In this review,the pathogenesis,clinical presentations,diagnosis of occupational asthma(OA)are discussed.The agents that cause OA are more than 300 kinds of high and low molecular-weight substances.The diagnosis of OA is generally established on the basis of a suggestive occupational history,symptoms,abnormal lung function and lab examination.Specific inhalation of bronchial challenge(SIC)comes closest to a gold standard test for some agents causing(sensitizer-induced)OA.

Objective To explore the relation between serum Hcy,Cys C levels and type2 diabetic macro-vascular complications and its clinical significance.Methods The serum levels of Hcy and Cys C were measured with immunoturbidimetry in 80 cases of type 2 diabetic patients with macrovascular complications and 80 cases of type 2 diabetes without macrovascular complications,and in 80 healthy subjects which was seleted as control.Results Serum levels of Hcy and Cys C of type 2 diabetic patients with macrovascular complications were (26.42 ± 5.75)μmol/L and (2.30 ±0.40)μmol/L,which were higher than those of patients without macrovascular complica-tions for (15.31 ±3.13)μmol/L and (1.51 ±0.27)μmol/L(t =15.17,14.64,all P <0.05);Moreover,which were also higher than those in the healthy control group for (8.86 ±1.62)μmol/L and (0.85 ±0.14)μmol/L(t =26.29, 30.56,all P <0.05).The serum levels of Hcy and Cys C of type 2 diabetic patients with carotid arteries increased were (32.53 ±6.46)μmol/L and (2.83 ±0.52)μmol/L,which were higher than those of patients without carotid arteries for (18.46 ±3.63)μmol/L and (1.65 ±0.30)μmol/L(t =11.64,12.06,all P <0.05).In patients of type 2 diabetic with macrovascular complications,Hcy was positively correlated with serum Cys C(r =0.617,P <0.05). Conclusion sCD40L and YKL -40 may have important role in the pathogenesis of type 2 diabetic patients with ma-crovascular complications,which can be used as a valuable reference target in the diagnosis and monitoring of vascular complications in elderly type 2 diabetes,and it may be one of the important independent risk factors of patients with type 2 diabetes.

Evidence-Based Practice ; Humans ; Practice Guidelines as Topic

Evidence-Based Medicine ; Evidence-Based Practice ; Humans ; Practice Guidelines as Topic

Evidence-Based Practice ; Practice Guidelines as Topic

Objective To study some risk factors of acquired nosocomial pneumonia in tumor case nosocomial infection.Methods 77 tumor case with nosocomial infection were chosen as cases from the patients in hospital for 1:1 case control study.Results It was found that the fatality rate of acquired NP in tumor pattens was 14 3%.Some risk factors of acquired nosocomial infection in tumor case remained significant through logistic regression analysis showed,such as state of an immunosuppression therapy; operation,hospitalization duration,antibiotics application time and mechanical ventilation.Conclusions It was suggested that the iatrogenic pneumonia is comes from multiple risk factors and it should be paid attention. This is the most important step to control nosocomial infection of tumor case in the hospital happen.

Objective To study the expression and significance of vascular endothelial growth factor(VEGF) in serum of umbilical blood from the newborns of women with severe pre-eclampsia.Methods Radioimmunoassay was used to measure the serum VEGF of umbilical blood from 26 newborns of women with severe pre-eclampsia (severe pre-eclmpsia group) and 30 newborns of normal pregnancy women (control group). According to birth weight-gestational age relation,severe pre-eclampsia group included 15 newborns small for gestational age (SGA group) and 11 newborns appropriate for gestational age (AGA group).Results (1)The VEGF level of umbilical vein blood and umbilical artery blood in severe pre-eclmpsia group was significantly higher than that in control group respectively(t = 2.16, P < 0.05;t = 4.82, P < 0.01). (2) In control group and severe pre-eclampsia group, the VEGF level in umbilical artery blood was significantly higher than that in umbilical vein blood (control group: t = 2.24, P < 0.05;severe pre-eclampsia group: t = 3.00, P < 0.01). (3)In both control group and severe pre-eclampsia group, there was no significant correlation respectively between VEGF levels in umbilical vein blood or umbilical artery blood and newborns' gestational age or birth weight. (4)VEGF level of umbilical artery blood in SGA group was significantly higher than that in AGA group as well as in control group(t = 3.22, P < 0.01 ;t = 6.80, P < 0.01). Conclusions The serum VEGF level of umbilical vein blood and umbilical artery blood from the newborns of women with severe pre-eclampsia was significantly higher than that of normal pregnancy women respectively. The VEGF level of umbilical artery blood can reflect the severity degree of the damage of hypertensive disorder complicating pregnancy to their newborns to some degree.

Objective To assess the diagnostic value of ChromID for Clostridium Clostridium infection (CDI) on the premise of large sample size,with Meta-analysis.Methods The literature inclusion and exclusion standards were made,and the databases were searched,including PubMed,Cochrane Library,China Biology Medicine disc (CBM),China National Knowledge Infrastructure (CNKI) and so on,using the keywords (ChromID,Clostridium difficile,and chromomgenic agar) along with each of the following words (detection,diagnosis,and infection).Quality assessment of diagnostic accuracy studies (QUADAS) was used to evaluate the quality of the literature.The Meta-disc 1.4 software was used to analyze the data.Results Five studies on 1 851 patients were included in this meta-analysis.The pooled sensitivity was 0.793 (95 ％ CI:0.750 ～ 0.832) for the diagnosis of CDI on 48 h,the pooled specificity was 0.942 (95 ％ CI:0.972 ～0.955),the pooled positive likelihood ratio was 16.817 (95％ CI:7.042 ～ 40.157),with negative hkelihood ratio was 0.124 (95％ CI:0.040 ～0.386) and diagnostic odds ratio for 244.64 (95％ CI:17.711 ～3 379.3).The area under the working curve (AUCSROC) of the subjects was 0.981 4 and the Q* index was 0.939 9.Conclusions Meta-analysis on ChromID for diagnosis of clostridium difficile infection revealedChromID had higher sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio,which can be recommended for clinical use.

Objective To observe the clinical effect by using insulin detemir therapy in children and adolescents with type 1 diabetes mellitus(T1DM).Methods Thirty children and adolescents with T1DM were divided into 2 groups to receive Humulin R and Determir(observation group,n =15) or Humulin R and neutral protamine hagedorn (NPH) (control group,n =15)insulin therapy.Daily insulin dose,glycemic variability,incidence of non-severe and severe hypoglycemia events after the institution of insulin therapy were collected.Results The daily doses of insulin were (1.16 ± 0.30) U/kg in the observation group and(1.21 ± 0.35) U/kg in the control group,respectively.There was no clinically important change between 2 groups(t =0.526,P ＞ 0.05).Within-subject variation in fasting plasma glucose was significantly lower in observation group(29％)than that in control group(65％) (t =5.296,P ＜0.01).One case of severe hypoglycemia event occurred in the observation group,but 5 cases occurred in the control group(t =4.863,P ＜ 0.0l).Two cases of nocturnal hypoglycaemia(22:00-7:00) events occurred in the observation group,7 cases occurred in the control group(t =4.506,P ＜ 0.01).Conclusions Institution of insulin detemir therapy is associated with low within-subject variation in fasting plasma glucose and decreased rates of severe and nocturnal hypoglycemia while dose of insulin did not increase.This makes insulin detemir a valuable new tool for the treatment of children and adolescents with T1 DM.