Objective To analyze the epidemiological characteristics of occupational hand-arm vibration disease (OHAVD) in Guangdong Province from 2006 to 2022. Methods The data of newly reported OHAVD cases and suspected occupational disease cases in Guangdong Province from 2006 to 2022 was collected from the Report Card of Occupational Diseases and Report Card of Suspected Occupational Diseases using Occupational Diseases and Health Hazard Factors Monitoring Information System under China Disease Prevention and Control Information System. Epidemiological characteristics of the newly reported OHAVD cases and related suspected occupational disease reports were analyzed. Results A total of 660 newly reported OHAVD cases were reported in Guangdong Province from 2006 to 2022. The number of cases showed a periodic fluctuating trend over the years. Males accounted for 98.64% of the newly reported OHAVD cases with a median age of 38 years and a median hand-transmitted vibration exposure period of 8.7 years. These cases were predominantly distributed in the Pearl River Delta region, including Zhongshan City, Dongguan City, Guangzhou City, Shenzhen City and Foshan City, accounting for 99.25%. The manufacturing enterprises had 98.79% of the cases, investment enterprises of Hong Kong, Macao and Taiwan merchants of China had 83.18% of the cases, and large- and medium-sized enterprises had 92.73% of the cases. The 660 cases were distributed in 440 enterprises, but there were some characteristics of group outbreaks. There were 20 enterprises (4.55% of the total number of enterprises) had more than three cases involving 219 cases (33.18%). There were five enterprises which had more than 10 cases and the cases number ranged from 12 to 56. Among 382 newly reported OHAVD cases from 2014 to 2022, 44.24% were identified as suspected occupational diseases before diagnosis, of which 59.76% (101/169) were determined by occupational health inspection institutions. Conclusion Newly reported OHAVD cases in Guangdong Province were aggregated in terms of regional distribution, industry, enterprise ownership, and enterprise scale, with a risk of group outbreaks. It is suggested to enhance the OHAVD prevention and control in male workers exposed to hand-transmitted vibrations in the Pearl River Delta's manufacturing enterprises.

OBJECTIVETo develop a rapid preimplantation genetic diagnosis method for -thalassemia SEA deletion based on blastocyst cell whole genome amplification (WGA) combined with short fragment Gap-PCR.

METHODSUsing multiple displacement amplification (MDA) WGA technique, we established a double-fluorescent PCR system of the housekeeping genes GAPDH and β-actin for WGA quality testing, and a genotyping PCR system of mutant and normal short sequences for α-thalassemia SEA deletion. The sensitivity and accuracy of this method for diagnosis of -thalassemia SEA deletion were evaluated by detecting lymphocyte samples containing different cell numbers from carriers of SEA deletion. The applicability of this method was evaluated by testing of 12 blastocyst biopsy samples.

RESULTSDetection of lymphocyte samples with different cell numbers using the method developed in this study revealed no ADO in 3-cell samples, and the product quantity of WGA became stable for 4-cell samples. Genotyping of the 10 blastocyst biopsy samples with successful WGA showed a genotype of --/ in 5 samples and / in the other 5 samples, which were consistent with the verification results.

CONCLUSIONSThe method developed in this study is a complete testing process for 4-6 blastocyst biopsy cells to allow rapid, accurate, and cost-effective PGD genotyping of -thalassemia SEA deletion using short fragment gap-PCR.

Objective:To perform textual researches on name, origin and distribution of Maidong to clarify the medicinal varieties and history recorded in ancient literatures and provide evidence for clinical use. Methods:Ancient herbal works were performed textual research, and the resource investigation and modern data were analyzed. Results:According to the ancient herbal records and modern researches, Maidong had lots of alias, while only Maimendong and Maidong were used as the medicine common names. According to the records of main origin, original plant morphological and medicinal characteristics of Maimendong, it was preliminarily concluded that Maidong recorded in the ancient herbal records was mainly produced in Jiande of Zhejiang province, Mianyang of Sichuan prov-ince, Xiangyang of Hubei province and the surrounding areas. The chemical compositions and pharmacological activities of Maidong and Shanmaidong were similar;therefore, they both could be used as the medicines. Conclusion:In the light of the ancient and mod-ern medicinal customs, modern chemistry and pharmacology researches and clinical practice of TCM, it deserves further discussion on whether Maidong and Shanmaidong can be used as multi source varieties of traditional Chinese medicines just like Polygonaceae plants palmatum L. , Rheum tanguticum Maxim, ex Balf. and Rheum officinale Baill. , and Ranunculaceae plants Coptis chinensis Franch. , Coptis deltoidea C. Y. Cheng et Hsiao and Coptisteeta Wall.

Objective To observe the learning and memory ability of rats after injection of Aβ25-35 protein in different concentrations into the lateral ventricle assessed by Morris water maze test, and to explore the optimal concentration of Aβ25-35 in the preparation of AD model rats.Methods Male SD rats were randomly divided into sham operated group and model group.The rats of model group received Aβ25-35 injection in concentrations of 2 μg/μL, 4 μg/μL and 8 μg/μL, respectively.According to the Rat Brain Stereotaxic Atlas, 5 μL of aggregation of Aβ25-35 was injected into the right lateral ventricle to establish the AD rat model.7 days after successful modeling, Morris water maze was used to test thechanges of learning and memory ability of the rats.Results There was no significant difference in the average swimming speed between the two groups (P > 0.05).The escape latency time of rats in the model group was significantly increasedcompared with the sham group (P < 0.05).In the model group, the escape latency time of rats treated with 4 μg/μL and 8 μg/μL Aβ25-35 was significantly increased compared with the rats injected with 2 μg/μL (P < 0.05), while there was no significant difference between rats treated with 4 μg/μL and 8 μg/μL Aβ25-35 (P > 0.05).The activity time and distance of target quadrant of the rats injected with different concentration of Aβ25-35in the model group were significantly reduced compared with the sham group (P < 0.05), but no significant difference amongthe rats treated with different Aβ25-35 concentrations (P > 0.05).Compared with the sham-operated group, the number of platform-crossing of rats injected with different doses of Aβ25-35in the model group were significantly reduced (P < 0.05).In the model group, the rats treated with 4 μg/μL and 8 μg/μL was significantly reduced compared with the group with 2 μg/μL injection (P < 0.05).There was no significant difference between the rats injected with 4 μg/μL and 8 μg/μL (P > 0.05).Conclusions The recommended dose and concentration of Aβ25-35 to be injected into the unilateral ventricle to establisha rat model of Alzheimer's disease is 4 μg/μL in a volume of 5 μL.

OBJECTIVE:To investigate the clinical efficacy and safety of cilostazol combined with alprostadil in the treatment of peripheral arterial disease(PAD). METHODS:A total of 68 PAD patients in our hospital from Jan. 2015 to Jan. 2016 were di-vided into observation group(34 cases)and control group(34 cases)according to random number table. Control group was given basical treatment,and Alprostadil injection 2 mL+0.9% Sodium chloride injection 100 mL,ivgtt,qd. Observation group was addi-tionally given Cilostazol tablets 100 mg,po,bid,on the basis of control group. Both groups were treated for 30 days. Clinical effi-cacies of 2 groups were observed. The hemorheology indexes(hematocrit,whole blood high-shearing viscosity,erythrocyte aggre-gation index,erythrocyte deformation index,plasma viscosity),inflammatory factor indexes(TNF-α,IL-6,IL-8, hs-CRP),oxida-tion stress indexes(GSH-Px,SOD,T-Aoc,MDA),arteriosclerosis indexes(ABI,TBI,dorsalis pedis artery blood flow)were de-termined before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group (91.18%)was significantly higher than that of control group(79.41%),with statistical significance(P<0.05). Before treatment, there was no statistical significance in hemorheology indexes,inflammatory factors indexes,oxidant stress indexes or arteriosclero-sis indexes between 2 groups(P>0.05). After treatment,hematocrit,whole blood high-shearing viscosity,erythrocyte aggregation index,erythrocyte deformation index,plasma viscosity,the levels of TNF-α,IL-6,IL-8,hs-CRP and MDA in 2 groups were de-creased significantly;while the levels of GSH-Px,SOD,T-Aoc,ABI,TBI and dorsalis pedis artery blood flow were increased sig-nificantly;the improvement of above indexes in observation group was significantly better than control group,with statistical signif-icance(P<0.05). There was no statistical significance in the incidence of ADR between observation group(14.71%)and control group(11.76%)(P>0.05). CONCLUSIONS:For PAD,cilostazol combined with alprostadil can effectively improve hemorheolo-gy indexes,inflammatory factor indexes,oxidation stress indexes and arteriosclerosis indexes with good safety.

Through the comparison of curriculum provision,curriculum content,teaching methods and evaluation methods of medical humanity education between China and the United States,this paper put forward some suggestions about integrating resources of humanities and social sciences,improving the setting of medical humanity education curriculum and optimizing the teaching methods;improving the effectiveness of teaching and tightly connecting with the clinical practice,cultivating the ability of medical humanity practice and reforming the assessing methods of medical humanities,establishing formative assessment system and so on,to promote the level of medical humanity education in China.

Based on the analysis on the present status and importance of medical humanity education for inter-national medical students during the clinical internship, this paper discussed the importance of strengthening medi-cal students′humanistic education during the clinical internship and proposed ways to promote the humanity educa-tion:optimizing the setting of humanity education curriculum and adhering to the humanity education throughout the whole process of clinical internship;improving the clinical supervisors′humanity quality and ensuring the quality of humanity education;holding the orientation of evaluation and adding the humanity quality as one of the evaluation indicators; establishing hospital atmosphere with humanity spirit and highlighting environmental education effect;building theuniversity-intern hospital two-grade platform of humanity education and standardizing the relevant systems.

OBJECTIVETo summarize the experience with emergency coronary artery bypass grafting (ECABG) for management of acute coronary syndrome and analyze the mid-term follow-up results.

METHODSForty-five ECABG surgeries were performed in 34 male and 11 female patients (aged 65.6∓5.8 years) for cardiogenic shock (5 cases), acute heart failure (6 cases) and refractory unstable angina (34 cases). Twenty patients received the operation within one week after acute myocardial infarction (AMI) and 18 were preoperatively supported by intra-aortic balloon pumping (IABP). All patients had triple-vessel disease and 15 had left main stenosis. Ten patients experienced two myocardial infarctions and 6 had chronic renal dysfunction including two requiring hemodialysis. On-pump operations were performed in all cases with a mean CPB time of 104.2∓29.7 min and cross clamping time of 69.0∓21.3 min. Cold blood or HTK cardioplegia was used for myocardial protection. The left internal mammary artery (LIMA) was routinely anastomosed to the left anterior descending artery (LAD), and the great saphenous vein (GSV) to other target vessels. The mean number of grafts was 2.9∓0.6.

RESULTSForty-one patients were cured and discharged and 4 patients died with an in-hospital mortality of 8.9%, including one associated with cardiac event (2.2%). IABP was weaned off within 28.5∓10.6 h after surgery except for one patient who died of multiple organ and system failure (MOSF). Thirty-eight patients (92.7%) were followed up for a mean of 37.3∓16.7 months, during which 2 patients died with a mid-term survival rate of 94.7%. Thirty-five (92.1%) patients had New York Heart Association (NYHA) class I and II. The freedom from cardiac event was 90.5%. Follow-up echocardiography showed significantly improved left ventricular dimension and ejection fraction in these cases (P<0.05), and graft patency was 95.8% for the LIMA and 90.5% for the GSV.

CONCLUSIONDespite a slight increase of the in-hospital mortality, ECABG can improve the mid-term survival, freedom from cardiac event, and cardiac function when the indications and timing for surgery are well controlled with optimal perioperative management.

Acute Coronary Syndrome ; surgery ; Aged ; Angina, Unstable ; Aortic Valve ; Coronary Artery Bypass ; Coronary Artery Disease ; Echocardiography ; Female ; Follow-Up Studies ; Humans ; Intra-Aortic Balloon Pumping ; Male ; Mammary Arteries ; Middle Aged ; Myocardial Infarction ; Survival Rate ; Treatment Outcome

This study was aimed to observe the therapeutic effect onendometritis rat model by Gui-Zhi Fu-Ling (GZFL) capsuleand its mechanism. Endometritis rat model was replicated. After 15 days, rats were randomly divided into six groups, which were the sham operation group, model group, lowdosage (0.5 g·kg-1) of GZFL capsule group, middle dosage (1.0 g·kg-1) of GZFL capsule group, large dosage (2.0 g·kg-1) of GZFL capsule group, and Fu-Ke Qian-Jin (FKQJ) capsule (1.2 g·kg-1) group. After 28-day intragastric administration of medication, pathological changes of endometrium were observed. The contents of monocyte chemoattractant protein-1 (MCP-1), interleukin-1β (IL-1β), interleukin-10 (IL-10) were determined in blood serum.The expression of TGF-β1 in endometritis rats were measured by immunohistochemistry. The results showed that GZFL capsule canobviously alleviate the pathologi-cal damage of endometrium in rat model. In comparison with sham operation group, the serum IL-10 content in the model group was significantly decreased, contents of MCP-1and IL-1β were significantly elevated; the TGF-β1 pro-tein expression was significantly elevatedin the uterus tissues. After the treatment of GZFL capsule, compared with the model group, the serum IL-10 was obviously elevated in the treatment group. The contents of MCP-1 and IL-1βwere obviously decreased. The expression of TGF-β1 in the uterus tissues was obviously decreased. It was concluded that GZFL capsule had treatment effect on endometritis. The mechanism may be related to the regulation of inflam-matory cytokines.

Objective To summarize the experience with emergency coronary artery bypass grafting (ECABG) for management of acute coronary syndrome and analyze the mid-term follow-up results. Methods Forty-five ECABG surgeries were performed in 34 male and 11 female patients (aged 65.6±5.8 years) for cardiogenic shock (5 cases), acute heart failure (6 cases) and refractory unstable angina (34 cases). Twenty patients received the operation within one week after acute myocardial infarction (AMI) and 18 were preoperatively supported by intra-aortic balloon pumping (IABP). All patients had triple-vessel disease and 15 had left main stenosis. Ten patients experienced two myocardial infarctions and 6 had chronic renal dysfunction including two requiring hemodialysis. On-pump operations were performed in all cases with a mean CPB time of 104.2 ± 29.7 min and cross clamping time of 69.0 ± 21.3 min. Cold blood or HTK cardioplegia was used for myocardial protection. The left internal mammary artery (LIMA) was routinely anastomosed to the left anterior descending artery (LAD), and the great saphenous vein (GSV) to other target vessels. The mean number of grafts was 2.9±0.6. Results Forty-one patients were cured and discharged and 4 patients died with an in-hospital mortality of 8.9%, including one associated with cardiac event (2.2%). IABP was weaned off within 28.5 ± 10.6 h after surgery except for one patient who died of multiple organ and system failure (MOSF). Thirty-eight patients (92.7%) were followed up for a mean of 37.3 ± 16.7 months, during which 2 patients died with a mid-term survival rate of 94.7%. Thirty-five (92.1%) patients had New York Heart Association (NYHA) class I and II. The freedom from cardiac event was 90.5%. Follow-up echocardiography showed significantly improved left ventricular dimension and ejection fraction in these cases (P<0.05), and graft patency was 95.8%for the LIMA and 90.5%for the GSV. Conclusion Despite a slight increase of the in-hospital mortality, ECABG can improve the mid-term survival, freedom from cardiac event, and cardiac function when the indications and timing for surgery are well controlled with optimal perioperative management.