Objective: To investigate the clinical features of pneumoconiosis complicated with pulmo-nary emphysema. Methods: selected 868 patients with pneumoconiosis were selected from December 2015 to December 2016 in Hunan occupational disease prevention and treatment hospital. Collected the results of high-resolution spiral CT, arterial blood gas, ECG, pulmonary function and MRC score. The subjects were divided into pneumoconiosis complicated with pulmonary emphysema group and simple pneumoconiosis group accord-ing to the results of HRCT. The smoking, MRC score, pulmonary function, blood gas and complications were compared. Results: A total of 868 patients were enrolled in the study. Emphysema 232 people, accounting for 26.73%. The incidence of emphysema in the first phase of pneumoconiosis was 12.69%, and the incidence rate of emphysema in pneumoconiosis was 17.03%, The incidence of three Stage pneumoconiosis was highest, up to 60.76%, the incidence of emphysema increased with the increase of stages of pneumoconiosis (P=0.000) .The smoking index of pneumoconiosis combined with emphysema group was significantly higher than that of simple pneumoconiosis group (P<0.01) . The MRC score of pneumoconiosis complicated with pulmonary em-physema group was higher than that of simple pneumoconiosis group (P=0.000) . In pneumoconiosis complicat-ed with pulmonary emphysema group the FEV_1.0%, FVC%, FEV_1.0/FVC, DLCO%, oxygen partial pressure were significantly lower than that of simple pneumoconiosis group (P≤0.05) . The combined rate of Bullae of lung in pneumoconiosis complicated with pulmonary emphysema group was higher than that of simple pneumo-coniosis group (P<0.01) . Conclusion pneumoconiosis stage and smoking. Patients with pneumoconiosis com-plicated with pulmonary emphysema had heavier breathing difficulties, more serious pulmonary function and active endurance, the degree of hypoxia is more serious, and had a higher incidence of complications. The pul-monary function of pneumoconiosis complicated with pulmonary emphysema is not consistent with the typical CPFE.

OBJECTIVETo evaluate the effect of beta irradiation on intimal proliferation and apoptosis in vein grafts.

METHODSAutogenous vein graft model was established in 80 rats by transplanting the internal branch of the jugular vein to the carotid artery by end to end anastomosis. The veins were irradiated by (32)P solution before anastomosis. Two dose schedules were studied: control group (graft, nonirradiated) and radiation group (20 Gy). The grafted veins were harvested at 3, 1, 2 and 4 week respectively after the operation. intimal hyperplasia (IH), smooth muscle cell (SMC), proliferation, p53, bcl-2 and bax were observed pathologically and immunohistochemically. They were analyzed by a computerized system. The presence of apoptotic VSMC was demonstrated by TUNEL method.

RESULTThere was a significant decrease in the average intimal thickness at 7, 14 and 28 days (t = 15.694, P < 0.05) in the radiation group. Immunohistochemical analysis of PCNA indicated decreased positive cells in the radiation group compared with the controls at 1 and 2 weeks (t = 60.157, P < 0.01). Apoptosis of VSMC was higher in the radiation group than in the control group at 2 weeks (t = 56.176, P < 0.01). There was no significant difference in expression of P(53) between the two groups, and there was a significant increase in bax/bcl-2 in the radiation group at 2 weeks (t = 9.783, P < 0.05).

CONCLUSIONThese preliminary results demonstrated that low dose of beta irradiation in the vein graft inhibits SMC proliferation and induces the apoptosis of VSMC in rats.

Animals ; Apoptosis ; Beta Particles ; Brachytherapy ; Disease Models, Animal ; Graft Occlusion, Vascular ; metabolism ; pathology ; In Situ Nick-End Labeling ; Male ; Muscle, Smooth, Vascular ; pathology ; radiation effects ; Proliferating Cell Nuclear Antigen ; metabolism ; Rats ; Tumor Suppressor Protein p53 ; metabolism ; Tunica Intima ; pathology ; radiation effects

Objective: To investigate the change in peripheral nervous conduction velocity in patients with occupational chronic mercury poisoning and related influencing factors. Methods: From February 2011 to December 2014, urinary mercury examination and neural electromyography were performed for 104 patients with occupational chronic mercury poisoning. The data on age, type of work, working years of mercury exposure, and past medical history were collected, and peripheral nervous conduction velocity and its correlation with age, working years of mercury exposure, and urinary mercury concentration were analyzed. Results: All the 104 patients with occupational chronic mercury poisoning had a mean of 45.37±9.82 years, median (P₂₅, P₇₅) working years of 7 (3, 11) , and a median (P₂₅, P₇₅) urinary mercury concentration of 88.50 (56.25, 163.03) μg/g Cr. The major clinical manifestations of peripheral nerve injuries were numbness of extremities (20.2%) , hypopselaphesia/hypalgesia or hyperpselaphesia/hyperalgesia (9.6%) , and bone/muscle pain in the extremities (6.7%) . Neural electromyography showed an increase in denervation potential (fibrillation potential or positive sharp wave) and a detection rate of abnormal peripheral nervous conduction velocity as high as 65.4%. The patients with an older age and more working years had a higher incidence rate of abnormal sensory conduction velocity of the ulnar nerve. There were significant reductions in motor and sensory conduction velocities of the median nerve, motor and sensory conduction velocities of the ulnar nerve, motor conduction velocity of the common peroneal nerve, and the sensory conduction velocity of the superficial peroneal nerve (P<0.05) , with the increase in urinary mercury concentration. Conclusion Patients with occupational mercury poisoning have a high rate of abnormal neural electromyographic findings, which can be used as an important method for early identification of chronic peripheral nerve injuries induced by mercury poisoning. The degree of peripheral nerve injuries increases with the increasing time of mercury exposure and urinary mercury concentration.

Objective: To investigate the safety and influencing factors of ct-guided percutaneous lung biopsy in pneumoconiosis patients. Methods: The data of 63 patients with pneumoconiosis who underwent ct-guided percutaneous lung biopsy in our hospital were studied to analyze the incidence of complications and influencing factors of percutaneous lung biopsy. Results: 63 cases of pneumoconiosis patients received CT guided percutaneous lung biopsy. There were 29 cases of complications (46.03%) , including 20 pneumothorax (37.75%) , 12 bleeding (19.05%) , and 3 cases of liquid pneumothorax (4.76%) . The single factor chi square analysis showed that there were significant differences in age, depth of focus, puncture position and puncture times (P<0.05) , and there was significant difference between the occurrence of hemorrhage and age, type of focus, size of focus, and the location of puncture site (P<0.05) . The unconditional LogisticL multiple factor regression analysis showed that the depth of the lesion was an independent risk factor for concurrency pneumothorax, and the size of the lesion was an independent risk factor for bleeding. Conclusion Complications of CT-guided percutaneous pulmonary biopsy are mainly pneumothorax and hemorrhage. Age, focus type, focus size, focus depth, puncture site, and puncture times are all the factors of complications.

Objective: To investigate the compliance of inhalation during stable phase of pneumoconiosis complicated with COPD and to explore the factors influencing compliance. Methods: The patients with pneumoconiosis complicated with COPD who were hospitalized in the four Department of occupational disease prevention and treatment in Hunan province from December 2016 to August 2017 were selected as the research subjects. The examination of Chest radiograph, HRCT and lung function was perfected, and CAT score and MRC score were carried out. The age, culture, smoking history, acute aggravation of 1 years, medical insurance and so on were collected, and follow-up was conducted after 6 months. Results: Of the 115 patients who had successfully followed up, 14 cases (12.17%) were persisted in medication, and 101 cases (87.83%) did not adhere to the medication. The smoking index median of the non adherence group was 30 (15, 40) , while that of the adherence group was 16 (6, 31) . The smoking index of the adherence group was lower than that of the non adherence group. The FEV1% in the unadhered group was 44.69+15.48, and the drug group was 37.12+16.98, the FEV₁/FVC in the unadhered group was 52.43+9.19, and the drug group was 44.43+11.88, and the lung function of the drug group was worse than that of the unadhered group. The adherence rate of group COPD (group D) was higher than that of group A, B and C, and the difference between D group and B group was statistically significant. The adherence rate of pneumoconiosis stage Ⅲ was higher than that of pneumoconiosis stageⅡand pneumoconiosisⅠ. Conclusion The compliance of long acting bronchodilator inhalation is low in stable phase of pneumoconiosis complicated with COPD. The poorer the lung function, the higher the compliance of inhalation. The compliance of pneumoconiosis patients with Medical insurance for industrial injury is higher than that of pneumoconiosis patients with New rural cooperative medical service.

Objective To compare the advantage and disadvantage of peroral endoscopic myotomy (POEM)and pneumatic dilation(PD)for the treatment of achalasia of cardia(AC). Methods Patients with confirmed AC undergoing endoscopic therapy in Southwest Hospital, Third Military Medical University between January 2011 and September 2014 were divided into POEM treatment group(n=56)and PD treatment group(n = 30), according to the decision of the patients and their families. Postoperative improvement of clinical symptoms, changes in the maximum esophageal diameter, complications, hospital stay,and inpatient expenses were compared between the two groups. Results No significant differences were observed in general preoperative data between the two groups,including gender,age,body mass index (BMI),maximum esophageal diameter, Eckardt score and disease duration(all P>0.05). The Eckardt score showed a significant decrease in 1, 6, and 12 months after operation compared to the pre?operation score in both groups(P<0.05). No matter 1 month or 6 months after operation, the Eckardt score had no significant difference between the two groups(P>0.05). Six months after operation, the response rate between the two groups was no significantly different[93%(52/56)VS 80%(24/30), χ2=0.115, P=0.076],but the maximum esophageal diameter of the POEM group was smaller than that of the PD group (25.39±7.12 mm VS 32.12±9.99 mm,t=3.612,P=0.001). Twelve months after operation,the Eckardt score of the POEM group was lower than that of the PD group(0.44±0.85 score VS 1.26±1.74 score,t=2.940,P= 0.004), and the response rate was higher in the POEM group[93%(52/56)VS 80%(24/30),χ2=0.115, P=0.076]. The incidence of pneumatic complications was 32%(18/56)in the POEM group,but none occurred in the PD group(χ2=12.195,P=0.000). The hospital stay of the POEM group and the PD group was 12.33±4.13 days and 6.50±2.28 days, respectively(W=616, P=0.000). The inpatient expense of the POEM group and the PD group was 8 013.283± 4 322.695 yuan, and 1 571.018±1 590.193 yuan,respectively(W=505,P=0.000).Conclusion Both POEM and PD showed good short?term efficacy for AC.POEM is more effective,and its treatment outcome lasts longer,whereas PD has more widely indications because it is easier to operate with less complications,shorter hospital stay,and lower costs.Trail registration Chinese clinical trial registry,ChiCTR?OOC?15005889.

OBJECTIVE: To investigate the application value of computed tomograph( CT) guided percutaneous lung biopsy in the diagnosis of occupational pneumoconiosis( the following is referred to as “pneumoconiosis”). METHODS: A total of63 cases of CT-guided percutaneous lung puncture biopsy from patients with pneumoconiosis,were analyzed for the successful rate of percutaneous lung puncture,the positive rate of pneumoconiosis pathological results and diagnostic accuracy. RESULTS: The successful rate of puncture was 100. 0% in these 63 cases. Pathological examination revealed60 cases of pneumoconiosis like change,with a positive rate of 95. 2%. Among them,56 cases were diffuse fibrosis,48 cases were dust deposition,and 32 cases were dusty nodules. There were 5 cases of tuberculosis granuloma,1 case of tumor,1 case of macrophage pneumonia and 1 case of infection. According to the pathological examination results,54 cases of simple pneumoconiosis,1 case of occupational hard metal lung disease,1 case of pneumoconiosis combined with tumor,4 cases of pneumoconiosis combined with tuberculosis and 2 cases of simple tuberculosis were confirmed. The diagnostic accuracy was 98. 4%. CONCLUSION: CT guided percutaneous lung biopsy is an ideal clinical method for obtaining pathological specimens of lung tissue. The positive rate of detecting pneumoconiosis pathological changes is high.The accuracy of pneumoconiosis diagnosis is high. It has high application value in the diagnosis and differential diagnosis of pneumoconiosis.

The anterior cruciate ligament (ACL) injury is a common sports injury that has a significant impact on knee function and patients′ mobility. With the popularity of national fitness campaign in China, the incidence of ACL injury is increasing year by year. Currently, there still lacks clinical standards or guidelines on how to choose appropriate treatment methods, surgical plans and rehabilitation protocols for ACL injury. In order to timely reflect the new treatment concept of ACL injury, standardize its diagnosis and treatment and improve the curative effect, the Sports Medicine Society of Chinese Research Hospital Association and the Editorial Board of Chinese Journal of Trauma organized domestic orthopedic and sports medicine experts to formulate the "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)" based on the level of evidence-based medicine and in compliance with the principle of scientificity, practicability and advancement. The present guideline includes 12 recommendations for the diagnosis, treatment and rehabilitation of ACL injury in order to provide guidance and assistance for the clinical diagnosis and treatment of ACL injury in China.