[Objective]To understand the changes of children's blood lead levels and intelligence quotient (IQ) andthe effects of automobile exhaust on the prevelance rates of respiratory symptoms of children. [Methods] 151 pupilsof Y primary school in urban area were selected as exposure group, 160 pupils of Z primary school in Pudong districtwere selected as control group. The health questionaire survey and health examination were carried out amongpupils. The peripheral blood lead levels of the forth finger were determined. The IQ was determined by combinedRaven's Test. The data were statistically analzed by EPI Info and SAS statistic softwares. [Results] Significant differ-ences of blood lead levels were observed between exposure group and control group. The blood lead levels (x) negatively correlated with children's IQ (y) (y= 120. 11--0. 129x) . The prevelance rates of sore and uncomfortable feelings and foreign body sensation in throat and cough of exposure group were significantly higher than those in controlgroup. The ORs of corresponding symptoms were 1.71, 2, 64 and 2. 92 respectively. The multiple linear regressionanalysis showed that exposure to automobile exhaust and the distances from the residential region to street with heavytraffic were the main factors affecting the children's peripheral blood lead levels and the prevelance of respiratorysymptoms. [Conclusion] Further control of the emission of automobile exhaust and reasonable planning of location ofresidential areas were the main measures to control the prevelance of lead poisoning and its related diseases of children.

Objective To compare the efficacy of different antibiotics strategy,introperitoneal (IP) cefazolin plus third-generation cephalosporin versus IP Vancomycin plus thirdgeneration cephalosporin on peritoneal dialysis (PD)-related peritonitis.Methods All episodes of PD -associated peritonitis happened in prevalent PD patients between January 2008 and December 2012 were recruited from the PD Center of Peking University First Hospital.According to their empiric antibiotics scheme,episodes were divided into group A (where IP cefazolin plus third-generation cephalosporins were administrated) and group B (where IP Vancomycin plus third-generation cephalosporins were administrated).Multivariable logistic regression model was used to explore the influence of different emnpiric antibiotics scheme on peritonitis outcome.Results Patients in Group B had significantly lower level of serum albumin (33.5±6.0 vs 35.3±5.2 g/L) and cholesterol (4.6±1.3 vs 4.9± 1.1 mmol/L) than those in group A.In group A,the percentage of gram-positive bacteria was similar to group B (43.2％ vs 43.3％,P =0.96),but gram-negative bacteria was numerically lower (16.9％ vs 24.7％,P =0.08).Different empiric antibiotics strategy was not independent predictor of peritonitis outcome [OR =1.07,95％ CI(0.45,2.56),P=0.87].Conclusion Both cefazolin and vancomycin can be selected as first-line empiric antibiotic covering gram-positive organisms in the treatment of PD related peritonitis.

Atlanto-Axial Joint ; injuries ; Child ; Humans ; Joint Dislocations ; etiology ; Male ; Tympanoplasty ; adverse effects

Objective: To establish a risk prediction model and scoring system in patients with side branch (SB) occlusion during coronary bifurcation intervention. Methods: A total of 7007 consecutive patients who received percutanenous coronary intervention (PCI) in our hospital from 2012-02 to 2012-07 were recruited and 1545 patients (with 1601 bifurcation lesions) treated by single stent technique or main vessel stenting ifrst strategy were selected for our study. According to weather SB occlusion occurred during operation, the lesions were divided into 2 groups: Non-SB occlusion group,n=1431 and SB occlusion group,n=114. The data set of the ifrst 1200/1601 lesions by time sequence, was used for establishing the risk model and scoring system, the data set of rest 401 lesions was used for model validation. Results: The modeling data set presented that the relationship between pre-operative main vessel plaque and the position of branch vessel, the main blood vessel pre-stenting TIMI grade, the stenosis degree of pre-operative bifurcation nucleus, the angle of pre-operative bifurcation and the ratio of pre-senting stenosis degree of branch diameter and pre-operative main vessel to branch vessel diameter were the independent risk factors for branch occlusion. The risk model ROC=0.80, 95% CI 0.75-0.85, Hosmer-Lemeshow HLP=1.00; the scoring system ROC=0.76, 95% CI 0.71-0.82, HLP=0.12. The validation data set ROC=0.81, 95% CI 0.73-0.89, HLP=0.77; the scoring system ROC=0.77, 95% CI 0.69-0.86, HLP=0.58. The quartile integration of both data sets indicated that the patients with the integration score ≥ 10 had the higher risk for SB occlusion than those with integration score < 10 during the operation,P<0.001. Conclusion: Our research developed a simple and user-friendly system, it may distinguish the patients with high risk of SB occlusion during bifurcation intervention by quantitative stratiifcation of coronary angiographic imaging.

Host-Pathogen Interactions ; Humans ; Immunocompromised Host ; MicroRNAs ; genetics ; immunology ; RNA, Viral ; genetics ; immunology ; Viruses ; genetics ; immunology

Adult ; Bone Neoplasms ; Humans ; Male ; Nose Neoplasms ; Osteoblastoma ; Skull Base Neoplasms

OBJECTIVE: The study is to evaluate our results of patients with sinonasal inverted papilloma (SIP) undergoing endoscopic sinus surgery and to investigate the recurrence relative factors of SIP. METHOD: A retrospec- tive analysis was performed of medical records for 54 cases SIP treated with endoscopic resection. Compared to pre operation imaging evaluation and intraoperative observation, efficacy assessments included endoscopy during follow-up after operation and combined with CT examination results. RESULT: The incidence of 54 cases with ethmoid sinus, part of the lateral wall of the nasal cavity was higher. The recurrence rate was higher in the cases invaded front and/or inferior wall of maxillary sinus, frontal recess. There was no case with middle turbinate. Canceration with the same time accounted for 1.85%. CONCLUSION Misdiagnosis as polyps, the lesion sites of tumour, involving the frontal recess, front and inferior wall of maxillary sinus are the risk factors of recurrence. The preoperative accurate judgment of the primary tumor site and surgical resection completly are the most effective means of preventing recurrence. Postoperative endoscopy examination combined with CT examination is an effective means for the evaluation of recurrence.
Endoscopy ; Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Nasal Cavity ; Neoplasm Recurrence, Local ; Papilloma, Inverted ; surgery ; Papillomavirus Infections ; Paranasal Sinus Neoplasms ; surgery ; Turbinates

Objective To investigate the effects of two different dosages of dexmedetomidine on short-latency somatosensory evoked potentials (SLSEP)in intracranial surgery.Methods Forty pa-tients,ASA Ⅰor Ⅱ,aged 20-65 years old,selected for intracranial surgery were randomly divided in-to two groups,20 patients in each group.Bolus dose of 0.5 μg/kg dexmedetomidine was infused within first 10 min and followed by continuous infusion of 0.5 μg·kg-1·h-1 for 10 min in group A;Bolus dose of 1.0 μg/kg dexmedetomidine was infused within first 10 mins and followed by continu-ous infusion of 1.0 μg·kg-1·h-1 for 10 min in group B.SLSEP indications include N20-P25 amplitute and N20 latent period were observed.MAP,HR,N20-P25 amplitute and N20 latent period were re-corded respectively before dexmedetomidine adminstraition (T0 )and 20 mins after dexmedetomidine adminstraition (T1 ).Results Compared with T0 ,MAP and HR at T1 significantly decreased in both groups(P <0.05).N20-P25 amplitude had no statistically significant difference in both groups,while N20 latent period significantly prolonged (P <0.05).Conclusion Both doses of 0.5 μg/kg and 1.0μg/kg dexmedetomidine can significantly prolong the latent period of N20.

Lynch syndrome is the most common type of genetically determined colon-cancer predisposition syndrome, accounting for 5%of all colorectal cancer (CRC) cases. This hereditary syndrome is characterized by the germline mutation of human mismatch repair genes and microsatellite instability. Recent studies have shown that Lynch syndrome and sporadic CRC differ in diagnosis and treat-ment;these results are especially relevant for the clinical management of Lynch syndrome. In this review, we reverted to the original characterization of Lynch syndrome, and the developments in its screening and diagnosis were summarized. Furthermore, the manage-ment of families with this disorder was discussed.

To report the process of diagnosis and treatment of 1 case with SRY gene mutation of 46, XY complete gonadal dysplasia, and to discuss the clinical characteristics, diagnosis and treatment of the disease.Due to clitoral enlargement for 8 months, a 9 years old girl was admitted to the Children′s Hospital Affiliated to Zhejiang University School of Medicine.Previously, she had early breast development, and suffered from high gonadotropin expression when she was 6 years and 4 months old.Physical examination: breast B3 stage, female vulva, clitoris hypertrophy, normal urethra, normal vaginal opening, slightly thick hymen ring, the development of pubic hair was 2 stages, and Prader score level 1.Laboratory data showed elevated levels of estradiol, testosterone, and human chorionic gonadotrophin.Genetic examination revealed that the chromosome karyotype was 46, XY and SRY gene detection was positive.Therefore, the patient was diagnosed with 46, XY complete gonadal dysplasia.Bilateral gonadectomy was performed, and the posto-perative pathological diagnosis was bilateral gonadoblastoma with left dysgerminoma.The tumor did not recur after che-motherapy.The etiology of early breast development needs to be carefully identified.Patients with sexual characteristics dysplasia need to accept the chromosome karyotype analysis and gene detection, and surgical exploration should be performed when necessary for a correct diagnosis as soon as possible.