Objective To explore the clinical features of Shenzhen service worker with upper gastrointestinal bleeding and association with medical insurance. Methods 169 patients(service workers in Shenzhen city)with upper gastrointestinal bleeding were retospectiveng analyzed, the treatment time, the severity of bleeding, the cause of the bleeding and bleeding incentive, diagnosis and treatment compliance, and other characteristics were analyzed; the differences between the case of group health insurance and the case of group no-health insurance, were observedResults For the case of non-insurance group the treatment time was delayed( P＜0. 01 ) ;the non-standard pre-hospital diagnosis and treatment was higher( P＜0. 01 ). The rate of moderate and severe cases was higher( P＜0. 05 ). The rate of the patients do not comply with gastroscopy and refused hospitalization, the non-insurance group was higher than the insurance group(P＜0. 01 and P＜0. 05 respectively). In compliance with the treatment of the cases,ly the efficiency and the total effective rate were sigmficantly higher in the insurance group than non-insurance. Conclusion Public participation in health insurance services enable the upper gastrointestinal bleeding in patients with timely medical treatment fixed medical institutions in order to get more early diagnosis and treatment,access to better efficacy and prognosis.

A sequential extraction procedure has been proposed for the evaluation of the speciation of heavy metals including Cd,Cu,Pb and Zn in sediments from mariculture area,and the speciation of heavy metals was separated and defined as acid soluble fraction,reducible fraction,fraction bound organic matter,fraction bound sulfides and residual fraction. Matrix effects of high salinity on the determination of heavy metals in sediments were eliminated by matrix matching and internal standard methods when inductively couple plasma optical emission spectroscopy (ICP-OES) and mass spectroscopy (ICP-MS) were used,respectively. The results showed that the measured values of marine sediment reference materials were consistent with the standard values when the digestion solutions were determined after dilution. The extraction results of the prepositional extraction procedure and European Community Bureau of Reference Program (BCR) procedure were compared and the selectivity of extractants was investigated. The preliminary studies indicated that this sequential extraction procedure was applicable for evaluating the speciation of heavy metals in sediment with organic substances pollution and eutrophication,especially for fraction bound organic matter and fraction bound sulfides.

A new sesquiterpene hydroquinone (1) was isolated from a deep sea sediment derived fungus, Phialocephala sp.. Its structure and stereochemistry were established on the basis of spectroscopic data and optical rotation. This compound was tested for cytotoxicity against P388 (murine leukemia cell) and K562 (human leukemia cell) cell lines, and displayed strong cytotoxic effects with IC50 value of 0.16 and 0.05 micromol x L(-1), separately.

BACKGROUND:Kienb?ck disease lacks of suitable animal models, which are similar to the pathological process of avascular necrosis of human lunate bone.
OBJECTIVE:To establish a new animal model of Kienb?ck disease using medical TH adhesive embolism and to explore the rationality of model establishment.
METHODS:A total of 30 healthy adult New Zealand rabbits, male or female, were selected. Using self-control method, the rabbits were randomly assigned to experimental sides and control sides. By dril ing in the center of the lunate bone, 0.2 mL of medical TH glue was injected three times. An equal volume of physiological saline was injected into the center of the lunate bone on the control side. X-ray examination, general observation, Micro-CT measurement of bone, and tissue pathology detection were conducted at 4, 8 and 12 weeks.
RESULTS AND CONCLUSION:Gross specimen, X-ray and histological results showed that ischemic necrosis of the lunate bone on the experimental side was visible at 8 weeks after model induction. The ischemic necrosis of the lunate bone became more typical at 12 weeks. Among the Micro-CT microscopic parameters of trabecular bone, trabecular bone density parameters bone volume fraction and the number of trabecular bone were significantly lower on the experimental side than those on the control side (P<0.05). Spatial parameters of trabecular bone significantly increased. Trabecular separation and structure model index on the experimental side were significantly greater than those on the control side. Results suggested that ischemic necrosis of the lunate bone appeared on the experimental side at 8 weeks after injection of medical TH glue. Rabbit models of ischemic necrosis of the lunate bone can be established at 12 weeks. Thus, alterations, which were similar to ischemic necrosis of human lunate bone, appeared, such as blood transportation damage in the lunate bone, trabecular bone fracture, and empty lacuna, when surrounding tissues were not obviously injured.

BACKGROUND: Digit amputation coupled with neighboring composite skin loss frequently occurs. Conventional treatment for this lesion is somewhat less desirable in that it either results in shortened or lost fingers as well as delayed skin resurfacing. Therefore, the curative effect is not satisfactory.OBJECTIVE: To observe free forearm venous flap for soft-tissue reconstruction in digit amputation accompanied with neighboring soft tissue loss and postoperative rehabilitation and its effect on functional recovery.DESIGN: Before-and-after controlled observational trial based on the patients.SETTING: Department of orthopedics of a university hospital.PARTICIPANTS: Totally 11 patients, 8 males and 3 females aged 20 to 45years, who were treated between October 2000 and May 2004 in the Department of Orthopedics, Third Affiliated Hospital of Sun Yat-sen University,for digit amputations accompanied with composite skin flaps avulsed in dorsal fingers or hand, were recruited.METHODS: Eleven free venous flaps measuring 1. 5 cm × 1.0 cm to 5 cm × 6. 5 cm from anteromedial ipsilateral forearms were elevated and transferred to the defected sites either antegradely or retrogradely with respect to the nature of the defects. Microvascular anastomosis was performed at both ends of the flaps to the wounds in an end-to-end fashion. Digit replantations in 13 digits were performed simultaneously at one stage. The donor sites were closed primarily by direct suturing or skin grafting. After operation, early rehabilitation was initiated under professional guidance.RESULTS: Complete healing was achieved in 9 out of 11 venous flaps and 12 out of 13 replanted digits. After one-year follow-up, finger motion function in seven cases was satisfactory; however, all the flaps presented diminished sensation.CONCLUSION: The free venous flap from anteromedial forearm is an alternative flap for soft-tissue reconstruction in digit amputation. Easy access,ideal thickness, and good pliability are the advantages of the flap whereas limited sensory recovery is the main shortcoming.

Objective To investigate the diagnostic value of MRI in chronic completely tear of the anterior cruciate lig-ament(ACL). Methods From January 2013 to September 2015 in our hospital,the clinic and MRI data of 20 cases with chronic completely tear of the ACL proved by arthroscopy. Results The diagnostic accuracy rate of MRI was 75%(15/20), and 25%(5/20) was misdiagnosed as partial tear.The MRI signs were: ACL ligament direction (n=20, 100%), abnormal ACL increased signal (14 cases, 70%), tibia forward (n=19, 95%), abnormal deeper lateral femoral notch or bone contusion or cartilage erosion(n=20, 100%), smaller bending angle index of posterior cruciate ligament(n=20, 100%), with the medial meniscus injury(n=18, 90%). MRI also clearly showed other lesions in the knee joint. Conclu-sion MRI has high diagnostic accuracy in chronic completely tear of the ACL, so which is worthy of application.

The clinical data of 31 patients with congenital heart disease(CHD)receiving minimally invasive surgical closure through chest or femoral venous catheter from June 2016 to September 2017 were analyzed retrospectively.All patients were diagnosed with esophageal echocardiography before operation.During the operation,the insert of guide wire and the sheath tube,and the placement of the sealing parasol were monitored and guided by transesophageal echocardiography (TEE).Satisfactory results were obtained in 30 patients.In 1 patients,the sealing parasol was detached,and open chest surgery was performed to remove the detached parasol and to repair the defect.TEE-guided minimally invasive surgical closure through chest or femoral vein catheter is safe and effective in the treatment of congenital heart disease and has certain clinical applicative value.

Anopheles minimus was once a main malaria vector in Hainan Island and had been e-liminated basically through the campaign of indoor residual spraying launched in 1959. It again became an incriminated vector of some focal malaria outbreaks in recent years. The present study was conducted in a selected county-Danxian and a typical hilly area-Feibar in the west part of Danxian county in 1989-1990.An. minimus was found in 50% and 62. 5 % of the surveyed sites at mountainous and hilly area of Danxian county,but not found in coastal region. An. minimus was found in all 18 sites surveyed in Feibar district constituting 52% of anopheline composition. Man-biting rate made by human-baited collection was 3. 2 before midniaght and 38. 2 when collected through whole night in some sites. However, the behaviour characteristics of An. minimus has changed. It has become exophilic,exophagic, and has an equal preference for man and cattle. The vectorial capacity of An. minimus estimated by quantitative data was in accord with malaria infection rate in Feibar district ,and the malaria infection rate among the inhabitants in three types of residential quarter with different socioeconomic conditions. Malaria infection rates of residential quarter of land-reclamation outcomers, villagers and state farm residents were 10%,2. 9% and 0. 5% respectively during 40 days from July to August,1990.Owing to the fact that An. minimus has become a secondary vector only next to An. dirus, with a wide range of distribution and a considerable different characteristics in behaviour compared to that before spraying campaign , it is suggested that a malaria control programme must be seriously planned to adjust the new problem of malaria epidemiology in Hainan Province.

Objective To investigate the MRI findings of displaced bucket-handle tear in medial meniscus. Methods From April 2011 to August 2015 in our hospital, the clinic and MRI data of 12 patients with displaced bucket-handle tear in medial meniscus confirmed by arthroscopy were retrospectively analyzed. Results 12 cases were unilateral. Fragment shift sign, double posterior cruciate ligament sign, flipped meniscus sign and double meniscus forefoot sign, abnormal circumferential meniscus sign, bow tie broken sign and disproportional posterior horn sign could be seen in all cases. Conclusion Displaced bucket-handle tear in medial meniscus has some characteristic manifestations on MRI, MRI can be used as a preferred imaging methods for displaced bucket-handle tear in medial meniscus.

OBJECTIVE: To compare the efficacy of mechanical thrombectomy with transcatheter thrombolysis in the treatment of acute iliac femoral venous thrombosis. METHODS: The clinical data of 170 patients with acute iliac venous thrombosis treated in Ningbo No.2 Hospital from September 2015 to September 2017 were retrospectively reviewed. Among them, 94 cases were treated with AngioJet mechanical thrombolysis or additional thrombolysis for residual thrombus (PMT group) and 76 cases were treated with catheter-directed thrombolysis(CDT group). After thrombolytic treatment if there was stenosis of iliac vein, the transluminal angioplasty was also performed. The clearance of thrombus and safety were evaluated and compared between two groups. RESULTS: In PMT group there were 86 cases (91.5%) with grade Ⅲ, 5 cases (5.3%) with grade Ⅱ, 3 cases (3.2%) with grade Ⅰ clearance of thrombus; while in CDT group, there were 63 cases (82.9%) with grade Ⅲ, 7 cases (9.2%) with grade Ⅱ and 6 cases (7.9%) with grade Ⅰ clearance of thrombus (>0.05). The differences of diameter of two lower extremities 15 cm above knee after treatment in PMT and CDT groups were (2.3±0.9) cm and (2.5±1.1) cm, respectively (>0.05). The time of thrombolysis in group PMT was significantly shorter than that in group CDT[(2.6±1.2) d vs. (5.3±1.5) d, <0.05]. The dosage of urokinase in PMT group was significantly lower than that in CDT group[(15.0±5.0)×10 U vs. (26.5±7.5)×10 U, <0.05]. Hemoglobin decrease was observed in both groups, which was more significant in PMT group (<0.01). During the following period, there was no significant difference in the incidence of recurrence and post-thrombosis syndrome in two groups (all >0.05). CONCLUSIONS Both PMT and CDT have good thrombus clearance effect in the treatment of acute iliac femoral venous thrombosis, however, PMT has the advantages of short thrombolytic time and less urokinase.
Catheterization, Peripheral ; Fibrinolytic Agents ; therapeutic use ; Humans ; Iliac Vein ; pathology ; surgery ; Retrospective Studies ; Thrombectomy ; Thrombolytic Therapy ; Treatment Outcome ; Venous Thrombosis ; surgery ; therapy