Objective To compare the efficacy and safety of vitrectomy combined with internal limiting membrane flap and vitrectomy combined with internal limiting membrane peeling for the treatment of idiopathic macular hole with different sizes.Methods A total of 127 consective patients (127 eyes)were divided into two groups according to the size of the hole diameter of the smallest split points by less than or equal to 500 μm (small diameter macular hole group) and more than 500 μm (huge diameter macular hole group).According to different surgical methods the patients were divided into non ILM flap coverage group (peeling 1 group and peeling 2 group) and ILM flap cover group (covering 1 group and covering 2 group).All the patients underwent vitrectomy combined with internal limiting membrane peeling or vitrectomy combined with limiting membrane flap.Preoperative and postoperative best correct visual acuity,closure ratio of macular hole and postoperative major complications were observed and followed up.Results The postoperative best correct visual acuity improved in all the groups,there was no significance difference between small diameter macular hole group and huge diameter macuiar hole group (t =0.112 2,0.750 8;all P ＞0.05).The closure ratio of peeling 1 group and covering 2 group at postoperative 6 months were all 100％,there was no statistical difference (P ＞ 0.05),which in peeling 2 group and covering 2 group were 84.85％ and 100.00％,there was statistical difference (x2 =13.292,P ＜ 0.05).There was no statistical difference in preoperative defect diameter of the inner and outer junction between peeling 2 group and covering 2 groups (P ＞0.05),there was also no statistical difference between peeling 2 group and covering 2 groups at postoperative 1 months (P ＞ 0.05),but there were statistical differences at postoperative 3 months,6 months and 12 months (all P ＜ 0.05),the covering 2 group were less than the peeling 2 group.Conclusion ILM flap coverage helps to heal macular holes greater than 500 μm diameter,and has no extra effect on healing of diameter less than 500 μm.

Objective To assess prevalence and risk factors of illness within the past 2 weeks among rural residents in Menglian,under the background of essential public health service implemented generally. Methods In February 2012, the questionnaire method was employed to investigate the two-week morbidity in 2011 rural residents sampled by multistage stratified random sampling from Menglian population. Results The prevalence, that of illness within two-week among 2011 rural residents in Menglian, was 97.5‰ (95%CI 84.5‰-110.5‰) . It was lower than that of the rural region IV in China (149.6‰, <0.05) .Its age trend was the same as that of the rural region IV in China,the prevalence in 0-14 years old children,however,was higher than the counterpart in the rural region IV in China. The diseases, which two-week morbidity ranked the top five, were acute upper respiratory infection, acute gastroenteritis, hyperostosis, acute tracheobronchitis and rheumatoid arthritis. The results of multilevel logistic regression model fitted by group-level explanatory variable mountainous area, individual-level random slopes variable gender and other individual background variables indicated that there were across-level interactions between mountainous area and gender ( <0.05), the family income lower than RMB 15000 (odds ration 3.2378, 95%CI 1.9014-5.5130) and age (odds ration 1.0163, 95%CI 1.0002-1.0327) had a positive effect to two-week morbidity, and contrasting to unmarried, married had a negative effect to two-week morbidity (odds ratio 0.4727, 95%CI 0.2534-0.8819) . Conclusions Comparing with that of the rural region IV in China before implementing essential public health service, the two-week morbidity in Menglian was lower. For further elevating the health level of population, the strategies, such as intensifying material and child hygiene in the mountain area, improving sanitary conditions of low income family, and updating health consciousness in single population,would be implemented.

Objective To assess the implementation of essential public health services (EPHS), and determine the main influencing factors for EPHS in Menglian. Methods In September 2012, the questionnaire survey method was employed to collect the data of EPHS implementation in 2011 in three community medical institutes and the EPHS evaluation of health staff sampled by stratified random sampling in Menglian. Results In 2011, the report rates of infectious diseases epidemics, public health emergencies and health inspection were all 100%, the inoculation rates of most vaccines were over 90%,and the health management rates of the children aged 0 to 6 years,pregnant and lying-in woman,aged population,hypertensives, type 2 diabetes patients and serious psychotics were high (about 85%) . The establishment rate of heath archives (60%to 70%),the controlling rates of blood pressure in the hypertensive population (about 50%), the rates of glycemic control in type 2 diabetes patients (55%to 70%) and the steady rates of serious psychotics (50% to 60%), however, were low. The implementation of EPHS was unbalance among towns, suburbs and outer suburbs. The main factors that influenced the EPHS implementation were inadequate human resources, insufficient or unused health devices, ambiguous responsibilities among the health institutes, non-cooperative behaviors, and unhealthy living habits in rural residents. Conclusions The implementation of many EPHS items is good. For promoting EPHS,it is necessary to train human resources,activiate unused health devices,get support of residents and carry out health education.

OBJECTIVE: To evaluate the sub-acute oral effect of titanium dioxide (TiO₂) nanoparticles on the oxidation/antioxidation biomarkers and inflammatory cytokines in blood, liver, intestine, and colon in rats. METHODS: Twenty four 4-week-old clean-grade Sprague Dawley (SD) rats were randomly devided into 4 groups by body weight (n=6, control, low, middle, and high), in which the rats were orally exposed to TiO₂ nanoparticles at doses of 0, 2, 10 and 50 mg/kg body weight/day for 28 consecutive days separately. Food intake, body weight and abnormal behaviors during the experiment were recorded. The rats were euthanized on the 29th day. The blood was collected via abdominal aortic method and centrifuged to collect the serum. Tissues from liver, intestine and colon were collected and homogenated. Then enzyme-linked immunosorbent assay (ELISA) and microwell plate methods were used to detect oxidation/antioxidation biomarkers including superoxide dismutase (SOD), glutathione (GSH), glutathione peroxidase (GSH-Px), total mercapto (T-SH), glutathione disulfide (GSSG), malomdialdehvde (MDA) and inflammatory cytokines including interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in the serum, liver, intestine and colon in the rats. RESULTS: Compared with the control group, no significant differences in body weight, food intake and organ coefficients were observed in all the three groups after TiO₂ gavage. No significant changes in GSH, GSH-Px, T-SH, and IL-6 were observed. Compared with the control group, significant increase of SOD activity in serum in high dose group, signi-ficant increase of GSSG concentration in intestine in middle and high dose group and significant increase of MDA concentration in liver in low and high dose group were observed. Compared with the control group, a significant increase of TNF-α in liver in middle and high dose group was observed. CONCLUSION TiO₂ nanoparticle can increase antioxidant enzymes activities in blood, increase oxidative biomarkers in liver and intestine, increase inflammatory cytokines in liver in rats after a 28-day sub-acute orally administration. Among blood, liver, intestine, and colon, liver is most sensitive to the toxicity induced by TiO₂ nanoparticles, followed by intestine, blood, and colon in sequence.
Animals ; Antioxidants ; Biomarkers ; Cytokines ; Nanoparticles ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Titanium

Objective To explore the relationship of dynamic changes between the iodine nutritional condition and growth of children born before and after the implementation of universal iodine.Methods By means of sampling investigation,urinary iodine and goiter,height,weight,intelligence quotient(IQ)were comprehensively evahated in children aged 7～14 years old born before and after the implementation of iodine in 10 counties and 2 cities of Qiannan.Results The median of urinary iodine of children Was 91.88μg/L in 1984,133.33μg/L in 1994,316.00μg/L in 2006;goiter rate was 21.40%(122/570)in 1984,12.86%(107/832)in 1994,5.28%(45/851)in 2006;the average IQ was 89.18±4.10 in 1994,94.26±0.94 in 2006;children in each age group in 2006 has a higher height and a heavier weight compared with those in 1984.Conclusion The physical development and intelligence of children in the areas of iodine deficiency have improved along with the correction of iodine deficiency.

BACKGROUND: In the past, the incidence rates of infectious diseases,natural epidemic diseases and endemic diseases in three gorges areas were always high. Because the flooded areas of Kaixian was enormous, the population of Kaixian was intensive density, the pollution may harm to the population health after the dam has been established.OBJECTIVE: To predict the influence of the Three-gorges dam on population health in Kaixian County of Chongqing and put forward to scientific evidence of preventive measures through analyzing the main health indicators and influence factors in Kaixian.DESIGN: Cross-sectional study.SETTING: Public Health College of Chongqing Medical University and Disease Controlled Center in Kaixian County of Chongqing.PARTICIPANTS: The survey was conducted in Kai County of Chongqing,from February to May 2004. All disease surveillance data of people in this county was investigated and other people lived in three-gorges area or around area were selected as the controls.METHODS: Collect and sort relevant indicators of social development,population health and public health system of Kaixian and related area to go deep into the representative townships to do some filed investigation,collect water samples of local drainage areas to carry out laboratory quantitative analysis; carry out comparative analysis based on the relevant materials; carry out comprehensive predicting and evaluation to the potential impact on population health of the three gorges engineering by combining the quantitative and qualitative analysis methods.general people in Kai county, Chongqing city and all over the nations durKai county, Chongqing city and all over the nations during 1999 and 2003;ty, Chongqing city and all over the nations during 1999 and 2001: Mortality rates of infants and under-five children were also higher than that average levels of whole country and Chongqing respectively; Multi-indicators showed that the general population health status of Kaixian was great bad,which stood a distinct gap among average levels of the whole country and Chongqing maintained about 250/100 000 or so, which was higher than the national level (190/10 000), however, the incidence rate of infectious diseases of Kaixian was rising year after year, even that of the recent two years has been reached up to more than 1.5 times higher than that of the whole of the water-based infectious diseases, especially the virus hepatitis, was severe. Another potential impact on population health of three-gorge dam is the emergence of natural epidemic diseases and insect-based infectious diseases. Malignant tumor such as hepatocarcinoma.CONCLUSION: We should strengthen current public health system, and cognition to the possible threat on disease epidemic and public health.With the construction of three-gorge dam, it is necessary to speed up establishment of effective measures to reduce predictable influence on population health.

Objective To investigate the efficacy of medial plantar flaps with cutaneous nerves on fixing palm skin defects for patients injured while working.Methods All cases with palm skin defects who received medial plantar flaps grafting from June 2003 to January 2013,were analyzed retrospectively.The data included 13 males and 10 females,with the mean age of 36 years old (range,18-61 years old).There were 16 cases with right hand injury and 7 cases with left,whose skin defects ranged from 3.6 cm×2.8 cm to 7.0 cru×5.5 cm.All cases had skin and soft tissue injury while 5 cases with vascular and nerve injury,3 cases with tendon involvement and being exposed,6 cases with open metacarpal fractures.15 patients were treated with emergency surgery within 8 hours after injury,while 8 patients were treated 10 days after debridement surgery.Results Altogether,23 patients who received medial plantar flaps grafting operations,with palm skin defects,were included in this study.All cases were followed up for 3 to 36 months with a average period of 18 month.The grafted flaps range from 4.6 cm×3.8 cm to 8.0 cm×6.5 cm.Among the patients,19 of them recovered excellently with healing by first intention,with 7-14 d healing time,fully-retained hand functions and palm appearance,and 4-8 mm for between two points distinguish test.Flaps survived fairly well in 3 patients because partial necrosis happened at plantar skin graft donor site.After being debrided and dressed,the wound healed at second phase with a healing time of 12-21 d and 5-9 mm for between two points distinguish test.The operated hands could flex and extend functionally in the follow-up period.Only one patient did not recovered from medial plantar flap grafting and the flap did not survive operationally.The patient recovered after another operation with groin skin grafting later.According to Gu Yudong et al' evaluation criteria,such as improved hand function,19 cases were scored as excellent recovery,3 cases as good,and 1 as poor.The excellent rate was 95.7％ (22/23).Conclusion Medial plantar flaps with cutaneous nerves are ideal flaps for palm skin defects restoration,which characterized by the advantages of fixed anatomical position,high survival rate and being good to the functional recovery and palm appearance.

Objective:Based on the survey of qualitative and quantitative on rural doctors in 6 provinces and cities in China , this paper aimed to compare the present situation of construction of rural doctors under the new health care reform and explore the impact of the new health care reform as well as to propose some suggestions . Methods:Based on the survey of questionnaire and in -depth interviews on rural doctors in 6 provinces and cities in China .Results:The problems existed for rural doctors in China such as insufficient number of personnel , ag-ing, lack of young rural doctors supplement , low level the requirements and situation of professionalism , etc.Con-clusion:It should accelerate the process of the cultivation of rural doctors , promote the education level of rural doc-tors, gradually ease the current situation of the rural doctor shortage .

Objective To investigate the magnetic resonance imaging (MRI) and computerized tomography (CT) imaging findings of hepatic angiomyolipoma (AML).Methods Twelve cases of hepatic AML,which were confirmed by pathologists between 2009 and 2011 in our hospital,were retrospectively analyzed.Results There were 3 males and 9 females with an average age of 44.17 years (range,34 to 60 years).There were 14 lesions,8 in left lobe,6 in right lobe.All of 12 cases were confirmed as angiomyolipoma by pathologists.Nine cases were performed with MRI,2 with CT,and 1 with both CT and MRI.The border of lesions were clear in 8 cases.Fat contents were shown on CT and/or MRI in 8 cases.After administrated with contrast medium,the lesion enhancement was still apparent or slightly decreased in 9 lesions from portal phase to delayed phase.The suppression of portal vein and inferior vena cava by tumor were seen in 5 lesions.Abnormal vascular distortion was seen in 6 lesions.None of 12 lesions were found with portal vein thrombosis.Conclusion The diagnosis of hepatic angiomyolipoma should be considered when CT and MRI show good boundaries,intratumoral fat content,delayed lesion enhancement,and vascular distortion.