Objective To evaluate the investigation outcome of eliminating iodine deficiency disorders(IDD)in Ya'an city of Sichuan province,and to master the current situation of IDD in the whole city.Methods In 2009,according toCounties'Assessment Guideline in Sichuan for Implementing the Measure to Eliminate Iodine Deficiency Disorders,assessments were conducted.At county level,composite score was given to collected data of the eight counties(districts)and monitoring data of household iodized salt were statistically analyzed.A township (town)was randomly selected by east,west,south,north and center locations,respectively.One primary school was randomly selected in each selected township(town),eighty children aged 8 to 10 in each selected school were checked of their thyroid by palpation(WS 276-2007)and urinary iodine level of20 children among them was measured by As3+_Ce4+ catalytic spectrophotometry(WS/T 107-2006).Thirty fifth-grade students and 10 housewives lived around school were asked to take a questionnaire survey.Results Average score of the 8 counties(districts)was 89.96,ranged from 85.42 to 92.90.The coverage rate of iodized salt of household was 100.00%(2328/2328),rate of qualified iodized salt was 97.98%(2281/2328).and consumption rate of qualified iodized salt reached 97.98%(2281/2328).The goiter rate of children aged 8-10 was 0.91%(33/3620),median urinary iodine was 235.85μg/L,and 1.50%(12/800)of child's urinary iodine was less than 50μg/L.The rate of passing a knowledge questionnaire survey of the fifth-grade students and women was 92.33%(1 131/1225)and 9413%(397/421),respectively.Conclusions Ya'an city in Sichuan province has reached the goal of eliminating iodine deficiency.disorders,but there is a coexist trend of IDD and iodine excess.They should pay attention to the daily consumption of iodized salt in the future;sustained elimination of IDD can be reached only by iodine supplementation scientifically.

Objective To explore the dose and effects of mixtures of pethidine and haloperidol for Postoperative Deliri-um. Methods Retrospective analysis was conducted on treatment dose and effects of 85 cases of patients with deliri-um during narcotic awake period or 1 day to 2 days after operation by mixtures (haloperidol with pethidine) from 2005 to 2006 in Affiliated Hospital of Hainan Medical College. Results 1/4 dose of mixture (pethidine 100 mg and haloperidol 5 mg) cured 9 patients, 1/2 dose of mixture cured 61 cases, we add 1/4 dose of mixture when 10 cases occurred delirium again ,5 cases added 1/2 dose of mixture again, all were cured. After administration ,aublood pres-sure declined all, but all were within normal range, the 17 cases's pulse oxygen saturation is less than 95%, Conclu-sion The mixture (haloperidol with pethidine) can be effective treatment for delirium during awake period of general anesthesia or after operation. However, application of low dose therapy from the beginning, and attention to its impact on respiration.

Background and purpose:The morbidity and mortality of lung cancer are currently the highest malignant tumor in China and the world. Most onset age of the illness is after 60 years old. Therefore, surgical resection of lung cancer in the elderly is very worthy of concern. This study aimed to investigate the clinical features, epidemic characteristics and conditions in perioperative period between the elderly and middle-aged patients with lung cancer, and provide the reference for clinical treatment.Methods:Totally 1 019 patients with lung cancer who were admitted to the hospital and accepted the operations in department of thoracic surgery in Shanghai Pulmonary Hospital from Jan. 2007 to Dec. 2012 were analysed retrospectively. The clinical data including gender, pathological type, TNM stage, intraoperative amount of bleeding and post-operative length of hospitalization were compared.Results:There was a signiifcant difference in sexual factors between these two groups (P?0.05), and compared with the middle-aged group, the proportion of male was more higher in the elderly group (76.91%vs 52.81%). Adenocarcinoma was the most common and squamous carcinoma was the next in both two groups. The constituent ratio of the pathlogical type between the elderly group and the middle-aged group was statistically signiifcant (P?0.05). The squamous carcinoma in the elderly group was higher than that in the middle-aged group (37.5%vs 15.6%). On the contrary, adenocarcinoma was more common in the middle-aged group (72.8%vs 50.7%). StagesⅡa,Ⅱb, andⅢa were more common in the elderly group and stagesⅠa, andⅠb were the most clinical stage in the middle-aged group. The clinical stage between two groups was statistically significant (P?0.05).The intraoperative amount of bleeding was higher and the post-operative length of hospitalization was longer in the elderly group, with a signiifcant difference as compared with that in the middle-aged group(P?0.05). And there was a signiifcant difference in incidence of accompanying diseases between the two groups, compared with the middle-aged group, the proportion of accompanying diseases was more higher in the elderly group(58.6%vs42.3%).Conclusion:Elderly patients with lung cancer are more common in males, with adenocarcinoma being the most common. The cancer mostly belongs to a medium or advanced stage. Elderly patients have the trend with more amount of bleeding in operation and lengh of stay.

10.3969/j.issn.1000-3606.2013.06.003

Objective To investigate the effects of Thomas solution in combination with nitroglycerine of different concentrations on rat cardiac preservation for 8 h. Methods Thirty Wistar rats were selected,and Langendorff heart perfusion models were established.Rats were randomly divided into Thomas solution group,Thomas solution+4?10-6 mol/L nitroglycerine group and Thomas solution+4?10-5 mol/L nitroglycerine group(n=10).After hypothermic preservation(4 ℃)for 8 h,the cardiac function of each group was determined.Tissues of left ventricular wall were obtained,and changes of myocardial ultrastructure were observed by electron microscopy. Results Compared with Thomas solution group,the cardiac function was significantly improved and the myocardial ultrastructure injury was less severe in Thomas solution+4?10-5 mol/L nitroglycerine group after hypothermic preservation(4 ℃)for 8 h,while there was no significant difference in myocardial ultrastructure injury and cardiac function between Thomas solution group and Thomas solution+4?10-6 mol/L nitroglycerine group. Conclusion Thomas solution in combination with 4?10-5 mol/L nitroglycerine can significantly improve the preservation effects for isolated hearts in rats.

Objective To explore the expression and regulatory mechanism of hypoxia inducible factor-1?(HIF-1?)during fracture healing. Methods Mouse models of tibia fracture healing were established,and callus samples were collected 1,3,7,14,21 and 28 days after fracture.The development of callus and new bone formation were evaluated with roentgenology,Micro-CT and tetracycline double labeling method,and the expression of HIF-1?,vascular endothelial growth factor(VEGF),Runx2 and ALP in callus were detected with RT-PCR,Western blotting and immunohistochemistry.The relationship between HIF-1? and fracture healing was analysed. Results The expression of HIF-1? was detected in cells in the fracture sites as well as in evolved osteoblasts,chondrocytes and osteocytes in early callus under hypoxia.The highest expression rate of HIF-1? achieved on the 7th day after fracture,lasted for about 7 days,then decreased gradually,and returned to intact level on the 28th day after fracture.The expression tendency of VEGF resembled that of HIF-1?.Bone formation activity was more active in early callus,and the callus volume peaked on the 14th day after fracture and decreased gradually.The mineralization of callus mainly took place in the late healing period(14th to 28th day after fracture).Conclusion Cells involved in fracture healing are hypoxia-responsive cells,which express HIF-1?.HIF-1? can regulate cell state and function,and can promote angiogenesis so as to play a crucial role in fracture healing.

OBJECTIVETo discuss arthroscopic technique of single Kirschner wire and suture avoiding epiphyseal line fixation for tibial intercondylar eminence fracture and its clinical results.

METHODSFrom May 2008 to December 2012, 21 patients (13 males, 8 females, ranging in age from 6 to 14 years old) with tibial intercondylar eminence fracture were treated arthroscopically with single Kirschner wire and suture avoiding epiphyseal line fixation technique. According to Meyers and McKeever classification, 7 patients were type II, 10 patients were type III, and 4 patients were type IV. Active rehabilitation began at one week after operation. The patients were followed up for 10 to 30 months. X-ray films were taken to evaluate fracture healing at 1, 3, 6 months after operation; range of motion, the anterior drawer test, the lachman test and the Lysholm knee score were used to evaluate clinical effects.

RESULTSAll fractures were healed without displacement at 6 weeks after operation. Anterior drawer test and the lachman test were both negative in all patients at 3 months after operation. Lysholm knee score was 95.5 ±2.5 at 6 months after operation, and postoperative X-ray film did not find epiphyseal line broadening or narrowing.

CONCLUSIONArthroscopic treatment for tibial eminence intercondylar fracture with single Kirschner wire and 8-shaped suture avoiding epiphyseal line fixation technique has many advantages, such as firm fixation,early mobilization, less invasive, less injury of physis and satisfactory effect.

Adolescent ; Arthroscopy ; Bone Wires ; Child ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Sutures ; Tibial Fractures ; surgery

Objectiye To observe the prevalence of prolonged seizures and the changes of biochemical markers of myocardial injury in patients with prolonged seizures after modified electroconvulsive therapy(MECT).Methods Patients treated with MECT or simulated ECT were divided into three groups.Group Ⅰ , 26 patients,experienced at least one prolonged seizure after MECT;group Ⅱ,41 selected patients, had not prolonged seizures at all during a course of MECT treatments and group Ⅲ, 31 patients, received simulated ECT.Biochemical markers of myocardial injury, including phosphocreatine kinase (CK), MR isoenzyme of phosphocreatine kinase (CK-MB), lactate dehydrogenase ( LDH ), α-hydroxybutyrate dehydrogenase ( α-HBDH ) and cardiac troponin (cTnT) ,were measured immediately, 3 hours later and on the following day after the first prolonged seizure for group Ⅰ ,the same time points as group Ⅰ after the first treatment of MECT for group Ⅱ , immediately after simulated ECT for group Ⅲ.These indexes were compared between the patients of three groups.Results The positive rate ofcTnT was 30.8%(8/26) and 17.1% (7/41)in group Ⅰ and Ⅱ respectively, but no difference was found(P＞0.05 ).CK measured immediately after MECT in patients of group Ⅰ was significantly higher than that of group Ⅲ(P ＜ 0.05 ).CK-MB (immediately), LDH ( immediately and 3 hours later) and α-HBDH ( immediately, 3 hours later and on the following day) in patients of group Ⅰ were significantly higher than those of group Ⅱ and Ⅲ measured after MECT or simulated ECT(P＜0.05 ).Conclusion More attention should be paid that absolute or relative hypoxemia may lead to minor myocardial injury.

BACKGROUND:A large amount of studies have confirmed that synovial mesenchymal stem cells have the similarity in cellmorphology, immune phenotype, colony forming ability and differentiation potential with bone marrow mesenchymal stem cells. But bone marrow mesenchymal stem cells are better than synovial mesenchymal stem cells in the ability to differentiate into cartilages. OBJECTIVE:To discuss the possibility of using synovial mesenchymal stem cells as seed cells for meniscal tissue engineering. METHODS:The synovial mesenchymal stem cells were isolated from rabbit synovial tissues with limiting dilution monoclonal culture method, and then the cells were purified. The morphology, ultrastructure, molecular phenotype, proliferation kinetics, karyotype and tumorigenicity of the in vitro cultured cells were analyzed. RESULTS AND CONCLUSION:The synovial mesenchymal stem cells isolated from the rabbit synovial cells had high proliferation capacity during in vitro monolayer culture. The synovial mesenchymal stem cells grew to peak at 6 days, and the doubling time was (30.2±2.4) hours. Flow cytometry results showed the synovial mesenchymal stem cells could express some molecular makers of mesenchymal stem cells, such as CD44 and CD90. DNA contents check, karyotype test and oncogenicity test confirmed isolated and purified synovial mesenchymal stem cells were the normal diploid cells without tumorigenicity, so the cells can be used as seed cells for meniscal tissue engineering.

Objective To investigate the feasibility and safety*with the low dose fentanyl for valve replacement fast track cardiac anesthesia. Methods 40 cases with cardiac valve replacement were divided into two groups,group Ⅰ :20 cases with fast track anesthesia,group Ⅱ :20 cases with large dose fentanyl anesthesia. The blood presure, HR, SpO2, CVP,Temperature, airway pressure were observed at different time points. The postoperative extubation time,ICU stay,hospital stay,postoperative pulmonary complications were recorded. Results The fentanyl(μg/kg) of group Ⅰ (23. 25 ± 1.32) was less than that of group Ⅱ ( 35.75 ± 6. 84) ( P < 0. 05 ); Extubation time (hours), ICU stay ( hours),length of stay (days) were ( 7.92 ± 3. 16), (25. 12 ± 7.50), ( 28.50 ± 8. 94 ) in group Ⅰ , and that were (13.70±5.63) ,(37.53 ±13. 19) ,(38.00 ± 12. 90) in group Ⅱ. The group Ⅰ were shorter than the group Ⅱ ,P<0. 05; There were four cases of lung infection in group Ⅱ, no one in group Ⅰ ( P < 0. 05 ); There were significant differences between the two groups. There were no significant differences in the remaining observations. Conclusion The low dose fentanyl anesthesia for fast track anesthesia in heart valve replacement surgery was reliable and safe;It could help to reduce postoperative extubation time, ICU stay time and hospital stay time and reduce postoperative pulmonary complications and hospital costs.