Objective To investigate the incubation period, degree of injury, distribition of pathological changes, and therapeutic effect of eye injury in “8?4” mustard gas poisoning accident. Methods The relationships among contact pattern, contact time and incubation period and degree of injury were analyzed, and the distribition of pathological changes and therapeutic effect were assessed. Results An incubation period was found in eye injury after the exposure to mustard gas. It varied with the mode of contact and the time of exposure to the gas. The conjunctiva was the main site of injury, follwed by the eyelid, and then the cornea and the iris. Conclusions The length of the incubation period varied with the degree of injury and contact time and mode. Thorough washout and medicinal intervention should be instituted as early as possible.

Objective To evaluate the effects of continuous femoral nerve block combined with in?filtration anesthesia on postoperative analgesia in the patients undergoing total knee arthroplasty. Methods Ninety patients, aged 50-80 yr, weighing 45-90 kg, of ASA physical status Ⅰ-Ⅲ, scheduled for elective unilateral total knee arthroplasty, were randomly divided into 3 groups ( n=30 each) using a ran?dom number table: continuous femoral nerve block + infiltration anesthesia group ( group A); continuous femoral nerve block group ( group B); continuous femoral nerve block + single sciatic nerve block group ( group C) . The femoral nerve was catheterized for block before induction of general anesthesia in the three groups, and then a single sciatic nerve block was performed in group C. In group A, 20 ml mixture was in?jected into the posterior part of the joint capsule before prosthesis implantation, and 20 ml mixture was in?jected around the collateral ligaments and incision sites after prosthesis implantation and before closing. The mixture included ropivacaine 2?5 mg∕ml, fentanyl 2?5 μg∕ml, and methylprednisolone 1 mg∕ml. In group B, 40 ml of normal saline was given as the method previously described in group A. Patient?controlled anal?gesia with 0?2% ropivacaine 250 ml was used for postoperative analgesia, lasting for 48 h. The patient?con?trolled analgesia pump was set up with a 5 ml bolus dose, a 30 min lockout interval and background infusion at a rate of 5 ml∕h. Tramadol was used as rescue analgesic and was given orally to maintain the VAS score ≤ 5. VAS scores at rest were recorded at 4, 8, 12, 24 and 48 h after surgery, and VAS scores during activity were recorded at 8, 12, 24 and 48 h after surgery. The total consumption of tramadol within 48 h after surgery was recorded. The motor function of the affected extremity was assessed and scored at 12, 24 and 48 h after surgery, and the sensory and motor function was evaluated at 72 h after removal of the catheter. The occurrence of bleeding or exudates from the site of catheterization and adverse effects were recorded. Results Compared with group B or C, VAS scores at rest at 4-24 h after operation, VAS scores during activity at 8-24 h after operation, and the total consumption of tramadol were significantly de?creased in group A. Compared with group B, no significant changes were found in motor block score of the affected extremity in group A. Compared with group C, the motor block score of the affected extremity was significantly decreased in A and B groups. There were no significant differences in the incidence of bleeding or exudates from the site of catheterization and nausea and vomiting between the three groups. Conclusion Continuous femoral nerve block combined with infiltration anesthesia can provide sufficient analgesia with?out influencing the recovery of sensory and motor function, and the safety is good for the patients undergoing total knee arthroplasty.

Objective To investigate the value of laboratory testing in kidney diseases and to assess whether these marks can predict the renal histological lesions for screening the best clinical test combination.Methods The main clinical data,pathological types and laboratory examination indexes in 117 patients with renal biopsy in our hospital from December 2010 to March 2014 were collected and graded according to the WHO renal pathological classification standard and the Katafuchi semi-quantitative score standard classification (Ⅰ,Ⅱ,Ⅲ,Ⅳ).The differences in serum CysC,urine NAG,urine alpha 1-MG,urine mAlb and 24 h urine total protein (24h-UTP)level were compared among the various groups and their relations with the glomerulus was analyzed;the correlation and the statistical significance of each index in different groups was analyzed.Results NAG,alpha 1-MG and CysC had statistical differences between in the grade Ⅳgroup and the gradeⅠ,Ⅱ,Ⅲ groups (P <0.05),24h-UTP and mAlb had significant correlation in reflecting the kidney diseases (r=0.565,P =0.000);NAG and alpha 1-MG also had significant correlation in reflec-ting renal tubular interstitial disease (r=0.509,P =0.000).Conclusion The detection results of various detection indicators when rising to a certain height can be used for judging the progression of the patients clinical and pathological condition,illustrating the serious condition of illness;at the same time according to the correlation among the indexes and the detection efficiency,three indi-cators of Cys C,mAlb,alpha 1 - MG are screened out for conducting the combination detection,the detection efficiency could be greatly improved.

Objective To explore diagnostic value of MR perfusion weighted imaging(PWI)on complications and tumor recurrence in hypopharyngeal and laryngeal cancer after operation and radiotherapy. Methods MR PWI was performed in 31 patients with hypopharyngeal and laryngeal cancer who suffer from tumor recurrence, granulation or infection after operation and radiotherapy. Blood flow (BF), blood volume(BV), mean transit time(MTT) and time to peak (TTP) values were measured in the lesions. Analysis of variance and pair-wise comparison of q test were used for statistical analysis. Results Eleven cases with tumor recurrence,11 case with granulation tissues, 9 cases with infection were confirmed by pathological examinations. Average BF, BV, MTT and TTP values of recurrent tumors were (145.1 ± 29.3)ml · 100 g-1 · min-1,(14.2 ± 3.2)ml · 100 g-1,(5.4 ± 0.6)s,(13.7 ± 1.3)s respectively;Average BF, BV MTT and TTP values of granulation tissues were(109.1±27.4)ml·100 g-1·min-1,(11.1±1.7)ml·100 g-1,(7.7±1.0)s, (19.8 ± 2.1)s respectively;Average BF, BV, MTT and TTP values of infectious tissues were(86.9 ± 7.7)ml · 100 g-1·min-1,(8.8±1.0)ml·100 g-1,(8.0±0.9)s,(19.7±1.3)s respectively. Average BF and BV values of the recurrent tumors group were higher than those of the granulation(q=4.89, 4.64 respectively,P<0.01)and infection group(q=7.52,7.71 respectively,P<0.01)respectively. Average BV values of granulation group was higher than that of the infection group(q=3.31,P<0.05), Average MTT and TTP values of recurrent tumor group were lower than those of the granulation (q=9.38, 12.48 respectively,P<0.01)and infection group(q=9.77, 11.53 respectively,P<0.05). There were no significant difference in average BF, MTT and TTP between the granulation and infection group. Conclusion MR PWI can be helpful in the diagnosis of complications and tumor recurrence in hypopharyngeal and laryngeal cancer after operation and radiotherapy.

Objective To compare the effect of three β-thalassemia prenatal screening strategies in Guangdong province. Methods A total of 13 284 hospital-delivered couples and 13 369 newborns were recruited from 91 hospitals in 21 counties or districts of Guangdong province from June to December 2012. Mean cell volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin A2 (Hb A2) were tested for all the couples, and all the couples and newborns were detected by 17 types ofβ-globin gene mutations. The effect of three β-thalassemia prenatal screening strategies were compared as following:(1) MCV/MCH with Hb A2 serial screening(SS):Hb A2 was tested if the woman′s MCV<82 fl and(or)MCH<27 pg. If the woman′s Hb A2>3.5, it meant positive. And if the woman wasβ-thalassemia carrier and her husband′s Hb A2>3.5, it meant couple positive. (2) MCV/MCH with Hb A2 parallel screening(PS):if the woman′s MCV<82 fl and (or) MCH<27 pg and(or) Hb A2>3.5 pg, it meant couple positive. And the husband would be tested forβ-globin gene mutations if the woman was β-thalassemia carrier. (3) MCV/MCH with Hb A2 serial screening for couples(SSC):if one of the couple or both of them had MCV<82 fl and(or) MCH<27 pg, the couple would be tested for Hb A2, and if one of the couple got Hb A2>3.5, it meant couple positive. Results (1) For the SS strategy, the sensitivity was 92.69%(583/629);the specificity was 99.87%(12 638/12 655); the positive predictive value was 97.17%(583/600);and the negative predictive value was 99.64%(12 638/12 684). The results ofβ-globin gene mutations tested showed that the rate ofβ-thalassemia carriers was 4.74%(629/13 284) in the 13 284 pregnant women, and it was 4.29%(570/13 284) in their husbands. (2) The SS strategy detected 27 (0.20%,27/13 284) β-thalassemia carrier couples. For the SS strategy detecting β-thalassemia carrier couples, the missed diagnosis rate was 11.11%(3/27);the sensitivity was 88.89%(24/27);the specificity was 100.00%(27/27); the positive predictive value was 100.00%(24/24); and the negative predictive value was 99.98%(13 257/13 260). (3) When using the SS strategy for 13 369 offsprings, there were 582β-thalassemia carriers (4.35%,582/13 369), including 578 (99.31%,578/582) minorβ-thalassemia, 3 (0.52%,3/582) intermediaβ-thalassemia and 1 (0.17%,1/582) major β-thalassemia. The SS strategy detected 25 fetuses who neededβ-thalassemia prenatal diagnosis. (4) For the PS strategy, the sensitivity was 98.09%(617/629); the specificity was 88.73%(11 229/12 655); the positive predictive value was 30.20%(617/2 043); and the negative predictive value was 99.89%(11 229/11 241). (5) When using the PS strategy for theβ-thalassemia carrier couples, the sensitivity was 100.00%(27/27);the specificity was 95.55%(12 667/13 257);the positive predictive value was 4.38%(27/617);and the negative predictive value was 100.0%(12 667/12 667). (6) The PS strategy detected 28 fetuses who needed β-thalassemia prenatal diagnosis in 13 369 offsprings. (7) For the SSC strategy, the sensitivity was 93.80%(590/629); the specificity was 95.75%(12 117/12 655); the positive predictive value was 52.30%(590/1 128); and the negative predictive value was 99.68%(12 117/12 156). When the SSC strategy was used for the husbands, the sensitivity was 92.28%(526/570); the specificity was 95.27%(12 112/12 714);the positive predictive value was 46.63%(526/1 128); and the negative predictive value was 99.64%(12 112/12 156). (8) When the SSC strategy was used inβ-thalassemia carrier couples, the sensitivity was 100.00%(27/27);the specificity was 91.69%(12 156/13 257);the positive predictive value was 2.39%(27/1 128);and the negative predictive value was 100.00%(12 156/12 156). (9) The SSC strategy detected 28 fetuses who neededβ-thalassemia prenatal diagnosis. Conclusions All the three β-thalassemia prenatal screening strategies had good effect in clinical practice and public health. While in the high-prone area of β-thalassemia, MCV/MCH with Hb A2 parallel screening and MCV/MCH with Hb A2 serial screening for couples stratigies were better.

Objective To investigate the effect of progesterone on the expressions of inflammation-related factors of cortical cyclooxygenase-2 ( COX-2 ),prostaglandin E2 ( PGE2 ),inducible nitric oxide synthase (iNOS) and NF-κB in the cortex after traumatic brain injury (TBI) in rats so as to study the possible molecular mechanism of neuroprotective effect of progesterone on TBI.Methods Fortyfive male Spraque-Dawley rats were enrolled in the study and randomly divided into three groups,ie,sham operation group (n =15),TBI group (n =15) and progesterone treatment group (n =15).The rat model of TBI was duplicated with the improved Feeney' s method.The PROG treatment group was given i.p.injections of progesterone ( 16 mg/kg) at 1 and 6 hours after injury.The rats were sacrificed in three groups at 24 hours after injury and the specimens were removed.The changes of the positive cell numbers and protein level of COX-2,PGE2,iNOS and NF-κB in the cortex were examined by immunohistochemistry and Western blot.Results The positive cell numbers and protein levels of COX-2,PGE2,iNOS and NF-κB in the cortex of the TBI group were distinctly higher than those of the sham operation group (P＜O.05).While the positive cell numbers and protein levels of COX-2,PGE2,iNOS and NF-κB in the cortex of the progesterone treatment group were distinctly lower than those of the TBI group ( P ＜O.05).Conclusions Progesterone may exert protective effect on TBI through inhibiting NF-κB activity,blocking the inflammation response course of NF - κB and iNOS and decreasing the expressions of COX-2 and PGE2.

Objective To compare the effect and cost of three different α-thalassemia prenatal screening strategies used in Guangdong, China, and to provide evidence for α-thalassemia prevention. Methods In total, 13 284 hospital-delivery couples and 13 369 newborns/fetuses (offspring) from 21 counties or districts of Guangdong Province were included in this study, who were treated from June to December 2012. Mean cell volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin A2 (Hb A2) were detected in the couples, and 6 types ofα-globin gene mutations were found in all couples and newborns. The strategies were MCV/MCH and serum Hb A2 (protocolⅠ) or parallel screening based on pregnant women (protocolⅡ), and serum screening based on couples (protocolⅢ). The validity and reliability of the three strategies were then compared using the Chi-square test. Results The sensitivity and the specificity of pregnant women who wereα-thalassemia carriers in protocolⅠwere 74.82%(1 352/1 807) and 74.11%(8 506/11 477), and were 89.82%(1 623/1 807) and 48.60%(5 578/11 477) in protocol Ⅱ , respectively. And 1.67% (221/13 284) couples were bothα-thalassemia carriers by the gene test. The rate of missed diagnosis in bothα-thalassemia carrier couples in protocolsⅠ,ⅡandⅢwas 50.68%(112/221), 11.76%(26/221) and 11.31%(25/221), respectively. In couples who needed prenatal diagnosis, the rates of missed diagnosis, sensitivity, specificity, positive predictive value, and negative predictive value were 17.46%(11/63), 82.54%(52/63),98.35%(13 003/13 221), 19.26%(52/270) and 99.92%(13 003/13 014) in protocolⅠ;4.76%(3/63), 95.24%(60/63), 88.18%(11 658/13 221), 3.70%(60/1 623) and 99.97%(11 658/11 661) in protocolⅡ;and 3.17%(2/63), 96.83%(61/63), 59.31%(7 842/13 221), 1.12%(61/5 440) and 99.97%(7 842/7 844) in protocol Ⅲ , respectively. The diagnosis of severeα-thalassemia was not missed in all three screening strategies. The mean cost of protocols Ⅰ, Ⅱ and Ⅲ for detecting a couple who needed prenatal diagnosis was 37 049.23, 50 836.00 and 40 321.64 RMB, respectively. Conclusions The three screening protocols have good efficiency in screening forα-thalassemia. However, protocolsⅡandⅢare preferred when financial conditions permit.

Objective There is a high occurrence rate of thalassaemia in Guangdong Province .Major and intermedia thalas-saemia bring severe burden for patients , families, and societies.This study aimed to reveal the economic burden of thalassaemia major and intermedia thalassaemia in Guangdong Province . Methods Eight areas of Guangdong Province were selected as the sampling ar-eas.Patients with major or intermedia thalassaemia were enrolled in the study .The patients′economic burden of this disease , inclu-ding direct economic burden , indirect economic burden and intangible economic burden was calcultated .The direct economic burden was estimated by outpatient fee , hospitalization expense , nutrition and transportation fees , indirect economic burden was evaluated u-sing disability adjusted life years ( DALY) combined with human capital , and intangible economic burden was calculated using method of willingness. Results Per average annual direct economic burden of 45 patients with major or intermedia thalassaemia was 43 058.66 yuan, per average annual indirect economic burden was 20 474.51 yuan, and per person intangible economic burden was 302 466.67 yuan. Conclusion Economic burden of major and intermedia thalassaemia is huge and most patients do not receive standardized treatment .More effective way should be taken to reduce the economic burden of thalassaemia and help the patients to re -ceive standardized treatment .

Objective To evaluate the effect of ropivacaine-induced convulsion on hippocampal synaptic development in neonatal rats.Methods Sixty 21-day-old Sprague-Dawley neonatal rats,weighing 40-41 g,were randomly divided into 3 groups (n=20 each) using a random number table:control group (group C),single convulsion group (group SC),and recurrent convulsion group (group RC).Normal saline 0.1 ml was intraperitoneally injected in group C.Group SC received single intraperitoneal injection of 0.5％ ropivacaine 33.8 mg/kg.In group RC,0.5％ ropivacaine 33.8 mg/kg was intraperitoneally injected once a day for 5 consecutive days.The rats developed convulsion were included in the study.Five rats were selected at 24 h,3 days and 7 days after convulsion and at the age of 60 days in C and SC groups,and at 24 h,3 days and 7 days after the last convulsion and at the age of 60 days in group RC,the rats were sacrificed,and the hippocampus was removed for examination of the ultrastructure of neurons (with a electron microscope) and for determination of the number of synapses,synaptic space and thickness of synaptic density.Results Compared with group C,the number of synapses was significantly decreased,and the synaptic space was widened at 24 h and 3 days after convulsion,and the thickness of synaptic density was thinned at 24 h after convulsion in group SC,and the number of synapses was significantly decreased,and the synaptic space was widened,and the thickness of synaptic density was thinned at 24 h,3 days and 7 days after convulsion in group RC (P＜0.05).Compared with group SC,the number of synapses was significantly decreased,the synaptic space was widened,and the thickness of synaptic density was thinned at 24 h,3 days and 7 days after convulsion in group RC (P＜0.05).There was no significant difference in the parameters mentioned above at the age of 60 days between the three groups (P＞0.05).Neurons exhibited nuclear swelling,mitochondria showed edema,and disrupted mitochondrial cristae and vacuoles were observed at 24 h and 3 days after convulsion,and these changes mentioned above were significantly attenuated at 24 h,3 days and 7 days after convulsion.Conclusion Ropivacaine-induced convulsion exerts no effects on hippocampal synaptic development in neonatal rats.

Objective To observe the effect ofTripterygium Wilfordii Hook. F. andTripterygium Hypoglaucum (Lévl.) Hutch on macrophage inflammatory factor, and to provide the oretical basis and experimental basis for the clinical application of these drugs.Methods Two batches ofTripterygium Wilfordii Hook. F. andTripterygium Hypoglaucum (Lévl.) Hutch were collected, and then the samples turned into alcohol extract by extraction and isolation. The IC50values of alcohol extracts were measured by MTT in BMDM cell. BMDM cell induced by the 4 batches of samples with IC50, then IL-6, IL-10, iNOS were detected by Elisa. Results The content of IL-6 (5.08 ± 0.96 pg/ml, 6.24 ± 0.20 pg/mlvs. 7.92 ± 0.84 pg/ml) and iNOS (0.14 ± 0.04 ng/ml, 0.36 ± 0.11 ng/mlvs. 0.86 ± 0.13 ng/ml) in Anhui and Guizhou groups were significantly lower than sulfasalazine (P<0.05), and the content of IL-10 (21.20 ± 4.24 pg/ml, 26.49 ± 4.44 pg/mlvs. 9.06 ± 0.40 pg/ml) in Anhui and Guizhou groups were significantly higher than sulfasalazine (P<0.05). The content of IL-6 (4.22 ± 0.38 pg/ml, 4.55 ± 0.44 pg/mlvs. 7.92 ± 0.84 pg/ml) and iNOS (0.07 ± 0.04 ng/ml, 0.28 ± 0.10 ng/mlvs. 0.86 ± 0.13 ng/ml) in Hunan and Zhejiang groups were significantly lower than sulfasalazine (P<0.05) .Conclusion The anti-inflammatory effect ofTripterygium WilfordiiHook. F. treat rheumatoid arthritis is better than sulfasalazine andTripterygium Hypoglaucum (Lévl.) Hutch.