This paper describes a method for determination of ascorbic acid with 1, 10-Ph-enanthroline-irou (III) as a colour reagent.It involves formation of fertion when ascorbic acid reacts with a mixture of iron (III) and 1,10-Phenanthrolive, and measurement of the absorbance at 510nm. This method has been applied to assay of pharmaceutical preparation and food indurstry of Vitamin C. The results how that this method is simple, rapid and sensitive

OBJECTIVETo verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts.

METHODSThe prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke.

RESULTSThe data of 4 cohorts including 76,227 persons, with 745,346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8% increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15% for men, and 22% of both diseases for women.

CONCLUSIONBMI < or = 18.5, 24-27.9 and > or = 28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.

Adult ; Aged ; Body Mass Index ; Cardiovascular Diseases ; epidemiology ; etiology ; mortality ; Cause of Death ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Obesity ; complications ; Prospective Studies ; Reference Values ; Smoking ; adverse effects ; Stroke ; epidemiology ; etiology ; mortality

Since 2005,guidelines for the management of adults with CAP or HAP were updated in United States,Europe and Japan,respectively.In these new CAP guidelines,severity-of-illness scores could be used to decide site of care.Routine diagnostic tests to identify an etiologic diagnosis were optional for outpatients with CAP.Empirical antibiotic therapy regimen,time to first antibiotic dose and duration of antibiotic therapy were all detailed explained.In new HAP guidelines,prevention was still emphasized.In order to prevent VAP,measures should be taken to reduce the risk of aspiration,including subglottic drainage and maintenance of stable optimal endotracheal tube cuff pressure.Cultures of lower respiratory secretions have diagnostic value for VAP.The diagnostic accuracy of blind sampling was similar to that of bronchoscopy-directed methods.Much more attention was paid on multidrug resistant bacteria infections.

OBJECTIVETo investigate the application of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis.

METHODSFrom July 2005 to June 2013, 25 patients with multi-segmental myelopathic cervical spondylosis were treated by the expanding forming under the plate through cervical spatium intermusculare approach including 16 males and 9 females with an average age of 56.5 years old ranging from 35 to 78 years old. Among them, 10 cases were onset without causes slowly, 7 cases were onset without causes suddenly, 8 cases were onset after mild trauma or tired. JOA scoring, incidence of postoperative axial symptoms and imaging studies were used to evaluate the effect.

RESULTSTwenty-five cases were followed up for 6 months to 7 years and 6 months with an average of 2 years and 9 months. There were no infection, cerebrospinal fluid leakage after the operation, and complications such as nerve damage were occurred. The operation time was 120 to 150 min, the bleeding was 300 to 500 ml. Imaging examination showed vertebral canal sagittal diameter increased, the vertebral canal increased significantly in the cross sectional area of the spinal cord, cervical curvature was straighten in 4 cases (2 cases of them became normal sequence). There were no more cases of cervical protruding and segmental instability increased. Postoperative walking ability enhanced, the finger activity of majority of patients improved on flexibility, grip strength, and accuracy of using chopsticks improved, numbness and chest waist band feeling had different degree of reduce, preoperative urine impairment were improved to varying degrees. Preoperative JOA scores were 3 to 13 points with an average of (8.86 ± 4.25) points; Postoperative 12 months' JOA scores were 7 to 17 points with an average of (13.76 ± 3.56) points, period was 60.19% in average, JOA score had statistically difference between before and after operation (P < 0.05). The result were excellent in 14 cases, good in 6 cases, and fair in 4 cases and poor in 1 case.

CONCLUSIONApplication of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis, through muscular clearance, can retain complete cervical back muscle, maintain stability of cervical spine, and vertebral canal can get effective decompression at the same time.

Adult ; Aged ; Bone Plates ; Cervical Vertebrae ; Female ; Humans ; Laminectomy ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Spondylosis ; surgery

OBJECTIVETo explore the surgical method and its effects of adjacent spinal segment degeneration after anterior cervical fusion.

METHODSFrom March 2000 to March 2011, 27 patients with spinal segment degeneration who had accepted the operation of anterior cervical fusion were treated with surgical treatment. There were 16 males and 11 females with an average age of 55.3 years (ranged from 48 to 72 years). JOA scores and image examination were used to evaluate the clinical effects.

RESULTSAll patients were followed up for 1.8 to 7.2 years with an average of 3.6 years. All pathological segments obtained fully decompression with good spinal bombe, no internal fixation loosening and cervical spine instability were found. Nerve root pain had disappeared and nerve function had significantly improved. Before operation, 3 days after operation and at last follow-up, JOA scores were 9.15 +/- 3.46, 13.96 +/- 2.79 and 13.52 +/- 2.91, respectively, and there was significant difference between preoperation and postoperation (P < 0.05). Intervertebral height and physiological curvature improved obviously than preoperation (P < 0.05).

CONCLUSIONIn order to relief spinal compression and rebuild spinal stability, a surgical treatment will be recommend to adjacent spinal segment degeneration combining spinal nerve symptoms and physical sign as soon as possible. Selecting an appropriate surgery to treat different compressed segment would receive satisfactory results.

Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Middle Aged ; Spinal Fusion ; adverse effects

Objective:To assess the genetic relationship of clinical isolates of carbapenem-resistant A.baumannii (resistant to both imipenem and meropenem) from January 2007 to March 2008 in Peking University Third Hospital for measures to decrease the isolates; to investigate the characteristics of patients with carbapenem-resistant A. baumannii colonization or infection and to evaluate antibiotic treatment for health care-associated infections caused by carbapenem-resistant A. baumannii. Methods: The medical records of patients with carbapenem-resistant A. baumannii colonization or infection were reviewed. Antibiotic susceptibilities of the isolates were determined by the standardized disk-diffusion method and the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis. Results: A total of 49 carbapenem-resistant A. baumannii strains were isolated from the 49 patients hospitalized during the study period and pulsed-field gel electrophoresis typing yielded 7 different patterns. A total of 45 (91.8%)genotyped strains showed clonal relationship. The most frequently identified predisposing factors were intensive care unit stay, invasive procedures, and hypoalbuminemia. Chronic obstructive pulmonary disease (12 cases) and cerebrovascular disease (10 cases) were the most common comorbid conditions.The mortality of patients with carbapenem-resistant A. baumannii infection was 38. 1% (8 of 21 patients), and the acute physiology and chronic health evaluation Ⅱ score, initial antibiotic therapy failure rate and the presence of hypoalbuminemia were significantly increased in the death group. Combination therapy regimens had higher success rates than monotherapy regimens (11/13, 84. 6% vs. 3/17,17.6%). Conclusion: There has been clonal spread of carbapenem-resistant A. baumannii strains among patients in our hospital since 2007. Intensive care unit stay, invasive procedures, hypoalbuminemia, chronic obstructive pulmonary disease and cerebrovascular disease were common in patients with carbapenem-resistant A. baumannii colonization or infection. Antibiotic combination therapy may be effective for carbapenem-resistant A. baumannii infection.

Adult ; Condylomata Acuminata ; pathology ; Female ; Humans ; Laryngeal Diseases ; pathology

Acute Disease ; Case-Control Studies ; Child, Preschool ; Echocardiography, Doppler ; Female ; Heart ; physiopathology ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; diagnostic imaging ; physiopathology

Objective To study clinical characteristics and diagnostic methods of lymphoma with chest invovement. Methods Twenty-five lymphoma patients with chest involvement were retrospectively analysed, they were all diagnosed in Peking University Third Hospital during 2000 to 2007. The data were collected including clinical manifestations, blood examinations, chest X-ray and CT scan, diagnostic methods and pathologic diagnosis. Results The median age of the 25 patients was 46 years old. Pyrexia(13 cases), weight loss over 10 percent in 6 months(11 cases), cough(10 cases), shortness of breath(9 cases) and painless enlargement of the peripheral lymph nodes(16 cases) were common manifestations. Erythrocyte sedimentation rate and serum lactate dehydrogenase(LDH) level were increased in 72.7% and 81% patients, respectively. The enlargement of mediastinum lymph nodes(16 cases, 64%) was the most common presentation of chest radiography, followed by pulmonary involvement(15 cases, 60%) including infiltration or pulmonary consolidation, mass, multiple nodules, diffuse ground-glass shadow, miliary lesion. There were also presentations of pleural effusion(10 cases, 40%), pericardial effusion(4 cases, 16%), chest wall mass(2 cases, 8%). Eighteen patients(72%) had at least two kinds of these presentations. The appearance of pleural effusion were yellow turbid, bloody or chyliform. Rivaha tests were all positive. The median value of plearal effusion examinations were listed as follows: specific gravity 1.031, total cells 9800×10~6/L, WBC 6.72×10~9/L, lymphocyte 86%, neutrophil 14%, protein 31.4 g/L, LDH 296 U/L,adenosine deaminase (ADA) 67.4 U/L Most patients(16 cases) were diagnosed by surgical biopsy,especialy peripheral lymph nodes biopsy (12 cases). Other patients were diagnosed by ultrasound or CT-guided biopsy (5 cases), video-assisted thoracoscopic pleural biopsy (1 case), video-mediastinoscopic mediastinum lesion biopsy(1 case), bronchial mucosa biopsy through bronchoscope(1 case), bone marrow examination(1 case). All the cases were non-Hodgkin lymphoma except one. Conclusions There was no specific clinical manifestation for lymphoma with chest involvement, but in almost half of patients there were enlargement of not only peripheral but also mediastinum lymph nodes. And there were some characteristics in serum, pleural effusion, chest X-ray and CT scan. Surgical biopsy of peripheral lymph nodes was a simple and convenient method for diagnosis. Micro-invasive biopsy had good diagnostic value for lymphoma with chest involvement, including ultrasound-or CT-guided biopsy for superficial mass, pleura, lung, liver, spleen and deep lymph nodes, video-assisted thoracoseopic and video-mediastinoscopic biopsy for pleura, lung and mediastinum lesions. But bronchial mueosa and lung biopsy during bronchoscopy had a low diagnostic rate for lymphoma.

Objective To analyse the detection of The Heidelberg Retina Tomograph Ⅱ (HRT-II ) for macular diseases. Design Retrospective observational case series. Participants 110 patients(201 eyes). Methods Fifty-two normal eyes, 74 eyes with macular edema, 23 eyes with macular hole, 31 eyes with macular premembrane and 21 eyes with choroidal neovascularization were examined with macular edema module(MEM) of HRT-Ⅱ. Main Outcome Measures Edema index (E value), signal width value (W value) and features of reflectance pictures. Results In normal eyes, E value and W value of some areas in macula were partly associated with age(r=0.207-0.359). E value and W value in macular diseases were significantly different from normal eyes (P=0.000). HRT-II could display macular edema cysts, configuration and size of macular holes, extension of macular premembrane and its relationship with retina and druen or subretinal neovascularization in age-related degeneration. Conclusion The reflectance pictures of HRT-Ⅱ have characteristic appearances in different macular diseases, and the measurements of E value and W value altered in pathologic stage of macular diseases. Especially E value of central zone can reflect changes of retinal thickness and light reflectance in macula, and it is obviously different in macular edema.