OBJECTIVETo examine the effect of short-term occupational lead exposure on the inflammatory response system in blood among workers.

METHODSA total of 255 lead-exposed workers (length of service ≤1 year) at an electronics factory in Dongguan, China (exposure group), as well as 205 managers without any occupational exposure at another factory (control group), were included in the study. Occupational physical examination was done to get peripheral blood counts. The blood lead levels of workers were determined by atomic absorption spectrometry. The relationship between blood lead and peripheral hemogram was analyzed using SPSS software.

RESULTSThe exposure group had blood lead levels of 0.07∼1.70 µmol/L, falling within the normal range. The leukocyte count, percentage of granulocytes, and absolute value of granulocytes were significantly higher in the exposure group than in the control group, and the results remained unchanged after adjustment for age and sex (P < 0.05). There were no significant differences in red blood cell count and hemoglobin value between the two groups (P > 0.05).

CONCLUSIONShort-term occupational lead exposure may increase the counts of inflammatory cells in blood, but it has little effect on red blood cells and hemoglobin.

Adult ; Blood Cell Count ; China ; Electronics ; Female ; Humans ; Lead ; blood ; Lead Poisoning ; blood ; Male ; Occupational Exposure ; Young Adult

The liver injury induced by Polygonum multiflorum Thunb. (PM) was investigated based on idiosyncratic hepatotoxicity model co-treated with lipopolysaccharide (LPS) at a non-hepatotoxic dose. Sprague-Dawley (SD) rats were intragastrically administered with three doses (18.9, 37.8, 75.6 g crude drug per kg body weight) of 50% alcohol extracts of PM alone or co-treated with non-toxic dose of LPS (2.8 mg·kg(-1)) via tail vein injection. The plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were assayed and the isolated livers were evaluated for histopathological changes. The dose-toxicity relationships of single treatment of PM or co-treatment of LPS were investigated comparatively to elucidate the idiosyncratic hepatotoxicity of PM. The results showed that no significant alterations of plasma ALT and AST activities were observed in the groups of solo-administration of LPS (2.8 mg·kg(-1), i.v.) or different dosage (18.9, 37.8 and 75.6 g·kg(-1), i.g.) of PM, compared to normal control group (P > 0.05); while significant elevations were observed in the co-administration groups of PM and LPS. Treatment with LPS alone caused slight infiltration of inflammatory cells in portal area but no evident hepatocytes injury. Co-treatment with LPS and PM (75.6 g·kg(-1), i.g.) caused hepatocyte focal necrosis, loss of central vein intima and a large number of inflammatory cell infiltration in portal areas. When further reduce the dosage of PM, significant increases of plasma ALT and AST activities (P < 0.05) were still observed in co-administration groups of LPS and PM (1.08 or 2.16 g·kg(-1)), but not in LPS or PM solo-administration groups. Nevertheless, the co-treatment of low dosage of PM (0.54 g·kg(-1)) with LPS did not induce any alteration of plasma ALT and AST. In conclusion, intragastric administration with 75.6 g·kg(-1) of PM did not induce liver injury in normal rats model; while the 2 folds of clinical equivalent dose of PM (1.08 g·kg(-1)) could result in liver injury in the LPS-based idiosyncratic hepatotoxicity model, which could be used to evaluate the idiosyncratic hepatotoxicity of PM.
Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Chemical and Drug Induced Liver Injury ; pathology ; Hepatocytes ; pathology ; Lipopolysaccharides ; Polygonum ; toxicity ; Rats ; Rats, Sprague-Dawley

Objective To observe the ultrasonographic features of primary squamous cell carcinoma of the breast and its clinical and histopathological characteristics. Methods The ultrasonographic features, clinical and histopathological characteristics of 7 middle-aged women (median age 61 years old) with primary squamous cell carcinoma of the breast confirmed histopathologically from January 1995 to December 2014 in Peking Union Medical College Hospital were retrospectively reviewed. Results There were 8 lesions in seven cases. Six cases were single lesion and 1 case with multiple lesions, the diameters of the lesions were 7.0-60.0 mm [mean (34.0±19.6) mm]. On grayscale ultrasound, 6 lesions with solid compoments were hypoechoic, 2 lesions with solid and cystic compoments were complex echogenic, the lesions all had irregular shape and indistinct margin, 2 lesions had calcifications. On color Doppler flow imaging, 7 lesions had rich blood flow signals (Ⅱor Ⅲ) and 1 lesion had no blood flow signal. On gross histopathological examination, 6 masses were solid, pale-white colored, medium texture and the boundary was not clear. Two masses had cystic cavity. One old patient who was 70 years old had several times chest wall recurrence after mastectomy. On ultrasonography, the lesion showed an anechoic cyst with thick wall. Two chest wall recurrence lesions were cystic with thick wall. Microscopic examination showed squamous cell carcinoma infiltrating into the fiber adipose and skeletal muscle tissue. Conclusions Primary squamous cell carcinoma of the breast is more common in large tumor size. Ultrasound can show the more cysticcomponents of the tumor and abundant vascularity, which is helpful for diagnosis.

The liver injury induced by Polygonum multiflorum Thunb. (PM) was investigated based on idiosyncratic hepatotoxicity model co-treated with lipopolysaccharide (LPS) at a non-hepatotoxic dose. Sprague-Dawley (SD) rats were intragastrically administered with three doses (18.9, 37.8, 75.6 g crude drug per kg body weight) of 50% alcohol extracts of PM alone or co-treated with non-toxic dose of LPS (2.8 mg·kg(-1)) via tail vein injection. The plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were assayed and the isolated livers were evaluated for histopathological changes. The dose-toxicity relationships of single treatment of PM or co-treatment of LPS were investigated comparatively to elucidate the idiosyncratic hepatotoxicity of PM. The results showed that no significant alterations of plasma ALT and AST activities were observed in the groups of solo-administration of LPS (2.8 mg·kg(-1), i.v.) or different dosage (18.9, 37.8 and 75.6 g·kg(-1), i.g.) of PM, compared to normal control group (P > 0.05); while significant elevations were observed in the co-administration groups of PM and LPS. Treatment with LPS alone caused slight infiltration of inflammatory cells in portal area but no evident hepatocytes injury. Co-treatment with LPS and PM (75.6 g·kg(-1), i.g.) caused hepatocyte focal necrosis, loss of central vein intima and a large number of inflammatory cell infiltration in portal areas. When further reduce the dosage of PM, significant increases of plasma ALT and AST activities (P < 0.05) were still observed in co-administration groups of LPS and PM (1.08 or 2.16 g·kg(-1)), but not in LPS or PM solo-administration groups. Nevertheless, the co-treatment of low dosage of PM (0.54 g·kg(-1)) with LPS did not induce any alteration of plasma ALT and AST. In conclusion, intragastric administration with 75.6 g·kg(-1) of PM did not induce liver injury in normal rats model; while the 2 folds of clinical equivalent dose of PM (1.08 g·kg(-1)) could result in liver injury in the LPS-based idiosyncratic hepatotoxicity model, which could be used to evaluate the idiosyncratic hepatotoxicity of PM.

Objective To investigate clinical nursing pathway management combined with nurse hierarchical system so as to promote the smooth implementation of clinical pathways.Methods The process of clinical nursing pathway was distributed into the work of nurses at different levels by using the present available resources; their process quality was quantitatively evaluated, which was closely related to their achievements, with the aim of making the nursing activity procedurized and standardized.Results Patients' satisfaction before and after implementing the clinical care pathway management combined with nurse hierarchical system was significantly different (P<0.01); the average hospital stay for a single disease was decreased after its implementation (P<0.05).Conclusions Implementing clinical nursing pathway management combined with nurse hierarchical system could effectively control the health care costs, improve quality of care and achieve the best possible care and management objectives.

Objective To investigate the methods for establishment of evaluation index system of clinical nursing pathway management.Methods Delphi method was used to screen evaluation indexes of clinical nursing pathway management and three rounds of expert consultation was carried out to establish the clinical nursing pathway management evaluation system. Analytic hierarchy process and comprehensive evaluation method was used to determine the levels of the index weight,and finally the establishment of weight factors at all levels.Results Aiming at the process of clinical nursing pathway management and following the principle of continuous improvement,an evaluation index system of clinical nursing pathway management was established.Conclusions The evaluation index system of clinical nursing pathway management provides a feasible and effective evaluation tool for the application and improvement of clinical nursing pathway and guides the promotion of application and development of clinical nursing pathway.

Objective To investigate the current level of cardiopulmonary resuscitation skill and analyze the possible influence factors,provide basis for CPR skill training for clinical nurse.Methods A total of240 nurses from 13 hospitals in Shanghai Pudong were selected by stratified random sampling,examined by a self-designed CPR-BLS scale.Influence factors were analyzed by scores summarize.Results The skills of clinical nurses were low with a total,8.33％ good rate and 0.83％ excellent rate; In one grade hospital,there were 26.67％ passing rate,0.83％ good rate and 0.00％ excellent rate; Hospital level,professional title and CPR training experience were the relative factors of CPR skill performance(t =9.774,2.522,-3.194,respectively; P＜0.05).Conclusions The clinical nurses have a low CPR skill level in the one and two grade hospital,standardized and systematic training and retraining should be adopted.

OBJECTIVE: To establish a new high performance liquid chromatography (HPLC) method for determining the concentration of cefazolin, cefradine, cefoperazone and cefotaxime in blood and urine, as well as to investigate its applicability. METHODS: Protein in blood and urine was precipitated directly by acetonitrile with acetanilide was used as the internal standard using Agilent Zorbax SB-Aq column (250 mm x 4.6 mm, 5 microm). The mixed solvents of water (triethylamine 0.12%, acetic acid 0.12%) and acetonitrile were used as the mobile phase to separate cephalosporins using gradient elution method at 1 mL/min (flow rate) and 254 nm (detection wavelength). RESULTS: The working curve of four cephalosporins showed a good correlation (r = 0.9993), with the detection limit up to 0.01 microg/mL. The recovery rate was more than 81.2%. CONCLUSION This method is fast, easy and accurate. It is suitable for biological analysis of the 4 cephalosporins of the blood and urine in practical cases.
Adult ; Anti-Bacterial Agents/urine* ; Cefazolin/urine* ; Cefoperazone/urine* ; Cefotaxime/urine* ; Cephalosporins/urine* ; Cephradine/urine* ; Chromatography, High Pressure Liquid/methods* ; Forensic Toxicology ; Humans ; Male ; Sensitivity and Specificity ; Specimen Handling

Objective To optimize the extraction and alcohol precipitation process of Qizhi Yifei Granules by multi index orthogonal experiment. Methods With extraction rate of astragaloside in Astragali Radix, quercetin-3-O-β-D-glucose-7-O-β-D-gentian diglucoside in Descurainiae Semen Lepidii Semen and yield rate of dry extract as indexes, the extraction process of Qizhi Yifei Granules was optimized. Taking the retention rate of astragaloside and quercetin-3-O-β-D-glucose-7-O-β-D-gentian diglucoside as indexes, the alcohol precipitation process was optimized. Results The best water extraction process was as follows: adding 10 times amount of water, extracting for 1.5 h, 3 times. The optimum alcohol precipitation process was: concentrated to the relative density of 1.05–1.10 (60 ℃), adding ethanol to 60％ and alcohol precipitation. Conclusion The optimized extraction and alcohol precipitation process is stable and feasible, which can provide the basis for the preparation.

Objective To analysis the influencing factors on underweight and stunting among children aged 0-3 years in rural areas from ten provinces in China.Methods Children under study were identified by multi-stage stratified cluster from rural areas of ten provinces in China.The ascertainment methods mainly included questionnaire and anthropometric measurements.Results There were 58 926 children under investigation,with 50.91％ were boys.The overall rates on underweight and stunting were 5.05％ and 10.49％ respectively.The rate in the 6 month-olds (1.97％,3.79％ ) was the lowest,while the highest were in the 24 month-olds (7.80％) and the 36 month-olds (16.83％).Age,sex,birth weight,gestational weeks as well as maternal education and fathers' schooling were factors significantly related to childhood underweight and stunting (P＜0.0001).Conclusion The status of underweight and stunting among children aged 0-3 years in rural areas was impressive,with birth weight was the key factor influencing the growth of children.Perinatal health care should be improved to promote the growth of children.