Hepatic angiosarcoma is a rare,highly malignant tumor originating from liver blood vessels or lymphatic vessels.Its clinical manifestations and imaging examinations are not specific,and pathological biopsy is needed to confirm the diagnosis.This article reports a 47-year-old male patient with hepatic angiosarcoma,who has clinical manifestations of abdominal pain,jaundice,and disseminated intravascular coagulation.The CT and MRI findings of this patient are similar to hepatic sinusoidal obstruction syndrome.Relevant literature on hepatic angiosarcoma in recent years was reviewed.The manifestations,diagnosis and treatment of hepatic angiosarcoma were summarized to improve clinicians'understanding of the disease.

Objective:To observe the clinical efficacy of DING's Tuina(Chinese therapeutic massage)plus Western medication in treating rotator cuff injury(RCI)and its impact on pain,shoulder function,and shoulder muscle strength in the patients.Methods:Sixty-two RCI patients were divided into an observation group and a control group using a simple randomization method,each consisting of 31 cases.Both groups of patients were prescribed oral celecoxib capsules.In addition,DING's Tuina treatment was offered to the observation group.After 6 weeks of treatment,the two groups were observed for changes in the Constant-Murley score(CMS)for shoulder joint function,the short-form McGill pain questionnaire(SF-MPQ)score,and peak torque(PT)and peak torque to body mass ratio(PT/BM)at angular velocities 120 °/s and 90 °/s as well as the peak torque ratio(PTR)of agonist muscles to antagonist muscles[including adductors to abductors(ADD/ABD)and flexors to extensors(F/E)].Results:After treatment,both groups presented decreased SF-MPQ scores and increased CMS,and the intra-group differences were statistically significant(P<0.05);the observation group had a lower SF-MPQ score and a higher CMS than the control group,showing statistical significance(P<0.05).After the intervention,the ADD/ABD decreased in the control group at the angular velocity 120 °/s in abduction,and the intra-group change was statistically significant(P<0.05);in the observation group,the PT and PT/BM increased compared to the baseline at angular velocities 120 °/s and 90 °/s in abduction,adduction,forward flexion,and backward extension,showing statistical significance(P<0.05).After treatment,the PT and PT/BM at angular velocities 120 °/s and 90 °/s and ADD/ABD at 120 °/s were higher in the observation group than in the control group,and the between-group differences were statistically significant(P<0.05).Conclusion:DING's Tuina combined with oral celecoxib capsules can reduce pain,improve the joint's motor function,and enhance the strength of shoulder muscle groups in RCI patients,and this treatment has a positive impact on the stability when performing shoulder joint abduction and adduction.

Hepatic angiosarcoma is a rare,highly malignant tumor originating from liver blood vessels or lymphatic vessels.Its clinical manifestations and imaging examinations are not specific,and pathological biopsy is needed to confirm the diagnosis.This article reports a 47-year-old male patient with hepatic angiosarcoma,who has clinical manifestations of abdominal pain,jaundice,and disseminated intravascular coagulation.The CT and MRI findings of this patient are similar to hepatic sinusoidal obstruction syndrome.Relevant literature on hepatic angiosarcoma in recent years was reviewed.The manifestations,diagnosis and treatment of hepatic angiosarcoma were summarized to improve clinicians'understanding of the disease.

Objective:To observe the clinical efficacy of DING's Tuina(Chinese therapeutic massage)plus Western medication in treating rotator cuff injury(RCI)and its impact on pain,shoulder function,and shoulder muscle strength in the patients.Methods:Sixty-two RCI patients were divided into an observation group and a control group using a simple randomization method,each consisting of 31 cases.Both groups of patients were prescribed oral celecoxib capsules.In addition,DING's Tuina treatment was offered to the observation group.After 6 weeks of treatment,the two groups were observed for changes in the Constant-Murley score(CMS)for shoulder joint function,the short-form McGill pain questionnaire(SF-MPQ)score,and peak torque(PT)and peak torque to body mass ratio(PT/BM)at angular velocities 120 °/s and 90 °/s as well as the peak torque ratio(PTR)of agonist muscles to antagonist muscles[including adductors to abductors(ADD/ABD)and flexors to extensors(F/E)].Results:After treatment,both groups presented decreased SF-MPQ scores and increased CMS,and the intra-group differences were statistically significant(P<0.05);the observation group had a lower SF-MPQ score and a higher CMS than the control group,showing statistical significance(P<0.05).After the intervention,the ADD/ABD decreased in the control group at the angular velocity 120 °/s in abduction,and the intra-group change was statistically significant(P<0.05);in the observation group,the PT and PT/BM increased compared to the baseline at angular velocities 120 °/s and 90 °/s in abduction,adduction,forward flexion,and backward extension,showing statistical significance(P<0.05).After treatment,the PT and PT/BM at angular velocities 120 °/s and 90 °/s and ADD/ABD at 120 °/s were higher in the observation group than in the control group,and the between-group differences were statistically significant(P<0.05).Conclusion:DING's Tuina combined with oral celecoxib capsules can reduce pain,improve the joint's motor function,and enhance the strength of shoulder muscle groups in RCI patients,and this treatment has a positive impact on the stability when performing shoulder joint abduction and adduction.

Objective To investigate the risk factors of severe hypoxemia after cardiovascular surgery with cardiopulmonary bypass in adults.Methods Retrospective analysis of clinical data of 395 adult patients after cardiovascular surgery with cardiopulmonary bypass from January 2021 to December 2021.The general socio-demographic data,disease-related data,preoperative test results,intraoperative data,test indexes within 6 hours after surgery and oxygenation index within 72 hours after surgery were collected using an electronic case system;patients with postoperative oxygenation index ≤ 100 mmHg was defined as severe hypoxemia group(20 cases),oxygenation index＞100 mmHg was defined as non-hypoxemia group(375 cases),compared the perioperative clinical data of two groups,and explored the risk factors for severe hypoxemia by multifactorial logistic review.Results A total of 395 patients were included,and the incidence of postoperative severe hypoxemia was 5.06％(20/395).Multifactorial logistic retrospective analysis showed that body mass index(OR=3.713,95％CI 1.946～7.083,P＜0.001),preoperative neutrophil count(OR=1.164,95％CI 1.034～1.312,P＜0.012),and aortic clamping time(OR=1.009,95％CI 1.001～1.018,P=0.030)were independent risk factors for postoperative severe hypoxemia.In addition,the duration of invasive ventilation,ICU stay,and total hospital days were prolonged and the incidence of reintubation was higher in the severe hypoxemia group(P＜0.05).Conclusion The results howed that body mass index,preoperative neutrophils count,and aortic clamping time were independent risk factors for postoperative severe hypoxemia after cardiovascular surgery with cardiopulmonary bypass,and patients with severe hypoxemia had a worse prognosis.

Objective To analyze and compare the curative effect of thoracic laparoscopy combined with resection of esophageal carcinoma and conventional three incision resection of esophageal carcinoma .Methods From January 2012 to January 2016,sixty-two patients received esophageal cancer resection in Shanxi Provincial Cancer Hospital were selected in the research.The patients were divided into laparoscopic group (28 cases) and traditional group(34 cases) according to surgical methods ,and they were treaded with thoracic laparoscopy combined with resection of esophageal carcinoma and three incision resection of esophageal carcinoma ,respectively.The amount of blood loss , the number of lymph node dissection ,the postoperative 1d flow,the ventilator use of 24h and the number of tracheotomy were recorded.The time of hospitalization,the time of closed drainage and the incidence of postoperative complications were recorded and compared between the two groups at discharge time.Results The operative time,amount of blood loss,drainage volume,drainage time and hospitalization time of the laparoscopic group were (3.22 ±0.64)h,(218.20 ± 45.42)mL,(235.67 ±42.15)mL,(3.32 ±1.81)d,(14.28 ±2.53)d,respectively,which were significantly lower than those of the traditional group [(4.52 ±1.11)h,(407.42 ±50.06)mL,(321.71 ±37.82)mL,(5.16 ±1.78)d, (17.35 ±4.38)d,t＝5.764,15.438,8.465,4.020,3.448,all P＜0.05].The incidence rates of pulmonary infection and atelectasis in the laparoscopic group were 3.57% and 0.00%,respectively,which were significantly lower than those in the traditional group (23.53% and 17.65%,χ2＝4.929,5.471,all P＜0.05).The ventilator -assisted breathing rate and postoperative tracheotomy rate of the laparoscopic group were both 0.00%,which were significantly lower than those of the traditional group (23.53%and 14.71%,χ2＝7.564,4.479,all P＜0.05).Conclusion It is safe and reliable to complete lymph node dissection and surgical treatment of thoracic laparoscopy combined with resection of esophageal carcinoma,and compared with conventional three incision resection of esophageal carcinoma it has the advantages of small trauma,low incidence rate of complication and fast recovery,which is worthy of further promotion.

Objective To study the effects of mechanical load on in vivo degradation performance of high-purity magnesium (HP Mg, 99.99 wt.%) quantitatively. Methods Cylindrical Mg specimens, with a 2 mm diameter and a 14 mm length, were mounted in polyetheretherketone (PEEK) rings to bear compressive stresses ［（6.2±0.6） MPa］, tensile stresses ［（4.6±0.1） MPa］ or no stress (as control). The specimens under different stress states were implanted subcutaneously in dorsal abdominal regions of SD rats for 4 weeks. The mass loss, residual volume and surface morphology of the specimens and staining of surrounding soft tissues were used to analyze the degradation rate of HP Mg. Results Specimens and rings were completely encapsulated by membranous tissues after implantation for 4 weeks. No significant differences in the degradation rates were noted between specimens bearing stress and the control. The corrosion layers of specimens under each stress state were uniform. Conclusions The compressive and tensile stresses (4-6 MPa) could not affect significantly HP Mg degradation performance in vivo. The research findings provide theoretical references for the design and clinical application of Mg-based degradable implants.

OBJECTIVEIn China, the coverage rate of work injury insurance was 23.2%in 2011, which was far lower than expected. The factors affecting the insurance's enrollment has very little known. This paper aims to study the existing coverage of work injury insurance scheme and its influencing factors.

METHODSThe data were collected from 2 836 workers who came from 9 industries in three cities of Zhejiang province using face-to-face questionnaire interview.

RESULTSOf these 2836 workers, the work injury insurance coverage was 50.1%, and 29.6% were not sure if they were covered or not. The results showed that the awareness of occupational disease and industrial injury insurance was helpful in increasing the coverage rate. Besides, the logistic regression analysis showed that in certain circumstances working population shared higher coverage of work injury insurance. For examples, male workers with local household registration and longer working years; people who had been informed about occupational risk factors, and thus gained more training on the issue; people who had exposed to occupational hazards or involved in administrative duties; and people who had already insured by a medical insurance scheme. In the contrary, the heavier family burden with longer working hours per week they needed, the lower possibility they joined the insurance scheme.

CONCLUSIONSThe coverage of work injury insurance is higher than native average level but much lower than the average international level. The awareness of occupational disease and injury insurance was closely associated with the coverage of work injury insurance. Therefore, it is imperative to popularize the knowledge on OHS for migrant workers, as well as to reinforce the supervision and management of the issue would have been an effective way to elevate the coverage rate of work injury insurance.

China ; Cities ; Health Services Needs and Demand ; Humans ; Insurance Coverage ; statistics & numerical data ; Male ; Occupational Diseases ; Surveys and Questionnaires ; Transients and Migrants

OBJECTIVETo investigate workers' willingness to participate and wiliness to pay for a hypothetical industrial injury insurance scheme, to analyze the influential factors, and to provide information for policy making of the government.

METHODSMultistage cluster sampling was used to select subjects: In the first stage, 9 small, medium, orlarge enterprises were selected fromthree cities (counties) in Zhejiang province, China, according to the level of economic development, transportation convenience, and cooperation of government agencies; in the second stage, several workshops were randomly selected from each of the 9 enterprises. Face-to-face interviews among all workers in the workshops were conducted by trained interviewers using a pre-designed questionnaire.

RESULTSIt was found that 73.87% (2095) of all workers were willing to participate in the hypothetical work injury insurance scheme and to pay 2.21% of monthly wage (51.77 yuan) on average, and more than half of the workers were willing to pay less than 1%of monthly wage (35 yuan). Of the 741 workers who were not willing to participate, 327 thought that the premium should be borne by the state or enterprises, instead of individuals, and others were not willing to participate because of low income, unstable job, or poor understanding of the hypothetical industrial injury insurance scheme. Logistic regression analysis showed that workers with higher education levels, longer length of services, longer weekly working time, or more knowledge of occupational diseases showed higher willingness to participate in the scheme; workers who were exposed to physical hazards, had health records, or had participated in the existing medical insurance or industrial injury insurance were more willing to participate. Multiple linear regression analysis showed that with increasing average monthly wage, weekly working time, and self?health evaluation, the proportion of workers with willingness to pay increased; however, with increasing work intensity and awareness of occupational disease, the proportion of workers with willingness to pay decreased. The workers who were not covered by the industrial injury insurance paid more than those covered by the industrial injury insurance.

CONCLUSIONThe hypothetical industrial injury insurance scheme increased the applicability and advantage of independent third-party running and lifetime insurance, which significantly increased the workers' willingness to participate in or to pay for the insurance scheme. Therefore, the industrial injury insurance can be improved in these aspects to promote workers' willingness to participate in and to pay for the insurance scheme. This conclusion provided a reference for the solution of delayed or shirking corporate responsibility for paying the premium.

Accidents, Occupational ; economics ; Attitude to Health ; China ; Cluster Analysis ; Financing, Personal ; Health Policy ; Humans ; Insurance ; Insurance, Health ; economics ; utilization ; Models, Theoretical ; Occupational Diseases ; economics ; Surveys and Questionnaires

Objective To investigate the effect of isoflurane inhalation during gestation period on plasticity of hippo-campal synapses in offspring rats. Methods Ten healthy pregnant SD rats at 14 day gestation were randomly divided into 2 gorups ( n = 5 each): control group (group C) and isoflurane group (group I). The rats in group C were mechanically ventilated with O2 while in group I the rats inhaled 1.3% isoflurane in O2 for 2 h a day until labor. Four weeks after birth 4 offspring rats from each pregnant rats (2 male, 2 female) were tested for learning and memory abilities using Morris water maze. Then the offspring rats were sacrificed and hippocampi isolated. The synaptic structure of hippocampal CA1 area was examined by trans-electron microscopy. Results Morris water maze test showed that the escape latency was significantly shorter and the number of times of spanning flat roof greater in group C than in group I. The structure of hippocampus was intact in group C but incomplete in group I. Meanwhile the thickness of synaptic density was significantly decreased in group I. Conclusion Isoflurane anesthesia of pregnant rats may induce learning and memory disabilities in offspring rats by inhibiting the plasticity of synaptic structure in hippocampus.