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 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 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.

Humans ; Occupational Exposure ; Occupational Health

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.

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 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.

Objective Obstructive sleep apnea hypopnea syndrome (OSAHS) often causes damage to multiple systems, especially to the central nervous system, inducing cognitive dysfunction.This study aims to explore the possible correlation of the expressions of serum hypoxia-inducible factor-1α (HIF-1α) and brain-derived neurotrophic factor (BDNF) with cognitive impairment in rats under different hypoxia conditions.Methods Twenty-four Wistar rats were equally randomized into a normal control, a chronic intermittent hypoxia (CIH), and a chronic continuous hypoxia (CCH) group.The rats of the CIH group were placed in a hypoxia chamber filled with N2 and air, the oxygen concentration switched from (7±0.5)% to 21%, 1.5 minutes for each state and 4 minutes for each cycle, while those of the CCH group were placed in another hypoxia chamber with the oxygen concentration of (7±0.5)%, 8 hours a day and all for 30 days.Then we recorded the body weight of the rats, detected the expressions of serum HIF-1α and BDNF by ELISA, and observed the changes of behavior by Morris water maze test and those of the hippocampal morphological structure by HE staining.Results At 30 days after modeling, the body weight of the rats was significantly decreased in the CIH and CSH groups as compared with the normal control ([195.75±6.497] and [180.88±12.017] vs [218.63±15.287] g, P<0.05).Positioning navigation showed that the escape latency was significantly longer in the hypoxia models than in the controls (P<0.05), even longer in the CIH than in the CCH group (P<0.05).Spatial exploration test manifested a lower frequency of crossing the platform in the CIH and CCH groups than in the control ([2.63±1.45] and [3.22±1.30] vs [4.97±0.47] times, P<0.05).The expression levels of serum HIF-1α and BDNF were significantly higher in the CIH ([36.14±9.34] and [1625.34±332.44] pg/mL) and CCH ([27.27±6.88] and [1204.07±363.81] pg/mL) than in the normal control group ([14.11±4.06] and [1036.40±124.48] pg/mL) (P<0.05), even higher in the CIH than in the CCH group (P<0.05).HE staining exhibited scattered and disorderly arrangement of hippocampal neurons in the model rats, with unclear nuclear membrane, pyknosis of the nuclei, darkly stained cytoplasm, and some damaged cells.More obvious absence and vacuolization of some cells were observed in the rats of the CIH group.Conclusion Chronic hypoxia inhibits the growth and development of rats and induces cognitive dysfunction.High-level HIF-1α in chronic intermittent hypoxia indicates hypoxia-stress of the body, while compensatory increase of serum BDNF may be involved in neuronal cell damage regulation.