Objective To understand common X-ray signs of bone and joint of forearm and shank,in order to provide a basis for diagnosis of skeletal fluorosis.Methods A total of 15 villages which were built for more than 50 years in Nongan and Qianan counties of Jilin province were selected and surveyed by quantitative epidemiological methods.These villages had no industrial and coal-burning-borne fluorine pollution; no other high fluoride sources; had not yet changed to low-fluoride drinking water,and had complete and stable historic data of fluoride content in drinking water.Drinking water fluoride content was determined.Inhabitants lived in the local for more than 10 years,between the age of 16-60 were chosen from the villages based on the 11 levels of fluoride content of drinking water from 0.5-7.0 mg/L and these people were divided into 5 age groups:16-,21-,31-,41-,51 to 60.In each age group,10-15 individuals were taken by stratified random sampling to do the forearm and shank joint X-ray examination.Drinking water fluoride content between 0.5-1.0 mg/L acted as the low fluoride group(control group),1.5-7.0 mg/L as the high fluoride group and various X-ray findings and the detection rate were observed.Results Three X-ray signs of skeletal fluorosis,joint degenerative change and osteoporosis were observed.Thereinto,joint degenerative change was the most common.In the high fluoride group(31.55％,153/485),the detection rate of joint degenerative change was higher than that of the low fluoride group (21.58％,41/190) and the difference was statistically significant (x2 =6.62,P ＜ 0.05).Seventy two of 675 peoples used by X-ray were detected with skeletal fluorosis,which occurred mainly in the higher intake of high fluoride group (x2 =25.65,P ＜ 0.01).When water fluoride was up to 6.0-7.0 mg/L,the detection rate of endemic skeletal fluorosis was increased to 44.92％(53/118).Regardless of higher or lower of water fluoride and mild or more serious of the state of fluorosis,changes of X-ray signs of bone surroundings happened first; on average with a detection rate of 95.83％ (69/72),the joint change followed by 79.17％ (57/72) and bone substance change the least at 56.94％(41/72),and the difference was statistically significant (x2=9.64,P ＜ 0.01).Regardless of water fluoride high and low,joint of elbow knee and wrist underwent degenerative change.Degenerative change of elbow joint happened first with a detection rate of 17.78％ (120/675),knee joint followed by 15.41％ (104/675),and wrist joint was the least at 7.85％ (53/675).The difference was statistically significant (x2 =30.74,P ＜ 0.01).Elbow degeneration detection rate(21.03％,102/485) in high fluoride group was significantly higher than that of the low fluoride group(9.47％,18/190; x2=12.47,P ＜ 0.01).X-ray examination showed 35 kinds of signs; most signs could be seen in the high fluoride and the low fluoride groups.But the changes of bone around were seen more often in higher fluoride content group than in lower fluoride content group.Conclusions X-ray signs of endemic skeletal fluorosis are complex and diverse.Only after comprehensive analysis,the diagnostic results are accurate and reliable.

Objective To describe a new method of reconstruction of anterior crucial ligament(ACL) so as to avoid additional injury of peripatellar tissue and complications caused by procuring autograft from the patellar tendon. Methods To reconstruct the injuried ACL under arthroscopy by means of identical length of allogenic achilles tendon which was stored in deep hypothermia. At the same time, injuried medial collateral ligament(MCL) was reconstructed by using the achilles tendon. Results From January 1996 to June 2000, the ACLs in 31 cases were reconstructed by allogenic achilles tendon under arthroscopy. The average period of follow up of 25 cases(26 sides) was 18.9 months(12-49 months). Among them, 4 injuried MCLs were also reconstructed, 5 torn meniscus were sutured, and 6 were resected or partially resected. According to the Lysholm score method, the average score was 53.5 preoperatively, and 84 postoperatively, the satisfactory rate was 84.6%. The objective examination showed anterior drawer test(ADT) positive in 23 preoperatively, 1 postoperatively; Lachman test was positive in 25 preoperatively, 1 postoperatively, and weak positive in 2 postoperatively. There were 2 with pain in knee joints and 3 with limitation of activity of knee joints(5?-20?)postoperatively. Conclusion Allogenic achilles tendon, a materials can be procured in advance, and the injury and complications caused by the autograft can be decreased, and MCL can be reconstructed at the same time. With this technique, the material is convenient to obtain, the operative method is simple, and there is no need for internal fixation.

Objective The investigation was to evaluate the method and the efficacy of double-bun-dle anterior cruciate ligament reconstruction with semitendinosus and gracilis tendon through two bone tun-nels.Methods From April1998to May2000,12patients underwent double-bundle anterior cruciate liga-ment reconstruction were reviewed and followed up more than18months.There were12male and2female patients aging from17to38years old(mean,25.5years).5cases were associated with simple anterior cru-ciate ligament injury,and the other7cases suffered from anterior cruciate ligament injury with concomitant torn meniscus.Two bone tunnels of4.5mm diameter were made in the tibial and the femoral attachment site of ACL anteromedial bundle and posterolateral bundle respectively.The anteromedial bundle was recon-structed using semitendinosus tendon,and the posterolateral bundle was reconstructed using the gracilis ten-don.The attachments of the semitendinosus and gracilis tendon outside tibial tunnels were reserved,the re-paired tendons were tied as a knot outside femoral tunnels.There was not need to do any internal fixation.Anterior drawer test was performed in30,60and90degrees of flexion of the knee joint,and Lysholm rating system was used to determine the function of the knee and the level of activity of the patients.Results Be-fore operation,anterior drawer test in30,60and90degrees of flexion of the knee joint was positive in all patients,the mean Lysholm scores were50.5points(range,40to58points).18months after operation,ante-rior drawer test in30,60and90degrees was negative in9cases,anterior drawer test in60,90degrees of flexion of the knee joint was negative in2cases,in90degrees negative in1case;The mean Lysholm scores was85points(range,62to92points).The good and excellent results were obtained in91.7%.Conclusion The combination of double-bundle anterior cruciate ligament reconstruction makes a great progress to anatomic reconstruction,provides better dynamic stability of the knee joint,and predisposes the patients sat-isfactory clinical effects.

Decontamination ; methods ; Gastric Lavage ; methods ; Humans ; Poisoning ; therapy

Objective To observe the effect of antisense hypoxia inducible factor-1?(HIF-1?) on (chemosensitivity) of human pancreatic cancer cell line BxPC-3 under hypoxia. Methods BxPC-3 cells were divided into 3 groups:(1)BxPC-3 cells were non-transfected with antisense HIF-1? plasmid and exposed to 0.5% O_2 for 4hr(hypoxia control);(2)normoxic BxPC-3 cells were non-transfected with antisense(HIF-1?) plasmid(normoxia control);(3)BxPC-3 cells were transfected with antisense HIF-1? plasmid and exposed to 0.5% O_2 for 4hr(experimental group).Expression of HIF-1? and survivin was detected by RT-PCR and Western Blot.Growth inhibition rates and apoptosis rates of BxPC-3 cells under different(dosages) of chemotherapeutic agents(5-fluorouracil,doxorubicin and gemcitabine) were measured by MTT(colorimetric) assay and flow cytometry (FCM).Results Expression of HIF-1? was obviously down-regulated and at the same time susvivin expression was markedly down-regulated in experimental group(P

Objective To evaluated the effect of hyperbaric oxygenation therapy(HBO)on the RhoA ex- pression and nerve function after transient focal cerebral ischemia in a rat model of middle cerebral artery occlusion. Methods One hundred and twenty-six healthy Sprague-Dawley rats were used and randomly divided into a sham op- eration group(shame group,n=42),a treatment group(n=42),and a control group(n=42).The animal model of middle cerebral artery occlusion(MCAO)was established by using the Zea-Longa method with the animals in the treatment and the control groups,and sham operation was performed with those in the sham group.HBO was applied to the animals in the treatment group.The RhoA protein expression was observed by using immunohistochemistry technique,and the neurological function was evaluated by Bederson's scale at different time points after MCAO.Re- sults(1)Weakly positive expression of RhoA could be located in bilateral cortex and the basal ganglia in the sham group.The expression of RhoA in the treatment group and control group was increased as early as 6 hours after MCAO when compared with that of the sham group,and peaked at 48 h after MCAO and decreased after then,but was still higher than that of the shame group at 7th day to 14th day after MCAO.It was also found that the expression of RhoA of the treatment group was significantly lower than that of the control group(P

Objective To investigate the necessity of low-intensity anticoagulation standard in patients after heart valve replacement and the rationality of INR in our hospital.Methods 681 eligible candidates were anticoagulated under the current guidelines for postoperative anticoagulation therapy in our hospital(AVR 1.5-2.0,MVR 2.0-2.5,DVR 2.0-2.5,TVR 2.5-3.0).We monitored the patient 's PT regularly and analyzed the occurrence of anticoagulation-related complications,such as bleeding,thrombosis and embolism.Results 602 cases completed the follow-up.During the period of follow-up,66 patients had bleeding tendencies,the incidence of bleeding complications was 10.96％ (66/602).1 1 patients had embolism complications,the incidence of thrombotic complications was 1.83 ％ (11/602).The average of INR was 2.24± 0.68,the mean oral Warfarin dose was(3.12± 1.14) mg/d.Conclusion Our study suggest that the effect of low-intensity anticoagulation after heart valve replacement is reliable.Further more,the current anticoagulation standards of our hospital meet the requirements of postoperative clinical anticoagulant after heart valve replacement in our region.

Objective To investigate the clinical characteristics of 40 patients with ocular toxocariasis (OT) on the first attendance.Methods A total of 40 consecutive patients who were clinically and serologically diagnosed with OT were retrospectively reviewed.Results The mean age of patients was (12.12±10.42) years.There were 29 males and 11 females.29 cases presented with decreased vision,4 children with leukocoria,2 cases with strabismus and 5 cases was found abnormal during regular eye examination.Initially 8 eyes (20％) were misdiagnosed as retinoblastoma (1 eye),Coat' s disease (1 eye),cataract (2 eyes),iridocyclitis (2 eyes) and retinal detachment (2 eyes).23 eyes had retinal detachment,19 eyes had cataract.OT was the initial diagnosis for 15 patients (37.5％).The best corrected visual acuity (BCVA) were NLP to 0.7.Ultrasound biomicroscopy (UBM) were performed in 29 eyes,and identified peripheral granulomas in 23 eyes and adjacent tractional retinal detachment in 12 eyes.We also identified 17 cases (68.0％) with elevated IgE level among 25 patients with positive serological antibody test.Conclusions Tractional retinal detachment,vitreous opacities and cataract are the common clinical findings at the first attendance of OT patients.The adjunctive test of serum total IgE level may be helpful for the diagnosis.The application of UBM and specific IgG detection in serum and intraocular fluid,can also improve the diagnosis.

Objective To investigate the effect of integrin-?1 antisense oligodeoxynucleotide(ASODN) on(human) pancreatic cancinoma transplanted subcutaneously in nude mice.Methods The models of human(pancreatic) cancinoma transplanted subcutaneously were established in nude mice,then divided randomly into 3 groups and different treatment was given respectively(control group,random oligodeoxynucleotide group and ASODN group).After treatment,the weight of nude mice and tumor volume were observed,and the tumor growth inhibitory rate and the tumor response rate were calculated.The expressions of integrin-?1 mRNA and protein in tumor tissue were determined by RT-PCR and Western-blot.Results The tumor growth inhibitory rate in the random oligodexynucleotide group and the ASODN group was 4.75% and 72.70%,respectively.The tumor decrease rate of the ASODN group was 10.91%.The expression level of integrin-?1 mRNA and protein was decreased in the ASODN group compared with other 2 control groups. Conclusions Our findings suggest that integrin-?1 antisense oligodeoxynucleotides result in marked inhibition of human pancreatic(cancinoma) growth in nude mice.It may be a novel treatment approach for human pancreatic carcinoma.

Objective To compare the diagnosis results of endemic skeletal fluorosis from clinical and X-rays examinations, in order to provide the foundation for revising clinical diagnostic standard of endemic skeletal fluorosis. Methods The 675 inhabitants aged 16 to 60 years old were retrospectively chosen as subjects in 15 villages drinking un-improved water, where they lived for 10 years or more. Drinking water fluoride were rated as 0.5,1.0, 1.5,2.0,2.2,2.4,3.0,3.5,4.0,6.0,7.0 mg/L levels in Qianan and Nongan County of Jilin Province. The clinical and X-rays results of endemic skeletal fluorosis were analyzed and compared at different drinking water fluoride levels. Results The clinically detectable rates of endemic skeletal fluorosis(21.43%,22.45% ,21.28%, 19.05%, 38.89%) were higher than that of X-rays(0,2.04%,0,4.76%, 12.96%, X2=7.96,9.49,11.19,4.08,9.45, P<0.05) when fluoride content of drinking water was 2.0,2.2,2.4,3.0,4.0 mg/L. X-rays detective rates were 0 at water fluorides levels of 2.0,2.4 mg/L and still low at water fluoride levels of 3.0,4.0 mg,/L. The difference of detective rates of endemic skeletal fluorosis between the clinical (1.00%,4.44%, 7.23%, 18.00%, 54.39%, 49.18%) and X-rays (0,2.22%, 3.61%, 8.00%, 36.84%, 52.46%) were not statistically significant at water fluorides levels of 0.5,1.0,1.5,3.5,6.0,7.0 mg/L(X2=1.00,0.17,0.47,2.21,3.54,0.13, P>0.05). Conclusions The detectable rates of skeletal fluorosis increase with the increased concentration of water fluoride, which is more reliable for clinical examination than for X-rays method.