Objective To find out the iodine nutritional status of children in Xiamen island, and to provide the scientific basis for iodine supplimentation. Methods On March 2010, thyroids of all children aged 6to 12, from primary school on the Xiaodeng island of Xiamen were examined by palpation, urinary iodine, iodine content of salt athome and IQ level were tested, and were collected 20 households, iodine content of drinking water was tested randomly. Results IQ testing and thyroid palpation were carried out among a total of 156 children, the goiter rate of children was 1.28% (2/156), the mean IQ was 110; 154 urine samples were taken, the median urinary iodine was 219.1 μg/L; a total of 153 salt samples were tested, and the qualified rate of iodized salt was 87.58%(134/153), and the mean iodine content in the tap water was 4.52 μg/L Conclusions Iodine nutritional status of the island residents is better, and there are no such problems as excessive iodine.

Objective To investigate the current conditions of water iodine,childrens'iodine nutrition and residents'edible circumstance of iodized salt in the villages with high iodine in drinking water and the adjacent three villages in Xiamen city of Fujian province.Methods Four natural villages of Qianbian,Donglian,Dazhong and Dongshan of Xiangan county were chosen as survey spots in 2008.In each village,one running water sample and all well water samples were collected to obtain the benchmark for each location.All children aged 7-13 year in the four villages underwent thyroid palpation and were selected to measure the urine iodine and the salt iodine.The water iodine and urine iodine were determined by As3+-Ce4+ catalytic spectrophotometry digestion,salt iodine was determined by direct titration.Results In four investigated villages,iodine of four running water samples were all 1.5μg/L.The range of 237 well water iodine samples was from 0.1 μg/L to 506.0 μg/L.There were 18.6% (44/237)specimens in which the well water iodine less than 10 μg/L,73.4%(174/237)between 10 μg/L and 150 μg/L and 8%(19/237)more than 150μg/L.The median of urinary iodine was 153.3 μg/L in 79 urine samples,which was 114%(9/79)more than 200μg/L and less than 300μg/L,12.7%(10/79)equal or more than 300 μg/L and less than 500μg/L,7.6%(6/79)equal or more than 500μg/L and less than 800 μg/L in all samples.Seventy-nine students were examined by palpation and the total goiter rate of children measured was 11.4% (9/79).Seventy-one samples of iodine salt were detected and the coverage rate of iodized salt was 77.5%(55/71).Conclusions The well water iodine contents have a wide distribution in the investigated villages.We should enhance the community awareness by educating them on the damage of iodine excess and iodine deficiency.

Objective:To compare the clinical and imaging outcomes of fascia lata autograft bridging repair reinforecd with an artificial ligament as the internal brace with the autograft bridging repair for the treatment of irreparable massive rotator cuff tears (IMRCTs).Methods:The data of 26 patients with IMRCT who underwent fascia lata autograft bridging repair augmented with artificial ligament as the internal brace (internal brace group) and of 24 patients with IMRCT who underwent bridging autograft repair alone (control group) were retrospectively evaluated preoperatively and at 2-year follow-up. Clinical outcomes were assessed using shoulder activity, the American Shoulder and Elbow Surgeons (ASES) Score, University of California Los Angeles (UCLA) Score, and visual analogue scale (VAS) for pain. Imaging outcomes were evaluated using acromiohumeral distance (AHD), Goutallier grade, and status of fascia lata grafts according to radiographs or magnetic resonance imaging results.Results:All 50 cases were followed up for 34.2±7.2 months (range 24-45 months). Compared to the control group, the internal brace group showed better ASES score (93.5±5.3 vs. 89.5±5.7, P<0.05), UCLA score (31.7±3.8 vs. 28.5±5.6, P<0.05), improvement in UCLA score (19.6±4.2 vs. 15.9±5.7, P<0.05), active elevation (167.3°±8.4° vs. 159.4°±13.6°, P<0.05), abduction strength (8.9±1.2 vs. 8.2±1.2, P<0.05), improvement in abduction strength (4.1±1.2 vs. 3.3± 1.0, P<0.05), AHD (7.0±1.4 mm vs. 5.9±1.0 mm, P<0.05), improvement in AHD (3.3±1.5 mm vs. 2.0±0.6 mm, P<0.05), and healing rate of fascia lata autografts (92% vs. 54%, P<0.05) at 2-year follow-up. Conclusion:Fascia lata autograft bridging repair reinforced with an artificial ligament as the internal brace improves healing rate of bridging graft and postoperatively short-term clinical outcomes of patients with IMRCT.

Objective To assess efficacy and safety of oral brivudine 125 mg once daily versus 4 times daily in the treatment of herpes zoster.Methods A five-centre,randomized,double-blind,parallel- controlled study was performed on 226 patients with herpes zoster.Oral brivudine 125 mg was given once daily to 112 patients,and four times daily to 114 patients,both for 7 days.All patients were followed up for 3 weeks after the end of treatment.Results The time to the last formation of new vesicles was 3.88 days for the once daily group,and 3.79 days for the 4 times daily group,without significant differences between the two groups.There was also no significant difference between the two groups with respect to the time to total resolution of vesicles,time to first crusts,time to full crusting,time to first loss of crusts,time to full loss of crusts,time to first relief of pain,and time to complete relief of pain.Postherpetic neuralgia occurred in 34.5% of patients in the once daily group,and 30.4% of patients in the 4 times daily group.The incidence of treatment-related adverse events was 5.4% and 9.6%,in the once daily group and 4 times daily group, respectively.Conclusions Brivudine 125 mg once daily is equally effective,more convenient and safe in comparison with brivudine 125 mg 4 times daily for the treatment of herpes zoster.

The case is a 54-year-old man with hypertrophic cardiomyopathy, mid-ventricular obstruction, apical aneurysm, and recurrence sustained monomorphic ventricular tachycardia (VT). A coronary angiogram revealed myocardial bridging located in the middle of the left anterior descending coronary artery (LAD), and the left ventriculogram showed an hour-glass appearance of the left ventricular cavity. There was a significant pressure gradient of 60 mmHg across the mid-ventricular obliteration at rest. A successful myectomy of the inappropriate hypertrophy myocardium and excision of the apical aneurysm were performed. Pathologic analysis demonstrated fibrosis in the apical aneurysm and thickened and narrowed vessels in the adjacent area. During the follow-up of eighteen months, the patient remained clinically stable and free from arrhythmic recurrence.
Cardiomyopathy, Hypertrophic ; diagnosis ; physiopathology ; Female ; Heart Aneurysm ; physiopathology ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular ; physiopathology

Acute Disease ; Aged ; Cardiomyopathies ; etiology ; pathology ; China ; Female ; Humans ; Stress, Psychological ; complications

Objective To investigate the clinical effect of compositive chest physiotherapy for the prevention of atelectasis after thoracotomy in the elderly patients.Methods Sixty-eight elderly patients after thoracotomy were randomly divided into two groups, the experimental group adopted compositive chest physiotherapy(n = 35), the control group were given the traditional chest physiotherapy(n = 33).The factors considered included the action abide by doctor,the effect of expectoration, the improvement difference of PaO2 ,PaCO2 , SaO2 by blood gas analysis, the incidence of atelectasis.Results There were significant differences in the action abide by doctor and the effect of expectoration. After intervention, the improvement difference of PaO2 ,PaCO2 and SaO2 were significant higher than that of the control group(P <0.05); The rates of atelectasis were 5.71% (2 cases) and 27.27% (9 cases) in experimental group and control group respectively (P < 0.05).Conclusions Compositive chest physiotherapy is superior to traditional physiotherapy for elderly patients in pedoperation, which can clear sputum more effectively, improve blood oxygen partial pressure and lung expansion, also can prevent pest-operative atelectasis more effectively in the elderly patients.

OBJECTIVEWe evaluated our method and effects of needle laparoscopic varicocelectomy for the treatment of varicocele.

METHODS72 patients (105 lateral) diagnosed varicocele were performed laparoscopic varicocelectomy under epidural combined intravenous anesthesia from Feb, 2003 to Apr, 2005. Two 2 mm incisions and one 5 mm incision were made on the midline of lower abdomen, by which two 2 mm trocars and one 5 mm trocar were introduced. Vessel-sealing device (Ligasure) was used to seal the internal spermatic veins.

RESULTSAll operations were completed successfully. Mean operation time was 15 minutes unilateral and 21 minutes bilateral. The patients were hospitalized for 3 to 5 days after procedure. Follow-up was scheduled for 6 to 12 months and there was no recurrence.

CONCLUSIONNeedle laparoscopic varicocelectomy gives favorable effect with minimal invasion, rapid recovery, which is the best choice for the treatment of varicocele.

Adolescent ; Adult ; Child ; Follow-Up Studies ; Humans ; Laparoscopy ; Ligation ; methods ; Male ; Middle Aged ; Spermatic Cord ; blood supply ; surgery ; Varicocele ; surgery

OBJECTIVETo investigate the distribution of beta-2-AR +46 A-->G variant in Kazakans of Xinjiang and the relationship of the variant with low density lipoprotein-cholesterol (LDL-C) level in this population.

METHODSThe genotypes of beta-2-AR gene Arg16/Gly variant were detected by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique in 506 Kazakans with age from 30 to 69, and its distribution and relationship to LDL-C level were investigated.

RESULTS(1) The frequencies of genotypes AA, AG, GG and alleles A, G of beta-2-AR +46 variant in this population were 0.310, 0.455, 0.235 and 0.538, 0.462 respectively, which were accorded with Hardy-Weinberg equilibrium. (2) The Gly16/Gly genotype had highest LDL-C level in the three genotypes, and were significantly higher than Arg16/Gly genotype (P < 0.05). (3) Comparing the effect of beta-2-AR gene +46 variant on serum lipid in males with females, we found that females with Gly16/Gly genotype had the highest level of serum LDL-C.

CONCLUSIONSThese data show that Gly16/Gly genotype of beta-2-AR gene +46 A-->G variant is associated with higher level of serum LDL-C in this population, especially in female.

Adult ; Aged ; Alleles ; Asian Continental Ancestry Group ; genetics ; Cholesterol, LDL ; blood ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Receptors, Adrenergic, beta-2 ; genetics

BACKGROUNDThe laparoscopic radical cystectomy (LRC) with orthotopic ileal neobladder is now applied to treat invasive bladder cancer, however, it has not been well codified and illustrated. We describe in this paper a technique step by step that we have developed in 33 patients and achieved excellent results.

METHODSThe surgical procedure can be divided into eight steps: laparoscopic pelvic lymphadenectomy and mobilization of the distal ureters; exposing Denonvillier's space and the posterior aspect of prostate; exposing retropubic space and anterior surface of the bladder; dividing the lateral pedicles of the bladder and the prostate; dividing the apex of the prostate; extracorporeal formation of the ileal pouch; extracorporeal implantation of the ureters; and laparoscopic urethra-neobladder anastomosis. This operation was performed in 33 patients, 29 males and 4 females, with muscle invasive bladder cancer between December 2002 and September 2004.

RESULTSThe operating time was 5.5-8.5 hours with an average of 6.5 hours; the estimated blood loss was 200-1000 ml with an average of 460 ml. The surgical margins of the bladder specimen were negative in all patients. There was no evidence of local recurrence at follow-up of 1-21 months in all the patients. However lymph node metastases were found in one case at 9 months postoperatively. Most of patients achieved urine control 1 to 3 months after surgery. The daytime continence rate was 94% (31 cases) and nighttime continence rate was 88% (29 cases). Urodynamic evaluation was performed between 3 and 6 months postoperatively for all cases. The mean value of neobladder capacity was (296 +/- 37) ml. The mean value of maximum flow rate was (18.7 +/- 7.1) ml/s. The mean residual urine volume was (32 +/- 19) ml. In all cases, excretory urography at 1 to 2 months postoperatively demonstrated slightly dilated upper urinary tracts without ureteral obstruction, which resolved at follow up. Cystography showed neobladders being similar in shapes to normal. Two small ureteral nipples with intermittently efflux of urine were observed at cystoscopy in most patients. Postoperative complications occurred in 6 of 33 patients (18%), including pouch leakage in 2 cases, pelvic infection in 1, partial small bowel obstruction in 2 and neobladder-vaginal fistula in 1.

CONCLUSIONSThe LRC with orthotopic ileal neobladder is a feasible option for bladder cancer when radical cystectomy is indicated. The extracorporeal formation of the ileal pouch and ureteral implantation through a small lower midline incision can simplify the complexity of the procedures, shorten the duration of surgery and reduce the medical expenses.

Adult ; Aged ; Aged, 80 and over ; Cystectomy ; methods ; Female ; Humans ; Ileum ; transplantation ; Laparoscopy ; Male ; Middle Aged ; Urinary Bladder Neoplasms ; surgery ; Urinary Reservoirs, Continent