²=0.577, P=0.749). Conclusions The continuous anesthesia of Dexmedetomidine combined with local infiltration of Ropivacaine incision can alleviate the postoperative inflammatory reaction and promote the rapid recovery of children.

AIM: To explore the clinical effects of Glucocorticoids, Cyclophosphamide and Octreotide in the treatment of Graves' ophthalmopathy(GO).

METHODS: A retrospective study was conducted. Totally 102 patients(152 eyes)with GO admitted to the hospital between June 2018 and October 2019 were divided into glucocorticoid group(33 cases, 51 eyes), cyclophosphamide group(38 cases, 59 eyes), and octreotide group(31 cases, 42 eyes)according to the treatment method. All groups received 12wk of treatment. The treatment results were comparatively analyzed. Changes in proptosis degree, diplopia, intraocular pressure and visual acuity before and after treatment were measured. Clinical activity scoring(CAS)of thyroid associated eye movements was performed. Changes in ocular axes, eyeball transverse diameter, ocular apex distance, retrobulbar perimeter, area and volume were measured by eye ultrasound. Changes in thyrotropin receptor antibody(TRAb), thyroid peroxidase antibody(TPOAb)and thyroid volume before and after treatment were determined. The incidence of adverse reactions was counted.

RESULTS: Compared with octreotide group, grades of curative effect of glucocorticoid group and cyclophosphamide group were better(P<0.05), but there was no statistically significant difference between glucocorticoid group and cyclophosphamide group(P>0.05). After 12wk of treatment, the proptosis degree and CAS scores of the three groups were decreased(P<0.05), visual acuity and conscious diplopia were improved, ocular apex distance, retrobulbar perimeter, area and volume, TRAb, TPOAb and thyroid volume were decreased(P<0.05). The proptosis degree, CAS scores, ocular apex distance, retrobulbar perimeter, area and volume, TRAb, TPOAb and thyroid volume of glucocorticoid group and cyclophosphamide group were smaller than those of octreotide group(P<0.05), without statistically significant differences between glucocorticoid group and cyclophosphamide group(P>0.05). During treatment, the incidences of weight gain and the total incidence of adverse reactions were higher in glucocorticoid group than in cyclophosphamide group and octreotide group(P<0.0167), but there were no statistically significant differences between cyclophosphamide group and octreotide group(P>0.0167).

CONCLUSION:Glucocorticoids and cyclophosphamide are better than octreotide in the treatment of GO, which can better improve ocular signs and thyroid-related lesions. Additionally, the incidence of adverse reactions caused by cyclophosphamide is lower than glucocorticoids, and its safety is higher. Therefore, cyclophosphamide is the first choice for treating GO.

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.