OBJECTIVETo investigate the epidemiological factors in the first aid, early management, and treatment of chemical burns.

METHODSMedical records of 615 inpatients with chemical burns out of 2682 burn patients hospitalized from January 2001 to December 2010 were screened to retrospectively analyze the clinical data, including gender, age, burn area and depth, occurrence regularity, injury cause, injury-causing chemicals, wound site, complications, pre-hospital management, treatment and prognosis. Annual number of burn patients and annual number of patients with chemical burns were statistically analyzed with linear trend test.

RESULTS(1) Among all the chemical burn patients, 562 (91.4%) were male and 53 (8.6%) female. The mean age of patients was (32 ± 12) years. Burn area ranged from 1% to 95%, with mean area of (30 ± 25)% TBSA. Full-thickness burn area ranged from 0 to 85%, with mean area of (18 ± 24)% TBSA. (2) The annual number of burn patients showed a slow trend of increase during the last decade (χ(2) = 4.009, P < 0.05). There was no statistically significant difference in the annual number of patients with chemical burns among the last decade (χ(2) = 0.060, P > 0.05). Chemical burns mainly occurred in summer and autumn, and the incidence gradually increased in April, peaked in August, and then gradually decreased. (3) Five hundred and seventy-two cases (93.0%) were injured while working, among these patients 70.8% (405/572) were injured in private enterprises. (4) Acid was the most common injury-causing chemical (299 patients, accounting for 48.6%). (5) The extremities and head were the most involved areas. (6) Among 615 patients with chemical burns, 47 cases (7.6%) were complicated by inhalation injury, 94 cases (15.3%) by ocular burns, 51 cases (8.3%) by combined injury, and 67 cases (10.9%) by poisoning. (7) Most patients did not receive (30.4%, 187/615) or only insufficient (61.1%, 376/615) immediate irrigation after injury in pre-hospital management. (8) Two hundred and twelve patients (34.5%) underwent skin grafting or flap transplantation after early total or tangential excision of eschar within one week post injury. Among all the patients, 599 cases were cured with 11 eyes becoming blind in 8 patients, and sixteen patients died with a mortality rate of 2.6%.

CONCLUSIONSPatients with chemical burns accounted for a high proportion of the burn patients admitted to our unit in the same period, and they were mainly injured while working. Sufficient irrigation and immediate detoxification are key points in the treatment of chemical burns. Early total or tangential excision of eschar of deep wounds could reduce the possibility of poisoning.

Adolescent ; Adult ; Aged ; Burns, Chemical ; epidemiology ; therapy ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Because of the specificity of infectious diseases , the the medical ethics education and concepts need to be paid more attention to .During the clinical teaching of infectious diseases , pay attention to teachers′medical ethics accomplishment level of ascension , teaching teachers should play the role of shape model , encourage interac-tion, eliminate the fear and discrimination interns and strengthen medical ethics consciousness and the combination of legal concepts , promote the medical students medical ethics consciousness of the form .

Objective To explore the association between folic acid supplementation during periconcerptional period and congenital heart disease in newborns to provide scientific evidence for making intervening measures.Methods Using stratified random cluster sampling,a total of 30 counties were sampled from Shaanxi Province.A questionnaire survey was conducted among childbearing-aged women pregnant between January 2010 and November 2013.All of the included women had definite pregnancy outcomes and had signed the consent form.Logistic regression was performed to investigate the association between folic acid supplementation during pregnancy and congenital heart disease in newborns.Results In total,28 354 questionnaires were available for analysis.The overall prevalence of congenital heart disease among live-birth neonates in the present study was 7.3‰.The percentage of childbearing-age women who had taken folic acid supplementation during pregnancy was 64.4％,while only 17.2％ of them took folic acid according to the specification.Taking folic acid regularly during pregnancy was associated with a lower risk of congenital heart disease among the newborns (OR 0.502,95％ CI:0.279 0.902).The multiple-factor analysis results also showed that taking folic acid regularly during periconcerptional period could reduce the risk of congenital heart disease (adjusted OR=0.512,P=0.046) when we controlled the family background factors,mother factors and exposure risk factors during pregnancy.However,no association was found between irregularly taking folic acid during periconcerptional period and the risk of congenital heart disease.Conclusion Taking folic acid according to the specification during periconcerptional period (taking folic acid during 3 months before pregnancy to 3 months after pregnancy with a daily dose of 0.4mg for more than 90 days) may prevent congenital heart disease of newborns.

OBJECTIVETo optimize the extraction process of compund kaliziran gel.

METHODOrthogonal design was used to optimize the extracting process of eight herb medicines with the extract yield, the content of psoralen, isopsoralen and osthole as indexes, and to optimize the extracting process of Polygonum multflorumi and Seman sinapis albae with the extract yield and the content of 2,3,5,4'-tetrehydroxy-stilbene glucoside as indexes.

RESULTThe optimum extraction progress was as follows:eight herb medicines were extract 2 times for 1 hour with 8 times of 60% alcohol; P. multflorumi and S. sinapis albae were extract 2 times for 1 hour with 8 times of 40% alcohol.

CONCLUSIONThe optimum extraction processes are stable and feasible.

Alcohols ; chemistry ; Chemical Fractionation ; methods ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Plants, Medicinal ; chemistry ; Technology, Pharmaceutical ; methods

This study examined the effect of intensive insulin therapy on immune function and inflammatory factors at the early phase after severe trauma. At day 1, 3, 5, 7 after admission, subsets of CD4(+) helper T lymphocytes (Th1/Th2) and human leukocyte antigen (HLA)-DR expression on CD14(+) monocytes were flow cytometrically measured. Levels of cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10) and other immunity markers, such as IgA, IgG, IgM, C3, C4 and C reaction protein (CRP) were examined in two groups. The results showed that TNF-α, IL-6 and CRP levels in the intensive insulin therapy group were significantly lower than those in the conventional therapy group, whereas IL-10 levels were substantially increased after intensive insulin therapy. C3 level at day 3, 5, 7 and C4 levels at day 5, 7 were lower in the intensive therapy group than in the conventional therapy group. Th1/Th2 ratios decreased gradually over time in both groups, and were much lower at day 3, 5, 7 in intensive therapy group. There were significant differences among day 3 to day 7 after admission in HLA-DR expression in CD14(+) monocytes. It was concluded that the intensive insulin therapy could decrease pro-inflammatory cytokines and increase anti-inflammatory cytokines in the elderly suffering from severe trauma, at the same time, with complement recovery being delayed. Moreover, intensive insulin therapy promoted immune suppression and, therefore, measures need be taken to address the issue.

This study examined the effect of intensive insulin therapy on immune function and inflammatory factors at the early phase after severe trauma. At day 1, 3, 5, 7 after admission, subsets of CD4(+) helper T lymphocytes (Th1/Th2) and human leukocyte antigen (HLA)-DR expression on CD14(+) monocytes were flow cytometrically measured. Levels of cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10) and other immunity markers, such as IgA, IgG, IgM, C3, C4 and C reaction protein (CRP) were examined in two groups. The results showed that TNF-α, IL-6 and CRP levels in the intensive insulin therapy group were significantly lower than those in the conventional therapy group, whereas IL-10 levels were substantially increased after intensive insulin therapy. C3 level at day 3, 5, 7 and C4 levels at day 5, 7 were lower in the intensive therapy group than in the conventional therapy group. Th1/Th2 ratios decreased gradually over time in both groups, and were much lower at day 3, 5, 7 in intensive therapy group. There were significant differences among day 3 to day 7 after admission in HLA-DR expression in CD14(+) monocytes. It was concluded that the intensive insulin therapy could decrease pro-inflammatory cytokines and increase anti-inflammatory cytokines in the elderly suffering from severe trauma, at the same time, with complement recovery being delayed. Moreover, intensive insulin therapy promoted immune suppression and, therefore, measures need be taken to address the issue.
Aged ; Aged, 80 and over ; Cytokines ; immunology ; Female ; Humans ; Hyperglycemia ; drug therapy ; immunology ; Hypoglycemic Agents ; therapeutic use ; Immunity, Innate ; drug effects ; immunology ; Immunologic Factors ; immunology ; Insulin ; therapeutic use ; Male ; Treatment Outcome ; Wounds and Injuries ; drug therapy ; immunology

OBJECTIVETo investigate the relationship among serum reproductive hormone levels, serum homocysteine (Hcy) levels, metabolic syndrome (MS), and the components of MS in middle-aged and elderly males.

METHODSUsing the cluster and stratified sampling methods and a unified structured questionnaire, we conducted a survey among 948 men aged 40 - 80 years in the rural community, measured their basic physical parameters, and obtained their reproductive hormone levels, serum Hcy concentrations, and metabolism-related indicators. We collected 868 valid questionnaires along with their serum samples, divided the subjects into an MS and a non-MS control group in a 1:1 ratio, and measured their serum Hcy concentrations.

RESULTSAmong the subjects included, 132 were diagnosed with MS. Nonparametric tests showed statistically significant differences between the MS and non-MS groups in the waist circumference (WC), waist-hip ratio (WHR), body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) (P < 0.05), but not in age (P > 0.05). Significant differences were also observed between the two groups in the levels of serum tT, SHBG, LH, and FTI (P < 0.05) , but not in the concentrations of serum Hcy (P > 0.05). The concentration of serum Hcy exhibited no correlation with BMI, SBP, DBP, FBG, TG, and HDL-C (P > 0.05) and had no influence on MS.

CONCLUSIONThe concentration of serum Hcy is not significantly correlated with MS, nor with its components. The levels of male serum reproductive hormones are associated both with MS and with its components.

Adult ; Aged ; Blood Pressure ; Body Mass Index ; Homocysteine ; blood ; Humans ; Luteinizing Hormone ; blood ; Male ; Metabolic Syndrome ; blood ; diagnosis ; Middle Aged ; Reproduction ; Rural Population ; Sex Hormone-Binding Globulin ; metabolism ; Surveys and Questionnaires ; Testosterone ; blood ; Thyroxine ; blood ; Waist Circumference ; Waist-Hip Ratio

OBJECTIVETo set up a new process to access the preparation of decellularized artery grafts. And to evaluate the feasibility of decellularized artery allografts was evaluated.

METHODSThis study compared the effects of four extraction chemicals [1% t-octyl-phenoxypolyethoxyethanol (Triton X-100), 1% tri (n-butyl) phosphate (TnBP), and 1% sodium dodecyl sulfate (SDS) and trypsin (0.125, 0.25%) on thoracic artery vascular for 24 h (except trypsin for 2 h). At the base of it, a four-step process, including hypotonic, hypertonic solutions and combining with 1% Triton X-100 and 1% SDS detergents, were performed in rabbit thoracic artery vascular. Histological examination, tensile tests and expanding-burst tests were done on the samples. The decellularized carotid artery allografts were transplanted in other rabbits.

RESULTSTreatment with 1% SDS or 1% Triton X-100 for 24 h could remove most cells with retention of near normal structure. A four-step process could remove all cells with the extracellular matrix well conserved. The pulling mechanical properties and burst pressure of decellularized carotid artery were similar to the control. The decellularized carotid artery allografts (diameter of 2 mm) were patent at explanting up to 2 months.

CONCLUSIONSThe acellular artery vascular graft matrix is well prepared with four-step process including detergents, such as TritonX-100, SDS without compromising the graft structure or mechanical properties significantly. The carotid artery allografts (diameter of 2 mm) decellularized by the process are patent at explanting up to 2 months.

Animals ; Aorta, Thoracic ; cytology ; Bioprosthesis ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; Carotid Arteries ; cytology ; transplantation ; Feasibility Studies ; Female ; Male ; Protease Inhibitors ; pharmacology ; Rabbits ; Sodium Dodecyl Sulfate ; pharmacology ; Tissue Engineering ; methods

Objective:To investigate the characteristics and change trends of electroencephalogram (EEG) in patients with drug resistant epilepsy (DRE) after vagus nerve stimulation (VNS).Methods:Twenty-five patients with DRE, admitted to our hospital from July 2016 to May 2019, were chosen; all patients accepted VNS and followed up for 12 months. Long range video EEG (VEEG) monitoring was performed before VNS, and 3, 6 and 12 months after VNS, and the tracing time of each monitoring was longer than 12 h. The EEG characteristics of these patients before and different times after VNS were analyzed.Results:In the VEEG monitoring before VNS, 25 patients showed sharp wave, spike wave, sharp slow wave, and compound spike slow wave in the interictal period; 3 patients (12%) could locate the brain region. The interictal EEG of 11 patients 3 months after VNS showed different degrees of improvement as compared with the preoperative one, which manifested as mixed rhythms: mono-spiking as sharp wave, sharp slow wave or spike wave; 8 patients had McHugh grading I-II. The interictal EEG of 18 patients 6 months after VNS showed different degrees of improvement as compared with the preoperative one; 11 patients had McHugh grading I-II. The interictal EEG of 21 patients 12 months after VNS showed different degrees of improvement as compared with the preoperative one; 15 patients had McHugh grading I-II.Conclusion:The EEG improvement effect of DRE patients after VNS is gradually improved with time; in some patients, the EEG improvement is earlier than improvement of clinical symptoms.

Objective:To investigate the characteristics and change trends of electroencephalogram (EEG) in patients with drug resistant epilepsy (DRE) after vagus nerve stimulation (VNS).Methods:Twenty-five patients with DRE, admitted to our hospital from July 2016 to May 2019, were chosen; all patients accepted VNS and followed up for 12 months. Long range video EEG (VEEG) monitoring was performed before VNS, and 3, 6 and 12 months after VNS, and the tracing time of each monitoring was longer than 12 h. The EEG characteristics of these patients before and different times after VNS were analyzed.Results:In the VEEG monitoring before VNS, 25 patients showed sharp wave, spike wave, sharp slow wave, and compound spike slow wave in the interictal period; 3 patients (12%) could locate the brain region. The interictal EEG of 11 patients 3 months after VNS showed different degrees of improvement as compared with the preoperative one, which manifested as mixed rhythms: mono-spiking as sharp wave, sharp slow wave or spike wave; 8 patients had McHugh grading I-II. The interictal EEG of 18 patients 6 months after VNS showed different degrees of improvement as compared with the preoperative one; 11 patients had McHugh grading I-II. The interictal EEG of 21 patients 12 months after VNS showed different degrees of improvement as compared with the preoperative one; 15 patients had McHugh grading I-II.Conclusion:The EEG improvement effect of DRE patients after VNS is gradually improved with time; in some patients, the EEG improvement is earlier than improvement of clinical symptoms.