Alveolitis, Extrinsic Allergic ; Humans ; Occupational Diseases

Objective: To assess the trend of statin application for in-hospital acute myocardial infarction (AMI) patients with its impact factors in eastern urban China from 2001 to 2011. Methods: A 2-stage random sampling design was performed to extract representative AMI sample patients. In the ifrst stage, a simple random-sampling was used to identify participating hospitals. In the second stage, a systematic sampling was conducted in 2001, 2006 and 2011 to select the cases from participating hospitals, to take medical records and clinical information for calculating the in-hospital statin application rate. The impact factors for statin application was assessed by multi Logistic regression model with generalized estimating equations. Results: A total of 5940 AMI records from 32 hospitals were enrolled. From 2001 to 2011, the in-hospital statin use rate increased from 46.0% in 2001 to 82.2% in 2006 and to 93.7% in 2011,P<0.001 for trend. Multi Logistic regression analysis indicated that the patients with LDL-C>3.37 mmol/L were more likely to receive statin therapy than those with LDL-C<1.81 mmol/L (OR=1.59, 95% CI 1.10-2.30,P=0.013); the patients with chest pain at admission (OR=1.82, 95% CI 1.14-2.91, P=0.012), combining hypertension (OR=1.44, 95% CI 1.02-2.03,P=0.038), with in-hospital PCI (OR=2.99, 95% CI 1.71-5.23, P<0.001) were also more likely to receive statin therapy. The application rate of statin was reduced by reduced LDL-C level accordingly and the patients without LDL-C examination, accounting for 21.3%, had the lowest statin application rate. Conclusion: Statin therapy for in-hospital AMI patients was dramatically increased from 2001 to 2011 in eastern urban China and the guideline was rapidly popularized in clinical practice. However, the improvement has been needed especially in patients without LDL-C examination or with low LDL-C levels; we emphasize that AMI patients should receive statin therapy regardless their LDL-C levels.

Objective To retrospectively review the PET/CT imaging features of sarcoidosis and improve the diagnostic accuracy of this benign disease.Methods The PET/CT imaging characteristics and clinical data, including lesion size, distribution, standardized uptake value (SUV) and the ratio of misdiagnosis, of 11 sarcoidosis patients (5 confirmed pathologically and 6 clinically) were retrospectively analyzed.Results (1) Eleven patients had lymph node involvement:mediastinum and hilar lymphadenopathy in 11/11, supraclavicular fossa lymphadenopathy in 8/11, retroperitoneal lymphadenopathy in 8/11, pelvic cavity lymphadenopathy in 3/11.(2) Extrathoracic lesions were found in 7/11 with 4 lung involvement, 2 liver involvement, 1 parotid gland and temporalis involvement and 1 bilateral iliac and sacral bone involvement.(3) The size of the lesions ranged from 1.0 to 4.6 cm and the CT density ranged from 30 to 40 HU.The lesions in the lung are hypodense and in the liver are slightly hypo-or iso-dense.18F-fluorodeoxyglucose (FDG) uptake of all lesions was definitely increased in 6 cases; 18F-FDG uptake of some lesions was moderately or definitely increased in 2 cases, and slightly increased uptake in 3 cases.(4) The PET/CT diagnosis was consistent with the final diagnosis in 6/11.The 5 cases of misdiagnosis were malignant lymphoma (4/11) and lung cancer ( 1/11 ).Conclusions Differentiation between sarcoidosis and lymphoma in patients presenting with hilar lynphadenopathy can be difficult.Whole-body PET/CT may be helpful in the differentiation of the two diseases.

Objective: To investigate the association of Internet gaming disorder (IGD) and sleep quality in adolescents of Xi an, thereby providing theoretical evidence for prevention of IGD and improvement of sleep quality of adolescents. Methods: A total of 1 181 adolescents from 3 middle schools of Xi an were randomly selected between August, 2019 and February, 2020. These adolescents were assessed by a series of questionnaires, including basic information questionnaire, IGD and Insomnia Severity Index (ISI). Univariate analysis and multivariate Logistic regression model were used to evaluate the association between IGD and insomnia. Results: Among 929 junior middle school students who participated in online games and the IGD Diagnostic Questionnaire was filled out in the past 12 months, the prevalence of IGD was 20.0%(186). Univariate analyses indicated that gender,whether single family, whether they living with their parents, whether they were addicted to online games, whether they could control the time of online games, and the severity of insomnia influenced IGD ( χ 2=17.11, 8.33, 202.92, 91.23, 29.06, P <0.05). The multivariate Logistic regression of the total population showed that participating in online games was not associated with the severity of insomnia ( OR = 1.62 , 95% CI =0.92-0.85, P >0.05). The people who participated in online games in the past 12 monthsthe severity of insomnia was positively correlated with the risk of IGD ( OR =3.56，95% CI =1.92-6.61, P <0.01). Conclusion Internet gaming disorder become a severe situation in the middle school students. The severity of insomnia might become the risk factor of IGD, so social should pay more attention to the prevention of internet addiction.

OBJECTIVETo investigate the best choice of operation opportunity and operation plan for limb fractures combined with severe craniocerebral trauma in children.

METHODSFrom January 2005 to July 2012,36 patients with limb fractures and severe craniocerebral trauma were received,including 24 males and 12 females aged from 1 to 13 years old (mean, 6.1 +/- 3.0). The time from injury to hospital was (18.0 +/- 15.0) h. Glasgow coma score were less than 8 with an average of 6.4 +/- 1.3. AIS-ISS score were 25.9 +/- 8.1. Thirteen patients were open fracture, 23 were closed fracture. Patients were divided into immediate operation group (21 patients) received fracture fixation with 24 h, the average time was (15.0 +/- 7.4) h, and delayed operation group (15 patients) received fracture fixation after 24 h, the average time was (165.4 +/- 114.6) h. All patients were treated by open reduction, and 33 cases by internal fixation, 3 cases were external fixation. Operative time, blood loss, fracture healing time and brain trauma,physical trauma, postoperative rehabilitation situation were observed and evaluated.

RESULTSAll patients were healed at stage I ,and no dead, aggravating of coma, disorders of breathing and circulation occurred during operation. Operative time,blood loss,healing time in immediate operation group was (44.5 +/- 25.3) min, (47.1 +/- 36.5) ml, (2.7 +/- 0.5) months, respectively; while in delayed operation group was (87.0 +/- 40.0) min, (112.7 +/- 67.5) ml, (3.8 +/- 1.2) months,respectively; and there were obvious differences between two groups. There was no siginificant meaning in Glasgow coma score and Fugl-Meyer motor function between immediate operation group (4.7 +/- 0.6, 97.9 +/- 2.7) and delayed operation group (4.7 +/- 0.5, 97.7 +/- 3.9) (t = 0.23, P > 0.05; t = 0.11, P > 0.05).

CONCLUSIONThe condition of limb fractures combined with severe craniocerebral trauma in children is seriously, comfortable surgical opportunity should according to particular case, and immediate operation can performed on the condition of stabled vital signs.

Adolescent ; Child ; Child, Preschool ; Craniocerebral Trauma ; surgery ; Extremities ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation ; Fracture Fixation, Internal ; Fractures, Open ; surgery ; Humans ; Infant ; Male

Objective The detection of malignant lymphoma with invasion in liver and spleen using PET/CT has not been well documented in the literature. This study aimed to investigate the usefulness of PET/CT in this regard and to compare it with plain CT. Methods Forty-one pathologically confirmed malignant lymphoma patients with liver and spleen invasion were recruited into this study. Among all patients, there were 38 non-Hodgkin's lymphoma (NHL), 2 Hodgkin's lymphoma (HL) and 1 gastric mucosa associated lymphoma. PET/CT imaging was recorded 1h after injection of 296～444 MBq 18F-fluorodeoxyglucose (FDG). Results (1) There were 30(30/41) patients with liver invasion, including hepatic nodules, mass and portal nodes. The mass was large to invade surrounding liver parenchyma. (2) There were 23(23/41) patients with spleen invasion. The spleen was enlarged and demonstrated diffused hyper-metabolism. (3) Other invasion included: lung (n=13), cortical bone and marrow (n=12), stomach (n=9), pleural (n=6), and subcutaneous soft tissue (n=5) and so on. Conclusion PET/CT could accurately diagnose the invasion in liver and spleen of malignant lymphoma, which was of potential role on the diagnosis and staging of lymphoma.

Objective To investigate the expression of caspase-10 in differentiated thyroid carcinoma and association with its development and metastasis. Methods Thyroid samples from 37 patients in a period from January 2006 to December 2007, with differentiated thyroid carcinoma were retrospectively analyzed for caspase-10 by immunohistocbemistry(streptavidin-perosidase, S-P), compared to control group of 46 cases with nodtdar goiter. The relationship between the expression of caspase-10 and the clinical pathologic characteristics of thyroid carcinoma were also explored simultaneously. Results caspase-10 were observed as brown or yellow particles located in the cytoplasm or cell membrane of nodular goiter but there were no significant evidence for its positive expression in thyroid carcinoma, caspase-10 expression was markedly down-regulated in differentiated thyroid carcinoma(29.73%,11/37) compared with benign nodules(71.74%,33/46, χ2=14.528, P<0.01). The positive expression in 18 cases with lymph node metastasis(11.11%,2/18) was significantly lower than those in 19 patients without lymph node metastasis(47.37%,9/19; χ2=4.210, P<0.01). There was no significant correlation(P> 0.05) between the expression of caspase-10 and the clinical pathologic characteristics including male, age, TNM stage and pathologic type. Conclusion Down-regulation of caspase-10 may play a critical role in carcinogenesis and development of differentiated thyroid carcinoma.

Objective To study the change and rule of immunological function among the patients with coal arsenic poisoning in order to provide a basis for tumor risk evaluation and monitoring.Methods Seventy patients with coal arsenic poisoning aged from 24 to 71 years old(44 men,26 women,averaging 41 years old)were divided into 4 groups including 23 cases having a course less than 10 years,21 case8 lasting for 10～19 years,20 cages for more than 20 years,6 cases of cancer,and 26 healthy normal controls.Flow cytometer(FCM)was used to analyze the frequency of CD3+(total T cell),CD3+CD4+(inducer/helper T cell),CD3+CD8+(suppressor/cytotoxic T cell),CD19+(B lymphocyte),and CD56+CD16+(natural killer cell)lymphocyte subsets in the peripheral blood of the subjects and the expression rates of lymphocytic membrane surface molecules of human leucocvte antigen (HLA)-DR,CD25,CD38 were also determined by FCM.Results The pmportions of CD3+cells in periDheral blood of less than 10 years,10～19 years,more than 20 years and cancer groups were (63.76±9.32)%。(55.63± 12.97)%,(51.00±12.23)%and(49.83±,9.89)%respectively,which were significantly lower than that in control group[(68.10±8.62)%],and there was a significant difference between different groups(F=12.862,P<0.05). In less than 10 years,10～19 years,more than 20 years and cancer groups,the proportion of CD3+CD4+cells cells was (31.35±6.62)%,(28.38±8,66)%,(24.13±6.46)%and(19.17±4.96)%respectively,which wag significantly lowerthan that in control group[(34.28±7.32)%],and significant in a-group difference was found(F=10.455, P<0.05).The percentages of CD19+cells in more than 20 yeats and cancer groups[(9.00±5.32)%,(9.00± 3.29)%]were lower than that in control group and less than 10 years group[(11.80±3.43)%,(12.35±4.53)%] (P<0.05),while no statistical difference was found between other groups.The expression rates of CD25 and CD38 in lymphocytes of cancer group[(17.96 ±4.98)%,(41.38±8.54)%]were obviously higher than those in control group[(13.10±338)%,(28.60±5.51)%]and there were statistical differences between the experimental groups(P<0.05).The expression rate of HLA-DR in 10～19 years groups[(18.20±6.25)%]was significantly higher than that in control group[(10.72±7.06)%]and less than 10 years group[(11.78±5.13)%],while it was the same in more than 20 years and cancer group[(20.30±8.01)%,(21.82±10.97)%].Conclusions Reduction of cellular immune function caused by coal arsenic poisoning may be an important mechanism of skin cancer.CelMar immune function may be used as a warning signal of skin cancerization of patients with coal arsenic poisoning.

Objective: To assess the trends in clinical characteristics, treatment, and outcomes for hospitalized patients undergoing percutaneous coronary intervention (PCI) in central-western urban hospitals of China in 2001, 2006 and 2011. Methods: We used a 2-stage, random sampling strategy to create a Chinese central-western urban hospital representative sample of 2152 patients undergoing PCI at 26 hospitals in China PEACE- retrospective CathPCI study and calculated the weighted data of clinical information in each year. Results: Between 2001 and 2011, the admission rate for PCI increased by 46 folds. Compared with 2001, the patients undergoing PCI were more likely to be female, older than 80 years, and to have history of diabetes, dyslipidemia and PCI in 2011. The proportion of trans-radial PCIs increased from 3.5% in 2001 to 87.6% in 2011 (Ptrend < 0.0001); the proportion of drug eluting stents (DES) among all the implanted stents increased from 16.4% in 2001 to 95.7% in 2011 (Ptrend < 0.0001), largely due to increased use of domestic DES. Less than 5% of medical record of admission for PCI documented door time and balloon time. The median length of stay decreased from 13 days in 2001 to 10 days in 2011 (Ptrend < 0.0001). In-hospital mortality did not change signiifcantly, but both any bleeding and access bleeding events were decreased signiifcantly over time (Ptrend < 0.05). Conclusion: There has been a rapid increase in the volume and significant change in treatment patterns of PCI over the 10-year period from 2001 to 2011 in Chinese central-western urban hospitals. We identiifed quality gaps that represent opportunities to improve medical care.

Objective: To explore the application and affecting factors of clopidogrel loading therapy in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in china in 2006 and 2011. Methods: Based on “China patient-centered evaluative assessment of cardiac events retrospective study of acute myocardial infarction”, we collected clinical information of STEMI patients with PCI in 2006, 2011 and analyzed clopidogrel loading therapy status in different years and different hospitals. According to clopidogrel doses, the patients were divided into 2 groups: Clopidogrel 300mg group, the patients received a single dose of clopidogrel ≥300mg while <450mg and Clopidogrel 600mg group, the patients received a single dose of clopidogrel ≥450mg while ≤600mg. The relevant factors affecting clopidogrel loading therapy status were identiifed by binary Logistic regression analysis. Results: A total of 2481 eligible patients were enrolled and their mean age was (60.9 ± 12.0) years including 21.4%female. From 2006 to 2011, the overall application of clopidogrel loading was (51.0% vs 47.4%), the ratio for patients in Clopidogrel 300mg group was (43.1% vs 39.2%), in Clopidogrel 600mg group was (7.8% vs 8.2%), allP>0.05. In 2006, the hospital median rate of clopidogerl application was 44.4% (IQR 21.8% to 69.0%) and in 2011, it was 48.1% (IQR 25.0% to 70.8%),P=0.940. Binary logistic regression analysis showed that the patients were admitted within 12 hours of onset, with primary PCI and treated in central region had the higher rates of clopidogrel loading therapy. Conclusion: Clopidogrel loading therapy was seriously inadequate in STEMI patients with PCI, variation was across hospitals and the status was similar between 2006 and 2011. Clopidogrel loading therapy should be improved.