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 evaluate the feasibility and clinical value of color Doppler flow imaging(CDFI) guided inferior vena caval filter insertion(IVCFI). Methods Thirty-one consecutive patients with unilateral lower extremity deep venous thrombosis were selected for IVCFI. Screening CDFI was performed in all the patients. Locations of renal veins (RV),maximum diameter of the inferior vena cava (IVC),and presence or absence of thrombus were documented. If visualization was adequate,IVCFI was performed under guidance of CDFI. CDFI and abdominal plain film of radiograph were used to document proper deployment,and circumferential engagement of the filter struts in the IVC wall. Also,CDFI was repeated each one month to assess IVC filter migration,thrombus adherent to the filter,and IVC patency. Results CDFI visualization was adequate in thirty-one patients(100%) and the average diameter of IVC was 19.7 mm. Thirty-one VenaTech IVC filters were placed without technical difficulty. No technical complication occurred in all the patients. Follow-up examination showed that no filter uncompleted opening and migration and no IVC thrombus were observed. Seven cases (29%) with embolus trapped by IVC filter were found. There had been no report of pulmonary emboli after IVCFI. Conclusions Placement IVC filter is feasible and safe with CDFI. CDFI-guided IVCFI substantially reduces the procedural cost and avoids the need for radiation exposure and intravenous contrast.

Objective To assess long-term outcomes of electrocoagulation for treating varicose veins of the lower extremities. Methods A retrospective review was made on clinical data of 426 cases of varicose veins of the lower extremities treatd by electrocoagulation from October 1996 to October 2001.Postoperative follow-ups were carried out with clinic checkups or questionnaires.Results Of the 426 cases,follow-ups for 4~9 years(mean,5.8 years) were completed in 364 cases(500 limbs) and a loss to follow-up was encountered in 62 cases,the follow-up rate being 85.4%.The cumulative rate of recurrent varicose veins was 10.4%(52/500),in which the recurrent varicose veins were cured with sclerosing agents in 50 limbs and with re-operations in 2 limbs.The relief rate of sensation of heaviness and tension was 95.1%(309/325).Accompanying venous ulcers in 20 limbs healed up within 2~8 weeks.The incidences of subcutaneous hematoma and saphenous nerve injury were 0.8%(5/594) and 1.2%((7/594),) respectively.Skin burns happened in 5 limbs(0.8%,5/594). Conclusions Electrocoagulation for varicose veins of the lower extremities is proved to be a novel minimally invasive method,with advantages of safety,effectiveness,low costs,and short hospital stay.

Objective To compare electrocoagulation effects of three types of electrodes for varicose veins.Methods Twelve dogs(24 veins in hind limbs)were randomly divided into 3 groups with 4 dogs in each group:columnar electrode group,circular electrode group,and radial electrode group.Each dog's long saphenous veins were high ligated and electrocoagulated.The activated partial thromboplastin time(APTT)was measured and pathological examinations(HE and Weigert)were performed immediately following operation and on the 7th and the 14th postoperative day,respectively.The destruction depth and extent,residual vessels,and skin burn after electrocoagulation were compared among the three groups.Results One case of skin burn on the left hind limb occurred in the columnar electrode group.Immediately following the operation,the number of vessels that were destroyed beyond 50% of perimeter in the radial electrode group was 8,which was significantly higher than that in the columnar electrode group(3 vessels)and the circular electrode group(4 vessels)(Fisher's exact test,P=0.013 and 0.038),and the number of vessels that were destroyed deep to the meddle membrane in the radial electrode group was 1,which was significantly lower than that in the columnar electrode group(7 vessels)and the circular electrode group(6 vessels)(Fisher's exact test,P=0.005 and 0.020).On the 7th day after operation,there was no statistical difference among the 3 groups in the number of vessels with remnant area above 50% of the perimeter(?2=5.371,P=0.068).On the 14th day after operation,the number of vessels with remnant area above 50% of the perimeter in the radial electrode group(1 vessel)was significantly lower than that in the columnar electrode group(7 vessels)and the circular electrode group(6 vessels)(Fisher's exact test,P=0.005 and 0.020).There was no statistical difference among 3 groups in APTT immediately following operation and on the 7th and the 14th postoperative day(P=0.905,0.871,and 0.865).Conclusions Compared with the other two catheters,radial electrode has the largest destroyed area,the smallest remnant area of the vessel,and the lowest risk of skin burn.

Objective To summarize the clinical application of the Tempofilter Ⅱ temporary caval filter.Methods The Tempofilter Ⅱ temporary caval filter was employed in 24 patients from April 2002 to August 2006.Before the implantation,we performed color ultrasonography to detect the extent of thrombus and the situation of inferior vena cava,renal vein,and access vein(right internal jugular vein).Under the guidance of color ultrasonography and X-ray fluoroscopy(free of contrast agent),the temporary filter was placed in the inferior vena cava distal of the renal vein orifice through a guide wire by using the Seldinger technique.Results The filter was successfully implanted and removed in all the 24 patients.The duration of placement was 5 days～6 weeks(mean,16.8 days).Filter thrombosis occurred in 4 patients at 3 days ～ 2 weeks after operation.The thrombi(

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.