Objective To evaluate the therapeutic efficacy of retrobulbar injection with triamcinolone acetonide (TA) for macular edema caused by retinal vein occlusion (RVO). Design Retrospective case series. Participants 21 eyes of 21 patients with macular edema caused by RVO. Methods Retrobulbar injection with TA 40 mg was performed on 21 eyes. The visual acuity, intraocular pres-sure, fundus fluorescein angiography (FFA) and macular central thickness under the optical coherence tomography (OCT) were recorded and analyzed before and after treatment. The follow-up duration was 6-11 months. Main Outcome Measures The visual acuity and the macular central thickness of OCT. Result Visual acuity was improved at the end of follow-up in 16 eyes (76.2%) and unchanged in 5 eyes (23.8%). Macular central thickness was (287.55±121.70) μm at the end of follow-up and (617.23±185.58) μm before treatment. The difference was statistically significant(P=0.000). After treatment, the comparison of visual acuity and macular central thickness be-tween CRVO patients and BRVO patients, as well as between ischemic RVO patients and non-ischemic RVO patients had no significant difference (P>0.05). In patients of course less than 6 months, the visual prognosis after treatment is better than that of before treatment (P=0.011, 0.01), while in patients of course more than 6 months, no difference of vision could be detected before and after treatment (P= 0.583). The result of FFA showed decrease of fluorescein leakage. During follow-up, intraocular pressure of all patients was in the nor-real range. Recurrence of macular edema was found in 8 eyes 2 to 6 months after treatment. Conclusions Retrobulbar injection with TA is a safe, effective, and easy method to treat macular edema caused by RVO. Early treatment can get better efficacy. (Ophthalmal CHN, 2009, 18: 254-256)

Objective To explore the diagnosis,treatment and pathology of malignant brain tumor in children.Methods The clinical data of 61 children with malignant brain tumor were reviewed,including their age distribution,diagnosis,operation route(according to the position of the brain tumors),chemotherapy [using bischloro-nitrosourea(BCNU),teniposide(VM-26) and temozolomide]and radiotherapy (part and whole brain irradiation,three diamensions conformal therapy,gamma knife and X-kinfe).Results Of 61 cases,which including 37 boys and 24 girls whose mean age was 11.3 years,24 cases were supratentorial tumors and 37 cases were infratentorial.Forty-five tumors received total or subtotal recession,10 cases with major recession,and 6 cases with partial recession.After operation,39 cases (63.9%) received radiotherapy,and 29 cases (47.5%) with chemotherapy.Follow-up of 49 cases were achieved,in which 22 cases died and 27 cases survived.Conclusions Surgical removal is still the chief treatment for malignant brain tumor in children.The exairesis profect should be formulated according to the specificity of each case.Radiotherapy methods should be related to post-operational images(CT or MRI).And it was different from the brain tumors in adult.It is good to prolong survival duration for some chosen cases with optimal chemotherapy.

Objective To evaluate the effectiveness of health education on controlling of coal-burning-borne endemic fluorosis(referred to as endemic fluorosis) in Guizhou,and to provide a scientific basis for development of control strategies.Methods A total of 37 counties were selected in Guizhou province,and 3 townships were chosen in each project county.Heath educational activities were carried out in the classes of grade 5 in the Central Primary School of each selected township.In the meantime,3 villages were chosen in each selected township where the health education for women of child-bearing age in the community was carried out.Survey on knowledge questionnaire of endemic fluorosis control was conducted among 30 students of grade 5 in the Central Primary School and 15 women of childbearing age of each selected township before and after the health educational activities.Results The knowing rate of endemic fluorosis control of pupils in all the 37 counties increased from 45.03％(14637/32505) to 89.79％(52898/58910),of women of child-bearing age increased from 38.97％ (5729/14700) to 76.55％(19198/25080) after the health education.ConclusionsThe knowing rate of endemic fluorosis control among pupils and women of child-bearing age is remarkably increased after implementing the health education projects.They have better life and health habits,and the project has reached desired goal.

Adenocarcinoma ; diagnosis ; metabolism ; pathology ; Carcinoma, Signet Ring Cell ; diagnosis ; metabolism ; pathology ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Neoplasm, Residual ; metabolism ; Prostatic Hyperplasia ; metabolism ; Prostatic Intraepithelial Neoplasia ; metabolism ; Prostatic Neoplasms ; diagnosis ; metabolism ; pathology ; Racemases and Epimerases ; metabolism ; Sensitivity and Specificity

Objective To investigate the daily total fluoride intake in relating to the prevalence of skeletal fluorosis in two villages in Jiangsu Province,in order to provide the scientific evidences for the control and prevention of endemic fluorosis.Methods Adults sampled from a high-fluoride Village,Wamiao,and a low-fluoride Village,Xinhuai,were surveyed in this study according to the fluoride concentration in their household shallow well.The average daily total fluoride intake from difierent sources and the skeletal fluorosis were investigated in each subject.Then the subjects from two villages were allocated into five subgroups(＜2.00,2.00～,3.00～,4.00～,≥5.00 mg/d),the relation fluoride intake and prevalence of osteofluorosis was analyzed.Results The prevalence of skeletal fluorosis in Wamiao Village was 31.06%(41/132),but no skeletal fluorosis case(0/35)was found in Xinhuai Village.According to the daily total fluoride intake,subjects with higher daily total fluoride intake tended to associated with a higher prevalence of skeletal fluorosis in a significant dose-response relationship(regression equation:y=2.624-6.855x+3.424x2:r=0.997).The benchmark dose lower limitation of daily total fluoride intake with 95% confidencewas 2.50 mg/d calculated according to this dose-response relationship,the reference dose(RfD)was 2.50 mg/d.In Wamiao Village a significant difference was also found between daily total fluoride intake in 41 subjects[(5.09±1.20)mg/d]with X-ray detectable skeletal fluorosis and in 91 subjects[(3.08±1.12)mg/d]without X-ray detectable skeletal fluorosis(t=-9.32,P＜0.01).Conclusions These findings indicate that the daily total fluoride intake has a significant dose-response relationship with the prevalence of skeletal fluorosis in an endemic fluorosis area associated with high-fluoride drinking water;and the RfD in this study was lower than that in the national standard of"Chinese hygienic standard for daily total fluoride intake(WS/T 87-1996)"(3.50 mg/d).

OBJECTIVEThe best approach for blood pressure (BP) measurement in children remains controversial, especially on the choice of Korotkoff phase 4 (K4) vs. Korotkoff phase 5 (K5) for diastolic BP (DBP) and to compare the differences between K4 and K5 in school-aged children and their predictions to hypertension in adult.

METHODSThe "Beijing children and adolescents BP study" cohort population consisted 2505 school-aged children aged 6 to 17 at baseline survey in 1987, when datum of systolic BP (SBP), DBP measured using K4 and K5, were collected respectively. Among them, 412 individuals with 220 males and 192 females at age of 23-37 years old, were successfully followed up and invited to take part in a clinical examination including anthropometric measurements, SBP and DBP recordings, and a questionnaires in 2005. Method for the BP measurements at both baseline and followed-up was by auscultation with a standard sphygmomanometer. Child hypertension at baseline was diagnosed according to the age-specific cutoffs recommended by the World Health Organization in 1996 (WHO 1996). Adult hypertension was diagnosed according to the China Guideline for Hypertension Prevention and Control issued in 2005. Partial correlation coefficients were calculated to describe the association of K4 and K5 in childhood with SBP and DBP level in adulthood. Multivariate logistic regression analysis was conducted to examine the impact of choice of K5 and K4 as DBP in childhood on prediction to the hypertension in adulthood. Potential confounders such as gender and adult-height were controlled for.

RESULTSAt baseline, the prevalence rates of hypertension were 5.0% with DBP measured using K4, and 2.4% with DBP measured using K5, respectively. The geometric mean difference value of K4 minus K5 (K4 - K5) was (10.1 +/- 1.7 mm Hg) (1 mm Hg = 0.133 kPa) for the 2505 school-aged children, and decreased as age increased. There was no significant difference regarding the values of K4 - K5 between males and females in all age groups except for children who at pubertal stage. The distribution of K4 - K5 value across age groups was statistically significant (P < 0.001), 59.6%, 60.5%, 56.3% and 45.1% of children who aged 6-9 years, 10-12 years, 13-15 years, and 16-17 years with their K4 - K5 value over 10 mm Hg. K4 in childhood was better correlated to both SBP and DBP in adulthood than K5. In general, K4 seemed to be superior to K5 in predicting hypertension in adulthood. The odds ratios of hypertension in adulthood were 1.69 (95% CI: 1.11-2.00), 1.45 (1.05-2.02), 2.18 (1.37-3.47), and 1.66 (1.07-2.59) with each 5 mmHg increasing of K4 measured in children aged 6-9 years, 10-12 years, 13-15 years, and 16-17 years, respectively. The agreement diagnosis between child hypertension and adult hypertension was higher for childhood DBP measured using K4 (20.2%) than that using K5 (12.8%).

CONCLUSIONThere was significant difference between K4 and K5 in Chinese children and adolescents. Choice of diastolic Korotkoff blood pressure could affect DBP tracking from childhood into adulthood. K4 seemed superior to K5 when using auscultator technique to measure DBP.

Adolescent ; Adult ; Blood Pressure ; physiology ; Child ; Female ; Humans ; Hypertension ; epidemiology ; Male

Objective To investigate the effects of 3 different ventilation methods,including conventional mechanical ventilation (CMV),high frequency oscillatory ventilation(HFOV) and partial liquid ventilation (PLV),on the changes of inflammatory factors and pulmonary surfactant associated protein A (SP-A) in bronchoalveolar lavage fluid (BALF) in newborn piglets with acute lung injury(ALI).Methods Twenty-four newborn piglets,no more than 3 days old,were enrolled.After ALI made with saline lavage(38 ℃,35 mL/kg),newborn piglets were randomly assigned to 4 groups:control group (n =6,no ventilation),CMV group(n =6),HFOV group(n =6),and PLV group(n =6).Piglets were sacrificed after being ventilated for 24 h.Tumor necrosis factor-α (TNF-α),interleukin-8 (IL-8),interleukin-1 (IL-1) and SP-A in BALF were measured quantitatively by using enzyme-linked immunosorbent assay.Results In 3 groups using different ventilation methods,the population mean of TNF-o,IL-8,IL-1 and SP-A were statistically different (all P =0.000).SP-A in PLV group and HFOV group were higher than that in CMV group (all P ＜ 0.05),while IL-8,IL-1 and TNF-α in PLV group were lower than those in CMV group (all P ＜ 0.05),IL-8 and TNF-α in PLV group were lower than those in HFOV group (all P ＜ 0.05),IL-8 and TNF-α in HFOV group were lower than those in CMV group (all P ＜ 0.05).Conclusions Pulmonary inflammatory reaction was different in 3 ventilation groups.Compared with CMV and HFOV,PLV attenuated inflammatory reaction,so it could increase the expression of SP-A and decrease the degradation of SP-A.

Objective To observe the electrocardiogram changes of threatened crowds in Keshan disease (KSD) endemic area in Shandong province. Methods In 2008,inhabitants from 21 villages of Zoucheng,Sishui,Tengzhou, Yishui, Pingyi, Wulian, Juxian and Qingzhou regions were selected as subjects undergoing electrocardiogram. No less than 100 people were chosen from each village and the examination rate was not lower than 85%. Results Among the 3378 inhabitants investigated,460 cases showed abnormal electrocardiogram and the total incidence of abnormal electrocardiogram was 13.62% (460/3378). The relatively high incidence was T-wave changes,QRS low voltage and ST-T changes,the detection rate being respectively 2.69% (91/3378), 1.92% (65/3378) and 1.72% (41/3378). The highest incidence of abnormal electrocardiogram (26.76%,55/213),the intermediate(21.50%,43/200) and the lowest(5.50%,12/218) was respectively found in Pingyi,Qingzhou and Sishui. Conclusions The threatened crowds in KSD endemic area in Shandong province are still in a state of high abnormal electrocardiogram detection,and electrocardiogram is of great value in the evaluation of KSD patients.

Objective Color doppler ultrasonography of chronic Keshan disease (CKD) was evaluated to provide evidences for clinic diagnosis of the disease. Methods From September to Novermber 2009, according to "Diagnostic criteria of Keshan disease" (GB 17021-1997), 64 cases of CKD were randomly sampled from five Keshan diseased districts in Shandong province, Zoucheng, Sishui, Yishui, Wulian, Jvxian, and Pingyi as patient group. Thirty four healthy volunteers being checked up by Shandong Institute for Endemic Diseases Control and Research were put in control group. All the subjects were examined with Color doppler ultrasonography. The indexes of cardiac structure, left ventricular (LV) systolic function and LV diastolic function were measured.Results Left atrial internal diameter, LV end-diastolic internal diameter, LV end-systolic internal diameter, right ventricular diameter, aorta diameter, right atrial transverse diameter, right atrial long diameter and left ventricle mass of the patient group[(35.38 ± 6.89), (61.57 ± 8.61), (45.39 ± 10.29), (17.22 ± 3.79), (28.69 ± 2.81),(38.00 ± 6.05), (42.68 ± 8.65)mm, (283.22 ± 103.12)g] were higher than that of control group[(26.70 ± 3.27),(45.41 ± 4.93), (26.91 ± 4.35), (13.76 ± 2.27), (24.09 ± 2.89), (31.50 ± 3.32), (35.82 ± 3.14) mm, (156.03 ±39.86)g, t = 6.93, 10.09, 9.98, 4.87, 7.64, 5.81, 4.46, 6.90, all P＜ 0.05]. The LV ejection fraction and fractional shortening of the left ventricular of the patient group[(49.25 ± 14.33)%, (26.11 ± 9.17)%] were lower than that of control group[(73.88 ± 4.04)%, (42.88 ± 3.62)%, t = - 9.79, - 10.22, all P＜ 0.05]. Diffuse hypokinetic motion of the left ventricle reduced in 95% (61/64) of CKD patients, and 5% (3/64) of CKD patients had segmental LV dyskinesia. Seventy five per sent(48/64) of the patients accompanied with mitral regurgitation, and 39% (26/64) of these cases accompanied with tricuspid regurgitation. Meaningful Mitral or tricuspid regurgitation was not found out in control group. Conclusions The CKD patients' bore of atrio-ventricular cavity and LV mass are enlarged, and their motion of ventricle is reduced or partly reduced. They have poor heart function. Mitral regurgitation are more than tricuspid regurgitation. Color doppler Ultrasonography is important in diagnosis of chronic Keshan discase.