OBJECTIVETo identify the potential determinants of return to work (RTW) following work-related injury.

METHODSA historical cohort of workers with occupational injury in a state-owned locomotive vehicle company in central China was followed up for RTW. Demographic, employment and medical information was retrieved from the company archival documents; and post-injury information was interviewed by questionnaires. Univariate analysis and Cox Regression Model were used to examine the associations between potential determinants and outcomes of RTW.

RESULTSThree hundred of the 323 included cases (92.9%) eventually returned to work after the median absence of 43 days (average of 49.2 days). Factors from socio-demographic, clinical, economic and psychological domains were found affecting RTW in the univariate analyses. The multivariate analysis indicated that age, injury severity, injury locus, injury nature, pain in the injury locus, self-reported health status and pre-injury monthly salary were significant determinants of RTW.

CONCLUSIONSThere are multidimensional factors affecting RTW after occupational injury. Proper clinical treatment and rehabilitation, as well as economic and social support to facilitate workers' RTW would be the priorities for intervention. Future studies should be conducted in a larger representative sample to confirm the findings and to develop a multidisciplinary intervention strategy towards promoting RTW.

Adult ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Occupational Health ; statistics & numerical data ; Occupational Injuries ; Proportional Hazards Models ; Retrospective Studies ; Sick Leave ; Surveys and Questionnaires ; Work

Objective To compare the difference of biochemical characteristics and virulent Pst Ⅰ of Yersinia pestis strains in traditional focuses of plague in Yunna Province and in the new focuses of plague in Yulong County. Methods The identification data of biochemical characteristics(Rhamnose, Glycerol, Maltose, L-Arabina and Melibiose fermentation) and virulence factor(Pst Ⅰ) from different focuses of plague in Yunna Province were Retrospectively collected by tube test followed by the analysis using statistics software SAS 8.0 by Fisher exact probability of disordered two-way R × C table χ2 test. Results Among 48 strains of Yersinia pestis from hantaan type plague focus, 1 strain fermented L-maltose, 48 strains fermented Glycerol. Among 165 strains of Yersinia pestis from the Soul type plague focus, 1 strain did not ferment L-maltose, only one of them fermented Glycerol. 1 strain from the Soul type plague focus was confirmed to have mutation, for the test of nitrate reduction reaction was negative. All 5 strains of Yersinia pestis from the new focuses of plague in Yulong County fermented L-maltose and Glycerol. The statistical result showed that the differences in L-maltose and Glycerol fermentation of Yersinia pestis from different natural focuses of plague in Yunnan Province were statistically siguificant (P < 0.01). The differences of other biochemical characteristics and Pst Ⅰ were not statistically significant (P > 0.01). Conclusions Biochemical characteristics of Yersinia pestis from the hantaan type plague focus and the Soul type plague focus in Yunnan province are overlapping. Biochemical characteristics of Yersinia pestis from the new focuses of plague in Yulong County are different from those tradition focuses of plague in Yunna Province but share similarities to those from Unquiculatus focuses in North Tibet.

Objective To evaluate the appearance of CT in patients with severe acute respiratory syndrome (SARS) in the recovery phase, and to study the correlation of CT findings with pulmonary function.Methods From June to August in 2003, 100 patient with confirmed SARS accepted examination in our hospital. Among them, 91 patients (39 men, 52 women, mean age 36.4 years, age range 19- 66 years) received CT examination and pulmonary function test on the same day. The interval between SARS onset and the examination ranged from 52 to 125 days (mean 87.4 days). CT appearances of pulmonary parenchymal abnormalities including distribution and extent of involvement were quantitatively analyzed, and four levels on CT scan including the aortic arch, the tracheal carina, the pulmonary venous confluence, and the dome of right diaphragm were selected to score the lesions. The correlation of CT scores with the results of pulmonary function tests was studied.Results Of the 91 cases, 47 patients had normal CT appearance in the recovery phase, whereas the other 44 patients still had parenchymal abnormalities, including residual ground-glass opacification and reticular shadow. CT visual score had correlation with DLco% ( r =-0.618, P

Objective To study the risk factors of acute bilirubin encephalopathy (ABE) in neonates with severe hyperbilirubinemia (total serum bilirubin ≥ 427.5 μmol/L).Method Clinical information of neonates with severe hyperbilirubinemia admitted to the Neonatal Department of Baoan Maternal and Child Health Hospital in Shenzhen from December 2013 to October 2017 were collected.The enrolled cases were grouped as ABE and the control group (without ABE).The risk factors for ABE were compared between the two groups and the Logistic regression analysis was used to evaluate the independent risk factor.Result A total of 104 neonates were recruited.There were 32 cases in the ABE group and 72 cases in the control group.The level of total serum bilirubin and indirect bilirubin,the ratio of total bilirubin/albumin,the incidence of glucose-6-phosphate dehydrogenase deficiency and metabolic acidosis and sepsis,the rate of using traditional Chinese medicine and the failure of treatment in other hospitals and non-resident population were all significantly higher in the ABE group than the control (P ＜ 0.05).Logistic regression analysis showed that total serum bilirubin (OR =1.013,95％ CI 1.007 ～ 1.020) and sepsis (OR =6.343,95％ CI 1.801 ～22.338) were the independent risk factors for ABE.Conclusion The severe hyperbilirubinemia infants,particularly with sepsis,are at higher risk of developing acute bilirubin encephalopathy.

OBJECTIVETo determine the mutation responsible for the congenital fibrosis of the extraocular muscles type I(CFEOM1) in a Chinese family.

METHODSDirect sequencing of exons 20 and 21 in the KIF21A gene was performed for the proband. The mutation c.2860C to T in exon 21 was examined by allele specific-PCR (AS-PCR) analysis in other family members. Haplotype analysis was performed using four STR markers (D12S1668, D12S2194, D12S331 and D12S1048).

RESULTSA heterozygous mutation c.2860C to T in the KIF21A gene was identified in all three affected members with CFEOM1. Haplotype analysis suggested that the mutation might derive from maternal germline mosaicism.

CONCLUSIONThis Chinese family with CFEOM1 may be caused by a c.2860C to T mutation in the KIF21A gene.

Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; China ; Exons ; Female ; Fibrosis ; Haplotypes ; Humans ; Kinesin ; genetics ; Mutation ; genetics ; Oculomotor Muscles ; metabolism ; pathology ; Pedigree ; Phenotype ; Syndrome

OBJECTIVETo explore the influence of glucagon-like peptide-2 (GLP-2) on the proliferation of the intestinal mucosal cells in scalded rats.

METHODSFifty-five Wistar rats were employed in the study and were randomly divided into normal control (C), simple scald (S) and scald with GLP-2 treatment (G) groups. The rats in G group received GLP-2 introperitoneally in a dose of 200 micro g/kg two times a day. The rats in S and G groups were sacrificed at 6 postburn hours (PBHs), 12 PBHs, 1 postburn day (PBD1), PBD3 and PBD5 and the rats in C group were also sacrificed. Plasma diamine oxidase (DAO) activity, cell cycle protein cyclin D expression and the proliferating cell nuclear antigen (PCNA) in all groups were determined. And the histological change in the intestinal mucosal tissue was observed simultaneously. with all the above determinations.

RESULTSCompared with those in C group, the PCNA expression at 6 and 12 PBHs in S group was enhanced slightly and weakened at PBD1, reaching the lowest level at PBD3 and it was still lower than that in C group at PBD5. Changes in PCNA in G group were similar to that in S group, except that the expression at PBD3 and PBD5 was stronger than that in S group. The intestinal mucosal cyclin D protein expression was increased at 6 and 12 PBHs in S group, but decreased by 40% before injury at PBD1. Nevertheless, the cyclin D protein expression in G group was much higher than that in S group at PBD1, PBD3 and PBD5. The plasma DAO activity increased significantly in rats after burn injury. But the activity decreased obviously after GLP-2 treatment for 5 days (P < 0.01). It was observed histologically in G group that the lining of Exogenous intestinal villi was regular and well arranged without evident epithelial exfoliation.

CONCLUSIONExogenous GLP-2 might ameliorate intestinal mucosal injury in scalded rats, and promotion of the expression of PCNA and cyclin D, resulting in proliferation of injured intestinal mucosal cells, might be the underlying mechanisms.

Animals ; Burns ; metabolism ; pathology ; Cell Proliferation ; drug effects ; Cyclin D ; biosynthesis ; Female ; Glucagon-Like Peptide 2 ; pharmacology ; Intestinal Mucosa ; metabolism ; pathology ; Male ; Proliferating Cell Nuclear Antigen ; biosynthesis ; Rats ; Rats, Wistar

Objective To investigate the protective effect and mechanism of serum containing Euonymus fortunei on the rat pancreatic islet cells. Methods Forty male SD rats were randomly divided into 5 groups (n=8 in each group), including the control group (normal rat islet cells were cultured with normal rat serum), ischemic preconditioning group (abdominal aorta was blocked first and then re-opened before the pancreas was obtained, and the pancreatic islet cells were cultured with normal rat serum), Euonymus fortunei treatment group (normal rat islet cells were cultured with rat serum containing Euonymus fortunei), Euonymus fortunei group and blank group (normal rats were administered orally with Euonymus fortunei extract or distilled water for the preparation of rat serum). Diphenylthiocarbazone (DTZ) staining was utilized to observe and calculate the quantity of islets. Acridine orange (AO)/propidium iodide (PI) staining was adopted to calculate the survival rate of islet cells. The insulin release experiment was performed to calculate the stimulation index (SI) and evaluate islet cell function. The concentration of glutathione (GSH) and nitric oxide (NO) in islet cells was detected using GSH and NO kits. The expression level of inducible nitric oxide synthase (iNOS) messenger RNA (mRNA) was quantitatively measured by reverse transcription polymerase chain reaction (RT-PCR). Results Islet cells were observed in specifically scarlet color after DTZ staining. The quantity of islet cells did not significantly differ among different groups (all P>0.05). Along with the prolongation of culture time, the activity of islet cells in each group was gradually decreased. At 72 h after isolation and culture, compared with the control group, the survival rate of the cells was significantly higher in the Euonymus fortunei treatment group (P<0.05). The insulin release test results demonstrated that compared with the control group, the SI of the ischemic preconditioning and Euonymus fortunei treatment groups was significantly increased (both P<0.05). Compared with the control group, the GSH contents of pancreatic islet cells in the ischemic preconditioning and Euonymus fortunei treatment groups were considerably enhanced, the NO content was significantly decreased, and the expression level of iNOS mRNA was significantly down-regulated (all P<0.05). Conclusions Euonymus fortunei can increase the survival rate of islet cells and enhance the function of pancreatic islets by increasing the level of GSH, down-regulating the expression of iNOS and decreasing the NO production.

OBJECTIVETo investigate the influence of arginine hydrochloride and arginine acetate on the immune function and acid-base balance in rabbits with severe burns.

METHODSOne hundred and ten flap-eared rabbits were used in the study, in which 8 served as normal control, while the rest were inflicted with 30% TBSA full thickness burn. All the rabbits were divided into 10 groups, i.e. normal control (C, n = 14), burn control (B, n = 14, with intravenous infusion of Ringer's solution), 0.3 g/kg arginine hydrochloride (AH, n = 12), 0.3 g/kg arginine acetate (AA, n = 10), 0.6 g/kg AH (n = 10), and 0.6g/kg AA (n = 10) groups, 1.2 g/kg AH (n = 10), 1.2 g/kg AA (n = 10), 2.4 g/kg AA (n = 14) and 2.4 g/kg AH (n = 12) groups. AA and AH in different doses were fed to rabbits in corresponding groups 2 times a day for 7 days. The changes in the immune function, acid-base balance, chloride ion metabolism, and mortality were determined.

RESULTSDisorder in immune system was found after severe burns, with enhanced immune function at the beginning and weakening afterwards. The lymphocytic transformation rate, the CD4/CD8 ratio, the phagocytosis rate and the chemotactic index of white blood cells on 7 post burn day (PBD) were obviously lower in B group compared with C group (P < 0.05 or 0.01). These indices were obviously higher in 1.2, 2.4 g/kg AA and AH groups than those in B group on 7 PBD (P < 0.05 or 0.01). There was no difference in improvement of immune functions between 0.3, 0.6g/kg AH, AA group and B group. The values of blood pH, base excess (BE), buffer base (BB), HCO(3)(-) level in AH group were significantly lower than those in C group on 7 PBD (P < 0.05 or 0.01), while there were no obvious changes in AA group, they were obviously higher than those in AH group (P < 0.05 or 0.01). The contents of chloride ion in but 2.4 g/kg AH group during 5 to 7 PBD were obviously higher than those in C group and 2.4 g/kg AA group (P < 0.05 or 0.01), while no difference was found between 2.4 g/kg AA and C groups. The mortality in B group was obviously higher than that in 0.3, 0.6, 1.2 g/kg AH and AA groups (P < 0.05 or 0.01), but significantly lower than that in 2.4 g/kg AA and AH groups (P < 0.05).

CONCLUSIONDisorders in immune functions were observed in severely burned rabbits. Administration of arginine acetate as well as arginine hydrochloride could enhance the immune function, but arginine acetate seemed to be safer than arginine hydrochloride. Excessive dosage should be avoided to prevent a rise of the mortality.

Acetates ; chemistry ; therapeutic use ; Acid-Base Equilibrium ; Animals ; Arginine ; chemistry ; therapeutic use ; Burns ; immunology ; physiopathology ; therapy ; Enteral Nutrition ; Female ; Male ; Rabbits ; Wound Healing

Adult ; Female ; Humans ; Laparoscopy ; methods ; Liver Neoplasms ; diagnostic imaging ; pathology ; surgery ; Magnetic Resonance Imaging ; Neoplasms, Multiple Primary ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo study the feasibility and effect of substituting esophagus with stomach or colon without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preserved.

METHODSTwenty-four patients with cervical esophageal carcinoma were retrospectively reviewed. The esophagus was resected and substituted with 19 gastric pull-up and 5 colon interposition. Nineteen patients received radiotherapy postoperatively (dose 50 - 70 Gy).

RESULTSTwenty two patients were follow up over 3 years. The 3- and 5-year survival rates for T2 were 3 and 1, for T3, T4 8 and 3, respectively. The laryngeal function preservation rate was 77% (17/24) and the decannulation rate was 75% (12/16). The complication rate was 29%.

CONCLUSIONSurgical resection of cervical esophageal carcinoma with removal of the extraesophageal invaded tissues while preserving the laryngeal function is possible. The continuity of the esophagus is restored by stomach transposition and colon interposition. Combined with radiotherapy, the survival rate and life quality of the patient might be improved.

Adult ; Aged ; Esophageal Neoplasms ; mortality ; physiopathology ; surgery ; Esophagoplasty ; methods ; Female ; Follow-Up Studies ; Humans ; Larynx ; physiopathology ; Male ; Middle Aged ; Quality of Life ; Survival Rate ; Thoracotomy