Anemia, Aplastic ; diagnosis ; etiology ; Benzene ; poisoning ; Expert Testimony ; Humans ; Male ; Occupational Diseases ; diagnosis

Baculoviral IAP(inhibitor of apoptosis protein) gene was identified firstly in IAP gene family.The structurcal feature of baculoviral IAP genes are characterized BIR and RING domain;Despite similar to P35 in antiapoptotic function,baculovrial IAP and P35 differ in structure and mechnism of action.Phylogenetic analysis of IAP genes and lots of evidence sppport the origin of this viral gene by capture of a host gene early in the evolution of Lepidoptera.

Objective To investigate if the 23 strains of highly-resistant P.aeruginosa isolated from different patients in the in- tensive care unit (ICU) have the same origin;and explore the related mechanisms of carbapenem resistance in these multidrug- resistant P.aeruginosa.MethOds Antimicrobial susceptibility testing was performed using disk-diffusion technique.The strains were genotyped by rep-PCR with the primer ERIC2 followed by electrophoresis in agarose gel.We used a previously described imipenem-EDTA double-disk test for screening MBL-producing P.aeruginosa.Polymerase chain reaction for amplification of blaOprD, blaIMP, and bla VIM were performed to detect corresponding mutants.Results The result of antimicrobial suscepti- bility testing showed that 20 of the 23 P.aeruginosa isolates were muhidrug-resistant and highly resistant to imipenem and meropenem, and at least 5 antimicrobial agents tested in this study.The analysis of the rep-PCR products indicated that all the 19 carbapenem-resistant strains had an identical band pattern, which was different from that seen in the sensitive strains.Al- though imipenem-EDTA double-disk test identified 5 MBL-producing strains, PCR found that all the 23 strains were negative for bla VIM and blaIMP.Only one OprD-deficient mutant was identified.Conclusions The 19 highly-resistant strains of P. aeruginosa derive from a common origin.More researches are needed to clarify their mechanism of carbapenem resistance.

Air Pollutants, Occupational ; analysis ; Carcinogens, Environmental ; analysis ; Chromium ; analysis ; Environmental Monitoring ; methods ; Workplace

Objective To compare the diagnostic value of prenatal ultrasound with magnetic resonance imaging(MRI)in the abnormalities of fetal urinary reproductive system,and explore the value of combining prenatal ultrasound and MRI in diagnosis of fetal urinary and reproductive system abnormalities.MethodsTwenty-seven fetal abnormalities in urinary reproductive system detected by prenatal ultrasound received MRI examination within 24 hours after ultrasound,confirmed by autopsy or clinical follow-up.The results of prenatal ultrasound and MRI were analyzed retrospectively.Results Ultrasound,MRI,autopsy or after birth,postpartum follow-up confirmed 27 cases of Genitourinary system anomalies,including 2 cases of hydronephrosis,renal agenesis in 6 cases,14 cases of renal cystic disease,renal fusion in 3 cases,1 case of renal tumors,ovarian cyst in one case of crown .Fetal ultrasound can diagnose the majority of the genitourinary system anomalies (25/27),MRI can diagnose fetal anomalies of 26 cases of genitourinary system.Conclusion Ultrasound could diagnose the majority of fetal abnormalities in urology reproductive system accurately.However,combining ultrasound and MRI could establish more precise estimation in urology reproductive system,such as the level of obstruction of urinary system in hydronephrosis,the pulmonary hypoplasia secondary to urology system abnormalities,and location of cyst in the renal parenchyma or in the renal capsule.

OBJECTIVETo investigate the result of hip arthroplasty for failed internal fixation of femoral neck fractures.

METHODSFrom June 2007 to January 2014, 29 cases who underwent hip arthroplasty for failed of internal fixation of femoral neck fractures were reviewed. There were 12 males and 17 females. The mean age was 60.3 years (ranged 43 to 83 years) at the time of the fracture. Left hip was in 16 cases, right hip was in 13 cases. The average interval from fracture to arthroplasty was 23.3 months (ranged, 3 to 48 months).

RESULTSAll of 29 cases were performed total hip arthroplasty. There were 20 cases of cementless cup,7 cases of cementless cup with bone graft, 2 cases of cemented cup with bone graft; 13 cases of cementless stem, 16 cases of cemented stem. There were no complications occurred such as intraoperative fracture of the greater trochanter. The average operative time was (115 ± 38) minutes,the mean intraoperative blood loss was (420 ± 175) ml, the average postoperative drainage volume (240 ± 119) ml, intraoperative blood transfusion was (200 ± 220) ml, intraoperative fluid volume was (2,200 ± 400) ml, the average postoperative blood transfusion was (300 ± 200) ml. There was 1 case get postoperative dislocation. All patients were followed up for 14.7 months in average (ranged, 5 to 24 months). There was no revision for mechanical failure. Harris Hip Score significantly was improved from 51.1 ± 7.5 before the conversion to 88.5 ± 6.4 points at the final follow-up.

CONCLUSIONThe effect of the hip replacement for patients with failed internal fixation of femoral neck fractures was confirmed. This method can shorten the time on the bed and reduce the complications. It benefits the patients earlier functional recovery, but it must control operation indication. The long term efficacy is necessary to further observation.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Failure

Objective To evaluate the value of cough test in the tension-free vaginal tape (TVT)procedure.Methods A cohort of 85 women with stress urinary incontinence underwent the TVT procedure with cough test (n =41) or without cough test (n =44).Patients in cough test group were performed according to the Ulmsten’s method strictly,with the stress of tape adjusted in light of cough test; whereas in other 44 operations,the tape was placed on the urethral tract without stress,and no cough test was performed.The urine catheter was removed after 48 hours postoperatively and follow-up evaluation was carried out at 12 month postoperatively.Results TVT procedure was carried out successfully in all patients by a single experienced surgeon.Four cases of urinary retention and 5 cases of voiding difficulty were observed in the cough test group.However,urinary retention or voiding difficulty was not detected in the nun-cough test group.Based on the twelve-month follow-up results,the cure rate was 92.6％ (38/41) in the cough test group and 93.1％ (41/44) in the non-cough test group.Flow-pressure study indicated that 11 cases in cough test group were in the obstruction zone,while only 3 cases in the obstruction zone were detected in the non-cough test group.Conclusions TVT is a safe as well as effective minimally invasive surgical procedure to treat female stress urinary incontinence.However,Adjusting stress of tape in accordance with cough test during the TVT may potentially increase the incidence of urinary dysfunction postoperatively.Therefore,no convincing evidence was gained to support the efficacy of cough test during TVT in terms of preventing postoperative voiding dysfunction.

Objective To study the prevalence of fatty liver and its risk factors in adult population of Pudong New District,Shanghai detected by combination of B-type uhrasonographic features and elevated serum activity of alanine aminotransferase (ALT).Methods A cross-sectional survey was performed in 2017 residents aged 16 years over recruited from four neighborhoods of Prdong New District of Shanghai with multi-phase cluster sampling,including interview with questionnaire,physical check-up,anthropometry, measurement of plasma glucose and lipid profile,ALT activity and real-time B-type ultrasnnography.Serum hepatitis B surface antigen (HBsAg) was further detected for those with elevated ALT activity.Results Prevalence of fatty liver was 21.32 percent (430/2017) in the residents of the District participated in this survey.Prevalence of abdominal obesity,hypertriglyceridemia,hyperlipoproteinemia (low-density lipoprotein-cholecterol),essential hypertension,impaired glucose tolerance,diabetes and metabolic syndrome were 71.16,71.16,11.86,66.74,35.58,24.40 and 47.21 percent in those with fatty liver, respectively,as compared to 26.34,12.73,4.79,39.57,24.01,6.81 and 11.28 percent in those without fatty liver (controls),respectively.Multivariate logistic regression analysis showed that body mass index, 2-h postprandial glucose level,diastolic blood pressure,serum level of triglyceride,abdominal obesity and diabetes all were independent risk factor for tatty liver,with odds ratio (OR) of 1.080,1.149,1.035, 1.526,1.960 and 1.391,respectively.Conclusions Prevalence of fatty liver was relatively high in Shanghai Pudong New District.Fatty liver closely associates with disturbance of carbohydrate and lipid metabolism.

Objective This study aimed to explore the epidemiological characteristics and related factors of overweight and obesity in Tianjin adults. Methods With multi-stage randomized cluster sampling, 19 271 people aged 18 years and over were selected from both urban and rural areas of six geographical regions of Tianjin in 2006, using a cross-sectional methodology. Data from these residents was collected, using a questionnaire by face-to-face interview conducted by trained interviewers. Demographic, anthropometric data were collected in all participants. Data was analyzed with SPSS 13.0 software. For diagnosis of overweight and obesity, we adopted the standard of overweight and obesity recommended for Chinese adults. Age, gender and area distribution of overweight and obesity in the population of Tianjin were described, and the related factors were analyzed. Results Prevalence of overweight and obesity in adults from Tianjin were 32.8%(95%CI: 32.1%-33.5%) and 11.7% (95% CI: 11.2%-12.2%), with the standardized rates as 33.1% and 12.2%, respectively. Those figures were higher than the national average levels. The prevalence rates of overweight and obesity were increasing with age. The overweight rate in 50-59 year olds and the obesity rate in 60-69 year olds reached their peak values. The prevalence rate of obesity was higher in rural (13.5%,with 95%CI: 12.8%-14.2%) than in the urban areas (11.1%,with 95%CI: 10.4%-11.7%) and in females (12.6%,95%CI: 11.9%-13.2%) than in males (10.9%,95%CI: 10.3%-11.5%). Results from logistic regression model analyses indicated that the prevalence of overweight and obesity in Tianjin were statistically associated with age, gender, educational level, smoking, alcohol consumption and exercises. Conclusion As the urbanization progressing, the prevalence of overweight and obesity was much higher in the population of Tianjin city. Many factors were related to adults overweight and obesity. An active community-based public health intervention should be taken.

Objective To investigate the type 2 diabetes mellitus(T2DM)prevalence and related risk factors in adult population with obesity in Tianjin. Methods With stratified cluster randomized sampling, 2888 obese people with BMI≥28 kg/m2, aged 18 years old and over were selected from three urban and three rural regions of Tianjin, in 2006. Information on risk factors was collected with questionnaire through face-to-face interview by trained workers and data on fasting blood glucose(FBG)was collected at the same time. 2hrPPG was tested among the people who' s FBG ≥6.1 mmol/L at the hospital. Prevalence of T2DM was calculated and the distribution of T2DM in the described subgroups and the risk factors analyzed with SPSS software. Results The prevalence of T2DM in adult population with obesity was 11.74%, with females(13.90%)higher than males (8.75%). The prevalence rates of T2DM were statistically different among different groups, classified by age, education, occupation, district and BMI. Results from the univariate and multivariate logistic regression analysis showed that the risk factors of T2DM were age(OR=1.383, 95% CI: 1.254-1 .525)and sex(OR= 1.591,95% CI: 1.230-2.059)while the protective factor was fruit intake(OR=0.867, 95% CI: 0.774-0.971). Conclusion The prevalence of T2DM in adult with obesity was considered to be high. The distribution of T2DM in different subgroups and affecting factors of T2DM in obese adults were different from general population.