Objective To understand the quality of care for disabled elderly persons in ethnic areas and its influencing factors.Methods A questionnaire survey was carried out using multi-stage stratified random cluster sampling method for the disabled elderly persons in ethnic minority areas,and the relevant factors affecting the quality of care were analyzed.Results The object with different regions,ethnicity,marital status,residence and social support condition,education degrees,health status,the degree of disabilities affecting their life,occupations,income showed different scores in each dimension of care quality.Multiple linear regression analysis showed that other ethnic people with disabilities,unmarried,unemployed/laidoff people with disabilities,disabilities extremely influenced the quality of life affected the total score of care quality.Conclusions To improve the financial aid for disabled elderly people in ethnic areas,attach great importance to the physical and mental care of unmarried disabled elderly people,perfect and establish effective handicapped rehabilitation mechanism,can improve the care quality of disabled elderly people.

This study was aimed to investigate the theoretical basis of Jian-Shen Li-Shui (JSLS) formula. Knowledge
of acute phase of cerebral hemorrhage in ancient Chinese medicine literature, modern pathophysiology theories, experimental researches and clinical results were studied, in order to discuss theoretical basis of JSLS formula. The results showed that JSLS formula embodied basic theories of traditional Chinese medicine (TCM) and experiences of physicians from different generations. It also reflected modern pharmacology research results. It was supported by animal experiments and clinical research results. It was concluded that JSLS formula was in accordance with essence of TCM syndrome differentiation. There were enough evidences for the formation of the formula. It was worthy of further study.

This study was aimed to explore the function of c-Jun N-terminal kinase (JNK) signaling pathway in the induction of brain ischemic tolerance, and observe the function of Shu-Xue Tong-Mai (SXTM) capsule pretreatment. Ischemic preconditioning was performed for 3 min on rats to induce cerebral ischemic tolerance. Rat model of cere-bral ischemia reperfusion (the ischemia pretreatment group, I/R group) was established 24 h later. Western blot was used to detect the protein expression of JNK and phosphorylation of c-Jun N-terminal kinase (P-JNK), comparing to the expression with the sham operation group, I/R group and SXTM capsule group. Tunel method was applied to de-tect the apoptosis of neurons. Relationship between expression of JNK, P-JNK and apoptosis of neurons was also studied. The results showed that compared with the model group, expressions of P-JNK in ischemia preconditioning group and SXTM group were declined significantly (P < 0.05); and the apoptosis of neurons quantity was also de-clined (P< 0.05). It was concluded that ischemia preconditioning can decrease the apoptosis of neurons in cerebral ischemia reperfusion, and improve neurologic function. Its mechanism related to the inhibition of JNK signaling path-way. SXTM capsule pretreatment can protect the cerebral by inhibiting the JNK signaling pathway.

Multi-leaf collimators are devices to block rays from medical linear accelerators, which directly affect doses to targets and organs at risk by adjusting field shape and dose distribution in radiation therapy. As multi-leaf collimators are diversified in structure, there has been growing research on dosimetric comparison of various multi-leaf collimators. In this paper, we introduced the classifications of multi-leaf collimators according to their basic components, as well as the hardware structure and design features of the products of main accelerator manufacturers, including Varian’s Millennium MLC, HD120 MLC, and Halcyon, Elekta’s MLCi/i2 and Agility, and Accuray’s InCise 2 MLC and TomoTherapy. In terms of clinical application evaluation, focusing on radiotherapy plans for nasopharyngeal carcinoma, we reviewed comparative studies on the dosimetry performance of multi-leaf collimators and the effects of relevant parameters on dose distribution. We hope this review on the design and application evaluation of multi-leaf collimators can provide a reference for more innovative design and accelerator selection and parameter setting in clinical individualized treatment.

BACKGROUNDTamsulosin, an alpha-1 receptor antagonist, has been demonstrated effective in promoting distal ureteral stone passage and in reducing pain associated with stone expulsion. This study aimed to evaluate the effect of tamsulosin in comparison with nifedipine and extracorporeal shock wave lithotripsy (ESWL) on the expulsion rate of distal ureteral stones at different sizes.

METHODSWe assigned 314 patients to three categories: I, the stone with maximal diameter of 4.0 - 5.9 mm; II, 6.0 - 7.9 mm, and III, 8.0 - 9.9 mm. Patients in each category were randomly subdivided into three treatment subgroups: group A (nifedipine group), group B (tamsulosin group), and group C (ESWL group). Stone-free rate and the dose of analgesics were recorded weekly during the 4-week follow-up period.

RESULTSThree hundred and three patients completed the study. The results showed that nifedipine and tamsulosin treatments promoted a small (4 - 8 mm, categories I and II) stone expulsive rate that was comparable with ESWL treatment. Nonetheless, when the stone diameter was 8.0 - 9.9 mm, ESWL showed a greater stone free rate than nifedipine and tamsulosin treatments; no significant difference existed between the latter two therapies. Although the ESWL treatment group required the least analgesics, tamsulosin treatments required less pain medication than nifedipine (P < 0.05).

CONCLUSIONSTamsulosin treatment is recommended for patients with the stone diameter smaller than 8 mm because of its feasibility, effectiveness and safety. ESWL is more appropriate than tamsulosin therapy for the patients whose stones are larger than 8 mm.

Adrenergic alpha-Antagonists ; pharmacology ; Adult ; Calcium Channel Blockers ; pharmacology ; Female ; Humans ; Lithotripsy ; Male ; Middle Aged ; Nifedipine ; therapeutic use ; Sulfonamides ; therapeutic use ; Treatment Outcome ; Ureteral Calculi ; drug therapy ; therapy

BACKGROUND: Simultaneous pancreas and kidney transplantation (SPK) has been considered an effective therapeutic means of diabetes mellitus (including type 1 and type 2) combined with end stage uremia. Because the pancreas possesses high immunogenicity, so a feasible immunosuppressive regimen is a key to successful pancreas transplantation. OBJECTIVE: To investigate the feasible immunosuppressive regimen after simultaneous pancreas and kidney transplantation (SPK). METHODS: From January 2005 to June 2009, 9 patients with diabetic nephropathy and end stage uremia, consisting of 5 males and 4 females, received SPK. The pancreatic allograft exocrine secretion was drained into the proximal jejunum via a side-to-side duodenojujunostomy. Quadruple immunosuppressive regimen including induction of interleukin-2 receptor monoclonal antibody, tacrolimus, mycophenolate mofetil and steroid, and gradual tacrolimus monotherapy. The clinical data of the 9 patients were analyzed retrospectively. RESULTS AND CONCLUSION: SPK was successfully applied to all patients without serious surgical complications such as pancreatitis, graft dysfunction and pancreatic fistula. One patient died of cardiovascular accident in the early stage after SPK. The other 8 patients were followed up for 4-50 months. Serum creatinine decreased to normal range within 1 week after surgery. The 8 patients achieved euglycemia during early postoperative stage with insulin independence time (11.5±3.5) days and with fasting blood glucose recovery time (15.4±6.3) days. Acute rejection of the renal graft occurred in 4 patients, 1 patient died of cardiovascular accident and the other 3 recovered after antihuman thymocyte globulin or steroids bolus treatment. No rejection was noted in pancreatic grafts. These findings indicate that SPK is an effective treatment for patients with diabetes mellitus-related middle- and end-stage uremia．Quadruple immunosuppressive regime including interleukin-2 receptor monoclonal antibody induction is feasible after SPK, and such a regimen can be safely converted to tacrolimus monotherapy.

OBJECTIVETo study the effect of dust exposure and smoking on mortality.

METHODSBased on the Guangzhou Occupational Health Surveillance Record System established in 1989-1992, 61,648 factory workers, aged > or = 30, occupationally exposed to dust and non-exposure to dust or any other hazardous substances(controls), were included in a prospective cohort study.

RESULTS(1) 28 were lost to follow-up. Malignant neoplasm was most common among 1,186 deaths. (2) Most subjects were male workers, aged 35 to 44, with secondary education, and married. 42.2% had ever smoked and 32.8% were ever-drinkers. (3) To compare with non-exposure, non-smoking + non-smoking and non-exposure respectively, the adjusted RR of death from all causes, malignant neoplasm and respiratory diseases were 1.24, 1.34 and 1.96 respectively for dust exposed workers(compared to control, P < 0.01), 1.16, 1.37 and 1.63 respectively for those smoking(compared to non-smoker except RR of death from respiratory diseases, P < 0.01), and 1.48, 1.85 and 3.12 respectively for those smoking and dust exposure, which were far greater than those either smoked or exposed to dust alone(P < 0.01). (4) The influence of dust exposure on death was mainly showed in occupational exposure to silica dust and wood dust.

CONCLUSIONBoth dust exposure and smoking may increase the mortality, and they had synergistic effect.

Adult ; Cohort Studies ; Dust ; Female ; Humans ; Male ; Occupational Exposure ; adverse effects ; Prospective Studies ; Silicon Dioxide ; Smoking ; mortality ; Wood

OBJECTIVETo study the main causes of death in workers from different industries in Guangzhou.

METHODSThe industrial systems in Guangzhou were classified into six categories according to the Chinese Public Health Inspection Statistical Report. Baseline data on 79,547 workers, age > or = 35, were retrieved from individual health records under the Guangzhou Occupational Health Surveillance Record System established in 1989-1992. In this prospective cohort study, the workers' vital status and causes of death were followed up until 31 December 1998. Using SPSS 10.0, crude death rates were calculated and relative risks(RR) (95% CI) were estimated using Cox proportional-hazard models.

RESULTS(1) Among 79,547 workers were 49,355 men and 30,192 women, with mean age of (43.8 +/- 6.5) years, and 64% were aged 35-44. The mean age difference of workers in different industries was +/- 1 year. At baseline, 41% had been exposed to occupational hazards. Exposure was most prevalent in petroleum chemical industry(53.9%), followed by metallurgical industry, and the lowest exposure was in mechanical industry (30.2%). (2) The mean follow-up period was (8.0 +/- 1.3) years with 633,510 person-years. 1,577 workers had died with a total death rate of 248.9 per 100,000 person-years. The death rate in rubber industry was the highest, followed by metallurgical and petroleum chemical industries. Malignant neoplasms, vascular and respiratory diseases were most common, constituting 80.3% of all causes of death. (3) For all causes of death and the three main categories, the top three crude death rates were observed in rubber and petroleum chemical industries, and in the metallurgical industry except for vascular causes. The rubber industry had the highest crude death rate for all and vascular causes, and the metallurgical industry for malignant neoplasms and respiratory causes. (4) With the light industry as a reference (RR = 1.0), the metallurgical industry had the highest adjusted relative risks (RR) (95% CI) of 1.62(1.20-2.18) and 7.42(3.38-16.31) for malignant neoplasms and respiratory causes, respectively. The rubber industry had the highest RR of 1.69(1.40-2.04) for all causes. A significant RR of 2.03(1.43-2.88) for vascular causes was observed only in the rubber industry.

CONCLUSIONSThe main causes of death varied from industry. Malignant neoplasms and respiratory diseases were the leading causes in metallurgical and petroleum chemical industries. In rubber industry, vascular and respiratory causes were most common. Preventive measures for disease control should be tailor-made for each industry.

Adult ; Aged ; Cause of Death ; Cohort Studies ; Female ; Humans ; Industry ; Male ; Middle Aged ; Occupational Diseases ; mortality ; Occupational Exposure ; Proportional Hazards Models ; Prospective Studies

OBJECTIVETo investigate the clinicopathological features of nonalcoholic steatohepatitis (NASH) and elucidate its diagnosis and differential diagnosis.

METHODSLiver biopsy tissues and clinical data of 32 patients with NASH were collected and the clinicopathological findings by HE and Masson staining were evaluated for NASH grading.

RESULTSBallooning degeneration of the liver cells and fibrosis around hepatic sinusoid was scarce in mild NASH cases and increased in moderate to severe cases. Steatotic and inflammatory cells in the liver lobes decrease in liver cirrhosis related to seatohepatitis.

CONCLUSIONBallooning degeneration of the liver cells and fibrosis around the hepatic sinusoid have important value in differential diagnosis of mild from moderate to severe NASH, and correct histological grading benefits clinical intervention and prognostic evaluation of NASH.

Adult ; Biopsy, Needle ; Diagnosis, Differential ; Fatty Liver ; diagnosis ; pathology ; Female ; Humans ; Image Interpretation, Computer-Assisted ; Liver ; pathology ; Male ; Middle Aged ; Prognosis

Adult ; Hernia, Umbilical ; diagnosis ; surgery ; Humans ; Intestinal Obstruction ; diagnosis ; surgery ; Male