Humans ; Occupational Exposure ; Occupational Health

The newly-formed TCM medical group is characteristic of innovative management,diversified medical service provision,integration of medical resources,building of urban/rural medical service systems,promoting medical resources availability to primary care,perfecting hierarchical medical service mechanism,leveraging advantages of traditional Chinese medicine and its primary care capabilities,centralizing human,financial,and material resources management.

China ; Humans ; Occupational Health ; statistics & numerical data ; Physical Examination ; trends

Objective To evaluate the treatment and p re vention of urethral stricture complicated by transurethral vapo-resection of pr ostate (TVP). Methods Retrospective analysis was conduct ed by reviewing medical records and following up the patients under study.Among 3012 patients with benign prostatic hyperplasia treated with TVP, urethral stric ture occurred 4 weeks to 22 months following surgery in 95 cases (3.15 %), inclu ding anterior in 47 (49.5%),posterior in 31 (32.6 %) and bladder neck contractur e or occlusion in 17 (17.9%).Their mean age was 68.7 years (range, 55 to 85 year s). Results The 95 patients were followed up for 4～36 m o nths (mean,14 months).Of them,65 cases underwent conventional dilation, in them 59 (90.8%) were cured and 6 had failure,then turning to internal urethrotomy;19 cases underwent internal urethrotomy plus dilation,in them,13 (68.4%) were cured and 6 had failure,then turning to urethroplasty;17 cases of bladder neck contra cture or occlusion underwent transurethral resection of bladder neck scar tissue ,with a cure rate of 88.2% (15 were cured and 2 experienced failure). Conclusions Urethral stricture is a common complication after TVP. The key points of managing the strictures are patients’ alert,close follow-up and early effective treatment.

OBJECTIVE:To analyze the effect of precision filtration infusion apparatus and other methods on reduction of ADR induced by Acanthopanax injection. METHODS:532 patients receiving intravenous infusion of Acanthopanax injection were randomly divided into observation group and control group;observation group used disposable precision filtration infusion appara-tus,while control group used disposable ordinary infusion apparatus. The occurrence of ADR were compared between 2 groups. RE-SULTS:The incidence of ADR in observation group(2.68%)was significantly lower than in control group(7.75%),with statisti-cal significance(P<0.05). CONCLUSIONS:Intravenous infusion of Acanthopanax injection with disposable precision filtration in-fusion apparatus can effectively reduce the occurrence of ADR.

Objective To investigate the effects of butorphanol pretreatment on myocardial injury induced by limb ischemia/reperfusion.Methods Forty patients with distal lower extremity orthopedic surgery (ASA Ⅰ or Ⅱ) were divided into two groups by random digits table method with 20 cases each:butorphanol group and control group.Epidural anesthesia was selected in all patients.In butorphanol group,patients were given butorphanol 0.04 mg/kg intravenously 15 min before tourniquet.In control group,equal volume of normal saline was infused at the same time.Blood samples were taken from jugular vein before tourniquet (T0),then 5 min(T1),2 h (T2),6 h (T3),12 h (T4) and 24 h (T5) after the second reperfusion of tourniquet.The serum creatine kinase isoenzyme MB (CK-MB),cardiac troponin Ⅰ (cTnI),tumor necrosis factor-α (TNF-α) and malondialdehyde (MDA) levels were determined.Results Compared with those at T0,the serum C K-MB levels were increased at T2-T5,the serum cTnI,MDA,TNF-α levels were increased at T1-T5 in control group,and there were significant differences (P ＜ 0.05).Compared with those at T0,the serum CK-MB levels were increased at T3,T4,the serum TNF-α levels were increased at T1-T3,the serum cTnI levels were increased at T1-T5 in butorphanol group,and there were significant differences (P ＜ 0.05).Compared with those in control group,the serum CK-MB levels were decreased at T2-T5 [(20.2 ± 5.0) U/L vs.(35.3 ±6.8) U/L,(32.3 ±3.7) U/L vs.(48.6 ±8.5) U/L,(29.5 ±5.4) U/L vs.(51.5 ±8.0) U/L,(22.2 ±4.8) U/L vs.(33.7 ±6.7) U/L],the serum cTnI,TNF-α levels were decreased at T1-T5 [(0.158 ± 0.016) μg/L vs.(0.278 ±0.021) μg/L,(0.169 ±0.036) μg/L vs.(0.332 ± 0.062) μg/L,(0.357 ±0.049) μg/L vs.(0.623 ±0.083) μg/L,(0.178 ±0.045) μg/L vs.(0.383 ±0.059) μg/L,(0.138 ±0.016) μg/L vs.(0.263 ±0.023) μg/L; (1.63 ±0.13) μg/L vs.(2.12 ±0.08) μg/L,(1.69 ± 0.08) μ g/L vs.(2.28 ± 0.09) μ g/L,(1.63 ± 0.09) μ g/L vs.(2.25 ± 0.07) μ g/L,(1.23 ± 0.14) μμg/Lvs.(1.93±0.12) μg/L,(1.13±0.15) μμg/Lvs.(1.79±0.07) μμg/L],theserumMDAlevelswere decreased at T1-T4 [(4.82 ±0.53) nmol/L vs.(6.68 ±0.67) nmol/L,(4.99 ±0.61) nmol/L vs.(7.59 ±0.72) nmol/L,(5.02 ±0.43) nmol/L vs.(7.54 ±0.63) nmol/L,(4.52 ±0.55) nmol/L vs.(6.52 ±0.47) nmol/L] in butorphanol group,and there were significant differences (P ＜0.05).Conclusion Butorphanol pretreatment can improve the serum CK-MB,cTnI levels,and has a protective role for myocardial injury induced by limb ischemia/reperfusion.

Objective To explore the severity of toxicity reaction after treated by the sequential chemoradio-therapy,alternate chemoradiotherapy or concurrent chemoradiotherapy in limited -stage small cell lung cancer. Methods 63 cases of limited -stage small cell lung cancer were reviewed,according to the chemoradiotherapy order,all cases were divided into:sequential chemoradiotherapy 15 cases,alternate chemoradiotherapy 25 cases, concurrent chemoradiotherapy 23 cases.The correlation of the factors(leukocypenia,gastrointestinal reaction,pneumo-nia,esophagitis)with different treatment groups after treated in 2 months,4 months,6 months were analyzed.Results Three groups of all the factors treated in 2 months had no significant change(χ2 =0.275,0.051,0.513,1.215, 0.051,0.231,all P >0.05).In 4 months the cases of sequential chemoradiotherapy >or =2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 33.3%,33.3%,0.0%,0.0%;In the cases of alternate chemoradiotherapy >or =2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 16.0%,4.0%,16.0%,0.0%;In the cases of concurrent chemoradiotherapy >or =2 myelosuppression,the gastroin-testinal reaction,the pneumonia and the esophagitis were 52.2%,34.8%,34.8%,4.3%;>or =2 myelosuppres-sion,each level gastrointestinal reaction and the pneumonia of the three groups treated were statistically significant (χ2 =7.054,9.702,7.947,6.145,7.373,all P <0.05).In 6 months the cases of sequential chemoradiotherapy >or =2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 26.7%,13.3%,13.3%, 0.0%;In the cases of alternate chemoradiotherapy >or =2 myelosuppression,the gastrointestinal reaction,the pneu-monia and the esophagitis were 40.0%,56.0%,12.0%,0.0%;In the cases of concurrent chemoradiotherapy >or =2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 69.6%,65.2%,43.5%,0.0%;each level myelosuppression,>or =2 gastrointestinal reaction and the pneumonia of the three groups treated were statistically significant(χ2 =6.174,7.663,10.544,6.286,all P <0.05).Conclusion Leukopenia and gastrointestinal reaction are closely related with chemotherapy,chemoradiotherapy results in the worsen of myelosuppression.Pneumonia and esophagitis are closely related with chemotherapy,chemoradiotherapy result in the worsen of radiation pneumonitis.

A strain C4 with ability of bioconversion from steroid RSA to hydrocortisone was selected fron the soil sample. It was identifide as Cuvularia Iunata according its morphological characters of clump and individuals. The optimum culture medium was established by orthogonal experiments :glucose 10g ,soybean powder 10g,water 1000mL, pH6.5. Determined by silica gel chromatography and high-performance liquid chromatography, the bioconversion ratio of hydrocortisone was 34%. At the same tine, the percentage change of RSA,hydrocortisone and other byproducts were measured during the course of bioconversion.

A strain C4 with ability of bioconversion from steroid RSA to hydrocortisone was selected fron the soil sample. It was identifide as Cuvularia Iunata according its morphological characters of clump and individuals.The optimum culture medium was established by orthogonal experiments:glucose 10g,soybean powder 10g,water 1000mL, pH6.5.Determined by silica gel chromatography and high performance liquid chromatography, the bioconversion ratio of hydrocortisone was 34%.At the same tine, the percentage change of RSA,hydrocortisone and other byproducts were measured during the course of bioconversion.

OBJECTIVE:To learn the application and tendency of hepatoprotective drugs in a third grade class A hospital dur-ing 2011-2014,and to provide reference for rational drug use. METHODS:DDDs analysis and consumption ordering method were adopted to analyze the change of DDDs,DDC and other index of hepatoprotective drugs in this hospital from 2011 to 2014. RE-SULTS:2011-2014,the amount and DDDs of Hepatoprotective injection in this hospital increased year by year,while oral dosage form decreased year by year. DDC order of each drug kept stable during 2011-2014;DDC and DDDs of drugs for promoting ener-gy metabolism were all in high level,and ornithine aspartate and ademetionine always took up the first 2 places in 4 years. Polyene phosphatidylcholine and Reduced glutathione injection were cheap,but had higher DDDs. Except Glutathione tablet,DUI of other hepatoprotective drugs had no great difference in 3 years,and fluctuated in 2014;hepatoprotective drugs with DUI>1 and DUI<1 occupied a large proportion. From 2010 to 2014,compared with previous year,the drugs with consumption sum/DDDs ratio num-ber close to 1 reduced significantly in the next year,decreasing year by year. CONCLUSIONS:In this hospital,injections are used too frequently,and overuse of drugs for promoting energy metabolism exist. Polyene phosphatidylcholine and Reduced glutathione injection can be used as a valuable drug in the clinic,and their cost are more acceptable,but not in excess.