Adult ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Lead ; blood ; Lead Poisoning ; blood ; epidemiology ; Middle Aged

Objective To analyze the ophthalmologic characteristics and examinations which caused by vertebral-basilar insuffi- ciency.Design Retrospective case series.Participants 469 eases of vertebral-basilar insufficiency.Methods Retrospective analysis of 469 cases of vertebral-basilar insufficiency patients with ophthalmologic signs' features,incidence,the main cause,color Doppler flow imaging and(or)digital subtraction angiography clearly stenosis location,the degree of stenosis from July 1st 2005 to July ist 2007 in PLA General Hospital.Main Outcome Measures Ophthalmologic signs' related reasons and supplementary examination.Results 96 cases were with the corresponding eye symptoms(20.4%).Vision decreased in 83 cases,diplopia was in 56 cases,ipsilateral hemiopia quadrant blind in 12 cases and depending on deformation in 10 cases,fundus arteriosclerosis in 72 cases,nystagmus in 39 cases,the eye movement disorder in 16 cases.Among 96 patients with associated ocular symptoms,75 patients with color Doppler flow imaging (CDFI)showed unilateral vertebral artery abnormal in 66 cases(88%),among those blood flow velocity decreased in 26 cases,17 cases with vascular plaque stenosis,thinning in 20 cases,3 cases with complete occlusion;different bilateral vertebral artery abnormal in 9 cases(12%),among those velocity dropped in 4 cases,two cases with vascular plaque stenosis and thinning in 3 cases.Forty-five cases with the digital subtraction angiography(DSA),left vertebral artery was abnormal in 24 cases,18 cases with stenosis,occlusion in 5 cas- es,abnormal bending in 1 case.Right vertebral artery was abnormal in 16 cases,13 cases with stenosis,occlusion in 3 cases.Bilateral vertebral artery stenosis was found in 2 cases;vertebral artery stenosis was in 3 patients.Conclusion Vertebral-basilar insufficiency may cause eye-related symptoms,therefore,vision acuity decrease,fundus 'arteriosclerosis,diplopia and nystagmus symptoms are more likely for patients with vertebral-patients with basilar artery insufficiency performance of the eye.(Ophthalmol CHN,2002,16:406-410)

Objective To investigate the safety and efficacy of retroperitoneal laparoscopy for adrenal tumor and report the experience with this procedure for adrenal surgery.Methods From June 2003 to March 2007,we performed 24 laparoscopic tumorectomy via the retroperitoneal approach.Results All procedures were successful. The average operative time was 1.7 hours(ranging from 1 to 3.5 hours).All patients had no need of transfusion and no complication.All patients recovered.The average hospital stay was 4.5 days(ranging from 3 to 8 days).Patholog- ic diagnosis:10 cases of nonfunctional adenoma,6 cases of primary aldosteronism,4 cases of adrenal cyst,2 cases of pheochromocytoma,2 cases of Cushing's adenoma.Conclusions Retroperitoneal laparoscopic surgery for adrenal oc- cupying lesion had such advantages as minimal invasive,safe and effective,early recovery and shorter stay in hospital. It should be the flint choice of treatment for adrenal occupying lesion.

Objective To evaluate the significance of CT assessment for extraarticular anatomy in treatment of displaced intraarticular calcaneal fractures.Methods(1)Measurement of normal calcaneum 40 pieces of adult calcaneum specimen were measured,items of measurement included height of culmination of posterior facet and tuberosity,width of posterior edge of sustentaculum and tuberosity.(2)CT measurement of calcaneum.Transverse(axial)and coronal CT scanning were obtained from 20 feet with displaced intraarticular calcaneal and 20 normal feet as control.Following items were measured in CT scanning:the height of culmination of posterior facet and tuberosity,the coronal talocalcaneal angle,in coronal scanning,the width of posterior edge of sustentaculum and tuberosity,the axial calcaneocuboid angle,in axial scanning.Results(1)Measurement of height of calcaneum height of culmination of posterior facet and tuberosity of calcaneal specimen were(43.07?2.85)mm and(44.69?3.67)mm respectively,and these two items from CT scanning of normal feet were(42.84?1.66)mm,(43.40? 3.01)nun,and from CT scanning of feet with calcaneal fractures were(34.76?3.24)mm,(40.41? 3.69)mm.There was a statistically significant different between these two items for normal calcaneal specimen and for CT scanning of feet with ealcaneal fractures(P

Objective The study is designed to evaluate the difference in identification for depression and clinical effectiveness of its treatment between psychiatrists and non-psychiatric Dhysieians at out-patient departments of general hospitals and to analyze its related factors.Methods Totally,680 patients who visited psychiatric clinics in nine general hospitals of Shanghai at first time were screened by psychiatrists using Composite International Diagnostic Interview(CIDI)for depression and the screening resuhs were compared to the diagnosis made by non-psychiatric physicians as goal-keepers there.Altogether 297 patients with depression were recruited and assessed using Hamilton Depression Rating Scale(HAMD)and Hamilton Anxiety Rating Scale(HAMA).A self-made questionnaire for basic information was used to assess the ability for identification of depression in non-psychiatric physicians of general hospitals.Results Psychiatrists identified depression correctly in 337 of 680 patients who visited psychiatric clinics in general hospitals at their first visit,but non-psychiatric physicians only identified 216 patients,with statistically significant difference(χ2=30.73,P=0.000).A consistent agreement on depression diagnosis between the findings by psychiatrists and by CIDI was reached with Kappa of 0.774,but Kappa for that between the findings by non-psychiatric physicians and CIDI was 0.439.Effectiveness of treatment for depression by psychiatrists was better than that by non-psychiatric physicians,with higher total score and scores for each item of HAMD four,eight and 12 weeks after treatment,respectively(P＜0.05 or P＜0.01).Length of professional work of non-psychiatric physicians and annual time for professional training in management of mental disorders associated with their ability of identification for depression(P＜0.05).Conclusion Ability of non-psychiatric physicians to identify alQd cope with depression in the psychiatric department of general hospitals was insufficient,suggesting that more importance should be attached to the management of service quality at psychiatric department of general hospitals.

Adolescent ; Adult ; Dust ; analysis ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Occupational Exposure ; analysis ; Pneumoconiosis ; prevention & control ; Sentinel Surveillance ; Surveys and Questionnaires ; Welding ; Young Adult

OBJECTIVETo discuss the technical points, advantages, follow-up results and mechanism of endovenous holmium laser treatment for varicose veins.

METHODSEndovenous holmium laser procedures were performed for 96 patients (99 legs) with primary varicosity of lower extremities. Perioperative Duplex was used for preoperative diagnosis, intraoperative guide and postoperative follow-up. The time of procedure and clinical results were observed. The mean follow-up time was 7 months.

RESULTSSixty-seven in 99 legs with saphenous vein occluded immediately during operation. All saphenous veins were confirmed to be occluded 7 days after the procedure. There was no recanalization with Duplex finding during the follow-up period. No wound complications. Two cases were with minor skin burn. One case was with saphenous nerve injury. Three cases were with thigh ecchymosis.

CONCLUSIONPreliminary results show endovenous holmium laser treatment for varicose veins is safe and effective in treating varicose veins with cosmetic appearance and quicker recovery.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Holmium ; therapeutic use ; Humans ; Laser Coagulation ; methods ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Saphenous Vein ; surgery ; Treatment Outcome ; Ultrasonography, Doppler, Duplex ; Varicose Veins ; diagnostic imaging ; surgery

OBJECTIVETo investigate the expression levels of telomere repeat binding factor 1(TRF1) protein in normal kidney tissue and kidney cancer.

METHODSSpecimens of kidney cancer and pericancerous tissues were collected from 32 cases of renal carcinoma. A quantitative Western blotting technique was developed using TRF1 monoclonal antibody to determine the expression level of TRF1 protein in total protein extracts from tissue specimens.

RESULTSThe expression level of TRF1 protein was higher in normal kidney tissues (3.611 +/-1.922 microg/microl) than that of cancer tissues (2.428 +/-1.352 microg/microl) (t=5.776, P<0.01).

CONCLUSIONThe expression level of TRF1 protein is significantly reduced in kidney cancer and the level is negatively correlated with malignant degree of the cancer.

Adenocarcinoma, Clear Cell ; metabolism ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kidney ; metabolism ; Kidney Neoplasms ; metabolism ; Male ; Middle Aged ; RNA, Messenger ; biosynthesis ; genetics ; Telomeric Repeat Binding Protein 1 ; biosynthesis ; genetics

OBJECTIVETo study the clinical effects of percutaneous vertebroplasty and kyphoplasty in the treatment of fresh thoracolumbar fractures in the elderly.

METHODSFrom May 2004 to March 2009, among 29 patients (32 vertebras) with thoracolumbar fractures, 18 patients (21 vertebras) were treated with percutaneous vertebroplasty (PVP) and 11 patients (11 vertebras) were treated with percutaneous kyphoplasty (PKP). The visual analogue scale (VAS) and mobility were evaluated 3 days before and after operation. During follow-up period, patients were observed and evaluated in terms of relief of back pain and regaining of living ability. Complications such as bone cement leakage were analyzed.

RESULTSAll the patients got successful operation. The average operation time was 38.6 minutes for the 18 patients (21 vertebras) with PVP performed, and 3.2 ml (2-5 ml) bone cement was injected. For the 11 patients (11 vertebras) with PKP performed, the average operation time was 43 minutes, and an average of 3.8 ml (2-6 ml) bone cement was injected. The VAS decreased from preoperative (7.5 +/- 0.7) to (2.2 +/- 0.5) at the 3rd day after operation; the mobility scores of the patients decreased from preoperative (2.4 +/- 0.6) to (1.2 +/- 0.3) at the 3rd day after operation; the vertebral height increased from an average of (52.4 +/- 9.7)% pre-operation to (85.2 +/- 10.6)% after operation; and the average kyphosis correction of Cobb angle was 11.2 degrees. During an average of 12.6 months follow-up, no patients reported vertebral pain. Review of X-ray films showed no significant loss of vertebral height. One patient died from complications of heart disease 5 months being discharged from hospital. Another patient died from the same cause at 6 months after opertaion. Paravertebral leakage of bone cement was also found in 2 patients. No serious complications occurred and patients were satisfied with the treatment.

CONCLUSIONPVP, PKP can be used to instantly reinforce vertebral injury, relieve pain, and improve the patient's mobility. For elder people with fresh thoracolumbar fractures, when health conditions are allowed, PVP or PKP surgery is the right treatment.

Aged ; Aged, 80 and over ; Bone Cements ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Vertebroplasty ; methods

BACKGROUND: High-volume hemofiltration (HVHF) is technically possible in severe acute pancreatitis (SAP) patients complicated with multiple organ dysfunction syndrome (MODS). Continuous HVHF is expected to become a beneficial adjunct therapy for SAP complicated with MODS. In this study, we aimed to explore the effects of fluid resuscitation and HVHF on alveolar-arterial oxygen exchange, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in patients with refractory septic shock. METHODS: A total of 89 refractory septic shock patients, who were admitted to ICU, the Provincial Hospital affiliated to Shandong University from August 2006 to December 2009, were enrolled in this retrospective study. The patients were randomly divided into two groups: fluid resuscitation (group A, n=41), and fluid resuscitation plus high-volume hemofiltration (group B, n=48). The levels of O2 content of central venous blood (CcvO2), arterial oxygen content (CaO2), alveolar-arterial oxygen pressure difference P(A-a)DO2, ratio of arterial oxygen pressure/alveolar oxygen pressure (PaO2/PAO2), respiratory index (RI) and oxygenation index (OI) were determined. The oxygen exchange levels of the two groups were examined based on the arterial blood gas analysis at different times (0, 24, 72 hours and 7 days of treatment) in the two groups. The APACHE II score was calculated before and after 7-day treatment in the two groups. RESULTS: The levels of CcvO2, CaO2 on day 7 in group A were significantly lower than those in group B (CcvO2: 0.60±0.24 vs. 0.72±0.28, P<0.05; CaO2: 0.84±0.43 vs. 0.94±0.46, P<0.05). The level of oxygen extraction rate (O2ER) in group A on the 7th day was significantly higher than that in group B ( 28.7±2.4 vs. 21.7±3.4, P<0.01). The levels of P(A-a)DO2 and RI in group B on the 7th day were significantly lower than those in group A. The levels of PaO2/PAO2 and OI in group B on 7th day were significantly higher than those in group A (P<0.05 or P<0.01). The APACHE II score in the two groups reduced gradually after 7-day treatment, and the APACHE II score on the 7th day in group B was significantly lower than that in group A (8.2±3.8 vs. 17.2±6.8, P<0.01). CONCLUSION: HVHF combined with fluid resuscitation can improve alveolar- arterial-oxygen exchange, decrease the APACHE II score in patients with refractory septic shock, and thus it increases the survival rate of patients.