Cadmium ; adverse effects ; Dose-Response Relationship, Drug ; Environmental Exposure ; adverse effects ; Humans ; Occupational Exposure ; adverse effects ; Risk Assessment

Aim To evaluate the effect and safety of azithromycin injection produced in China and cefazolin in the treatment of respiratory tract infections.Methods 50 patients with respiratory tract infections were divided randomly into two groups. Patients in the test group recieved azithromycin in the dosage of 250 mg?d-1,qd for 5 d iv with double dosages at the first time and patients in the control group recieved cefazolin in the dosage of 2.0 g,bid,iv for 5～10 d. Results No statistical significant differences of overall clinical effect were observed between two groups .The fully recovery,effective and side reaction rates for the test group were 46.67%,90% and 3.3%,respectively,and for control group the data were 60%,95%,and 0%, respectively.Conclusion Azithromycin injection produced in China is effective and safe in the treatment of respiratory infections.

Objective To study the safety and feasibility of laparoscopic distal pancreatectomy in different modalities.Methods From September 2005 to October 2012,57 patients with masses located at pancreatic body/tail were treated by laparoscopic distal pancreatectomy.According to the operation procedure,patients were divided into four groups:distal pancreatectomy with splenectomy; Spleenpreserving distal pancreatectomy with conservation of the splenic artery and vein; spleen-preserving distal pancreatectomy and without conservation of the splenic artery and vein and laparoscopic to open distal pancreatectomy.Data of each group for operation time,blood loss and complications were collected and statistically analyzed.Results In 57 patients,5 cases were converted to open distal pancreatectomy.52 cases underwent successful laparoscopic operation (including 1 cases of hand-assisted).22 cases of spleen preserving operation (39％),and 30 cases of splenectomy operation (61％).Among the 4 groups of patients operation time,intraoperative blood loss,postoperative length of stay were not significantly different (all P ＞ 0.05).There was no operative mortality.Two cases suffered from B level postoperative pancreatic leakage,there was no C level pancreatic leakage.Conclusions Laparoscopic distal pancreatectomy with or without splenectomy is safe for the treatment of body and tail tumors of the pancreas.

Objective To investigate the relationship of placental vascular anastomosis and physical development and morbidity of the disease in twin neonates.Methods Fourteen pairs of twin neonates deliveried from Sep.2005 to Aug.2009 were enrolled in Newborn Intensive Care Unit,the Third Affiliated Hospital of Zhengzhou University.These twins were divided into 2 groups according the conditions of placental vascular anastomosis:significant placental vascular anastomosis group(group A) and no significant vascula anastomosis group(group B).Birth weight,head circumference,length,the morbidity of disease were all investigated in 2 groups.Clinic follow-up included neonatal behavioral neurological assessment(NBNA) and children′s development center of China(CDCC).The correlation of neonates placental vascular anastomosis between twin neonates were compared.Results There were statistically significant differences between group A and group B in birth weight,head circumference and body length(t=6.070,5.237,5.784,Pa

AIM: To evaluate the clinical outcomes of management in younger patients with primary chronic angle-closure glaucoma (PCACG).METHODS: Thirty-eight patients (50 eyes) aged 40 or younger with confirmed diagnosis of PCACG in advanced or late stage who received surgical treatment in Zhongshan Ophthalmic Center from January 2000 to December 2005were retrospectively investigated. All patients underwent trabeculectomy. The mean follow-up was 23.6±7.5 months.Full ophthalmic examinations were performed. The clinical outcomes including clinical presentations, surgical results and complications were evaluated.RESULTS: The mean age of patients was 33.5±6.1 years old. There was a female preponderance (60.5%). The mean axial length was 22.4±3.5mm with 18.0% short axis of eyeball and 14% nanophthalmos. There was 60.0% fiat anterior chamber depth (＜1.9mm). Ultrasonic Biomicroscopy identified that plateau iris was the most common underlying etiology (80.6%). There was a statistically significant difference in intraocular pressure (IOP) reduction postoperativelyvs preoperatively (P＜0.001). Four eyes failed to control IOP and received second filtration surgery. The main postoperative complications included shallow anterior chamber (20.0%) and malignant glaucoma (12.0%).CONCLUSION: The younger PCACG patients in advanced or late stage can be effectively managed by trabeculectomy.They have more frequency of postoperative sustained shallow anterior chamber and malignant glaucoma. Careful ophthalmic examinations, delicate surgical procedures and well-managed technique of complications were suggested on younger PCACG patients.

Objective To explore the clinical characteristics, surgical treatment and related factors of traumatic implantation cyst of the iris. Design Retrospective cases series. Participants Thirty-six cases of traumatic implantation cyst of the iris. Methods Thir- ty-six cases of traumatic implantation cyst of the iris were reviewed. Main Outcome Measures Age, surgical history, history of disease, surgical method of patients. Results All cases of traumatic implantation cyst of the iris were secondary to perforating injury. 10 cases had been undertaken cataract surgery. The histories of disease in 6 months～1 year and 1 year～10 years were 30.56% respectively. Sur- gical exicision was taken in all cases. There were 2 recurrence cases. Conclusion Traumatic implantation cyst of the iris is almost see- ondary to perforating injury. Surgical excision is an effective strategy to treat this disease.

Objective To evaluate laparoscopic partial splenectomy (LPS) for benign splenic tumors.Method Data of 55 patients undergoing laparoscopic partial splenectomy (20 cases) vs total splenectomy (LTS in 35 cases) at Peking University Third Hospital from August 2008 to July 2016 were collected and retrospectively analyzed.Results There was no difference in sex,BMI,preoperative H GB,preoperative PLT,operation time,operative blood loss and hospital stay between two groups.Age in LPS cases was younger than LTS group,while the tumor size was larger.On the 4th day postoperatively,PLT level was significnatly higher in LTP group.More patients in LTS group suffered from thrombocytosis.Conclusions Laprtoscopic partial splenectomy is a safe and effective procedure for the management of splenic benign tumors.

Objective To study the safety,feasibility and efficacy of thoracoscopic hepatectomy for liver carcinoma. Methods Thoracoscopic hepatectomy was performed in 3 cases with single liver neoplasm from 2007 to 2011,including hepatocellular carcinoma ( HCC ) in one case and metastatic liver cancer in 2 cases.By preoperative imaging the tumor was located accurately to simulate the port position in operation.Patients were placed in a left lateral decubitus position,and 3 ports were inserted into the chest wall surrounding the tumor. Through the use of intra-operative thoracoscopic uhrasonography (IOTU),the diaphragm just above the tumor was opened.IOTU was performed on the liver surface and the resection line was marked.Throughout the course of parenchymal transection,IOTU was performed repeatedly to guide the resection line,and ensure the complete removal of the tumor.After meticulous hemostasis of the resection surface,the diaphragm was closed. A thoracic drain was left. Results Thoracoscopic hepatectomy succeeded in all 3 cases,the median total operating time was 150 min (110 -210 min),and the medianblood loss was 297 ml (130 -600 ml). Patients recovered quickly and had no major post-operative complications.During 9 to 42 months' follow-up,one patients died of other cause,no relapse of the diseases was found. Conclusions Thoracoscopic hepatectomy is a safe and feasible operation in selected patients and has advantages in post-operative morbidity and in hospital time.

Objective:To investigate the expression of miR-92a in colorectal cancer (CRC) and its effect on the regulation mechanisms of tumor angiogenesis. Methods:The miRNA-92a expression in 25 CRC tissues and HT29, SW620, SW480, and HCT116 CRC cells was detected using quantitative real-time polymerase chain reaction. The CD31 positive expression of blood microvessels in CRC tissues was measured by immunohistochemistry. Pearson correlation analysis was used to analyze the relationship between miR-92a and tu-mor angiogenesis. The miR-92a mimic or inhibitor was transfected into HCT116 and SW620 cells in vitro to upregulate or downregu-late the miR-92a expression. The effect of miR-92a overexpression or suppression on the formation of human umbilical vein endotheli-al cell (HUVEC) tubules was detected by tube formation assay. Changes in phosphatase and tensin homolog (PTEN) protein expression were measured by Western blot. Results:The expression level of miR-92a in CRC tissues was significantly higher than that in matched adjacent tissues (P<0.01). The expression levels of miR-92a in HT29, SW480, SW620, and HCT116 colon cancer cell lines were signifi-cantly higher than that of the normal colorectal epithelium control (P<0.05). The number of CD31 positive expression of microvessel density (MVD) in CRC tissues was significantly higher than that in adjacent tissues (P<0.01), and the miR-92a expression level was posi-tively correlated with the MVD in CRC tissues (r=0.580, P=0.01). The cell culture supernatant of HCT116 with miR-92a overexpression could significantly promote the formation of HUVEC tubules (P<0.05). The upregulation of miR-92a expression could significantly inhib-it the expression of PTEN protein in CRC cells (P<0.01). Conclusion:The miR-92a was highly expressed in CRC cells and tissues, which was closely related to the formation of tumor angiogenesis in CRC. The miR-92a could promote tumor angiogenesis in CRC by inhibit-ing PTEN expression.

Objective To retrospectively investigate the causes , location and the duration of hospital stays of the hospitalized patients with hard-to-heal wounds so as to provide data guidance for the prevention and research of these diseases. Methods Clinical data of hospitalized patients with hard-to-heal wounds in plastic surgery center of General Hospital of Guangzhou Military Command were collected from June , 2011 to December, 2013. Whether ulceration was recovered in the patients with skin tissue defect after 2 months treatment was regarded as the standard to screen the patients with hard-to-heal wounds. The causes , location, age and the duration of hospital stays of the hospitalized patients with hard-to-heal wounds were investigated by retrospective case-control method. Chi-square test and t-test were used in analyzing the investigation. Results 2 136 cases, aged from 20 to 86, were treated in plastic surgery center of the hospital. 120 cases have hard-to-heal wounds, which constituted 5.62% of all hospitalized patients. (1) Metabolic disease was the main causes of wound (43.3%), followed by wound infection and tumor (20.0% for each) (χ2 = 62.917, P < 0.01). ( 2 ) The peak age for patients with hard-to-heal wounds was 40 to 60 years old patients , followed by patients′age from 60 to 80 years. (3) The mostly like hard-to-heal wounds was on limbs (61.6%), especially on the foot (38.3%) (χ2 = 17.546, P = 0.002). (4) The average days for hospitalization of in the plastic surgery center were (7.41 ± 8.98), while the average days for hospitalization of the patients with years were (33.21 ± 28.27)(t = -9.968, P < 0.05). Conclusion The average diagnostic age of patients with hard-to-heal wounds is the middle and old aged patients. Chronic skin ulcers, which often occurs in a limb, seriously affects a person′s ability to move , which can prolong hospital stays , causing serious burden for the families of patients and the society.