Adult ; Humans ; Male ; Scleroderma, Systemic ; Silicosis ; Syndrome

Objective To investigate the epidemiological characteristics and risk factors of clonorchiasis of hospital patients in Heilongjiang Province,so as to provide the evidence for formulating the control and prevention strategies. Methods A total of 2 359 suspected patients from human parasitic disease research institute of Harbin medical university were investigated. Total?ly 6 718 stool samples and 2 359 serum samples were tested by Kato?Katz technique and the enzyme linked immune method re?spectively. Meanwhile,the information of the patients was collected by questionnaires. Results Totally 513 suspected patients were infected with Clonorchis sinensis. The infection rate of the suspected patients was higher in the ≥29 group(P<0.05), and the infection rate and positive rate of blood tests of the rural suspected patients were both higher than those of the urban sus?pected patients(both P<0.05). The habit of eating raw fish and shrimp was the risk factor of clonorchiasis. Conclusion Clo?norchiasis is one of the main food?borne parasitic diseases in Heilongjiang Province. The habit of eating raw fish and shrimp is the risk factor of clonorchiasis.

The provision of hospice care can improve the quality of life for terminal patients. Currently the measurement tools for knowledge, attitudes and practices(KAP)of hospice care providers have been developed and widely used internationally. This article reviews the measurement scales and relevant factors for KAP of hospice care to provide reference for further studies. The databases of CNKI, Wanfang data, PubMed, Web of Science databases, Google and Baidu search engines were systematically searched. According to the retrieval strategy, 42 literatures were finally included for analysis. The development of measurement scales and influencing factors about KAP of medical staff were reviewed from the included studies. It appeared some mature scales have been applied in different extent, or available for interpretation into different language versions. Most of researches adopted quantitative tools to measure medical staff's KAP on hospice care. The current researches conducted in China mainland showed a change on target population from nurses to specialized doctors and from a single group to multidisciplinary medical team. In the future, it would be more focusing on multidisciplinary team mainly comprised of general practitioners, nurses and social workers. Till recently, there is little literature evidence for study of the characteristics of localization.

OBJECTIVETo study whether co-stimulatory molecule CD40 of alveolar macrophage (AM) participated in the occurrence and development of silicosis, and to explore the intervention of Yiqi Huoxue Decoction (YHD) in the fibrosis of silicosis patients.

METHODSTotally 46 silicosis inpatients and outpatients were recruited and randomly assigned to the Western treatment group (A) and the Chinese medicine (CM) treatment group (B), 23 in each group. Patients in Group A received routine symptomatic treatment such as anti-inflammation, phlegm resolving, anti-spasm, and asthma relief, and so on. Patients in Group B additionally took YHD, one dose daily for 14 successive days. Besides, another 18 patients with chronic cough and sense of laryngeal foreign bodies were recruited as the normal control group, who had no obvious lesion confirmed by bronchofi6roscope and clinical diagnosis of the lung. They were treated by symptomatic supporting treatment. The alveolar lavage fluid was collected from all patients and isolated, and AM cells were cultured. The level of CD40 mRNA was detected by RT-PCR. The expression of CD40 protein was detected by Western blot.

RESULTSCompared with the normal control group, expression levels of CD40 mRNA and CD40 protein significantly increased in Group A (P < 0.01). Compared with Group A, expression levels of CD40 mRNA and CD40 protein significantly decreased in Group B (P < 0.01).

CONCLUSIONSHighly expressed co-stimulatory molecule CD40 of AM might participate in pulmonary fibrosis. YHD could hinder its roles, inhibit the progression of fibrosis, thereby playing an interventional role of treatment.

CD40 Antigens ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Fibrosis ; Humans ; Lung ; Male ; Pulmonary Fibrosis ; RNA, Messenger ; metabolism ; Silicosis ; drug therapy ; metabolism

Objective: To analyze the clinical features and outcomes of cardiac resynchronization therapy (CRT) in patients with dilated-phase hypertrophic cardiomyopathy (DHCM). Methods: A total of 16 DHCM patients received CRT in our hospital from 2007-03 to 2016-01 were retrospectively studied to analyze their clinical features and outcomes. Results: There were 12 male and 4 female patients at the mean age of (53.3±13.5) years. Pre-operative QRS duration of ECG was (158.7±32.2) ms, left ventricular ejection fraction (LVEF) was (33.6±6.3) %, the patient with NYHA class I, II, III and IV were 1, 5, 8 and 2 respectively. 13 patients received new CRT device, 3 received upgraded device and 8 (50%) combining atrial fibrillation (AF). The patients were followed-up for (2.56±2.13) years, 5 of them died including 3 of heart failure, 1 of sudden death and 1 of stroke. At 6 months follow-up time, 7 patients had the response to CRT which was defined by the improvement of NYHA class≥1 and the absolute elevation of LVEF≥5%; NYHA class improved from (2.69±0.79) to (2.38±0.89), P=0.02; LVEF increased from (33.6±6.3) % to (40.03±9.83) %, P=0.01. Conclusion: DHCM patients with CRT indication had the higher incidence to suffer from AF, those were more in patients with traditional pacemaker or ICD upgrading. DHCM patients with CRT had the poor general prognosis, while there was still certain proportion of patients had the response to CRT.

To analyze the predictors and prognosis for super-response to cardiac resynchronization therapy (CRT) in patients with different etiology. Methods: A total of 181 patients received CRT in our hospital from 2012-01 to 2016-01 were enrolled. The patients were divided into 3 groups: Non-response group, n=63, Response group, n=62 and Super-response group, n=56. The patients were followed-up at 6 months after CRT. Results: There were 30.9% (56/181) patients having super-response. Compared with the other 2 groups, Super-response group had more patients with NYHA II-III and less NYHA IV, the patients were with the smaller LAD, LVESD, LVEDD andless patients had CRT-D implantation. The baseline cardiac function was obviously improved at 6 months after CRT in all 3 groups. The basic LVEDD, LVESD, CRT-D implantation, non-ischemic cardiomyopathy (NICM) and NYHA IV were the independent predictors for super-response occurrence. In addition, compared with ischemic cardiomyopathy (ICM), NICM patients had the higher ratio for super-response occurrence (37.6% vs 7.5%), P<0.001. Survival analysis indicated that NICM patients had the lower risk of all cause mortality (HR=0.31, 95% CI 0.14-0.80), cardiac death (HR=0.27, 95% CI 0.09-0.48) and combined endpoints (HR=0.36, 95% CI 0.27-0.78). Conclusion: At baseline condition, the patients with less degree of left ventricular reconstruction, CRT-D implantation, NICM and NYHA IV had more chance to suffer from super-response after CRT. NICM patients had the better response and prognosis to CRT.

Objective To investigation the pathological characteristics of esophageal squamous cell carcinoma to provide reference criteria for delineating the target area in radiotherapy.Methods Fifty-two patients from the Fourth Hospital of HeBei Medical University underwent resection whom all had been proved to have esophageal squamous cell carcinoma before operation.Chest CT was scanned and transmitted to the 3- dimensional conformal planning system for radiotherapy by VRX-16 scanner.The lesion of esophageal carcinoma was delineated in the 3-dimensional rebuild CT image and the lesion volume was computed by digital rebuild program.Every surgically resected specimen was made into pathologic giant section.The actual size of the specimen was obtained by calculating the size under the microscope with the shrinkage ratio.Multicentric carcinomatous lesion,severe dysplasia and direct intramural infiltration were observed in the giant section with a microscope and the order of such pathological characteristics were analysed statistically.Results 1.The tumor length by different method of preparation of operated specimens differed obviously.The longest was shown by CT. 2.Multicentric carcinomatous lesion was found in 15(29%)cases out of 52 patients.Proximal to the tumor,the mean distance between the multicentric carcinomatous lesion and the main lesion plus the length of the multicentric carcinomatous lesion was 3.02?1.45cm.Distal to the tumor,it was 2.60?2.44 cm.Severe dysplasia was found in 28 patients.Proximally,the mean distance between the severe dysplasia and the main lesion plus the length of the severe dysplasia was 2.45?1.30 cm.Distal to the tumor,it was 3.24?2.19 cm.Direct intramural infiltration was found in 41 patients,of which the mean length being 2.80?1.52 cm proximally and 2.02?1.51 cm distally. 3.Tumor thrombus was found in 6 patients and lymphoduct infiltration in 36 patients.Direct intramural infiltration was found at higher incidence in specimens complicated with lymphoduct infiltration(86%)and those complicated with tumor thrombus(91%).There were no apparent factors affecting severe dysplasia.The proximal distance to direct intra- mural infiltration was much longer than distally.Conclusions Multicentric carcinomatous lesion,severe dysplasia and direct intramural infiltration may be observed in esophageal squamous cell carcinoma.Multicentric carcinomatous lesion and direct intramural infiltration are obviously correlated with lymphoduct infiltration.To cover 95% of the microscopic extension,a margin of 5.0 cm is needed proximal to the base of gross tumor volume,and 7.5 cm distal to it.To cover 90% of the microscopic extension,a margin of 4.5 cm is needed proximally,and 5.0 cm distally.

OBJECTIVETo study the ECG features in children with dilated cardiomyopathy (DCM), and related factors for the occurrence of arrhythmia secondary to DCM.

METHODSData from 68 children with DCM from January 1998 to March 2011 were studied. The children were classified into three groups: severe arrhythmia (n=42), non-severe arrhythmia (n=20) and non-arrhythmia (n=6). Left ventricular end diastolic diameter (LVED), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were compared.

RESULTSAbnormal ECG results were found in all of the 68 children with DCM. Sinus tachycardia (91%) and ectopic pulsatile (86%) were common. LVED in the severe arrhythmia group (74±6 mm) was greater than that in the non-severe arrhythmia group (65±4 mm; P<0.05) and non-arrhythmia group (61±3 mm; P<0.05). LVED in the non-severe arrhythmia group was also greater than that in the non-arrhythmia group (P<0.05). LVEF and LVFS in the severe arrhythmia group were (30±11)% and (22±4)%, respectively, which were lower than those in the non-severe arrhythmia group［(37±12)% and (28±5)%, respectively］and non-arrhythmia group［(45±9)% and (34±7)%, respectively］(P<0.05). There were also significant differences in the LVEF and LVFS between the non-severe arrhythmia and non-arrhythmia groups (P<0.05).

CONCLUSIONSThe common abnormal ECG findings are sinus tachycardia and ectopic pulsatile in children with DCM. Arrhythmia is one of the main clinical manifestations of DCM. The occurrence of arrhythmia is associated with the left ventricular size and heart function.

Adolescent ; Arrhythmias, Cardiac ; etiology ; Cardiomyopathy, Dilated ; complications ; physiopathology ; Child ; Child, Preschool ; Electrocardiography ; Female ; Humans ; Infant ; Male

Objective To investigate the liver injury and pathological changes of rat and patients with Clonorchis sinensis(C, sinensis) infection, and to clarify the role of apoptosis in the injury induced by C. sinensis.Methods Wistar rats were divided into two group: 60 in infection group and 20 in control. The rats in infection group were infected with C. sinensis via oral feeding encysted cercaria;rats in control group were fed with normal saline. The rats were sacrificed 4, 6, 8 and 12 weeks after infection, respectively. Liver tissue specimens of the patients infected with C. sinensis were collected. The pathological changes of liver tissue were observed by light microscopy and the apoptofic rate of hepatocyte was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL) assay. Results Parasites and eggs could he seen around the bile duct, and the duct was associated with mucosa and adenoma papillary hyperplasia, wall thickening, inflammatory cell infiltration, a small amount of fibrous tissue hyperplasia, and periportal liver cells surrounded by a number of nuclear condensation, all these changes meant morphological characteristics of apoptosis. Apoptotic rates of liver cells in infection group 4, 6,8 and 12 weeks after infection were (7.15 ± 1.50)%,(11.61 ± 3.09)%,(13.21 ± 3.47)% and (11.26 ± 4.06)%,respectively, which was significantly higher than that in control group [(2.57 ± 0.72)%, (3.17 + 0.77)%, (3.67 ±0.96)% and (2.84 ± 0.87)%, t values were 4.45, 5.49, 5.95 and 4.74, respectively, all P < 0.01]. Conclusions These findings indicate that C, sinensis can stimulate both hepatoeytic apoptosis and degeneration which may he related to clinical manifestations and liver lesions in patients with clonorchiasis.

Objective To study the expressions of foliate binding protein 1(Folbp1),Wnt and ?-catenin genes on the heart of offspring during the development of embryo,whose mother was deficient of folic acid.Methods Control group involving 18 rats and study group involving 18 rats were choosen from the total 36 adult female SD rats randomly copulate with the male normal rats after feeding different fodder for 2 weeks.The heart of the 13.5,17.5 days embryos and the newborns were obtained.The expressions of Folbp1,Wnt and ?-catenin genes mRNA at the 3 periods were evaluated by RT-PCR.Results The expressions of Folbp1,Wnt and ?-catenin genes mRNA of the study group were significantly weaker than those of the control group in heart of the 13.5,17.5 days embryos and the newborns(all P