Objective To evaluate the completion of a goal in elimination of iodine deficiency disorders IDD) in the 12th five-year plan for prevention and control of endemic diseases,to analyze the present situation of IDD in prevention and to improve sustainable control strategies in the city of Wuhai in Inner Mongolia.Methods In 2015,using the specific sampling method,5 units were selected from 3 counties of Wuhai according to their subarea positions of east,south,west,north and center,and then 1 township was randomly selected from each unit,40 school children (half males and half females) aged 8-10 and 20 pregnant women were investigated in each township.Goiter of children aged 8-10 was examined by B ultrasonic,the urinary iodine levels were detected by acid digestion arsenic-cerium contact method and the salt iodine levels were measured with the method of direct titrimetric method.Results Totally 900 edible salt samples of local residents had been examined and the median iodized salt iodine was 24.2 mg/kg,the consumption rate of iodized salt was 99.56％ (896/900),the coverage rate of iodized salt was 99.78％ (896/900),and the rate of qualified iodized salt was 99.78％ (898/898).The goiter rate of children was 0.33％ (2/600),urinary iodine level (UI) median was 221.6 μg/L in 600 children aged 8-10,the ratio of urinary iodine levels between 100-199 μg/L was 31.7％ and the median of urinary iodine was 122.15 μg/L in 300 pregnant women,the ratio of urinary iodine between 150-250 μg/L was 26.7％ (80/300).Conclusion Wuhai has achieved the goal of prevention and control of endemic disease prevention andcontrol of the 12th five-year plan,and reached the continuous state of elimination of IDD.

Antiviral Agents ; Diabetic Retinopathy ; Drug Combinations ; Hepatitis C, Chronic ; Humans ; Interferon-alpha ; Polyethylene Glycols ; Recombinant Proteins ; Ribavirin

Objective To explore the risk factors and prognosis of hospitalized patients with bloodstream infection due to carbapenem-resistant Acinetobacter baumannii (CRAB).Methods 163 patients with CRAB bloodstream in-fection from 2010 to 2013 were conducted retrospective case-control study,68 patients with bloodstream infection due to carbapenem-susceptible Acinetobacter baumannii (CSAB)during the same period were as control group. Results The independent risk factors for CRAB bloodstream infection were stay in intensive care unit(ICU)(OR, 1 .27[95%CI ,5.55-22.89])and emergency department(OR,3.57 [95%CI ,1 .67 -7.62])before infection.Pa-tients with CRAB bloodstream infection had lower 28-day survival rate than those with CSAB bloodstream infection (66.17% vs 96.95%,χ2 =15.71 ,P <0.001 ).The independent risk factors for influencing prognosis of Acineto-bacter baumannii bloodstream infection were infection of CRAB (HR 95% CI ,3.01 -67.28),blood disease(HR 95%CI ,3.77-25.97),cardiac insufficiency(HR 95%CI ,2.10-20.41),stay in ICU(HR 95%CI ,1 .01 -5.28), and age(HR 95%CI ,1 .01 -1 .04).Conclusion The independent risk factors for CRAB bloodstream infection are stay in ICU and emergency department before infection,CRAB bloodstream infection is risk factor for influencing prognosis of patients.

Objective To explore strategies and measures to improve hand hygiene (HH)compliance and correctness of health care workers (HCWs)in a large hospital.Methods The WHO multimodal hand hygiene improvement strategy was adopted by healthcare-associated infection(HAI)management department of a hospital,measures consisted of five key com-ponents,including:system change,education and training,evaluation and feedback,reminders in the workplace,and insti-tutional safety climate.HH compliance and correctness of HCWs were observed by infection control practitioners,HH compliance and correctness in January-June of 2012 (pre-intervention)and January-June of 2014 (post-intervention)were compared,effectiveness of intervention strategies were evaluated.Results HH compliance rate and correctness rate of post-intervention were both higher than pre-intervention (75.92% [8 369/11 023]vs 53.67% [5 127/9 553],P <0.001;94.11%[7 782/8 269]vs 83.88%[3 642/4 342],P <0.001).Of different occupations,HH compliance rates of doctors and nurses were significantly different before and after intervention (both P <0.001),while workers and staff of other oc-cupations before and after intervention were not significantly different(both P >0.05).Except ‘after body fluid exposure’, HH compliance rates of the other four indications for HH before and after intervention were significantly different(all P <0.001).Conclusion HH compliance and correctness of HCWs can be improved after adopting WHO multimodal hand hy-giene improvement strategy.

Objective:To identify the characteristics and risk factors of the refractures after percuta-neous kyphoplasty ( PKP) and percutaneous vertebroplasty ( PVP) .Methods:A retrospective analysis of 148 patients who had undergone PKP or PVP between March 2006 and October 2013 inPeking University People’ s Hospital was conducted.In the study, 29 patients with 42 refractured vertebra and 119 patients without refracture were included.All the patients were observed for a time of (34.4 ±26.8) months. Clinical, imaging and procedure related factors ( gender, age, height, weight, body mass index, the level of the injured vertebra, the time interval between the procedure and the refracture, the level of the refractured vertebra, the bone cement volume injected, performed PKP or PVP,performed unilateral or bilateral, the percentage of anterior vertebral height restoration, the correction of the Cobb angle, cement diffusion, bone mineral density, presence or absence of diabetes mellitus, history of fractures of the whole body, anti-osteoporosis treatment, cement leakage) for each group were analyzed by Cox propor-tional hazards regression analysis.Results:Of all the patients,16 (55.17%, 16/29) had refractures in the adjacent vertebra, and 13 (44.83%, 13/29) had refractures in the nonadjacent vertebra.Refrac-tures within 3 months accounted for 31.03%(9/29) of all the refractures, and within 1 year accounted for 55.17%(16/29).Both older age (P=0.027, HR=1.051, 95%CI=1.006-1.098) and a his-tory of fractures of the whole body (P=0.012, HR=0.386, 95%CI=0.184-0.812) were statistical-ly significant as the independent risk factors for predicting refractures.Others were not associated with re-fractures ( P>0.05) .Conclusion:Older age and a history of fractures of the whole body are the inde-pendent risk factors of the refractures after PKP and PVP.The mechanism of the refractures after PKP and PVP is mainly the natural development of osteoporosis.

Objectives To investigate the ability of T1 mapping and intravoxel incoherent motion imaging (IVIM) parameters for evaluating renal allografts at the early stage after renal transplantation. Methods This prospective study protocol was approved by the local ethics committee, and written informed consent was obtained from all subjects. Sixty two recipients 2 to 4 weeks after kidney transplantation and 20 healthy volunteers (control group) underwent routine MRI, T1 mapping, and IVIM imaging (11 b values, 0 to 700 s/mm2). Recipients were divided into two groups base on their estimated glomerular filtration rate (eGFR):37 recipients with good allograft function (eGFR≥60 ml·min-1·1.73 m-2) and 25 recipients with impaired allograft function (eGFR<60 ml·min-1·1.73 m-2). The ADC, true diffusion coefficient (ADCslow), pseudo-diffusion coefficient (ADCfast), perfusion fraction (f) and T1 values were measured on both cortex and medulla. Differences among groups were compared using the one-way analysis of variance. Correlations between eGFR and the parameters in renal allografts were assessed by using Pearson correlation analysis. ROC was performed to assess the diagnostic utilities of using these parameters to discriminate allografts with impaired function from good function. Results Excepting for cortical T1, ADCfast and medullary T1, f values, allografts with good function showed no differences in other parameters compared with healthy control. Excepting for medullary T1 and ADCfast,the other values showed significantly differences in allografts with impaired function compared to allografts with good function (all P<0.05). Excepting for medullary f and ADCfast values, allografts with impaired function showed significantly differences in the parameters compared with good function group(all P<0.05). In renal allografts, excepting for medullary T1, ADCfast, and f values, cortical T1 exhibited a negative correlation with renal function, and there was a significant positive correlation between eGFR and other parameters. Cortical T1 value showed high sensitivity(91.9%) to discriminate renal allografts with different function, with the threshold of 17.36 × 102 ms, and ADC value showed high specificity(96.0%)with the threshold of 1.98 × 10-3 mm2/s. Conclusion T1 mapping and IVIM technique may be useful for detecting renal allograft dysfunction, and be a reliable imaging for evaluating and monitoring allograft function.

Objective To investigate the dynamic changes in peripheral blood CD34+cells and plasma levels ofvascular endothelial growth factor(VEGF)in patients with acute cerebral infarction.and explore the roles of CD34+ cells and VEGF in acute cerebral infarcfion. Methods In 40 patients with acute cerebral infarction,the counts of CD34+cells in tlle peripheral blood were measured using flow cytometry on days 3,7,10 and 14 following the onset,with 40 healthy individuals as the control.Plasma levels of VEGF were also measured in these subjects at the same time points using enzyme-linked immunoassay(ELISA). Results Peripheral CD34+ cells increased significantly after the onset of acute cerebral infarction,reaching the peak level on day 10.Plasma VEGF levels also increased significantly in the patients as compared with that in the control subjects,reaching the peak level on days 7to 10.An obvious correlation was noted between the levels of pefipheral blood CD34+cells and VEGF levels in the patients with acute cerebral infarction. Conclusion Increased peripheral VEGF level and CD34+cells folMwing acute cerebral infarction may promote angiogenesis,improve brain tissue hypoxia isehemia,and so play a role in the protection of nerve function.

OBJECTIVE: To explore the current situation and tendency of the forensic psychiatric examination of the cases of labor disputes. METHODS: This study reviewed 156 cases examined during the period of 1990-2001, analyzing some related factors. RESULTS: It was shown that most of these cases were related to the termination and interruption of labor contracts, while the quantity of cases related to labor pay increased considerably. The intervals between the beginnings of disputes to examinations were prolonged, while 69.2% of the intervals were within 12 months. 91.2% conclusions of the examinations were consistent with the diagnosis of psychiatric history. The rates of limited civil capability and incapability were 23.1% and 52.6%. CONCLUSION The quantity, type and interval of the cases of labor disputes were changing greatly during recent years. More attention should be paid to this kind of cases.
Adolescent ; Adult ; Aged ; Collective Bargaining/legislation & jurisprudence* ; Expert Testimony/legislation & jurisprudence* ; Female ; Forensic Psychiatry ; Humans ; Intellectual Disability/diagnosis* ; Male ; Mental Disorders/diagnosis* ; Middle Aged ; Retrospective Studies ; Schizophrenia/diagnosis* ; Schizophrenia, Paranoid/diagnosis*

OBJECTIVE: To create an instrument to determine the mental prisoners' competency to serve a sentence, which is according with the Chinese legal system. METHODS: Integrating the Chinese criminal jurisprudence and the authors' forensic psychiatric experience, the research team created an instrument which called Competency to serve a sentence Rating scale firstly, then used the instrument retrospectively, in the end the validity and reliability of the instrument were inspected and, through an diagnostic test, the feasibility of the instrument was evaluated. RESULTS: Homogeneity reliability of the instrument is 0.8779, the correspondence of the conclusion between the instrument and the expertise is 0.909, except the positive likelihood ratio is 0.0683, the other diagnostic index are better. CONCLUSION The Competency to serve a sentence Rating Scale is feasible.
Adult ; Expert Testimony ; Female ; Forensic Psychiatry ; Humans ; Male ; Mental Competency ; Mental Disorders/psychology* ; Mentally Ill Persons/psychology* ; Prisoners/psychology* ; Psychiatric Status Rating Scales ; Retrospective Studies ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo determine the location of the vertebral artery foramens from C(3) to C(6) and their relationship to the point 1 mm medial to the center of the lateral mass and to identify the value of oblique radiograph for cervical lateral mass screw trajectory by a cadaveric study.

METHODS(1) Twenty-eight cervical specimens (C(3)-C(7)) of human cadavers aged from 28 to 79 years were analysed. The transverse radiographs of C(3)-C(6) vertebrae were taken and the angle between the parasagittal plane and the line connecting the point of the lateral mass with the lateral limit of the transverse process foramen of C(3)-C(6) were measured. (2) The K-wires were drilled into lateral mass of C(3)-C(6) starting 1 mm medial to the center of the lateral mass and exiting by the juncture between the transverse process and the facet in ten specimens. Four wire placements under direct visualization, including placement of the wire tip staying the ventral cortex and 2, 4, 6 mm over-penetration of the ventral cortex of lateral mass, were performed separately on each specimen. After each placement, radiographs were taken on 45 degrees oblique left and 45 degrees oblique right views. Each intervertebral foramen on the oblique radiographs was divided into two parts: superior and inferior parts. The former is the true intervertebral foramen, while the latter is the intertransverse foramen on the gross specimen. The number of wire tips in each part was quantified for each placement. All results on the radiographs were compared with those on the gross anatomy.

RESULTS(1) The angles between the parasagittal plane and the line connecting the posterior starting point of the lateral mass with the lateral limit of the transverse foramen (C(3)-C(6)) were lateral to the sagittal plane, ranging from 5 degrees to 12 degrees. Among the vertebrae, there were no statistically significant difference (P > 0.05). (2) 15% of the wires without over-penetration and 41.3% with 2 mm over-penetration were found in the inferior parts of the intervertebral foramen in oblique views, while the wires were not noted in the intervertebral foramen by gross anatomy. with 4 mm over-penetration of the ventral cortex, 35% and 65% of wires were noted in the superior and inferior parts of the intervertebral foramen respectively, while only 28.8% of wires were found in the inferior part approximating the nerve roots in gross specimens. With 6 mm over-penetration, the number in the intervertebral foramen were 63.8% superiorly and 36.2% inferiorly on the oblique radiographs while all the tips were at the inferior part (intertransverse foramens) in gross specimens. The tip of wire crossed the line connecting the posterior borders of the intervertebral foramens in oblique radiographs when it penetrated the ventral cortex of lateral mass 4 mm or more.

CONCLUSIONS(1) There is no risk of damaging the vertebral artery if a screw is directed more than 15 degrees lateral to the sagittal plane at C(3 approximately 6) starting 1 mm medial to the center of the lateral mass. (2) Ideal screw tip position on oblique radiograph may not cross the line connecting the posterior borders of the intervertebral foramen on radiograph. If the screw tip is noted in the superior part of intervertebral foramen on the oblique radiograph, the screw may be identified as dangerous.

Adult ; Aged ; Bone Screws ; Cadaver ; Cervical Vertebrae ; anatomy & histology ; surgery ; Humans ; Internal Fixators ; Middle Aged ; Models, Anatomic ; Spinal Fusion ; instrumentation ; methods ; Spinal Nerve Roots ; anatomy & histology ; Vertebral Artery ; anatomy & histology