Objective To quantify the morphometric characteristics of the pedicles of the infantile thoracolumbar spine and to determine the feasibility and safety of pedicle screw fixation in very young children. Methods A total of 52 patients younger than three years of age underwent standard spiral computed tomography (CT) were enrolled in this study. The patients were grouped according to age, group 1 (0 ～ 18months of age) and group 2 (18 ～ 36 months of age). Images were reformatted, and multiplanar reconstructions were used to attain images of thoracic and lumbar pedicles on sagittal, coronal and transverse planes.The measurements included the inner and outer pedicle diameters on the transverse plane, pedicle sagittal diameter, pedicle length and the pedicle angle on the transverse. Characteristics of the pedicles of the immature thoracic and lumbar spine were studied. Results Pedicle diameters on the transverse plane decreased gradually from T1 to T5 and increased gradually from T6 to L5. The shortest transverse diameter of the thoracic pedicle was T5 or T6. The inner diameter of the segment of L4 in infant (younger than eighteen months) was less than 3.0 mm and the external diameter less than 3.5 mm from T3 to T9. The inner diameter of the segment from T5 to T8 in infant (more than eighteen months) was less than 3.0 mm and the external diameter from T4 to T7 was less than 3.5 mm. The sagittal diameter was significantly more than the transverse diameter. Pedicle diameters on the transverse plane, the sagittal diameter, and the length of the pedicle changed significantly with age, but the pedicle angle did not changed significantly with age. Conclusions The pedicles in the segment from T3 to T9 of less than eighteen months and from T4 to T7 of more than eighteen months were too small, there was no feasibility and safety of pedicle screw fixation. So pedicle screw fixation was feasible and safe for below T9 segment in the infants who are younger than three years old.

Objective To study the effectiveness of ultrasonography in thyroidnodule disease detection and malignant/benign lesion differentiation during health check-up.Method Thyroid examination data of Peking Union Medical College Hospital(PUMCH)staff over the last 6 years were retrospectively reviewed.The results of thyroidnodule scanning by using ultrasonography were compared with the findings of physical examinations.Results Among 6348 health check-up receivers from 2006 to 2010,450 were found to have thyroidnodule(detection rate 7.09％).Twenty malignant lesions were confirmed in histological examinations(mean detection rate per year 0.38％).In 2011,1706 thyroid glands were scanned by both physical examination and ultrasonography,and 525 thyroidnodules were identified(detection rate 30.77％).Surgical operations were performed for 22 suspected malignant tumors,and 18 malignant lesions were finally confirmed(detection rate 1.06％).Conclusion Ultrasonography can improve the detection of thyroidnodule.Irregular shape,microcalcification,and rich blood-flow may indicate malignant nodules.

Objective:To understand the status of two -week prevalence and the influencing factors in rural preschool leftover children of Shandong , so as to provide evidence for putting forward effective health intervention means .Methods:Using the method of stratified -cluster-random sampling and elect 646 cases of preschool lefto-ver children from 2 counties of Shandong .We surveyed with self -made questionnaire .Results:The two-week prevalence of the rural preschool leftover children is high;the influencing factors of the two -week prevalence with the rural preschool leftover children including whether children are only -child, the type of children guardianship , whether children piddle and whether left -behind children can avoid dangerous .Conclusion: The two -week prevalence present situation of rural preschool left -behind children is low , and its problems of health and ethics are clear.Therefore, effective measures should be carried out to improve the health level of rural leftover children .

Aim To investigate the effect of orientin on proliferation and differentiation of 3T3-L1 pre-adipocytes and on insulin resistance(IR) in 3T3-L1 adipocytes and the possible mechanisms.Methods MTT assay and oil red O staining were applied to investigate the proliferation and the differentiation of 3T3-L1 pre-adipocytes, respectively.The intracellular triglyceride(TG) contents were detected by enzymatic analysis.IR model was induced with dexamethasone.A fluorescent glucose analogue, 2-NBDG, was used to measure the rate of glucose uptake.Western blot was used to detect the protein level of GLUT4 and phosphorylation of AMPK and ACC.The GLUT4 translocation was measured by fluorescent-immunohistochemistry.Results Orientin decreased the formation of lipid droplets and intracellular TG contents(P<0.01) in a concentration-dependent manner(P<0.05), but it had no obvious effects on the cell vitality.Under the IR state, orientin significantly increased 3T3-L1 adipocytes glucose uptake(P<0.05).Meanwhile, orientin up-regulated the protein expression of p-AMPK, p-ACC, and enhanced GLUT4 translocation and its expression.Conclusion Orientin can effectively inhibit the differentiation of 3T3-L1 pre-adipocytes and increase insulin sensitivity due to the activation of AMPK/GLUT4 signal pathway.

Glomerulonephritis, IGA ; diagnosis ; therapy ; Humans ; Integrative Medicine ; Risk Assessment

Objective To analyze the chemical constituents from rat kidney tissue of Juglans mandshurica by UPLC-Q-TOF/MS. Methods The kidney tissue was collected after oral administration of ethanol extract of J. mandshurica. The gradient elution was performed using a Waters Acquity UPLC BEH C18 column (100 mm × 2.1 mm, 1.7 μm), 0.1% formic acid water (A), and 0.1% formic acid acetonitrile (B) mobile phase system. An electrospray (ESI) ion source was used for mass spectrometry to collect data in positive ion mode. Combined with Peakview 2.0/masterview 1.0 and Metabolitepilot data analysis software, the kidney tissue components of J. mandshurica were identified by comparing the retention time, isotope kurtosis ratio, exact mass of the parent ion, and MS/MS fragment. Results Twenty-four chemical constituents including 16 prototypic components and eight metabolites were identified from rat kidney tissue, which contains 12 naphthoquinones, five flavonoids, three diarylheptanoids, and four triterpenoids. Conclusion The prototype components and metabolites of kidney tissue of J. mandshurica were determined. In further study, it provides reference for the safety and effectiveness of the treatment of J. mandshurica and provides a methodological reference for its in vivo composition and tissue distribution.

OBJECTIVETo investigate the triaging pathways of patients after coronary computed tomography angiography (CCTA).

METHODSThe patients undergoing CCTA were enrolled consecutively during the period from March 3, 2008 to June 23, 2009. The rate of coronary angiography (CAG) examinations after CCTA was calculated. The rates of normal CAG, medication, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) were compared between CCTA and direct CAG cohorts.

RESULTSA total of 8030 cases receiving CCTA and 3260 receiving direct CAG were included in the study. The CCTA patients had significantly fewer risk factors than those having direct CAG. Of the 8030 patients undergoing CCTA, 953 (12.03%) received further CAG and 6977 (87.97%) did not. Of the patients who received CAG after CCTA, 35 (3.7%) had normal CAG findings, 604 (63.4%) underwent PCI, 108 (11.3%) received conservative treatment with medications, and 206 (21.6%) underwent CABG. In the 3260 patients directly undergoing CAG, 706 (52.3%) underwent subsequent PCI, 142(4.4%) underwent CABG, 815(25.1%) received medications, and 579 (17.9%) had normal CAG findings. Comparison between the cases receiving direct CAG and CAG after CCTA showed that CCTA resulted in a significant increase in the revascularization rate (P<0.0001).

CONCLUSIONCCTA can help prevent unnecessary CAG and allows more accurate patient triage.

Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed

Objective To investigate the triaging pathways of patients after coronary computed tomography angiography (CCTA). Methods The patients undergoing CCTA were enrolled consecutively during the period from March 3, 2008 to June 23, 2009. The rate of coronary angiography (CAG) examinations after CCTA was calculated. The rates of normal CAG, medication, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) were compared between CCTA and direct CAG cohorts. Results A total of 8030 cases receiving CCTA and 3260 receiving direct CAG were included in the study. The CCTA patients had significantly fewer risk factors than those having direct CAG. Of the 8030 patients undergoing CCTA, 953 (12.03%) received further CAG and 6977 (87.97%) did not. Of the patients who received CAG after CCTA, 35 (3.7%) had normal CAG findings, 604 (63.4%) underwent PCI, 108 (11.3%) received conservative treatment with medications, and 206 (21.6%) underwent CABG. In the 3260 patients directly undergoing CAG, 706 (52.3%) underwent subsequent PCI, 142(4.4%) underwent CABG, 815(25.1%) received medications, and 579 (17.9%) had normal CAG findings. Comparison between the cases receiving direct CAG and CAG after CCTA showed that CCTA resulted in a significant increase in the revascularization rate (P<0.0001). Conclusion CCTA can help prevent unnecessary CAG and allows more accurate patient triage.

Objective To investigate the triaging pathways of patients after coronary computed tomography angiography (CCTA). Methods The patients undergoing CCTA were enrolled consecutively during the period from March 3, 2008 to June 23, 2009. The rate of coronary angiography (CAG) examinations after CCTA was calculated. The rates of normal CAG, medication, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) were compared between CCTA and direct CAG cohorts. Results A total of 8030 cases receiving CCTA and 3260 receiving direct CAG were included in the study. The CCTA patients had significantly fewer risk factors than those having direct CAG. Of the 8030 patients undergoing CCTA, 953 (12.03%) received further CAG and 6977 (87.97%) did not. Of the patients who received CAG after CCTA, 35 (3.7%) had normal CAG findings, 604 (63.4%) underwent PCI, 108 (11.3%) received conservative treatment with medications, and 206 (21.6%) underwent CABG. In the 3260 patients directly undergoing CAG, 706 (52.3%) underwent subsequent PCI, 142(4.4%) underwent CABG, 815(25.1%) received medications, and 579 (17.9%) had normal CAG findings. Comparison between the cases receiving direct CAG and CAG after CCTA showed that CCTA resulted in a significant increase in the revascularization rate (P<0.0001). Conclusion CCTA can help prevent unnecessary CAG and allows more accurate patient triage.