Objective To evaluate the efficacy of facial vein-superior ophthalmic vein approach to embolize carotid-cavernous sinus fistulas.Metheds The involved cavernous sinus was catheterized through the femoral vein-facial vein- superior ophthalmic vein approach, GDC, EDC, free microcoil, or silk were used to pack the sinus and occlude the shunt. If therer was any difficulty in catheterizing the faical vein, facial vein was exposed surgically and punctured, and then, through the superior opthalmic vein, the cavernous sinus was packed. Results 16 cavernous sinuses in 14 CCF patients(5 traumatic CCFs, 9 dural CCFs) were catheterized through facial vein-superior ophthalmic vein approach, and the technical success was achieved in 15 cavernous sinuses. Immediate angiographic cure of the shunts was achieved in 11cases, residual shunts with inferior petral sinus drainage in 2. Facial vein occlusion was encountered in 1 patient during the facial vein catheterization, further packing of the cavernous sinus was not performed, but follow-up angiography at the 21 st day revealed the spontaneous cure of the shunt. The VI cranial nerve palsy present after balloon embolization in a type A CCF was not improved after the packing of the cavernous sinus. Ocular symptoms in other patients disappeared after tranvenous embolization. The clinical follow-up period ranged from 3 to 21 months, no recurrence of the symptoms was found. Follow-up angiography in 2 patients with residual shunting showed the unchanged shunts, no further embolization was performed. No follow-up angiography was performed in other patients.Conclusions The facial vein-superior ophthalmic vein approach can be chosen as an optimum treatment for dural CCFs, and an important alternative treatment for type A CCFs after the failure of the initial balloon embolization.

Objective To summarize the technique of stent placement in treatment of fusiform aneurysms and dissecting aneurysms of vertebral artery. Methods we report a retrospective analysis of 16 aneurysms which underwent stent placement ,9 fusiform aneurysms which performed by using stent and GDC;7 dissecting aneurysms which performed by using stent first, Stent placement was followed by coil placement in the 5 aneurysms. Results all patients were cured,2 of 11 aneurysm showed up transient ischemia of cerebral.Follow-up angiographic studies performed in 13 patients from 3 months to 24 months revealed no aneurysm regrowth and no incident of in-stent stenosis.Conclusions the treatment of fusiform aneurysms and dissecting aneurysm of vertebral artery is distinguishing, Using stent combined with GDC to treat fusiform and dissecting aneurysm may restore the patency of parent artery and become safe and effective treatment for fusiform and dissecting aneurysm of vertebral artery.

Objective To understand the situation of indoor air fluoride and arsenic pollution caused by coal-burning and the impact of the pollution on children health in the rural area,southern Shaanxi Province.Method 77 fluoride samples and 186 arsenic samples were collected in 65 investigated villages of 5 counties in southern Shaanxi Province.13 120 children aged 8-12 years were selected for dental fluorosis examination,13 386 children aged 6-18 years for arsenism examination.Results Both of the average content of fluoride and arsenic in the indoor air exceeded the national standard limit.Fluorine content was 0.001-0.541 mg/m3 with an average of 0.038 4 mg/m3,arsenic content was 0.00-63.83 ?g/m3 with an average of 4.76 ?g/m3.The prevalence rates of dental fluorosis and arsenism were 45.50% and 1.86% respectively.Conclusion The indoor air fluoride and arsenic pollution caused by coal-burning in the investigated rural area is serious and the pollution has caused the prevalence of endemic fluorosis and endemic arsenism among the local children.

Objective To master the running conditions of water project and the defluoridation results in monitoring sites of drink-water type fluorosis in Shaanxi Province,to provide a scientific basis of preventing and controlling endemic fluoroisis. Methods Every April and September 1998—2005 children aged 8～12 at school from the two monitoring sites of Wupo and Bayi village received the dental fluorosis examination by using the Deans method.The urine samples of 50 children from 5 age groups who were selected randomly and were grouped in 5 with 10 children each were collected,measured in accordance with WS/T 89—1996 Determination of Fluoride in Urinlon Selective Electrode Method,evaluated by Manual of Endemic Fluorosis Control(1991). At least 5 water samples were collected randomly from five directions(east,west,north,south,center).The fluoride contents in urine and drinking water were determined with FSIE,in accordance with GB/T 5750--2006 Standard Examination Methods for Drinking Water,evaluated by GB 5749—2006 Standards for Drinking Water Quality.Results After changing water,morbidity rate of children dental fluorosis fell from 66.67%in 1998 to 31.79%in 2005 and the dental fluorosis index also fell form 1.49 to 0.65 of Wupo village,morbidity rate of children dental fluorosis fell from 33.15%in 1998 to 13.10%in 2005 and the dental fluorosis index also fell from 0.50 to 0.24 of Bayi village.The fluoride contents in urine of children and the fluoride contents in drinking water were maintained stability.Conclusion After water improvement,the fluorosis has been effectively controlled in a certain degree in the investigated area.

This article elaborated the theory of chronic and complex disease treatment based on collaterals. It put forward that complex virtual evil stasis was the common pathogenesis of chronic and complex disease treatment. Combined with articles published in recent 5 years, from the perspective of cytokines and genes, it summarized traditional Chinese medicine (TCM) compound targets in chronic and complex disease treatment. It put forward the transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), vascular endothelial growth factors (VEGFs), matrix metalloproteinases/tissue inhibitor of metalloproteinase (MMPs/TIMPs) were its high-frequency targets. It provided a basis for future experiment design on chronic and complex disease treatment based on collaterals as well as new drug development.

The rebleeding rate,morbidity and mortality of the ruptured intracranial aneurysms are very high.Early treatment is very important to reduce the rebleeding rate.However,there are still a lot of controversies for its indications.The early treatment modalities of the ruptured intracranial aneurysms are mainly including craniotomy and interventional treatment.This article reviews the indications of early treatment of ruptured intracranial aneurysms and the selection of treatment modalities.

Objective To investigate the therapeutic effect of total mesorectal excision(TME) for low rectal cancer.Methods One hundred nineteen patients with rectal cancer,located on an average within 8 cm of the anal verge,were included in the study.Fifty-four patients underwent traditional operation,and sixty-five patients underwent total mesorectal excision.Operation time,loss of blood at operation and local recurrence rates were compared between the two groups.Results The average operation time and blood loss were 118 minutes,and 100mL respectively in TME group,and they were 182 minutes,and 340 ml respectively in traditional operation group.There were significant differences between them(all P0.05).Conclusions In TME group,operation time was shorter,operative blood loss was less,and local recurrence rate was lower.TME should be applicated for patients with low rectal cancer.

Objective To understand the schedule and effectiveness of water-improving defluoridation projects comprehensively in control of fluorosis in drinking-water-borne endemic fluorosis areas in Shaanxi Province,and to provide a scientific basis for making strategies in prevention and control the disease for the next step.Methods The progress of drinking-water-borne endemic fluorosis water-improving defluoridation projects and operation condition were investigated in Shaanxi (fluoride content of drinking water was greater than 1.2 mg/L in the endemic areas) in 2014,and children aged 8 to 12 in 32 epidemic villages of six counties including Jingbian,Dingbian,Dali,Jingyang,Qian and Liquan were selected to survey dental fluorosis.Results In Shaanxi Province,the number of villages with water fluorine content of more than 1.2 mg/L was 5 005 and water improvement rate was 83.42％ (4 175/5 005),water-improving projects operated normally rate was 85.05％ (3 551/4 175),and scraped was 37,accounted for 0.89％ (37/4 175).There were 830 epidemic villages without water-improving projects in Shaanxi Province,and high fluoride exposed population was 579 400,mainly distributed in Yulin,Xianyang,Weinan and Yan'an cities.A total of 1 849 children aged 8 to 12 in the 6 counties were examined,the detection rate of dental fluorosis was 56.57％ (1 046/1 849),the index of dental fluorosis was 1.11.Conclusion In drinking-water-borne fluorosis epidemic areas of Shaanxi,the improved-water rate is generally high,and the normal operation of waterimproving projects is overall good,but the measures for water-improving defluoridation must be reinforced and improved.

Objective To analyze retrospectively the death pattern, risk factors, and death time of 253 patients at the Respiratory Care Unit of General Hospital of PLA in order to improve care quality and reduce mortality.Methods The information of patients was extracted from the hospital information system ( HIS) , and then classified and calculated accord-ing to different time points.Results Between November and next March,the mortality rate was higher than in other months (P<0.05), accounting for 19.5%.Mortality of those admitted between 8∶01 and 9∶00 or between 23∶01 and 24∶00 was higher than at other times(P<0.05), accounting for 41.7%and 50.0%, respectively.There was statistically significant difference(P<0.01) in mortality between days of the week,with the highest on Saturday, accounting for 43.1%.Mortality on non-work days was higher than on workday(P<0.01), accounting for 38.3% and 13.2%, respectively.Mortality at off-hour was higher than at office time(8∶00-11∶30 and 14∶30-18∶00 on workday) (P<0.01), accounting for 31.3%and 5.2%, respectively.Logistic regression analysis showed that age, month of admission, and the hour of discharge were associated with the outcome.Conclusion The high mortality between November and next March may be related to the higher incidence of respiratory diseases in winter, air pollution and cold weather.High mortality is also significantly associ-ated with the care quality of the medical staff.

Objective To investigate the characteristics of X-ray signs of water-related and coal-burning borne endemic fluorosis in Shaanxi Province,so as to provide a theoretical basis for revising X-ray diagnostic criteria of skeletal fluorosis in the future.Methods The X-ray data of 2 525 cases of patients with endemic fluorosis from the central subsidies to local public health programs were collected from 2008 to 2011,and the X-ray signs,age,gender distribution,detection rate were analyzed statistically ; skeletal fluorosis was diagnosed on the basis of skeletal diagnostic criteria(WS 192-2008).Results The 2 525 cases observed were taken X-ray film on forearm and shank.In the X-ray signs of patients from fluorosis areas,the detection rates were higher,and these signs were mainly radial crest of increase,marginal sclerosis,surface thickening and forearm interosseous membrane ossification and forearm interosseous membrane calcification which showed bud break ground sign,which accounted for 29.91％(242/809),17.92％(145/809) and 17.69％ (143/809),respectively.Three X-ray signs occurred in the forearm,and the total detection rate based on the forearm signs was 88.12％ (721/809); 682 cases of skeletal fluorosis were detected and the detection rate was 27.01％ (682/2 525),including 401 mild cases accounting for 15.88％ (401/2 525); 236 moderate cases that accounted for 9.35％ (236/2 525); 45 severe cases accounted for 1.78％(45/2 525).With age,the prevalence increased gradually.After the age of 55 reached the peak,and the difference was significant statistically between different ages (x2 =228.58,P ＜ 0.05).The total prevalence was not significantly different between male group and female group (x2 =0.74,P ＞ 0.05).Conclusions With age,the prevalence of skeletal fluorosis is increased,and the skeletal fluorosis is not different between different sexes.The X-ray sign results have showed that the prevalence based on forearm signs is high and specific.We suggest to diagnose skeletal fluorosis by the X-ray signs of the forearm in the diagnostic standard revision,so as to reduce financial input,workload and radiation level to the patient.