Evidence-Based Medicine ; Humans ; Occupational Diseases ; prevention & control ; Occupational Medicine ; methods

To determine the content of 10-Hydroxy -2-decenoic acid in Chongcaojing Wangjiang Capsule by HPLC.The column was Discovery C 18 .The detective wavelength was at 209 nm. The mobile phase was acetonitrile: 0.5% phosphoric acid (25∶75) with the flow rate being 1.0 mL/min and the column temperature at 25℃.There was a good linearity (r=1) winthin the range of 0.02144 ～ 0.38592 ?g. The average recovery rate was 101.8%, RSD= 1.6%. [Conclusion] This method can be used for the quality control standard of Chongcaojing Wangjiang Capsule.

Objective:To compare the effects of different doses of atorvastatin on blood lipid and endothelial function in patients with hypertension and carotid plaque.Methods:Ninety-two patients with hypertension and carotid plaque who received treatment from June 2019 to June 2020 were included in this study. They were assigned to receive treatment with either atorvastatin 20 mg (control group, n = 46) or atorvastatin 40 mg (study group, n = 46) for 3 months. Blood lipid level and endothelial function were compared between the two groups. Results:There were no significant differences in sex, age, course of disease, body mass index (BMI) and carotid plaque grading between the two groups (all P > 0.05). Before treatment, there were no significant differences in serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) between two groups (all P > 0.05). After treatment, serum levels of TC, TG and LDL-C in each group were significantly decreased compared with before treatment [study group: TC: (5.8 ± 2.3) mmol/L vs. (3.5 ± 1.3) mmol/L, t = 5.904; TG: (2.5 ± 0.8) mmol/L vs. (1.2 ± 0.5) mmol/L, t = 9.346; LDL-C: (5.0 ± 0.4) mmol/L vs. (3.3 ± 0.4) mmol/L, t = 20.382; control group: TC: (5.9 ± 1.8) mmol/L vs. (4.5 ± 1.5) mmol/L, t = 4.052; TG: (2.6 ± 0.3) mmol/L vs. (1.8 ± 0.7) mmol/L, t = 7.125; LDL-C: (4.9 ± 0.5) mmol/L vs. (4.2 ± 0.5) mmol/L, t = 6.714, all P < 0.01). After treatment, serum level of HDL-C in each group was significantly increased compared with before treatment [study group: (0.8 ± 0.5) mmol/L vs. (1.5 ± 0.3) mmol/L, t = 8.142; control group: (0.8 ± 0.4) mmol/L vs. (1.3 ± 0.2) mmol/ L, t = 7.583, both P < 0.01]. After treatment, serum levels of TC, TG and LDL-C in the study group were significantly lower than those in the control group ( tTC = 3.417, tTG = 4.731, tLDL-C = 9.533, all P < 0.01). After treatment, serum level of HDL-C in the study group was significantly higher than that in the control group ( tHDL-C = 3.762, P < 0.01). Before treatment, there were no significant differences in endothelium-dependent (flow mediated dilation, FMD) and endothelium-independent diastolic function (nitroglycerin- mediated dilatation, NMD) between the two groups (both P > 0.05). After treatment, FMD in each group was significantly enhanced compared with before treatment [study group: (7.5 ± 1.8) % vs. (10.9 ± 2.5) %, t = 7.486; control group: (7.7 ± 1.5) % vs. (8.9 ± 2.2) %, t = 3.057; both P < 0.05]. After treatment, FMD in the study group was significantly higher than that in the control group ( t = 4.073, P < 0.01). There was no significant difference in NMD between before and after treatment in the control group. After treatment, NMD in the study group was significantly increased compared with before treatment [(12.5 ± 2.3) % vs. (13.6 ± 2.5) %, t = 2.196, P = 0.031]. Conclusion:Atorvastatin 40 mg once a day can effectively regulate blood lipid level and improve endothelial function in patients with hypertension and carotid plaque, which exhibits superior effects to atorvastatin 20 mg once a day.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation. Methods Forty cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and Jan. 2010 in our center were retrospectively analyzed. Results Regarding surgical complications, 4 cases had severe hematuria after operation,which needed clinical intervention, including 1 patient receiving catheterization in duodenum to stop bleeding. Two patients were treated with continuous bladder irrigation, and the remaining one received surgical haemostasis because of donor's duodenum and bladder anastomotic artery hemorrhage.Abdominal hemorrhage occurred in 4 patients, including pancreatic hemorrhage in 3 cases and duodenal muscularis hemorrhage in one case. All of them received surgical treatment for hemostasis.Abdominal infection occurred in 8 cases: one died of multiple organ failure, 2 cases were cured after drainage of abscess, 2 cases underwent surgical removal of abscess, and 3 cases were cured after antibiotic therapy. In one case of postoperative anastomotic leakage, pancreas was resected. Four cases of postoperative ileus were cured by continuous clysis with traditional Chinese medicine. Seven cases had pulmonary bacterial infections, including one cases associated with fungal infection. They were cured by the anti-infective treatment. Other complication included poor healing in 5 cases and urinary infection in 2 cases. After combined simultaneous pancreas-kidney transplantation, 10 patients received reoperation because of surgical complications (14 operations). The re-operation rate was 25 %, including 2 patients (4 operations) for hematuria, 4 patients for abdominal hemorrhage, 2 patients (3 operations) for abdominal infection, 1 patient for pancreatic venous thrombosis, 1 patient for anastomotic leakage, and 1 patient for pancreatic fistula. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with endstage renal disease, surgical complication is still affecting the pancreas and kidney grafts after transplantation.

Objective To analyze characteristics of severe liver trauma and efficacy of different surgical procedures. Methods Clinical data of 109 patients with severe liver trauma treated in the recent 10 years were retrospectively analyzed. Debriding suture was performed in 32 patients, gauze tamponade in 5, debridement hepatectomy in 59 and anatomical hepatectomy in 13 patients. Results In all the 109 patients, 92 were cured and 17 died. The dead patients included 3 with grade Ⅲ trauma,9 with grade Ⅳ trauma, and 5 with grade V trauma. Among the dead patients, there were 3 patients with simple liver injury (17.6%) and 14 with associated injury (82.4%). Conclusion Right hepatic serious damage is the main type of severe liver trauma and is always complicated with associated injury and needs emergency treatment. Application of the most appropriate surgical approach according to the traumatic condition is important to promote the successful rate of treatment.

Objective To investigate the relationship between plasma docetaxel concentration and the efficacy as well as toxic and side effects in patients with breast cancer after chemotherapy.Methods Seventy -one patients with breast cancer who accepted AC sequential T chemotherapy regimen as first line treatment were selected from April 2015 to September 2015 in Hubei Provicial Tumor Hospital.The plasma concentration of docetaxel was detected by latex immunoturdidimetry after the docetaxel continuous infusion in each cycle.The three groups were assigned according to the concentration distribution of docetaxel:group A (plasma concentration docetaxel ≤ 2.0mg·h -1 · L -1 ),group B (2.1 -2.5mg·h -1 ·L -1 )and group C (≥2.6 mg·h -1 ·L -1 ).The relationship between the drug plasma concentration,therapeutic efficacy and adverse reactions in different docetaxel plasma concentration was analyzed retrospectively by Chi -square tests.Results The average plasma concentrations of docetaxel of the three groups were (1.55 ±0.36)mg·h -1 ·L -1 ,(2.28 ±0.13)mg·h -1 ·L -1 ,(2.87 ±0.38)mg· h -1 · L -1 respectively.The adverse reactions were enhanced with the increasing of docetaxel plasma concentration (χ2 =5.169, 4.463,3.630,P =0.023,0.035,0.047).The therapeutic efficacy of group C and group B was same(95.8%),which was higher than 87.0% of group A,but there was no statistically significant difference (χ2 =1.559,P =0.24). Conclusion Breast cancer patients whose plasma concentration of docetaxel is between 2.1 ~2.5mg·h -1 ·L -1 has a better prognosis,and its adverse reactions are controlled in a certain extent.

OBJECTIVE To study the effect of laryngopharyngeal and gastroesophageal reflux on the development of the laryngeal precancerous lesion and cancer.METHODS Twelve patients with vocal fold precancerous lesions and one patient with laryngeal cancer proved pathologically underwent 24-hour dual probe pH monitoring.All patients had been operated on and follow-up.RESULTS Seven of 13 patients(53.85%)showed positive pH monitoring in laryngopharynx,8 of 13(61.53%)patients showed positive pH monitoring in esophagus.Positive pH monitoring in both sites was found in 6 patients(46.15%).Among 7 patients with laryngopharyngeal reflux and 8 patients with gastroesophageal reflux,positive RSI was found in 5 cases and positive RFS was found in 6 cases.CONCLUSION The laryngopharyngeal reflux may be a risk factor in the development of the laryngeal precancerous lesion laryngeal cancer.

Objective To explore the relationship between serum tumor markers and cervical cancer by using Logistic regression, and to further establish the diagnosis model of squamous cell carcinoma antigen (SCC) in cervical cancer by using chi-squared automatic interaction detector (CHAID) analysis of decision tree.Methods Total of 581 cases of cervical cancer,342 cases of cervical benign diseases and 341 cases of healthy controls who detected tumor markers in Taizhou Hospital of Zhejiang during 2010-2013, were retrospectively studied.The test results of carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), SCC, and alpha fetoprotein (AFP) were reviewed.The Logistic regression were firstly used in screening the related tumor markers of cervical cancer, and then the CHAID method of decision tree was used in determining the values of the related tumor markers on the diagnosis of cervical cancer.The SCC elevated cases of uterine disease from January 2014 to December 2014 were collected to verify the diagnostic value of SCC in cervical cancer patients.Results Logistic regression analysis showed that among the 5 tumor markers which might be associated with cervical cancer, SCC was the only one which had statistical significance between cervical cancer and cervical benign diseases (Wald x2 =22.120,P =0.000), the OR and its 95％ CI was 1.900 (1.454-2.483).With the SCC numerical increases, the proportion of patients with cervical cancer also gradually increased, when SCC ＞ 2.20 μg/L, the positive predictive value was 94.7％.In 284 cases of SCC higher than 2.20 μg/L who considered as uterus related diseases, there were 270 cases (95.1％) who were eventually confirmed as cervical cancer.Conclusion There was a good diagnostic value of SCC for cervical cancer patients.