Certification ; China ; Humans ; Occupational Health Physicians

Certification ; Humans ; Occupational Health Physicians

Objective To observe the effects of telramethylpyrazine(TMP)on the splanchnic blood flow in severe acute pancreatitis(SAP)rats and to elucidate the underlying mechanism.Methods Thirty-two rats were randomly divided into 2 groups:telramethylpyrazine group(TMP group,n=16)and SAP group(n=16).At 12,24 hours after the induction of SAP,serum amylase was measured.The regional pancreatic blood flow was measured by Doppler ultrasound;the blood flow of portal vein,spleen artery and superior mesenteric artery were also measured.Results The level of the serum amylase was lower in the TMP group than that in the SAP group(P

AIM:To observe the effect of fresh amniotic membrane transplantation ( FAMT) in acute ocular chemical burns.
●METHODS:A prospective study of 25 consecutive cases (36 eyes) with acute ocular chemical burns were treated with FAMT. The clinical efficacy was observed such as the time of amniotic membrane absorbed, corneal epithelialization & transparency, visual acuities and complications.
●RESULTS: With follow-up ranged from 3 to 6mo, 31 eyes′ amniotic membrane were dissolved in 2wk (86%). A total of 33 eyes showed corneal epithelialization in 4wk ( 92%) , 3 eyes showed persistent corneal epithelial defects and need secondary limbal stem cell transplantation or corneal transplantation ( 8%) . A total of 10 eyes showed superficial corneal vascularization (28%), 6 eyes′ cornea were opacity in part (17%), and one eye was symblepharon (3%).
●CONCLUSION:Early FAMT is an effective treatment in the management of acute ocular chemical burns to support epithelial healing, restore ocular surface integrity with potential to improve vision and reduce the incidence of complications. Furthermore, FAMT has advantages of easily obtain and convenient usage, which is suitable in local hospital of our country.

Quintessential course is a kind of demonstration course,therefore,various colleges paid great attention to the construction and utilization of quintessential courses.In order to promote educational reform,improve teaching quality of medicine and reflect the value of quintessential courses,we should adopt a variety of measures to ensure the smooth undergoing of the whole process in teaching and research section of neurology including information resource sharing,video recording of class teaching,network platform constructing,teaching team constructing as well as individuation and diversification.

Objective To investigate the feasibility of using low volume of low concentration isotonic contrast medium for 320 row coronary CT angiography.Methods 64 patients whose heart rate 70 beats per minute or less,normal cardiac rhythm,BMI≤24 kg/m2 were scanned using a 320 row dynamic volume CT with the tube voltage of 100 kVp and injection of contrast medium with a concentration 270 mg I/mL.Prospective ECG gating technique and adaptive iterative dose reduction algorithm reconstruction were used.In group A,22 patients were injected 50 mL contrast medium by a rate of 5.0 mL/s.In group B,21 patients were injected with the dosage of contrast medium calculated by 0.7 mL/kg and injection rate was 4.5 mL/s.In group C,21 patients were injected with the dosage of contrast medium calculated by 0.6 mL/kg and the injection rate was 4.0 mL/s.The attenuation value,signal-to-noise(SNR),con-trast-to-noise ratio(CNR),image quality and iodine intake between three groups were compared using One-Way ANOVA .Results There was no significantly statistical difference of age,sex ratio,BMI,heart rate between the three groups (P >0.05).However,the dosage of the contrast agent and different injection time had statistical significance (P <0.05).The attenuation value from group A to group B and then to group C was on the decline,the CT value of group A was obviously higher than that of group B and group C,and the differences were statistically significant (P <0.05),and there was no significantly statistical difference between the group B and group C (P >0.05).The image quality,SNR and CNR in three groups did not have significant difference (P >0.05).The total iodine and iodine injection rate were lowest in group C.Conclusion In 320 row coronary CT angiography with 100 kVp tube voltage and iterative reconstruction algorithm,the patients whose heart rate 70 beats per minute or less,BMI≤24 kg/m2 injected the low concentration of contrast medium by 0.6 mL/kg dose injection can give a good image quality which can meet the diagnostic requirement.Mean-while,it can also reduce the iodine intake and the risk of contrast induced nephrology (CIN).

Objective To explore the value of color doppler ultrasonography by bed side in the early diagnosis of HIE in full term neonates.Methods The changes of cerebral parenchymal and cerebral arterial blood stream parameter on 35 cases of neonates clinically diagnosed HIE of mild and moderate degree and 40 cases of normal newborns on the 24,48 and 72 hours after birth were observed by color doppler ultrasonography by bed side.Results 1.The cerebral parenchyma was even echo in normal newborns,but it was maldistributed and reinforced in mild asphyxia neonates and it was more serious in moderate degree.The echo of cerebral parenchyma in mild degree was near normal in 48 hours after birth,while the echo of cerebral parenchyma in moderate degree was still maldistributed and reinforced in 48 and 72 hours after birth.2.There was obvious changes in the cerebral arterial blood stream parameter and hemodynamics of the asphyxia newborns compared with normals.The systolic peak velocity(Vs)and end diastolic velocity(Vd)of the cerebral arteries in mild and moderate degree were obviously lower than that of control group in 24,48 hours after birth(Pa0.05).3.Resistance index(RI)of the cerebral arteries in mild and moderate degree were higher than that of control group in 24,48 hours after birth(Pa0.05).Conclusion Color doppler ultrasonography by bed side is a convenient,noninvasive method for diagnosing HIE.

OBJECTIVETo measure and analyze the personal noise exposure of city metro station workers by using noise dosimeter.

METHODSAccording to job category and work type, all workers were divided into 4 groups. The workers from each group were selected as subjects for personal noise exposure measurement. CEL-320 dosimeters were worn by each subject and noise data collected by a phone fixed at collar. All subjects were asked to take notes about their working activities when they were wearing CEL-320 dosimeters. Each worker's one workday LAeq, geometric mean and range of each group were computed.

RESULTSThere were many noise sources in the metro station, and the noise exposure was unstable. The varieties of personal noise levels were recorded among 48 workers, the highest LAeq work type was of the instrument room, (81.8 +/- 2.5) dB (A), and the biggest LAeq rang was of the hall, 8.1 dB (A). The lowest LAeq was of the station control room (68.7 +/- 1.8) dB (A) and the lowest LAeq rang also was there, 4.0 dB (A).

CONCLUSIONThe personal noise exposure of metro station should be implicated. Measuring personal noise exposure individually with dosimeters might obtain the noise exposure level more integrally in the complicated environment.

BACKGROUND: Pancreatic damage in critically ill patients is associated with the progressive failure of multiple organs, but little is known about its clinical characteristics. At present, no guidelines are available for the diagnosis and management of pancreatic damage. This study was undertaken to analyze the clinical and pathologic characteristics of pancreatic necrosis in critically ill children, and to find some biological markers of pancreatic damage or pancreatic necrosis. METHODS: We retrospectively reviewed the clinical data, laboratory results, and autopsy findings of 25 children, who were admitted to Hunan Children's Hospital, China from 2003 to 2009, and died of multiple organ failure. The autopsy revealed pancreatic necrosis in 5 children, in whom sectional or gross autopsy was performed. RESULTS: The 5 children had acute onset and a fever. Two children had abdominal pain and 2 had abdominal bulging, flatulence and gastrointestinal bleeding. Four children had abnormal liver function, characterized by decreased albumin and 3 children had elevated level of C-reactive protein (CRP). B-ultrasonography revealed abnormal acoustic image of the pancreas in all children, and autopsy confirmed pancreatic necrosis, which may be associated with the damage of the adrenal gland, liver, lung, heart, spleen, kidney, intestine, thymus, mediastinal and mesenteric lymph nodes and other organs. Children 1 and 2 died of acute hemorrhagic necrotizing pancreatitis (AHNP);children 3-5 died of multiple organ dysfunction syndrome (MODS) due to pancreatic necrosis. CONCLUSION: Pancreatic damage or pancreatic necrosis in critically ill children is characterized by acute onset, severity, short course, multiple organ damage or failure. It may be asymptomatic in early stage, and easy to be ignored.

Objective To analyze hemolysin and virulence -related genes in incomplete hemolytic Staphylococcus aureus.Methods Fifty strains of incomplete hemolytic Staphylococcus aureus were isolated from patients admitted in the Second Affiliated Hospital of Soochow University during 2013 and 2014, and the isolates with complete hemolytic phenotype were also collected at the same period as the control strains . All the strains were inoculated and subcultured on four kinds of sheep blood agar plates supplied by different manufacturers to compare their hemolytic phenotype .The relative mRNA expressions of hemolysin genes (hla, hlb, hlc, hld) in standard strain, complete and incomplete hemolytic phenotype strains were detected by real-time quantitative polymerase chain reaction (RT-qPCR), and valued by 2 -△△Ct method.t test was used to compare mRNA expressions of hemolysin genes .Western blot was performed to analyze the expression of α-hemolysin.Antibiotic susceptibility test of incomplete hemolytic strains was performed using broth microdilution method.Resistant gene mecA and virulence genes pvl, tst were detected by PCR.Results The steady and hereditary incomplete hemolysis was observed in 50 strains of incomplete hemolytic Staphylococcus aureus on the sheep blood agar plates from different suppliers .Taking mRNA expression of hla, hlb, hlc, hld in standard strain as 1, the relative mRNA expressions of hemolysin genes in incomplete hemolytic strains were 0.02, 7.51, 0.06 and 0.12 respectively, there were statistical differences between standard strain and incomplete hemolytic strains (t =8.46, -56.40, 8.12 and 7.61, all P <0.05).And the expression of α-hemolysin was decreased in incomplete hemolytic strains .All the strains were identified as methicillin resistant Staphylococcus aureus (MRSA).Three strains exhibited different minimum inhibitory concentrations of teicoplanin and linezolid after subcultured , but the differences had no impact on the final results of antibiotic susceptibility test .mecA, pvl and tst genes were positive in incomplete hemolytic strains . Conclusion Staphylococcus aureus with incomplete hemolytic phenotype is methicillin resistant with higher expression of β-hemolysin and lower expressions of α-hemolysin, γ-hemolysin and δ-hemolysin.It carries plv and tst virulence genes and is of high virulence .