低浓度混苯对女工生殖激素分泌的影响

目的：探讨低浓度混苯作业对女工月经周期生殖激素分泌的影响。方法：对50名暴露组女工采用气相色谱法测定呼吸带空气中的苯、甲苯和二甲苯的浓度,对暴露组女人及外对照组和内对照组女工各35月进行月经 周期特征前瞻性调查,用酶免疫分析法测定尿液中的孕二醇－3－葡糖苷酸（PdG)、雌酮结合物（E1C）和卵泡刺激素（FSH）。结果：空气中混苯以低浓度苯为主,苯检出率29．10％、浓度8．88（0．90－876．47）mg/m^3、超标率21％、最大超标倍数20．91倍;与内对照组和外对照组相比,低浓度浊苯接触组女工黄体期长度缩短,与内对照组相比,暴露组的排卵前E1C水平、卵泡早期FSH水平以及卵泡早期和黄体期PdG水平明显降低,结论：低浓度混苯可以干扰接触女工下丘脑－垂体－卵巢轴中FSH、雌激素和孕激素的正常水平。     

Assessment of the adequacy of bronchial stenting by flow-volume loops

Airway compression is a common problem in children with certain forms of congenital heart disease. Although various surgical approaches are available to overcome this form of airway obstruction, internal stenting is necessary in a minority of patients. It can be difficult to assess the success of stenting at the time of the procedure, and the interval to successful extubation is usually used as an outcome measure. Measurement of relevant parameters of respiratory physiology with flow-volume and volume-pressure loops permits immediate quantitative assessment of the adequacy of stenting. A 3-month-old infant who underwent bronchial stenting and physiological assessment at the time of the procedure is described.     

A pathological study of tumour regression in oesophageal adenocarcinoma treated with preoperative chemoradiotherapy

AIMS: To measure residual tumour in oesophageal adenocarcinoma treated with preoperative chemoradiotherapy, to correlate specific pathological variables with survival, and to describe morphological changes in tumour and non-neoplastic tissue resulting from preoperative treatment. METHODS: Resection specimens from 47 cases of oesophageal adenocarcinoma treated with preoperative 5-fluorouracil/cisplatin and radiotherapy were reviewed. Residual tumour was assessed in terms of tumour regression grade (TRG), pTNM stage, lymphovascular space invasion, and resection margin involvement. Survival analysis was performed using the Kaplan-Meier method and log rank test. Cox's proportional hazard model was used for multivariate analysis. RESULTS: A complete pathological response (TRG1) was present in eight cases. The absence of residual tumour was confirmed by negative immunohistochemical staining for MNF116. Tumour corresponding to TRG2 was present in five cases, to TRG3 in nine, to TRG4 in 22, and to TRG5 in three. By multivariate analysis, pN0 status (n = 35) had a positive effect on survival (p = 0.04) and TRG had no significant effect on survival (p = 0.06). Patients with pN0 tumours had a median survival of 48 months versus eight months for those with pN1 tumours (log rank test, p < 0.0001). We found that giant fibroblasts were discernible from single large residual tumour cells on haematoxylin and eosin alone. CONCLUSION: Response to preoperative chemoradiotherapy in oesophageal adenocarcinoma is variable. Although there are as yet no reliable predictors of response to treatment, patients who are identified at diagnosis as having negative loco-regional lymph nodes should benefit considerably from this treatment approach.     

Interleukin-17 producing mucosal associated invariant T cells - emerging players in chronic inflammatory diseases?

Mucosal associated invariant T (MAIT) cells are a population of evolutionarily conserved T cells, which express an invariant T cell receptor (TCR) and represent a significant subset of innate-like T cells in humans, yet their role in immunity is still emerging. Unlike conventional αβ T cells, MAIT cells are not restricted by MHC molecules, but instead uniquely recognize microbially derived vitamin metabolites presented by the MHC-I like molecule MR1. MAIT cells are enriched in mucosal sites and tissues including liver and adipose tissue where they are thought to play an important role in immunosurveillance and immunity against microbial infection. In addition to their putative role in antimicrobial immunity, recent research on MAIT cells, in particular IL-17 producing MAIT cells, has demonstrated their involvement in numerous chronic inflammatory conditions. In this review, we give an overview of the work to date on the function and subsets of MAIT cells. We also examine the role of IL-17 producing MAIT cells in chronic inflammatory diseases ranging from autoimmune conditions, metabolic diseases to cancer. Furthermore, we discuss the most recent findings from the clinic that might help deepen our understanding about the biology of MAIT cells.     

Blood cultures in acute surgical admissions

IntroductionObtaining blood cultures prior to the administration of antimicrobial therapy was a key recommendation of the 2012 UK Surviving Sepsis Campaign. Few studies have examined the effect blood cultures have on clinical management and there have been none on acute surgical admissions. This retrospective study sought to evaluate the effect of blood cultures on clinical management in acute surgical admissions.MethodsData on acute surgical patients admitted between 1 January and 31 December 2012 were extracted from hospital records. Patients given intravenous antibiotics within 24 hours of admission were identified. Data collected included antibiotics administered, blood culture results, admission observations and white blood cell count. Case notes were reviewed for patients with positive cultures to establish whether the result led to a change in management.ResultsOf 5,887 acute surgical admissions, 1,346 received intravenous antibiotics within 24 hours and 978 sets of blood cultures were taken in 690 patients. The recommended two sets of cultures were obtained in 246 patients (18%). Patients who had blood cultures taken had the same in-hospital mortality as those who had none taken (3.6% vs 3.5%, p=0.97). Blood cultures were positive in 80 cases (11.6%). The presence of systemic inflammatory response syndrome did not increase positivity rates (12.9% vs 10.3%, p=0.28). Overall, cultures altered management in two patients (0.3%).ConclusionsBlood cultures rarely affect clinical management. In order to assess the additional value that blood cultures bring to sepsis management in acute surgical admissions, a prospective randomised trial focusing on outcome is needed.