Ethylene Dichlorides ; poisoning ; Humans ; Intracranial Pressure ; drug effects ; Occupational Exposure ; adverse effects

BACKGROUND: The pathogenesis of hepatic encephalopathy is still not completely clear at present, and the theory of ammonia poisoning may be the most powerful, the mechanism for lactulose in decreasing ammonia is clearer, and there are many studies on hepatic encephalopathy treated by lactulose at home and aboard, but the comparative studies on the long-term and short-term treatment of lactulose and placebo control treatment are still in lack. OBJECTIVE: To given long-term and short-term treatment of lactulose to patients with minimal hepatic encephalopathy, and compare the effect on the quality of life (QOL) of the patients with minimal hepatic encephalopa thy. DESIGN: A case-control observation. SETTING: Department of Geriatrics, Guangzhou First People's Hospital. PARTICIPANTS: Sixty patients with minimal hepatic encephalopathy, who were abnormal in the number connection test (NCT), digital symbol test (DST) and/or evoked potential examination and cooperated with the treatment, were selected from the patients with cirrhosis treated in the De partment of Geriatrics of Guangzhou First People's Hospital between June 1998 and March 2002, and they were randomly divided into control group (n=20), short-term lactulose group (n=20) and long-term lactulose group (n=20). METHODS: All the patients were given vitamin B for 24 weeks, two tablets for each time, three times a day; besides, the patients in the short term lactulose group and long-term lactulose group were orally adminis tered with lactulose (15-90 mL per day) for 8 and 24 weeks respectively. They were assessed with WHOQOL-BREF at the end of 0, 8, 16 and 24 weeks respectively, the incidence rate of hepatic encephalopathy was observed, and the ammonia conc entration in blood was detected at the same period.MAIN OUTCOME MEASURES: The changes of QOL and ammonia concentration in blood during the treatment were observed.RESULTS: During the treatment, one case in the control group lost to the follow-up, one case in the short-term lactulose group died from traffic accident, and two cases in the long -term group quitted because they could not endure the side effect of diarrhea, and totally 56 cases finished the treatment and entered the analysis of results. ① The incidence rate of hepatic encephalopathy at 6 months was 40%(8/20), 30%(6/20), 5%(1/20) in the control group, short-term lactulose group and long-term lactulose group respectively, and it was significantly lower in the long-term lactulose group than in the control group and short-term lactulose group (P ＜ 0.05), but there was no significant difference between the short-term lactulose group and control group (P ＞ 0.05). ② At 8, 16 and 24 weeks after treatment,the score of environment in QOL had no significant difference among the control group, short-term lactulose group and long-term lactulose group (P ＞ 0.05), but there were significant differences in the scores of physiology,psychology and social relationship (P ＜ 0.05); At 8 weeks, there were more obvious differences in the long-term lactulose group and short-term lactulose group than in the control group, but no significant difference between the long and short-term lactulose groups; At 16 weeks, there were more obvious differences in the long-term lactulose group than in the short-term lactulose group and control group, but no significant difference between the short-term lactulose group and control group; At 24 weeks, the long-term lactulose group had more improvements than in the control group and short-term lactulose group. ③ At 16 and 24 weeks after treatment, the ammonia concentrations in blood were significantly decreased in the long-term lactulose group as compared with the control group and short-term lactulose group.CONCLUSION: The long-term treatment of lactulose can improve the QOL of patients with minimal hepatic encephalopathy, eventually reduce the incidence of hepatic encephalopathy and decrease the ammonia concentration in blood; However, the short-term treatment of lactulose could not.

Objective:To optimize the extraction process for the total alkaloids of Longzuan Tongbi Fang by central composite design and response surface method.Methods:The independent variables were the ethanol contention,solvent consumption and extraction time,and the dependent variable was the weighted overall desirability of the content of total alkaloids and kukoline.The extraction process for the total alkaloids of Longzuan Tongbi Fang was optimized by central composite design and response surface method.Results:The optimum extraction conditions were as follows:9-fold amount of solvent was used,refluxed for 130 min,extracted twice,and the ethanol concentration was 75%.Conclusion:The central composite design and response surface method used for the extraction optimization for the total alkaloids of Longzuan Tongbi Fang is very simple and highly predictive.

Objective To investigate the clinical pathological characteristics and pattern changes of gastric polyps in the past 15 years.Methods From 1998 to 2012,the cases of gastric polyps diagnosed by gastroscopy were collected.Data of gender,age,location,number,size,Yamata type,pathological type,Helicobacter pylori (H.pylori) infection were retrospectively analyzed.The data were analyzed by Chi square test.Results Among 62 975 cases received gastroscopy,gastric polyps were detected in 2 643 patients and the gastric polyps detection rate was 4.20％,which of female (5.91％,1 790/30 269) was higher than that of male (2.61％,853/32 706).And patients aged ≥60 years old has a high prevalence of gastric polyps; the detection rate was 6.39％(1 124/17 590).The positive rate of H.pylori infection in patients detected with gastric polyp was 12.70％ (321/2 527).Gastric body (40.41％,1 068/2 643) and fundus (26.79％,708/2 643) were two predilection sites of gastric polyps.About 69.05％(1 825/2 643) patients' polyps were solitary,74.76％(1 976/2 643) patients' polyps were less than 0.5 cm in diameter and mainly were Yamata type Ⅰ (30.68％,811/2 643) or type Ⅱ (54.41％,1 438/2 643).The common pathological types were hyperplastic polyps (43.80％,1 109/2 532),inflammatory polyps (34.24％,867/2 532),fundic-gland polyps (19.55％,495/2 532) and adenomatous polyps (2.41％,61/2 532).The detection rate of polyps gradually increased in the past 15 years.Between 1998 to 2002,2003 to 2007,2008 to 2012,the average of 5-year detection rates were 1.11％,2.50％ and 6.49％,respectively.However,the proportion of pathological types didn't change significantly.Conclusions The detection rate of gastric polyps gradually increased year by year,and elderly woman is at high risk.Hyperplastic and inflammatory polyps ware the most common types.

A total of 178 patients with the time of mechanical ventilation beyond 48 hours in the second affiliated hospital of Wenzhou medical college from January 2010 to December 2013 were enrolled in this study,and there were fifty-six patients with ventilator-associated tracheobronchitis (VAT).The associated factors included age,sex,blood pressure,blood glucose,BMI,the time of mechanical ventilation,tracheal intubation methods,raise head to 30-45°,proton pump inhibitors (PPI),prophylactic antibiotic treatment,glasgow coma scale (GCS),acute physiology and chronic health evaluation (APECHE) Ⅱ score.The related factors of VAT were evaluated by using univariate logistical regression analysis,and the statistical significant variables were analyzed by using multivariate logistical regression analysis.By using univariate logistical regression analysis age,blood glucose,the time of mechanical ventilation,raise head to 30-45°,prophylactic antibiotic treatment,GCS and APECHE Ⅱ score were the important factors of VAT (P ＜ 0.05),but sex,blood pressure,BMI,tracheal intubation methods and PPI were insignificant related to VAT(P ＞ 0.05).By using multivariate logistical regression analysis the time of mechanical ventilation (OR =4.072,95％ CI 2.036-8.146),GCS[2.198(1.155-4.184)],age[2.128 (1.119-4.046)],APECHE Ⅱ score [2.109 (1.084-4.104)] and raise head to 30-45 ° [0.488 (0.243-0.979)] were associated independently with the VAT.The time of mechanical ventilation,GCS,age over 60 years,APECHE Ⅱ score and raise head to 30-45°were the independent factors associated with VAT.

Objective To retrospectively investigate the clinical features and incidence trends of hypertriglyceridemic acute pancreatitis (HLAP) in Guangzhou First People's Hospital for 20 years.Methods The medical records of 1 362 patients,who were admitted to Guangzhou First People's Hospital with acute pancreatitis during January 1991 to December 2010,were reviewed and 99 patients met the HLAP criterion.These patients were divided into four groups according to years (1991 ～ 1995,1996 ～2000,2001 ～2005,and 2006 ～2010).The incidence and clinical features were compared among the 4 groups.Results Among the 99 patients,there were 61 males and 38 females,the mean age was (44 ± 12) years old,and young male was predominant in HLAP.HLAP accounted for 7.3％ of all AP patients,and the incidence was increased 1.5 times during the 20 years period (5.4％,5.7％,6.7％,and 8.3％ respectively).The serum amylase level was (513.3 ±462.7) mmol/L,TG level was (12.7 ± 7.0) mmol/L,Ranson score was (1.2 ± 1.1),CTSI score was 2.2 ± 1.1,incidence of SIRS was 36.4％,and the incidence of MODS was 18.2％,and the incidence of pancreatic pseudocyst was 5.1％,but the incidence and mortality of SAP was not changed with time.The incidence and mortality of SAP of HLAP were significantly higher than those of acute biliary pancreatitis (20.2％ vs 8.5％,6.1％ vs 2.8％).The rate of blood purification increased from 0 to 10.7％,and the hospital stay was decreased from 26 d to 14 d,and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Incidence of HLAP is increased gradually,with a trend towards more severe disease,but the prognosis is improved.

BACKGROUND:Ceramic-on-ceramic total hip arthroplasty can be applied to young patients requiring frequent activity and high quality of life.
OBJECTIVE:To explore the short-term efficiency of ceramic-on-ceramic total hip arthroplasty in young and middle-aged patients of femoral neck fractures.
METHODS:Fifty-one young and middle-aged patients under 50 years old with ceramic-on-ceramic total hip arthroplasty were selected to analyze the function of hip joints and the complication after operation.
RESULTS AND CONCLUSION:Al the patients were fol owed up for 6 months to 44 months. At the last fol ow-up, the average Harris score was 92.0±3.4 points with an excellent and good rate of 94.1%. No dislocation was observed and three cases exhibited mild limping. Imaging examination showed that, no prosthesis loosing, broken, sinking or radiolucent line around prosthesis was observed. Ceramic-on-ceramic total hip arthroplasty in young patients with femoral neck fractures can effectively decrease the osteolysis, prosthesis loosing and sinking caused by the debris of wearing, prolong the working life of the prosthesis, and improve the patient’s quality of life.

Objective: To observe the effect of tripterygium polyglycosid(TP,雷公藤) on airway inflammation and remodeling in rats with asthma.Methods: Forty rats were randomly divided evenly into negative control group,positive control group,normal dose TP group(TPⅠ group) and small dose TP group(TPⅡgroup).The experimental model was induced by ovalbumin sensitization.Number of cells in bronchoalveolar lavage fluid(BALF) was observed by immunocytochemical staining.The expressions of nuclear factor-?B(NF-?B),matrix metalloproteinases-9(MMP-9) and tissue of inhibitor of metalloproteinases-1(TIMP-1) were detected by immunohistochemistry method.Results: Compared with the negative control group,the counts of lymphocyte,neutrophilic leukocyte,macrophage and eosinocyte in BALF were elevated significantly,positive cell percentages of NF-?B, MMP-9 and TIMP-1 in lung tissues increased greatly in positive control group,the differences being significant(all P

Objective To evaluate the effects of infliximab (TNF-α monoclonal antibody ) on intestinal barrier injury in ANP complicated with MODS in a rat model.MethodsThirty SD rats were randomly divided into sham operation group (SO),ANP group and infliximab treatment group.Sodium taurocholate (4.5％) was injected into the pancreatic duct to induce ANP complicated with MODS model.Infliximab (8 mg/kg) was injected via tail vein in 6h after modeling in infliximab group.Same amount of 0.9％ NS was injected into the pancreatic duct in SO group.After 24 h of modeling,all rats were sacrificed,intestine and pancreas samples were collected for pathologic examination.The blood samples were harvested.The serum levels of amylase,TNF-α,diamine oxidase( DAO),D-lactate,and the rate of carbon propelling in ileum were measured.ResultsThe serum levels of amylase were ( 1125 ± 331 ),( 11024 ± 2203 ),( 545 ±30) U/L in SO group,ANP group and infliximab group; the serum levels of TNF-α were (12.1 ± 4.0),(107.6 ± 18.5),(75.8 ±5.9) U/L; the pathological scores of pancreas were 2.25 ±0.38,14.10 ±0.22,3.93 ± 0.67,the difference among the 3 groups was statistically significant ( P ＜ 0.05 ).The pathological scores of intestine were 2.29 ± 0.32,6.61 ± 0.58,3.91 ± 0.41 ; the DAO levels were ( 87.88 ± 34.51 ),(146.30 ±12.99),(115.00 ± 18.58) ng/ml; the D-lactate levels were (1.50 ±0.49),(2.32 ± 0.35),(2.02 ± 0.25 )mmol/L; and the rates of carbon propelling in ileum were (0.64 ± 0.04 )％,(0.28 ±0.08)％,(0.52 ±0.09)％,the difference among the 3 groups was statistically significant (P ＜0.05).ConclusionsInfliximab can effectively prevent dysfunction of intestinal barrier and improve motility in ANP rats.

Humans ; Occupational Health ; Occupational Health Services