Objective By X-ray measurement of metacarpal and phalange bones in the right hand of adult patients with Kaschin-Beck disease in Qinghai Province,to provide anatomic data and information for clinic diagnosis of the disease and application of hand surgery.Methods Fifty-four cases of adult patients with Kaschin-Beck disease,who came from Guide County and Xinghai County in Hainan Prefecture,Qinghai Province,were selected as investigation subjects,then their right hand X-ray film were taken,metacarpal and phalange bones were measured by electronic digital vernier caliper.All data were analyzed with SPSS 19.0.Results The axis length of the metacarpal bones was in the order of:the 2nd metacarpal ＞ 3rd metacarpal ＞ 4th metacarpal ＞ 5th metacarpal ＞ first metacarpal.The axis length of proximal phalange bones was in the order of:the middle finger proximal ＞ ring finger proximal ＞ index finger proximal ＞ little finger proximal ＞ proximal thumb,while the middle,distal phalanx axis length varied greatly.The length of metacarpal and phalange bones of all male was longer than that of female(all P ＜ 0.01).The width of the metacarpal bones was in the order of:the 2nd metacarpal ＞ 3rd metacarpal ＞ 5th metacarpal ＞ 4th metacarpal.The width of the 2nd-5th metacarpal of male and female was (8.57 ± 0.90),(8.25 ± 0.80),(6.84 ± 0.69),(7.70 ± 0.77)mm and (7.40 ± 0.74),(7.36 ± 0.70),(6.00 ± 0.57),(6.62 ± 0.65)mm,respectively,the differences were significant(t =5.24,4.32,4.85,5.55,all P ＜ 0.01).The matacarpal bone index of female[(8.23 ± 0.90)mm] was significantly larger than that of male[(7.61 ± 0.76)mm,t =2.73,P ＜ 0.01].Conclusion X-ray measurement of hand may provide reference information for diagnosis of Kaschin-Beck disease and determination of metacarpal and phalange length in hand surgery.

Objective By investigating newly diagnosed Kashin-beck disease,to understand distribution range,epidemic intensity and prevalence trend of Kashin-Beck disease(KBD)in Xinghai County.Method According to monitoring method on national KBD,we carried on epidemical investigation,clinical examination and X-ray photograph on school children aged 7-13 years in 6 villages from 4 towns in Xinghai County,and hair,grain,water and soil were sampled to detect selenium content using naphthalene fluorescence.Resuit Three hundred and seventy.three school children aged 7-13 years underwent the clinical examination,the prevalence rate was 12.06%(45/373);347 school children were went on X-ray,the detection rate of X-ray was 21.61%(75/347).The selenium content was the lowest in Quanqu Village,Ziketan Town,which were(77.70±42.04),(7.44±6.93)μg/kg respectively;the selenium content Was highest in Cainaihai Village,Qushian Town,which were(103.88±58.57),(29.58±24.11)μg/kg respectively;level of in internal and external environment in 4 KBD region were all low.Conclusion These four region are new KBD region.The prevalence state of KBD is serious,pathogenetic factor of Kashin-Beck disease is very active.

Cell Proliferation ; drug effects ; Cells, Cultured ; Epidermis ; cytology ; drug effects ; Humans ; Polychlorinated Dibenzodioxins ; pharmacology

BACKGROUNDMediastinoscopy has experienced a renaissance due to the introduction of neoadjuvant treatment protocols and recognition of the limitations of noninvasive mediastinal staging of lung cancer by CT and PET. The aim of this study is to determine the value of video-mediastinoscopy in mediastinal staging of lung cancer.

METHODSA total of 60 patients who underwent video-mediastinoscopy for known or suspected lung cancer were retrospectively reviewed. There were 52 cervical mediastinoscopies, 2 parasternal mediastinoscopies and 6 combined procedures. All the patients were found to have enlarged mediastinal lymph nodes on radiographic examination of the chest (more than 1.0cm on its shortest axis).

RESULTSOf the 60 patients, 42 patients were found with N2 or N3 disease on video-mediastinoscopy and then were confirmed pathologically. The other 18 mediastinoscopy-negative patients underwent thoracotomy for pulmonary resection and mediastinal lymph node dissection in the same operative session, in which thoracotomy-proven N0 was found in 17 patients, and N2 in 1 patient (false-negative result by video-mediastinoscopy). The sensitivity, specificity, and accuracy of video-mediastinoscopy for mediastinal staging of lung cancer were 97.7%, 100% and 98.3%, respectively. In the entire group of 60 patients, there was 1 complication (1.7%) , and no perioperative death.

CONCLUSIONSVideo-mediastinoscopy is a highly effective and safe procedure. It can be used routinely in mediastinal staging of lung cancer.

Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; virology ; Male

Objective To explore the relationship among professional commitment, learning burnout and academic self-efficacy of undergraduate nursing students. Methods 506 undergraduate nursing students were investigated with the three Questionnaires of college students: professional commitment questionnaire, learning burnout inventory and academic self-efficacy scale. Results The scores of affective commitment, ideal commitment, normative commitment and continued commitment of the undergraduate nursing students were (28.229 ± 5.327), (20.348 ±4. 507), (19. 405 ± 3. 730), (18. 148 ± 2. 954) and( 86. 130 ± 13. 421), respectively. And the scores of depression, misconduct, low sense of accomplishment, total bumrnut of the undergraduate nursing students were(21.733 ±5.338), (18.459 ±3. 918) , (17.083 ±3. 596)and(57. 275 ±9. 766) , respectively. As well as the scores of learning ability of self-efficacy, learning behavior of self-efficacy and total self-efficacy were(35.765 ±5.835), (35.247 ±4.840)and (71.012 ±9.659), respectively. The affective commitment,ideal commitment and normative commitment of professional commitment were negatively correlated with the dimensions of learning bumout. And the continued commitment was significant correlated with the low sense of accomplishment. Otherwise, the dimensions of professional commitment were positive correlated with the dimensions of academic self-efficacy. However, the dimensions of academic self-efficacy were significant negative correlated with the dimensions of learning burnout (P＜ 0. 01). Conclusions The professional commitment, learning bumout of undergraduate nursing students are closely related with the academic self-efficacy of undergraduate nursing students. The higher the levels of professional commitment and academic self-efficacy are, the lower the level of learning bumout is.

Objective To evaluate the correlation between fluid balance and myocardial function and the mortality in patients with septic shock.Methods Ninety two septic shock patients enrolled between January 2013 and January 2015 were divided into survival group and non-survival group based on 28-day mortality.Fluid balance,haemodynamic parameters and B-type natriuretic peptide (BNP) were collected on days1,3,7 after admission.Results Forty four patients survived the crisis while 48 died.The 7 day average fluid balance volume in survival group was lower than those in non-survival group [(55 ± 9)ml/kg vs.(187 ± 14)ml/kg,t =54.260,P ＜0.01].The initial left ventricle ejection fraction (LVEF) in survival group was lower than that in non-survival group [(42％ ±4％) vs.(54％ ±6％),t =10.100,P ＜0.01].Serum BNP level was significantly lower than those in non-survival group [(267 ± 54) ng/L vs.(681 ± 22) nig/L,t =48.580,P ＜0.01].Multivariate logistic regression analysis showed that fluid positive balance,LVEF and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) were the independent predictors for 28 day mortality (P ＜ 0.05).Conclusions Fluid balance and myocardial function can serve as risk predictors for septic shock patients.

Objective To report an improved method, color-ultrasonography-guided inferior vena cava (IVC) filter placement, for preventing the pulmonary embolism (PE) caused by the deep venous thrombosis (DVT). Methods Color-ultrasonography-guided IVC filter insertion was performed in 9 patients with DVT of lower limb, 1 of which also had PE accompanied with at the time of admission. Out of the 9 patients, 5 patients underwent embolectomy immediately after the filter placement while the other 4 patients were treated conservatively. Results The placements were all completed successfully. Follow-up observations for 1～7 months (mean 2 months) found no complications or occurrence of PE. No recurrence of PE was found in the patient already with PE. Conclusions The color-ultrasonography-guided IVC filter placement can effectively prevent PE caused by DVT. The method is suitable for severe, immovable patients, as well as patients with renal insufficiency and being allergic to intravenous contrast, and is safe, convenient, cheap and prone to popularization.

Objective To evaluate the efficacy and value of mediastinoscopy in the diagnosis of superior vena cava obstruction syndrome (SVCOS). Methods 12 patients with SVCOS underwent mediastinoscopy. This group consists of 9 males and 3 females aged 16 to 71 years. 7 cervical mediastinoscopies and 5 parasternal mediastinoscopies were performed. Results In eleven patients, definite pathological diagnosis was obtained, included: primary lung cancer in 8, lymphoma in 3 and invasive thymoma in 1. There were no operative morbidity and mortality. Only in 1 patient with lymphoma the symptom got worse after cervical mediastinoscopy and soon released by chemotherapy. Conclusion Mediastinoscopy is an effective method in the diagnosis of SVCOS.It can be considered as a routine procedure if other methods failed.

Objective To investigate the effective predictors of response in HBeAg-positive patients treated with adefovir dipivoxil(ADV)and to provide evidence for individualized treatment.Methods Patients administered with ADV for 48 weeks in a randomized,placebo-controlled,multicenter trial were studied.Statistical analyses,such as Backward stepwise logistic regression and 2?2 method were used for predictors analysis at week 48.Results The baseline serum ALT levels,HBV DNA levels,and undetectable serum HBV DNA by PCR at week 24 were predictors for HBV DNA negativity at week 48.The median of serum ALT levels and HBV DNA levels prior to treatment were 134.5 U/L and 6.57 lg copies/mL,respectively.Patients with baseline ALT levels higher than the median,HBV DNA levels lower than the median,and serum HBV DNA undectectable by PCR at week 24 had greater rate of HBV DNA negativity(93.3%),HBeAg loss(60%)and HBeAg seroconversion(40%)at week 48 than the others.47.8% of patients whose HBV DNA levels were positive at week 24 also achieved HBV DNA negativity at week 48,and 8.6% achieved HBeAg seroconversion.Conclusion Better response at week 48 has significantly higher serum ALT levels and lower HBV DNA levels prior to treatment and HBV DNA negativity at week 24 compared with non-response.Patients whose HBV DNA levels ware still positive at week 24 should continue therapy.