Objective To investigate the feasibility of video-assisted thoracoscopic sympathetic trunk clipping in the treatment of craniofacial hyperhidrosis. Methods A total of 10 patients were operated on under general anesthesia with double-lumen endotracheal intubation. The patients were placed in lateral recumbent position with one-lung ventilation. A 7 mm trocar and a 4.5 mm trocar were inserted at the 2~3 intercostal space on the midaxillary line and at the 4~5 intercostal space on the posterior axillary line, respectively, to introduce surgical instruments and thoracoscopic camera. Alongside the sympathetic chain, the sympathetic nerve trunk immediately below the second costal margin was blocked with small-sized titanium clips. Then the lung was inflated and the incision sutured. Afterwards, the procedure in the contralateral hemithorax was performed using the same method. Results The operating time was 55~130 min (mean, 110 min). Symptoms of craniofacial hyperhidrosis disappeared in the 10 patients, all of who were satisfied with curative results. The postoperative hospital stay was 2~3 days. Neither Horner’s syndrome nor other serious complications were observed. Seven of the patients developed slight compensation hyperhidrosis in their chest, abdomen, back or legs. All the patients had normally returned to work and physical exercises in 7~10 days. Postoperative follow-up for 1~9 months (mean,6.3 months) in all the patients found no recurrence. Conclusions Video-assisted thoracoscopic block of sympathetic trunk below the second costal margin for craniofacial hyperhidrosis is safe and effective.

Objective To investigate the clinical and imaging features in patients with vertebrobasilar dolichoectasia (VBD) through a comparative study in patients with ischemic stroke with or without VBD.Methods The patients with acute cerebral infarction were divided into either a VBD group or a non-VBD group according to magnetic resonance angiography.The VBD group was further divided into an anterior circulation infarction subgroup and a posterior circulation infarction subgroup.The cardiovascular risk factors,the diameter of basiar artery (BA),bifurcation height,and horizontal displacement were compared in all groups.Results A total of 269 patients with acute cerebral infarction were included,28 had VBD,accounting for 10.41％ of the patients with acute cerebral infarction during the same period.The proportion of male patients (78.6％ vs.66.8％ ;x2 =4.392,P =0.036),age (70.38 ± 10.58 years vs.62.86 ± 12.20 years; t =2.870,P =0.009),and the proportion of hypertension (89.3％ vs.47.7％ ; x2 =17.367,P =0.000) in the VBD group were significantly higher than those in the non-VBD group.The multivariate logistic regression analysis showed that the advanced age (odds ratio [OR] 1.248,95％ confidence interval [CI] 1.137-1.371; P=0.000),hyperglycemia (OR 1.599,95％ CI 1.181-2.164; P =0.002),hypertension (OR 1.251,95％ CI 1.020-1.534; P =0.032) and increased triglyceride level (OR 1.876,95％ CT 1.021-3.445; P =0.043) were the independent risk factors for VBD,while female gender (OR 0.133,95％ CI 0.024-0.735; P =0.021) was the independent protective factor for VBD.Of the 28 cerebral infarction patients with VBD,9 had anterior circulation infarction and 19 had posterior circulation infarction.There were significant differences in BA diameter ([5.40 ± 0.49] cm vs.[6.00 ± 0.77] cm; t =2.046,P =0.041),and the proportions of high score in bifurcation height (x2 =6.768,P =0.037) and horizontal displacement (x2 =5.241,P =0.042) between the 2 groups (all P ＜0.05).The multivafiate logistic regression analysis showed that the BA bifurcation height was an independent risk factor for posterior circulation infarction (OR 1.347,95％ CI 1.069-2.457; P =0.038) in patients with VBD.Conclusions VBD accounted for 10.41％ of the patients with acute cerebral infarction during the same period.Advanced age,hyperglycemia,hypertension and increased triglyceride level were the independent risk factors for VBD.Female gender was the independent protective factors for VBD,and the BA bifurcation height was an independent risk factor for VBD occurring posterior circulation infarction.

Objective:To analyze the characteristics of health financing at the provincial level according to the total health expenditure since China health system reform began in 2009 and provide evidence for improving health fi-nancing policy. Methods:20 provinces were chosen and vertical and horizontal Comparative approach was used to an-alyze the data. Results:Total health expenditure increased for all regions, of which the biggest rate was Anhui prov-ince, about 82. 97%, while the largest increasing for government health care expenditure was Ningxia province, a-bout 108 . 71%. In 2012 , the provinces with social health expenditure share of total above 40% were allocated in the east region, and the number of provinces with out-of pocket payment share of total above 40% reduces to 5. Conclu-sion:Total health expenditure grew in all regions, but there were differences in the degree that this spending matched the economic level;The financing structure was optimized, but the characteristic of regional financing was different. Some provinces were under huge pressure to reduce out-of pocket payments. Suggestions: Under the premise of im-proving the funding level, financing structure adjustment must be focused, and public funding should play a bigger role and out-of pocket payments should be reduced.

Objective To analyze the effect of residual cholesterol (RC) on hearing loss in noise-exposed workers. Methods A total of 3 412 workers engaged in noise operation work in an underground railway enterprise were selected as the research subjects using the judgment sampling method. Their occupational health examination data were collected to analyze the relationship between RC and hearing loss. Results The noise intensity of workplace in the underground rail enterprise was 80.0-85.0 (81.4±3.2) dB(A). The detection rate of hearing loss was 20.2% (691/3 412). The rates of abnormal total cholesterol, triacylglycerol, high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol were 35.6%, 25.7%, 9.5% and 42.4%, respectively. The median and the 25th and 75th percentiles [M(P₂₅,P₇₅)] of RC level were 0.24 (0.15, 0.37) mmol/L. The levels of total cholesterol, triacylglycerol and RC of workers in hearing loss group were higher than those in normal hearing group [M(P₂₅,P₇₅): 4.91(4.37, 5.58) vs 4.84(4.30, 5.46) mmol/L, 1.29(0.91, 1.93) vs 1.16(0.82, 1.67) mmol/L, 0.26(0.16, 0.41) vs 0.24(0.14, 0.37) mmol/L, all P<0.05]. The detection rate of hearing loss in abnormal triglyceride group was higher than that in normal triglyceride group (24.8% vs 18.7%, P<0.01), and the detection rate of hearing loss in abnormal HDL-C group was higher than that in normal HDL-C group (25.0% vs 19.8%, P<0.05). The higher the serum RC level, the higher the detection rate of hearing loss (P<0.01). Multivariate logistic regression result showed that individual with older age, longer work time and higher serum RC level had higher risk of hearing abnormality (all P<0.05), and the risk of hearing abnormality was higher in patients with abnormal fasting blood glucose than patients with normal faseing blood glucose (P<0.05) after controlling for confounding factors such as gender, alcohol consumption, body mass index, and elevated blood pressure. However, abnormal triacylglycerol and HDL-C levels were not significantly related to the risk of hearing abnormality (both P>0.05). Conclusion Serum RC levels are an independent risk factor for hearing loss among noise-exposed workers exposed to noise level of 80.0-85.0 dB(A) in the workplace.

OBJECTIVE: To investigate the effect of health education in the treatment of pneumoconiosis patients with bronchoalveoar lavage( BAL) during perioperative period. METHODS: Ninety-six pneumoconiosis patients treated with BAL in hospital were divided into observation group and control group( 48 cases in each group). The patients in the control group were given routine perioperative health education, and the patients in the observation group implemented perioperative health education in accordance with the health education pathway. Adverse reactions in hospital were collected,and the awareness of perioperative health knowledge of BAL was surveyed. RESULTS: Before implement of the health education pathway,there was no difference( P > 0. 05) in the health knowledge between the 2 groups. After implementation of the health education pathway,the awareness of health knowledge of observation group and control group were higher than that of the same group before implementation of the health education pathway( P < 0. 01). The awareness of 15 items of health knowledge was higher( P < 0. 05) and the incidences of intraoperative cough and postoperative low fever were lower in the observation group than in the control group( 4. 2% vs 25. 0%,2. 1% vs 16. 7%,P < 0. 05).CONCLUSION: Executing effective healthy education pathway in perioperative BAL is helpful to improve the knowledge of disease prevention and control in pneumoconiosis patients,and reduce the occurrence of adverse reactions during BAL.